Snoring

What is Snoring?

Snoring refers to the rattling, grumbling, or snorting sound that some people make while sleeping. It usually occurs due to an obstruction in the airway.

Is Snoring Normal?

Snoring is a common issue and is considered normal for many people. Almost everyone snores at some point in their life, including infants and young children.

However, if the snoring is loud or disruptive, it could be a sign of sleep apnoea, a condition where breathing pauses during sleep. If you experience snoring along with gasping for air during sleep or symptoms such as daytime fatigue or irritability, it is advisable to consult a healthcare professional.

Symptoms

The sound of snoring varies from person to person and may include:

• Silent vibrations
• Whistling
• Snorting
• Grumbling
• Rumbling

Additionally, those who snore may:

• Have a sore or dry throat upon waking.
• Toss and turn during sleep.
• Experience daytime fatigue.
• Suffer from headaches.
• Feel irritable or moody.
• Have difficulty concentrating.

Causes

When breathing, air passes through the nose, mouth, and throat. An obstruction in the airway can cause the tissues in the following areas to vibrate as air moves through:

• Tongue
• Soft palate (back of the roof of the mouth)
• Tonsils
• Adenoids

As the tissues vibrate, they create the rattling and rumbling sounds associated with snoring.

Various factors contribute to airway obstruction, including:

• Age: As we age, snoring becomes more common due to a weakening of muscle tone, which narrows the airways.
• Alcohol and sedatives: Alcoholic drinks and certain medications relax the muscles, limiting airflow through the mouth, nose, and throat.
• Anatomy: Enlarged adenoids, tonsils, or a large tongue can restrict airflow. A deviated septum, where the cartilage between the nostrils is misaligned, can also obstruct airflow.
• Sex assigned at birth: Individuals assigned male at birth (AMAB) are more likely to snore.
• Family history: Snoring tends to run in families, so if your biological parents snore, there is a higher likelihood that you may as well.
• Overall health: Conditions such as nasal congestion from allergies or colds can block airflow through the nose and mouth. Hormonal changes during pregnancy may also cause snoring.
• Weight: Having a body mass index (BMI) of over 25 or being overweight increases the likelihood of snoring and other sleep-related breathing problems.

Is Snoring Bad?

No, snoring is not always considered bad. Most people snore at some point in their life. However, if your snoring is loud or affects your quality of sleep, you should consider consulting a healthcare provider.

Diagnosis and Tests

How is snoring diagnosed?

To diagnose snoring, your physician will perform a physical examination of the mouth, nose, and throat. You or your partner may be asked questions such as:

• How frequently do you snore?
• What does your snoring sound like?
• Do you feel rested throughout the day?

Sleep study

If the physician suspects a sleep disorder such as sleep apnoea, they may recommend a sleep study (polysomnography). This can be done either at home or in a sleep centre, where you spend the night. The sleep study assesses the following:

• Brain activity during sleep.
• Breathing patterns, including any pauses in breathing or gasping for air.
• Oxygen levels and heart rhythm.
• Movements during sleep, such as tossing, turning, or limb movements.
• Snoring patterns.

Management and Treatment

How is snoring treated?

There are many treatment options for snoring, and the best choice will depend on factors such as the severity of your snoring, your health history, and your preferences.

Nonsurgical Snoring Treatments

Nonsurgical treatments aim to improve sleeping posture or clear the airway. These include:

• Lifestyle adjustments: Changing your sleeping position, avoiding alcohol, and maintaining a healthy weight can help reduce snoring.
• Medications: Over-the-counter medicines for colds or allergies can relieve nasal congestion and make breathing easier.
• Nasal strips: Elastic bands applied to the outside of the nose can help keep nasal passages open.
• Oral appliances: Specialised oral appliances worn during sleep can help keep the jaw in the correct position, allowing air to flow more easily. These devices are sometimes called mouth guards or mouthpieces, but sports mouth guards will not help with snoring.

Surgical Snoring Treatments

For more severe cases, surgical options may be recommended. These aim to remove or reduce excess tissue or correct structural issues such as a deviated septum. Surgical treatments include:

• Laser-assisted uvulopalatoplasty (LAUP): This procedure reduces excess tissue in the soft palate to improve airflow.
• Ablation therapy (Somnoplasty®): This uses radiofrequency energy to shrink excess tissue in the tongue and soft palate.
• Septoplasty: This surgery corrects a deviated septum by reshaping the bone and cartilage, allowing for better airflow through the nose.
• Tonsillectomy or adenoidectomy: These surgeries remove excess tissue from the back of the throat (tonsillectomy) or nose (adenoidectomy) to improve airflow.

Prevention

How can I prevent snoring?

A few lifestyle changes can help reduce or prevent snoring:

• Avoid sedatives (such as clonazepam, zolpidem, and eszopiclone) or alcohol before bed.
• Talk to your healthcare provider about medications to ease nasal congestion.
• Stay active, exercise regularly, and maintain a healthy weight.
• Elevate your head while sleeping to improve airflow.
• Sleep on your side instead of your back.
• Use a snore-reducing pillow to help keep your head in the correct position during sleep.

For further advice on preventing or reducing snoring, consult your healthcare provider, who can offer personalised suggestions tailored to your needs.

Outlook / Prognosis

What is the outlook for those who snore?

Infrequent snoring is generally harmless. However, frequent, loud, and disruptive snoring can be a sign of sleep apnoea, a serious condition. Persistent snoring may also increase the risk of health problems such as:

• Low blood oxygen levels (hypoxia)
• Difficulty concentrating
• Extreme daytime fatigue
• Heart attack
• Stroke
• High blood pressure
• Type 2 diabetes

Living With

When should I be concerned about snoring?

Consult a doctor if snoring affects your sleep or causes problems such as headaches, fatigue, or gasping for air during sleep. They can conduct tests to determine if you have sleep apnoea or another sleep-related breathing disorder.

What questions should I ask my healthcare provider?

• What is causing my snoring?
• Could my snoring lead to any serious health issues?
• Do I need treatment, and if so, which option do you recommend?
• What lifestyle changes can help relieve my snoring?

Additional Common Questions

How can I tell if I snore during sleep?

If you share a room or bed, your partner may have already informed you of your snoring. If you live alone, try using a sound recorder or a smartphone app that detects snoring sounds while you sleep.

Is snoring a sign of sleep apnoea?

Snoring does not always indicate sleep apnoea. While snoring is a common symptom of sleep apnoea, there are other causes as well.

Should I be worried if my child is snoring?

Children often snore, and it is usually due to nasal congestion or a stuffy nose. However, if you are concerned, it is a good idea to consult your child’s doctor to determine the cause of snoring and whether treatment is necessary.

A Note from MD.co.uk

Snoring is generally common and harmless. However, chronic, loud snoring that disrupts sleep could indicate a more serious condition. Symptoms such as irritability, daytime fatigue, headaches, or gasping for air during sleep may suggest sleep apnoea. If you are concerned about your snoring and how it affects your health, it is best to consult your doctor, who can help determine the cause and recommend appropriate treatment if needed.