Is snoring keeping you and your partner awake at night? Get help and advice from Dr Guy Meadows...
Definition – Snoring is the snorting and rattling sound made by the vibration of the airway tissue at the back of the mouth, nose and throat during sleep as we breathe in and out. It occurs because of a partial blockage in the airways due to the relaxation of the muscles holding them open. Snoring is very common with as many 40% of adults being affected. It is twice as common in men, as in women and is known to increase with age.
Snoring can cause sleep disturbance for both the snorer and those around them leading to symptoms of excessive daytime sleepiness, reduced mental function, emotional upset and relationship issues. If severe it can also be an early warning sign for obstructive sleep apnoea, whereby people intermittently struggle or stop breathing during the night. Receiving help for such sleep related breathing disorders is essential as they are linked to an increased risk of traffic accidents and cardiovascular disease.
Types and tests
Understanding where your snoring originates from (e.g. mouth, nose or throat) is vital for getting the most successful type of treatment.
Mouth based snoring – this is when you breathe through your mouth during sleep, rather than using your nose. A simple test is to see if you can make the snoring noise with your mouth closed. If you can only do it when it is open then using devices to keep your mouth closed at night could help to reduce the snoring.
Tongue based snorer – this is when the tongue falls into the back of the throat blocking the airway. A simple test is to stick your tongue out as far as it will go and grab it between your teeth. If the snoring noise is reduced in this position, then you are probably a tongue based snorer. Sleeping on your side or using a Mandibular Advancement Device to move your jaw and tongue forward as you sleep could be of help.
Nasal collapse or congestion – this is when the nostrils either collapse or are congested causing the airway to be blocked. A simple test is to press one side of your nose closed with a finger and then try to breathe in with your mouth closed. If the nostril collapses then using some form of nasal dilator can be helpful. If you simply can’t breathe due to congestion then it could be worth checking for allergies.
Palatal Flutter – If non of the above tests work then your snoring could be caused by the vibration of the soft tissue in your throat. Following some of the advice below or seeking professional help would be advised.
For additional information please refer to the British Snoring and Sleep Apnoea Association (www.britishsnoring.co.uk)
Help for snorers
- Weight loss and exercise – being overweight or having a large neck circumference (>16”) increases the risk of fat pushing down on the throat and worsening snoring. Starting a weight loss and exercise programme can significantly reduce snoring in many individuals.
- Change position – sleeping on your side can prevent the tongue from falling back and blocking the throat during sleep. Pillows can be used to prevent individuals from rolling back onto their backs during the night.
- Limit Alcohol – drinking alcohol relaxes the airway muscles even more than normal causing further airway collapse and a worsening of the snoring. Limit alcohol consumption (for weight loss) and avoid drinking it at least 4hrs before going to bed.
- Stop smoking – Smoking causes nasal congestion and inflammation leading to a worsening of snoring. Quitting smoking can help to reduce snoring and improve your overall health.
- Sedatives – certain medications such as sleeping pills and anti histamines are designed to have a relaxing effect and can therefore worsen snoring. Speak with your Doctor before making any changes to your medication as they might be able to provide non sedative alternatives.
- Prevent mouth opening – if you know that you snore with your mouth open then it can be helpful to keep it closed during sleep by either using specifically designed adhesive tape or mouth guards.
- Mandibular Advancement Device (MAD) – If you know that you are a tongue based snorer then using a MAD can help to move your jaw forward and prevent your tongue from blocking the back of your throat during sleep.
- Prevent nasal collapse – If you know that you suffer from nasal collapse then using some form of adhesive nasal dilator strip placed over the outside of the nose can help to keep the airways open and reduce snoring.
- Check for allergies – nasal congestion and inflammation caused by allergies is a common cause of snoring. Being tested for allergies can therefore help you to identify and reduce potential allergens in your sleeping environment (e.g. types of bedding, dust mites, pet hair etc) and lessen snoring.
- Surgery – If none of the standard methods mentioned above work to reduce the snoring, then speaking with an Ear, Nose and Throat Specialist about the possibility of surgery can be considered as a last resort.
Help for partners
- Block out the noise – the noise of snoring can disturb sleep and therefore blocking it out by using ear plugs can be helpful. Many different types exist today and the key is finding one that works best for you. If you don’t like wearing ear plugs, white noise can also be played to drown out the noise of snoring.
- Notice the noise – when we listen to noise we tend do so with judgment such as whether it is good or bad. Snoring is typically judged as bad and therefore promotes stress and wakefulness. It can therefore be helpful to describe the sound of the noise objectively as you hear it such as “I can hear a rattle, a snort, a whisper, a wheeze” or “It starts soft and gets loud”. Describing it in this objective and non judgmental way releases you from its emotional grip and increases the chance of actually sleeping.
- Let go of the worries – whilst loud snoring can be sleep disturbing, often it can be our reaction to the noise that keeps us awake. Thoughts such as “I know he is going to start snoring soon” or “I’m never going to be able to sleep with this noise” can race around our minds and keep us awake even before any noise has been produced. Learning to notice when such unhelpful thoughts pop in, can help us to break free from such stressful thinking patterns. To do this try pre-fixing the thoughts in your mind with “I am having the thought that…” or welcoming them when they arrive such as “Hello, snore thoughts” and then gently returning to going back to sleep.