Topic Overview

Is this topic for you?

This topic is about simple snoring. If you stop breathing, choke,
or gasp during sleep, you may have a problem called sleep apnea, which can be
serious. For more information, see the topic
Sleep Apnea.

What is snoring?

You snore when the flow of air from your mouth or nose to your
lungs makes the tissues of your throat vibrate when you sleep. This can make a
loud, raspy noise. Loud snoring can make it hard for you and your partner to
get a good night’s sleep.

You may not know that you snore. Your bed partner may notice the
snoring and that you sleep with your mouth open. If snoring keeps you or your
bed partner from getting a good night’s sleep, one or both of you may feel
tired during the day.

Snoring may point to other medical problems, such as obstructive
sleep apnea. Sleep apnea can be a serious problem,
because you stop breathing at times during sleep. So if you snore often, talk
to your doctor about it.

Snoring is more common in men than in women.

What causes snoring?

When you sleep, the muscles in the back of the roof of your mouth
(soft palate), tongue, and throat relax. If they relax too much, they narrow or
block your airway. As you breathe, your soft palate and
uvula vibrate and knock against the back of your
throat. This causes the sounds you hear during snoring.

The
tonsils and adenoids may also vibrate. The narrower
the airway is, the more the tissue vibrates, and the louder the snoring
is.

How is it treated?

You may be able to treat snoring by making changes in your
lifestyle and in the way you prepare for sleep. For example:

  • Lose weight if you are
    overweight.
  • Quit smoking.
  • Sleep on your side and not
    your back.
  • Limit your use of alcohol and medicines such as
    sedatives before you go to bed.
  • If a
    stuffy nose makes your snoring worse, use decongestants or nasal
    corticosteroid sprays to help you breathe.
  • Try using devices that you attach to the outside of your nose to help with breathing while you sleep. These include nasal strips and nasal disks.
  • When
    you sleep, use a device in your mouth that helps you breathe easier. This
    device pushes your tongue and jaw forward to improve airflow.

If these treatments don’t work, you may be able to use a
machine that helps you breathe while you sleep. This treatment is called
continuous positive airway pressure, or CPAP (say
“SEE-pap”). In rare cases, your doctor may suggest surgery to open your
airway.

Snoring isn’t always considered a medical problem, so find out
if your insurance covers the cost of treatment.

Frequently asked questions

Learning about snoring:

Being diagnosed:

Getting treatment:

Living with snoring:

Health Tools

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Decision Points focus on key medical care decisions that are important to many health problems.

Cause

You
snore when the flow of air from your mouth or nose to
your lungs makes the tissues of the airway vibrate. This usually is caused by a
blockage (obstruction) or narrowing in the nose, mouth, or throat
(airway).

When you inhale during sleep, air enters the mouth or nose and
passes across the soft palate (the back of the roof of the mouth) on its way to
the lungs. The back of the mouth-where the tongue and upper throat meet the
soft palate and
uvula-is collapsible. If this area collapses, the
airway becomes narrow or blocked. The narrowed or blocked passage disturbs the
airflow, which causes the soft palate and uvula to vibrate and knock against
the back of the throat, causing snoring. The
tonsils and adenoids may also vibrate. The narrower
the airway is, the more the tissue vibrates, and the louder the snoring is.

You do not snore when you are awake because the muscles of the
throat hold the tissues in the back of the mouth in place. When you sleep, the
muscles relax, allowing the tissues to collapse.

Snoring may be caused by:

  • Enlarged tissues in the nose, mouth, or
    throat. Enlarged tonsils are a frequent cause of snoring in
    children.
  • Blocked nasal passages, which make it more difficult to
    inhale. This affects the tissue of the throat, which may pull together during
    the extra effort it takes to breathe, which in turn narrows the airway. A
    blocked nasal passage can be caused by an
    upper respiratory infection (such as a cold), an
    allergy, or
    nasal polyps.
  • A
    deviated nasal septum, which disturbs airflow in the nose.
  • Loss of
    muscle tone in the throat, which makes it easier for tissue to collapse. This
    can be due to aging or lack of fitness.

Other things that may contribute to snoring include:

  • Drinking alcohol, which depresses the part of
    the brain that regulates breathing. This can overly relax the tongue and throat
    muscles, causing them to partially block air movement.
  • Obesity. Fat
    in the throat may narrow the airway.
  • Medicines that relax you or
    make you drowsy, such as those taken for allergies,
    depression, or
    anxiety.

Symptoms

Snoring is a noise that you may make while breathing
during sleep. Snoring can be soft, loud, raspy, harsh, hoarse, or fluttering.
Your bed partner may notice that you sleep with your mouth open and that you
are restless while sleeping. If snoring interferes with your or your bed
partner’s sleep, either or both of you may feel tired during the day.

