Snoring is a rattling noise made as we breathe during our sleep. It may not cause any problems to the person who snores, but it may be so noisy that it stops other people from sleeping. Sometimes it also interrupts the sleep of the person who snores, making them tired in the daytime. Many lifestyle factors make snoring more likely, and can be changed. If snoring becomes a problem, there are some treatments which can help. You should see a doctor about snoring if it is affecting your sleep, making you tired in the daytime, or upsetting other people.
What is snoring?
Snoring is a rattly sound made by breathing whilst you are asleep. It is caused by vibrations of the tissues of your upper airway, ie your nose, mouth or throat. It is very common. As many as 4 in 10 people in the UK are thought to snore regularly.
Simple snoring is making a rattly sound as you breathe while you are asleep. Many people snore sometimes - for example, if you have a cold or have had a lot of alcohol to drink. Habitual snoring is doing it regularly. Snoring can be quiet or extremely loud.
Obstructive sleep apnoea (OSA) is the term for breathing which becomes interrupted or irregular during the night. Most, if not all, people with OSA snore. If you have OSA your breathing stops for a short time. This may happen many times in the night. So you wake up still feeling sleepy. You have not got as much oxygen as you needed during the night. This is also known as obstructive sleep apnoea/hypopnoea syndrome (OSAHS) but not all experts use the definitions in the same way. This leaflet is about simple snoring. There is a separate leaflet called Obstructive Sleep Apnoea.
Why do people snore?
Snoring is due to vibrations in the soft tissues of the upper airway as we breathe. It can happen in any part of the upper airway:
- The nose.
- The soft palate. This is the part of the roof of your mouth which is right at the back of your mouth.
- The back of your tongue.
- The back of your throat. It may involve your tonsils, which are lumpy bits of tissue on either side of the back of your throat. It may involve your uvula, which is the dangly bit of flesh which hangs in the middle of the back of your throat.
What makes people more likely to snore?
There is no single cause for snoring. It is more likely if you have a problem which causes a blockage in your nose, mouth or throat. For example:
- Large tonsils.
- Soft fleshy swellings in your nose (nasal polyps).
- A deviated nasal septum. This occurs when the dividing tissue between the two sides of your nose is not straight. This may happen after an injury to your nose.
- Hay fever, or an allergy giving you extra mucus and congestion in your nose.
- A cold giving you extra mucus and congestion in your nose.
- An unusually shaped mouth, nose or jaw.
- An enlarged thyroid gland in your neck
- Acromegaly. (This is a rare condition where your body makes too much growth hormone. This can cause the tissues in your head and face to become bigger or thicker.)
You are also more likely to snore if you:
- Are overweight.
- Drink a lot of alcohol.
- Take medicines which make you sleepy (sedatives).
- Sleep on your back.
Snoring can happen at any age, to children or adults. It is most common between the ages of 40 and 60. It is more common in men than in women.
What problems can snoring cause?
Often the person who snores is not at all troubled by it. They are asleep and may be unaware they snore. Snoring may disturb the person they sleep with or who is near. If snoring is very loud it may even disturb people in other rooms. If you snore, this may be embarrassing. It may mean the person you sleep with wants to sleep somewhere else. This may affect your relationships.
It may be that snoring makes you slightly more likely to have a stroke or heart disease. It is not sure yet whether this applies to simple snoring or only to people who snore who also have obstructive sleep apnoea. If it does apply to snoring, it only very slightly increases the risk. This is thought to be because the vibration of snoring may cause a thickening of the blood vessels in the neck.
Do I need any tests?
If your snoring isn't troubling you or anybody else, you do not need to see a doctor. You should see your GP if:
- You wake up gasping in the night regularly.
- Your partner says you stop breathing during the night.
- You are feeling tired or sleepy during the day.
- Your snoring is affecting your partner or your relationship.
Your GP will ask you some questions and examine you. They will want to check your height and weight, and examine your nose, mouth, throat and neck. Usually no tests are needed. However, you may need:
- A blood test to check your thyroid hormone levels if your doctor thinks this may be relevant.
- A sleep test called polysomnography if your doctor thinks you may have OSA.
- Referral to an ear, nose and throat (ENT) specialist for an examination of your nose or throat. This would be done if the doctor suspects a blockage. The ENT specialist can look at your airway with a tube passed into your nose while you are either sedated or put to sleep.
What can I do to stop snoring?
