Science, Solutions

Do Nasal Sprays Work for Snoring?

Nasal sprays can be effective for snoring if you get the right type.

Snoring is often the result of a blocked or stuffy nose. Unblocking your nose can drastically reduce snoring, and a popular method is to use a nasal spray.

Not all nasal sprays are the same, and it’s important to match the appropriate type of nasal spray to your cause of nasal blockage.

Various causes of a blocked nose that can lead to snoring

In this guide, we’ll go through the different types of nasal spray available to give you the best chance of finding one that works for you.

Jump to the main types of nasal spray for snorers:

Antihistamine
Steroid
Anticholinergic
Decongestant
Mast cell inhibitors
Non-medicated saline

What’s blocking your nose and why does it make you snore?

If you breathe through a partially blocked nose, suction forces are created that can cause your throat to collapse and make your uvula and soft palate vibrate [1].

When your nose is fully blocked, you’ll start breathing through your mouth when you sleep – a common cause of snoring.

Why open mouth breathing is a leading cause of snoring

Find out

There are lots of causes of a stuffy nose, from colds and infections, hay fever and dust allergies to chronic nasal inflammation and non-allergic rhinitis. One type of nasal spray won’t cure all types of nasal blockage, so it’s important to know which one is which …

Different types of nasal spray

Side note: what does “topical” mean?

You will often see nasal sprays referred to as “topical”. This refers to the route of administration. Topical simply means that the drug is applied directly to the site it aims to treat, in this instance, the nose. This is the opposite to systemic administration, where the drug is usually swallowed or injected.

1. Antihistamine nasal sprays

In short, these are ideal for treating nasal blockage that arises due to allergy.

If your snoring is worse in the spring and summer when pollen spores cause hay fever, or if you’ve noticed dust in the home makes you stuffy and snore, then antihistamine sprays could work for you.

An allergy is when your body elicits an immune response – an infection-fighting tactic – to something non-infectious.

Histamine is a chemical inside the body that is released in high quantities in this immune response. Histamine and other chemicals rush to the site where allergens are detected (usually the nose and throat as this is the primary point of entry if breathing them in) and then bind to specific receptors to cause inflammation.

Antihistamines help to relieve your stuffy nose by reducing this inflammation via stopping histamine binding to other cells.

Summary: good for allergy sufferers, treats inflammation and runny nose, use when symptoms worsen.

Examples: azelastine, olopatadine

2. Steroid nasal sprays

Like antihistamines, these work by reducing inflammation. They can be suitable for treating allergies and non-allergic rhinitis or nasal polyps. Steroid nasal sprays are commonly prescribed to treat problematic snoring but can also be bought over-the-counter.

Side note – what is rhinitis?

Rhinitis simply means swelling in the nose. It is not a disease, but a term used to describe nasal symptoms including swelling, difficulty breathing and excess mucus. There are two categories of rhinitis:

Allergic rhinitis. This is an umbrella term for conditions like hay fever or nasal swelling experienced in response to other allergens.
Non-allergic rhinitis. This describes nasal symptoms caused by environmental factors including pollution and weather, infection and hormonal imbalance. This will sometimes be referred to as vasomotor rhinitis or idiopathic rhinitis. The cause is often vague.

The steroids in these nasal sprays are not to be confused with anabolic steroids used to build body mass. Nasal spray steroids are copies of naturally occurring hormones produced by glands above the kidneys.

Steroid nasal sprays reduce inflammation via several different mechanisms [2]. This includes stopping the function of a key enzyme which helps produce inflammatory chemicals in the body [3].

If prescribed steroid nasal sprays, remember that they are unlikely to provide instant relief and usually work after a few initial uses. If your nasal problems are chronic, you should use the spray regularly even if your symptoms improve.

Steroid nasal sprays don’t tend to produce any serious side effects and can be used by most people.

