Struggling to sleep next to a snorer? 

Snore Wars - the constant battle for better sleep

Snore Wars - the constant battle for better sleep

Although people who snore loudly are frequently the target of bad jokes - and the occasional victims of middle-of-the-night elbow thrusts - snoring is no laughing matter.

It was human rights activist Malcolm X who best summed up snoring’s blunt refusal to discriminate.

I remember one night at Muzdalifa, with nothing but the sky overhead, I lay awake amid sleeping Muslim brothers,” he said. “And I learned that pilgrims from every land - every color and class and rank, high officials and the beggar alike - all snored in the same language. Malcolm X, The Autobiography of Malcolm X

That language is universal and translates to millions of sleepless nights and strained relationships across the globe. Snoring might be common but that’s of little comfort to those who suffer from a potentially destructive sleep disorder. It’s also no consolation to the partners of serial snorers who frequently stay awake through no fault of their own. There’s no easy answer and no quick fix but understanding snoring is the first step towards finding a way forward.

Snoring%202029%20words%206045a15adc904475a962ba91dcd8ed05/snore-wars-trumpet_(1).svg

What causes snoring?

Snoring is caused by the tissues behind the nose and mouth vibrating. It happens when the airways are partially closed. This leads to air turbulence and, in turn, to the resulting noise. There can be a number of causes of this airway obstruction:

  • a lack of muscle tone in the neck which causes a partial closure when you lie down
  • a bit too much weight around the neck which can put pressure on the airway
  • alcohol, which can cause a weakening of muscle tone
  • an anatomical problem

Snoring is essentially noisy breathing

Snoring can be relatively quiet but the snoring we tend to hear about is the loud unpleasant kind. Loud snoring disrupts the sleep of the snorer and the sound is sufficient to wake them up - as well as their bed partner. Snoring is defined as loud upper-airway breathing. It is the sound generated during sleep by the vibration of loose tissue of the soft palate and the uvula in the upper airway. The noise is created by obstruction to air moving through the airway.

Snoring is very common and not usually harmful

It’s estimated that 10-30% of adults snore frequently. Both men and women snore. However, men are almost twice as likely to snore occasionally, compared to women 1 2.

Snoring%202029%20words%206045a15adc904475a962ba91dcd8ed05/snore-wars-conversation_(2).svg

Women are generally lighter sleepers than men, to a large degree because of hormonal changes throughout their lifespan. They are, therefore, more likely to be disturbed by a male bed partner snoring than the other way around 1 2.

However this may not be the only reason that women tend to report more disruption to their sleep from snoring bed partners compared to reports of male bed partners being kept awake by their partner snoring. Sociologists Jenny Hislop and Sara Arber postulated:

In accepting their commitment to their partner, women may, either consciously or subconsciously, subjugate their own needs and place themselves at a distinct disadvantage in terms of access to sleep.

In laymen’s terms this means that women will suffer their partners snoring without intervention. Men are a lot less likely to put up with a partner snoring 3.

Snoring gets worse with age

There are a number of reasons why snoring can become worse as we age 4. As we get older we tend to lose muscle tone, including in the upper airway. The soft palate in the back of the roof of your mouth, for example, becomes more susceptible to vibration as we age.

We all know that we’re susceptible to putting on a bit of weight as we get older and people who are overweight are more likely to snore.

Older people tend to take more medications compared to younger people and some medications can cause - or increase the frequency of - snoring.

Snoring%202029%20words%206045a15adc904475a962ba91dcd8ed05/snore-wars-age.svg

It’s thought that the hormone oestrogen can improve/strengthen muscle tone. Women have lower levels of oestrogen following the menopause, which means they are likely to have softer muscles - including in the upper airways 5.

Snoring can cause insomnia for the bed partner

Of course one of the issues of snoring is that it doesn’t just affect the snorer, who is asleep and often blissfully unaware of their snoring. Snoring also affects the bed partner and, in some cases, it’s only the bed partner who suffers.

Bed partners can be frequently woken by the noise of a snorer and prevented from falling asleep again until the snoring ceases, either naturally or in response to a sharp jab of the elbow.

Could you have insomnia?

Our team can help you find out and provide you with support to improve your sleep.

If you’re struggling to get a good night’s sleep due to a snoring partner and you feel like you might have developed insomnia, you should seek help to improve your sleep as sleep problems tend to get worse the longer we leave them.

Sleeping next to a snorer can be hard work

A study looking at the association between close relationships and sleep found that it was likely to be bi-directional and reciprocal. The quality of close relationships is influenced by how well we sleep and therefore sleep disturbances, such as snoring, can affect relationship quality.

