Asthma is a chronic inflammatory lung condition that causes the airways to narrow and swell, making breathing difficult. Snoring is the noisy breathing that happens during sleep when air movement is partially obstructed, causing soft tissues in the throat to vibrate. Since both conditions involve restricted airflow, asthma can contribute to or worsen snoring due to the shared anatomy of the respiratory tract.
The Causal Link Between Asthma and Snoring
Although asthma primarily affects the smaller airways deep within the lungs, the inflammation often extends to the upper airways, including the nose and throat. This means asthma-related breathing difficulties, especially at night, increase upper airway resistance.
The increased resistance and changes in airflow make snoring more likely or severe in asthma patients. Asthma symptoms often worsen at night (nocturnal asthma), a period when snoring is common. These flare-ups constrict the airways, interfering with the normal flow of air during sleep.
Airway Mechanisms That Lead to Snoring
Asthma influences snoring primarily through chronic inflammation and edema throughout the respiratory system. This persistent inflammation causes the lining of the airways, from the nasal passages to the bronchial tubes, to swell. This swelling narrows the passage, increasing the likelihood that soft tissues in the throat will vibrate as air passes through the reduced space during sleep.
Asthma also increases mucus production, contributing to airway restriction. When lying down, excessive mucus can pool in the upper respiratory tract, acting as a physical barrier to smooth airflow and intensifying snoring vibrations. This congestion forces harder breathing, which increases negative pressure within the upper airway.
Nocturnal bronchospasm, where asthma symptoms intensify at night, also generates snoring. As the lower airways constrict, the person must exert more effort to inhale and exhale. This increased effort creates negative pressure, pulling the soft tissues of the throat inward. This causes them to collapse or flutter, which is the audible mechanism of snoring.
Distinguishing Asthma-Related Snoring from Sleep Apnea
It is important to differentiate between simple snoring and the more serious Obstructive Sleep Apnea (OSA). OSA is a disorder where the upper airway repeatedly collapses during sleep, causing breathing pauses lasting ten seconds or longer, followed by a sudden awakening or gasp. Asthma patients have a significantly higher risk of developing OSA, with some studies showing an almost 40% greater risk.
The symptoms of simple snoring and OSA differ substantially, though loud snoring is a feature of both. Snoring is primarily a noise caused by tissue vibration, while OSA involves actual interruptions in breathing, often noted by a bed partner. OSA symptoms include observed pauses in breathing, abrupt awakenings accompanied by choking or gasping, and excessive daytime sleepiness.
A diagnosis of OSA requires a sleep study, known as polysomnography, which monitors breathing patterns, heart rate, and oxygen levels overnight. Screening for OSA is important for individuals with severe or poorly controlled asthma, as the two conditions can worsen each other cyclically. The inflammation and oxygen drops caused by OSA can further aggravate asthma symptoms, making accurate diagnosis and treatment crucial.
Treatment Approaches for Snoring in Asthma Patients
Managing snoring in asthma patients begins with optimizing asthma control, as treating the underlying inflammation is the most effective intervention. Strict adherence to prescribed management plans, including controller medications like inhaled corticosteroids and bronchodilators, helps open the airways and reduce systemic inflammation contributing to upper airway congestion. Reducing the frequency and severity of nocturnal asthma symptoms simultaneously decreases the triggers for snoring.
Beyond medical management, simple behavioral and positional changes can help alleviate snoring. Sleeping on one’s side, rather than the back, prevents the tongue and soft palate from falling backward and obstructing the airway. Maintaining a healthy weight and avoiding known asthma triggers, such as allergens and irritants, can also lessen airway inflammation and congestion.
If severe snoring is accompanied by warning signs of OSA, such as choking or excessive daytime fatigue, a physician may recommend a continuous positive airway pressure (CPAP) machine. The CPAP device delivers pressurized air through a mask to keep the upper airway open during sleep, eliminating snoring and treating the underlying apnea. For those with mild OSA, a mandibular advancement device (a dental appliance that repositions the lower jaw) is also a helpful treatment option.