Snoring is a common disease that affects about 30% of adults. Most of us would be familiar with snoring and know at least one person who snores during sleep. This could be your family or your friends or you yourself. Snoring is generally not considered as a very serious matter and the person who suffers from snoring is often ridiculed or made fun of.

It should be noted that snoring might be a symptom for a serious illness known as obstructive sleep apnea. Being infected by this disease is definitely no laughing matter. The patient must consult a physician to confirm the diagnosis and commence the necessary treatment.

Snoring can be defined as the annoying sound that accompanies breathing (usually inhaling) during sleep. It is the result of blockages in the narrow air passage due to swelling of the soft tissues in the throat or other defects in the nose.

In most cases, the patient suffers from partial blockage of the air passage, but in some cases, complete obstruction is also seen. In partial blockage, snoring continues for several seconds and in case of complete obstruction, snoring totally disappears and occurs again with the return of breathing, which starts with a long inhalation. When this happens, the patient is often infected with obstructive sleep apnea.

Snoring itself can be a disease without a blockage in the air passage and without any effect on the quality of sleep. Such a case is known as normal, initial, simple or benign (not dangerous to health). This problem may be more social than medical.

How does the benign (primary) snoring differ from snoring associated with apnea?

The benign or primary snoring does not affect the quality or stability of sleep. Therefore, it is not accompanied by other symptoms of sleep disorders such as insomnia, increased sleepiness during the day, etc.

In order to make sure that the snoring is benign, one might have to undergo a sleep test at sleep disorder center. A sleep test helps ascertain the stability of the electrical activity in the brain during sleep, the breathing quality and oxygen levels in the blood and the non-existence of any other symptom of sleep disorders.

How can I help patients with benign (primary) snoring?

The first step is to ascertain that the patient is not infected with obstructive sleep apnea. If a non-specialist doctor has diagnosed the benign snoring, you should take a little precaution until you consult a specialist in sleep disorders.

Once the diagnosis is confirmed, you can do a few things that might help you to get rid of snoring.

1. Reduction in weight may lead to a complete disappearance of the problem
2. Sleeping on a side may relieve the problem. Snoring generally occurs when the patient sleeps on his back
3. Avoid sleeping pillsas they may step-up the primary snoring into an interruption of breathing

In addition to the above, other more complicated things might be useful to some patients are:

• External nose extenders:These are adhesive tapes with a metal slat. These tapesstick directly on to the outer surface of the nose (under the bone of the nose). The metal slat expandsthe two openings of the nose and hence the internal nasal cavity. Studies have shown that this method may help some patients with snoring.
• Prosthodontics:This is a plastic structure placed inside the mouth, which helps expand the air passage and keep is open during sleep. There are different types of these structures including the following:

1. Structures that push the lower jaw forward. These structures are the most common.
2. Structures that attract the tongue forward and thus prevent the tongue from going back and blocking the air passage during sleep. These are not very popular.

• Surgery:Several surgical procedures have been introduced for the treatment of snoring. However, the treatments do not benefit all patients. Before undergoing any surgical procedures, the patient requires a careful examination of the air passage and nose.

The surgical treatments vary from operations under general anesthesia to laser surgery and Radiofrequency ablation (RFA) in which heat waves are used to remove the lean tissues in the throat, requiring one or more sittings at the clinic.

Ahmed BaHammam, FACP, FCCP
Professor of Medicine
Director, University Sleep Disorders Center
College ofMedicine, King Saud University