Snoring: why treat it? How to do ?

Snoring is never harmless. Annoying for those around him, it is often neglected by the snorer. This is regrettable, especially since it can hide more or less serious pathologies and there are currently effective treatments. We take stock.

19 million French people snore. And even if snoring (or ronchopathy, when it is regular) is rather masculine, women are not left out, especially when they are advancing in age. “Women are mostly affected by snoring and sleep apnea after menopause, explains Dr Yves-Victor Kamami, ENT, specialist in the treatment of snoring. Before, they’re sort of protected by their hormones. “ The hormonal drop induces in fact a relaxation of all tissues, including the back of the throat. Besides, from the age of fifty, it is estimated that there are as many women as men who snore. Whether it affects men or women, beyond the obvious nuisance for those around them, snoring can also be harmful to health. However, snorers rarely consult.

Why do we snore?

Snoring most often occurs on inspiration, when soft tissue in the throat is found in the passage of breathed air. The soft palate and uvula are the structures that vibrate most frequently.

More rarely, they are tonsils and, exceptionally, the basis of the language. These structures become “softer” during sleep and tend to sag when the body is lying down, especially on the back. Snoring is accentuated in case of overweight because fat coats the neck or infiltrates these famous soft tissues.

Snoring can also be favored by nasal obstruction. Finally, especially in thin people, a genetic factor (particular skeleton of the face, increased softness of the tissues) is quite often favorable.

How to limit snoring?

  • We start by monitoring our weight, and we try to lose it in case of excess.
  • Alcohol is suppressed in the evening: as it relaxes the muscles, the soft palate collapses even more than normal when lying down, increasing the noise.
  • Smoking is not recommended either: tobacco promotes inflammation of the mucous membranes, and therefore their swelling.
  • Finally, avoid sleeping on your back: in this position, the tongue and the soft palate further impede the passage of air.
  • There are also anti-snoring pillows: thanks to the central bulge, the head naturally tilts on one side. This may be effective for some, but may not be sufficient for heavy snorers.

What about anti-snoring products?

Sold in pharmacies or on the Internet, anti-snoring products appear as magical solutions to find silent nights! Lots of people try lots of it, end up spending a lot of money, without necessarily getting any results. One thing is certain, before trying anything, you must know where your snoring comes from: using a device for self-medication for the nose when the problem comes from the throat (and vice versa) will, of course, be difficult. lost.

>>Les sprays : those to be sprayed in the back of the throat are supposed to lubricate the mucous membranes, or to thicken them in an artificial way to decrease the vibrations. Some seem to improve within an hour or two. But you should not expect them to act all night, since saliva will inevitably eliminate them little by little. As for nose sprays, it’s like washing your nose with physiological saline.

>> Nasal devices: they act only at the entrance of the nose. They can allow you to breathe better and reduce light snoring, you still have to put something in your nostrils to sleep. Additionally, retractors and strips tend to fall off in the middle of the night. In addition, they are of little use in case of deviated nasal septum or deep obstruction in the nasal cavity.

>> Acupressure rings: placed on the little finger, they are supposed to act on acupuncture points to clear the airways. No study proves that it works!

How to treat snoring?

  • Mandibular advancement orthosis (OAM). Made to measure by a dental surgeon, it forces the lower jaw to move forward, opening the upper airways and thus allowing better air circulation; it retains the tongue to prevent it from “falling” into the back of the throat and obstructing it. It is effective both on snoring and on apnea, “but you must have a solid dentition because the orthosis pulls on it and can cause tooth displacement”, warns Dr. Lévy.
  • La ventilation nocturne (PPC). It is only offered to apneics and is less effective on snoring. The device continuously sends a flow of air at night, optimizing oxygenation.
  • Surgery. Performed under general anesthesia. Depending on the problem: shortening of the soft palate, removal of the tonsils or the uvula.
  • Laser or radiofrequency. Two alternatives to surgery, less burdensome, less expensive and fewer postoperative complications. “Used on an outpatient basis, the laser makes it possible to make a slit in the middle of the uvula, it lasts a quarter of an hour and leaves only a slight pain of angina,” says Dr. Kamami.

Our experts:

  • Dr Yves-Victor Kamami, ENT, specialist in the treatment of snoring
  • Dre Maguy Lévy, dental surgeon, founding member of the French Society of Dental Sleep Medicine (SFMDS)

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2/5 – Snoring can hide respiratory apnea
Inserm suggests that around 30% of people over 65 are affected (the risk increases with age, overweight, diabetes). The link with snoring? He is often straightforward. “Although not all snorers are apneic,” says Dr. Lévy, the two are generally linked. “ For his part, Dr. Kamami notes: “Most apneic people snore.” And snoring is one of the symptoms of sleep apnea, like daytime sleepiness or chronic fatigue.

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3/5 – Snoring can lead to sexual problems
Patients do not necessarily make the connection with snoring or respiratory apnea. Yet the link between snoring and / or sleep apnea and sexual disorders – in humans – is very real. “Snoring decreases the flow of air in the airways, the obstruction can be partial or complete, but in all cases it results in hypoxia: a decrease in oxygenation of the tissues.” Possible consequence? Erectile dysfunction which can also be combined with loss of libido. Fortunately, this problem subsides as soon as tissue oxygenation returns to normal.

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4/5 – Snoring increases the risk of depression
Snoring impairs the quality of sleep. If it is interspersed with breathing pauses, it irreparably affects daily life: decreased concentration, chronic fatigue, anxiety, aggressiveness, memory loss… So many disorders that can lead to depression. “Apneic patients find it difficult to make decisions, to plan, to organize, to stay motivated and they isolate themselves more and more from those around them, participating less and less in family activities.”

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5/5 – Snoring is associated with cardiovascular risk
This is particularly true when they are coupled with sleep apnea because the respiratory pause causes hypoxemia (drop in the level of oxygen in the blood), itself responsible for the progressive onset of cardiovascular disorders: high blood pressure or heart failure. In people who already have cardiovascular problems, snoring and apnea increase the risk of myocardial infarction and stroke.

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