There are lots of remedies available for snoring. However, there is not much evidence about how well any of them work. There is no one single treatment that will work for everyone. Which treatment will work for you may depend on the cause of your snoring, if there is one. In many people, this will be a combination of causes, so you may need a combination of strategies. The British Snoring and Sleep Apnoea Association (see below) has devised a snoring test which may help. You enter your personal characteristics and some information about how you sleep and breathe. This produces a result which suggests which type of treatment may help you. These are some of the options:
- If you are overweight, lose weight. This should always be the first thing to try if it is relevant for you. Losing weight results in less pressure on your upper airway and often stops snoring.
- If you smoke, stop smoking. Smoking makes your upper airway more swollen. This means there is less space for the air and you are more likely to snore.
- Do not drink large amounts of alcohol before you go to bed.
- Avoid medicines which make you more sleepy.
- Avoid sleeping on your back. Most people are more likely to snore if they sleep on their back. You may be able to stop yourself rolling on to your back by supporting yourself with pillows or bed wedges. Or try taping a tennis ball to the back of your pyjamas. This makes it uncomfortable to lie on your back, so you will turn over in your sleep.
Devices and gadgets
- Ear plugs. These are for your partner and may help them sleep better.
- Nasal strips. These may be helpful if the snoring noise is mainly coming from your nose. They are strips stuck around your nose each night before going to sleep. They aim to keep your nose open.
- Nasal dilators. These may be helpful if the snoring noise is mainly coming from your nose. It is a device placed inside the nose before going to sleep to hold the nose open.
- Chin straps. These are straps or bands you put under your chin to hold your mouth closed during the night. This is to force you to breathe through your nose rather than your mouth. This may be helpful if the snoring is coming from your mouth.
- Vestibular guard. This is a plastic mouth guard. You put it in your mouth before going to sleep to close off your mouth. This forces you to breathe through your nose. This may be helpful if the snoring is coming from your mouth.
- Mandibular advancement device. There are a number of splints and shields which are made to push your lower jaw and tongue forward. You put the device in your mouth before going to sleep. It makes more space in the airway and may help if the snoring comes from the base of your tongue. These are known to be more effective if fitted specifically for your mouth by an experienced dentist.
- Acupressure ring. This is a ring worn on your finger which is said to exert acupressure. This is an alternative therapy using the same sort of theory as acupuncture.
These options cannot be prescribed on the NHS. The British Snoring and Sleep Apnoea Association (see below) may be able to help advise on some products. There are many more commercially available. There is not much evidence about how well most of these devices work.
There are no medicines specifically for snoring. However, if you snore because of extra mucus and congestion in your nose, there are some options which may help. Steroid nasal sprays or antihistamine tablets may help if you have hay fever or an allergy. Decongestant tablets can be helpful if the extra mucus in your nose is due to a cold. Some people find nasal sprays or drops made from salt water (saline) help to clear the nose.
Most people who snore do not need an operation. Occasionally, however, an operation may be needed. The following are the types of operation which are sometimes helpful for people who snore.
- Operations on the nose. If you have nasal polyps, removing them may stop snoring. If the midline of your nose is crooked (nasal septum deviation) having this straightened may help.
- Tonsillectomy. This is most commonly of benefit for children who snore. Usually both tonsils and adenoids are removed. It is not done for snoring alone, but may be useful if the large tonsils are causing other problems - for example, OSA or regular bouts of tonsillitis.
- Uvulopalatopharyngoplasty (UPPP). This is an operation done with a general anaesthetic. Parts of tissue in and around the mouth and throat are removed, creating more space. This includes removing the strip of tissue that hangs in the middle at the back of your mouth (the uvula), tonsils, and some of your soft palate. It also involves some reorganising/rebuilding of the tissues at the back of the mouth.
- Laser-assisted uvulopalatoplasty (LAUP). This is a similar procedure, but done with a laser. The laser burns away the uvula and some of the soft palate.
- Radiofrequency ablation of the soft palate. This stiffens the soft palate to stop it vibrating so much. It is done with an injection to numb the roof of the mouth (a local anaesthetic). A device called an electrode is put into the roof of your mouth. Radiofrequency waves are sent into your soft palate through the electrode.
- Soft palate implants. These are implants injected into your soft palate, which stiffen it. This should stop it vibrating so much. This is also done with a local anaesthetic.
Operations are not usually used for people who snore and have OSA. This is because there are safer alternatives available, and there is not much evidence about how well they work.
Dr Mary Harding
Dr Mary Harding
Dr Hayley Willacy