SPECIAL FROM Next Avenue
By Kathy Mandry
Is there a cure? A loud, chronic snorer investigates all her options
It’s bedtime. I slip into my favorite flowered pajamas, brush my teeth, wash my face, smooth on moisturizer, dab on eye cream, comb my hair back away from my face. As I size up my reflection in the mirror, I know my attention to beauty will not prevent me, once asleep, from turning into a beast.
Indelicate as it may be, I snore.
My snoring is so resonant that it shakes the bed. Martin, my husband, thinks he could manage if I produced a steady, lulling, bass rhythm. "It would be more like white noise," he says. But it's a lot louder than that.
"Record me," I've told him.
But he says I wouldn’t want to hear it, that I would be shocked.
Maybe not. I come from a line of champion snorers. My mother and her siblings could shudder floorboards, rattle windowpanes, emit creepy animal sounds in the night.
It’s hard to take ownership of something you can’t hear yourself doing. When I am awakened by a "Stop snoring!" I am usually tangled up deep in a dream. Another rude awakening -- "Roll over!" -- and I can’t get back to sleep.
I’ve learned to move to the couch with my quilt and pillow, or to the small lounge in my office, or to my son’s old room. Some nights I just tuck in elsewhere from the start.
(More: How to Enjoy Better Sleep)
I’m hardly alone. USA Today reports that 27 percent of couples over the age of 40 sleep in separate bedrooms due to snoring.
According to the Dental Tribune International, an online publication for dentists, some 90 million Americans snore. That figure includes 60 percent of men -- and 40 percent of women -- over the age of 50.
Why more mid-lifers? As we get older, our breathing passages narrow, and air rushing through the tighter spaces creates vibration in the saggier soft tissue at the back of the mouth. Ergo, loud snoring.
There is, however, a difference between the sexes. When a man snores, everyone cracks jokes. When a woman snores, no one wants to talk about it. It’s just not feminine.
But if I ever hope to be cured, I have to find a solution. Over the last few years, that has meant talking to a lot of people and asking a lot of questions.
So Many Cures, So Little Relief
I started snoring in my 40s, an occasional blip in the night. Going full-bore now in my 60s, I expected medical science would have come up with a snore cure in these intervening years.
The snoring advice listed by WebMD is practical: no back sleeping, lose weight, stop smoking, avoid alcohol, practice good sleep hygiene, open nasal passages, change the pillows, stay hydrated.
Except for drinking wine with dinner (okay, sometimes a little before or after), I already do all those things. My weight is normal. I don’t have allergies.
As I’ve learned, snoring solutions are big business. You can find a plethora of over-the-counter products: nasal strips, chin straps, mouthpieces, nasal sprays, supplements, pliable nasal breathing aids. Some things work for some people. None of them worked for me.
A while back, while I was driving to meet a friend, an ad on my car radio touted a special pillow that promised not only to better align the neck and head, but to stop the snoring. I raced to the designated sleep shop and bought the pricey thing. My neck felt better in the morning, but I snored as usual during the night. In subsequent radio ads, the snoring claim was dropped.
A Doctor's Remedies and Confession
Last winter, during my annual physical, I confided in my primary doctor. He laughed. He said if he’d known in medical school that snoring would be the most common complaint among his patients, he might never have finished. Turns out, he snores too, and his wife won’t wear earplugs. It’s his problem, she says, he should fix it.
"With two kids away in college," he told me, "there are plenty of spare beds in my house, but when your partner banishes you from the bedroom, well, I can tell you what I do."
He then gave me three possible remedies:
Use Flonase at bedtime. This nasal spray is available only by prescription. Some nights it helped a little, but other nights I still snored.
Watch my wine intake. So I watched it — and saw my husband morph into a wine cop with warning looks and bedtime interrogations. "How many glasses?" he’d ask. I found out that I can snore after just one glass, though not as badly as when I have two or more glasses. I also found out that I can snore when I drink no wine.
Ask my dentist about a customized oral appliance. The device is designed to move the lower jaw and tongue slightly forward to open up the airway. But my dentist told me he’s seen erosion of the jaw joints from such appliances and wouldn’t recommend one.
My doctor also urged me to ask my husband to describe my snoring patterns to rule out choking or gasping sounds, which could signal sleep apnea. Unlike ordinary snoring, apnea is a serious, even life-threatening, condition.
