What is snoring and sleep disordered breathing?
Snoring is caused by the vibration of the soft tissue in the head and neck as you breathe in. Snoring occurs when a part of the throat air passage has a tendency to collapse and vibrate. When asleep, the muscles in the walls of the throat and other throat structures are relaxed, which allows the collapse and vibration of these structures when breathing in.
The main issues when assessing a patient with this problem are:
1. Where is the collapse/vibration occurring? This allows assessment for appropriate treatments.
2. Is there obstructive sleep apnoea? The extreme end of the spectrum is apnoea: when the throat collapses completely during sleep. This causes interruption of breathing because the throat is “shut” (apnoea). What happens as a result (at a simple level) is oxygen levels in the blood stream decrease. This causes a degree of arousal and the muscles of the throat tense up and the throat opens up, restoring normal breathing. A cycle of apnoea-arousal-resumption of breathing re-occurs throughout the night. In the long-term, obstructive sleep apnoea, untreated, can cause high blood pressure and put a strain on the heart. Also not to be under-estimated are the effects on permanent daytime tiredness on quality of life.
What factors influence the degree of snoring and sleep disordered breathing?
1. Weight: There is a well-proven and certain link between being overweight and sleep disordered breathing. If you are overweight, this is the first thing to address.
2. Alcohol: Drinking alcohol regularly in the evening promotes snoring and sleep disordered breathing by relaxing the muscles of the throat excessively.
3. Nasal obstruction: This occurs through a combination of mouth breathing (the jaw sinks back and narrows the throat) and breathing with more effort (more collapsibility as a result).
4. Large tonsils: Narrow the throat airway.
5. Other anatomical configurations such as a long palate, large tongue, floppy uvula, narrow voice box inlet, weak lower jaw, narrow throat etc. This is assessed in clinic and can determine whether a given form of treatment is likely to be successful.
What causes snoring?
Snoring is often related to a physical obstruction to your breathing during sleep. The muscles of your palate, the uvula, and the tonsils relax during deep sleep and the air you breathe in causes them to vibrate noisily.
Anything that narrows the airways will contribute to the problem, so excessive tissue bulk at the back of the throat is a major cause. A blocked nose can also restrict nasal respiration and will encourage the vibration we know as snoring. Advanced snoring problems are often associated with obstructive sleep apnoea which can sometimes indicate a serious medical disorder.
How common is snoring?
Habitual snoring is a problem for 30% of all men and 10% of all women, and it gets worse as people grow older. By the time they reach sixty, snoring affects 50% of men and 30% of women.
The social impact of snoring
Snoring certainly affects the sleep pattern of the snorer so sleep is affected. As a result, the snorer is not fully refreshed when he or she awakes. Indeed, the effect on other members of the family can be even more devastating. Snoring can completely disrupt family life. Sleeping partners, even people trying to sleep in nearby rooms, can lose excessive amounts of sleep, and this often causes resentment.
In a survey carried out in 2001, 40% of the couples interviewed said that snoring had adversely affected their relationship and 80% of these had resorted to sleeping separately to escape the noise.
Details about treatment can be found on the radiofrequency for snoring page.