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A silent night? Sounds dreamy

Today, there's more ways than one to get a handle on chronic snoring. As an expert puts it: 'Nobody should ever snore.'

August 11, 2008|Erin Cline Davis | Special to The Times

You're ON the verge of falling asleep, and then it starts. The snorting. The choking sounds. Sometimes there's even a little whistle to it. A family member or roommate sleeping nearby has launched into an all-night bout of snoring, and you're the one who is going to lie awake all night listening to it.

According to the American Academy of Otolaryngology-Head and Neck Surgery, 45% of normal adults snore at least occasionally, and 25% are habitual snorers. Of the habitual snorers, about 10% have obstructive sleep apnea, a serious medical problem in which people stop breathing completely, multiple times per night, for at least 10 seconds at a time. Apnea raises the risk for dangerous daytime drowsiness and a range of ills, including elevated blood pressure, heart attacks and strokes.

But risky or not, snoring is an embarrassment to the many who honk and saw their way through the night -- and can be a significant trial for their nearest and dearest. A 2005 “Sleep in America” poll by the nonprofit National Sleep Foundation found that 23% of couples resort to sleeping in separate rooms due to one partner's sleep troubles, most often snoring.

And snorers' bed partners who stick it out can end up losing a lot of sleep, according to a 1999 Mayo Clinic study. In that sleep lab study of 10 couples, wives were woken up so many times by their snoring husbands that they were predicted to miss out on about one hour of sleep per night.

There is hope, however, for noisy sleepers and those who sleep near them. Simple lifestyle changes or inexpensive over-the-counter remedies may do the trick -- even, for some spouses, something as simple as earplugs.

But if the low-tech options fail, medical intervention is available. Nonsurgical medical devices for snoring are getting smaller and more comfortable, and surgical options have become more and more refined, reducing pain and recovery time. There are even options that can be performed on an outpatient basis.

Dr. Rafael Pelayo, a professor at Stanford School of Medicine and a physician in its Sleep Disorders Clinic, says that of all the ailments he treats, "snoring is the one we can resolve."

"Nobody should ever snore," he says.

How it happens

Snoring occurs when the free flow of air through the passages at the back of the mouth and nose is obstructed. Interrupted air flow leads to vibrations, and this leads to noise. For many people, such noises can be traced to excess or loose tissue in the soft palate and uvula -- the little punching bag-like structure that dangles in the back of the throat.

"It's like a flag flapping in the wind," says Dr. Eric Mair, an otolaryngologist and adjunct clinical professor at the University of North Carolina at Chapel Hill.

Behavioral modification may be all that is needed for light or occasional snoring, says Dr. Eric Kezirian, director of the division of sleep surgery at UC San Francisco.

You can sleep on your side instead of your back to keep airways open. You can also avoid alcohol and other sedatives that relax muscles in the mouth and throat before bedtime. Giving up cigarettes can help too -- smoking can cause inflammation in the upper airways that leads to snoring.

Exercise and weight loss can improve muscle tone in the throat and may reduce the amount of tissue pushing on airways.

Dr. Lawrence Kline, medical director of the Scripps Clinic Sleep Center, says it is hard to predict how much weight a person will need to lose in order to reduce their snoring, but "weight loss clearly helps." Even for someone who is 100 pounds overweight, losing just 20 pounds may be enough to see improvement, he says.

Taking up a musical hobby might strengthen throat muscles and could be a fun and effective treatment for snoring. A study published earlier this year in the journal Sleep and Breathing compared 52 semiprofessional choir singers with a group of 55 nonsingers and found that the singers snored less. And a 2006 study in the British Medical Journal found that four months of regular practice of the didgeridoo -- the long, cylindrical indigenous Australian wind instrument -- led to improved sleep apnea symptoms and less partner disturbance by snoring. (Disturbances stemming from the sound of didgeridoo-practice were not investigated, however.)

If more help is in order, there are plenty of remedies for sale in drugstores and catalogs -- strips, sprays, pillows, wristbands and vests. But what really works?

"There's a lot of voodoo out there," Mair says.

Treating stuffy noses is a good place to start: A blocked nose forces breaths to be taken through the mouth, upping the likelihood of snoring. A 2001 University of Wisconsin study of 4,916 men and women ages 30 to 60 found at the start of the study that those who reported they always, or almost always, had nasal congestion were three times more likely to snore than those who were never congested.

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