Summary: good general nasal spray for a variety of conditions, especially for people with chronic nasal inflammation, can be used long-term

Examples: mometasone, fluticasone, beclometasone

3. Anticholinergic nasal sprays

This type of nasal spray is best to treat a runny nose. They reduce the amount of mucus that your nose produces and are suitable for a variety of causes of nasal blockage from allergic to non-allergic.

Unlike antihistamines and steroid spray, anticholinergic sprays will not relieve the inflammation and congestion. The side effect profile is typically mild.

Anticholinergic sprays work by blocking receptors which ordinarily lead to activation of nasal mucus glands and hence mucus production [4].

Summary: good for snorers with a runny nose

Example: ipratropium bromide

4. Decongestant nasal sprays

Congestion in the nose is caused by dilation (expansion) of blood vessels, reducing the space for air to flow freely. Decongestant nasal sprays work by constricting these blood vessels to widen your nasal passages.

Decongestants can be very effective in relieving a blocked nose in the short term, and most can be bought over-the-counter. However they are not suitable for everybody. Children, pregnant or breastfeeding women and people with high blood pressure shouldn’t use decongestant nasal sprays (this is because constricting blood vessels further increases blood pressure).

Decongestants are suitable for short-term use: a few times a day for no longer than a week. This is because overuse of decongestants can cause rebound congestion where the spray starts to have the opposite effect and cause nasal stuffiness.

Summary: good for nasal blockage caused by short-lived problems like a cold, should only be used short-term to avoid rebound congestion

Example: pseudoephedrine

5. Mast cell inhibitors

This type of nasal spray is suitable for those who suffer from seasonal allergies and can predict when their symptoms will arise. Because mast cell inhibitors are preventative, they need to be used a couple of weeks before the onset of symptoms.

These sprays work in a similar fashion to antihistamines in that they stop mast cells (a type of immune cell) from breaking down and releasing inflammation-causing histamine.

Summary: suitable to long-term sufferers of hay fever who can time the onset of their symptoms

Example: cromolyn

6. Saline nasal sprays

Saline nasal sprays are non-medicated. Instead, they are a mixture of water and salt (sodium chloride) which moisturize your nasal passages to soothe inflammation and can also break down excess mucus.

This type of spray works in a very similar way to using a neti-pot, the only difference is the mode of delivery. Because saline nasal sprays are non-medicated (though do read the label, some are “combination” sprays containing some medication), they can be used by nearly everyone, including children.

Saline nasal sprays can also be used to make other snoring remedies work better. Steroid sprays don’t work well if there is a lot of mucus present. Using a saline spray first can help break up excess mucus, allowing medicated sprays to work more effectively. Saline sprays can also help to moisten your airways before using CPAP.

Summary: suitable for all and useful for soothing chronic nasal inflammation and clearing excess mucus, can be used as an adjunct to other remedies

Causes, Science

Lesser-Known Snoring Causes

Snoring is often the result of a combination of factors. When trying to find your snoring triggers, it’s important to make note of anything that’s making your snoring worse.

However, there are things that you may not realise play a role in your snoring. Here, we explore the lesser-known factors that can make snoring worse.

Anatomy

Many snorers are victims of their anatomy. Humans are already predisposed to snoring due to some of the features that allow us to speak and stand upright. There are also some key anatomical qualities that make certain people more likely to snore than others …

Deviated septum

Sometimes inherited, sometimes caused by facial trauma, a deviated septum can cause problems with nasal breathing which brings on snoring.

This is where the cartilage that separates the cavities of the nose becomes bent out of shape, making one cavity smaller than the other.

Our noses go through a natural cycle, switching preference for a nostril to breathe through (to give the other one a rest). People with a deviated septum will often notice their nasal breathing difficulties coming and going throughout the day or more importantly – the night.

When breathing through the smaller side, airflow is disturbed and snoring ensues.

Septal deviation can often be corrected with a straightforward surgical procedure called a septoplasty.

Recessed jaw/overbite

Snoring can happen if your tongue falls back and blocks your airway. People with a small and recessed lower jaw are at greater risk of tongue snoring as they have less space in that part of their airway.

