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Chronic snoring can create health problems for both the snorer and their partner

Q&A: Are there any effective cures for snoring?

Q – Please can you help. My partner snores really loudly and it has become a real problem for me because it keeps me awake and I also worry that it is bad for him as well. Are there any effective cures?

A – It can be loud. It can be annoying and it can be the butt of somewhat hollow jokes. But snoring is also a serious healthcare problem. In the UK a staggering four out of ten men and up to three out of ten women snore; that amounts to over three and a half million people (and their partners) in the UK who suffer from this problem. Worldwide the problem may affect as many as two billion people.

There are two common types of snoring: palatal snoring and base of tongue snoring.

Palatal snoring is the commonest form of snoring, accounting for around 15% of referrals to snore clinics. With this type of snoring a flapping or vibration is set up in the region of the soft palate and uvula during inspiration (breathing in) which gives rise to a rough rasping or ‘pig-like’ sound.

Base of tongue snoring is caused by restricted space behind the tongue that causes turbulence as the air flows with a ‘deep breathing’ sound. It is less intrusive than palatal snoring, and causes a higher frequency cleaner, less rasping sound.

Both types of snoring can result in loss of sleep for the snorer’s partner, according to one study at least an hour a night. To put it in greater perspective, a day a week is lost to the partner of a chronic snorer.

Snorers suffer too

Whilst base of tongue snoring may cause less ‘noise pollution’, it is more likely to lead to obstruction to the flow of air with a reduction in the quality of breathing than palatal snoring. This is known as obstructive sleep apnoea (OSA) where the snorer suddenly stops breathing, and then just as suddenly resumes breathing with a snort or a choking sound. This can happen several times each night.

Sleep apnoea is a more serious health concern than simple snoring. Inadequate sleep quality and quantity, nighttime drops in the body’s oxygen levels, and headaches are common side effects. Studies have shown that people with sleep apnoea are so fatigued during the daytime that when driving, their performance is similar to that of a drunk driver.

Of greater concern, however, is the well-established association between snoring and OSA and both stroke and heart disease. In both men and women high blood pressure and coronary artery disease have been linked to snoring and, perhaps counter-intuitively, the link between snoring and heart problems is strongest in people of normal weight, even if they are relatively young. Some researchers suggest that all snorers should be routinely screened for these disorders.

Diabetes is also a risk. One study found that obese men with hypertension who snore were significantly more likely to develop diabetes.

In women, snoring is more common after menopause, due to a drop in progesterone levels, and is strongly associated with high blood pressure. In children snoring may be linked to poor academic performance.  Special education needs in a child increase by 7% for each year they suffer sleep problems  and snoring may also have important links with ADHD. Recent information suggests that snoring is more than twice as common among children with attention deficit disorder.  When the snoring is treated, the ADHD often improves, decreasing or eliminating the need for medicines.

OSA has also been linked to adult brain damage.Research at Imperial College London found that sleep apnoea may in some cases indicate a problem leading to brain damage and loss of memory.

The scientists scanned the brains of seven people with the disorder, and seven without it and found that sleep apnoea patients had lower concentrations of grey matter in the hippocampus than non-sufferers. The hippocampus is a brain region that plays a key role in memory.

What causes snoring?

If we knew what caused snoring finding a cure might be easier. Unfortunately, there appear to be no clear-cut answers. While alcohol consumption has long been thought a cause of snoring, several studies have been unable to verify the link.

Better evidence suggest that allergies can inflame the nasal passages, sinuses, and airways of the lungs and can both cause and contribute to snoring. Research shows that people with allergic rhinitis and asthma are more likely to be snorers than are nonallergic people. Children who snore are also more likely than other children to have allergies, indeed one study found that more than half of children with allergies are snorers.

Although it’s not a cause, being overweight and sedentary may also increase the likelihood of heavy snoring, even in children. 

As if anyone needed another reason to quite, smoking also increases the likelihood of snoring because of the way it constricts and dries out nasal passages and sinuses. The link with cigarettes spans all ages; even teenagers who smoke are more likely to snore. Worse, exposure to environmental smoke, or “second-hand smoke,” has been shown to increase the likelihood of snoring in children.

Things that will help

Stop smoking, reduce alcohol and cut out allergens and you are likely to cut down if not totally cure your snoring problem.Other good advice includes:

The position you sleep in may also be influential. Whether you suffer from OSA or common-or-garden snoring, the evidence also shows that you should sleep on your side. OSA is often found to worsen when patients lie on their backs; in fact some people have what is termed “positional” sleep apnoea, with episodes of decreased or shallow breathing at least twice as high when on their backs as when on their sides.

Lose weight and exercise more, In fact, one trial found that weight loss was more important in reducing snoring than either changes in sleep position or use of a nasal decongestant spray.

Open nasal passages. If the problem originates in your nose and not within the soft palate, keeping nasal passages open may help air to move more smoothly through them. A hot shower before you go to bed can help open nasal passages, Nasal strips may also work to lift nasal passages and open them up.

Try an anti-snoring mouthpiece. Also known as a tongue retaining device, there gadgets help reposition the jaw to help snorers breathe easier and more quietly. Some people find them effective.

Time to change your pillows? Allergens in your bedroom and in your pillow may contribute to snoring. Dust mites accumulate in pillows and can cause allergic reactions that can lead to snoring. Allowing pets to sleep on the bed causes you to breathe in animal dander, another common irritant. Make sure you wash pillows regularly and replace when needed.

Keep hydrated. Secretions in your nose and soft palate become stickier when you’re dehydrated and this can trigger snoring.

Continuous positive airways pressure (CPAP) is another proposedsolution for OSA. With CPAP the snorer is fitted with a nose mask attached to a pump supplying air slightly above atmospheric pressure, thus keeping the airways open. It’s a awkward device, however, and other than case reports there is little robust evidence to show it works consistently. Snoring usually resumes if and when you stop using the device.

Some ear nose and throat specialists recommend surgery to physically enlarge the upper airways and ameliorate snoring, But according to Spanish scientists, going under the knife – or laser – to try to solve either snoring or sleep apnoea will probably not work. The researchers carried out scans of the airways of dozens of sleeping volunteers – and found the problems may have less to do with an abnormal shape, and more with the way they work. They found that in sleep apnoea patients, the variation in the potential aperture was much greater than in non-snoring patients. If true, this means having surgery to try to correct either snoring or OSA could mean enduring a great deal of discomfort for little or no improvement.

Alternative remedies. Unfortunately there are not a lot of alternatives for snoring. There are a variety of throat and nasal sprays on the market but their efficacy can be hit and miss. A small preliminary study found that singing may help improve muscle control of the soft palate and upper throat. The researchers study found some decrease in snoring in participants who sang prescribed singing exercises for 20 minutes a day for three months. Even more offbeat another small study found that playing the didgeridoo, a musical instrument from Australia that produces a droning sound, may help train muscles of the upper airway and lessen daytime sleepiness. Those who played the instrument for about 25 minutes a day most days of the week experienced less daytime sleepiness — a complication of sleep apnoea and snoring. Unfortunately the same benefits haven’t been found in studies of wind or brass instrument players.