What Makes Snoring Or Sleep Apnea Worse Over Time?
- Posted on: Mar 25 2019
It is important to understand that snoring and obstructive sleep apnea are the same condition. It is just a matter of severity. The condition can worsen over time for a variety of reasons.
Snoring is resistance to airflow through the upper airway during sleep that creates vibration of the soft palate, tongue, and tonsil area. This vibration creates a noise called snoring. Snoring bothers the bed partner and may disrupt the sleepers quality of sleep but it does not result in medical disorders.
When the resistance to airflow through the upper airway is more severe, cessation of airflow can occur. This is called an apnea episode. If this is happening 5 or more times per hour then by definition the patient doesn’t just have snoring they have obstructive sleep apnea (OSA). Patients with OSA typically snore, bothering the bed partner, but also have poor quality, non-restorative sleep. They also have a risk of many health issues such as heart issues, hypertension, obesity, and diabetes.
What Causes Snoring/Obtructive Sleep Apnea?
There are 5 main anatomical reasons a person may snore and/or have OSA.
1. Nasal and sinus blockage
2. A long floppy redundant soft palate and uvula
3. A large tongue relative to the jaw and floor of mouth space
4. Obesity – specifically weight gain in the neck and belly area
5. Tonsil enlargement
Nasal and sinus blockage
Many times the issue starts simply with a nasal and sinus issue that is not diagnosed or treated. A deviated nasal septum, bad allergies, chronic sinus issues are frequently the main reason why a person may snore at night time. The associated congestion in the nose creates rapid and turbulent airflow as the airflow is squeezed through the tight nasal airway. This rapid and turbulent flow arrives at the back of the nose and the base of the tongue and causes the vibration that creates the snoring.
The nasal congestion creates mouth breathing at night time that further exacerbates the contact of the tongue and soft palate as it lets the jaw and tongue fall back into the airway. The secretions tend to dry out and this makes for stickier and louder noise production.
A long floppy redundant soft palate and uvula
The constant rapid airflow past the soft palate and associated vibration can cause the soft palate to become swollen, longer, and more redundant over time. In fact, patients may wake up with a swollen uvula after a night of snoring. So in essence, reason number 1 for snoring and OSA (nasal and sinus blockage) creates reason number 2 (A redundant long floppy soft palate and uvula). This then creates a worsening of the snoring and/or OSA.
A large tongue relative to the jaw and floor of mouth space
Now the plot thickens. The constant dehydration of the tongue from nightly mouth breathing actually makes the tongue progressively enlarge over time. The larger the tongue becomes, the more the airway is compromised and the greater the snoring and/or OSA will become. So in essence, reason number 1 for snoring and OSA (nasal and sinus blockage) also creates reason number 3 as well (A large tongue relative to the space available in the mouth).
Obesity – specifically weight gain in the neck and belly area
With a combination of issues now present, nasal blockage – a long floppy soft palate – a large tongue, the patient is likely having significant sleep disruption and OSA present. This deprives the patient of deep quality restorative sleep and alters many hormones related to the patient’s metabolism. Alterations of cortisol, growth hormone, testosterone, and insulin occur and the patient tends to gain weight in the neck and belly area even if they are trying to diet and exercise. The weight gain in the neck circumferentially squeezes the upper airway closed, increasing the snoring and OSA. The belly fat also makes the diaphragm have to work harder, worsening the airway collapse, snoring and OSA. So the combination of reasons 1,2, and 3 create reason number 4 (weight gain in the neck and belly). Even worse the weight gain worsens the OSA and the OSA worsens the weight gain. The cycle continues to worsen itself.
Lastly, chronic mouth breathing can also lead to chronic tonsil stone formation, chronic tonsillitis, and enlargement of the tonsils. This further worsens the airway and will also worsen the snoring and OSA. There is a direct correlation between problem number 1 (nasal and sinus issues) and chronic tonsil issues (problem number 5).
Schedule A Consultation
If you are snoring or are concerned that you may have OSA come earlier rather than later to stop the cycle of worsening factors that contribute to this potentially serious condition. Contact us at 512.601.0303 to schedule an appointment!