If you temporarily stop breathing during the night, you may have
sleep apnea, a serious condition. For more
information, see the topic
Sleep Apnea.

What Happens

Snoring occurs when the flow of air from the mouth or
nose to your lungs makes the tissues of the airway vibrate. This usually is
caused by a blockage (obstruction) or narrowing in the nose, mouth, or throat
(airway).

When you inhale during sleep, air enters the mouth or nose and
passes across the
soft palate (the back of the roof of the mouth) on its way to the lungs. The
back of the mouth-where the tongue and upper throat meet the soft palate and
uvula-is collapsible. If this area collapses, the
airway becomes narrow or blocked. The narrowed or blocked passage disturbs the
airflow, which causes the soft palate and uvula to vibrate and knock against
the back of the throat, causing snoring. The tonsils and adenoids may also
vibrate. The narrower the airway is, the more the tissue vibrates, and the
louder the snoring is.

You do not snore when you are awake because the muscles of the
throat hold the tissues in the back of the mouth in place. When you sleep, the
muscles relax, allowing the tissues to collapse.

Snoring can be so loud that it keeps your bed partner awake. You
may also have a less restful sleep. Sleep quality may decrease as the loudness of the snoring increases. And snoring can result in
daytime sleepiness.

Snoring that affects how well you sleep may increase your risk of high blood pressure.footnote 1, footnote 2

Snoring may progress to
upper airway resistance syndrome or
sleep apnea, a serious condition. For more
information, see the topic
Sleep Apnea.

What Increases Your Risk

Things that may increase your risk of
snoring include:

  • Being male. Men are more likely to snore than
    women.
  • Age. Snoring is most common in middle-aged people.
  • Heredity. Snoring
    may run in families.
  • Weight gain and obesity.
  • Smoking.
    Exposing children to tobacco smoke may also increase their risk of
    snoring.
  • Use of alcohol or sedative
    medicines.
  • Chronic nasal congestion during sleep. This is often
    caused by colds or allergies.
  • Jaw abnormalities, such as a small
    chin and overbite (class II malocclusion-the upper jaw and teeth overlap
    the bottom jaw and teeth). This may be an especially important factor in
    women.

When To Call a Doctor

Call your doctor if you or your bed partner:

  • Snores loudly and heavily.
  • Snores
    and feels sleepy during the day.
  • Snores and falls asleep at
    inappropriate times, such as when talking or while eating.
  • Stops breathing, gasps, or chokes during sleep.

Snoring is the main symptom of
sleep apnea, a potentially serious sleep disorder in
which you periodically stop breathing during sleep. For more information, see
the topic
Sleep Apnea.

Watchful waiting

Watchful waiting is a period of time during which you and your
doctor observe your symptoms or condition without using medical treatment.
Watchful waiting may be appropriate if your
snoring doesn’t disturb your bed partner or if you
aren’t overly sleepy during the day. If home treatment doesn’t help your
snoring, contact your doctor.

Watchful waiting may not be appropriate if you or your sleeping
partner snores loudly and heavily, is restless during sleep, is sleepy during
the day, or stops breathing when sleeping. These may point to sleep apnea.
Contact your doctor.

Who to see

Health professionals who can treat
snoring include:

If sleep apnea is suspected, a doctor who specializes in
treating sleep disorders (often a
neurologist or
pulmonologist) can help set up tests to diagnose sleep
apnea. If your doctor recommends an
oral breathing device, you may be referred to a
dentist.

To prepare for your appointment, see the topic Making the Most of Your Appointment.

Exams and Tests

Diagnosis of
snoring focuses on finding out whether you might have
sleep apnea. Your doctor will do a
physical exam and ask questions about your
medical history. Because a physical exam and medical
history cannot determine if you have sleep apnea, a
sleep study almost always will be done if your doctor
suspects the condition.

For more information, see the topic
Sleep Apnea.

Children

According to the American Academy of Pediatrics:footnote 3

  • All children should be screened for snoring
    as part of a routine checkup.
  • If sleep apnea is suspected, a
    complete sleep study generally is needed.

Treatment Overview

Snoring is treated through lifestyle changes such as
losing weight (if needed), quitting smoking, changing sleep habits (such as
sleeping on your side instead of your back), and avoiding the use of alcohol
and sedatives before you go to bed. Also, you can try over-the-counter medicines to reduce nasal congestion. Or you can use a device to help keep your airway open while you sleep.

If snoring continues despite these treatments,
continuous positive airway pressure (CPAP) or surgery
may be tried. Implants that stiffen your palate can help reduce snoring and the daytime sleepiness it causes.footnote 4 But snoring is not always considered a medical problem, so
insurance may not cover treatment.

