I carry an Elmo Halloween basket as my tool bag at work! The kids way prefer it to a starched white coat and the parents generally seem amused! My intangible tool bag, however, is pharmaceuticals. I make a daily concerted effort to treat illness with the right medication, and often in pediatrics, a gentle dose of time. The resources available for treatment are vast depending on the issue, but possibly only partially explored by mainstream medicine. Yesterday, more than one parent talked about nightly snoring in her child during a well visit… not secondary to a cold or presumed due to allergic rhinitis or obesity, but just chronic snoring with daytime fatigue. On exam, some nasal inflammation was present – it is Fall and both viruses and allergies abound, but otherwise the exam was normal – no gigantic tonsils or other findings that might explain soft tissue obstruction with sleep. My first step for patients that present this way is often to trial a medicated (steroidal) nasal spray and perhaps nasal saline and a good nose blowing before bed. This approach usually works, but when does a parent discontinue the nasal spray? What side effects, if any, are present? What is an alternative approach?

Thyme, a fragrant herb used frequently in cooking, is purported to have multiple medicinal benefits with almost no known side effects. Per WebMD, thyme could interact with medications used to slow blood clotting, such as aspirin (taken by people with clotting disorders, i.e. people who clot too easily) and make these medications even more effective, possibly resulting in bruising etc. This concern applies to a very small portion of my patient population and in the method of use we will be discussing below is probably irrelevant. Reported benefits of thyme are vast, but most evidence supports its role in reducing airway inflammation and acting as an expectorant with cough and bronchitis. There is also some data on its role in reducing agitation in elderly patients, improving alopecia (hair loss), and reducing spastic movement in pediatric movement disorders. Furthermore, some sources suggest that thyme can help with bedwetting, acne, bad breath etc. The internet community absolutely loves thyme!! The ability of thyme to help reduce overall airway inflammation (even at the mouth and throat) is the key that supports its use in snoring treatment.

With little to no negative impact with topical (diluted in coconut or olive oil and applied to the big toe at night) or via an aromatic diffuser, it’s worth a shot to treat snoring, especially in combination with a nasal saline spray and a good nose blowing before bed.

Certainly this approach makes sense before trying a pharmaceutical spray, as the side effects of a steroid nasal spray are certainly more substantial, especially with long-term use. However, it is important to recognize that in many cases, a steroid nasal spray is necessary. Herbal remedies are often perfect for less severe cases but perhaps not enough in the severely allergic kids or those with recurrent ear/sinus infections. It is just an important reminder for me, that a stepwise approach makes the most sense and less is often times more. Just because my tool bag is equipped with prescription medications doesn’t always make that singular approach best…

P.S. —singing and playing wind instruments has also been shown to reduce snoring secondary to strengthening muscle groups in the affected space! And of course, side sleeping and angling the bed help too! Thoughts???

 

http://www.webmd.com/vitamins-supplements/ingredientmono-823-thyme.aspx?activeingredientid=823&activeingredientname=thyme

http://www.medicalnewstoday.com/articles/266016.php

http://www.mayoclinic.org/diseases-conditions/snoring/basics/lifestyle-home-remedies/con-20031874