Treatment for snoring

Snoring is the sound that is produced by the vibration of the soft tissues of the upper airways during periods of sleep. It is often identified as a loud rattling, grunting or snorting sound made by a person who is asleep. 

The reasons a person suffers from snoring depends on several factors. However, snoring is usually associated with an obstruction of the airways. Snoring is thought to be more common in men than in women. 

The symptoms of snoring are easily recognized. A snoring patient emits silent vibrations and/or hissing, grunting, snoring or rumbling sounds while asleep. Some of these sounds can be caused by sleep apnea. 

The following are the most common symptoms in individuals who snore:

• Headaches upon waking in the morning.
• Sudden weight gain.
• Tiredness or chronic fatigue.
• Confusion upon waking up.
• Difficulty concentrating.
• Dryness or pain in the throat.
• Restlessness during sleep.
• Angry or irritable state of mind.

When trying to ascertain the causes of snoring, it is necessary to first identify the type of snoring a patient presents. With this information, the specialist can pinpoint the causes and then determine how the snoring should best be treated. 

The most frequent types of snoring are as follows:

Nasal/nose snoring

Nasal Snoring is produced by an obstruction in the nose. It is caused by a physical anomaly or by a respiratory condition such as the flu, a cold or an allergy. 

However, nasal snoring is more commonly associated with chronic sinusitis that causes the airways to close. 

Tongue snoring

Tongue snoring is one of the most common types of snoring. It is caused by back sleeping. 

This type of snoring occurs when the tongue is overly relaxed. The tongue then slides toward the back of the throat and produces a loud noise during breathing. 

Snoring caused by sleep apnea

Snoring can be caused by sleep apnea, a condition that causes the person to stop breathing for several seconds. The severity of this type of snoring depends on how long the apnea lasts: mild (5 to 15 seconds), moderate (15 to 30 seconds), or severe (over 30 seconds).   

Furthermore, it has been shown that obstructive sleep apnea presents a risk to patients who have a history of heart disease, high blood pressure, diabetes and even emotional problems. It can cause irritability and mood swings.

It is important to point out that there are some factors that contribute to the onset of snoring in some people at some point in their lives. Alcohol and nicotine consumption can trigger a relaxing effect in the throat that will erode airways over time. The following are risk factors that influence the onset of snoring: 

• Age: The appearance of snoring becomes more common as people age. Airways contract and decrease in size, making airflow more difficult.
• Sex: Snoring is more frequent in women when compared to men due to craniofacial alterations in the upper and nasal airways. Particularly during menopause, women can present more severe snoring symptoms due to hormonal changes that occur during this time.
• Anatomy: Adenoids, tonsils or a particularly large tongue can cause difficulty when breathing. This same situation happens with people who a have deviated septum, for example.  
• Family history: Although snoring is not hereditary, the possibilities of suffering from snoring are greater if genetic factors are involved.  
• Overweight: People with a high body mass index are often more prone to suffering from snoring, especially when those individuals also suffer from a respiratory condition or disorder.
• Pregnancy: Women often snore during pregnancy due to the hormonal changes and fatigue they experience during this time. It is more common during the first months of pregnancy. 
• Alcohol and tobacco use: Many studies have proven the damage caused by alcohol consumption and tobacco use. However, patients who snore suffer breathing difficulties, congestion and a diminished lung capacity, all which will increase the snoring pattern.

You should visit a specialist when you experience any of the following symptoms repeatedly:

• Chronic fatigue despite getting a full night’s sleep.
• Snoring that interrupts the patient and/or his or her partner’s quality of sleep.
• A previous diagnosis of Obstructive Sleep Apnea. 
• Suffering from symptoms of bruxism when you wake up in the morning. 

The specialists at the Clínica Gil will evaluate your symptoms as well as your past medical history to determine if it is necessary for you to have a more thorough physical exam. 

Contact Clínica Gil to schedule an appointment and obtain a personalized diagnosis in one of our conveniently located clinics in Escazu or San Pedro.  

The diagnosis can be made in the following ways:

Diagnostic Imaging

The patient will undergo an evaluation of the morphology of the facial skeleton to determine if any obstructions are present in the airways or if there is a deviated septum. The evaluation is carried out through diagnostic imaging tests such as X-rays, computerized tomography scans or magnetic resonance imaging.

This type of diagnosis is usually accompanied by a sleep study. The specialist will also talk to the patient’s partner or close family members about information about the patient’s sleep habits. 

Polysomnography

The polysomnography, also known as a sleep study, is a test used to analyze and measure a patient’s body functions when he or she is asleep. 

