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Snoring

Published by Bupa's health information team, July 2008.

This factsheet is for people who snore, or who would like information about snoring.

Snoring is a rough, rattling sound that comes from your mouth and nose when you're asleep. It can disturb your and your partner's sleep, making you feel tired in the day.

Snoring is very common. It affects as many as four in 10 people.

• About snoring
• Symptoms of snoring
• Causes of snoring
• Diagnosis of snoring
• Treatment of snoring
• Further information
• Questions and answers
• Related topics
• Sources

About snoring

When you're awake, muscles in your nose, mouth and throat keep your airways open. This allows you to breathe freely.

However, when you're asleep, your muscles relax. This means the airways can sometimes close up, preventing the air from getting in or out easily. When this happens and you try to breathe, the soft tissue in your mouth, nose and throat vibrates, making noise; this is what we call snoring.

Tissues that can affect snoring

Is snoring harmful?

By itself, snoring isn't considered harmful. However, if you snore you may also have a more serious condition called sleep apnoea. If you have sleep apnoea you repeatedly stop breathing at intervals throughout the night and then wake up. This needs to be treated as it causes extreme tiredness in the day and can lead to accidents (for more information see Related topics).

You should think about how much your snoring is affecting the other people who live with you. For many couples, and in some cases whole families, snoring can cause major sleep disturbance and lead to real problems. If you know you are a snorer you should talk to your GP about it.

Symptoms of snoring

Your partner or your family will be able to tell you if you snore while you sleep.

Causes of snoring

There are several factors that can make you more likely to snore. These can be divided into lifestyle factors and physical factors.

Physical factors

Certain physical characteristics make you more likely to snore, for example:

• a receding lower law, which causes an overbite
• a blocked nose, caused by congestion, catarrh, nasal polyps or damage to the nose
• having a large uvula or enlarged tonsils
• being male
• being elderly - muscle tone reduces as you get older, which raises the risk of snoring
• having low levels of thyroid hormone (hypothyroidism)
• being in the menopause is linked with snoring

Lifestyle factors

There are certain lifestyle factors that make you more likely to snore.

• If you're overweight you're more likely to snore. This is thought to be due to the excess fat around your neck. This makes your airways more likely to collapse.
• Alcohol causes your muscles to relax more than usual during a normal night's sleep so you are more likely to snore. It also irritates the nasal lining which can make breathing more difficult.
• Sedatives, like alcohol, make your body's muscles relax more than usual, causing you to snore. If you're worried about how a sedative is affecting your sleep, talk to your GP about it. There may be a non-sedative alternative. Don't stop taking prescribed medicines without talking to your doctor.
• Smoking cigarettes causes swelling, inflamation and irritation to your nostrils and throat, making snoring more likely. Even passive smoking can make snoring worse.
• If you suffer from allergies you are likely to have a blocked, itchy and runny nose. The lining of the nose and throat may also be swollen. This may interfere with sleep and make snoring more likely.

Diagnosis of snoring

If you or anyone you live with is concerned about you snoring or having sleep apnoea, talk to your GP about it. He or she will ask about your symptoms and examine you. Your GP may also ask you about your medical history. It's often useful if your partner attends the appointment as they can describe the pattern and duration of the snoring.

Depending on what your GP thinks is causing your snoring, he or she will give you advice on what to do. If this doesn't help, he or she may refer you to an ear, nose and throat (ENT) specialist or recommend that you see a dentist (see Treatment).

If your GP thinks you have sleep apnoea you might be referred to a specialist at a sleep clinic. These are centres where you are monitored while you sleep, to help diagnose sleep apnoea.

Treatment of snoring

Self-help

There are several ways you can control your snoring.

