Sound Effects

Snorers have always been the butt of jokes. In cartoons, their nasal roar lifts the roof off houses. In sitcoms, there's the wife who rolls her eyes at her snoring bedmate. But in reality, it's not all that funny. In fact, snoring can be a nightmare for snorers and their beleaguered partners, who may wake up several times a night to poke, prod and maybe hoist loved ones onto their sides for a little relief. It's no wonder that bleary spouses can wake up grumpy and resentful.

But the nightly racket is more than a potential relationship strain. According to the latest research, an increasingly older and heavier population may make this condition an even greater a health risk than we previously thought. For Maggie Moss-Tucker, successful treatment for a longtime snoring problem came almost by accident. One fall morning in 2005, she saw a sign at her local gym seeking snorers as volunteers for a study at Boston's Brigham & Women's Hospital. Moss-Tucker, now 56, was intrigued. She had started snoring nearly a decade earlier. "I'd tried everything to stop," she says, from sleeping upright to using nose strips or a mouth guard. But to her and her husband's dismay, nothing worked. When she signed up for the study and spent a night at a suburban Boston sleep lab, she found out why.

After reviewing her sleep patterns and oxygen levels, researchers told her that her snoring was actually an indication of something worse. She suffered from sleep apnea, a condition in which patients stop breathing repeatedly as they sleep and can wake up as many as 100 times a night—often without remembering it. That kind of revelation has led to doctors re-evaluating a condition once treated as little more than a nuisance. "In the past, snoring has been treated like a joking matter; you never talked about it with your doctor," says Dr. David Rapoport, medical director of the Sleep Disorders Center at New York University Medical Center. "But when it becomes very prominent or such that it wakes you up or interferes with breathing, it can be a problem."

Not everyone who snores regularly has sleep apnea. UCLA pulmonologist Michael Littner, who is certified in sleep medicine by the American Board of Internal Medicine, estimates 50 to 60 percent of those with habitual loud snoring have it. But research is finding that sleep apnea is not the only health condition associated with snoring. The sound occurs when the flow of air from the mouth or nose to the lungs makes tissues in the airway vibrate, usually because of an obstruction or a narrowing of the airway. The more the airway closes or is blocked, the harder the body has to work to push air, which puts pressure on the heart. That's why, over time, loud snoring can lead to high blood pressure, says Rapoport's colleague, Joyce Walsleben, past director of the New York University sleep center. "People who are just snorers have higher incidence of stroke and cardiovascular disorders."

Sleep apnea, in which the airway becomes blocked or, less often, the brain fails to properly control breathing during sleeping, can be viewed as one extreme of the snoring spectrum. Soft or sporadic snoring, which is not generally considered a health hazard, would be at the other end. As the sound and persistence of a patient's snoring grows, so do the health concerns. A study published in the March 1 issue of the journal Sleep found that loud snorers had a 40 percent greater risk than nonsnorers of suffering from high blood pressure, 34 percent greater odds of having a heart attack and a 67 percent greater chance of having a stroke.

That's a problem given the number of noisy sleepers out there. In a recent poll by the National Sleep Foundation, about one third of U.S. working adults reported snoring at least a few nights in the previous month. Snoring generally worsens with age so the rate is even higher among the elderly. And, contrary to common perceptions, it's nearly as common in women as men. Menopause appears to be a factor, as is weight. Being overweight can cause thickness in the airway tube, constricting the flow of oxygen.

Yet many who regularly snore don't realize that it could be bad for their health. The research linking hypertension, cardiac problems and loud snoring is relatively new. And though awareness of sleep apnea is growing, specialists say the condition is still vastly undertreated. Primary-care physicians don't routinely ask patients about the quality of their sleep—though that is beginning to change—and few patients think to tell their doctors that they're snoring, unless it becomes disruptive to their partner. Sleep specialists estimate that between 12 million and 18 million Americans have some form of sleep apnea but many of them, like Moss-Tucker, remain undiagnosed for years. Research from the National Sleep Foundation indicates that only half of those with sleep apnea are being treated. Since it is a progressive condition, says Michael Twery, director of the National Institutes of Health's National Center on Sleep Disorders Research, "the person who's affected is usually not aware of how severe the condition is."