Snoring is the top reason that patients come to see Jennifer Hsia, a sleep surgeon at University of Minnesota Health in Minneapolis. Most of the time, they come in not because they are worried about their health, but because their partner has been complaining about the noise.
"It's very rare that I have someone come in and say, 'I think I have sleep apnea,' " she says. "It's more, 'I'm snoring quite badly and my bed partner wants me to do something about it.' "
Even if the person you sleep with doesn't care, it's worth seeing a doctor if you snore, experts say. Although there may be nothing to worry about, accumulating evidence suggests a link between snoring and cardiovascular disease. Snoring can also be a sign of sleep apnea, a more serious disorder that causes people to periodically stop breathing in their sleep.
"All people that have sleep apnea snore, but not all people who snore have sleep apnea," says Ricardo Osorio, a sleep expert and neuroscientist at NYU Langone Medical Center in New York. Getting evaluated is the only way to know for sure.
"If the snoring is bad and you have witnessed apneas and there is some suspicion of daytime sleepiness or poor performance at work or risk of car accident because you're sleeping at the wheel, go to a sleep doctor," he says. "Generally, the only thing that can happen when you go to a sleep physician is that you can improve the quality of your life a little bit."
Data is scarce about how common snoring is, Hsia says. But studies from around the world suggest that up to half of people do it.
Snoring happens because our throats are made of soft tissues without rigid structures, Hsia says. As you fall asleep, the throat muscles relax, which causes your airway to narrow. To pass through a now-smaller tube, air then has to move more quickly, producing turbulent airflow that vibrates anything floppy or loose in the back of your throat, such as the uvula or soft palate. That vibration causes the jackhammer-like noise of snoring.
It's not clear why only some of us snore, Hsia says. But there are some trends: People become more likely to snore with age, as the throat tissues get looser. Being overweight can crush the airways, raising the risk of snoring. And men tend to snore more than women. Having a drink before bed can also exacerbate snoring because alcohol is a muscle relaxant.
Whether snoring itself is a health concern remains somewhat unclear. In the past decade, some studies have suggested a link between snoring and a higher risk of stroke, based on evidence that people who snore have thicker carotid arteries — a condition called atherosclerosis. But those studies cannot definitely say that snoring is to blame. And other studies have shown no increase in the risk of stroke from snoring.
"That is a gray area where there is a physical finding but we don't exactly know what it means," Hsia says. "I think you can safely say there seems to be an association, but you can't necessarily say at this point that snoring directly causes strokes."
Some people can snore all night long and wake up feeling great. For others, snoring can disrupt sleep — either by waking the snorer up, or by waking up a bed partner, who repeatedly pokes at the snorer through the night. Interrupted sleep can lead to daytime fatigue, diminished productivity and a risk of car accidents. Inadequate sleep has also been linked to chronic health consequences, such as diabetes and depression.
If you snore and you experience daytime sleepiness even after a full night's sleep, you may have obstructive sleep apnea, which affects up to 7 percent of men and 5 percent of women in the United States, according to a 2008 study. A more recent study found that, if you include people without daytime sleepiness, rates jump to 24 percent of men and 9 percent of women.
Sleep apnea is like snoring to the extreme: The airway becomes so narrow during sleep that it completely closes off. An alarmed brain then causes a brief awakening. Someone with a severe case can wake up 60 or more times each hour. And during each arousal, Osorio says, the body responds with increased blood pressure and oxidative stress. Damage develops over time.
If untreated, studies show that moderate to severe sleep apnea increases the likelihood of developing cardiovascular disease. Sleep apnea may also increase the risk for cancers, diabetes and pregnancy complications, among other complications, including Alzheimer's disease, according to Osorio's work.
"You don't want to sound too alarming," Osorio says. But he suspects that sleep apnea creates "an environment that makes the depositing of proteins and [Alzheimer's] pathology more likely."
To learn whether you have sleep apnea, you need to do a sleep study that counts how many times you hold your breath throughout the night and how your oxygen levels drop when that happens. Normally, a sleep study happens in a sleep lab, but many people can do it at home.
The ideal way to treat sleep apnea is with a CPAP machine that uses air pressure to keep the airway open during sleep, Hsia says. But compliance tends to be low. For people who can't tolerate the machine, mouth guards that change the position of the tongue, jaw and other structures sometimes help. Surgery may also be an option.
Dealing with snoring in the absence of sleep apnea is more complicated, in part because causes differ among individuals, so solutions vary, too. And without definitive research to link snoring with health outcomes, Hsia says, insurance plans don't cover anti-snoring products.
