By Rachel Burge
Plagued by snoring? Up to 40 per cent of adults in the UK are believed to snore when they sleep – that’s around 15 million people.
But snoring isn’t just a problem for the millions of sleep-deprived partners forced to seek refuge in the spare room every night. As well as putting a strain on relationships, snoring caused by obstructive sleep apnoea (OSA) can have serious health consequences for the sufferer, too.
What makes us snore?
Not every snorer sounds the same – there’s the freight train impersonator, pneumatic drill, and wounded walrus to name but three – and it turns out that people snore for a variety of reasons. So why do some of us snore and not others?
‘When we are awake, we have enough muscle tone to keep our airway open,’ says Consultant ENT Surgeon Michael Oko. ‘But when we sleep, we lose muscle tone and the tongue, throat and roof of the mouth relax, causing the loose tissue in the throat to sag, which narrows the airways.
‘For some, this reduced breathing space causes the soft tissue in the air passages to vibrate, which results in snoring. Other people snore because they have an obstruction, which could be due to a nasal deformity, enlarged tonsils, or nasal congestion due to allergies or polyps.’
While being overweight and lifestyle factors are most commonly to blame, a combination of factors can sometimes play a part, says Oko.
‘A blocked nose caused by a twisted septum. The size of your tonsils. Having a small jaw, which means the tongue is squashed and tends to fall backwards during sleep. Even your cross-bite or having a longer than usual uvula, the little piece of flesh that hangs down from the rear portion of the soft palate, can mean you’re more likely to snore.’
When should you take snoring seriously?
Oko suggests using the ‘STOP BANG‘ questionnaire. If you score more than three you should see your GP for advice. If you score more than five, then your doctor should consider sending you to see a specialist for a sleep study. This will tell the specialist if you have simple snoring, or mild, moderate or severe sleep apnoea. In addition to snoring, people with OSA may have the following symptoms:
- Multiple trips to the loo at night
- Early morning headaches
- Short term memory loss
- Loss of interest in sex
The best snoring remedies
Oko recommends the following five remedies, depending on what type, and how bad a snorer you (or your partner) are:
1. Mandibular Advancement Device (MAD)
Some people snore because their tongue drops to the back of their throat while they are asleep, creating an obstruction which makes the airway vibrate. A Mandibular Advancement Device (MAD) is worn while sleeping. It works by holding your lower jaw slightly forward to pull your tongue forward, as it is attached to the back of your jaw, preventing the upper airway from collapsing.
As a result, air is able to flow more freely, reducing soft tissue vibration. The device can be used for simple snoring and mild to moderate sleep apnoea. The cheapest ones are self-fitted after softening in hot water, but the best results (70% success) are achieved from having a specialist dentist fit the device.
2. Internal nasal dilator external nasal strips
Some people’s nostrils tend to collapse when they breathe through their nose. You can find out if you’re one of them with this simple test. Look in a mirror and take a deep, rapid sniff in with your mouth closed. If the nostril collapses, then a nasal dilator may be helpful. This is a small and ‘springy’ bit of plastic that holds open the nostrils, making it easier to breathe.
If you don’t like the idea of wearing something inside your nose, nasal strips are another option. These are a bit like sticking plasters that you fix over your nose to help open up the nostrils. Like nasal dilators, these are best for mild snoring.
3. Treat nasal allergies/polyps
If you suffer with nasal allergies it is worth treating these with a combination of topical nasal steroid sprays with a non-sedating antihistamine. Often you can buy these over the counter at a chemist or get them from your GP on prescription. If your nose is blocked, your mouth will open and you will snore.
4. Lifestyle/positional changes
Avoiding sedative medications and alcohol will definitely help, as they cause respiratory depression and make you snore deeper and louder. Staying off your back while you sleep will help as we all tend to snore more in this position as our tongue flops back.
5. CPAP machine
If you have moderate to severe obstructive sleep apnoea, or you’ve tried other snoring remedies without success, a CPAP machine may help. A study of 15,325 patients carried out between 2008 and 2016 found that treatment with CPAP was associated with a greater reduction in symptoms of daytime sleepiness and with improved quality of life, mood, and attendance at work.
It delivers a continuous flow of air through a mask, which you wear over your nose/or nose and mouth at night. The machine senses snoring sounds and apnoeas (pauses in breathing) and automatically increases air pressure to counteract them.
To use a CPAP machine, you’ll need a prescription from your sleep apnoea specialist. The new machines are very quiet and certainly less noisy than your snoring. The mask can take some getting used to, though you should have a range of masks to try. Most people love them and find it helps them – and their partner – to get a better night’s sleep.