Snoring Treatment

Understanding Snoring: More Than Just a Nuisance

Snoring affects an estimated 90 million American adults—nearly 40% of adult men and 24% of adult women snore regularly. While often dismissed as a mere nuisance or source of jokes, snoring has significant implications for both the snorer and their bed partner:

• Disrupted sleep architecture for the snorer, reducing sleep quality even without conscious awakening
• Fragmented sleep for bed partners, leading to their own sleep deprivation
• Relationship strain from frustration, resentment, and separate sleeping arrangements
• Potential indicator of sleep apnea, a serious medical condition with significant health risks
• Daytime fatigue and reduced cognitive function from poor sleep quality

At Aloha Sleep Apnea & Airway Center, we take snoring seriously as both a quality-of-life issue and a potential health concern. Our approach addresses the root cause of snoring while ensuring any underlying sleep apnea is properly diagnosed and treated.

The Prevalence and Impact of Snoring

Snoring statistics reveal its widespread impact:

• 37 million Americans snore on a regular basis
• 59% of people report having a partner who snores
• Snoring is cited in 27% of surveyed couples as a factor in sleeping separately
• Bed partners of snorers may lose up to 1 hour of sleep per night
• Snoring severity tends to increase with age and weight gain

What Causes Snoring?

Snoring occurs when airflow through the mouth and nose is partially obstructed during sleep. As you breathe, air passes through narrowed passages, causing the soft tissues of the throat—including the soft palate, uvula, tongue base, and pharyngeal walls—to vibrate. This vibration produces the characteristic snoring sound.

The Mechanics of Snoring

During wakefulness, muscle tone keeps your airway open. During sleep, especially deeper sleep stages, muscle tone decreases naturally. In snorers, this relaxation allows soft tissues to partially collapse into the airway, creating:

1. Airway narrowing: Reduced space for air to flow
2. Increased airflow velocity: Air moves faster through the smaller opening
3. Tissue vibration: Soft palate, uvula, and throat walls flutter
4. Sound production: Vibration creates audible snoring

The louder the snoring, generally the greater the degree of airway obstruction.

Contributing Factors to Snoring

Multiple factors can contribute to snoring:

Anatomical Factors

Throat and Oral Structures:

• Large tongue (macroglossia) that falls back during sleep
• Enlarged tonsils and adenoids (especially in children)
• Elongated or thick soft palate and uvula
• Excess soft tissue in the throat
• Narrow pharyngeal airway

Nasal Factors:

• Deviated nasal septum
• Nasal polyps
• Chronic nasal congestion or allergies
• Turbinate hypertrophy (enlarged nasal structures)

Jaw and Facial Structure:

• Retrognathia (recessed lower jaw)
• Micrognathia (small jaw)
• Facial bone structure affecting airway
• High arched palate

Lifestyle and Behavioral Factors

Substance Effects:

• Alcohol consumption: Relaxes throat muscles, worsening snoring—especially within 3-4 hours of bedtime
• Sedative medications: Muscle relaxants, sleeping pills, antihistamines increase muscle relaxation
• Smoking: Causes airway inflammation and swelling

Weight and Body Composition:

• Excess weight: Fat deposits around the neck and throat narrow the airway
• Neck circumference > 17” (men) or > 16” (women): Strongly correlates with snoring
• Weight gain: Often correlates with snoring onset or worsening

Sleep Position:

• Supine (back) sleeping: Gravity pulls tongue and soft tissues backward
• Pillow position: Neck flexion can worsen airway obstruction

Age-Related Changes

As we age, snoring often increases due to:

• Decreased muscle tone in throat and tongue
• Tissue changes including increased laxity
• Weight redistribution and overall weight gain
• Hormonal changes (especially in women post-menopause)
• Accumulated effects of lifestyle factors

When Snoring Signals a Bigger Problem

Snoring is the most common symptom of obstructive sleep apnea (OSA), a serious medical condition where breathing repeatedly stops during sleep. The same airway narrowing that causes snoring, when more severe, causes complete obstruction.

Warning Signs That Snoring May Indicate Sleep Apnea

Observed Breathing Pauses:

• Bed partner witnesses episodes where you stop breathing
• Gasping, choking, or snorting to resume breathing
• Restless sleep with frequent position changes

Daytime Symptoms:

• Excessive daytime sleepiness despite “adequate” sleep
• Morning headaches
• Difficulty concentrating or memory problems
• Irritability or mood changes

Sleep Quality Issues:

• Waking unrefreshed despite sufficient hours in bed
• Frequent nighttime urination (nocturia)
• Night sweats
• Dry mouth or sore throat upon waking

Physical Risk Factors:

• Overweight or obese (BMI > 25)
• Large neck circumference
• High blood pressure
• Type 2 diabetes

Why Proper Diagnosis Matters

Important: We strongly recommend evaluation for sleep apnea before treating snoring alone. Treating snoring without checking for apnea can:

• Mask a serious condition: Snoring reduction doesn’t treat the breathing pauses of apnea
• Delay necessary treatment: Untreated sleep apnea increases cardiovascular and metabolic risks
• Provide false reassurance: Quiet sleep doesn’t necessarily mean healthy sleep
• Miss the opportunity for proper diagnosis and treatment

Sleep apnea must be diagnosed by a physician through a sleep study (polysomnography or home sleep test). We coordinate with sleep medicine physicians who can provide appropriate testing.