To avoid paying for products that don't work, she recommends visiting a doctor to sleuth out why you snore. Then — as long as sleep apnea is ruled out — start with an inexpensive product before committing to a more high-end version.
For example, many people find that their snoring is worst when they lie on their backs. In those cases, Hsia suggests putting a few tennis balls into a cheap fanny pack and strapping it onto your waist, keeping the balls against your back. When you roll onto your back, the balls will cause enough discomfort to make you roll back over.
If staying on your side controls the snoring, you can invest in nicer pillows or foam blocks that are designed to work as body positioners. Some products achieve the same result with vibrations that alert a sleeper every time he rolls onto his back.
If your snoring is caused by nasal congestion, on the other hand, it might take medication to control allergies or even surgery to fix a deviated septum.
For some people, losing weight below a particular threshold resolves snoring. Others benefit from a mouthguard, although over-the-counter versions tend to be one-size-fits-all, which makes them uncomfortable for most, Hsia says. If a cheap mouthguard works after a couple of nights, dentists can create custom versions that feel better.
It might take some trial-and-error to find the right solution. "It's a 'different-things-are-going-to-work-for-different-people' kind of a situation," Hsia says. "It is worth getting looked at because there's no one fix for every person."
How snoring has managed to persist through evolution remains an open question. Hsia says she wonders whether snoring was once seen as a sign of being a good sleeper, and only now do we realize that it might not be so great. There's another possibility, too: By the time someone is sound asleep and snoring, the passing on of genes may be already complete.
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Water covers a road near Valley, Nebraska, on Friday, March 15, 2019.
Heavy machinery stacks up concrete chunks on the shore of the Elkhorn River at the Q Street bridge as part of an effort to stabilize the bank on the recently flooded river.
Sarpy County Sheriff's Deputy Darin Morrissey rides an ATV through floodwaters in Hawaiian Village.
Omaha Roncalli's Shane Orr celebrates their double overtime win over Aurora during a semifinal game in the Class B Nebraska state basketball tournament at Pinnacle Bank Arena.
The Auburn bench and crowd react to Auburn's Cameron Binder hitting what would be the game winning shot against North Bend Central during the championship game in the Class C1 Nebraska state basketball tournament at Pinnacle Bank Arena.
Creighton's Jordan Hovey (5), right, celebrates hitting a home run with his teammates in the 2nd inning.
Nebraskaâ€™s Adrian Martinez runs out of the end zone after a play during spring football practice at the Hawks Championship Center in Lincoln, Nebraska.
Treyton Gubser, left, and his uncle Daniel Gubser paddle using shovels through the floodwaters after they rescued Daniel's kid's cat, Bob, in Hamburg, Iowa.
Highway 81 is covered in floodwaters south of Columbus, Nebraska.
A Nebraska National Guard helicopter flies over a flooded Waterloo, Nebraska, in March.
Cars drive drive across a flooded Platte River on Highway 50 just north of Louisville, Nebraska.
A Canada goose flies over Matthew J. Placzek's "Monument to Labor" sculpture as floodwaters from the Missouri River begin to recede on the Omaha riverfront.
Floodwaters closed Ave I at North 26th Street in Council Bluffs, Iowa.
A truck drives through a flooded road near the Platte River in April.
Lincoln Pius X's Austin Jablonski holds up the net after his team defeated Omaha Roncalli in the championship game in the Class B Nebraska state basketball tournament at Pinnacle Bank Arena.
Amelia Fritz, right, holds on to her daughter-in-law Tesha Fritz in Glenwood, Iowa. They were evacuated from Pacific Junction, Iowa, after floodwaters hit the town last night. They were part of 15-relatives all staying in the same house or in a camper in the front driveway.
Robert Jones looks around his flood damaged house north of Highway 50, near Louisville,Nebraska. The floor, which is normally a white tile, is covered in mud.
Aurora's Nicholas Hutsell, left, fouls Omaha Roncalli's Alexander Rodgers during a semifinal game in the Class B Nebraska state basketball tournament at Pinnacle Bank Arena.
Lincoln Pius X's Charlie Easley, left, and and Omaha Roncalli's Alexander Rodgers stretch for a loose ball during the championship game in the Class B Nebraska state basketball tournament at Pinnacle Bank Arena.
Humphrey/Lindsay Holy Family's Trent Reardon, left and Jason Sjuts celebrate their victory over Fremont Bergan during the championship game in the Class D1 Nebraska state basketball tournament at Pinnacle Bank Arena.
Aurora's Kaleb Moural wipes the sweat from his face during the second half against Omaha Roncalli during a semifinal game in the Class B Nebraska state basketball tournament at Pinnacle Bank Arena.
Bob the cat looks on from a basket in a boat after being rescued from floodwaters in Hamburg, Iowa.
