Strong snoring in women in a dream: what to do, treatment

A rattling vibrating sound in a dream, coming from the larynx is called snoring. It is more characteristic of men than women. When the representative of the stronger sex snores, it is considered quite normal, and for women it is a complete moveton. What do these night sounds show and how can we fight them?

Epidemiology

Research shows that every fifth person on the planet over 30 snores. The prevalence of snoring among men is 35% -45%, in women from 15% to 28%, and is the main symptom of breathing problems during sleep. Sleep apnea causes excessive drowsiness, which is also a common disease with prevalence rates from 3% to 7% in men and from 2% to 5% in women.[1], [2], [3]

The differences between men and women in the prevalence of snoring decrease with age, mainly as a result of a marked increase in the prevalence of snoring in sleep in women after menopause. [4], [5]

Causes of the snoring in women

Snoring occurs as a result of relaxation of the muscles of the palate and tongue under the influence of the flow of air passing through the airways. But not all sleeping snore, which indicates the presence of certain causes of this phenomenon. These include:

• congenital abnormalities (curvature of the nasal septum, polyps);
• malocclusion; [6]
• nose injuries;
• anatomical features narrow nasal passages, long uvula; [7]
• neck circumference, as a predictor of obesity, is a well-known risk factor for obstructive sleep apnea and cardiovascular diseases; [8]
• neoplasms;
• age-related changes (in women after 40, 50 years, muscles lose elasticity, including pharyngeal tone decreases);
• endocrine disease acromegaly; [9], [10]
• thyroid dysfunction (hypothyroidism); [11]
• Studies have clearly shown familial susceptibility to snoring. [12], [13]

It has been suggested that female sex hormones have some kind of protective effect on upper airway patency and / or respiratory activity. [14]The hormone progesterone is a well-known respiratory stimulant that enhances the response of chemoreceptors to hypercapnia and hypoxia and increases the muscle tone of the upper respiratory tract. Progesterone levels decrease after menopause. Hormones can also play a role in the distribution of fat in the body. Postmenopausal women have a higher fat mass compared with the period before menopause, and the distribution of fat is greater in the upper body and body region compared to the lower body.[15], [16]

Risk factors

Such factors as:

• bad habits (smoking [17], alcohol [18]); 
• excess weight;

Some studies have shown that the prevalence of habitual snoring in women is highly dependent on age and BMI, while alcohol dependence is associated with snoring in thin women, while lack of physical activity is a risk factor for snoring in women with high BMI. [19]

• taking sleeping pills; [20]
• fatigue, excessive daytime sleepiness; [21]
• chronic lack of sleep.

Pathogenesis

Obstructive sleep apnea (OSA) is characterized by a recurrent collapse of the pharyngeal airways during sleep, which leads to a significant decrease (hypopnea) or complete cessation (apnea) of the air flow, despite continuing respiratory efforts. These respiratory disorders lead to periodic disorders of blood gases (hypercapnia and hypoxemia) and jumps in sympathetic activation. Loud snoring is a typical feature of OSA, and in most cases the culmination of a respiratory event is associated with a brief awakening from sleep (agitation). These events lead to cyclical breathing and fragmented sleep, when the patient oscillates between waking and sleeping. In severe cases, respiratory events can occur more than 100 times per hour, and usually each event lasts 20-40 seconds.[22], [23]

The pathophysiological causes of snoring vary considerably from person to person. Important components are probably the anatomy of the upper respiratory tract, the ability of the upper respiratory dilators to respond to respiratory problems during sleep, the tendency to wake up from rapid breathing during sleep (excitation threshold), the stability of the respiratory control system and the possibility of changes in the volume associated with the state lungs to influence these factors.

Since the muscles in a dream lose their tone, the mobility of the pharyngeal walls increases. When inhaling, the airways are deformed, the pulmonary ventilation stops. The lack of oxygen is a signal of distress to the brain and activates it.

He regains control of the muscles, opens the way for the flow of air, which leads to snoring. The following sounds are a repetition of a cycle, of which there are 400-500 per night, which means 3-4 hours in terms of time.

Symptoms of the snoring in women

Usually, strong snoring occurs when women sleep on their backs as a result of sagging muscles in the soft palate. But if this is observed when lying on your side, stomach, then this is a serious reason to get worried and consult a doctor.

Obstructive sleep apnea (OSA) is characterized by recurring nocturnal complete collapses (apnea) or partial collapses (hypopnea) of the upper respiratory tract during sleep. These events are associated with desaturation of oxygen and / or waking from sleep.

Women with snoring in their sleep complain of symptoms such as insomnia, restless leg syndrome, depression, nightmares, palpitations and hallucinations, while men report snoring and apnea episodes more often.

