Snoring

Overview of Snoring

Snoring is estimated that 25% of adult males and 15% of adult females snore. Its prevalence increases with age

• Sleep apnea. It is cessation of breathing that lasts for 10 s or more during sleep. Less than five such episodes is normal.
• Apnea index. It is number of episodes of apnea in 1 h.
• Hypopnea. It is reduction of airflow. Some define it as drop of 50% of airflow from the base line associated with an EEG defined arousal or 4% drop in oxygen saturation.
• Respiratory disturbance index (in other words, RDI). Also called apnea– hypopnea index. It is the number of apnea and hypopnea events per hour. Normally RDI is less than five. Based on RDI, severity of apnea has been classified as mild, 5–14; moderate, 15–29; and severe ≥ 30.
• Arousal. Transient awakening from sleep as a result of apnea or respiratory efforts.
• Arousal index. In detail, It is number of arousal events in 1 h. Less than four is normal.
• Sleep efficiency. Minutes of sleep divided by minutes in bed after lights are turned off.
• Multiple either sleep latency test or nap study. Patient is given four or five scheduled naps usually in the daytime. Latency period from wakefulness to the onset of sleep and rolling eye movement (in other words, REM) sleep are measured. It is performed when narcolepsy is suspected or daytime sleepiness is evaluated objectively.

Indian epidemiology then other

Causes of Snoring

In children most common cause is adeno-tonsillar hypertrophy. In adults cause of snoring could be in [1]

The nose or nasopharynx such as

• Septal deviation,
• Turbinate hypertrophy,
• Nasal valve collapse,
• Nasal polypi or
• Tumors;

In oral cavity and oropharynx such as

• Elongated soft palate and uvula,
• Tonsillar enlargement,
• Macroglossia,
• Retrognathia,
• Large base of tongue; or
• Its tumor;

In the larynx and laryngopharynx such as

• Laryngeal stenosis or
• Omega-shaped epiglottis.

Other causes include obesity and thick neck with collar size exceeding 42 cm. Use of alcohol, sedatives and hypnotics aggravates snoring due to muscle relaxation.[1]

AAA

Risk factors are things that make you more likely to develop a disease in the first place.

Pathogenesis refers to the development of a disease. It’s the story of how a disease gets started and progresses.

This is the entire journey of a disease, encompassing the cause but going beyond it.

Pathophysiology of Snoring

Muscles of pharynx are relaxed during sleep and cause partial obstruction. Breathing against obstruction causes vibrations of soft palate, tonsillar pillars and base of tongue producing sound. Sound as loud as 90 dB has been recorded during snoring. Snoring may be primary, i.e., without association with obstructive sleep apnea (OSA) or complicated, i.e., associated with OSA. Primary snoring is not associated with excessive daytime sleepiness and has apnea–hypopnea index of less than five.[1]

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Sign & Symptoms

Excessive loud snoring is socially disruptive and forms snoring-spouse syndrome and is the cause of marital discord sometimes leading to divorce. In addition, a snorer with obstructive sleep apnea may manifest with:

• Excessive daytime sleepiness
• Morning headaches
• General fatigue
• Memory loss
• Irritability and depression
• Decreased libido
• Increased risk of road accidents

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Complications are what happen after you have a disease. They are the negative consequences of the disease process.

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Treatment

1. Avoidance of alcohol, sedatives also hypnotics.
2. Reduction of weight.
3. Sleeping on the side rather than on the back.
4. Removal of obstructing lesion in nose, nasopharynx, oral cavity, hypopharynx and larynx. Radiofrequency has been used for volumetric reduction of tissues of turbinates, soft palate and base of tongue.
5. Performing uvulopalatoplasty (UPP) surgically with cold knife or assisted with radiofrequency (RAUP) or laser (LAUP).[1]

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Homoeopathic Treatment for Snoring

Homeopathy treats the person as a whole. It means that homeopathic treatment focuses on the patient as a person, as well as his pathological condition. The homeopathic medicines are selected after a full individualizing examination and case-analysis, which includes the medical history of the patient, physical and mental constitution, family history, presenting symptoms, underlying pathology, possible causative factors etc.

