Snoring Treatment Options

Snoring Treatment Options

Background

During sleep, the pharyngeal airway (throat) narrows, due to a reduction in muscle tone. Snoring is simply a vibratory noise generated by the back of the relaxed tongue, pharynx and soft palate. Further narrowing produces not only louder snoring, but also laboured inspiration (breathing in). Finally, further narrowing may cause complete airflow obstruction known as obstructive sleep apnoea.

There comes a point where the increased inspiratory effort is sensed by the sleeping brain and a transient arousal is provoked (brief awakening to breathe before returning to sleep). A few of these arousals do not really matter.

However, when there are many (sometimes hundreds), sleep becomes seriously fragmented, resulting in daytime symptoms of excessive sleepiness. Snoring and sleep apnoea are part of a spectrum extending from ‘benign’ or ‘simple’ snoring with no sleep disturbance, through to obstructive sleep apnoea with severe daytime sleepiness symptoms and the physiological consequences of recurrent asphyxia (insufficient oxygen).

There are many claims made for snoring ‘cures’ or treatments and our understanding of snoring and sleep apnoea has increased enormously in the last ten years. Much can be done to help both these conditions. As a result, there has been an extraordinary rise in the number of hospital referrals for these conditions.

The purpose of this part of the BSDSM website is to help the bed partner and snorer find non-commercially biased, objective information about the available treatment options.

Is treatment really necessary?

Is treatment really necessary?

‘Benign’ snoring can be far from benign. The social consequences can be extremely distressing: banishment from the bedroom, marital disharmony, no holidays because of enforced sleep disruption when sharing a hotel room, fear of travelling – falling asleep during long journeys on public transport and the consequent ridicule and embarrassment. Many of the stories we hear are very sad and not worthy of the all too common joking approach to snoring.

There is no doubt that treatment is essential for obstructive sleep apnoea and extremely appropriate for snorers. Obstructive sleep apnoea, resulting in serious sleep disruption, can produce greatly impaired performance at work, at home, and on the road. Car accidents are statistically much more common in this group. The response to appropriate therapy can be extraordinarily dramatic with commonly, a return to a state of alertness and vitality often not previously experienced for years or even decades.

Is the problem only severe snoring?

Is the problem only severe snoring?

‘Benign’ snoring can be far from benign. The social consequences can be extremely distressing: banishment from the bedroom, marital disharmony, no holidays because of enforced sleep disruption when sharing a hotel room, fear of travelling – falling asleep during long journeys on public transport and consequent ridicule and embarrassment.

Many of the stories we hear are very sad and not worthy of the all too common joking approach to snoring.

There is no doubt that effective treatment is essential for obstructive sleep apnoea and extremely appropriate for snorers.

Obstructive sleep apnoea, resulting in serious sleep disruption, can produce greatly impaired performance at work, at home, and on the road. Car accidents are statistically much more common in this group. The response to appropriate therapy can be extraordinarily dramatic with, commonly, a return to a state of alertness and vitality often not previously experienced for years or even decades.

There is evidence that so called ‘simple snoring’ is also linked with persistent daytime hypertension, insulin resistant diabetes and carotid artery atherosclerosis. Many now believe that ‘simple snoring’ may be a precursor to OSA.

Are any of these features of Sleep Apnoea present?

  • Daytime sleepiness (not tiredness) e.g. nodding off during less stimulating activities: reading, watching TV, meetings, etc.
  • Bed partner reports episodes of breathing cessation (although any snorer will have occasional such events, especially when sleeping supine – ‘on your back’).
  • Patient experiences waking with choking/obstructed episodes.
  • Regularly waking un-refreshed in the morning.
  • Neck circumference over 17″ (usually, but not always, indicates being overweight).
  • Small pharynx (throat) on visual inspection.
  • Waking hearing the ‘end of your own snore’.
  • Obesity, BMI >30 (weight in kilograms divided by height in meters squared)
  • Having to sleep propped up.
  • Making frequent trips to the bathroom during the night.