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You might’ve thought that once your husband started using his CPAP machine, his snoring would be a thing of the past. But here you are, still hearing those familiar nighttime noises. What’s going on? CPAP (Continuous Positive Airway Pressure) is meant to keep airways open, so why is he still snoring? Let’s dive into some of the common reasons why CPAP doesn’t always solve the snoring issue and what you can do about it.

Important Notice: Please consult a doctor if you have any medical conditions. We do not provide medical advice or make claims, and we are not liable for individual health outcomes.

What Causes Snoring and How to Address It

Understanding the Root Causes of Snoring

Snoring occurs when airflow through the mouth and nose is obstructed during sleep, causing the surrounding tissues to vibrate. It’s a common condition that affects millions of people, and it can range from being a mild annoyance to a sign of more serious health issues like sleep apnea. Although snoring is often seen as a trivial problem, it can affect sleep quality, both for the snorer and their partner, and may lead to daytime fatigue and other complications. Let’s explore the primary reasons why people snore.

Physical Obstructions and Anatomy

• Nasal Congestion: Colds, allergies, or sinus infections can block the nasal passages, forcing you to breathe through your mouth, which increases the likelihood of snoring.
• Deviated Septum: A crooked nasal passage can lead to chronic snoring because airflow is restricted.
• Obstructed Airways: Enlarged tonsils, a thick soft palate, or a large uvula can partially block the airways, leading to the vibrations that cause snoring.
• Low Muscle Tone in the Throat: When throat muscles relax too much during sleep, they collapse into the airway and cause snoring. This can be particularly problematic in people who sleep on their backs, as gravity can further contribute to the collapse of the airways.

Lifestyle Factors That Contribute to Snoring

• Weight Gain: Extra tissue around the neck and throat can press on the airway, making it more prone to collapsing and leading to snoring.
• Alcohol Consumption: Drinking alcohol before bed relaxes the muscles in the throat more than usual, increasing the chance of airway obstruction.
• Sleeping Position: Sleeping on your back allows gravity to pull the tissues in your throat down, which can obstruct the airway and lead to snoring.
• Smoking: Smoking irritates the mucous membranes in the nose and throat, leading to swelling and increased airway resistance.

Sleep Apnea and Snoring

Snoring is often a symptom of sleep apnea, a sleep disorder where breathing repeatedly stops and starts throughout the night. There are two primary types of sleep apnea that can lead to snoring:

• Obstructive Sleep Apnea (OSA) occurs when the muscles in the back of the throat fail to keep the airway open. OSA is the most common form of sleep apnea and is often accompanied by loud snoring.
• Central Sleep Apnea (CSA) occurs when the brain fails to signal the muscles to breathe, but it is less commonly associated with snoring.

People with sleep apnea may experience daytime sleepiness, irritability, and difficulty concentrating due to the repeated interruptions in their sleep cycles.

Identifying the Type of Snoring

Understanding the type of snoring is crucial for determining the most effective treatment. Not all snoring is the same, and different underlying causes may require different solutions. The two most common types of snoring are nasal snoring and mouth snoring, each stemming from different issues within the airway.

1. Nasal Snoring

This occurs when airflow through the nasal passages is restricted, causing you to breathe through your mouth instead. This type of snoring is often the result of nasal congestion, which can be caused by allergies, colds, sinus infections, or even seasonal changes. Structural issues, such as a deviated septum, can also contribute to nasal snoring by making it difficult for air to flow freely through the nose. When the nasal passages are blocked or inflamed, the body compensates by switching to mouth breathing, which is less efficient and more likely to lead to vibrations in the throat that cause snoring. In many cases, treating nasal congestion or addressing structural problems with the nose can reduce or eliminate nasal snoring.

2. Mouth Snoring

It happens when the mouth falls open during sleep, allowing the tongue to relax and fall backward into the throat. This can obstruct the airway and cause vibrations that result in snoring. Mouth snoring is especially common in people who sleep on their backs, as gravity makes it easier for the tongue to slip back and block the airway. It can also occur in individuals who breathe through their mouths due to chronic nasal congestion or other conditions that limit nasal airflow. Mouth snoring can sometimes be managed with positional changes, oral appliances that keep the airway open, or devices that encourage nasal breathing over mouth breathing. In more severe cases, addressing the underlying issue, such as sleep apnea or excessive tissue in the throat, may be necessary.

Reasons Why Your Husband Is Still Snoring with CPAP

CPAP (Continuous Positive Airway Pressure) machines are designed to keep the airways open and prevent snoring and sleep apnea. However, if your husband is still snoring while using CPAP, there could be several factors contributing to this. Let’s explore some common reasons why CPAP may not fully stop snoring.

Mask Leaks

One of the most common reasons for snoring with CPAP is air leakage around the mask. If the mask doesn’t fit properly or is worn out, it can allow air to escape, which prevents the CPAP from delivering the necessary pressure to keep the airways open. Even small leaks can result in snoring because the air pressure isn’t sufficient to prevent the collapse of throat tissues. Mostly this can happen if:

1. Mask Fit is Improper 

Masks that are too loose or too tight can cause leaks. A mask that’s too loose allows air to escape, while a mask that’s too tight can be uncomfortable and lead to poor seal. Ensuring that the mask fits snugly without being overly tight is crucial.

2. Mask Type is Mismatch

Some CPAP users wear nasal masks or nasal pillows, which can be problematic if the person is a mouth breather. If air is escaping through the mouth, snoring can still occur. In these cases, a full-face mask might be more effective.