A miasmatic tendency (predisposition/susceptibility) is also often taken into account for the treatment of chronic conditions.

Homeopathy Doctor

A homeopathy doctor tries to treat more than just the presenting symptoms. The focus is usually on what caused the disease condition? Why ‘this patient’ is sick ‘this way’. The disease diagnosis is important but in homeopathy, the cause of disease is not just probed to the level of bacteria and viruses. Other factors like mental, emotional and physical stress that could predispose a person to illness are also looked for.

Now a days, even modern medicine also considers a large number of diseases as psychosomatic. The correct homeopathy remedy tries to correct this disease predisposition. The focus is not on curing the disease but to cure the person who is sick, to restore the health. If a disease pathology is not very advanced, homeopathy remedies do give a hope for cure but even in incurable cases, the quality of life can be greatly improved with homeopathic medicines.

Homeopathic medicines for Snoring

The homeopathic remedies (medicines) given below indicate the therapeutic affinity but this is not a complete and definite guide to the homeopathy treatment of this condition. The symptoms listed against each homeopathic remedy may not be directly related to this disease because in homeopathy general symptoms and constitutional indications are also taken into account for selecting a remedy.

Amm-c.—

*Stoppage of nose mostly at night; must breathe through mouth (Nux-v.). Without any cold. Starts up every time the child tries to go to sleep.

Argentum nitricum

Coryza at first dry, then moist, discharging thick, yellow, purulent mucus, mingled with clots to blood; chilliness, lachrymation, sneezing [3]

Arum Triphyllum

Profuse coryza, discharge burning and ichorous, making nostrils and lips sore; feverishness and hot, dried skin; child picks at his skin, even producing raw places

Calcarea Carb

Nose dry and of offensive smell, nostrils sore and ulcerated, discharge thick and pus-like, or thin and watery; moist during day and dry at night; enlargement of glands; profuse sweat, especially about head and feet; hoarseness; very susceptible to external influence, currents of air, cold, heat, noise, excitement.

Cham.

Nose runs, yet stuffed; one cheek red, the other pale; characteristic irritability. [3]

Graphites

Herpetic children, catching cold easily; dryness of nostrils, or alternate flowing and dryness; cracked also ulcerated nostrils; bloody mucus or thick foetid discharge; frequent sneezing. [3]

Kali Carb

Anemic children of cachectic appearance, with puffy swelling over upper eyelids, especially mornings; cannot breathe through nostrils in a warm room, (>) in open air; nostrils raw also bleeding; profuse, fetid, yellow-green discharge.[3]

Lycopodium

Dry from of chronic coryza, with much sneezing during the day and complete closure at night, so that child breathes with mouth open (Elaps) and protruding tongue; constipation, flatulency; coryza extending down air-passages; causing with loose expectoration; child starts out of sleep; rubbing its nose.

Nux-v

Coryza fluent during day; stopped at night; nose dry and stuffed; breathes through mouth. "Coryza prevents infants from breathing while nursing; worse especially at night and towards morning."[3]

Samb.

"Child suddenly awakens nearly suffocated, sits up in bed and turns blue; grasps for breath, which it finally gets, then lies down again in bed, to be aroused again sooner or later by another spell." "Nose perfectly dry and completely obstructed, preventing breathing also nursing; constant snuffles." Child *inspires but cannot expire (Chlorine, Mephitis). Lastly, Edematous swelling in nose giving rise to snuffles.

Sticta.

Nose stuffed up. Constant need or inclination to blow nose, but nothing is discharged; excessive dryness of nose. (Tertiary syphilis.)

1. Lose weight if you are higher-weight person.

Generally, This will help reduce the amount of tissue in the throat that might be causing your snoring. You can lose weight by reducing your overall caloric intake by eating smaller portions and more healthy foods. Additionally, Make sure you get regular exercise daily. You may also consider seeing your doctor or a nutritionist for help.[2]

2. Sleep on your side.

Sleeping on your back sometimes causes the tongue to move to the back of the throat, which partly blocks airflow through your throat. Furthermore, Sleeping on your side may be all you need to do to allow air to flow easily and reduce or stop your snoring.

