Cause of and Remedy for Snoring, the Thwarter of Sound Sleep

"I cannot sleep with my wife due to her snoring." "I`m not refreshed even after sleep and wake up with a headache." "I`m sleepy even in daytime and have difficulties in working and driving."

These are the problems that Mr. Choi (33, office worker), who lives in Daechi-Dong Kangnam-ku, Seoul, is suffering from. He snores a lot when he sleeps, and sometimes stops breathing for a second. He once heard of a `surgical operation for snoring` but has no inclination to get it done because he was frightened by the news that a certain politician died after he had an operation for snoring.

But the remedy for snoring does not always mean an operation. There are various remedies for snoring in psychiatry, otorhinolaryngology, ENT, and dentistry.

▽ Cause of Snoring = When breathing, air passes through soft organs like the palate, uvula, tonsils, and tongue. Limbus muscles allow these organs to maintain their positions in the daytime. Hence, these organs do not close the passage, and make no sound. But they become flabby during sleep, narrowing the passage. Therefore, the air passing through creates vibrations on these soft organs and makes snoring noises.

▽ In Psychiatry, Neurology, and ENT = It is obstructive sleep apnea if he or she stops breathing for over 10 seconds during sleeping. It should be treated if apnea happens over 40 times a night. To pronounce a diagnosis, it requires a polysomnography. The polysomnography measures an electrocardiogram, level of snoring noise, blood pressure, breathing motion, and oxygen saturation degree during sleep (8 hours) over a two-night stay in the hospital.

70 to 80 percent of the patients with these symptoms are overweight. Hence posture therapy, which let the patient lose weights and sleep on his side, is applied in the first stage of the treatment.

The main form of therapy is to use `sustaining press on the upper respiratory tract`. This form of therapy utilizes a machine that provides air at a fixed pressure to the nose, which opens the breathing passage. It is like widening the closed passage of a flabby rubber balloon by injecting air. But it has the drawback of wearing a mask on the nose and it takes around 3 weeks to adapt to it. Hence, many patients give up halfway. It makes a 90 percent improvement when used for over 6 months.

Medicinal therapy, which stimulates breathing muscles with medicine, is not effective yet because it has a side effect that hinders sleeping.

▽ In Otorhinolaryngology = When swollen uvula or tonsils close the breathing passage, one should be treated in otorhinolaryngology usually by operation.

▽ In dentistry = If symptoms are not so severe, or operation is of no use, and `sustaining press on the upper respiratory tract` is unfavorable, one can receive treatment in dentistry as the second best option. Dentistry usually makes use of oral devices. Wearing a venal device, which is similar to a denture, in the mouth improves the symptoms by widening the breathing passage.

It makes 80 to 90 percent improvement for patients who suffer from excessive snoring.

Jin-Han Lee likeday@donga.com