Tongue-based snorer

Causes of snoring and tips that can help you stop.

28 November 2005

4 min read.

The vibrations produced by prolonged and heavy snoring injure the airways and affect the upper airway muscles (pharyngeal, laryngeal, tongue and soft palate). Vibrations induced by snoring may also damage the nerves of these muscles and interfere with blood supply. In normal individuals these muscles support the airway and prevent it from collapsing, but due to the damage caused by snoring it is thought that the upper airway muscles are more likely to suffer from fatigue in snorers and are more prone to collapse.

If you are a ‘tongue base snorer’, this means that you snore because your airway is liable to vibrate at the base of the tongue. Turbulent air is trying to get into your lungs through this restricted airway and in doing so it vibrates the tissues of the tongue. The tongue may partially or completely block the airway preventing you from breathing. This is termed apnoea which means ‘without breath’.

A small “gum shield” device known as a Mandibular Advancement Device (MAD) can gently bring your lower jaw forward and keep your tongue away from the back of your throat, thus preventing the obstruction.

Are you a tongue-based snorer? try this simple test:

Tongue test:

Stick your tongue out as far as it will go and grip it between your teeth. Now try and make a snoring noise. If the snoring noise is reduced with your tongue in this forward position then you are probably a “tongue base snorer”.

Mandibular Advancement Devices (MAD)

Clinical studies consistently show that MADs are an acceptable form of treatment in the long term for patients with tongue base snoring and mild/moderate sleep apnoea. Patients from one study categorised the device as fair or good after 10 years of wear. 70% of these patients were wearing the device every night for 6 hours.

Controlling snoring with a MAD will not only reduce snoring but will also improve general health and wellbeing. One study reported significant changes to snoring, breathing pauses, daytime sleepiness, concentration, night time sleep quality, work efficiency, tiredness, general health and mental status, following MAD treatment. Similar improvements in health and wellbeing were also reported by bed partners.

Many snorers using a MAD for the first time believe that it will interfere with their sleep. However, these fears are unfounded. Studies, in which sleep architecture has been monitored, clearly show an improvement in sleep quality and a significant decrease in sleep fragmentation.

Around 30% of patients using a MAD suffer minor side effects, although this does not appear to influence compliance. The majority of patients indicate that they find the device comfortable or only slightly uncomfortable. The most frequent side effects are excessive salivation, teeth discomfort and jaw discomfort. The frequency and severity of side effects are undoubtedly affected by the type of appliance, wear time, degree of protrusion and care taken in the fitting process.

It has recently been found that MADs are also suitable for individuals whose snoring originates from the soft palate. The researchers found that snoring originating from palatal flutter was significantly improved following MAD use. They concluded that not only does a MAD increase the airway dimension at the tongue base but also at the level of the soft palate.