Snoring

When asleep, your muscles relax, allowing tissues in your airways to vibrate as you breathe. These vibrating tissues narrow your airways, causing a sound as air is pushed through.

About four in 10 people snore, with men more likely to snore than women. Getting older increases your risk of being a snorer, with women more likely to snore after menopause. You are also more likely to snore if you are overweight, drink alcohol or smoke. Other risk factors for snoring include if you: 

• Have a family history of snoring or obstructive sleep apnoea (OSA) — OSA occurs when your airways become temporarily blocked while sleeping
• Have a problem with the back of your throat eg a very low soft palate or weakness at the back of your throat
• Have an underactive thyroid (hypothyroidism)
• Have nasal congestion, perhaps caused by nasal polyps (growths in your nose), a deviated septum (the tissue which divides your nostrils) or allergies
• Sleep on your back
• Take sleeping pills — these can relax your muscles too much, triggering snoring

In children, snoring is usually caused by a blocked nose when they have a cold or if they have very large tonsils or adenoids.

Snoring can come and go but may become a chronic (long-term) condition that can disrupt sleep and cause insomnia, leading to tiredness and irritability. It can also disturb the sleep of the person sleeping next to you. However, you can often stop snoring by making lifestyle changes, using special devices at night or, occasionally, with surgery.

Snoring is rarely a sign of a serious condition but it can be a symptom of OSA.

Snoring occurs when your muscles relax as you sleep, allowing soft tissues in your airways to vibrate as you breathe. This can occur in any part of your upper airway including the: 

• Back of your throat — soft tissues that may vibrate in this area include your:
• Tonsils — small oval-shaped tissue on both sides of your throat
• Uvula — a hanging piece of tissue in the middle back of your throat
• Back of your tongue
• Soft palate — the roof of your mouth at the very back of your mouth

Causes of snoring include: 

• Defects in your nose eg a deviated septum or nasal polyps
• Drinking too much alcohol before bedtime — alcohol relaxes your throat muscles, which increases the likelihood of soft tissues vibrating and of your airways becoming temporarily blocked
• Chronic nasal congestion
• Sleep deprivation — this can further relax your throat muscles
• Sleeping on your back — the effect of gravity on your throat is greatest in this position and narrows your airways

You may be unaware you are snoring but your partner may notice harsh, repetitive breathing noises when you’re sleeping.

If your snoring is a symptom of OSA, your partner may also notice sudden pauses in your breathing. These pauses or slowing in breathing usually occur at least five times per hour of sleep. You might also have:

• Difficulty concentrating and excessive daytime tiredness — in children, this may present as a very short attention span, behaviour issues and poor performance at school
• Headaches in the morning
• Increased need to urinate 
• Loud, laboured breathing when sleeping, interrupted by gasps, snorts or choking noises
• Restlessness when sleeping, often accompanied by sudden jerking movements 
• Sore throat on waking up

You may also have high blood pressure and chest pain at night. 

Chronic snoring associated with OSA can put you at risk of: 

• Daytime sleepiness 
• Difficulty concentrating
• Frequent anger, frustration and irritability 
• High blood pressure, heart conditions and stroke
• Motor vehicle accidents due to lack of sleep 

In children, behaviour and learning problems are more likely.

It is important to see your GP as sleep apnoea can be serious if it is not treated. See your GP if: 

• Snoring is seriously affecting your sleep or daily life
• Snoring is seriously affecting your partner’s sleep or daily life
• You feel sleepy in the daytime
• You make gasping or choking noises while you sleep

Your GP will discuss your symptoms and how they are affecting you. As your partner may be more aware of your symptoms than you, it might help to take them with you.

Your GP may also examine your nose, mouth, throat and neck to check for any problems that might be causing your snoring. They may check your height and weight too.

They may look for causes of nasal congestion or a condition such as an underactive thyroid or allergies. They’ll give you advice about how to stop snoring, including, if needed, support to quit smoking.

Tests are not usually needed. However, if your GP suspects you have OSA, they may refer you to a sleep clinic for assessment, diagnosis and treatment. They may also refer you to an ear, nose and throat doctor.

Snoring remedies

To stop snoring, try:

• Avoiding alcohol, especially before bedtime
• Changing your sleeping habits — this includes: 
• Sleeping for at least seven hours each night if you are an adult — for children recommended hours for sleeping at night vary according to their age
• Sleeping on your side — sleeping on your back can put pressure on the back of your throat which may cause snoring; to stay sleeping on your side all night, you can tape or stitch a tennis ball into the back of your sleepwear or buy a special pillow or bed wedge
• Sleeping with your upper body slightly raised — try raising the top part of your bed by about 10cm
• Decongestants to help relieve nasal congestion
• Losing any excess weight — you can speak to your GP about what a healthy body weight is for you or try using a body mass index calculator (a healthy BMI is between 18.5 and 25)
• Stopping smoking
• Using over-the-counter anti-snoring devices, such as nasal strips and throat and nasal sprays

If your snoring is disturbing your partner, they can try wearing earplugs. 

You should avoid sleeping pills as these can cause snoring. 

Snoring aids

If snoring is having a serious effect on your life, your GP or consultant may recommend a:

• Mandibular advancement device (MAD) for snoring caused mainly by the vibration of tissues at the base of your tongue — a simple device you place over your teeth at night, bringing your lower jaw forward and keeping your airways open; these work best if fitted specifically for your mouth by a dentist
• Nasal dilator for snoring caused mainly by the vibration of tissues in your nose — place the device inside your nose before sleeping to hold your nose open
• Special chin strap to keep your mouth closed while sleeping — this makes you breathe through your nose instead of your mouth
• Vestibular guard — a plastic mouthguard that you insert before sleeping to prevent you from breathing through your mouth, so you have to breathe through your nose

Evidence for the effectiveness of these treatments is limited. So first try the snoring home remedies above before investing money in any of these devices. 

If a cold is triggering your snoring, you can try a short course of nasal decongestant spray. Long-term use of nasal decongestants is not recommended as they can damage the inside of your nose. 

Snoring surgery

If there is a physical reason for your snoring or other treatments have not worked, your GP or consultant may suggest surgery. This may not cure you of snoring and the problem may later return.

Surgery for snoring includes: 

• Uvulopalatopharyngoplasty (UPPP) — tissue in and around your mouth and throat are removed to create more space; this is performed under general anaesthetic and includes shortening the uvula (the hanging tissue in the middle back of your throat) and cutting parts of your soft palate at the back of your mouth
• Laser-assisted uvulopalatoplasty (LAUP) — similar to UPPP but performed using a laser that burns away the tissue of the uvula and soft palate
• Nasal surgery — this includes surgery to:
• Correct a deviated septum ie when the midline tissue of your nose is crooked
• Remove nasal polyps
• Radiofrequency ablation of the soft palate to stiffen the soft palate — this reduces the amount your soft palate vibrates and is performed under local anaesthetic; it involves placing an electrode on your soft palate through which radiofrequency waves are sent
• Soft palate implant — injection of implants into your soft palate to stiffen it and reduce the amount it vibrates; this is performed under local anaesthetic
• Tonsillectomy to remove both tonsils and adenoids — this is usually performed in children, not just for snoring but also if very large tonsils are causing other health problems