All About Snoring

According to the British Snoring and Sleep Apnoea Association, 41.5% of the UK adult population snore, which means there are around 15 million UK snorers. Of course, it’s not just the snorers who are affected by this but their partners too, which means the condition affects many more people. It also seems to be something that affects more men than women, at a ratio of 2.3:1. In this article, we aim to demystify snoring to highlight what causes it and what you can do about it.

What is snoring?

Snoring is the sound produced when the tissues in the throat vibrate as air passes through. This can involve the uvula, the soft palate and the back of the tongue. The snoring noise can be soft and intermittent or loud and disruptive.

Snoring is pretty widespread but its health implications and severity vary. It can be a rare, light occurrence that is not concerning at one end of the scale or a severe sleep-related breathing disorder at the other end of the scale. Knowing when it is impacting health is important so that the right treatment can be put in place. 

Some snorers, especially those who sleep alone, are blissfully unaware of their snoring. If they don’t sleep alone, they may be woken by a partner or told about it in the morning—and it can cause significant relationship problems. 

What causes snoring?

Snoring can be caused by a range of factors. Often, multiple factors combined contribute to a person’s snoring. During sleep, a person’s muscles loosen, which causes the airway to narrow. When the person breathes in and out, the air makes tissues vibrate and make a sound.

Some individuals have a greater tendency to snore due to their anatomy and the shape or size of their muscles and tissue. Others might experience snoring more because their muscles relax to excess. 

Here are some common causes of snoring:

Nasal congestion

Obstructions in the nasal passages can cause snoring. This might be a temporary thing due to the common cold, a sinus infection or allergies. Alternatively, a deviated septum or nasal polyps can lead to snoring due to restricted airflow.

Throat relaxation or weakness

If the throat muscles become too relaxed when you’re asleep, it can cause the soft palate and tongue to collapse, which partially blocks the airways. This makes the tissues vibrate and causes snoring.

Sleep position

If you sleep on your back, the tongue and soft palate can collapse towards the back of the throat. This causes the airway to become partially obstructed, which causes snoring.

Obesity

Being obese, especially if weight is in excess around the neck area, can contribute to airway narrowing. This increases the likelihood of snoring.

Alcohol or sedative medications

Consuming alcohol or taking certain sedative medications can cause the throat muscles to relax, which increases the chances of snoring.

Age

A lot of people who didn’t snore when younger suddenly develop a problem in later life. This is because the throat muscles tend to lose elasticity and tone with age, making them more likely to collapse during sleep.

Gender

Being male increases your chances of snoring because men have narrower air passages. For women, hormonal changes can play a role in snoring too and many women find they snore more during pregnancy.

Anatomy

An individual’s unique anatomy can contribute to snoring. Enlarged adenoids and tonsils, for instance, or a low and thick, soft palate can increase a person’s snoring susceptibility. A set back or small jaw also increases the likelihood of snoring.

Sleep apnoea

Snoring can be a symptom of a sleep-related disorder called sleep apnoea. This is characterised by breathing interruptions during sleep. Sleep apnoea itself has specific causes and treatments. 

Obstructive sleep apnoea can have serious implications for day-to-day life. If you find yourself waking up feeling unrefreshed or you feel sleepy during the day, it might be worth considering sleep apnoea.

The common types of snoring

Not all snoring is problematic. Here are the different types of snoring that you might come across:

Light snoring

Infrequent, muffled snoring is normal. It doesn’t require treatment or medical intervention. Its only real impact is on anyone sharing the room or bed who might be bothered by the disruption to their own sleep.

Primary snoring

This is snoring that occurs on at least three nights a week. Due to the frequency, it is more disruptive for others. However, it isn’t usually considered to be a health problem unless signs of sleep apnoea are present or unless it’s disrupting normal sleep. If these symptoms are present, diagnostic tests might be required to rule out issues.

Sleep apnoea snoring

Obstructive sleep apnoea is a worrying health condition that causes snoring. This can impact upon a person’s health and wellbeing. Untreated, obstructive sleep apnoea (OSA) can cause dangerous daytime sleepiness. It can also cause or exacerbate other health problems like high blood pressure, diabetes, depression, stroke and cardiovascular problems.

Other signs of sleep apnoea include:

• Very loud snoring.
• Snoring accompanied by choking, snorting or gasping sounds.
• Recent weight gain or obesity.
• Drowsiness during the daytime.
• Poor focus and concentration.
• Headaches in the morning.
• Congestion.
• Frequent urination at nighttime.
• Teeth grinding at night.
• High blood pressure.

If sleep apnoea is suspected, it’s important to seek help from a medical professional.

The impact and health risks of snoring

As mentioned above, occasional snoring is not problematic and doesn’t pose significant health risks. However, loud or chronic snoring can have a range of impacts both on the health of the individual involved and whoever they share a bed with.

Here are some of the potential consequences of problematic snoring:

Disrupted sleep

Snoring disrupts sleep both for the snorer and anyone they share a bed with. The noise of snoring can lead to frequent awakenings and fragmented sleep, which has its own implications.

Fatigue and daytime sleepiness

Poor quality sleep as a result of snoring can cause excessive daytime sleepiness. It can also contribute to fatigue and make you less alert. As a result, cognitive function might be impaired and performance at work or with hobbies can be lower.