Martin did not report choking or gasping sounds. Except for loud snoring, I apparently did not fit the Mayo Clinic’s description of apnea: observed episodes of breathing cessation during sleep, abrupt awakenings with shortness of breath, waking up with a dry mouth or sore throat, insomnia, a morning headache.
Nope, I just snore.
Searching for a Snoring Solution
A few months ago, I was thrilled to see an ad in my local paper for a new clinic specializing in medical solutions to snoring problems. They promised a cure. I raced over to the address and found myself ensconced in a slick and tony space in an upscale, downtown San Francisco mall.
"There are reasons why you snore," said the clinic’s ENT as he examined me. He showed me images of my saggy soft palate, enlarged nasal turbinates and slightly enlarged tongue. He offered to implant plastic coils into my palate (the pillar procedure) to stiffen it up, and to perform coblation on my turbinates (the removal and shrinkage of nasal tissue masses).
He could do all that right then and there -- for a few thousand dollars. Later, he might also need to take away part of my uvula, that dangly thing that hangs at the back of the mouth.
His other suggestion: a sleep study, just in case I do have apnea (it would be a more reliable indicator than my husband). The sleep study can be done in a sleep lab or at home. Your face, head and chest are wired up to a small box that records the biophysical changes that occur during sleep, including respiratory airflow, which could indicate apnea. If I was diagnosed with apnea I’d have to use the CPAP machine, a small, noisy air-pressure generator that connects to a nasal mask you wear while sleeping. I told him I’d think about all those options.
It’s unrealistic to believe my snoring will somehow get better on its own. For that reason, I’m still considering a customized oral appliance and a sleep study.
I also just learned of a small nasal gadget for apnea called the Provent device, which was recently approved by the FDA. According to ABC News, it worked on about half the people who've tried it. It’s worth checking out.
And I haven’t ruled out a surgical procedure. But if I’m going to go that route, I want it to work — insurance doesn’t cover the expense. That's not the only thing that gives me pause: I ran into a woman I know who had the pillar procedure and turbinate coblation performed by the same ENT I saw at the snoring solutions practice. "I snore just as badly as before," she told me.
Maybe I should learn to play the didgeridoo, an aboriginal wind instrument that some say can cure snoring. And since a major hotel chain is currently in the trial phase of its "snore absorption room" for hotels across Europe and the Middle East, I might just go off to live in Paris.
If all else fails, I’ll convert my office into my bedroom. I’ll replace my large desk with a smaller one and get a new bed with a headboard, new pillows and a good reading light. I’ll wear my flowered pajamas and keep the door closed.
If no one can hear my beastly snoring, will I not be Beauty?
Kathy Mandry Cohn is an award-winning short story writer who lives in San Francisco. She runs the family lavender farm in Sonoma, Calif.
Exercise 30 minutes a day. Nothing exotic is required; a good half-hour stroll will do the trick, but avoid exercising within three to four hours of bedtime.
Limit the use of all caffeinated beverages (coffee, tea, soft drinks) throughout the day and do not consume any after lunch.
Talk To Your Doctor
Check all of your medicines with your doctor to see if they could be affecting your sleep.
Make The Bedroom A Bedroom
Use the bedroom just for sleep. It may be time to invest in earplugs, an eye mask or even heavier curtains to block out extra light and sound. Don't be afraid to give fidgeting pets the boot and avoid eating, watching television or finishing work in the bedroom.
Adjust Room Temperature
Make sure your bedroom is cool, dark and quiet. Try adjusting the temperature of the bedroom for a more optimal sleeping environment. (For easier temperature regulation throughout the night, ditch the singular heavy comforter and opt for piling on light layers that can be easily kicked off as needed.)
Every night budget a "pre-sleep" period of time (say, a half-hour) to read a book or watch the TV news, and then go to the bedroom with lights out after the period is up. Don't ruminate. Practice <a href="http://www.webmd.com/mental-health/positive-thinking-stopping-unwanted-thoughts#" target="_hplink">"thought-stopping"</a> where you only allow yourself to worry about a problem during daytime hours. Refrain from checking texts and e-mails (physically banish your cell to a different room if necessary!) before and during your bedtime routine.