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 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:
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.
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.
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.
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.
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.
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.
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.
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:
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.
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:
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.
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.
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.
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.
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 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.
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.
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.
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.
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Poor sleep can cause lots of problems and when it’s not treated, those problems can last for decades…
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