The good news is that you do not have to snore. Snoring can be completely controlled. There are many easy-to-follow solutions so that you and your entire family will sleep better. The options range from the least invasive lifestyle changes to surgery. I would recommend that you work down the ladder until your snoring is remedied. What’s more, if you properly treat your CAID symptoms, you may find that your snoring will go away on its own.
ARE YOU OVERWEIGHT?
The first course of action is almost always centered on weight loss. You will need to determine if your weight falls within a healthy range for your BMI. You don’t have to look or feel overweight in order for your BMI to be unhealthy. Table 1 has already done the math for you. To use the table, find your height in inches in the left-hand column. Move across the row to find your weight. The number at the top of the column is the BMI for your height and weight. Your BMI is then assessed by categories, according to the National Institutes of Health:
■ Underweight = <18.5
■ Normal weight = 18.5-24.9
■ Overweight = 25 - 29.9
■ Obese >30
If your BMI is high, see your primary-care physician. He or she may want to perform a quick blood test to see if your thyroid hormone levels are in order. If your thyroid is underactive, it could be a cause of your weight gain. You can be prescribed a thyroid hormone treatment that will control your gland: This simple step might lead to immediate
weight loss. It is important for you to treat your thyroid because weight gain is only one of the problems that you may encounter from having a low level of thyroid hormone.
I also check my patients to make sure that they are not anemic (low red blood cell levels). Anemia prevents the body from losing weight and can cause fluid retention. Additional iron supplements are necessary for better cell function and metabolism, and the primary reason for the anemia also needs to be uncovered. When an anemia workup is necessary, I typically work closely with the primary-care physician and, if
needed, an endocrinologist or a hematologist so that we can treat the anemia appropriately.
If your thyroid is working properly and you are not anemic, you’ll need to begin a weight-loss regimen. If you have more than 30 pounds to lose to reach a normal BMI, you might consult a nutritionist, primary-care physician, osteopath, or chiropractor who can develop a diet specific to your needs. Of course, a daily exercise routine is also helpful for weight loss.
An eating regimen that leads to weight loss and curbs snoring would primarily consist of a low-fat, high-protein diet, steering away from carbohydrates, especially at night. Carbohydrates do not directly affect snoring but metabolize into excess fat cells: The carbohydrate molecules that are not burned during the day will convert into body fat in a very short period of time. Alcohol adds lots of empty calories. All alcoholic beverages contain substantial calories and some alcohols are a form of carbohydrate. As a result, alcohol should be avoided; it can cause a flare-up of CAID, the extra calories lead to weight gain, and its sedative effect causes muscle flaccidity and collapse of the airway - all further aggravating the conditions that produce snoring.
Those who are dieting should eat three to four small meals a day, instead of skipping meals and eating larger portions. Frequent, smaller meals help keep your metabolism burning at a higher rate, thereby burning more calories. The last meal of the day should be eaten at least 3 hours before going to sleep. Many people do not eat breakfast or skip lunch, and then have a large dinner and go straight to sleep. This is not good: By following this eating schedule, you are not giving your body enough waking hours to digest such a heavy meal. A large meal and a couple of alcoholic drinks before you go to bed is a recipe for disaster for both your overall health and specifically for your snoring. What’s more, eating one meal a day slows down your metabolism and causes you to gain weight. Some people report that if they eat a larger lunch and a smaller dinner, their snoring significantly improves.
In addition, you should drink plenty of water - going to the bathroom a few times a day and having clear urine. Staying well hydrated is good for your entire body, including your skin, heart, circulatory,
respiratory, and gastrointestinal (GI) tract. If you eat right, stay well hydrated, and exercise, you will start to lose weight.
My patient Evan is a 51-year-old senior executive who came in complaining of a sinus infection. When asked if he snored, Evan became embarrassed. His wife, Laura, who was sitting with us in the examining room looked up toward the ceiling and started to laugh. “Are you kidding?” she said. “I haven’t slept well in years!” I reassured Evan that snoring was common and that there was nothing to be ashamed about.
Just by looking at him, I could tell that Evan needed to lose a few pounds. A BMI table showed that he needed to lose about 15 pounds to reach the top of the normal range, but he could probably stand to lose another 10 pounds as well. I found that Evan had an acute sinus infection, causing him significant nasal obstruction, which was also contributing to his snoring.
I started Evan’s treatment with an antibiotic to clear up his sinus infection and placed him on a nasal steroid spray, which brought down some of his nasal swelling. I told him about his need to lose weight and arranged for him to meet with a nutritionist. I also told him to follow Dr. Gary Josephson’s (my brother’s) protocol for hydration: Every morning Evan was to fill a large thermos with ice and sliced lemons or lime and top it off with water. He was told to keep the thermos at his desk and drink from it throughout the day, filling it back up when the water was gone. This would force him to drink at least 2-3 liters of fluids daily. We made another appointment for him to come back in 6 weeks so I could check on his progress.
When Evan came back, he was proud to share with me that he had lost more than 10 pounds, and his wife reported that his snoring had significantly improved. Evan had started to exercise and eat right, and he was staying well hydrated. Over the next 5 months, Evan lost a total of 21 pounds. Even Laura is now sleeping soundly, and Evan is much happier not sleeping on the couch.
If you follow the tips I gave Evan for an entire month and don’t see any results, I strongly suggest that you continue to diet while under the
care of a physician and a nutritionist, or other health-care provider. I do not recommend taking over-the-counter (OTC) or prescription diet pills unless you are under the care of a physician.