24 April 2017
The sound of someone snoring is often viewed as a humorous event, however it can make many people miserable. Sometimes it is an early warning sign of something more serious. It can cause loving couples to sleep in separate rooms and has even been blamed for some marriage breakdowns.
But there are solutions, and even simple changes in lifestyle to a range of operations can correct the causes of snoring and sleep apnoea.
As part of National Stop Snoring Week, April 20 to 26, Mr Vik Veer, an Ear, Nose and Throat Consultant Surgeon from the award winning NHS Sleep Surgery Department in Central London and Spire Bushey Hospital, looks at the causes and some of the ways we can tackle this problem.
Mr Vik Veer explained: “Snoring is very common, with around 40% of us being snorers at some level or other. In some cases it isn’t a cause for concern – well not for the snorer, although their partner might tell a different tale!
“It is caused by vibrations from the upper airway… a partial blockage may be located anywhere from the back of the nose to the voice box...This may occur when throat muscles become weak and collapse inwards and when excess tissue obstructs the airway (such as the uvula, tonsils or tongue). Identifying the cause of the obstruction and the location of the snoring noise is the most difficult part. Since everyone is different, each person requires a different treatment plan. One treatment certainly does not work for everyone and the research shows that very clearly.”
Mr Vik Veer also said that, in many cases, snoring may be reduced by making some simple lifestyle changes.
“Common-sense changes such as losing weight, not drinking alcohol within three hours of bedtime and stopping smoking can all have a beneficial effect. Sleeping on your side and treating nasal obstruction can also be very useful.”
However there can be times when medical intervention is needed.
“Snoring and particularly breathing problems are often due to obstruction at many different levels such as the nose, soft palate, tonsils, lateral walls and the tongue base.“
“Careful assessment to identify the level of obstruction helps to select patients who would benefit most from surgery or from a range of non-surgical devices. For example surgery to the nose such as a 5 minute turbinate operation (which can be performed under local or general anaesthetic), often help patients breathe much better and therefore reduce the snoring noise. By helping people breathe through the nose rather than with the mouth wide open, the volume can be reduced to a more ‘sociable level’ with very little intervention. In some cases palatal, tonsil, throat wall, and tongue operations may be used depending on the cause of the snoring and breathing problem.”
“There are a range of non-surgical products that can also be effective such as mandibular advancement devices that bring the lower jaw forward and improve the airway by making more room to breathe behind the tongue.”
However, Mr Vik Veer stressed that loud snoring is often a sign of sleep apnoea - a condition that interrupts your breathing when you are asleep.
“Apnoeas are caused when obstruction in the throat stops you from breathing for a short time, cutting off the oxygen going to the brain. This can occur multiple times each hour and sometimes a bed partner will actually witness an extreme event, which can be quite frightening. It looks like you are choking in your sleep. Being woken up so often during sleep leads to daytime tiredness, weight gain, morning headaches and difficulty in concentration. Untreated sleep apnoea leads to high blood pressure, heart attacks, strokes, depression and diabetes.”
“Sleep apnoea should be treated as quickly as possible to avoid the problems listed above."
The STOPBANG questions are a quick way of working out if someone might have sleep apnoea.
S – Snoring – is your snoring loud enough to be heard outside a closed door or does it disturb your partner?
T – Tiredness – are you tired during the day?
O – Has anyone Observed you stop breathing or choking/gasping during your sleep?
P – Blood Pressure – do you have, or are you on medication for high blood pressure?
B – Body Mass Index – is your BMI greater than 35? To work out your BMI you need to know your height and weight.
A – Age – are you older than 50?
N – Neck / collar size – is your collar size greater than 16½ inches (men) or 15½ (women)
G – Gender – Are you male?
If you answer more than 2 of these questions as a yes, then there is a chance you might have obstructive sleep apnoea.
To get a more accurate result visit http://stopbang.ca/osa/screening.php
If you have a high STOPBANG score, then please visit your GP as soon as possible. The traditional treatment for sleep apnoea is a CPAP (continuous positive airways pressure), although there are surgical options available as well. At Spire Bushey Hospital our expert sleep team will assess and treat you in a clean, comfortable environment at a time that suits you.