The purpose of this test is to determine if the patient suffers from a sleep disorder such as Sleep Apnea, Insomnia, Restless Leg Syndrome, or Narcolepsy. Sleep Apnea is one of the disorders that is most associated with snoring. The polysomnography measures:

• Heart rate.
• Breathing rate.
• Brain waves.
• Blood oxygen levels.
• Sleep cycles.
• Eye and leg movement. 

Detailed medical history

Along with the studies listed above, the specialist will also evaluate the patient’s medical history to determine the patient’s snoring patterns and other important aspects such as the type of snoring, relevant diseases, and risk factors such as alcohol or tobacco use or rhinitis (allergic or non-allergic). 

Once the cause of the snoring has been determined, the specialist will decide which is the most effective treatment. 

Currently, there exists a large variety of options on the market that can be used alone or in combination. These include anti-snoring products, pillows, and devices, among others. 

How can a dentist treat snoring?

A dentist can treat snoring in various ways, either with an isolated treatment in which a patient uses a temporary night guard, for example, or with a combined treatment, which utilizes several therapies in conjunction to minimize the symptoms of snoring. In severe cases, the dentist can request the support of an orofacial specialist and an otorhinolaryngologist to determine which is the most effective treatment, especially if the patient suffers from sleep apnea or another pathology of the nose or throat.

In order to treat snoring (and to prevent it as well), the specialist may recommend the following treatments: 

Anti-Snoring pillows

Anti-snoring pillows help to hyperextend the neck. In some case, for people who sleep on their side, this pillow facilitates the position of the head without causing harm to the neck and back. This helps improve posture, clear airways and improves sleep.   

This type of pillow is an excellent option for people who have the flu, a cold or nasal allergies.  

Oral appliances

The American Sleep Disorders Association (ASDA) defines oral appliances for the treatment of snoring as articles which are introduced into the mouth to modify the position of the jaw, tongue and other structures that support the upper airways.

Occlusal Splints

The use of occlusal splints to improve snoring and bruxism has become very popular. 

In patients who suffer from Obstructive Sleep Apnea, for example, it has been demonstrated that the use of mandibular advancement devices can improve snoring. However, it is a lifelong treatment that must be monitored in order to detect any craniofacial anomalies.   

Medication

If snoring is produced by a medical condition such as allergic rhinitis (or non-allergic), anti-allergy medicine is an option that can improve symptoms such as nasal congestion and airway obstruction. 

Surgery for snoring

Non-invasive surgical procedures are recommended for patients who present particular anatomical conditions. The objective of surgery for snoring is to minimize the patient’s structural problem. For example, a deviated septum.    

Some of the surgical procedures for snoring are the following:  

• Ablation treatment.
• Uvuloplasty
• Septoplasty.
• Tonsillectomy. 
• Adenoidectomy

Myofunctional therapy

An alternative therapy for cases of Obstructive Sleep Apnea is Myofunctional therapy. It involves performing oropharyngeal exercises to strengthen the tongue and upper throat muscles in order to reduce the most harmful symptoms, including snoring and sleepiness.

Which type of doctor treats snoring?

An otorhinolaryngologist treats cases of snoring that are associated with nose or throat pathologies. However, if the snoring is caused by apnea or any other sleep disorder, an orofacial pain specialist is recommended. This type of specialist will comprehensively address hygiene and sleep improvement. 

Why do people snore so loud?

The answer is due to several factors, such as sleep apnea, airway obstructions, alcohol and tobacco use and back.

Because snoring does not necessarily imply an underlying disorder, each individual case must be evaluated in order to determine the cause. 

Can smoking cause snoring?

The use of tobacco has been associated with snoring. Tobacco use irritates the airways and raises the probability of suffering from sleep apnea. 

What happens if a person snores a lot?

Excessive snoring is indicative of an underlying disorder or of specific habits that cause snoring.

A diagnosis from a specialist will determine if the snoring is caused by risk factors or illness, or due to the facial morphology or something else. 

When should I worry about snoring?

When a patient and/or his or her partner’s quality of sleep is affected by the snoring. 

Furthermore, if the snoring is caused by a sleep disorder such as Obstructive Sleep Apnea, it will require treatment to avoid the fatigue associated with the disorder. 

Which complications can cause snoring?

If the snoring is frequent, it can affect the quality of life of the patient and his or her partner. Additionally, it the snoring is caused by Obstructive Sleep Apnea, not only is it necessary for the patient to seek help, but it is also essential that he or she undergoes treatment to improve his or her quality of life and lessen the effects of the symptoms. 

If the patient does not treat the symptoms in a timely fashion, he or she can suffer significant complications, including the following:

• Frequent sleepiness, especially at night
• Lack of concentration.
• Mood swings.
• Risk of high blood pressure, heart and cerebrovascular conditions.  
• Behavior changes.
• Learning disabilities.

How long should I use an oral appliance?

The use of an oral appliance is a holistic treatment; its use depends on each particular case.