Women complain of frequent mood disorders, such as anxiety and depression, report poor quality of life in a number of questionnaires and show increased daytime fatigue, decreased quality of sleep, and worsening neurobehavioral symptoms.

Snoring while sleeping with the nose in women often occurs when the head cold, getting rid of which stops it. In a quarter of pregnant women, this phenomenon is also noted, since an enlarged abdomen crushes the trachea and lungs, and women often increase their weight in this position. Snoring in a dream is very common during pregnancy and, most likely, due to hormonal, physiological and physical changes. Maternal obesity, which is one of the main risk factors for respiratory distress during sleep, along with physiological changes during pregnancy.[24]

The prevalence of habitual snoring among pregnant women is estimated to be between 11.9% and 49% in the third trimester in cross-sectional studies. [25]Longitudinal studies have shown that habitual snoring (three or more nights a week) increases from 7-11% [26]in the first trimester of pregnancy to 16-25% in the third trimester [27].

Psychosomatics of snoring in women

The appearance of snoring in women is significantly affected by a psychological factor. They have such a wide range of emotions, from anxiety and anger to depression, [28], [29]  and sources of experiences that they often hide away, that if you lose control of your feelings during sleep, this results in snoring. 

Psychologists are advised to learn not to keep grudges in the soul, to let go of the past, to tune in positive thoughts, to struggle with complexes and to feel the importance of their existence in this world. With harmony in the soul, with deliverance from the emotional burden, sleep without snoring will be improved.

Complications and consequences

Snoring is not as harmless as it seems. In addition to inconvenience to others, it is dangerous to health, because it can lead to dangerous complications and consequences.

We are talking about obstructive sleep apnea (stop breathing during sleep). From this, 6-10% of people snore die, and after 50 years, these patients have heart attacks and strokes 2 times more often. Snoring is associated with a significant increased risk of cardiovascular disease in women [30], regardless of age, smoking, BMI, and other cardiovascular risk factors. [31], [32]Snoring is associated with an increased risk of developing type 2 diabetes, [33]hypertension [34].

Diagnostics of the snoring in women

Suspecting one or another reason for the occurrence of snoring, the therapist will refer you to various laboratory tests and consultations to narrow specialists: an otolaryngologist, an endocrinologist, a dentist.

Data from the University of Wisconsin's sleep lab showed that lower levels of snoring recognition in women compared to men are associated with the inability of women to recognize the symptoms of snoring and unwillingness to seek medical help or the inability of health workers to respond to the symptoms of snoring in women. [35], [36]

Difficulties in the correct diagnosis of female patients include such symptoms as depression and anxiety, which are also more common in women than in men without snoring. [37]

Currently, there is such a modern method of recording various functions of the human body during sleep, such as polysomnography. With its help, the work of the brain (electroencephalogram), eye movement (electrooculogram), cardiac activity (electrocardiogram), nasal and oral air flow, blood oxygenation, leg movements, snoring are recorded.

Methods of instrumental diagnostics help differentiate the diagnosis among all possible.

Treatment of the snoring in women

Personalized medicine has not achieved significant efficacy in treating snoring in women, despite different gender differences in symptoms.

The sleep doctor is engaged in sleep problems, and the science of sleep and its various disorders is called somnology. This is a fairly new area of medicine and, perhaps, not every clinic has such a specialist. Therefore, you first need to contact your local or family doctor, who, if necessary, refer to the right specialist.

Treatment usually consists of a set of methods, the choice of which depends on the causes and severity of the sleep disorder. Common in the treatment of all patients lies in a number of activities that are usually performed at home. We list them:

• sleep only on the side (tongue falls on the back) - in a dream it is impossible to control one's position, therefore, to accustom themselves to this attitude, they resort to tricks - between the shoulder blades of pajamas they sew a pocket into which they put, for example, a ball;
• sleep with a raised head - it is good to use contour cushions, ensuring its optimal position relative to the body;
• avoiding the use of sedatives and sedatives, relaxing muscles;
• alcohol restriction, especially in the evening;
• smoking cessation;
• weight loss;
• provision of free nasal breathing, use of vasoconstrictive drops in case of a head cold, surgical removal of polyps and curvature of the nasal membrane;
• the use of snoring devices (device for moving the lower jaw (MAD) and devices that hold the tongue (TRD), special nipples, sleep masks, Good Night rings); [38], [39], [40]
• feeding the airways with air; creating continuous positive airway pressure (CPAP) using a special apparatus. [41]

Remedies for snoring in women

There are various medications that are said to make breathing easier at night, for example, by acting on the muscles of the respiratory tract or by increasing control over breathing. Since it has not yet been proven that no medicine can help reduce snoring in sleep, it is currently not used as part of treatment. But drug data can be used to treat certain conditions that can cause snoring in a dream or aggravate an existing apnea.[42], [43]

Using pharmacological agents for snoring is not always effective, but can help in simple situations. One of these is the Asonor nasal spray.