How Oral Appliances Treat Snoring

Custom oral appliances work by mechanically repositioning the lower jaw (mandible) and tongue forward during sleep. This simple but effective action:

Mechanism of Action

1. Jaw Advancement: The appliance holds the lower jaw in a slightly forward position (typically 5-10mm of advancement)

2. Airway Opening: Forward jaw position pulls the tongue base and attached muscles away from the back of the throat

3. Increased Pharyngeal Space: More room for airflow behind the tongue and soft palate

4. Reduced Tissue Vibration: Open airway means smoother, non-turbulent airflow

5. Quiet Breathing: Without vibration, snoring is eliminated or significantly reduced

Types of Oral Appliances for Snoring

Mandibular Advancement Devices (MADs):

• Most common type for snoring treatment
• Custom-fitted to both upper and lower teeth
• Adjustable to optimize jaw position
• Hold jaw forward during sleep

Tongue Retaining Devices (TRDs):

• Hold tongue forward directly using suction
• Less common, used in specific situations
• May be option for patients with few teeth

At Aloha Sleep Apnea & Airway Center, we primarily use mandibular advancement devices, as they’re more comfortable and effective for most patients.

Effectiveness for Snoring

Research demonstrates that oral appliances are highly effective for snoring:

Clinical Studies Show:

• 85-90% of patients report significant snoring reduction
• 50-70% achieve complete elimination or near-elimination of snoring
• Bed partner satisfaction is high due to quiet nights
• Improvements are often immediate once proper fit is achieved
• Long-term effectiveness is maintained with consistent use

Compared to Other Options:

Our Snoring Treatment Process

Step 1: Comprehensive Evaluation

During your initial consultation, we thoroughly assess your situation:

Snoring History:

• Duration and progression of snoring
• Loudness and frequency (every night, occasional)
• Positional patterns (worse on back, all positions)
• Partner observations and impact on relationship
• Previous treatments attempted

Risk Factor Assessment:

• Weight, neck circumference, body mass index
• Alcohol and medication use
• Sleep schedule and habits
• Nasal congestion and allergies
• Family history of snoring or sleep apnea

Physical Examination:

• Oral anatomy assessment (tongue size, palate, tonsils)
• Airway visualization and Mallampati classification
• Nasal examination for obstruction
• Jaw function evaluation
• Dental assessment for appliance candidacy

Step 2: Sleep Study Coordination

Before treating snoring, we help coordinate diagnostic testing:

Why Testing Is Essential:

• Rule out obstructive sleep apnea
• Establish baseline measurements
• Ensure appropriate treatment approach
• Satisfy insurance requirements
• Protect your health

Testing Options:

• Home Sleep Apnea Test (HSAT)—convenient, done in your own bed
• In-lab Polysomnography—if more detailed evaluation needed

We coordinate with sleep medicine physicians who order and interpret these tests.

Learn more about HSAT coordination →

Step 3: Custom Appliance Fabrication

Once testing confirms you’re an appropriate candidate:

Digital Impressions:

• Precise 3D scans of your teeth
• Bite registration for jaw relationship
• No messy impression materials

Appliance Selection:

• Device type selected based on your anatomy
• Consideration of dental factors and preferences
• Discussion of design options

Laboratory Fabrication:

• Custom manufacturing typically takes 2-3 weeks
• Made from high-quality, durable materials
• Designed for comfort during all-night wear

Step 4: Fitting and Initial Adjustment

When your appliance arrives:

Fitting Appointment:

• Precise adjustment for comfort and retention
• Verification of proper fit on both arches
• Initial jaw advancement setting

Patient Education:

• Insertion and removal techniques
• Cleaning and care instructions
• What to expect during adaptation
• When to contact us with concerns

Initial Advancement:

• Conservative starting position
• Balances effectiveness with comfort
• Room for gradual optimization

Step 5: Optimization and Follow-Up

Over the following weeks:

Titration (Progressive Adjustment):

• Gradual advancement of jaw position
• Monitoring for snoring improvement
• Balancing effectiveness with comfort
• Finding optimal position

Follow-Up Appointments:

• Assessment of snoring reduction (partner feedback essential)
• Side effect monitoring and management
• Appliance adjustment as needed
• Dental health check

Long-Term Care:

• Regular check-ups (typically every 6 months)
• Appliance maintenance and replacement when needed
• Monitoring for any changes

Benefits of Oral Appliance Snoring Treatment

For the Snorer

Improved Sleep Quality:

• Reduced vibration means less sleep disruption
• Better airflow for more restful breathing
• Decreased arousal frequency

Enhanced Daytime Function:

• More energy from better sleep
• Improved cognitive function
• Better mood and emotional regulation

Treatment Advantages:

