What Causes Snoring and How Can It Be Treated? What Is Snoring?

Snoring is a common condition that may go unnoticed during the day but can make nighttime sleep difficult for both the person who snores and those around them. Although many people consider snoring merely an annoying sound, persistent, loud snoring, particularly when accompanied by pauses in breathing, may indicate certain health problems. Therefore, questions such as what is snoring, what causes snoring, and how is snoring treated are important not only for improving quality of life but also for identifying potential health risks at an early stage.

Medically, snoring is the sound produced when air passing through the upper airway during sleep causes the soft tissues in the throat to vibrate. During the day, air passes freely through the nose, nasopharynx, and throat when we breathe. However, the airway may narrow as the muscles relax during sleep. Air passing through this narrowed area causes the soft palate, uvula, tonsils, base of the tongue, and tissues surrounding the throat to vibrate. The characteristic snoring sound heard from the outside is the result of these vibrations.

The severity of snoring varies from person to person. Some people snore mildly only when they are extremely tired or sleep on their backs, while others may experience loud snoring almost every night, sometimes loud enough to be heard outside the room. For this reason, not all cases of snoring are assessed in the same way. Occasional, mild snoring is often associated with temporary causes, whereas persistent snoring may require a detailed evaluation.

How Does Snoring Occur?

During sleep, many muscles in our body relax. This relaxation also affects the muscles of the upper airway that help us breathe. If the airway is narrower than normal or the relaxed tissues partially obstruct airflow, the passing air causes the tissues to vibrate, producing the sound of snoring.

The structures that may contribute to snoring include:

• Soft palate

• Uvula

• Base of the tongue

• Tonsils

• Nasopharyngeal region

• Nasal airways (nasal septum and turbinates)

The narrower the airway becomes, the more the tissues may vibrate, making the snoring sound more noticeable. Therefore, nasal congestion, weight gain, enlarged tonsils, and problems involving the base of the tongue may play an important role in the development of snoring.

Is All Snoring a Sign of Disease?

No. Not all snoring indicates a serious health problem.

For example, the following may cause temporary snoring:

• Extreme fatigue after a busy day

• Temporary nasal congestion

• Seasonal allergies

• The common cold

• Alcohol consumption before bedtime

• The use of certain medications

This type of snoring may decrease or disappear completely once the underlying cause is resolved.

However, snoring that occurs several nights a week, continues for a long time, or is accompanied by pauses in breathing during sleep should not be dismissed as simply “sleeping noisily.” This pattern may be associated with conditions that require treatment, such as obstructive sleep apnea syndrome.

Over time, sleep apnea may be associated with conditions such as:

• Insulin resistance

• Diabetes

• Heart rhythm disorders

• High blood pressure

• Heart attack during sleep

• Sexual problems

In other words, sleep apnea may contribute to the development of these health problems. People diagnosed with these conditions may also have an increased likelihood of sleep apnea.

Episodes of apnea are among the most common reasons for seeking medical evaluation. They may be a source of concern for the patient's bed partner, who notices that the patient stops snoring when breathing pauses occur and appears to struggle to breathe. After being unable to breathe for a period of time (at least 10 seconds), the person may suddenly jerk awake. They then fall asleep again and start snoring, followed by another apnea episode. This cycle can result in extremely poor-quality sleep.

During sleep, particularly deep sleep, certain hormones that the body would normally release may not be released in the usual way. Substances that accumulate in the body throughout the day and are associated with oxygen metabolism may not be adequately managed by the antioxidant system. This situation may contribute to the development of the health problems mentioned above.

How Does Snoring Affect Quality of Life?

Snoring is not merely a sound produced at night. Poor-quality sleep may also affect a person's physical and mental performance the following day.

People who snore persistently may gradually experience the following complaints:

• Waking up feeling unrefreshed, particularly when apnea is also present

• Daytime sleepiness

• Difficulty concentrating

• Reduced attention

• Memory problems

• Declining performance at work or school

• Irritability and reduced quality of life

In addition, snoring affects not only the person who snores but also their partner or family members who share the same room. Persistent snoring may impair sleep quality for both partners and have consequences that extend to social life.

When Should Snoring Be Taken Seriously?

Occasional, mild snoring does not always indicate a significant health problem. However, certain symptoms may suggest that snoring requires a detailed evaluation.

Consultation with an ear, nose, and throat (ENT) specialist is recommended in the following situations:

• Snoring occurs most nights of the week.

• The snoring becomes noticeably louder over time.

• Pauses in breathing are observed during sleep.

• Frequent waking occurs during the night.

• The person wakes up with a dry mouth or headache.

• Excessive daytime sleepiness occurs.

• Attention and concentration problems develop.

• There is a history of high blood pressure or cardiovascular disease.

A detailed evaluation can help identify the cause of snoring and guide the planning of an appropriate snoring treatment.

What Should You Know About Snoring?

There are many misconceptions about snoring. One is the belief that “everyone who snores has sleep apnea.” However, not all snoring indicates sleep apnea. The opposite is also true: many people with sleep apnea experience noticeable snoring. Therefore, the cause of snoring cannot be determined by the loudness of the sound alone.

Another misconception is that snoring occurs only in men. Although it is more common in men, snoring can also develop in women, particularly after menopause, as well as in children and young adults, for various reasons.

What Should People Who Snore Do?

People who experience snoring should first observe whether the problem is temporary or persistent. If snoring does not improve or is accompanied by pauses in breathing, morning fatigue, or daytime sleepiness, seeking medical advice rather than relying on self-treatment is important.

