Do you (or someone you love) snore loudly? Interested in learning what we really know about conservative approaches, including some that are advertised that may not be helpful at all? I perform snoring and sleep apnea surgery all the time, but I use these steps all the time in taking care of my patients. This blog post may save you time and hassle but also help everyone get better sleep!

Snoring is common and can be important, for many reasons

Snoring affects well over 100 million Americans. Because the focus of my career has been snoring and sleep apnea surgery, patients (and friends) ask me all the time what they should do for their snoring—or for their loved ones who snore. While I am available for a formal snoring and sleep apnea surgery evaluations, whether contacting my offices for an appointment or video consultation, there are some basic first steps one can take.

To know where to start, you first need to collect more information. Ask the same questions I ask on my new patient questionnaire. Those who complain about your snoring should have plenty of information to guide you. How often and how loud is the snoring?  Is there any choking or gasping for air? Does anything make the snoring better or worse, whether sleeping on your back, drinking alcohol within 3 hours before going to bed, recent changes in body weight, being especially tired, or blockage in breathing through the nose?

Although people often joke about snoring and the challenges of getting a good night’s sleep next to someone who does, it can be the sign of a more-serious medical condition called obstructive sleep apnea. The entries on this blog should never be considered medical advice, so you should see a medical provider in person if there are any warning signs of sleep apnea. These include frequent choking or gasping for air while asleep; loud snoring that wakes up others and does not clear up with some of the basic steps outlined here; or poor sleep quality that can cause sleepiness or fatigue. You should also see a medical provider if you have significant medical concerns, such high blood pressure, heart disease, diabetes, or memory loss.

Here are some options that can stop your snoring:

There are many approaches that I will use in my snoring and sleep apnea surgery patients, whether as first steps or in conjunction with snoring and sleep apnea surgery.

1. Sleep on your sides or stomach instead of on your back.  Sleeping on your back worsens snoring and breathing at night for many people, and someone else can tell you if the snoring occurs only when sleeping on your back. I actually use this approach (positional therapy) with many of my sleep apnea surgery patients, as some procedures work better when patients are sleeping on their sides. If you want to sleep on your side but are unable to stay in that position, there is a silly trick involving a T-shirt and tennis balls that can minimize the amount of time you spend on your back. There are also a number of devices you can buy that work similarly by making it uncomfortable to sleep on your back. Although this can be helpful, it may not work for you because you are more comfortable sleeping on your back or just not comfortable on your sides (you develop shoulder or back pain, for example).

2. Avoid alcohol or other sedatives within 3 hours before bedtime. Think of sleeping as somewhat like driving. You want the alcohol to clear out of your system before you go to bed, as alcohol has a number of negative effects on snoring and sleep. The same is true for other sedatives and many recreational drugs.

3. Avoid most sleeping pills, including many over-the-counter antihistamines.  Many sleeping pills relax muscles and have negative effects on snoring and sleep, similar to alcohol. Antihistamines like diphenhydramine (the generic name for Benadryl) is an active ingredient in many over-the-counter medications (like Tylenol PM) and can have the same negative effects on sleep, surprisingly. Not all sleep aids worsen snoring and sleep quality, but it is good to ask your medical provider if you are not sure.

4. Lose weight. This is especially important if your snoring started or worsened substantially with weight gain. Of course, losing weight is always easier said than done, so for people who have been unable to lose weight easily, I tell them to continue trying but also discuss other treatments. Over the past several years, new medications have been developed to assist patients in their weight loss journey. I do not prescribe these medications but do recommend them for some patients (even some planning sleep apnea surgery) in whom weight loss can be beneficial.

5. Make sure you are getting enough sleep. Snoring tends to be worse when people are tired, generally because people are trying to get more deep sleep, where the muscles in your body are more relaxed. This leads to more snoring or blockage of breathing during sleep (the issue with obstructive sleep apnea). If you are able to get 7-8 hours of sleep on a typical night, your snoring should improve.

