Dear Dr Nina: My snoring is driving my partner mad. He's sleeping in our spare room
Question: I am in my mid-forties and over the course of the last year I have started to snore quite badly. My partner is at his wits end with me. I have tried everything from nasal strips on my nose, sleeping on my side to practising exercises specifically for my throat to see if that would help. I don't drink and exercise daily. What else can I do? I know I'm slightly overweight and this could be contributing to it. Please help as my partner is sleeping in our spare bedroom most nights.
Dr Nina replies: Snoring is a very common condition. It most commonly affects people aged between 40 and 60 and is twice as common in men as in women. It occurs when the soft tissue at the back of the mouth or throat becomes floppy and vibrates when a person breathes.
There are various grades of snoring. Grade one is fairly quiet and intermittent and doesn't lead to any altered sleep of the person who snores, but may disrupt that of their partner. It is not associated with any health complications.
Grade two snoring occurs on more than three nights a week and is quite loud. It may result in some breathing difficulties due to narrowing of the upper airway. This may disrupt sleep somewhat and can lead to the person affected feeling tired the next day.
Grade three snoring occurs every night, is loud and may be heard from another room. This grade of snoring is commonly associated with a condition and causes Obstructive Sleep Apnoea (OSA), which does indeed have long-term implications for an individual's health.
Grunting sounds at night are very typical of this.
It is estimated that 4pc of middle-aged men and 2pc of middle-aged women suffer from OSA. When we sleep the muscles in our throat become more floppy. In most people this is not a problem, however in those with OSA the muscles are so floppy that they cause the airway to narrow or collapse completely. This blocks off the airway causing breathing to stop (apnoea) or episodes of very shallow breathing (hypopnoea).
Many people who suffer from OSA are unaware that they are not sleeping well. They don't recall the frequent night-time waking, but their partners are usually very aware of the problem. Those with OSA often feel tired or drained during the day. People with severe symptoms may fall asleep during daily activities such as driving or operating machinery.
Other symptoms include, poor concentration or irritability, morning headaches, unrefreshing sleep and depression. The recurrent episodes of low oxygen cause increased release of stress hormones. This ultimately puts a strain on the heart leading to a significantly increased risk of high blood pressure, stroke, heart attack, and even heart failure.
Factors that increase the risk of snoring and OSA include, being obese, smoking, drinking alcohol in the evening, taking medication that makes you sleepy, sleeping on your back and having enlarged tonsils or a receding jaw. The risk increases to about 10pc in those over the age of 65 and it can run in families.
Lifestyle modification plays a very important part in the treatment of any snoring and should not be forgotten. It is essential to lose weight, avoid alcohol for four to six hours before bed, avoid sedatives, sleep on your side and stop smoking.
If you have problematic snoring and if you have any gaps in your breathing it is worth getting checked for OSA. Your GP can refer you.