Millions of Americans snore substantially. The ubiquity of snoring is pervasive in our culture; TV and radio shows depict people snoring for a laugh, or simply to demonstrate they are sleeping. For many, there is a simple one-to-one relationship between snoring and sleeping, such that it seems like you’re supposed to snore when you’re asleep.  It’s almost like it’s an inevitable part of the human condition.

Well, the problem is that snoring is not necessarily “normal.” On the most fundamental level, snoring is just the noise resulting from vibration of soft tissues in your throat while you breathe during sleep.  However, there is the potential for health effects with longstanding log-sawing.  Nonetheless, it’s very common for people to blow off concerns for their snoring.  Some potential reasons:

1. It’s so common. Millions of people in the U.S. are obese too, but that fact doesn’t make obesity normal, either.
2. You’re not awake to hear the snoring. By definition you don’t snore unless you’re sleeping, and you’re unaware of what is happening while you are asleep, so frequently people don’t think they snore, even when their spouses or bed partners complain bitterly about their nightly snoring noises.

Through the years I’ve heard all sorts of comments from incredulous loud snorers dragged into my clinic by angry spouses (usually wives, but husbands too). Some examples, often resulting in a dirty look or a punch in the arm by the spouse:

“Well, SHE snores loudly too!”
“She has a tendency to exaggerate things.”
“I don’t have that.”
“It’s really not a problem. She’s just making it a problem.”
“I’m telling you, I don’t snore. I don’t remember ever snoring.”
“Nobody has ever told me I snore except for HER.”

One time a man came to see me with his wife, who pulled out her iPhone and played back some audio of his intolerable snoring, only for him to reply, in all seriousness, “That wasn’t really me.”

On another occasion, a gentleman visited me in my clinic and told me when first sat down to talk, “I’m here as a birthday present for my wife.”

There are some very real reasons to take snoring seriously:

1. Marital and relationship discord. I’ve had patients actually get divorced in part because of the snoring, not necessarily because of the noise itself, but because of the spouse’s frustration in not being believed or taken seriously. That’s extreme, of course, but think about the millions of bed partners whose sleep is constantly disrupted by loud, open-mouthed snoring in close proximity. It would be maddening, right?  Many have to sleep elsewhere in the house or time their bed schedules just right to minimize prolonged awakenings.  Slowly, insidiously, this problem can wreck a whole family’s quality of life.
2. Loud snoring is often associated with obstructive sleep apnea.  Sleep apnea is a breathing disorder in sleep, in which one’s upper airway actually collapses or closes episodically during sleep.  This is a medically dangerous problem, associated with an increased risk for heart disease, early stroke and heart attack, hypertension, and sudden cardiac death.  Though you don’t need to snore loudly to have sleep apnea and you don’t have sleep apnea just because you snore loudly, often sleep apnea and loud snoring can go hand in hand, and the snoring can be a tipoff for your doctor to a problem with your breathing.
3. Snoring itself may be associated with medical problems. This is the subject of intense research at the moment, but there are suggestions now in the medical literature that snoring may be an independent risk factor for metabolic diseases and cardiac problems.

How can you tell if your snoring is loud? Loudness is a relative term; I’ve had patients who delayed medical evaluation for years, for example, despite very substantial snoring, because the spouse is hard of hearing and unaware of the snoring and breathing pauses during sleep. Some general benchmarks that suggest loud snoring:
1. If it can be heard in other rooms, or other floors, of the house. I’ve had patients whose neighbors next door or ACROSS THE STREET (no joke) called them to complain of their snoring.
2. If it regularly awakens the bed partner from a sound sleep.
3. If it is louder than an ordinary, casual conversational voice.

Bottom line from tonight’s post:  loud snoring is not normal just because many people snore loudly.  My recommendation is that loud snoring be reported to one’s primary care physician. In future posts I’ll discuss what to do to help the “heroic” snorer. If a loved one is having clearly witnessed breathing pauses during sleep, I strongly recommend that the snorer see someone like me, a physician sleep specialist, for the consideration of breathing problems during sleep.

Have a great evening, all!