The honk. The gronk. The wheeze. The low rumble, or the extended whine that sounds like an airboat in the Everglades. The gasp. The panicky snort.
It's snoring. It denies you restorative deep sleep. It can set you up for illness, irritation, high blood pressure, chronic tiredness and poor performance at work.
And you're not even the snorer!
No, it's the bed partner of the snorer — we'll call you the snoree — who suffers. The spouse or partner "has a sleep disorder too," says Greg Kantner, clinical coordinator at St. Anthony's Hospital's Sleep Disorders Center in St. Petersburg. It's not just annoying to be taking your pillow and blanket down the hall to the guest room when you just can't stand the snoring another minute; it can be hazardous to your health.
"The spouse or partner is tired all day. They talk to their doctor and say, I'm tired and I don't know why, I slept all night and I don't feel refreshed," Kantner said. Even if the snoree wasn't actually awakened, she — it's often she — is denied the deep stages of sleep that everyone needs for real rest. In extreme cases, her hearing may be damaged by what ought to be the sound of silence but instead is the bray of snoring.
It's no surprise, therefore, that it's often the snoree partners who insist that the snorer get some help. "It's the tired spouse who forces them to come in," Kantner said. But it's the snorer who reveals the bruised ribs, where the frustrated partner has been jabbing and poking all night, hoping the snorer will roll over and stop snoring, if only for a little while.
The mechanics of snoring
Who snores? Mostly men, and mostly between the ages of 40 and 70, but children as young as 5 have been treated, and there are plenty of female snorers. Snoring is reported in 44 percent of men and 28 percent of women between the ages of 30 and 60, says Dr. Jose E. Perez of the Sleep Disorders Center at St. Joseph's Hospital in Tampa.
Snoring may taper off with old age, possibly as snorers stop smoking or drinking alcohol, both of which increase the risk of snoring.
Why do we snore? Here's the quickie anatomy lesson. When you breathe through your mouth, the uvula and soft palate at the back of the throat start to vibrate. If the airflow in the breathing passage is blocked, the sound becomes louder. While we're asleep, the muscles of the tongue and jaw relax and the soft palate can fall back into the throat, blocking the airway. You snore.
So a couple of ways to stop snoring are to lose some weight or otherwise reduce that floppy tissue in the back of the throat that's cutting off the air supply. "Sometimes it's something very simple: You look in someone's mouth and see that they've got humongous tonsils. So you remove the tonsils," said Perez of St. Joseph's, and relief is on the way.
Exploring the causes
For centuries, snoring has been a joke. Sawing wood. The buzz saw. It was just something Dad and Grandpa did and there was nothing to be done about it. It was thought that snoring was harmless to the snorer and annoying to others, but nothing to worry about.
Then researchers realized that snoring can be an indicator of underlying conditions such as cardiovascular diseases and can lead to stroke or cardiac irregularity. Heavy snorers can develop carotid artery stenosis, i.e., those blocked arteries in the neck that need to be cleaned out or stented.
In 1966 researchers identified Obstructive Sleep Apnea as a real condition in which breathing stops. When the body becomes aware that it is short of air, it will do whatever it can to get some. A period of silence, with no breathing, is followed by a desperate, panicky snort and gasp that often wakes up even the snorer. Some people who die in their sleep do so because they are deprived of oxygen by the tissue that blocks the airflow. Sleep apnea can lead to high blood pressure, heart disease and stroke, among other conditions.
Not all snoring is linked to sleep apnea. Some people snore because they have nasal congestion, rhinitis or a deviated nasal septum. Surgery may repair an impaired upper airway. Some people suffer from insomnia. Some people are born with narrow airways. Some have endocrine disorders. Some of us snore when we have a bad cold and breathe through our mouths; the snoring stops when the cold goes away.
Starting in the late 1960s, researchers began to develop surgeries and treatments that could reduce or eliminate snoring. Suddenly, snoring wasn't something everyone had to live with.
Test can provide answers
Today, many snorers, or their long-suffering snoree partners, seek relief at sleep labs, like those at many major hospitals in the Tampa Bay area. They undergo a nightlong test called a polysomnogram, a test that measures bodily functions through electrodes that are attached all over the body. They measure brain waves, heartbeats, eye, chin and leg movements, breathing, blood oxygen levels and more.
Patients check in early in the evening, get themselves hooked up, then fall asleep as they normally do. Researchers monitor them throughout the night. Based on their findings and diagnosis, they can recommend a variety of therapies.
Sometimes it's as simple as sewing a tennis ball into the back of the snorer's T-shirt, which makes back sleeping uncomfortable. Typically, snoring decreases when the snorer sleeps on his side.
Or a doctor might recommend a special pillow to hold the head up and keep the airway open. Nasal strips open up the passages so sleepers can breathe through their noses. There are spray mists to keep the throat passages moist; dry passages are more snore-prone than moist ones. There are mouthpieces to hold the jaw up and the airway open. Or surgery may be called for to shrink the vibrating tissue.
Kantner of St. Anthony's suffered from sleep apnea and had a heart attack at age 44. Now, when he goes to sleep each night, he wears a CPAP mask — it stands for Continuous Positive Airway Pressure — that pumps a steady flow of air into his breathing passages.
"The patient no longer snores, he no longer awakens, he feels refreshed. But it has to be used nightly," cautions Perez of St. Joseph's. Some people just can't tolerate the notion of wearing a mask to bed every night. CPAP devices can cost $500 to $1,000 or more, typically covered by insurance.
Some patients are sent to a sleep center by other doctors, who are having trouble controlling their high blood pressure. "Once we diagnose and treat sleep apnea, it's much easier to control," Perez said. Or there are always those exhausted snoree partners. "Patients come in and they're tired of sleeping in separate rooms," he said.
"Snoring is a newly recognized problem from a medical point of view," he said, "but it's been present since man has been on earth."