How Bad Is It Really to Snore?

Nighttime should bring peace and quiet. But for some of us, our bedrooms sound more like a monster truck rally than a hatha yoga class.

About 40 percent of people assigned male at birth (AMAB) and 24 percent of people assigned female at birth (AFAB) snore on a regular basis, according to the American Academy of Sleep Medicine (AASM).

But aside from seriously bugging your bed partner, is there any harm in sawing logs when you turn out the lights?

To find out, we tapped experts in the field of sleep research to uncover the effects snoring has on your body, surprising signs you've been performing throat gymnastics at night and the latest and greatest ways to start sleeping like a baby again.

"Snoring is when the tissue in the back of the throat behind the base of the tongue, called the soft palate, vibrates in the air column as the air is moving past," says Ann Romaker, MD, professor of medicine and director of the University of Cincinnati Medical Center Sleep Medicine Center. "It usually occurs in people who have a narrowed opening back there."

This narrow passageway doesn't pose a problem when you're awake because you're in an upright position, and because when these tissues are active, they open up. "However, once they relax during sleep, they loosen and collapse somewhat," Dr. Romaker says.

"When the air tries to pass through this obstruction, the tissues flutter against each other," says dental sleep medicine expert Kent Smith, DDS, founder and chief medical officer at Sleep Dallas and president of the American Sleep and Breathing Academy.

Typically, this rattling is the source of the snoring sound.

Sleep apnea is kind of like snoring on steroids. If you have complete sleep apnea, the collapse of the airway entirely cuts off oxygen flow.

"You start to breathe in, and even though your abdomen, diaphragm and the muscles of the chest are trying to get air in, the throat muscles and throat tissue are closed," Dr. Romaker says. "Your body churns out a burst of adrenaline, causing you to snort and then go on breathing."

A less extreme version of this is hypopnea, which means a shallow breath. "Although the throat tissue is sucked toward the middle, it doesn't completely close off," Dr. Romaker says. "You don't get a full breath and your oxygen still drops — but not as far as it would with complete apnea."

Gaining weight can up your likelihood of breathing difficulties while you're in dreamland. You're also at higher risk if you're older than 55.

Another factor involved in determining whether or not you'll develop apnea is the sensitivity of the brain's respiratory control center, which regulates breathing.

"Some people are very sensitive," Dr. Romaker says. "With just a slight change in oxygen intake, the respiratory control center will stimulate you to take a deeper breath."

Others are not so sensitive; their laissez-faire brains fail to respond to a drop in oxygen levels.

In September 2014, the AASM reported that 26 percent of Americans between the ages of 30 and 70 have sleep apnea, a substantial increase over the past two decades, likely a result of rising obesity rates.

Loud, frequent, disruptive snoring is often a precursor to sleep apnea. "If you snore, you are more prone to develop sleep apnea," Dr. Smith says.

Not only are people who snore more likely to have overweight and be older, which are the same risk factors for sleep apnea, but a November 2018 study in ‌Chest‌ found that snoring leads to nerve degeneration in the upper airways, which can put you at increased risk for upper airway obstruction during sleep.

That said, the two are not necessarily always linked.

"Not everyone who snores has apnea, and not everyone who has apnea snores," Dr. Romaker says.

Although it's easier to tell if you've stopped breathing if you were making a lot of noise first, there is a "silent" version of sleep apnea where people make almost no sound at all, even though they are struggling to breathe.

If you're a snorer, you can give yourself a self-check by taking the STOP-bang Questionnaire, a widely-used screening tool to detect sleep apnea.

Despite the humorous snorts and wheezes people associate with it, snoring is no laughing matter.

"There is evidence that loud snoring may be a risk factor for stroke, even if you don't have apnea," Dr. Romaker says.

In a June 2014 study in ‌Laryngoscope‌, researchers looked at large groups of people AMAB who did ‌not‌ have sleep apnea. Using an ultrasound to measure both the carotid arteries in the neck and arteries on the groin, they found that the greater proportion of the night an individual spent snoring, the more narrowing there was in the arteries of the neck, while there was no narrowing in the groin arteries.

"They believe the vibration of snoring causes small tears in the lining of the arteries, which the body then repairs by laying down plaque," Dr. Romaker says. That plaque buildup increases your chances of stroke.

Not to mention that if there's someone sleeping beside you, they are probably getting low-quality, interrupted sleep, which presents a slew of health issues.

Sleep apnea opens up a whole other can of worms.

"Having your oxygen levels diving up and down, in addition to the surge of adrenaline during the night, puts stress on the heart, brain and blood vessels," Dr. Romaker says. "Apnea that is left untreated over time has been shown to cause high blood pressure, heart attacks, strokes, congestive heart failure, heart rhythm problems, car accidents, impotence, diabetes, Alzheimer's and even cancer."

Understanding what's triggering your raucous zzzs is the first step to finding a solution.

"Some folks have an anatomical predisposition to snoring," Dr. Romaker says. "It tends to run in families."

For example, you might have an overbite, where your lower jaw is not as prominent and there is limited room in the back of the throat. Or if your tongue is wider than your jaw, it can fall back into your throat when you're sleeping.

Some people have conditions like a deviated septum and nasal polyps, while others were born with bigger tonsils or adenoids — all of these factors make you prone to sawing logs.

When you have a cold or your allergies are flaring up, the interior of your nose swells.

"As a result, there is not as much room in your nasal cavity, and you have to work harder to pull the air in," Dr. Romaker says. "That can make the tissue down below vibrate, causing snoring."

