A reader asks: I am writing on behalf of my husband, who is 38-years old. He has a severe snoring problem. We recently got married, but this problem is forcing us to sleep in separate rooms. I am a very light sleeper. I need to have absolute silence, pitch darkness and a relaxed mind to be able to get sound sleep.
When he is in deep sleep, his snoring gets very loud and eventually wakes him up. I feel really bad for him, he tries his best to make the least noise. It is truly heart breaking when we part our ways at night. I have tried very hard to force myself to sleep in the same room, but we both have very stressful jobs, which requires us to give 100 per cent attention, and on the day when we try to sleep together I usually go to work tired and exhausted.
We tried the commonly available stickers, which enlarges the nostril, for smooth flow of air, but it made no difference. Upon insisting that we go see an ENT specialist, he mentioned that he had this problem for around 10 years, and previously he has been told to either get operated or lose weight.
My husband is now around 85kg, (we have not measured for the past two months) and around 4 years back he used to be 55kg.
We have met an ENT Specialist in a renowned hospital here. But was very unhappy with the service. We had hoped for some of our question like, ‘What is the reason for this? What are our options? Is it possibly passed on genetically? (as my mother-in-law also snores)' to be answered, but that didn’t happen.
The doctor just took a glimpse inside my husband’s nose and said he needed operation, and refused to give us any further details. On insisting repetitively, the doctor said it was an extra growth of muscle in his nose. And said it was a small procedure and the cost will be between Dh10,000/Dh15,000.
Please tell us what to do? Is there any alternative to surgery? We cannot currently go for this costly procedure. We are trying to lose weight, but this will take a while, we need an immediate and comparatively inexpensive solution. We are open to any alternative therapy (Homeopathy, Ayurveda, etc.)
Thank you so much for finding the time to read my email. We both will be sincerely grateful for any suggestions coming from your end.
Dr Dinesh Kartha (Ministry of Health Approved Naturopathic Medicine Practitioner, Chief Consultant and Managing Partner, Aura Alternative Medicine Center, Sharjah) replies: Snoring is due to the narrowing or incomplete obstruction of the upper airways of the respiratory system during sleep, which usually predisposes to OSA ( Obstructive Sleep Apnea) i.e. intermittent cessation of airflow to the nose and mouth during sleep. Studies show that about 40% of middle-aged men and 20% of middle-aged women snore. Even though a lot of factors contribute to snoring , sleep plays the crucial role as it reduces the activity of muscles and their protective reflex responses. Along with snoring, frequent arousal from sleep, daytime sleepiness, fatigue, difficulty with concentration, impaired work performance, nocturia, personality problems etc are other features of OSA.
Common causes of snoring are:
- Structural problems of mouth, nose, throat and related structures: DNS, cleft palate, enlarged adenoids , retrognathia, macroglossia.
- Sinus problems causes blockage of airways due to inflammation and secretions.
- Infections of nose, throat , sinuses etc.
- Allergies.
- Alcohol consumption, due to its depressant effect on upper airway muscles.
- Obesity contributes to reduction in size of the upper airways, either by increasing fat deposition in pharynx/throat or by compressing it by superficial fat masses in neck.
There are certain other factors that increases the chance of snoring:
- Gender: Men have narrower air passages than women and are more likely to snore.
- Age: Aging decreases lumen size of airways and muscle tone.
- Smoking
- Sleep posture: Sleeping in supine posture, i.e on back blocks the airway.
- Familial: In families where the jaw bones, maxilla and mandible are back set (retrognathia)
- Hormonal conditions: Hypothyroidsm and Acromegaly
- Pregnancy
In your husband’s case, obesity and the muscle growth inside the nose can be considered as the main causes.
Prevention
- Ask him to avoid alcohol and sedatives: It increases upper airway muscle tone.
- Weight reduction: Eradicating excess fat deposition in neck and associated areas helps to increase upper airway lumen size.
- Good sleeping habits and hygiene will help to prevent snoring.
- Avoid sleeping in supine position. Instead sleep on side with head raised. Raising the head of your bed will help.
- Avoiding allergens: like dust, dust mites, irritating chemicals from bedroom should be given prime importance.
- Avoid heavy meals three hours prior to sleep.
- Gargle with medicated lukewarm water, which helps to reduce inflammation of throat and helps to remove secretions.
- Treat nasal congestions and obstructions. Treat conditions like deviated nasal septum and nasal polyps, which can make snoring worsened.
Treatment
- Obviously lifestyle modification and use of alternative medicines and therapies can contribute in the management of snoring, especially in cases due to obesity, recurrent allergies and infections, sinus problems etc. First step is to improve quality of sleep by adopting good sleeping practices.
- Oral prosthetics: Anti-snoring mouth guard, CPAP: Continuous Positive Airway Pressure etc are some available measures. Surgical measures like uvulopalatophayngoplasty and tracheostomy are seen indicated in severe OSA. My advise would be to try surgery as a last resort.
- Natural and Herbal Supplements: Use of natural anti-inflammatory agents like ginger, garlic, wild yam, valerian, golden seal, peppermint oil, bitter orange and cinnamon will be useful. One has to take these supplements under supervision of a Naturopathy Doctor.
- Ayurvedic Treatments: Ayurvedic medicines help to manage obesity, as well as other inflammatory conditions due to allergy and infections. Administration of medicines through nose (nasyam), using proper hair oil etc are also helpful not only in the management of snoring, but also helps you to get quality sleep.
- Singing: Singing will help to better control and strengthening of muscles of soft palate and upper throat, thereby reducing snoring. Playing Didgeridoo, a musical instrument, also is helpful.
- Yoga: Tongue and throat exercises in Yoga help to make muscular structures stronger. Also practicing specific breathing exercises (Pranayamas) like Ujjayi, Nadisudhi etc. can be helpful. Other kriyas like Jalaneti, Sutraneti etc also can help.
Disclaimer: This blog is a conversation and is not an alternative for treatment. The recommendations and suggestions offered by our panel of doctors are their own and Gulf News will not take any responsibility for the advice they provide.
