Dr. Jonathan Greenburg is one of the world’s foremost experts in the field of snoring and Sleep Apnea.  He is presenting a series of articles for you to help better understand the causes, effects, and proper successful treatment of snoring and Sleep Apnea.

Causes of Snoring and Sleep Apnea

Well if you think about it, you have a big tongue in a small mouth.  The majority of patients I have ever treated have a large tongue in a small mouth.  Here’s a simple visual: take your foot, whatever size, and try to put it in a shoe that is three sizes too small for you.  What happens?   It’s only going to go in so far.  Where’s the rest of the foot going to go?  Well, simply, the rest of the foot is going to hang out of the back of the shoe.

The same thing happens if you have a big tongue in a small mouth.  Your teeth are in the front and on the sides.  The only place there is room for your tongue to go is the back of the throat.   Now, something that almost everyone I have come across in my work, is that people find that they snore the worst when they sleep on their back.  I always here the comment, “my wife [or husband] elbows me to roll over.”  When a snoring person rolls over and gets off their back, the snoring is always less.  Why is this?

Let’s look at this at its most basic and logical level.  There is no super-secret or any sort of rocket science involved here.  Many articles you may have read regarding Sleep Apnea, or when you speak with many doctors about Sleep Apnea, they say that Sleep Apnea is about the airway collapsing.  It is not necessarily the airway collapsing as much as it is about the airway becoming blocked.

When a snoring person rolls over (after being elbowed by their spouse), their tongue moves and no longer blocks the throat.  But, if it was only about the airway collapsing, you could be on your left side or your right side or your front or your back when you are sleeping, and it wouldn’t make a difference.   You would still have the same closure of the airway.  Snoring and sleep Apnea would still occur.  But we know that’s not the case.   When you roll on your side your tongue no longer blocks the air passage and you no longer snore.

For the thousands of sleep studies that I have reviewed, almost every sleep study shows that the Sleep Apnea is worse when the patient is sleeping on their back.

If you look anatomically at what is going on, the only thing that would make the Sleep Apnea worse when you are on your back is the tongue falling back due to gravity.  And that is a very very big issue.  When we look at it logically, we find that the tongue falls back due to gravity and closes the airway.   Now, a partial obstruction of the airway is what we call snoring.  Snoring makes the noise it does because as the airway becomes blocked, or the diameter of the airway shrinks from the tongue falling back closing the airway.

Famed Engineer – Daniel Bernoulli’s came up with the principle that in general terms says that if the airway shrinks, the smaller the diameter, the faster the velocity or air speed that is propelled through.  This creates turbulence and the turbulence creates noise.  In this case it’s snoring.

Sleep Apnea is the complete obstruction of the airway where the airway remains blocked for a minimum of ten seconds.  It can be as much as 70, 80 or 90 seconds or more.  But when it stays blocked even once for at least 10 seconds, it is called a Sleep Apneac event.  A partial blockage is snoring and a complete blockage is Sleep Apnea.

Join me next week for my next article It’s All About The Tongue for an in depth look at the causes of the tongue blocking the airway.

Written by Dr. Jonathan Greenburg.

Dr. J. G is the head of the Snore no more centers in southern California.  Dr. G is the inventor of one of the only appliances that is a single lower mouth piece similar to a night-guard or orthodontic retainer that specifically addresses holding the tongue back from blocking the throat with no surgery, no noise, and very effectively.  Dr. G conducts post sleep studies with all of his patients.  The results are extremely high and comparable to those of the success of a CPAP – only without the cumbersome mask, hoses, and noise.   Sleep well!