Snoring can have a profound effect of the quality of romantic relationships.

One half of bed partners reported being disturbed by snoring every night or almost every night 6 and one third of bed partners reported disharmony in their relationships from time to time - or repeatedly - due to snoring 6. Comfortable ear plugs can provide some relief for troubled bed partners.

Wearing earplugs can help if sleeping next to a snorer

Why do some people snore and others don’t?

Snoring can be triggered by many things including taking sleeping pills, nasal congestion and allergies 7 8. Persistent snoring may raise the lifetime risk of developing high blood pressure, diabetes, heart failure, and stroke 9 10. Snoring runs in families and common risk factors include:

  • Being male
  • Being overweight
  • Drinking alcohol
  • Smoking
Wearing earplugs can help if sleeping next to a snorer

How can I stop snoring?

Snoring, as such, cannot be cured. However, in many people it can be controlled through lifestyle changes such as losing weight, stopping smoking and not drinking alcohol 11 12. There are also various anti-snoring products, such as nasal strips and sprays, available in your local pharmacist and on the internet. Some of these products may help improve snoring in some people 13.

Unfortunately, it is a case of trial and error when it comes to finding a product that will benefit you as an individual 14 15. If your snoring, or someone else’s, continues to disrupt your sleep then you or they need to seek medical advice.

If you’re worried about your snoring, or think you could have insomnia, our team can help. You can start an online chat with them here.

In some cases, snoring can indicate a serious problem

For the majority, snoring has no serious medical consequences 16 but in an estimated 5% - often overweight, middle-aged men - extremely loud and habitual snoring is the first sign of a potentially serious disorder: Obstructive Sleep Apnoea.

It’s called obstructive sleep apnoea (OSA) because:

  • there’s an obstruction in the airway
  • it happens during sleep
  • it causes apnoea - you stop breathing

It can be hard to know if you have sleep apnoea because it’s not easy to observe yourself during sleep. If you sleep in the same bedroom as someone else, or can ask someone to stay with you while you sleep, it may help to ask them to check for the symptoms.

Snoring%202029%20words%206045a15adc904475a962ba91dcd8ed05/snore-wars-shaun-awake.svg

Symptoms of sleep apnoea include:

  • breathing stopping and starting
  • making gasping, snorting or choking noises
  • waking up a lot
  • loud snoring

During the day, you may also feel very sleepy and find it difficult to focus on tasks. Sleep apnoea can also affect your mood, causing you to experience mood swings.

Some of the symptoms of OSA can also be a signs of insomnia and it is possible to have both OSA and insomnia.

Interestingly, men and women have been shown to report symptoms of OSA differently. Men tend to report snoring, snorting, gasping and sleepiness. By contrast, women report un-refreshing sleep, fatigue, insomnia, and depression 17 18.

Snoring%202029%20words%206045a15adc904475a962ba91dcd8ed05/snore-wars-children_(1).svg

Snoring can also be a problem for children

Many children have enlarged tonsils or adenoids, often requiring surgical intervention. These problems can make their airways narrower, causing the child to snore 19. If the child’s sleep is affected by snoring over the long term, it can lead to various problems, including medical conditions. Children who snore score lower on tests that measure intelligence, memory and ability to maintain attention. They are also likely to exhibit challenging behaviour, including hyperactivity 20.

Uvulopalatopharyngoplasty

We haven’t fallen asleep on the keyboard. There is an operation that’s sometimes claimed to be a ‘cure’ for snoring known as an Uvulopalatopharyngoplasty or UPPP for short.

Can surgery improve snoring?

Uvulopalatopharyngoplasty sounds rather complex is but it’s actually relatively simple to perform. It removes the tonsils, uvula (the tissue that hangs from the middle of the back of the roof of the mouth) and part of the roof of the mouth in the back of the throat (called the soft palate). It is only performed on adults.

UPPP is effective for some people. However, before embarking on a surgical procedure, it’s important to be aware that UPPP is not always successful. If you undergo surgery there is no guarantee that the procedure will eliminate or significantly reduce your snoring 21.

Snoring%202029%20words%206045a15adc904475a962ba91dcd8ed05/snore-wars-pregnancy.svg

Can pregnancy cause snoring?

Snoring during pregnancy is fairly common. It affects around one in three women, including those who’ve never snored before. Snoring during pregnancy can be the result of an increase in the hormones associated with pregnancy. These hormones can cause the mucous membranes in the nose to swell, leading to nasal congestion that increases when lying down. It can also be caused by the increase in weight related to pregnancy, as it results in extra tissue around the head and neck that aggravates snoring.

