Men vs. Women - Who Snores More?
Men vs. Women – Who Snores More?
Do men snore more than women? The short answer to this question is yes. There are sex differences when it comes to snoring. But there’s a little bit more to it than that.
Type “snoring” into a search engine and click on images. What do you see? Nine of the fifteen pictures on my screen showed men with mouths wide open whilst unfortunate women wrenched pillows over their ears to block out the sound. It’s a cliché, but one that is based on some truth.
Twice as many men snore than women, with roughly 40% of men reporting snoring versus 20% of women. That still means that 840 million women are regular snorers. Snoring is certainly not just a male problem, but there are differences. Let’s explore why and how.
Men’s airways are primed for snoring
The reason more men snore is partly down to their airway anatomy. Studies have found that there are crucial differences in the structure of men’s airways.
More soft tissue
Firstly, there’s more tissue in the noise makers themselves. Studies indicate that the male soft palate – a key player in generating snoring sounds – has a larger cross-sectional area. There’s basically more tissue available to flap around and make noise [1].
Male upper airway collapses more
Secondly, men’s upper airways are more prone to obstruction. The vulnerable area between the hard palate and epiglottis is larger in men. This means there is a greater amount of unsupported soft tissue that will relax whilst asleep [2].
Side note:
It is important to note that this has nothing to do with men having deeper voices. Whilst men’s vocal folds are indeed longer, they have more structural support and reside lower than the collapsible area associated with snoring. The area below the roof of your mouth and above the epiglottis is the soft, flappy area we are interested in.
Men gain fat on the neck
Finally, men put weight on the areas that can cause snoring. The chance of your airway collapsing is increased if there is more weight on your neck. An increased neck size and fat around the neck therefore puts you at greater risk of snoring.
We know that obesity is a great risk factor in snoring, but men and women distribute fat differently which influences snoring patterns. Men put on more weight around their neck and chest, whereas women tend to gain fat on their thighs, hips and buttocks.
Snoring is linked to male hormones
Testosterone is the main male sex hormone. Its primary duty is the maintenance and development of reproductive tissue, but it also plays a part in snoring.
Side note: what are hormones?
Hormones are produced in various glands and are the body’s chemical messengers. They travel in the blood and are a means of communication between different areas of the body, regulating the inner workings of cells.
Various studies have looked into the effects of testosterone on breathing during sleep, with a focus on sleep apnea. It has been linked to increased airway collapsibility and greater breathing instability, though the exact mechanism is still uncertain [3].
Indeed, raised testosterone in women is linked to disturbed breathing during sleep. Women with polycystic ovarian syndrome, a condition where testosterone levels are higher than they should be in women, have a greater risk of developing obstructive sleep apnea [4].
Female hormones protect from snoring
Whilst male sex hormones increase the chance of snoring, female sex hormones have a protective effect.
Steady ventilation
Progesterone, a hormone particularly high during pregnancy, promotes steady ventilation. This causes a less pronounced drop in airflow during sleep and makes the soft airway less prone to collapse [5].
Less relaxed tongue
Progesterone, alongside another key female hormone, estrogen, enhances the ability of a key muscle in the tongue to contract, reducing the likelihood of it falling back and causing a blockage [6].
Menopause increases the likelihood of snoring
As female sex hormones decline rapidly at the menopause, the likelihood of developing snoring or sleep apnea increases.
Incidence of snoring increases with age for both sexes, but in women, the onset of the menopause is a watershed moment when it comes to snoring and sleep apnea.
Artificially re-introducing female sex hormones via hormone replacement therapy (HRT) has been shown to reduce the occurrence of sleep apnea [4].
Obstructive Sleep Apnea is different between men and women
Sleep apnea is less common than habitual snoring but the relative proportions of men and women are roughly the same, with twice as many men suffering from the condition as women. However, eight times more men are diagnosed [7].
Some time ago, the sleep apnea ratio of men to women was thought to be as stark as 60:1. We are learning now that this is because of frequent misdiagnosis and the fact that women often exhibit an atypical form of the condition.
The severity of sleep apnea is measured by counting the number of instances where breathing stops (apnea) or is severely reduced (hypopnea). This measurement is called the apnea-hypopnea index (AHI). As women are less likely to experience complete airway collapse, they tend to have a lower AHI score.
Importantly, these women aren’t necessarily experiencing less obstruction. Women display more frequent episodes of longer, partial obstruction that still causes the fatigue, sleepiness and health issues associated with OSA.
Conclusion
With snoring, as with many dysfunctions in the body, there are things that are out of our control. Our sex is obviously the main one. Seeing where you fit into the profile of the 2 billion people worldwide who snore can help you understand your snoring better and be ready to take the next steps.
Was this post helpful?
References
- Lin CM, et al. Gender Differences in Obstructive Sleep Apnea and Treatment Implications. Sleep Medicine Reviews 2008; 12(6): 481-496. https://www.ncbi.nlm.nih.gov/pubmed/18951050
- Malhotra A, et al. The Male Predisposition to Pharyngeal Collapse: Importance of Airway Length. American Journal of Respiratory and Critical Care Medicine 2002; 155(10): 1388-1395. https://www.ncbi.nlm.nih.gov/pubmed/12421747
- Andersen ML & Tufik S. The effects of testosterone of sleep and sleep-disordered breathing in men: Its bidirectional interaction with erectile function. Sleep Medicine Reviews 2008; 12: 365-379. https://doi.org/10.1016/j.smrv.2007.12.003
- Bixler EO, et al. Prevalence of Sleep-disordered Breathing in Women: Effects of Gender. American Journal of Respiratory and Critical Care Medicine 2001; 163(3): 608-613. https://doi.org/10.1164/ajrccm.163.3.9911064
- Saaresranta T, et al. Sleep disordered breathing: is it different for females? European Respiratory Journal, Open Research 2015; 1(2): 00063-2015. https://dx.doi.org/10.1183%2F23120541.00063-2015
- Popovic RM & White DP. Upper airway muscle activity in normal women: influence of hormonal status. Journal of Applied Physiology 1998; 84: 1055-1062. https://doi.org/10.1152/jappl.1998.84.3.1055
- Hines J. 2018. Women with Sleep Apnea: Why Women are Less Often Diagnosed with OSA. [ONLINE] Available at: http://www.alaskasleep.com/blog/women-with-sleep-apnea-why-women-are-less-often-diagnosed-with-osa [Accessed 16 August 2018].
