In the spring of 2010, a student in one of the dormitories in China stabbed his roommate because of snoring. Dozens of murders have been recorded worldwide for this reason. Among the causes of divorce, snoring ranks third in the United States and second in the United Kingdom.
Snoring is a fundamental problem that brings many issues both to the person who snores and to their loved ones. Let’s try to figure out what snoring is and what ways exist to deal with it.
It is worth noting that in the anti-snoring industry, as in the sleep industry, there are many low-quality products whose effectiveness is not proven, and their use can cause harm or be life-threatening. In the article we will try not only to review all the available means of combating snoring, but also, where possible, to refer to studies that confirm effectiveness or at least to reviews of real users on authoritative marketplaces.
What is snoring?
According to the definition of the global clinical evidence-based resource UpToDate, snoring is a sound that occurs due to the vibration of the soft tissues of the upper airway during sleep. It usually happens during inhalation, but it can occur during exhalation. Habitual snoring occurs in 44% of men and 28% of women aged 30 to 60.
Causes of snoring. Why does he/she snore?
- Obstructive sleep apnea (OSA) — increased resistance of the upper airway and enhanced collapse of the nasopharynx.
- Narrowing of the upper airway. Snoring can be associated with conditions that narrow the upper airway, including obesity, nasal congestion, craniofacial abnormalities, hypothyroidism (a deficiency of thyroid hormones), acromegaly (a pituitary hormonal pathology), and adenoid vegetation. These conditions, in turn, can cause snoring without OSA or snoring that arises as a symptom of OSA.
Fighting snoring. How to get rid of snoring
In the boundless sea of information about combating such a fundamental problem as snoring, it is very easy to get lost. Therefore, first of all, it is worth systematizing all the methods of dealing with this scourge.
We will divide the methods of combating snoring into active ones, that is, those that act on the source itself — help not to snore, and passive methods that help not to hear the snorer.
Active methods of combating snoring
Conservative therapy. No matter whether you refer to any other article on the Internet, ask ChatGPT, or come to a doctor’s appointment, everything starts with these recommendations:
- weight reduction
- giving up tobacco and alcohol
- sleep position
It is well known that sleeping on your back contributes to snoring much more than sleeping on your side. (Study PMID 12683476*) Based on this principle, a large number of different devices have been created that train the user to avoid sleeping on their back. Starting with a simple method using a tennis ball that can be placed into a pocket specially sewn on a T-shirt in the shoulder blade area and ending with rather complex devices with noise sensors designed to change position during sleep with “light mechanical impact.”
* — here and below — the unique study number. To access the study, copy into the search box of a search engine in the format: PMID 00000000 or PUBMED 00000000
Use of nasal expanders or dilators (anti-snoring clips and strips)
Nasal expanders are fairly safe devices that help widen the external nasal valve. This can be a strip attached to the wings of the nose or an anti-snoring clip that is inserted into the nose. Although a nasal strip is a less invasive accessory than a clip and the expected comfort of using such an accessory is higher, some studies show a small effectiveness of the second (PUBMED 1554449) and a lack of effectiveness of the first (PUBMED 9487771).
Anti-snoring remedies for the oral cavity
Use of CPAP devices for the treatment of OSA
CPAP devices, or devices that provide continuous positive airway pressure, are an effective and safe therapy for snoring, provided, of course, that it is easy for you to fall asleep with such a mask on your face:
A CPAP device is an air pump with a safe pressure control system that maintains constant pressure in the airways and prevents them from collapsing during sleep. A comparative study (PMID 26209075) showed a treatment effectiveness considering CPAP therapy at the level of 76%.
Palatal surgery for the treatment of snoring, uvulopalatoplasty
This involves the surgical removal of the tissues of the soft palate and the palatine tonsils. It can be performed by traditional methods as well as using laser technologies. There are a large number of studies showing the effectiveness of this treatment method, but many of them show the impermanence of the effect of the surgery — no more than 12 months, followed by a return to the problem. (PMID 17040580)
In addition, palatal implants made of braided polyester threads are also used. This method of treatment is quite effective for treating snoring, but its effect tends to decrease over the course of several years after surgery.
