This common habit can trigger a number of health problems, explains Dr Mel Wynne-Jones
Snoring doesn’t just affect overweight, middle-aged men – women, and even children may snore, too.
But obstructive sleep apnoea (OSA/blocked breathing during sleep) tends to be under diagnosed in women, and even though up to one in three sufferers is female, up to half don’t report OSA symptoms, perhaps because of embarrassment.
And their doctors may not spot the cause of their symptoms either, so men may be twice as likely to be referred for sleep investigations.
But OSA should always be taken seriously. Short-term, it can trigger accidents and disrupt relationships; longer term, it’s linked to weight gain, high blood pressure, heart attacks and irregular heartbeats, strokes, and type 2 diabetes.
Snoring isn’t just noisy in OSA – airways get partially or completely blocked, cutting off our oxygen supply until our brain wakes us up, with a snort or choking noise, to restore normal breathing.
This can happen dozens of times a night, reducing restorative deep sleep, although we may not realise what’s happening (our partner may notice we’re struggling to breathe or keep waking up).
This can affect our concentration, performance and memory, and cause daytime sleepiness (dangerous if we’re driving or operating machinery), headaches, nausea, reduced sex drive, irritability and lack of energy.
We (or our doctors) may blame stress, insomnia, the menopause, or depression instead, leading to delays and unnecessary tests or treatments.
Snoring may be due to a blocked nose – congestion, deviated septum, polyps, adenoids, tumours (rarely) – large tonsils, or other enlarged tissues at the back of the nose and mouth (common in obesity or underactive thyroid).
In OSA, the tongue, soft palate, throat and/or airways tissues become relaxed/floppy during sleep, cutting off airflow. This is more likely if we’re overweight, older, smoke, have taken alcohol or a sedative, or lie on our backs. It triples in women after the menopause, thanks to hormone-related muscle changes.
Lifestyle measures, such as losing weight, reducing alcohol, stopping smoking and avoiding sedative medication, can significantly improve OSA.
If you have daytime sleepiness, you must avoid driving until it stops, and inform the DVLA.
Nasal blockage may be cured by decongestants, allergy treatment or corrective surgery. Enlarged adenoids and/or tonsils may need to be removed.
But if you have severe OSA that can’t be cured, you may be offered a CPAP (continuous positive airways pressure) machine.
This pumps compressed air through a mask to stop your airways closing during sleep, improving sleep quality, reducing symptoms and long-term complications.
8 checks you could do/have
1. Ask someone who may know if you are a nose, mouth or throat snorer, and whether you stop breathing while you are asleep.
2. Your weight and height if you’re overweight.
3. A telescope ear, nose and throat examination (endoscopy) to look for possible blockages.
4. Heart, blood pressure and lung checks to look for adverse effects.
5. A questionnaire to see how it’s affecting daytime activities – the Epworth Sleepiness Scale.
6. Blood test for underactive thyroid (hypothyroidism).
7. Referral to a sleep clinic (sleep-apnoea-trust.org) to arrange home sleep monitoring – breathing sensors, and finger clip that measures heart rate and oxygen levels.
8. Studies of various vital functions while you sleep at a sleep clinic.