CPAP Pressure Is Too Low

The air pressure setting on the CPAP machine might not be high enough to keep the airways open throughout the night. This is often the case if your husband has gained weight or if his sleep apnea has worsened over time. If the pressure is inadequate, the airways may still partially collapse, leading to snoring.

Sleep Position

Even with CPAP, sleep position can affect snoring. If your husband sleeps on his back, gravity can cause the tissues in the throat to collapse, which increases the chance of snoring. This can happen even when using a CPAP machine.

Mouth Breathing

Mouth breathing is another common cause of snoring with CPAP, especially if your husband is using a nasal mask. When the mouth stays open during sleep, air escapes through it instead of entering the airways. This can lead to both snoring and less effective CPAP therapy.

How to Solve Snoring with CPAP?

Adjusting the Mask for a Better Fit

The first step is to ensure the CPAP mask is fitting properly. You may need to try different masks to find one that fits comfortably and snugly without leaking. Regularly check for wear and tear on the mask and replace it when necessary. If your husband is a mouth breather, switching to a full-face mask may help reduce snoring.

Increase CPAP Pressure Settings

If the pressure setting on the CPAP machine is too low, it might not be enough to keep the airway open. Consult with your husband’s sleep specialist to review his CPAP data and adjust the pressure settings if needed. Sometimes, a follow-up sleep study may be necessary to determine the appropriate pressure.

Consider Using a CPAP Humidifier

Adding a humidifier to the CPAP machine can help alleviate dryness and congestion in the airways, making breathing more comfortable and reducing the likelihood of snoring. Humidifiers provide moisture to the air, which can prevent dry mouth and reduce irritation in the throat.

Encourage Sleeping on the Side

If sleeping on the back is causing your husband to snore, positional therapy might be a simple solution. You can try using pillows or special devices that encourage him to sleep on his side, which helps keep the airways open and reduces snoring.

Alternatives to CPAP for Managing Snoring

If CPAP isn't effectively stopping your husband's snoring, or if he finds it uncomfortable, there are several alternative treatments that might help. These options vary depending on the cause of the snoring and can be tailored to suit individual needs.

Oral Appliances

Oral appliances are custom-made devices worn during sleep, similar to a mouthguard. They work by repositioning the lower jaw or tongue to help keep the airway open, making them ideal for individuals with mild to moderate sleep apnea. These devices are often a good alternative for those who find CPAP uncomfortable or inconvenient.

Types of Oral Appliances:

• Mandibular Advancement Devices (MADs): These devices move the lower jaw forward to keep the airway open.
• Tongue Retaining Devices (TRDs): These hold the tongue in place to prevent it from falling back into the throat and obstructing the airway.
• Combination Devices: A mix of MADs and TRDs to address both jaw and tongue positioning issues.

Surgical Options

Surgery may be considered for people whose snoring is caused by physical obstructions or anatomical issues in the airway. Various surgical procedures are available to reduce or remove excess tissue that contributes to airway blockages, leading to more effective airflow during sleep.

Types of Surgery:

• Uvulopalatopharyngoplasty (UPPP): Removes excess tissue from the throat and palate to widen the airway.
• Laser-Assisted Uvuloplasty (LAUP): Uses a laser to reshape the uvula and surrounding tissues, reducing snoring.
• Septoplasty: Corrects a deviated septum, which can obstruct nasal airflow and contribute to snoring.
• Genioglossus Advancement (GA): Repositions tongue muscles to prevent airway collapse.
• Soft Palate Implants: Inserts small implants in the soft palate to stiffen the tissue and reduce snoring.

Positional Therapy

Some people snore more when they sleep on their backs. Positional therapy helps to encourage side sleeping, which can prevent airway collapse and reduce snoring. There are various devices and techniques designed to keep you in a side-sleeping position throughout the night.

Positional Therapy Options:

• Specialty Pillows: Designed to encourage side-sleeping and support proper head and neck alignment.
• Positional Devices: Wearable devices that prevent rolling onto your back during sleep.
• Tennis Ball Technique: Sewing a tennis ball into the back of a shirt to discourage sleeping on your back.

Lifestyle Changes

Excess weight, particularly around the neck, can contribute to snoring by increasing the pressure on the airway. Making certain lifestyle adjustments can not only improve overall health but also reduce or eliminate snoring.

Lifestyle Changes to Reduce Snoring:

• Weight Loss: Losing even a small amount of weight can reduce tissue in the throat, improving airflow.
• Avoid Alcohol: Reducing alcohol consumption, especially before bedtime, helps prevent excessive muscle relaxation in the throat.
• Quit Smoking: Smoking causes inflammation in the airways, increasing the likelihood of snoring.
• Regular Exercise: Strengthens muscles, including those in the throat, which helps reduce snoring.

Nasal Strips and Dilators

For individuals who snore due to nasal congestion or structural issues, nasal strips and dilators can be a simple, non-invasive solution. These products work by improving nasal airflow and reducing the need for mouth breathing, which can contribute to snoring.

Conclusion

Snoring, even while using a CPAP machine, can be frustrating both for the person snoring and their partner. It’s important to understand that snoring with CPAP is often a sign that something isn’t quite right, whether it’s mask fit, pressure settings, or other underlying factors like sleep position or mouth breathing. By addressing these issues, adjusting the CPAP, or exploring alternatives such as oral appliances or lifestyle changes, you can significantly reduce or even eliminate snoring.

Additionally, innovative solutions like Ozlo Sleepbuds® provide a way for partners to block out disruptive snoring sounds and enjoy a peaceful night’s sleep. Ultimately, a combination of proper CPAP management and individualized solutions can lead to better rest and improved sleep quality for both partners, ensuring that snoring doesn’t continue to disrupt your lives.