Snoring a sign of respiratory depression/oversedation?

[Virgo_RN]

A comment in another thread got me thinking. I've heard this before, that if the patient is snoring, this can actually be a sign that they are oversedated. What if their respiratory rate is WNL and their sats are okay? You can walk down the hallway of any acute care unit and hear snoring emanating from a room or two. People snore. How does a nurse know when snoring is a sign that something is wrong?

Discuss.

[loricatus]

does the snore sound like an excited/agitated pig?

short, abrupt, erratic type snorts?

leslie:)

Sorry Leslie, never heard an excited pig. But, what you described sounds more like a laryngospasms (also an obstruction)

[CABG patch kid, BSN, RN]

Not sure if this is relevant here, but since I didn't read the other thread about snoring, I'll share this here. A scary story about emergent snoring....

On the tele floor, had four patients. All at the end of one hall. I'm sitting down at about 3 am to do some charting when I hear a really loud snore coming from somewhere. I start walking around, tilting my head towards each door trying to find the source. I find its one of my patients, snoring very very loudly. I turn on the light to find this lady slumped down in bed, mouth and chest covered with secretions, breathing but unresponsive. I yelled for help, another coworker came in and something in my brain clicked. I yelled for her to go get the accucheck machine and some D50. I tried a sternal rub but the patient was still unresponsive. Finally got the accucheck machine, blood sugar was 24!!!! Pushed D50, still unresponsive, pushed another D50, finally sugar was up to 240 but pt was still having neuro deficits. Actually she didn't come around for 30 minutes. Her sugar started dropping again, she ended up on a D10 drip and Q 1 hour accuchecks for the rest of the shift. About an hour after the incident, she was telling everyone how I saved her life, which for the first time in my career I actually felt I did, all from her snoring.

And anyone who says Lantus doesn't have a peak is full of it!! Because this lady apparently had a history of hypoglycemic episodes d/t Lantus, so watch out for your patients!!! And always check on snoring!!!!

[GoECU]

There is a different 'sound' to the obstructive caused snoring and the regular sleeping snore. Can't describe the sound here; but, it has nothing to do with the decibel level. Once you have heard the type where the patient desats d/t an obstruction, you will understand what I mean.

When I was rotating thru the ER they called it the "death rattle". We had a suspected CVA patient making this "different sound" and he was unresponsive...10 minutes later he was coding.

[GilaRRT]

By definition, snoring is always caused by an obstruction while sleeping. An obstructive process always causes snoring. Obviously, the cause of the obstructive process may be rather benign or significant. However, regardless of individual variations in volume, pitch, frequency, etc, snoring is a result of an underlying obstructive process.

[CaLLaCoDe, BSN, RN]

mistaken post

[CaLLaCoDe, BSN, RN]

Not sure if this is relevant here, but since I didn't read the other thread about snoring, I'll share this here. A scary story about emergent snoring....

On the tele floor, had four patients. All at the end of one hall. I'm sitting down at about 3 am to do some charting when I hear a really loud snore coming from somewhere. I start walking around, tilting my head towards each door trying to find the source. I find its one of my patients, snoring very very loudly. I turn on the light to find this lady slumped down in bed, mouth and chest covered with secretions, breathing but unresponsive. I yelled for help, another coworker came in and something in my brain clicked. I yelled for her to go get the accucheck machine and some D50. I tried a sternal rub but the patient was still unresponsive. Finally got the accucheck machine, blood sugar was 24!!!! Pushed D50, still unresponsive, pushed another D50, finally sugar was up to 240 but pt was still having neuro deficits. Actually she didn't come around for 30 minutes. Her sugar started dropping again, she ended up on a D10 drip and Q 1 hour accuchecks for the rest of the shift. About an hour after the incident, she was telling everyone how I saved her life, which for the first time in my career I actually felt I did, all from her snoring.

And anyone who says Lantus doesn't have a peak is full of it!! Because this lady apparently had a history of hypoglycemic episodes d/t Lantus, so watch out for your patients!!! And always check on snoring!!!!

Thank you for this post!!! This is one for my memory book of low blood sugars, wow! Who would have thunk it?!

Reminds me of a patient I had early on where he simply was acting demented, scrunching himself down in the bed, mumbling making no sense at all. My preceptor was wise enough to take his blood sugar, sure enough it was 39!!!! OMG...check the blood sugar every time, even if they have no history of diabetes. It could save their life.