Relationship strains

Snoring can disrupt a partner’s sleep, which can lead to irritability and tension. This can have an impact on the whole relationship.

Poorer quality of life

Chronic snoring is linked to poorer quality of life. It affects social functioning and emotional wellbeing.

Increased risk of cardiovascular problems

Untreated, severe snoring—especially if it is caused by sleep apnoea—can increase a person’s risk of cardiovascular problems like high blood pressure, heart disease and stroke. The increased risk of stroke can be put down to changes in blood flow and oxygen levels during sleep.

Impaired cognitive function

Chronic disruptions to sleep that are caused by snoring can mean a person suffers from impaired cognitive function. They may have problems with concentration or memory, for example. 

Impaired cognitive function, as well as daytime sleepiness, can also increase the risk of injuries and accidents at home or at work.

Impact on mental health

Sleep disruption, particularly over a long period of time, can contribute to mental health problems. It increases the risk of experiencing anxiety and depression.

Treatment for snoring

The treatment for snoring will depend on what is causing the snoring and the problems the snoring is also causing the individual. 

For those suffering from primary or infrequent snoring, treatment may not be required. If this is affecting your sleep (or your partner’s sleep) then treatment or help might be required. However, this can be a simpler, less invasive treatment than what might be needed for those with chronic snoring or sleep apnoea. 

The treatment prescribed will also likely depend on the cause of the snoring. Here are some examples:

• The tongue blocks the back of the throat: You might wear a mandibular advancement device which is something in the mouth that brings the tongue forward.
• The mouth falling open during sleep: You might wear something to keep your mouth closed during sleep or a device that forces you to breathe through your nose (a vestibular shield).
• Narrow airways or blocked nasal passages: You might wear a nasal dilator or strip to keep your nose open during sleep. You might also take decongestants or use a nasal spray to reduce any swelling inside of the nose.

Here is some more information about typical snoring treatments.

Changes in lifestyle

Snoring can be eased or stopped by lifestyle changes in some cases. These include:

• Being a healthy weight: Overweight and obesity are contributing factors to both snoring and sleep apnoea. Keeping your weight in check can help reduce or eliminate snoring.
• Reduce alcohol intake: Alcohol promotes snoring as does sedative medication. Reducing these can stop snoring or reduce it significantly.
• Adjusting how you sleep: Back sleeping triggers snoring due to airway obstructions. Changing the position in which you sleep can help you to stop snoring.
• Raising the bed position: Having your head higher up, either with a pillow or a riser, can help to reduce or eliminate snoring.
• Reducing congestion: By taking steps to reduce nasal congestion, whether caused by allergies or something else, you can reduce snoring. Antihistamines for allergies or decongestants for a cold can help.

Mouth exercises

Exercises to strengthen the throat, tongue and mouth can make the airway stronger and less likely to collapse to cause snoring. Anti-snoring exercises need to be completed often (daily) for a continual amount of time like two to three months.

Anti-snoring devices

Anti-snoring mouthpieces like a tongue retaining device or a mandibular advancement device can help reposition your tongue or jaw to prevent blockages in airways that cause snoring.

• A mandibular advancement device works by holding your lower jaw in a forward position. These are often adjustable to find something that works but is also comfortable.
• A tongue retaining device holds your tongue in position so that it can’t slide backwards when you’re asleep.

Positive airway pressure devices

For serious snoring and sleep apnoea, positive airway pressure devices like CPAP machines can be used. CPAP stands for continuous positive airway pressure. This device pumps pressurised air through a mask. It prevents the airway from collapsing as the air pressure is continual, even during exhalation. 

More serious sleep apnoea can be treated with a BiPAP (bi-level positive airway pressure) device which alternates the pressure during inhalation and exhalation. There are also auto-adjusting positive airway pressure (APAP) machines that respond to a person’s breathing patterns and then vary how much pressure is needed. 

All three types of machines are effective treatments for sleep apnoea and any associated snoring. However, these are only available by a prescribing clinician and would need to be calibrated.

A mask will often be cumbersome and so might be uncomfortable or difficult to get used to. However, most people find this easy to become accustomed to and find their snoring is reduced and their sleep improves.

Surgical treatment

Surgery is usually a last resort after trying other treatment methods and finding them ineffective. If snoring is caused by enlarged tonsils or adenoids, these might be removed. Another possible surgery is called uvulopalatopharyngoplasty. This surgery works to widen the airways and reduce tissue. 

Surgery can also be used to fix a deviated septum, deal with nasal polyps or remove any permanent blockages that could be contributing to the problem.

Final thoughts on snoring

While snoring is common and quite often benign, its loud manifestation can have a significant impact on both the snorer and their partner. The impacts of snoring go beyond the bedroom, as associated tiredness can affect daytime functioning and long-term health. Snoring can also impact relationships. Chronic snoring can be a sign of sleep apnoea, which needs to be investigated and treated. 

Understanding the cause of snoring is crucial to managing it effectively. Lifestyle changes can improve things, such as weight loss, changing sleep position and avoiding alcohol. 

With snoring addressed and treated, people can improve their sleep quality and wellbeing as well as that of their partner.