The initial evaluation may include:

• A detailed ear, nose, and throat examination

• Examination of the nasal and throat structures

• Endoscopic evaluation when considered necessary

• A sleep study (polysomnography)

These methods can help determine the cause of snoring. Based on the findings, an individualized treatment plan may be developed, ranging from lifestyle changes to surgical treatments.

Can Nasal Congestion Cause Snoring?

Nasal congestion is one of the most common causes of snoring. When breathing through the nose is difficult, a person may unconsciously begin breathing through the mouth during sleep. Mouth breathing may cause the tissues in the throat to vibrate more, potentially increasing the severity of snoring.

Conditions that may cause nasal congestion include:

• Seasonal allergies

• Chronic sinusitis

• Enlarged nasal turbinates (turbinate hypertrophy)

• Nasal polyps

• Upper respiratory tract infections

• A deviated nasal septum (septal deviation)

People with long-standing nasal congestion may experience not only snoring but also poor sleep quality, dry mouth, and waking up feeling tired in the morning.

What Should Be Done?

If nasal congestion persists, its cause should be investigated. Treating the underlying condition may help reduce snoring in some patients.

How Does a Deviated Nasal Septum Affect Snoring?

The septum is the structure that divides the nasal cavity into two passages. In some people, it may be deviated from birth or as a result of trauma. Commonly known as a deviated nasal septum, this condition may make airflow more difficult and contribute to snoring.

People with septal deviation may experience symptoms such as:

• Nasal congestion on one side

• Sleeping with the mouth open

• Frequent episodes of sinusitis

• Upper respiratory tract infections

• Snoring

• Poor-quality sleep

Not every deviated septum causes snoring. However, when the deviation significantly narrows the airway, a detailed evaluation by an ear, nose, and throat specialist may be necessary.

Can Enlarged Adenoids and Tonsils Cause Snoring?

Enlarged adenoids and tonsils are among the most important causes of snoring, particularly in children. However, enlarged tonsils in adults can also narrow the upper airway and lead to snoring.

People with enlarged adenoids may experience symptoms such as:

• Sleeping with the mouth open

• Snoring at night

• Restless sleep

• Frequent infections

• Daytime fatigue

Persistent snoring in children should not be considered normal. Therefore, children who have been snoring for a long time should be evaluated by an ear, nose, and throat specialist.

How Do the Soft Palate and Uvula Cause Snoring?

The soft palate and uvula, located at the back of the throat, may relax during sleep and partially narrow the airway. The vibration of these tissues as air passes through is one of the main mechanisms behind snoring.

In some people:

• The uvula may be longer than usual.

• The soft palate may sag.

• The tissues may lose elasticity with age.

These changes may become more noticeable when sleeping on the back.

Can the Base of the Tongue Cause Snoring?

As the tongue muscles relax during sleep, the base of the tongue may move backward. This can narrow the airway in the throat, causing snoring and, in some people, sleep apnea.

Airway narrowing related to the base of the tongue may be more common in:

• People who are overweight

• People with a larger neck circumference

• People who sleep on their backs

Why Does Excess Weight Increase Snoring?

There is a well-established relationship between snoring and excess weight. Fat tissue that accumulates around the neck and upper airway can narrow the airway. Air passing through a narrowed airway may produce more vibration.

Excess weight not only increases the risk of snoring but may also increase the likelihood of developing obstructive sleep apnea.

Research suggests that weight management may help reduce snoring in suitable patients. However, not everyone who snores is overweight, and people with a normal body weight may also snore for various reasons.

What Should Be Done?

• Adopt balanced eating habits.

• Engage in regular physical activity.

• Maintain a healthy weight.

Weight management should be planned according to individual needs, with professional support when necessary.

Do Smoking and Alcohol Affect Snoring?

Smoking can irritate the upper respiratory tract and cause swelling. These changes in the throat tissues may narrow the airway and contribute to more severe snoring.

Alcohol, when consumed before sleep, can cause the throat muscles to relax more than usual. This relaxation may narrow the airway and make snoring more noticeable.

Snoring symptoms may increase particularly in people who consume alcohol shortly before bedtime.

What Should Be Done?

• Stop smoking.

• Avoid alcohol before bedtime.

• Establish regular sleep habits.

Does Sleeping Position Affect Snoring?

Yes. Sleeping position can directly affect the severity of snoring in some people.

When a person lies on their back, gravity may cause the base of the tongue and the soft palate to move backward, narrowing the airway. For this reason, some people snore only when sleeping on their backs.

Sleeping on the side may help keep the airway more open. However, this recommendation may not be sufficient for everyone, and evaluating the underlying cause remains important.

Does Aging Increase the Risk of Snoring?

As people age, muscle tissue naturally becomes more relaxed. A loss of elasticity in the throat muscles may make the upper airway more likely to narrow during sleep. For this reason, snoring may be more common in older adults.

However, snoring is not limited to older people. It can also develop in young adults, women, and children for various reasons.

What Causes Snoring and How Can It Be Treated? What Is Snoring?

What Can Be Done to Reduce the Risk of Snoring?

The appropriate way to address snoring depends on identifying its underlying cause. Nevertheless, certain lifestyle changes may help reduce snoring in some people.

These include:

• Maintaining a healthy body weight

• Exercising regularly

• Stopping smoking

• Limiting alcohol consumption

• Treating conditions that cause nasal congestion

• Establishing regular sleep schedules

• Avoiding heavy meals before bedtime

• Changing sleeping position when appropriate

However, these recommendations may not be sufficient for every patient. If snoring persists for a long time, becomes increasingly severe, or is accompanied by pauses in breathing, an ear, nose, and throat specialist should be consulted. Following an evaluation, an individualized snoring treatment plan can be developed.

Emsey Medical Editorial Board