Silent night? Not if your spouse snores!

Most of us have experienced lying awake at night listening to a family member or roommate snore. The character and volume of the sound varies. Sometimes, it’s a snort, a choking noise, or even a whistling sound. And it could be just a very mild snoring or one that you swear could cause the walls of the room to vibrate.

According to the American Academy of Otolarynglogy–Head and Neck Surgery, 45 percent of normal adults snore at least occasionally and 25 percent are habitual snorers. Of the habitual snorers, about 10 percent have obstructive sleep apnea, a serious medical problem in which people stop breathing completely, multiple times during the night, for at least 10 seconds at a time. Apnea raises the risk for dangerous daytime drowsiness and a range of ills, including elevated blood pressure, heart attacks, and strokes.

But risky or not, snoring is an embarrassment to many people and can be a significant test for your beloved spouse. A 2005 “Sleep in America” poll by the non-profit National Sleep Foundation found that 23 percent of couples resort to sleeping in separate rooms due to one partner’s sleep troubles, most often snoring. And snorers’ bed partners who stick it out end up losing a lot of sleep, according to a 1999 Mayo Clinic study. In that sleep lab study of 10 couples, wives were awakened so many times by their snoring husbands that they were predicted to miss out on about one hour of sleep per night.

There is hope, however, for noisy sleepers and those who sleep near them. Simple lifestyle changes or inexpensive over-the-counter remedies may do the trick — even, for some spouses, something as simple as earplugs! But if the low-tech options fail, medical intervention is available. Nonsurgical medical devices for snoring are getting smaller and more comfortable, and surgical options have become more and more refined, reducing pain and recovery time. There are even options that can be performed on an outpatient basis.

Simple Solutions

You can sleep on your side instead of your back to keep airways open. You can also avoid alcohol and other sedatives that relax muscles in the mouth and throat before bedtime. Giving up cigarettes can help, too — smoking can cause inflammation in the upper airways that leads to snoring.

Exercise and weight loss can improve muscle tone in the throat and may reduce the amount of tissue pushing on airways. Dr. Lawrence Kline, director of the Scripps Clinic Sleep Center, says it is hard to predict how much weight a person will need to lose in order to reduce their snoring, but “weight loss clearly helps.” Even for someone who is 100 pounds overweight, losing just 20 pounds may be enough to see improvement, he says.

Taking up a musical hobby might strengthen throat muscles and could be a fun and effective treatment for snoring. A study published earlier this year in the journal Sleep and Breathing compared 52 choir singers with a group of 55 non-singers and found that the singers snored less. And a 2006 study in the British Medical Journal found that four months of regular practice of the didgeridoo — the long cylindrical indigenous Australian wind instrument — led to improved sleep apnea symptoms and less partner disturbance by snoring.

If more help is in order, there are plenty of remedies for sale in drugstores — strips, sprays, pillows, wristbands, and vests. But what really works? “There’s a lot of voodoo out there,” says Eric Mair, MD, an otolaryngologist at the University of North Carolina. Treating stuffy noses is a good place to start: A blocked nose forces breaths to be taken through the mouth, upping the likelihood of snoring. A 2001 University of Wisconsin study of 4,916 men and women, ages 30 to 60, found at the start of the study that those who reported they always, or almost always, had nasal congestion were three times more likely to snore than those who were never congested.

Adhesive external nasal strips that lift nostrils up and out may also help to some extent. Several studies have shown that people with congestion, as well as those who just have narrow nasal passages, get some relief from the strips. In one of them published in 2000 in the European Respiratory Journal, 12 snorers with chronic stuffy noses used either the strips or a placebo during overnight analysis. Monitoring of both groups found that although sleep quality and snoring loudness were not reduced, the total amount of snoring lessened in those with the strips.

Also available over the counter are sprays that claim to lubricate throat tissues and prevent noisy vibrations. But there is little evidence that these work, Dr. Kline says. A 2004 study of one spray published in the journal Otolaryngology-Head and Neck Surgery had 20 snorers try both an oil-based throat spray and a water-based placebo for one night each. It found that there was no improvement in snoring either when measured objectively, with audiotape analyzed for frequency, duration, and volume of snoring, or subjectively, via questionnaires filled out by bed partners.

Alarms and Other Devices

Oral appliances that fit in the mouth like a double retainer are an option for treating both regular snoring and obstructive sleep apnea. These devices work by pulling the jaw forward, repositioning and opening up the airway. They must be worn nightly to be effective, says Dr. Eric Kezirian, director of the division of sleep surgery at UC San Francisco. They are not, however, without risks as they can cause jaw pain and orthodontic problems such as tooth movement.

A dentist trained in sleep medicine can fit you for a prescription oral appliance. These have been shown to be a good option for sleep apnea and snoring treatment. A 10-year follow-up of patients using these devices published in the Journal of Prosthetic Dentistry last April found that 47 of 72 patients were still using their device at least six nights a week. Of these, 31 felt more refreshed upon waking. No measurement of actual snoring was made, however.

Finally, there are vibrating “snore alarms” that you strap to your wrist. The idea is that if you snore, the alarm will arouse you and you will readjust yourself and go back to sleep in a new, quieter position. Dr. Kline says that although a bed partner may think these alarms work wonderfully, all they are doing is continually waking the snorers, keeping them from entering the deeply relaxed stages of sleep where snoring is more likely to occur. This can backfire. By depriving the snorer of sleep, you can end up making them tired that when they finally rest, they conk out so hard and their muscles relax so deeply that the snoring is actually worse.

If you find that your snoring is at its worst when you are on your back but you just can’t keep yourself from rolling over during the night, anti-snore pillows can force you into a side sleeping position or at least keep your head elevated and airways open when you are on your back. There are also vests and backpacks with balls or hard foam in them that can make it so unpleasant to be on your back that you’ll roll over.

Of course, before purchasing any of these solutions, you can always try home remedies such as building a barricade of regular bed pillows behind yourself, raising the head of the bed, or sewing a tennis ball into the back of your nightshirt to help maintain a side-sleeping position. For some so-called socially unacceptable snorers — those whose snoring is so bad they disturb those around them — over-the-counter remedies may just not work. In these cases, stronger measures may be needed.

Not One–Size–Fits–All

Each of the medical treatments for snoring may work for some but not for others. Dr. Kline’s advice is to see a physician trained in sleep medicine who is able and willing to evaluate all possible causes of your snoring.

One final thing to bear in mind: If a treatment quiets the sounds of snoring but fails to address the underlying sleep apnea, a patient could be in danger. Dr. Rafael Pelayo, a professor at Stanford School of Medicine and a physician in its Sleep Disorders Clinic, stresses that habitual snorers should be checked for obstructive sleep apnea before any kind of surgery is done.

“Snoring is like a smoke alarm,” Pelayo says. “You can disconnect the smoke alarm, but you still have the fire!”