It increases the elasticity and elasticity of the muscles of the soft palate, moisturizes the mucous membrane. The period of its action after application - 7-8 hours (enough for the whole night). The maximum effect is achieved by the second week.

Slipex - made on the basis of essential oils of medicinal plants (eucalyptus, peppermint), dissolved in water-glycerin mixture. Increases the tone of weakened muscles, relieves swelling of the tissues of the pharynx, thus preventing the tongue from falling. Apply inhalation (2-3 sprays) not earlier than 30 minutes after meals. The interval between procedures is 8 hours. There are isolated cases of hypersensitivity reactions.

Silence - spray with mint flavor, has a bioadhesive formula. The barrel is equipped with a dispenser. Before use, shake, remove the cap, put on the nozzle-sprayer and pressed until the foam. The jet is sent to the back of the throat and swallowed, then again.

The volume of snoring decreases already from the first night, and in a month it becomes very weak.

One of the most intriguing (and possibly the most controversial) aspects of future snoring therapy in women is hormone replacement therapy (HRT). To date, one small clinical trial has been conducted that demonstrated that estrogen use appears to have a significant effect on respiratory impairment indicators during sleep. [44]However, HRT has been shown to have significant risks, including an increased likelihood of cardiovascular disease, stroke, and cancer.[45]

Vitamins

Recently, obstructive sleep apnea syndrome and fatigue have been proven to be associated with vitamin D deficiency. [46], [47]

Nasal congestion, catarrhal diseases that cause snoring can be overcome using vitamins that increase the body's defenses: A, C, E, Group B, D. They can be ingested either with food or as a vitamin-mineral complex. 

Physiotherapy

The most common methods of physiological treatment of snoring include electrostimulation of the muscles of the pharynx and neck, as well as a series of exercises aimed at strengthening them. [48], [49]

Alternative treatment

Nasal saline irrigation (SNI), a therapy with roots in Ayurvedic medicine, which consists in irrigating the nasal mucosa with a spray or a liquid saline solution, [50]as well as herbal rinses [51]can be used as an additional aid for diseases of the upper respiratory tract.

From an alternative treatment, you can apply recipes, ingredients that envelop the mucous membrane, such as cabbage juice in combination with honey. Effectively gargle with a solution of sea salt or olive oil. Nose instilled sea buckthorn oil.

For rinsing also use herbal teas: oak bark in combination with calendula flowers. Inside you can take infusions of collecting such plants: horsetail, sabelnik root, elderberry.

Surgery

Surgical treatment is usually intended for severe snoring, or if other treatment strategies fail. However, the results of surgical interventions are often suboptimal: some patients require more than one operation, while others still show signs of snoring. The operation is most effective in patients with tonsils 4+, nasal polyps or other obstructive anatomical lesions.[52]

In case of an uncomplicated disease, laser or radiofrequency effects are applied to the soft palate. The reaction to the procedure is a burn, during the healing of which the tissues are compacted, the tension of the palate is created, the vibration is reduced.[53], [54]

A more radical method - uvulopalatofaringoplasty is used in case of respiratory arrest in sleep (apnea) with various pronounced anatomical defects. It consists in increasing the lumen of the respiratory passages at the level of the pharynx due to the removal of the tonsils, palatine arches, etc. [55]In 50% of patients the reduction in the snoring index was more than 95%.[56]

Gymnastics for snoring in women

The systematic repetition of the same exercises for a long period in the morning and evening leads to the strengthening of the muscles of the pharynx. The following are recommended, running 20-30 times in a row:

• maximum stick out the tongue for a few seconds and hide;
• move the jaw back and forth, resisting with the palm of your hand;
• firmly grip the pencil or stick in your teeth, then relax.

During physical activity, the respiratory muscles, especially the diaphragm, work with increased frequency. This leads to metabolic and structural adaptations that improve resistance. Endurance exercises can strengthen the muscles of the upper respiratory tract, increase the diameter of the upper respiratory tract, reduce the resistance of the respiratory tract.[57]

Prevention

To prevent snoring in women will help the implementation of the points that make up the treatment. This is a healthy lifestyle, fighting overweight, a [58]comfortable orthopedic bed, strengthening the muscles of the pharynx with the help of gymnastics, and at the same time facial contours can significantly reduce obesity rates and reduce the signs of snoring in women.

Forecast

It is possible to get rid of snoring, if not quite, then at least reduce its strength.