• Non-invasive—no surgery or anesthesia
• Fully reversible—stop using if desired
• Portable—easy travel companion
• Comfortable—designed for all-night wear
• Quiet—no machine noise

For Bed Partners

Peaceful Nights:

• Elimination or significant reduction of snoring noise
• Uninterrupted sleep throughout the night
• Return to shared bedroom (if separated due to snoring)

Relationship Benefits:

• Reduced frustration and resentment
• Improved intimacy
• Better relationship quality overall

Their Health Improves Too:

• Better sleep quality for them
• Reduced sleep deprivation effects
• Improved daytime function

Compared to Other Treatments

Versus Surgery:

• No surgical risks, anesthesia, or recovery time
• Reversible if desired
• Can try before more invasive options
• Lower cost in most cases

Versus CPAP (if sleep apnea present):

• No mask, hose, or machine
• Completely silent
• Easy travel
• Higher compliance rates

Versus Over-the-Counter Devices:

• Custom fit for your anatomy
• Professional adjustment for optimal results
• Durable, long-lasting materials
• Monitored for dental health
• Significantly more effective

Over-the-Counter vs. Custom Professional Appliances

Understanding the difference is important:

Over-the-Counter “Boil-and-Bite” Devices

Characteristics:

• Generic one-size-fits-all approach
• Self-molded with hot water
• Purchased online or in stores
• $20-100 price range

Limitations:

• Inconsistent fit and comfort
• Often bulky and uncomfortable
• Cannot be precisely adjusted
• May cause jaw problems from poor fit
• Variable material quality
• Not appropriate for sleep apnea
• No professional monitoring

Custom Professional Oral Appliances

Characteristics:

• Precisely fitted to your unique anatomy
• Made from high-quality, durable materials
• Professionally designed and adjusted
• Comfortable for all-night wear

Advantages:

• Optimal fit maximizes effectiveness
• Adjustable to fine-tune jaw position
• Monitored for dental and jaw health
• Appropriate for sleep apnea treatment
• Long-lasting (3-5 years typically)
• Professional support and follow-up

The difference in outcomes is significant. Custom appliances consistently outperform OTC devices in both effectiveness and comfort.

Important Consideration: The Sleep Apnea Connection

Snoring and obstructive sleep apnea exist on a spectrum of sleep-disordered breathing:

• Simple snoring: Airway narrowing with vibration, no significant apneas
• Upper Airway Resistance Syndrome (UARS): Increased respiratory effort without frank apneas
• Obstructive Sleep Apnea: Complete or near-complete airway obstruction with breathing cessation

Why Proper Evaluation Matters

Treating snoring without evaluating for sleep apnea can:

1. Miss a serious diagnosis: Sleep apnea significantly increases cardiovascular, metabolic, and safety risks
2. Provide inadequate treatment: If apnea is present, snoring treatment alone doesn’t address the breathing pauses
3. Delay proper care: Early treatment of sleep apnea prevents long-term health consequences
4. Give false reassurance: Reduced snoring doesn’t mean the airway is functioning properly

Our Commitment

We always recommend sleep study evaluation before snoring treatment to ensure you receive appropriate, comprehensive care. If testing reveals sleep apnea, we provide oral appliance therapy that addresses both conditions. If testing confirms simple snoring without apnea, we proceed with snoring treatment with confidence.

Special Considerations

Snoring in Women

Snoring in women is often underreported and underdiagnosed:

• Women may describe symptoms differently (fatigue, insomnia vs. snoring, apneas)
• Hormonal changes, especially menopause, increase snoring risk
• Body weight distribution differs from men
• Women may be less likely to report snoring due to social stigma

Women experiencing snoring or sleep-related symptoms deserve the same thorough evaluation as men.

Snoring During Pregnancy

Pregnancy increases snoring risk due to:

• Weight gain and fluid retention
• Hormonal effects on airway tissue
• Nasal congestion from increased blood flow

Snoring during pregnancy may indicate gestational hypertension risk and warrants discussion with your OB provider.

Pediatric Snoring

Snoring in children is never normal and should be evaluated:

• Common causes include enlarged tonsils and adenoids
• Can affect growth, development, and behavior
• May cause or mimic ADHD symptoms
• Often resolved with adenotonsillectomy
• Oral appliances may help in certain cases

We assess pediatric patients and coordinate with ENT specialists when appropriate.

Start Your Journey to Quiet Nights

Don’t let snoring disrupt your sleep, your relationships, and your quality of life any longer. Whether you’re the snorer or the frustrated partner, we’re here to help.

At Aloha Sleep Apnea & Airway Center, we provide comprehensive snoring evaluation and treatment for patients throughout Aloha, Hillsboro, Beaverton, Portland, and the greater Oregon metro area.

Schedule a consultation to learn how oral appliance therapy can help you—and your partner—enjoy peaceful, restful nights.

Note: Home sleep apnea testing (HSAT) is ordered and interpreted by a physician. We coordinate testing and provide oral appliance therapy in collaboration with the patient’s sleep physician, ensuring that any underlying sleep apnea is properly diagnosed and treated alongside snoring.