Initial and ongoing treatment

Snoring is often treated successfully with
lifestyle changes. You can:

  • Lose weight (if needed).
  • Go to
    bed at the same time every night and get plenty of sleep.
  • Sleep
    on your side, not on your back. Try sewing a pocket in the middle of the back
    of your pajama top, putting a tennis ball into the pocket, and stitching it
    closed. This will help keep you from sleeping on your back.
  • Avoid
    using alcohol and sedatives before bed.
  • Quit
    smoking.
  • Raise the head of your bed
    4 in. (10 cm) to
    6 in. (15 cm) by putting bricks
    under the legs of the bed (using pillows to raise your head and upper body will
    not work).
  • Promptly treat breathing problems, such as a stuffy
    nose caused by a cold or allergies.
  • Use a nasal dilator to help keep your airway open. This is a device, such as nose strips or disks, that you attach to the outside of your nose while you sleep.

If nasal congestion is present, you can try
clearing your nasal passages or using medicines such
as decongestants and
nasal corticosteroid sprays. These open the airway, permitting a smoother
airflow, and may reduce snoring. Be safe with medicines. Read and follow all instructions on the label. Do not use the medicine longer than the label says.

Oral breathing devices, which push the tongue and jaw forward to improve airflow, sometimes can treat snoring,
especially if it is caused by jaw position during sleep.

If your bed partner is bothered by your snoring, he or she may
try using earplugs or machines that play ambient music or natural sounds. These
can block or cover up the noise.

If snoring continues, your doctor may want to examine you again
to see whether you have developed
upper airway resistance syndrome or
sleep apnea, a potentially serious sleep disorder in
which you periodically stop breathing during sleep. For more information, see
the topic
Sleep Apnea.

Treatment if the condition gets worse

If your
snoring gets worse, talk to your doctor. You may need
to be tested to see whether you have developed
upper airway resistance syndrome or
sleep apnea, a potentially serious sleep disorder in
which you periodically stop breathing during sleep.

Your doctor may suggest
continuous positive airway pressure (CPAP). CPAP is
the standard treatment for sleep apnea but is rarely used for snoring. For more
information on CPAP, see the topic
Sleep Apnea.

In extreme cases, surgery may be performed.
For more information, see Surgery.

Prevention

To help prevent
snoring, you can:

  • Avoid the use of alcohol and medicines that
    slow your breathing, such as sleeping pills and tranquilizers.
  • Eat
    sensibly, exercise, and stay at a healthy weight.
  • Go to bed at the
    same time every night and get plenty of sleep. Regular sleep patterns help you
    sleep better, and more restful sleep may reduce snoring.
  • Sleep on
    your side, not on your back. Sleeping on your back can increase snoring. Try
    sewing a pocket in the middle of the back of your pajama top, putting a tennis
    ball into the pocket, and stitching it closed. This will help keep you from
    sleeping on your back.
  • Quit smoking. This reduces inflammation and
    swelling in the airway, which may contribute to the narrowing of the
    airway.
  • Raise the head of your bed
    4 in. (10 cm) to
    6 in. (15 cm) by putting bricks
    under the legs of the bed. (Using pillows to raise your head and upper body
    will not work.) Sleeping at a slight incline can prevent the tongue from
    falling toward the back of the throat and contributing to a blocked or narrowed
    airway.
  • Promptly treat breathing problems, such as a stuffy nose
    caused by a cold or allergies. Breathing problems can raise the risk of
    snoring.

Home Treatment

Snoring typically is first treated at home. Treatment
includes:

  • Losing weight. Many people who snore are
    overweight. Weight loss can help reduce the narrowing of the airway and
    possibly reduce or stop the snoring.
  • Limiting the use of alcohol
    and medicines. Drinking excessive amounts of alcohol or taking certain
    medicines, especially sleeping pills or tranquilizers, before sleep may make
    snoring worse.
  • Going to bed at the same time each night and getting
    plenty of sleep. Snoring may be more frequent when you have not had enough
    sleep.
  • Sleeping on your side. Sleeping on your side may stop the
    snoring. Try sewing a pocket in the middle of the back of your pajama top,
    putting a tennis ball into the pocket, and stitching it closed. This will help
    keep you from sleeping on your back.
  • Promptly treating breathing
    problems. Breathing problems caused by colds or allergies can disturb airflow,
    leading to snoring.
  • Using a breathing device while you sleep. It helps keep your airway open. This could be a device that you put in your mouth. Other examples include strips or disks that you use on your nose.

Medications

Medicine can help prevent or reduce
snoring when it is caused by nasal congestion. Nasal
congestion is usually caused by colds or allergies. Medicine may open the nasal
passageway, permitting a smoother airflow and reducing snoring.

Decongestants (oral and nasal) and
nasal corticosteroids both reduce nasal congestion.
Be safe with medicines. Read and follow all instructions on the label. Don’t use the medicine longer than the label says. Overuse of a nasal decongestant can cause rebound congestion. It makes your mucous membranes swell up more than before you
used the spray.