3. Raise up the head of your bed.

Elevating the head of your bed by four inches may help reduce your snoring by keeping your airways open.

4. Use nasal strips or an external nasal dilator.

Stick-on nasal strips can be placed on the bridge of the nose to help increase the space in the nasal passage. This can make your breathing more effective also reduce or eliminate your snoring.

You could also try a nasal dilator, which is a stiffened adhesive strip that’s applied on top of the nose across the nostrils. This can decrease airflow resistance, making it easier to breath.

Try nasal strips to help reduce snoring.

5. Treat chronic allergies.

Allergies can reduce airflow through your nose, which forces you to breathe through your mouth. Additionally, this increases the likelihood that you’ll snore. Talk to your doctor about what kind of over-the-counter or prescription allergy medications may improve your condition.

Buy over-the-counter allergy medication now.

6. Correct structural problems in your nose.

Some people are born with or experience an injury that gives them a deviated septum. Additionally, This is the misalignment of the wall that separates both sides of the nose, which restricts airflow. In detail, It may cause mouth breathing during sleep, causing snoring. It may be necessary to get surgery to correct this condition. Talk to your doctor.

7. Limit or avoid alcohol before bed.

Try not to consume alcohol for at least two hours leading up to your bedtime. Alcohol can relax the throat muscles, causing snoring.

8. Avoid taking sedatives before bed.

If you snore and take sedatives, talk to your doctor to see what your options are. Stopping sedative use before bed may ease your snoring.

9. Stop smoking.

Smoking is an unhealthy habit that can worsen your snoring. Talk to your doctor about therapies — such as gum or patches — that can help you quit.[2]

 10. Get enough sleep.

In Brief, Make sure you get the recommended seven to eight hours of sleep you need each night.

11. Use an oral appliance.

Dental mouthpieces called “oral appliances” can help keep your air passages open, making it easier for you to breathe. This prevents snoring. Lastly, You need to see your dentist to get one of these devices made.

12. Use a CPAP (continuous positive airway pressure) machine.

If medically appropriate, wearing a pressurized air mask over your nose when you sleep can help keep your airway open. In detail, this treatment is often recommended to treat obstructive sleep apnoea.

13. Wear palatal implants.

Also called the “pillar procedure,” this treatment involves injecting braided strands of polyester filament into your mouth’s soft palate. Lastly, This stiffens it to reduce snoring.

14. Get UPPP (uvulo-palato-pharyngo-plasty).

This type of surgery tightens throat tissue in the hopes it will reduce snoring. Laser-assisted uvulo-palato-pharyngo-plasty (LAUPPP), which is sometimes more effective than UPPP, is also available.

15. Radiofrequency tissue ablation (somno-plasty).

This new treatment uses low-intensity radio waves to shrink the tissue on your soft palate to reduce snoring.[2]

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Reference use in Article Snoring

[1] Diseases_of_Ear_Nose_and_Throat_6E

[2] https://www.healthline.com/health/snoring-remedies#_noHeaderPrefixedContent

[3] Homoeopathic Therapeutics by Lilienthal

Frequently Asked Questions

What is Snoring?

Snoring is an undesirable disturbing sound that occurs during sleep.

Homeopathic Medicines used by Homeopathic Doctors in treatment of Snoring?

• Ammon carb.
• Argentum nitricum
• Arum Triphyllum
• Calcarea Carb
• Graphites
• Kali Carb
• Lycopodium
• Nux-v

What are the reasons of Snoring?

• Adeno-tonsillar hypertrophy
• Septal deviation
• Turbinate hypertrophy
• Nasal valve collapse
• Elongated soft palate and uvula
• Tonsillar enlargement
• Laryngeal stenosis
• Omega-shaped epiglottis

What are the symptoms of Snoring?

• Excessive daytime sleepiness
• Morning headaches
• General fatigue
• Memory loss
• Irritability and depression
• Decreased libido
• Increased risk of road accidents