6. Make sure your pillows are helping you—or at least not hurting you.  There is no special pillow to buy to end snoring, as you really just want a pillow that is comfortable. The one thing to think about is that the way your head rests when you sleep can matter.  An excellent Australian study showed that tilting the head forward (chin towards the chest) worsens breathing patterns and that tilting the head backwards has the opposite effect. Pillows advertised as “snore pillows” tilt the head backwards and can improve snoring in some people, but there is no reason to buy these if you can use your own pillows properly.  The bottom line: using large or too many pillows may be soft for your head but bad for snoring and breathing patterns. Make sure your pillow keeps your head tilted slightly backwards or in a neutral position.

7.  Sleep with your head elevated. Some people notice major benefits to sleep in a recliner, on a foam wedge, or even with a few pillows arranged to form an incline similar to a wedge. However, this is often not comfortable or practical as a long-term solution. There are many advertisements for adjustable beds to suggest that they clear up snoring, but the benefit is limited for most patients, so I never recommend these.

8. Avoid dehydration. Dehydration leads to thickened mucus in the mouth and throat, which can cause the surfaces inside to stick together and cause or worsen snoring.  Snoring sprays, which do not work for most patients, are mainly oils that reduce this tendency for sticking together. Drinking enough fluids during the day can reduce snoring in people who are dehydrated. That being said I do not recommend drinking a large amount of fluids right before bedtime because you may wake up from sleep to use the bathroom.

9. (Be able to) breathe easily through your nose. Mouth breathing often worsens snoring and breathing patterns during the night. Mouth breathing is complicated and occurs for a variety of reasons. If it is caused by being unable to breathe through the nose, it is important to open the nasal passages. Common causes of blocked nasal breathing include allergies, a deviated septum, and enlarged inferior turbinates, all of which require evaluation by a medical provider to discuss treatment. Treatment involves a range of options, including possible snoring or sleep apnea surgery, and a careful evaluation is the first place to start.

10. Be careful with mouth taping. Mouth taping have become nothing short of an obsession for some. I am not in that camp. The evidence on the benefits of mouth taping is, to put it kindly, limited. This lack of evidence has not prevented aggressive marketing. That being said, I tell my patients with simple snoring that they can try mouth taping if they like, but they should not expect results quite as dramatic as what the marketers and influencers would suggest. The results in my patients have matched the research evidence: some patients do have benefit, but for many mouth taping offers no help. The short answer is that mouth tape is a bad idea if you cannot breathe easily through your nose. I have written before about how mouth taping does not help most patients with obstructive sleep apnea and mouth taping for CPAP users with mouth breathing, so be wary if you have sleep apnea or some of the warning signs and symptoms of sleep apnea.

11. Stop smoking or vaping. Studies show that smokers are more likely to quit smoking or vaping if their medical provider tells them to do so. If you smoke or vape…STOP! It will be the best thing you do for your health. Smoke causes irritation of the lining of the nose and throat, and quitting can reduce your snoring—or eliminate it entirely.

12. Watch the outside of your nose while breathing. Some people have substantial collapse of the sides of their nose when they breathe. In my office, I start to examine the nose by watching my patients breathe, and you can do the same at home by watching yourself in the mirror. People with marked collapse of the sides of their nose can respond well to external nasal dilator strips (the most common ones are Breathe Right strips) or some devices that are placed in the nostrils to prop them open from the inside.

13. Discuss evaluation and treatment with a medical provider. An appointment can help determine which of these makes the most sense for you or whether other evaluations are appropriate, such as a sleep study to test for obstructive sleep apnea. You can also discuss appropriate treatment options from among the wide range of options, including snoring and sleep apnea surgery.

For more information about snoring and sleep apnea surgery options, please feel free to contact me via e-mail, find information on a video consultation or scheduling an appointment, or review the information available on www.sleep-doctor.com.