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Lifestyle Modification and Supplemental Therapies

There are multiple lifestyle modifications that have been associated with reduced snoring in clinical trials. These include weight loss, avoidance of alcohol and sedatives, positional training and nasal decongestion. Used in conjunction with an oral appliance these conservative measures can be an effective method of treatment.

Cigarette Smoking

Cigarette smoking, is an important risk factor for snoring. The effect of smoking may be related to the production of upper airway inflammation and edema by cigarette smoke. Smoking cessation has been shown to decrease snoring.

Weight Loss

Weight loss can reduce snoring and increase health. Keep in mind, that the results are variable. A reduction in snoring or complete elimination can occur even when sleep apnea is still present. A sleep study is the only way to be certain that oxygen levels and proper breathing occurs during sleep.

In a study of 123 bariatric surgery patients 82% were self-described snorers before treatment. Post treatment, the average BMI of the group dropped from 46 kg/m2 to 35 kg/m2 and only 14% reported snoring.1

Avoidance of Alcohol

Even moderate alcohol consumption increases upper airway resistance by relaxing the pharyngeal tissues. The severity of this effect is dependent on the amount of alcohol consumed, the length of time before going to bed and the individual’s metabolism. It is recommended that habitual snorers should avoid drinking alcohol 2-5 hours before bed.2&4

Positional Training

Sleeping on ones back often worsens snoring. Sleep studies of nonapneic snorers have shown a significant reduction in the duration and intensity of snoring when sleeping on their side.5 There are many products and makeshift solutions available for positional training such as sewing a tennis ball into the back of a t-shirt, or wearing a backpack to bed. Buyer beware !!

Nasal Decongestants

Nasal decongestants may help reduce snoring intensity but are not recommended for patients with hypertension or ischemic heart disease. Long-term use of nasal decongestants is also discouraged.3

Nasal Dilators

Nasal dilators such as Breathe Right nasal strips have limited success treating snoring and can sometimes result in a reduction in snoring frequency if not intensity. However, due to the harmless nature of the product it may benefit the patient to try using products such as these.

Expiratory Positive Airway Pressure (EPAP)

During inhalation, the microvalves open, allowing for relatively unrestricted airflow. However, during exhalation, the microvalves close, creating resistance to airflow and thus creating EPAP. Much like a bandaid Theravent is a non-prescription device.

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Sources

1. Dixon JB, Schachter LM, O’Brien PE: Sleep disturbance and obesity: changes following surgically induced weight loss. Arch Intern Med  2001; 161(1):102-106.

2. Issa FG, Sullivan CE: Alcohol, snoring and sleep apnea. J Neurol Neurosurg Psychiatry  1982; 45:353-359.

3. Larrain A, Hudson M, Dominitz JA, Pope 2nd CE: Treatment of severe snoring with a combination of pseudoephedrine sulfate and domperidone. J Clin Sleep Med  2006; 2(1):21-25.

4. Mitler MM, Dawson A, Henriksen SJ, et al: Bedtime ethanol increases resistance of upper airways and produces sleep apneas in asymptomatic snorers. Alcohol Clin Exp Res  1988; 12:801-805.

5. Nakano H, Ikeda T, Hayashi M, et al: Effects of body position on snoring in apneic and nonapneic snorers. Sleep  2003; 26:169-172.

Chest. 1995 May;107(5):1283-8. Treatment for snoring. Combined weight loss, sleeping on side, and nasal spray. Braver HM, Block AJ, Perri MG.

Chest. 1988 Apr;93(4):678-83. Risk factors in a general population for snoring. Importance of cigarette smoking and obesity. Bloom JW, Kaltenborn WT, Quan SF.

Sleep Med. 2008 Mar;9(3):290-6. Epub 2007 Jul 19.

Risk factors and correlates of snoring and observed apnea.

Ekici M, Ekici A, Keles H, Akin A, Karlidag A, Tunckol M, Kocyigit P.