SYMPTOMS

What is snoring?

Snoring refers to the loud sound produced during sleep as air passes through the respiratory tract, commonly known as "snoring." This sound occurs when the soft tissues of the upper airway vibrate due to airflow passing through narrowed areas during breathing. The process may involve brief episodes of oxygen deprivation or hypoxic breathing^[1]. Snoring mostly happens during inhalation, though it can also occur during exhalation.

Habitual snoring is actually quite common and can occur at any age. Studies show that about 3%–12% of children snore, meaning roughly 3 to 12 out of every 100 children^[2].

Among adults, the prevalence is approximately 53.1% in men and 29.9% in women, meaning about 53 men and 30 women out of every 100 adults snore, with men being more affected than women^[3].

Snoring can sometimes be a pathological symptom that should not be ignored. It disrupts sleep cycles and may lead to daytime drowsiness and fatigue.

It may also cause symptoms such as difficulty concentrating, high blood pressure, and throat or chest pain. Therefore, any snoring that affects quality of life should not be overlooked and should be treated appropriately.

What are the common symptoms of snoring?

• Breathing with low oxygen levels or brief pauses during sleep, accompanied by continuous snoring;
• Daytime fatigue, sleepiness, and poor mental state;
• Memory decline, difficulty concentrating, and slow reactions;
• Waking up thirsty with a sore throat;
• Possible teeth grinding or talking during sleep^[4].

TREATMENT

How to Relieve Snoring?

• For simple snoring (loud snoring without obvious sleep apnea), conservative treatment is the first choice, including quitting smoking, weight loss, avoiding alcohol within hours before bedtime, avoiding sedatives (such as benzodiazepines like diazepam and flurazepam), and sleeping in a lateral position^[5].
• Regular exercise helps improve cardiopulmonary function and may alleviate snoring to some extent.
• For those with chronic rhinitis-induced nasal congestion, standardized treatment of rhinitis and relieving nasal congestion can help reduce snoring.
• If conservative treatments fail, mild snorers with retrognathia (receding jaw) and good nasal airflow may try oral appliances (not suitable for patients with temporomandibular joint arthritis). Oral appliances should be fitted by a dentist experienced in treating sleep-related breathing disorders. Continuous positive airway pressure (CPAP) therapy is another option, delivering oxygen to the airway and keeping it open with pressure. While oral appliances are more convenient, CPAP is more effective and targeted for both general snoring and obstructive sleep apnea (OSA)^[5].
• Snorers who do not respond to conservative treatments and are unwilling to use long-term oral appliances or CPAP may consider surgical options after thorough consultation with a doctor. However, for those with only loud snoring and no apnea, nasal surgery is not recommended solely to reduce snoring unless there is significant anatomical obstruction (e.g., severe deviated septum or nasal polyps). Some pharyngeal surgeries may also fail to provide lasting relief^[4].
• If none of these measures alleviate snoring, or if snoring worsens with apnea, sleep deprivation, or poor mental state, seek medical attention promptly for further diagnosis.

DIAGNOSIS

Under what circumstances should snoring prompt a hospital visit?

• Frequent and loud snoring: If snoring occurs almost every night and disrupts family members' rest, consider seeking medical attention.
• Intermittent snoring: Pay special attention and seek prompt medical care if snoring stops and starts abruptly, particularly when followed by an especially loud snore after a silent pause lasting several seconds or minutes. This may indicate not just simple snoring but a condition called "obstructive sleep apnea syndrome" (OSA), commonly referred to as "snoring disease." Its main features include noticeable snoring, breathing pauses, and oxygen deprivation during sleep. Long-term snorers should ask family members if they observe these symptoms.
• Impact on daytime behavior and well-being: Additionally, long-term snorers who experience worsening sleep quality, persistent sleepiness, daytime fatigue, difficulty concentrating, memory decline, or increased irritability should seek medical advice.

Which department should you visit for snoring?

For snoring, it is recommended to visit the otolaryngology (ENT) department.

POTENTIAL DISEASES

What are the possible causes of snoring?

The main cause of snoring is increased airway resistance during sleep, where the vibration of surrounding soft tissues due to air movement produces sound. Therefore, any factor that increases airway resistance can lead to snoring.

Common causes include^[4]:

• Obesity: Excess weight can lead to fat accumulation in the throat, resulting in an enlarged soft palate, thickened pharyngeal walls, and a widened tongue, narrowing the upper airway. Upper airway structural abnormalities: The upper airway includes the nasal cavity and throat. Any condition causing narrowing or obstruction in these areas can increase airflow resistance, leading to snoring. Examples include nasal septum deviation, turbinate hypertrophy, nasal polyps, nasal tumors, tonsillar hypertrophy (grade II or higher), adenoid hypertrophy, relaxed soft palate, elongated or thick uvula, narrow pharynx, throat tumors, and congenital craniofacial deformities like craniosynostosis or micrognathia. Infections, trauma, or surgical scars causing airway stenosis can also contribute.
• Alcohol or sedative-hypnotic drugs: These substances relax the muscles that maintain airway tension, making the airway more prone to collapse and increasing resistance. Drinking alcohol a few hours before bedtime particularly worsens snoring.
• Smoking: Studies show that both current and former smokers are more likely to snore, possibly due to nocturnal nicotine withdrawal and nasal congestion.
• Certain systemic diseases: Conditions such as cerebrovascular disease, congestive heart failure, hypothyroidism, acromegaly, vocal cord paralysis, brain tumors, neuromuscular disorders, laryngopharyngeal reflux, gastroesophageal reflux, or mediastinal masses compressing the airway may disrupt respiratory regulation.
• Poor sleeping posture: Sleeping on the back (supine position) is more likely to cause snoring compared to side sleeping.