Causes of snoring

Why is it important to know the true causes of snoring? Because it gives you the opportunity to get rid of it, because almost every third person over 30 snores regularly, and 45-50% snore occasionally. At the same time, at least 40% of the entire male population of the planet and 18-24% of women are subject to ronchopathy. In addition, 6-15% of children snore in their sleep. [ 1 ]

Snoring as a breathing disorder

In ICD-10, snoring is classified as a breathing disorder and has the code R06.5 – mouth breathing. That is, the key cause of snoring is recognized as a violation of nasal breathing of various origins. This includes injuries or malformations of the nasal septum (including its curvature), the presence of polyps in the nasal cavity, inflammation of the paranasal sinuses – if snoring is observed after sinusitis; and, of course, nasal congestion, for example, with chronic rhinitis (chronic runny nose ) of any etiology.

Otolaryngologists explain the physiological component of snoring as a process that occurs when breathing through the mouth, a decrease in muscle tone of the nasopharynx during sleep - an involuntary relaxation of the tissues of the soft palate and folds near the tonsils, which, under the influence of the air flow during inhalation and exhalation, begin to vibrate with a characteristic sound accompaniment.

Ronchopathy often occurs when a person sleeps on their back, which causes the tongue (uvula) to sag and restricts the space for air to pass through. [ 2 ]

Being overweight (and having a short, thick neck) has been shown to be a risk factor for snoring, due to the increased volume of tissue (fatty infiltration) at the base of the tongue and in the upper part of the pharynx, as well as the increased size of the soft palate and tongue.

The genetically determined factor is the initial size of the tonsils of the pharyngeal lymphoid ring, and the pathological factor is considered to be hyperplasia of the tonsils.

Habitual snoring occurs in people with maxillofacial anomalies and malocclusion, in particular, with upper prognathism. And with too small a lower jaw (mandibular micrognathia or retrognathia), the reduction of the lumen of the upper respiratory tract occurs due to the lack of space for the tongue.

28% of chronic snorers suffer from sleep apnea – a short-term cessation of air flow in the airways. And snoring is a symptom of obstructive sleep apnea. [ 3 ]

The latter circumstance explains snoring after a stroke, which causes ischemic damage to the brain with disruption of the mechanisms of respiratory regulation and the development of apnea and insomnia, as well as a failure of the normal sleep-wake cycle. [ 4 ]

By the way, snoring after alcohol is associated with the effect on the brain and central nervous system.

Why do women snore?

In addition to all the above-mentioned factors for the occurrence of ronchopathy, there are reasons leading to snoring in women associated with certain physiological periods.

Quite a few women face the problem of snoring during pregnancy, and there are explanations for its occurrence. This is a natural weight gain (sometimes excessive), an increase in estrogen levels (leading to swelling of the mucous membranes of the nasopharynx), as well as the relaxing effect on muscle fibers of relaxin - a hormone that is produced during gestation not only by the corpus luteum of the ovaries, but also by the chorion (in the early stages), and then by the placenta and decidual intrauterine membrane.

If snoring does not go away for some time after pregnancy, that is, after childbirth, then this is due to a gradual decrease in the synthesis of estrogen and relaxin. Or, the reason is still in the same extra pounds gained during the period of bearing a child. [ 5 ]

In addition to the usual (breathing problems through the nose, accumulation of fat in the upper body, etc.), there are also special reasons for snoring in women over 50. And here too, it is a matter of hormones: due to a lack of the sex steroid progesterone, with the onset of menopause, the relaxation of the muscle tissues of the upper respiratory tract increases. [ 6 ]

Causes of snoring in children

It should be borne in mind that the lymphoid system of the body is formed in childhood, in particular, the largest palatine and pharyngeal tonsils, related to the immunocompetent organs - in children aged two to six years, and the peak of angina (tonsillitis) occurs in the period from four to seven or eight years. Thus, it is at this time that the adenoids increase, and their reduction begins on average from the age of 12. [ 7 ]

The tonsils are the first to protect the body from inhaled pathogenic microorganisms. This causes an influx of blood and activation of the M-cells present in the tonsils, which capture antigens produced by pathogenic bacteria and viruses. B- and T-lymphocytes of the tonsils are also activated and multiply. [ 8 ]

Frequent infections in young children with an imperfect general immune system can lead to hypertrophy of the palatine tonsils, causing snoring in a child after an illness, in particular after tonsillitis, which is also accompanied by swelling of the mucous membrane of the tonsils and the upper parts of the palatine arches. [ 9 ]

If the nose is stuffy and nasal breathing is impaired, then – until the swelling of the mucous membranes has completely subsided – short-term snoring may be observed in a child after an acute respiratory viral infection.

Restless sleep, nasal congestion, sleep breathing problems, and snoring are quite common after pneumonia in a young child.[ 10 ]

Snoring after surgery

In cases of hypertrophy of the pharyngeal (adenoid) tonsil, which disrupts nasal breathing and leads to other negative consequences, they resort to surgical intervention.

But sometimes, after some time, snoring occurs after adenotomy – removal of adenoids in children. This is explained by two reasons. Firstly, the formation of scars that narrow the lumen of the upper respiratory tract, and secondly, the regrowth of tissue of the pharyngeal tonsil (in children under five years of age). [ 11 ]

According to clinical data, performing total thyroidectomy in 30% of patients with goiter contributes to a significant reduction in the frequency of snoring and sleep apnea. However, snoring is possible after thyroid removal, which specialists in the field of endocrine surgery try to explain either by a postoperative decrease in the patency of the upper respiratory tract or by an increase in the folds of the mucous membrane lining them.