DEAR MAYO CLINIC: Is there anything that can be done for snoring other than using a CPAP machine? I have tried using one for the past year, and while my wife says it does prevent me from snoring, I cannot sleep comfortably with it on.
ANSWER: Although they do reduce snoring, continuous positive airway pressure, or CPAP, machines usually are prescribed for people who have sleep apnea, and not for snoring alone. If your snoring is a symptom of sleep apnea, there are a number of steps you can take to try to make the CPAP machine more comfortable. Other treatment options and lifestyle changes may help, too. If the problem is confined to just snoring, then a variety of alternatives are available.
Sleep apnea is a serious medical condition in which breathing stops and starts repeatedly during sleep. Loud snoring is a common symptom. A CPAP machine relieves sleep apnea by delivering air pressure through a mask placed over your nose while you sleep. With CPAP, the air pressure is somewhat greater than that of the surrounding air, so it keeps your upper airway passages open, preventing apnea and snoring.
CPAP is the most common and reliable way to treat sleep apnea. But the machine can be cumbersome or uncomfortable. Before you go to a different approach, you could try working with the company that supplies your CPAP machine to find a more comfortable mask. Adding heated humidity to the CPAP or lowering the CPAP pressure slightly also may make it easier to tolerate. Before you make these changes, though, talk to your doctor.
With an order from your doctor, you also could switch to a different device. One alternative is a unit that provides what is known as bilevel positive airway pressure, or BIPAP. It delivers more pressure when you inhale and less when you exhale, and tends to be better tolerated than CPAP. Another option is an oral appliance designed to advance your lower jaw to keep your throat open. This type of device is not as reliable as CPAP, but it usually is more comfortable.
You also could try nasal valves. These small, single-use devices are placed over each nostril. They allow air to move in freely. But when you exhale, air must go through small holes in the valve. This increases pressure in the airway and keeps it open.
Weight loss can often help relieve sleep apnea and decrease snoring. If you are overweight, talk to your doctor about creating a weight-loss plan. For many people, returning to a healthy weight can cure sleep apnea.
If you have been using CPAP only for snoring, a number of other remedies may be helpful. First, try a few lifestyle changes. Avoid alcohol, especially before bedtime. It relaxes the muscles in the back of your throat, increasing snoring. Sleep on your abdomen or side, rather than on your back. Sleeping on your back can cause your tongue and soft palate to rest against the back of your throat and block your airway.
If those measures are not enough to eliminate snoring, talk to your doctor. He or she may recommend an oral appliance. These custom-fit dental mouthpieces position your tongue and soft palate to keep your air passage open as you sleep. Or, in a treatment called the pillar procedure, a doctor can insert braided strands of polyester filament into your soft palate, which stiffens it and reduces snoring. Surgery to reduce snoring, which involves trimming and tightening the excess tissue in your throat, also may be an option.
Finally, in some situations, consultation with an ear, nose and throat, or ENT, specialist is appropriate. An ENT evaluation may reveal that nasal obstruction is causing snoring. That type of obstruction can often be effectively eliminated with medical or surgical treatment. ā Joseph Kaplan, M.D., Pulmonary and Critical Care Medicine, Mayo Clinic, Jacksonville, Fla.