Six things you need to know about snoring and how to stop it for good
It is a common problem among all ages and both genders but don’t let snoring ruin your relationship or a good night’s sleep. Learn what causes snoring and how you can put it to bed with our expert advice.
If anyone has ever told you that you snore, be aware that he or she has first very carefully considered the pros and cons of letting you live: next time you get into bed with that person, bear in mind the danger you might be putting yourself in.
But even for those who sleep alone, snoring is no laughing matter. According to the National Sleep Foundation in the US, snorers are more likely to experience thickening or abnormalities in the carotid artery, which can lead to atherosclerosis; a hardening of the arteries that triggers numerous vascular diseases.
Daytime grogginess, irritability and mood swings, problems concentrating and remembering, and an increased likelihood of car or other accidents are just some of the complications arising from self-interrupting, snore-ridden sleep. Since almost half of us regularly snore, isn’t it worth knowing more on what’s likely to be causing it, and what are the most effective measures of putting it to bed?
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• The Snoring Symphony
"Snoring occurs as a result of vibrations in the tissues of the soft palate, mouth, nose and throat during sleep, and when the muscles that keep your airways open are relaxed," says Irish doctor, Pixie McKenna (pixieandsera.com), a GP at the London Clinic.
McKenna says that as the body tries to breathe normally, the pressure to push air in and out causes the tissues to vibrate, and so begins the snoring symphony.
"Anyone can be a snorer. I have to confess to being one, but more men than women snore. This can be down to fewer trigger factors in women, such as being less likely to be heavy drinkers and anatomical differences too. But, that said, given the right variables anyone can snore. Alcohol consumption, excess weight, smoking, nasal problems caused by allergies and medication such as sedatives all can cause you to snore."
So, just like other maladies, the scale and management of the problem is wholly dependant on the exact cause.
"The first step to tackling snoring is to capture some sound bites. You can do this by downloading a recording app, which will provide you with excellent collateral evidence of snoring, as well as sleep quality and duration," says McKenna.
However, it may be that some heavy, regular snorers have sleep apnoea, a condition where the airways become completely blocked during sleep; symptoms include large pauses in breathing, and waking-up gasping for air. Regardless of whether it’s snoring or sleep apnoea, the first step is visiting your GP, says McKenna.
• Cause Before Cure
"We snore because of a relaxation of muscle tonus — a natural relaxation in muscles. Our airway is basically a muscular tube: it has the ability to close fully, which it does while we swallow," says Dr John O’Brien, a dentist working out of the Crescent Clinic in Clontarf, among other locations in Dublin.
He says many heavy snorers tend to wake themselves frequently in sleep, with the resulting patchy sleep leading to daytime sleepiness.
"These people often feel they are very good sleepers as they will sleep for hours if able to, in order to try compensate for poor sleep quality with increased sleep quantity. But, even still, they may confess to not feeling refreshed on waking, no matter how long they sleep for."
When trying to locate the cause or causes for your snoring, be methodical: without identifying where the source of the problem lies, it may prove difficult to cure.
"The first thing to consider is body fat, as obese people are very likely to snore" says O’Brien. In short, men are more prone to putting on fat in the neck area than women; fat which squashes the throat, leaving less room to breathe. Then there’s the smoking factor, since smokers are twice as likely to snore as non-smokers.
Also, ask your partner to observe if you sleep with your mouth open. "We were designed to breathe in through our noses so that the air is filtered, warmed and humidified before entering the lungs," says O’Brien. "When we breathe through the mouth, however, the air hits the back of the throat head-on and can create enormous vibrations in this soft tissue."
However, in other cases, a snorers’ noise derives from the base of the tongue, in which case a device worn in the mouth that brings the lower jaw, or the mandible, forward may be the best solution.
• Age, Sex & Position
According to O’Brien’s personal, and highly informative, website, snoringsolutions.ie, nasal dilators can also be used to great effect if one or both of your nostrils tend to naturally collapse when inhaling — check in front of a mirror.
Take heed, too, of sleeping position. Try elevating your bedhead by a few inches, or else encourage a more comfortable side-sleeping position by using an orthopaedic pillow, such as the Pro-Pil-O.
"Lying on your back is the worst possible sleeping position because the tongue falls backwards into the throat and partially restricts the air flow, causing turbulence and snoring," says O’Brien.
Furthermore, don’t underplay the role alcohol serves, as well as sedatives such as sleeping tablets. Both increase the state of muscle relaxation in the throat, while depressing respiratory drive. Then there is age and sex, as both men and women tend to snore more as they grow older. However, most women tend to start snoring during or after the menopause, with some reporting that Hormone Replacement Therapy subsequently resolved their snoring problem.