What is Snoring?
What is Snoring?
Snoring is the sound of partial airway obstruction which causes soft tissue to vibrate and make noise.
Nearly everyone snores at some point. Snoring can affect young and old, men and women, and people of all shapes and sizes. Roughly 40% of men and 20% of women snore – that’s over 2 billion inhabitants of planet Earth.
This habit is often shrugged off as annoying and embarrassing but otherwise nothing to be worried about. In reality, snoring can affect so much of life, having physical, mental and social repercussions.
But what is a snore?
Q. What is a snoring sound?
A. Vibrating soft tissue
Snoring is the sound of the soft palate and other soft tissue in the upper airway vibrating. This can include the uvula, tonsils, adenoids, nasal turbinates and other surrounding tissue.
These vibrations happen when air can’t move freely through your airway which causes the floppy soft tissue to flap and make noise.
Q. Why does snoring only happen during sleep?
A. Relaxation
When we fall asleep, many muscles in our body relax. This is true of the muscles in our airway.
Being still in our sleep prevents us from doing damage to ourselves and others by acting out our dreams or walking around when not fully conscious. Therefore our muscles – including those in our upper airway – are paralysed when we sleep.
Because we are lying down while we sleep, gravity compounds this relaxation to set up snoring – whether it’s your jaw falling open, your tongue falling back or your throat giving way to the weight around it.
All of us relax when we sleep – so why doesn’t everyone snore? Snoring occurs when this normal relaxation is added to abnormal airway obstruction.
Q. Why doesn’t air flow freely?
A. Obstruction at various places in the airway
Airflow becomes turbulent when there is an obstruction in the airway causing a partial blockage.
The obstruction can be in several areas in the upper airway, sometimes concurrently [1]:
Tongue. When this falls back, it can block your airway.
Soft palate. This is the soft tissue behind the harder roof of your mouth. Excess floppy tissue here stops air flowing freely.
Nose. The nose is the more efficient way of breathing, and when dysfunctional, mouth breathing ensues and heightens the risk of snoring. Breathing through a partially blocked nose can also create whistling and popping sounds, or even cause suction that collapses your airway.
Knowing your obstruction is the starting point in identifying what causes your snoring.
If you are lucky, there is one cause for your snoring. You can tackle this and sleep quietly. More often than not, multiple factors accumulate to cause your obstruction.
Q. What causes airway obstruction?
A. Many different factors can influence snoring
Understanding what causes your airway obstruction is vital for matching snoring solutions to you. This is what we strive to help with at SnoreLab.
The reasons for snoring are made of lifestyle factors that you can control PLUS physical traits that are beyond your influence.
Factors that you CAN control
Many lifestyle factors need scrutinising if you want to identify the causes of your snoring:
Bodyweight. The heavier you are, the more likely you are to snore as excess weight compresses your airway.
Sleeping position. Sleeping on your back is a big risk factor for snoring. This position allows gravity to compress your airway more than when you sleep on your side.
Allergies. Allergic reactions cause nasal blockage and airway inflammation. Allergy sufferers have trouble breathing through their nose and therefore have to switch to noisier mouth-breathing.
Alcohol. Depressant drugs like alcohol make muscles relax. Relaxed airway muscles are more prone to disrupting airflow.
Smoking. Cigarette smoke irritates the airways, causing inflammation which can lead to obstruction.
Common cold. Similar to allergies, colds mean stuffy noses and mouth-breathing.
Medication. Certain drugs used to control blood pressure, sleeping pills and even some medicated nasal sprays can increase nasal congestion and relax airway muscles.
Factors that you CAN’T control
Unfortunately, in some cases, the obstruction is simply a part of your anatomy and genes.
Certain face shapes predispose people to snoring. For example, those with a pronounced overbite have a recessed jaw which pushes the tongue further back into the airway, making it more prone to falling back and causing a blockage.
Age. Older people are more at risk of snoring. This is because as we age we lose muscle tone in much of our body – this includes the muscles of the airway.
Sex. Men are more likely to snore than women. This is due to several reasons including how fat is differently distributed, contrasts in male and female airway anatomy and hormones.
Hormonal balance. Some hormones are protective against snoring, whereas others confer heightened risk. Menopause is a time in many women’s lives where snoring starts for the first time. This is because of a decrease in hormones that help to prevent snoring.
Thankfully, these uncontrollable elements are usually associated with heightened risk but not a direct cause.
Conclusion
By understanding the basis of snoring you can gain better insight into what makes you snore. Just as snoring impacts upon your life, your lifestyle impacts upon your snoring.
There are many snoring remedies and solutions available, including products that enthusiastically tell you that this will stop you snoring. Many of them do work very effectively, but only if they are well matched to you and your snoring.
Understanding how your snoring works and finding your specific causes is the first step towards healthier, quieter nights.
Was this post helpful?
References
- Chokroverty S. 100 Questions & Answers About Sleep and Sleep Disorders. Jones & Barlett, Burlington 2007. p124