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Written by Robert J Lewis
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Snoring and Sleep Apnoea
We can all recognise the sound of snoring, but do you know what causes it? It is estimated that 41% of middle aged men and 28% of middle aged women snore.
Snoring is the sound made by the vibrations of the soft palate and other tissues of the mouth, nose and throat (the upper airway). It is caused by the partial blockage of the upper airway.
When we are awake there is sufficient muscle tone to keep the airway open. However when we are asleep this muscle tone is lost and the airway narrows. In addition to this, in people who snore there is often a partial obstruction of some kind somewhere between the nostrils and the Adam’s apple. The partial obstruction may be congestion (e.g. catarrh), swollen tissue (e.g. nasal stuffiness); small or collapsing nostrils, nasal polyps, or deformity (e.g. deviated septum or receding chin).
The noise of a snore is usually produced as the person breathes in. There is a related condition called sleep apnoea which we will look at separately but for now we will look at what is known as simple (or primary) snoring.
What can be done about snoring? The most important thing to do is to identify the cause and treat it appropriately.
The most common reasons for snoring are being overweight, smoking and drinking alcohol - if these are the cause then lifestyle changes may need to be made.
If there are abnormalities of the nasal airways e.g. polyps the person should seek advice from their doctor.
Smokers are twice as likely to snore than non-smokers as they are prone to catarrh, nasal congestion and coughs, all of which can aggravate snoring.
Sleeping on the back makes snoring worse as the mouth tends to fall open. If you start off sleeping on your side but roll onto your back unawares, try placing a pillow behind you to prevent you turning onto your back during your sleep.
Some people find that raising the head of the bed slightly helps; this can be achieved by placing a telephone directory under the head end of the bed.
A variety of anti-snoring devices are available. The most popular oral device is the Mandibular Advancement Device (MAD) – this is intended for those people whose snoring is due to the tongue dropping to the back of the throat causing an obstruction. The M.A. Device brings the jaw forward. However these devices are not suitable for all people, particularly if they have any loose teeth, missing teeth, dentures, gum disease or problems with the tempro-mandibular joint.
Sleep Apnoea
Sleep Apnoea is a condition in which breathing temporarily stops during sleep. Apnoea means “absence of breath”. The person has episodes of
complete obstruction of the upper airway for a brief period of time e.g. ten seconds or even longer. The silence of this period without breathing is usually followed by snorts and gasps as the person fights to take another breath. This can happen several times during the night making it difficult for them to get an adequate supply of oxygen and to get a good nights sleep.
It is estimated that up to 2% of the population suffer from sleep apnoea.
If the person is overweight (and/or has a collar size of 16 ½inches or over) the fatty tissue around the neck area may squeeze the airway closed and prevent air reaching the lungs. Sometimes it may be due to a blockage e.g. the tongue dropping to the back of the throat.
Sleep apnoea cannot be self diagnosed - it needs to be determined by undergoing an overnight sleep study. If it is suspected that someone has sleep apnoea they should be referred to their doctor who will arrange for a specialist assessment.
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Health 
