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Snoring is the noise of the soft palate and other loose tissue in the mouth, nose and throat vibrating on the in-breath. Snoring is very common, affecting around 60% of men and 40% of women by the age of sixty. It can be a serious problem within relationships and a social embarrassment. Partners can be driven to sleep in separate rooms, and difficulties arise when staying in hotels and with friends. Furthermore there is growing evidence from medical research that snoring is also a health issue. In addition to daytime sleepiness, and the attendant increased risk of accident, there is an association between snoring and an increased likelihood of high blood pressure, heart disease and stroke.
Simple snoring, where the obstruction is partial, can develop into sleep apnoea where the obstruction is total. On the in-breath the soft palate, back of the tongue and walls of the throat collapse back and completely obstruct the airway. This causes the sufferer to stop breathing, sometimes for many seconds, until their body's alarm system causes them to snort and partially wake themselves, enabling them to take a breath. Repeated apnoeas throughout the night leave the individual starved both of oxygen and deep sleep. Presently treatment for severe cases consists of wearing a mask throughout the night which blows air down the throat forcing the airway to remain open. (These are called C-PAP machines which stands for continuous positive airway pressure.) If you suspect you have sleep apnoea you should see your doctor as it can be a dangerous condition if left untreated.
Snoring is caused by an obstruction in the airway. Any tissue, at the back of the mouth, in the nose or the throat, that partially obstructs the airway, will cause an increase in the turbulence and force of the breath.
If the obstruction is slack tissue - such as an untoned soft palate flopping back across the throat - it will flutter in the in-breath like a flag in the wind. If the obstruction is firm - such as enlarged tonsils - the turbulent breath it causes continues through the airway triggering noisy vibration wherever there is lax tissue in its path. If the breath is very constricted, even tissue that might have had sufficient tone to resist a gentler breath can be forced into vibration. Hence most people will snore when they have a cold and their noses are bunged up.
Obesity is the single most common cause of snoring with excess tissue at the back of the throat causing the obstruction. However many people who are not particularly overweight start to snore in middle age simply because this is when our muscles lose their youthful firmness unless regularly exercised. Our upper throat muscles are no exception and, if their tone is poor, slack tissue at the back of the throat is prone to vibrate in the in-breath causing the snoring noise.
Fractions of a second before every in-breath the muscles of the upper airway, including the palatal and tongue muscles, tighten to help keep the airway open. In sleep, tension is lost from these muscles, and whilst non-snorers retain sufficient tone in their upper airway muscles to resist the air-flow and keep their throats open, snorers do not. Without this residual muscle tone, lax tissue collapses into the throat where it may cause turbulence and vibration (snoring) or completely block off the airway (sleep apnoea) (22). It would appear then that in order to resist collapse and obstruction of the airway - the source of snoring - the more residual tone left in the pharynx during sleep the better.