Snoring is particularly common during the final trimester of pregnancy and has been linked to adverse pregnancy outcomes including gestational diabetes, gestational hypertension, preeclampsia, cesarean delivery, preterm birth, low birth weight etc. 22 23 24 25 26 27.

Once hormone levels have returned to normal and the excess weight gained during pregnancy is lost, the snoring associated with pregnancy is likely to disappear.

Snoring%202029%20words%206045a15adc904475a962ba91dcd8ed05/snore-wars-clarinet.svg

Snoring can be controlled

Data has shown that singing 28 and playing the didgeridoo, brass or woodwind instruments 29 is effective in reducing snoring because these activities strengthen the upper airway.

Building on the idea that strengthening the upper airway helps to reduce snoring, the Soundly app has published data to show that it is effective in reducing snoring https://soundlyapp.com/ 30.

Mandibular advancement devices (MADs) can be used to control snoring. MADs are a bit like a boxer’s gum shield and, when fitted by a dentist, they can help to keep the airway open by stopping the jaw relaxing backwards 31.

If you have mild sleep apnoea then treatment may include advice on lifestyle management - including helping people to lose weight, stop smoking and/or reduce alcohol consumption.

Severe sleep apnoea is usually treated with a device known as CPAP (Continuous Positive Airway Pressure). This device uses air pressure to keep the upper airway open and improves the problem as a result. CPAP works very effectively in most people but you have to wear it for it to work.

Snoring%202029%20words%206045a15adc904475a962ba91dcd8ed05/snore-wars-sleep-apnoea.svg

A note of caution

If you or your bed partner suspect that either of you suffers from sleep apnoea then you must seek medical advice. OSA can usually be effectively treated but can cause serious problems if left untreated.

In summary

Think snoring’s boring? Think again. Snoring can occur for various reasons, at different stages of life and can affect men, women and children differently.

  • Snoring is very common and not usually harmful.
  • Men are more likely to snore than women.
  • Snoring can be improved by making healthy lifestyle choices like cutting down on alcohol or stopping smoking.
  • Snoring in children can cause further problems and should be investigated.
  • Snoring accompanied by daytime sleepiness should be reviewed by a doctor.
  • Some pharmacy products are effective for symptom management but don’t address the cause.
  • Snoring can cause insomnia for bed partners.
  • Sleepstation can help anyone struggling with insomnia.

References:


  • Svensson, M., Franklin, K.A., Theorell-Haglöw, J. and Lindberg, E., 2008. Daytime sleepiness relates to snoring independent of the apnea-hypopnea index in women from the general population. Chest, 134(5), pp.919-924

  • Mallampalli MP, Carter CL. Exploring sex and gender differences in sleep health: a Society for Women's Health Research Report. Journal of women's health. 2014 Jul 1;23(7):553-62.

  • Hislop J, Arber S. Sleepers wake! The gendered nature of sleep disruption among mid-life women. Sociology. 2003 Nov;37(4):695-711.4.

  • Dalmasso, F. and Prota, R., 1996. Snoring: analysis, measurement, clinical implications and applications. European Respiratory Journal, 9(1), pp.146-159.

  • Stoohs RA, Blum HC, Haselhorst M, Duchna HW, Guilleminault C, Dement WC. Normative data on snoring: a comparison between younger and older adults. European Respiratory Journal. 1998 Feb 1;11(2):451-7

  • Troxel WM, Robles TF, Hall M, Buysse DJ. Marital quality and the marital bed: Examining the covariation between relationship quality and sleep. Sleep medicine reviews. 2007 Oct 1;11(5):389-404.

  • Virkkula P, Bachour A, Hytönen M, Malmberg H, Salmi T, Maasilta P. Patient-and bed partner-reported symptoms, smoking, and nasal resistance in sleep-disordered breathing. Chest. 2005 Oct 1;128(4):2176-82.

  • Issa, F.G. and Sullivan, C.E., 1982. Alcohol, snoring and sleep apnea. Journal of Neurology, Neurosurgery & Psychiatry, 45(4), pp.353-359;

  • Kauffmann, F., Annesi, I., Neukirch, F., Oryszczyn, M.P. and Alperovitch, A., 1989.The relation between snoring and smoking, body mass index, age, alcohol consumption and respiratory symptoms. European Respiratory Journal, 2(7), pp.599-603.

  • Deary, V., Ellis, J.G., Wilson, J.A., Coulter, C. and Barclay, N.L., 2014. Simple snoring: not quite so simple after all? Sleep medicine reviews, 18(6), pp.453-462;

  • Young T, Finn L, Austin D, Peterson A. Menopausal status and sleep-disordered breathing in the Wisconsin Sleep Cohort Study. American journal of respiratory and critical care medicine. 2003 May 1;167(9):1181-5.