Turbinate hypertrophy is another condition that puts you at risk for inflammation-induced snoring. "It causes swelling in the lining of your nasal passageway, blocking airflow," Dr. Romaker says.

People are more likely to snort and snuffle when they are very tired.

"Fatigue causes your muscle tone to fall to pieces," Dr. Romaker says. "Your throat tissue becomes floppy and makes more noise."

When you've got a bun in the oven, your levels of progesterone soar. Called "the pregnancy hormone," progesterone helps nurture the developing fetus…and causes a noisy night's sleep along the way.

"It causes swelling in the membranes that lead to nasal congestion and snoring," Dr. Romaker says.

"As we age, gravity has more effect," Dr. Romaker says, pointing out that after age 55, two-thirds of people AMAB and 35 percent of those AFAB will snore. "Our muscle tone becomes weaker and the throat tissue that used to stay up out of the way now starts drooping."

Your tongue also gets lazier with age. "You lose the nerve enervation in your tongue, so you can't move it out of the way while sleeping," Smith says.

"Some people store fat in the base of their tongue or back of their throat, which will narrow your throat," Dr. Romaker says. "The larger your neck circumference on the outside, the greater the risk of apnea internally."

People AMAB with a 17-inch neck or greater and people AFAB with a 16-inch neck or greater are at higher risk.

Booze facilitates snoring.

"Alcohol preferentially relaxes the throat muscles more than the thoracic muscles, which we use for breathing," Dr. Romaker says.

Also good to know: "Marijuana does not appear to have the same effects on the throat muscles," Dr. Romaker says. (Still, smoking anything irritates your throat.)

"In the supine position, gravity allows the tongue to slide back to the back of the throat, restricting air flow," Dr. Smith says. In addition, the tissues in the back of your throat also hang down, blocking your windpipe.

According to the National Sleep Foundation, meds like Ativan and Valium can increase the likelihood of snoring because they relax your muscles — including those in your throat.

Some people's own nocturnal rumblings wake them up, while others have a bed partner who tips them off. But if you're single or your partner is dead to the world when they sleep, you might have no idea you're transforming into a lawn mower when you shut your eyes at night. Here are some telltale clues:

You're clocking seven to eight hours of sleep, but still feel super drowsy during the day. Called Excessive Daytime Sleepiness, or EDS, this can be a tipoff that you're snoring. Assess your exhaustion using the Epworth Sleepiness Scale. "If you score an 11 or higher, you have EDS," says Dr. Smith.

Is your blood pressure on the rise and you're not sure why? Sleep apnea might be to blame.

"If you are not breathing in enough oxygen, your heart has to beat a lot faster in order to supply more blood to your organs," Dr. Smith says.

If you are young and eat healthfully but have high cholesterol, consider if snoring could be the reason.

"Waking up every day with these symptoms is a sign you've been snoring," Dr. Romaker says.

If any of these ring true for you, record your nighttime noises using an app like SnoreLab, which takes sample recordings and measures how long and loud you snored.

It's important to nip snoring in the bud early on before it takes a turn for the worse (hello, sleep apnea) and becomes hazardous to your health. Try these fixes:

If you only snore when you're stuffed up, see if nasal strips help. These bandages are placed across the bridge of your nose and they have wings on each end, which pull your nostrils open.

"For some people, this makes a big difference," Dr. Romaker says, noting that you can also try an over-the-counter nasal spray. Steroid nasal sprays are available over the counter, and help reduce inflammation in the nose, per the American Academy of Asthma Allergy and Immunology (AAAAI). Not only will this help you breathe clearer during the day, but it could also help ease snoring due to allergies.

Nasal strips often alleviate snoring if you're expecting, too.

Avoid alcohol three to four hours before hitting the hay to give your body time to metabolize it.

"Sometimes you can fix your snoring simply by not drinking in the evening," Dr. Romaker says.

Sleeping on your back is frequently part of the problem.

"Hug a body pillow or put a pillow in the small of your back to help you stay on your side," Dr. Romaker says.

Or use a position sensor device such as NightBalance or NightShift: You place it around your neck or abdomen and if you shift to your back, it will vibrate with increasing intensity until you roll onto one side.

Another (albeit less comfortable) strategy to keep you off your back is to pin a sock full of tennis balls to the back of a tee shirt and wear it to bed.

Alternately, you can work against gravity by raising the head of your bed.

"Slide wedges under your mattress so that you are at a slope, which will open up your air passageway," Dr. Smith says.

If you have constant, disruptive snoring and these DIY strategies aren't doing the trick, then it's time to see a doctor.

"Dentists make oral appliances that pull the jaw forward to open up space in the back of the throat," Dr. Romaker says.

These mouthpieces are also available at many pharmacies or online, but she cautions that they could alter your bite. (You can try an over-the-counter version first to see if it helps, and then work with your dentist to have one custom fitted.)

Alternately, your dentist might suggest a tongue-retaining device that moves your tongue forward — but these can be uncomfortable.

"Once you develop severe sleep apnea, then a C-PAP [a machine that increases air pressure in your throat] is suggested," Dr. Smith says. "There are also some surgeries that are considered last resorts."

It depends on the level of snoring. Quiet puffs and putters are generally nothing to be concerned about.

But if you feel crappy the next day or your snoring disturbs people — say, your significant other has started sleeping in a different room, no one wants to bunk with you when you travel with friends or people in the hotel room next door complain — then you've got a problem you need to address.

"Basically, if it's not bothering your bed partner and you feel awake, energetic and alert during the day, then don't worry about it," Dr. Romaker says. "If those things are not true, then you should take a look at your snoring."