Does your partner's loud snoring ring through the halls all night? Well, then, you know it can be a nightmare for a variety of reasons.

1. You may wake up tired all the time because you find it difficult to fall asleep, stay asleep or go back to sleep during the night.
2. Your partner may wake up tired all the time because he or she didn't sleep restfully (perhaps because of your repeated elbowing to get him or her to shut up).
3. Resentment may develop on both sides. On yours, if your partner doesn't take the issue seriously or try to find a solution. On your partner's, if he or she has to change long-favored sleep habits, positions or patterns; go see a specialist; undergo a sleep study; or try unwanted equipment or treatments.
4. It could be a sign of something more dangerous for the snorer.

For all these reasons and more, people who specialize in sleep disorders and snoring often wind up sounding more like marriage counselors than physicians.

"The first thing I tell my patients is: it's a two-way street — you both have to be willing to give a little ground," says Dr. Omar Ahmed, a sleep medicine specialist with Houston Methodist. "Sleep deprivation is not conducive to relationship building — ask anyone who's ever had a newborn in the house."

However, sleeping in separate bedrooms every night also may not be healthy for the relationship. Not to mention, it may not even be feasible for people who don't happen to have an empty guest bedroom.

So, what's a couple to do when they find themselves in this situation? We asked Dr. Ahmed for his best advice on sleep, snore wars and long-term solutions that don't end in divorce."

Q: What's the best place to start?

I recommend figuring out what type of snore issue it is first. There are two main kinds. Sleep apnea is when your throat closes down and breathing stops and starts repeatedly throughout the night. This is a potentially serious sleep and health condition, though there is a range from mild to severe.

Primary snoring is the classic loud upper airway breathing sounds without any apnea, or cessation of breath. This is a nuisance, not so much a health concern.

Look for signs of sleep apnea first. Try to rule that out or get a diagnosis, because it will be easier to proceed when you know which one you're dealing with. First thing: discuss the symptoms and have the non-snorer listen carefully to the snorer for about an hour to make observations.

Does your partner:

• Usually get a full night of sleep but wake up feeling tired most mornings?
• Experience excessive daytime sleepiness and irritability?
• Wake up frequently in the night for unknown reasons (not due to noise or a need to go to the bathroom)?
• Stop breathing for 5-10 seconds or more at a time? How many times?
• Seem to be gasping for air during sleep? Wake themselves up gasping for air?
• Have a BMI above 30, high blood pressure or a wide neck circumference (>16 inches)?
  
  

These are the signs and risk factors for sleep apnea. If you said no to all of these questions, it's probably not sleep apnea. If you said yes to any of these questions, or you aren't sure, a sleep study is probably in order.

Q: How do you get a sleep study?

The easiest way is to have your primary care doctor refer you to one. These can be performed at home or in a certified sleep clinic.

The gold standard is the sleep clinic test because it gives you a more complete analysis of sleep apnea and how it may be affecting other chronic conditions. But at-home tests may be easier to schedule and undergo so often people start there.

Typically, these days, they just give you a special watch to wear. That's the only equipment needed. If the at-home sleep test doesn't provide definitive answers, you can then move on to do a test in a sleep clinic.

Many health insurance plans will cover these tests, but you'll want to verify coverage first.

It should give a definitive answer to whether it's sleep apnea or primary snoring.

Q: If it's sleep apnea, what should you do next?

Your partner will be referred to a specialist, typically a pulmonologist.

There are three different types of sleep apnea, each with varying levels of health risk. When lungs have to blow pressure against a closed throat, they are having to work extra hard, and it causes a lot of downstream effects. At a minimum, sleep apnea can severely disrupt performance and function during the day. And over time, it can contribute to risk of heart disease, stroke and exacerbation of other chronic health conditions.

CPAP machines, which look a bit like gas masks and deliver oxygen continuously throughout the night, are highly effective. If your partner is overweight, losing weight can reduce or prevent sleep apnea. Research shows that using CPAP consistently for sleep apnea treatment is associated with reduced conflict and higher relationship satisfaction for both partners.

Q: What if sleep apnea has been ruled out?

Once you know it's primary snoring, I recommend you "test" for a variety of factors like alcohol consumption, nighttime medication, sleep position, one pillow vs. two, etc. Have your partner try nose strips, which look like tiny bandages and are sold in drugstores; and nose spray, like Afrin. (Not recommending this for long-term use, just try it to see if it has an effect. If it does, you'll know that congestion plays a role.) Approach it like a scientist: journal if the sound gets better or worse, try to find a pattern.

After this testing phase, if you've identified a clear culprit and can avoid it, mitigate it or work around it — that should go a long way towards resolving the issue. On nights you know your partner is likely to snore, you can either sleep in different rooms, try to go to sleep well before your partner, or put earplugs or white-noise machines on to get through it.

Q: What if you don't find any pattern or notice any reduction in your partner's snores?

At that point, I would recommend seeing an otolaryngologist, also known as an ear nose and throat specialist or ENT. That's what I am. When patients come see me with all this information about what they've observed and ruled out, it is extremely helpful to the process.

An ENT will perform a physical exam to look for any anatomical causes. Patients with a deviated septum (imbalance between the two sides of the nose) can have issues in the snore department, along with a variety of other breathing problems. There are surgical remedies that will probably be recommended that will likely help with the snoring.

Some patients have alignment issues with their jaw, tongue and throat. These patients can be helped by using a retainer-like device that helps them breathe more easily. The device pushes the tongue and jaw forward to improve airflow and typically helps reduce snore sounds as well.

Some patients have enlarged uvulas (the flap at the beginning of your throat) or their tonsils and soft palate of the back of their throat may be causing extra vibrations and sounds. There are surgeries to address these issues, but they are often a little more invasive and uncomfortable for the patient, so we like to try other things first.

Q: What else can you try if there's no treatment that works?

You can make a point to go to bed earlier than your partner — ask them not to lie down until you've been asleep for at least 15-30 minutes. This should limit their ability to wake you up with their snores.

Or you can use noise canceling headphones until you are dropping off to sleep, then switch to soft earplugs suitable for sleep. You can angle away from each other, using pillows to prevent your partner from rolling over on their back. Many people find it easier to drown out the sound with white noise machines or music playing.

And if all else fails, you can revisit the separate bedrooms topic: Maybe make a pull-out bed in an office? Have the kids share a room? Buy a really comfortable couch. Remember, it's a two-way street. If your partner has made their best effort to address the issue but it still hasn't gone away, my advice is to work with the situation as best you can. To me, that certainly seems preferable to breaking up an otherwise happy relationship.