Training of the upper airway (myofunctional therapy)
This is a set of exercises with the repetition of certain sounds to increase the tone of the muscles of the palate, pharynx, and larynx.
With the patient’s motivation, it has high effectiveness in treating snoring and OSA. Smartphone apps are actively used for such exercises. They help systematize the exercises, maintain discipline, and turn the routine training process into a game form.
One study described a smartphone app for daily upper airway exercises lasting about 15 minutes. Participants showed a significant reduction in episodes of snoring with a loudness above 60 dB. (PMID 30032464)
App for myofunctional therapy Soundly
So such a method of combating snoring turned out to be quite effective; it is worth trying, but here it is impossible to do without self-discipline and persistence.
Passive methods of combating snoring
If above we described methods that make it possible to influence the source of snoring, now we will talk about those cases when there is no possibility to influence it, and instead those around have to protect their hearing.
This method often has to be resorted to because the snorer refuses to change anything in their habits and lifestyle, may be behind a wall in another room, or all the methods listed above do not help.
Earplugs for snoring
The loudness of snoring can reach 85 dB; the noise reduction rating of earplugs lies in the range of 24–39 dB. Simple subtraction makes it clear that even the most powerful earplugs will not give a feeling of complete silence. But do not despair; everything is not so bad. Earplugs help reduce the audibility of snoring; they will not let you wake up when you sleep. In the frequency range of snoring, mainly low and mid frequencies are present, therefore it is recommended to use earplugs that are inserted inside the ear canal — foam or molded reusable (trees).
Reusable sleep earplugs Kokon Universe
In addition to passive earplugs that create a barrier between the noise source and the eardrum, there are also earplugs with active noise cancellation. Similar to very compact wireless earbuds, in addition to eartips, they have a microphone and a special electronic module in their design. The microphone reads the ambient noise and, with the help of the electronic module, generates the same signal but phase-shifted. When this signal is converted into a sound wave from the earbud speaker and combines with the surrounding sound, the result is silence... It’s like in mathematics: (+1) + (−1) = 0.
Sound masking or white noise generators
White noise generators (WNGs), or as they are called — sound conditioners, do not suppress noise in a room; their task is to create a neutral, non-irritating noise background in the room by playing masking sounds. As a rule, this is white noise and its varieties — gray and pink. In addition, WNGs play sounds of nature, which in their characteristics are close to white noise — the sound of rain, a waterfall, surf, etc.
How does sound masking work? Try turning on a flashlight in a dark room. The beam will be clearly visible in the space and on the wall. And if you do the same in a well-lit room? Just as the lighting in a room, white noise combines with the irritating sound (the flashlight beam) and creates a neutral sound background. Our brain easily adapts to it and stops noticing it.
White noise generator Tuodi
A WNG can be implemented as a standalone device or as a smartphone app like SimplyNoise. A generator in the form of a standalone device has some advantages compared to an app — a more powerful speaker capable of effectively interacting with the noise of snoring, continuous sound that will not be interrupted by a call or phone alert, and convenience of operation in a dark room.
A WNG is usually placed as much as possible between the snorer and the person who is protecting themselves from snoring in order to achieve the greatest effect. In addition, the use of sound conditioners together with earplugs can increase the effectiveness of the latter.
Conclusion
Snoring occupies a rather high place among the discomforts faced by bedroom partners. The anti-snoring industry is rich in ineffective accessories. But among this chaos, it is important not to miss those remedies that really work. Some of them will require work on yourself; some will need getting used to. By studying the experience of previous users and trustworthy studies, you can choose an effective accessory and solve the problem of snoring.
And what helps you? Share in the comments!
Anatolii Barskyi
Project Manager
Sources:
UpToDate — Snoring in adults — James A Rowley, MD
UpToDate — Poor sleep and insomnia in hospitalized adults — Dennis Auckley, MD