A vehicle is stuck in floodwaters near 1st Street and Pierce Street in Fremont, Nebraska.
Tim Rockford, left, and David Bauer, tour the Bellwood Lakes neighborhood which was destroyed by the flooding days prior along the Platte River in Bellwood, Nebraska.
Lincoln East's Charlotte Bovaird practices her shot and she and her teammates warm up in the hallways before the start of the game. Lincoln East played Millard South in a Class A first-round basketball game during the girls state basketball tournament at the Pinnacle Bank Arena in Lincoln, Nebraska.
Elkhorn South's Ryee Gray (40) fights for a rebound with Sidney's Meaghan Ross (0).Sidney played Elkhorn South in a Class B first-round basketball game during the girls state basketball tournament at the Pinnacle Bank Arena in Lincoln, Nebraska. Elkhorn South defeated Sidney 51-37.
Westside poses with the championship plaque with the winning score on the wall behind them after Omaha Westside defeated Millard North 54-53 at Omaha Westside in Omaha, Nebraska.
Chris Saenz of Bellevue works out at FIT IN THE CITY in Papillion, Nebraska.
Dymond Meeks leaps across the snow pile in the center of Farnam Street near its intersection with 14th Street in Omaha, Nebraska, as she makes her way to work. Meeks said the snow was terrible. She said it took her 15 minutes to get down the hill her home is located on.
Hazley Eulberg, 10, of Kennard, Nebraska, takes in the trophy display in the Whitetail Kings Collection booth at the Omaha International Boat Sports and Travel Show at the CHI Health Center in Omaha, Nebraska.
The house-made carrot cake is one of the many desserts on the menu at J. Gilbertâ€™s Wood-Fired Steaks & Seafood in Omahaâ€™s Capitol District.
UNO's Mitch Hahn (44), right, grabs a rebound over the top of teammate JT Gibson (0). UNO played South Dakota State in a men's basketball game at Baxter Arena in Omaha, Nebraska.
Norfolk's Annika Harthoorn dives backwards at the start of heat 4 of the girls 100 yard backstroke at the Bob Devaney Sports Center on Friday, Feb. 22, 2019, in Lincoln, Nebraska, during the state swimming prelims.
UNO's Mitch Hahn (44) hugs his mom Kim Hahn following UNO's 85-84 win over South Dakota State. UNO played South Dakota State in a men's basketball game at Baxter Arena in Omaha, Nebraska.
Lincoln Pius X's Katie Stonehocker competes in the girls 200 yard freestyle at the Bob Devaney Sports Center on Friday, Feb. 22, 2019, in Lincoln, Nebraska, during the state swimming prelims.
Jen Freeman, who is training for a 100 mile race, jogs through the snow in Millard, Nebraska. Freeman said that she has to train no matter what the weather.
Mesquite grilled eight-ounce filet with heirloom carrots and burnt end mac and cheese. J. Gilbertâ€™s Wood-Fired Steaks & Seafood serves dinner seven nights a week in Omahaâ€™s Capitol District.
UNO's Matt Pile (40) gets tangled with Western Illinois' Zion Young (1), left and Brandon Gilbeck (52) in the first half as the University of Nebraska at Omaha hosts Western Illinois at the Baxter Arena in Omaha, Nebraska.
Omaha Burke assistant wrestling coach Jesse Peters takes a rest before the start of the semifinals at the CHI Health Center in Omaha, Nebraska, during the Nebraska State Wrestling Tournament. Peters said the nap helps him get through the long tournament days.
South Dakota State's Mike Daum (24) scores a basket against UNO. UNO played South Dakota State in a men's basketball game at Baxter Arena in Omaha, Nebraska.
UNO's Ayo Akinwole (10) drives past Western Illinois' Keshon Montague (22) in the first half as the University of Nebraska at Omaha hosts Western Illinois at the Baxter Arena in Omaha, Nebraska.
Creamed corn with bacon is among many side items on the menu at J. Gilbertâ€™s Wood-Fired Steaks & Seafood in Omahaâ€™s Capitol District.
The UNO basketball team celebrates their 85-84 win over South Dakota State. UNO played South Dakota State in a men's basketball game at Baxter Arena in Omaha, Nebraska.
UNO's KJ Robinson (5) reacts after missing a shot. UNO played South Dakota State in a men's basketball game at Baxter Arena in Omaha, Nebraska.
Omaha Bryan's Ladamien Sturdivant, left, tries to keep a hold on Fremont's Cody Carlson during their Class A 126 pound semifinals wrestling match at the CHI Health Center in Omaha, Nebraska, during the Nebraska State Wrestling Tournament.
