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Snoring Made Me Do It

August 23, 2010

Snoring drives a lot of people mad.  It led Guo Liwei, a student of Jilin Agricultural University, to kill Zhao Yan, his college roommate.

Guo  had argued with his roommate about his  loud snoring for some time.  Kept up night after night, he finally made a tape of Zhao’s sleep behavior and put it up on the school’s website.  He claimed many other students supported him, but  Zhao himself become incensed.  One sleepless night, Guo  stabbed him in the chest and back, killing him.  Pleading guilty to murder, for which he was sentenced to death (the sentence was commuted to probable life in jail) he claimed that Zhao “verbally abused me several times, prompting me to kill him.”

Conditions in Chinese universities are a far cry from those in North America.  Often families have scrimped for decades so their children can attend undergraduate schools.  School supported spaces for living and study may be spartan or nearly non-existent – it is a rare Chinese university that will proudly show its hundreds of library study carrels.  Yet in a society which greatly values social harmony, publicly humiliating a fellow student was itself remarkable, even shocking.  Zhao Yan’s angry reaction to Guo would be considered an appropriate response by many Chinese students.

When I’ve mentioned this case to patients, many spouses have admitted “angry or violent thoughts” when repeatedly kept up by their partner’s snoring.  Snoring is a major, unheralded cause of family discord, and a big reason so many Americans are insomniac or  sleep alone (see Rest Letter 1).  Fortunately, snoring is eminently treatable.

Regular Snoring Is Bad for Your Health

Loud, noisy breathing during sleep is not normal.  It means that something is blocking the air getting down your throat and into your airway.  You need that air to reach the lungs unimpeded so that you can oxygenate your blood.  Chronic snoring is associated with more heart attacks, strokes, and deaths, especially in younger people.

Lots of stuff can obstruct the airway.  Anything that makes the back of the throat less stiff and more floppy can cause snoring.  Alcohol and sleeping pills are major causes.   One personal story I can’t forget was a consult I received when teaching at Brown – a young woman had decided to “celebrate” her thirtieth birthday by downing a quart of vodka.  She went into respiratory failure and requiring intubation in the ICU.  What kept her on a breathing machine well beyond alcohol’s  brain based respiratory depression was the floppiness of her airway, which continued to block  airflow into the lungs. In general, most people are thought to develop snoring due to increasing weight, thereby augmenting the amount of tissue which can obstruct the back of the throat.

Over time, chronic snoring appears to produce sleep apneas, frequent stopped breathing episodes where more and more of the airflow is blocked.  One thing that probably happens with chronic snoring is that the information flow regulating breathing and circulation gets desynchronized.  Eventually, the two get so out of synch that apneas proliferate. Then people became at major risk of death through cardiovascular disease, decreased mood, and worsened intellectual and physical performance (sleep apnea is a major cause of traffic accidents.)

What To Do

First, ask yourself if the snoring is temporary or chronic.  If it’s caused by an upper respiratory infection or drinking too much booze, time and less alcohol can make it go away.  If snoring is weight related, following a simple process like FAR (Food-Activity-Rest) where you move or walk after each meal, can bring a surprisingly quick reduction in symptoms.

If  snoring is really loud and people seem to regularly stop breathing, you might want to consult a board certified sleep physician. GPs and others may be quick to order a night-time sleep test, which may or may not be indicated.  It’s best to get to speak with a sleep doctor concerned with long term treatment and prevention.  Much of snoring may be positional.  If that is the case, “high tech” solutions like sewing a pocket of tennis balls onto a large T shirt may abate snoring by keeping people sleeping on their sides, or commercial devices like a Zzoma belt can also work.  Weight loss is difficult for a lot of people, but becomes possible if they recognize that ordinary physical activity can make them feel and look a heck of a lot better – as well as literally make them smarter.  And if someone is diagnosed with sleep apnea, there are several treatments that are effective, beyond weight loss.

Zhao Yan did not have to die.  There are lots of ways to take care of snoring short of murder. You start by paying attention to what might be causing it.

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