Snoring
Dr. Bill is a qualified member of the American Academy of Dental Sleep Medicine. He is specifically trained in dental sleep medicine.
Snoring is caused by the vibrations of your soft and/or hard tissue palates as you breathe during sleep; causing sound waves to form. This process is similar to how the vocal cords vibrate when we speak to form our voice.
Vibration occurs as a result of increasingly narrow air passages. Narrow air passages create turbulent conditions for movement. As the airway narrows, airflow becomes more forceful. This causes vibration to increase, which in turn results in louder snoring. Loud snorers may have a more serious case of blocked air passages, known as apnea.
Common causes for snoring:
- Smoking
- Alcohol
- Health Problems
- Obesity
- Obstructed Nasal Passages - Deviated Septum
- Poor Muscle Tone of the Tongue
- Daytime Fatigue
- Sleep Apnea
- Hypothyroidism
- Allergies
Example Of Appliance Used For Snoring
What causes snoring?
When we breathe air circulates in and out in a continuous stream from our nose or mouth to our lungs. While sitting still and breathing quietly, relatively few sounds are produced. Exercise stimulates rapid airflow, creating sound as we breathe. During sleep, the soft palate may narrow. This narrowing effect disturbs airflow, resulting in vibration, which causes snoring. Narrowing can occur in the throat, nose or mouth.
Snoring affects millions of people of all ages, both male and female. We often assume that only overweight men with a thick neck are snorers. However, slender women can snore also and just as loudly. Snoring usually gets worse with age and weight gain.
The Soft Palate
The soft palate is the muscular structure at the back of the roof of the mouth that acts as a divider for the back of the mouth and the nasal passages. When we breathe through the nose, the soft palate moves forward, permitting the nasal airway to open. When we swallow, it moves backward, thus closing off the airway to allow food and liquid to flow through the esophagus. The soft palate hangs freely in the back of the mouth. The uvula is suspended from the middle of the soft palate. It assists with the proper functioning of the soft palate and is used to produce the guttural fricative sound common in such languages as Hebrew. Since the soft palate and uvula vibrate during snoring, these structures are altered during surgical treatment aimed at improving snoring conditions.
Normal Breathing
Ideally, natural breathing occurs through the nose. The nose humidifies, heats and filters air that enters the body. These processes do not occur when we breathe through our mouth, which can make breathing uncomfortable.
The nose is made up of two passages. The two parallel passages are separated by the septum, a relatively flat wall composed of cartilage, bone and tissue. Three nasal turbinates containing several small blood vessels are located on the lateral side of both passages. These blood vessels control airflow. If the vessels grow larger, the turbinate swells and limits airflow. If the vessels get narrow, the swelling of the turbinate decreases, thus improving the flow of air. Generally, everyone’s breathing shifts between both passages roughly every eight hours. This is more noticeable during a cold or if you suffer from an ongoing stuffy nose. Also, the turbinates may swell due to an allergic reaction, or as a result of exposure to environmental stimulants such as dirt or cold air.
Mouth breathers
People who must breathe through their mouth are known as mouth breathers. Because the flow of air through the mouth stimulates greater vibration, many mouth breathers snore. Some people cannot breathe through their nose because the nasal passages are obstructed due to a deviated septum, sinus infection, allergies, swollen turbinates or large adenoids. Adults commonly suffer from a deviated septum as a result of allergies or a broken nose.
The Narrow Airway and Snoring
Swollen tonsils, an abnormal soft palate or a tongue that is larger than normal, can all cause snoring.
Situated at the back of the mouth on each side of the throat, the tonsils swell as they fight off bacteria and viruses. Sometimes they remain enlarged even after the infection is gone. These enlarged tonsils can constrict the airway and cause snoring.
If the soft palate is too limp or loose or too long, it can vibrate and stimulate snoring. A uvula that is too long or thick can also lead to snoring.
The tongue plays a major role in directing food during chewing and swallowing. It also helps us to form words as we speak. In order to function properly, the tongue must have the ability to maneuver freely. In the event that the tongue is large or can slip backwards, it can constrict the space through which air flows in the pharynx, resulting in vibration and snoring.
Sleep Position and Snoring
Generally (not always) we sleep lying down. When we lie on our backs, gravity acts to pull the palate, tongue and tonsils backward; thus narrowing the airway and creating turbulence in the flow of air; this invariably leads to vibration and snoring. If we sleep on our side gravity no longer pulls the tissues backward. This decreases snoring.
Alcohol and Medication use verses Snoring
Some medications as well as alcohol can stimulate more relaxation during sleep. The more the muscles of the pharynx, neck, tongue and palate relax, the more the flow of air is disturbed. As a result, the airway is narrower and vibration of the tissue increases. Some medications stimulate a deeper level of sleep, which can also make snoring worse.
Stages of Sleep and Snoring
While snoring can occur during all or some of the phases of sleep, it most commonly occurs during Rapid Eye Movement (REM) sleep. During REM the brain transmits impulses to every muscle in the body (except those necessary for breathing) to relax. When the muscles of the throat, tongue and palate relax, they can collapse, which narrows the airway and makes snoring worse.