Surgery

Surgery for
snoring is rarely used and only considered in cases of
very severe snoring when other treatments have failed.

Surgery is used to:

  • Remove excess soft tissue from the throat to
    widen the upper airway. This may involve removing the
    tonsils and adenoids and other tissues in the back of
    the throat (uvulopalatopharyngoplasty).
  • Correct an abnormally
    shaped wall (septum) between the nostrils or remove
    nasal polyps that block airflow through the
    nose.
  • Change the position of the bony structures in the upper
    airway, allowing air to flow more freely, especially during sleep. More than
    one surgery may be needed to make these changes.
  • Implant plastic cylinders in the soft palate to stiffen it to prevent it from vibrating. This can reduce snoring and the daytime sleepiness it causes.footnote 4

Surgery choices

  • Uvulopalatopharyngoplasty removes
    excess tissue in the throat, widening the airway and leading to a smoother
    airflow. This may reduce snoring.
  • Laser-assisted uvulopalatoplasty uses a laser to remove excess tissue in the
    throat.
  • Radiofrequency palatoplasty is a procedure that
    uses an electrical current to shrink and stiffen the back part of the roof of
    the mouth (soft palate and
    uvula). When the soft palate and uvula are stiffer,
    they are less likely to vibrate, and you are less likely to
    snore.
  • Tonsillectomy and adenoidectomy may be used if you
    have enlarged
    tonsils and adenoids that are blocking your airway
    during sleep.
  • Nasal septoplasty repairs and straightens the bone
    and tissues (septum) separating the two passages in the nose. This procedure is
    done if a nasal deformity interferes with breathing.
  • Nasal
    polypectomy removes soft, round tissues (polyps) that can project into the
    nasal passages.
  • Implanting plastic cylinders into the soft palate can stiffen it and help prevent it from vibrating.footnote 4

What to think about

Surgery is rarely used to treat snoring. It may not completely
cure snoring, and the risks of surgery may not be worth the small benefit you
gain.

Snoring is not always considered a medical problem, so insurance
may not cover treatment.

Other Treatment

Other treatment for
snoring includes continuous positive airway pressure
(CPAP) and other breathing devices.

Nutritional counseling can help people who snore and are
overweight.

Other treatment choices

Continuous positive airway pressure (CPAP) is the
preferred treatment for
sleep apnea. In rare cases, CPAP is considered for
snoring. For information on CPAP, see the topic
Sleep Apnea.

Oral breathing devices sometimes can treat snoring,
especially if it is caused by jaw position during sleep.

Nasal dilators (such as nose strips and disks) can help keep your airways open while you sleep. Nose strips widen
the nostrils and improve airflow. Nasal disks have a valve that makes it harder for you to breathe out. This causes a little back-pressure in your airways that may help keep them open. You can get many of these devices without a prescription. Talk to your doctor or pharmacist about your options.

What to think about

Many products claim to cure
snoring. Some of them may provide some help,
but others may be of no value or may be harmful. Even if a product helps reduce
your snoring, it is important to see a doctor, because snoring is the main
symptom of
sleep apnea, a potentially serious condition.

Other Places To Get Help

Organizations

American Academy of Otolaryngology: Head and Neck Surgery
www.entnet.org

National Sleep Foundation (U.S.)
www.sleepfoundation.org

References

Citations

  1. Knutson KL, et al. (2009). Association between sleep and blood pressure in midlife: The CARDIA sleep study. Archives of Internal Medicine, 169(11): 1055-1061.
  2. Li AM, et al. (2009). Blood pressure is elevated in children with primary snoring. Journal of Pediatrics, 155(3): 362-368.
  3. Marcus CL, et al. (2012). Diagnosis and management of childhood obstructive sleep apnea syndrome. Pediatrics, 130(3): 576-584.
  4. Palatal implants for snoring and obstructive sleep apnea (2008). Medical Letter on Drugs and Therapeutics, 50(1282): 23-24.

Other Works Consulted

  • Collop NA, Cassell DK (2002). Snoring and sleep-disordered breathing. In TL Lee-Chiong Jr et al., eds., Sleep Medicine, pp. 349-355. Philadelphia: Hanley and Belfus.
  • Vlastos IM, Hajiioannou JK (2009). Clinical practice: Diagnosis and treatment of childhood snoring. European Journal of Pediatrics, July 21 (Epub ahead of print).

Credits

ByHealthwise Staff
Primary Medical Reviewer Anne C. Poinier, MD – Internal Medicine
Specialist Medical Reviewer Hasmeena Kathuria, MD – Pulmonology, Critical Care Medicine, Sleep Medicine

Current as ofMarch 25, 2017