Mandibular advancement devices are popular anti-snoring products; these work by moving the jaw forward to prevent the tongue falling back. Unfortunately, these devices are often unsuitable for people with a pronounced overbite as they can cause them jaw pain.

Small nostrils

The nose is the body’s preferred breathing route. Having a stuffy nose or small nostrils can make nasal breathing turbulent or impossible. If impossible, you’ll have to mouth-breathe – a common cause of snoring. Even if you breathe through your nose but with some difficulty, extra suction forces are created which act upon your airway to make you snore.

Enlarged uvula, soft palate and tonsils

Your snoring risk increases dramatically if the actual “noise-makers” are larger than normal. The soft palate plus the connected uvula and tonsils (the soft part behind your palate at the top of your mouth and the tissue dangling from it) are often responsible for the snoring sound. Simply put, if there is more tissue, it is more likely to vibrate and make noise, especially seeing as more tissue narrows the airway.

Often, the solution for snoring caused by your anatomy is surgery. Whilst this can work for many people, it is not always possible or effective in the long term.

Large evening meal

Snoring is linked to your diet. However, it’s not just what you eat but also when you eat. We have heard from many of our users that reducing or even skipping their evening meal can drastically reduce their snoring.

It is thought that having full belly can exert pressure on your chest and negatively affect your breathing. This is because your lungs and diaphragm share space with your stomach and small intestine. When your stomach is very full, your diaphragm has less room to expand and contract.

This explains the shortness of breath people often feel after a particularly heavy meal. If shortness of breath lingers until bedtime, the strained breathing can worsen snoring.

A big meal too close to bedtime can also produce acid reflux, another factor that can make snoring worse.

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Smoking

Smokers and even passive smokers are more at risk of snoring and experiencing sleep disordered breathing [1][2]. Some studies have found that smokers are 2.5 times more likely to suffer from obstructive sleep apnea [3].

Smoking contributes to greater inflammation and irritation in the upper airway. This causes a swelling of the tissues which vibrate and make noise [4].

In addition to this, smokers experience a wealth of breathing difficulties including shortness of breath, reflux, dry throat, excess mucus production and nasal congestion – all of which are linked to snoring [5].

Dehydration

Being dehydrated, in addition to disrupting sleep, can also aggravate your snoring. Dehydration causes the mucus that lines your airways to become thicker than normal. This makes the opposing surfaces of your airway more likely to stick together and cause a noisy obstruction [6].

Climate

Via the same mechanisms as dehydration, living in a warm, dry environment can worsen snoring. Whilst it may not fix the snoring entirely, using a humidifier can really help.

Confusingly, for others, humid environments and changes in weather can also intensify snoring. This is often true if snoring is caused by chronic nasal conditions where inflammation responds to changes in atmospheric pressure. Indeed, many snorers report louder snoring when a weather front is moving in!

Atmospheric pressure has even been seen to influence sleep disordered breathing, with lower pressures producing slightly increased obstructive apnea episodes [7].

Alcohol

Drinking alcohol causes your muscles to relax – even more than they do normally when you fall asleep. This increases the collapsibility of your airway and heightened resistance to incoming air which can aggravate snoring.

As well as helping your muscles relax, alcohol also dehydrates. This causes the mucus in your airway to become stickier.

Sedatives

These work in a similar way to alcohol in that they are depressants, helping your muscles relax which can produce snoring.

Sedatives are substances that have a calming or sleep-inducing effect and come in various guises. “Sedatives” doesn’t just refer to sleeping pills, other medications (such as for those for allergies) can have a sedating effect, as can some natural sedatives.

Excessive use of decongestant nasal sprays

Nasal sprays are a popular snoring remedy for people who snore due to a stuffy nose. There are various types and each work differently.

One type – decongestant sprays – work by constricting the blood vessels in the nose thus helping to expand the airway. If decongestant sprays are overused a “rebound effect” can occur where your nose becomes more stuffy. This is because of adaptations that occur in the nose in response to the spray [8].

Month: February 2019