• If you're overweight, make changes to your lifestyle so that you can lose some weight. This means eating a healthy balanced diet and doing more exercise.
• Don't drink alcohol before you go to bed.
• Stop smoking. Your GP can give you advice on this.
• Change your sleeping position. When you lie flat on your back, your tongue is more likely to fall back into your throat and block your airway. By sleeping on your side, or by having your head and shoulders slightly tilted upwards, you're less likely to snore.
• Use only one thick pillow (or two thin ones) to increase airflow.
• Elevate your mattress at the end where your head rests by putting pillows underneath it - having your head at a slight angle may help reduce nasal congestion.
• If you have any allergies, doing what you can to reduce contact with allergens (things you are allergic to) may help reduce your risk of snoring. However, more research is needed in this area.

Non-surgical treatments

Mouth guards

A type of mouth guard that pushes your lower jaw forward (mandibular advancement device) can be very effective at reducing snoring for some people. The mouth guard works by improving the air flow when you sleep, making snoring less likely. Your GP or dentist will be able to give you more advice.

Nasal sprays

If your GP thinks that a consistent blocked nose is part of the problem, you may be prescribed a nasal spray to help reduce congestion.

Hormone replacement therapy (HRT)

If your GP thinks the menopause has brought on your snoring, he or she may discuss HRT with you (see Related topics).

Treatment for hypothyroidism

If your GP thinks you have hypothyroidism (very low levels of thyroid hormone) he or she will refer you for some blood tests. If you have hypothyroidism, you will be given the hormone thyroxine. You will need to take this daily (see Related topics).

Surgery

If all other approaches haven't worked, your doctor may recommend surgery. There are several different types of operation; most are carried out on the soft palate in your throat. The aim of these operations is to remove, change or make smaller those parts of the soft tissues in your airways that vibrate when you're sleeping, causing you to snore. If you have large tonsils, having them removed can sometimes cure snoring.

These types of surgery aren't always effective at treating snoring. Your doctor will be able to give you more advice.

Further information

• The Sleep Apnoea Trust
  0845 60 60 685
  www.sleep-apnoea-trust.org

Related topics

• Menopause
• Hypothyroidism (underactive thtyroid)
• Healthy eating
• Physical activity
• Sleep apnoea

		Snoring Q&As See our answers to common questions about snoring, including: Does snoring run in families? I have a four year old daughter who snores - is it harmful and are there any treatment options? What is the best position to sleep in to avoid snoring, and can orthopaedic pillows really help?

Sources

• Guidelines for GPs and other doctors. The Sleep Apnoea Trust. www.sleep-apnoea-trust.org, accessed 14 March 2008
• Snoring and Sleep Apnoea. British Lung Foundation. www.lunguk.org, accessed 14 March 2007
• Who gets sleep apnoea? The Sleep Apnoea Trust. www.sleep-apnoea-trust.org, accessed 14 March 2007
• Sleeping well. Royal College of Psychiatrists. www.rcpsych.ac.uk, accessed 14 March 2007
• Snoring. Parker RJ, Hardinge M, Jeffries C. BMJ 2005; 311:1063. www.bmj.com
• Malhotra A, White DP. Obstructive sleep apnoea. The Lancet 2002; 360: 237-245
• Sleep apnoea. BMJ Clinical Evidence. www.clinicalevidence.com, accessed 14 March 2007
• Physical features of snoring. British Snoring and Sleep Apnoea Association. www.britishsnoring.co.uk, accessed 14 March 2007
• Kalra M, LeMasters G, Bernstein D et al. Atopy as a risk factor for habitual snoring at age 1 year. Chest. 2006;129:942-946. www.chestjournal.org
• Frayling TM, Timpson NJ, Weedon MN et al.,A common variant in the FTO gene is associated with body mass index and predisposes to childhood and adult obesity. Science 2007; 316 (5826): 889-894
• Simon C, Everitt H, Kendrick T. Oxford Handbook of General Practice. 2nd ed. Oxford: Oxford University Press, 2005: 401

This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Dr James Quekett, Bsc, MB, ChB, MRCGP, DRCOG, DFFP, General Practitioner (GP) and GP Appraiser, Gloucestershire, and by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.

Publication date: July 2008.

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