  • MacKay, S., 2011. Treatments for snoring in adults. Aust Prescriber, 34(3), pp.77-79;

  • Camacho, M., Malu, O.O., Kram, Y.A., Nigam, G., Riaz, M., Song, S.A., Tolisano, A.M. and

  • Kushida, C.A., 2016. Nasal dilators (Breathe Right Strips and NoZovent) for snoring and OSA: a systematic review and meta-analysis. Pulmonary medicine, 2016.

  • Counter, P. and Wilson, J.A., 2004. The management of simple snoring. Sleep Medicine Reviews, 8(6), pp.433-441.

  • Michaelson, P.G. and Mair, E.A., 2004. Popular snore aids: do they work?. Otolaryngology-Head and Neck Surgery, 130(6), pp.649-658;

  • Hoffstein, V., 1996. Is snoring dangerous to your health?. Sleep, 19(6), pp.506-516.

  • Kump K, Whalen C, Tishler PV, et al. . Assessment of the validity and utility of a sleep-symptom questionnaire. Am J Respir Crit Care Med 1994;150:735–741

  • Wheaton AG, Perry GS, Chapman DP, Croft JB. Sleep disordered breathing and depression among U.S. adults: National Health and Nutrition Examination Survey, 2005–2008. Sleep 2012;35:461–467

  • InformedHealth.org Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Enlarged tonsils and adenoids: Overview. 2019 Jan 17.

  • Brockmann, P.E., Urschitz, M.S., Schlaud, M. and Poets, CF, 2012. Primary snoring in

  • school children: prevalence and neurocognitive impairments. Sleep andBreathing, 16(1), pp.23-29.

  • Hassid, S., Afrapoli, A.H., Decaestecker, C. and Choufani, G., 2002. UPPP for snoring:

  • long-term results and patient satisfaction. Acta oto-rhino-laryngologica Belgica, 56(2), pp.157-162.

  • Facco FL, Ouyang DW, Zee PC, Strohl AE, Gonzalez AB, Lim C, et al. Implications of sleep-disordered breathing in pregnancy. Am J Obstet Gynecol. 2014; 210:559 e1–6. 10.1016/j.ajog.2013.12.035

  • Bourjeily G, Raker CA, Chalhoub M, Miller MA. Pregnancy and fetal outcomesof symptoms of sleep-disordered breathing. Eur Respir J. 2010;36:849–855. 10.1183/09031936.00021810

  • O'Brien LM, Bullough AS, Owusu JT, Tremblay KA, Brincat CA, Chames MC, et al. Pregnancy-onset habitual snoring, gestational hypertension, and preeclampsia: prospective cohort study. Am J Obstet Gynecol. 2012; 207(6):481–489.

  • O'Keeffe M, St-Onge MP. Sleep duration and disorders in pregnancy: implications for glucose metabolism and pregnancy outcomes. Int J Obes (Lond). 2013; 37:765–770.

  • Pamidi S, Pinto LM, Marc I, Benedetti A, Schwartzman K, Kimoff RJ. Maternal sleep-disordered breathing and adverse pregnancy outcomes: a systematic review and metaanalysis. Am J Obstet Gynecol. 2014; 210:52.e1–52.e14.

  • Franklin, K.A., Holmgren, P.Å., Jönsson, F., Poromaa, N., Stenlund, H. and Svanborg, E., Snoring, pregnancy-induced hypertension, and growth retardation of the fetus. Chest, 117(1), pp.137-141.

  • Pai, I., Lo, S., Wolf, D. and Kajieker, A., 2008. The effect of singing on snoring and daytime somnolence. Sleep and Breathing, 12(3), pp.265-268.

  • Valbuza, J.S., Oliveira, M.M.D., Conti, C.F., Prado, L.B.F., Carvalho, LBCD and Prado, G.F.D., 2008. Methods to increase muscle tonus of upper airway to treat snoring: systematic review. Arquivos de neuro-psiquiatria, 66(3B), pp.773-776.

  • Goswami U, Black A, Krohn B, Meyers W, Iber C. Smartphone-based delivery of oropharyngeal exercises for treatment of snoring: a randomized controlled trial. Sleep and Breathing. 2019 Mar 14;23(1):243-50.

  • Stuck, BA and Hofauer, B., 2019. The Diagnosis and Treatment of Snoring in Adults. Deutsches Aerzteblatt International, 116(48)

Further information