Snoring and Diabetes

Snoring is hard on a marriage, and it’s definitely hard on diabetes. How can you snore less, sleep better, and improve insulin function in the process?

Snoring is caused by tissues vibrating in the nose and throat. MedicineNet defines snoring as “A rough rattling noise made on inspiration during sleep by vibration of the soft palate (the back of the roof of the mouth) and the uvula (the structure dangling down at the back of the mouth).”

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You don’t snore when you’re awake because the muscles in the back of the throat hold the soft palate, the uvula, and the tonsils in place and prevent them from vibrating. When you’re asleep, the muscles relax, and these structures drop into the airway and vibrate with each breath.

Why is snoring a problem, and how can it cause or worsen diabetes? According to a study in the American Journal of Epidemiology, regular snorers are twice as likely as non-snorers to develop Type 2 diabetes. Occasional snorers were 48% more likely to get Type 2.

The snoring and diabetes connection held at all weights and was true in smokers and non-smokers, and among people with family history of diabetes or without.

How might snoring contribute to diabetes? The authors wrote that the airway obstruction caused by snoring or sleep apnea blocks you from getting oxygen. When you don’t have enough oxygen, the body releases stress hormones such as cortisol. Stress increases insulin resistance.

Many studies have shown that poor sleep promotes insulin resistance. An American study found that people with diabetes averaged 23% higher fasting glucose levels after a poor night’s sleep than after a good sleep.

Snoring is often a form of poor sleep, because you won’t be getting enough air. (Definitely a cause of poor sleep for your bed partner, too.)

Snoring and sleep apnea
The worst form of snoring is called obstructive sleep apnea (OSA). In OSA, you stop breathing, then wake up over and over to clear your throat and get air in. Then you fall back asleep without realizing it even happened.

Some people with OSA wake up every few minutes. If you wake in the morning tired and grumpy, or find yourself falling asleep in the middle of the day, you may have OSA. Get checked for it right away, because your life can be much more enjoyable and longer without it. OSA raises insulin resistance and blood sugar.

Many people with sleep apnea snore, but not everyone who snores has sleep apnea. You need to find out which story is yours. If you live with someone, ask him or her to tell you if they hear you stop breathing at night, then snort or gasp loudly and start again. That’s sleep apnea. If you have it, get treated.

If your housemate says you snore, but the sound is regular and doesn’t stop, you likely don’t have OSA. Congratulations, but snoring still increases insulin resistance. If you don’t have anyone at home, ask for a sleep study in a lab or at home with electrical monitoring equipment.

What causes snoring?
An article called “Why Do I Snore?” on the website of the British Snoring & Sleep Apnoea Association lists some causes and risk factors for snoring:

Smoking — this causes inflammation and swelling in the nose and throat, leading to snoring and potentially to OSA.

• Allergies — and other causes of nasal stuffiness.

• Small or collapsing nostrils — if your nostrils are small, it will be hard to get enough air. You may wind up breathing through your mouth, which also increases snoring.

• A large neck — “If you have a collar size of 16 1/2 inches or greater,” says the British Snoring & Sleep Apnoea Association, “you may not have the muscle tone needed to keep the airway open sufficiently at night to allow normal breathing. The narrow airway is more likely to vibrate.” This tends to be a problem for men more than women.

Alcohol and sleeping pills tend to relax your throat and mouth muscles more, so the vibrating parts sink down and cause snoring or OSA.

Sleeping position is crucial. Studies show that people who sleep on their side are less likely to snore and have less severe snoring than those who sleep on their back. OSA is far more common in back sleepers.

What to do about it
There are dozens of approaches and hundreds of products to help stop snoring. They don’t all work very well. The excellent “emotional and social health” site HelpGuide.org describes a number of approaches:

• Stop smoking. Get help with that if necessary.

• Avoid evening alcohol consumption and sleeping pills.

• Clear nasal passages. “If you have a stuffy nose, rinse sinuses with saline before bed. Using a…nasal decongestant or nasal strips can also help you breathe more easily while sleeping. If you have allergies, reduce dust mites and pet dander in your bedroom or use an allergy medication.”

• Keep bedroom air moist with a humidifier.

• Change your pillow — the right pillow can make a big difference. Getting your head at the right elevation makes air flow more easily. The right one may be thinner than your current pillow.

• A mouth appliance or nasal dilator. It might take some work to find a product that works with you, but these devices for your mouth or nose help some people stop snoring and sleep better.

• Exercise — working your arms, legs, or abs during the day may tone your throat muscles as well, reducing snoring. There are also throat exercises you do with your tongue, breath, mouth, or neck. You can see them on the HelpGuide site.

• Lose weight — even a few pounds sometimes make a big difference to your throat.

• Drink enough fluids. WebMD says dehydration worsens snoring.

• Become a side sleeper — this may be the most valuable and the most difficult. WebMD says changing sleep positions often disrupts sleep, but if you have OSA or diabetes, it might be worth trying.

The website Sleep Disorders says anyone can become a side sleeper. You can place a firm object behind you to keep you from rolling back. There are special side-sleeping pillows you can buy to help, and whole-body pillows that kind of wrap you in a cocoon. You can sew a sock with a tennis ball in it to the back of your pajamas to remind you to keep from rolling back.

• Consider a CPAP machine like those used by people with OSA. These and similar devices often eliminate snoring completely. You can ask your doctor about them.

• Doctors also have a range of surgeries and implants for snoring, but be careful! If you don’t have OSA, the Sleep Disorders site and others advise trying self-care measures before any invasive procedures.

Try a few of these ideas. Your partner, your diabetes doctor, and your body will appreciate the results.

  • Tossaway

    I use a CPAP with a mask over my mouth. I don’t feel any less tired, but now my wife stops nudging me multiple times a night complaining about my snoring.