Lincoln Pius X's Kara Owens rises from the water as she competes in heat 2 of the girls 100 yard backstroke at the Bob Devaney Sports Center on Friday, Feb. 22, 2019, in Lincoln, Nebraska, during the state swimming prelims.
Hilary Sehring punches the speed bag during an exercise round at 9Round Fitness in Omaha, Nebraska.
Gothenburg's wrestling coach Tom Scott cheers on Gothenburg's Wyatt Hotz as he takes on Lexington's Brady Fago during their 132 pound semifinals wrestling match at the CHI Health Center in Omaha, Nebraska, during the Nebraska State Wrestling Tournament.
Seventh-grade students from Nathan Hale Middle School are reflected in a â€œThe New Negro Escapist Social and Athletic Club,â€ a portrait by Rashid Johnson while touring 30 Americans, an exhibition from the Rubell Family Collection at the Joslyn Art Museum in Omaha, Nebraska. The traveling exhibit of 30 African American artists includes art with themes of slavery, the KKK and an emphasis on the beauty of black lives.
A man clears the snow from the top of a parking garage located near 10th and Jackson Streets in Omaha, Nebraska, after heavy snowfall.
UNO's Zach Jackson (21) delivers a slam dunk as teammate Ayo Akinwole (10) expresses his approval in the second half as the University of Nebraska at Omaha beats Western Illinois 77-63 at the Baxter Arena in Omaha, Nebraska.
Fremont assistant coach Cydney Granger cheers on Fremont swimmer Lauren Gifford in the girls 500 yard freestyle at the Bob Devaney Sports Center on Friday, Feb. 22, 2019, in Lincoln, Nebraska, during the state swimming prelims.
A pedestrian cruises past a sign of seasons to come in the window of Palm Beach Tan, 5417 S. 96th Street in Omaha, Nebraska.
UNO's Ayo Akinwole (10), left, drives around South Dakota State's David Jenkins (5). UNO played South Dakota State in a men's basketball game at Baxter Arena in Omaha, Nebraska.
Jim Stotts, of Glenwood, Iowa, walks a few laps around Stinson Park while passing time before going to see a movie at Aksarben Cinema, in Omaha, Nebraska.
Chris Kotulak, who is the Chief Operating Officer at Fonner Park, demonstrates how to play a PariMAX's historical horse racing game at the Fonner Park executive offices in Grand Island, Nebraska.
Western Michigan's Ethen Frank (26), Lawton Courtnall (10), and Hugh McGing (16) celebrate a goal during the second period of a college hockey game at Baxter Arena in Omaha, Nebraska.
People jog through the snow at Lake Zorinsky in Omaha, Nebraska.
Gage Beins, right, dumps snow on his friend Jeremy Boyd as they goof around in the snow at Lake Zorinsky in Omaha, Nebraska.
Jamie Kotera, 59, of Springfield, Nebraska, who works out five times a week is seen during her strength training workout with personal trainer Tyler Kottas at Better Bodies Fitness in Omaha, Nebraska.
A deer forages for food at Chalco Hills Recreation Area in Omaha, Nebraska, as snow falls.
A red-tailed hawk stands in the grass near 144th Steet and Giles Road in Omaha, Nebraska. He soon took off again as the light changed and traffic began to move.
Intern Daniel Holm, left, works with stage manager Amy Thomas backstage. The two were keeping track of the play as it progressed to know when they needed to make scene changes. Cast members were rehearsing "The Hobbit" at the Circle Theatre in Omaha, Nebraska.
The kimchi ramen at Ika San, new in the Old Market, includes the restaurant's signature crispy pork belly and rich pork broth, plus house-made kimchi, which is fermented cabbage.
Tom Dahir clears the snow from his driveway in Omaha, Nebraska, near the intersection of 97th Street and W. Center Road after a heavy snowfall.
UNO's Zach Jordan (27) and Western Michigan's Cam Lee (28) battle for the puck during the first period of a college hockey game at Baxter Arena in Omaha, Nebraska.
Actor Patrick Brusnahan does his makeup before the start of rehearsal. Brusnahan played the dwarf Bombur. Cast members were rehearsing "The Hobbit" at the Circle Theatre in Omaha, Nebraska.
Diederick Dillon, an Omaha Burke junior, clears snow from his car in the school's parking lot in Omaha, Nebraska. Omaha Public Schools were let out early because of the weather. Dillion said he was headed straight to work, despite being let out of school early.
A woman makes her way to a store as snow falls at Village Pointe in Omaha, Nebraska.
Milliner Margie Trembley designs, constructs and sells hats from her shop called Margie Trembley Chapeaux in Springfield, Nebraska.