For both sexes, anatomical defects can lead to snoring and it may be worth having your nose and throat checked out by an ear, nose and throat specialist. Lastly, the use of nasal sprays and nasal strips may reduce the level of snoring by opening up the nasal passages, though this won’t necessarily mean you mount will remain shut through sleep.
• Success Solution
"We can now treat people with sleep apnoea and snoring with an oral appliance," says O’Brien. "Most people aren’t aware that an oral appliance can eliminate snoring in the vast majority of cases, even though it’s been around for over 30 years."
The Mandibular Advancement Appliance effectively opens-up the airways by pushing the lower jaw forward. There at least 120 such oral appliances licensed in the US, for example, but all are variances of the original appliance and stick to the same principle.
"I’ve been using oral appliances for about 17 years now, after I received specialised training in UCLA in Los Angeles. At that point, I would have said they had an 80pc success rate in stopping snoring. But I’ve been using one appliance for the last 10 years, with a success rate between 95 and 100pc."
While Mandibular Advancement Appliances can be bought over the counter, or online, much like an effective gumshield, it usually pays long-term to have a customised one sourced and fitted by your dentist, says O’Brien. "It feels more comfortable, works better and lasts longer. Having a custom-made one can, in time, become more cost effective, and more effective overall."
This viewpoint is seconded by irishhealth.com, which says the appliances are "more effective if the snoring is at its worst when sleeping on the back and if lower jaw tends to be set back. If one of these devices is to be used long-term, it should be fitted by a dentist experienced in this area. Long-term use of ‘over the counter’ versions is not recommended, as it may lead to bite problems or pain in the tempero-mandibular joint," says the website, which is promoted by Dublin-based specialist healthcare publishing company, MedMedia.
The website also suggests that nasal surgery may be useful if polyps — soft, painless, non-cancerous growths on the lining of your nasal passages or sinuses — are present, or if there are breath complications following a nose injury.
It says laser surgery to the back of the throat is effective in around 70pc of snorers who are not obese, though snoring is reported as recurring in about 20pc of cases in the subsequent two years. In addition, the removal of tonsils and adenoids can be successful in particular cases of snoring.
• Snore Management
After a few years of regular, heavy snoring, Obstructive Sleep Apnoea (OSA) can develop. It’s understood that OSA occurs to a significant degree in 2-4pc of all adults, but as many as 10pc may suffer from a mild form of the condition. Nonetheless, sufferers are more likely to suffer from heart disease and Type 2 diabetes than non-OSA snorers.
OSA is a partial or complete temporary blockage of the airway, with complete stoppage of breathing for ten seconds or more being the result. Consequently, very little oxygen gets into the lungs. Your unconscious survival mechanism will then kick-in, causing a partial arousal from sleep to enable breathing to re-start. Only this re-start button will often be accompanied by loud gasping — to get air into the lungs — or, in some cases, tossing and turning and flailing of arms and legs.
Following several hours of this stop-start, fragmented sleep pattern through the night, daytime tiredness is almost unavoidable. As for whoever you might share a bed with, they should be knighted — assuming they’re not sectioned first.
A self OSA test can be taken on the snoringsolutions.ie website, but as OSA is a serious medical condition, it must be diagnosed by a physician. The most typical diagnosis is based on the results of an overnight sleep study, called a Polysomnogram.
While the standard snoring reliefs will also be suggested for the treatment of OSA, aside from surgery or an oral appliance, Continuous Positive Airway Pressure may possibly be recommended to you. In this, pressurized air is delivered through a tube, connected to a mask, covering the nose and mouth. Generated from a bedside machine, the force of the pressurized air blows the airway open.
• Can surgery stop snoring?
"50pc of people who have surgery to stop snoring will find they still snore after," says Dr John O’Brien, a dentist working out of the Crescent Clinic in Dublin’s Clontarf. He adds that although the most common form of snore surgery entails the removal of the soft palate, there can be no verifiable way on ascertaining where the noise is coming from.
But no surgery for snoring should proceed without a prior sleep study: only then you might better locate the exact source of the problem. For example, if tonsils or adenoids are clogging up your airway, they can be removed. Or if the snoring is caused by a deformity in your nasal passages, it can be operated on, requiring a general anaesthetic.
According to sleep.org, the website of the National Sleep Foundation in the US, more complex surgery may be available, which has close to a 100pc success rate, only it is usually reserved for very severe cases of OSA that cannot be controlled with other methods.