17 Sep 2018

Why do we snore and can we stop?

From Afternoons with Jesse Mulligan, 2:28 pm on 17 September 2018

It's an unconscious affliction that  can cause embarrassment and frustration and has even ended marriages, but snoring is really quite normal, sleep physician Andy Davies says.

snoring cartoon

Photo: 123RF

Dr Davies talks to Afternoons' Jesse Mulligan about what does and doesn't work in the battle against what he calls "turbulent air flow through your mouth".

"Snoring is never gonna kill anyone, but people do want to kill [other] people who snore," he says.

About 30 percent of men and about 10 percent of women snore, Dr Davies says, and that number rises to about 40 percent of the population for people aged between 30 and 70.

People sleep more noisily than many of our fellow mammals because cows, sheep and goats have 'straight' airways atop their abdomens, while humans stand upright with a bend in our necks - and airways.

"That little kink in the airway is what keeps me in business," Dr Davies says.

What do we know about why people snore?

Sleep medicine is the "nerdy little dark corner" of respiratory medicine and is a relatively new field about 25 years old, so we still have a bit to learn.

It may be that men snore more than women, Dr Davies says, because they're shifting more air through their airways, increasing the likelihood of "turbulence".

Lower estrogen levels, which are associated with skin that isn't as tight and "sagging airways" could also be a factor for both men and post-menopausal women.

Many women snore while pregnant, as their body's soft tissue increases in size and space in the airway gets reduced. This usually wears off over time, Dr Davies says.

Anatomy sometimes has a role to play. 

Usually, snoring relates to the size of the airway at the back of your throat, but a small nose can sometimes reduce airflow and lead to someone breathing out of their mouth more.

Narrow airways can be inherited via bone structure.

"Just like you inherit the front of your face from your family, you inherit the back of it," Dr Davies says.

Most people snore on the in-breath, but if you have large tonsils you may snore in both directions.

Snoring man and wife on bed

Photo: Paulus Rusyanto

What can help someone stop snoring?

Not sleeping on your back

"Your airway collapses in on itself on your back. If you're lying on your side or your front it hangs a bit more open."

Not drinking alcohol

Alcohol reduces the tone of the muscles.

"Just like your arms are all floppy when you've had a few drinks, the back of our throat sags more."

Losing weight

Excess weight has a high correlation with snoring as there is more weight deposited in the back of your tongue and your throat.

Davies rejects the idea that eating specific foods can help combat snoring.

What about anti-snoring devices?

Some people find the Buteyko breathing technique effective against snoring, but Davies says he hasn't seen much evidence and doesn't recommend it to patients.

"No [technique is] more effective than stitching a tennis ball in a patch of fabric in the back of a t-shirt between your shoulder blades," Davies says.

"It stops you lying flat and you're more like to roll over."

Surgery is only a worthwhile option if the cause of your snoring is massive tonsils, he says: "earplugs for your partner sometimes helps more."

Davies says that if you're a mouth breather with decent airflow through your nose, taping your mouth shut - and thereby reduce the resonance of the noise you're making - can be quite effective, but it's not a good idea if you might have sleep apnoea.

Sleep apnoea?

Sleep apnoea occurs when the walls of the throat come together during sleep and breathing stops for a short period of time – for some people many times a night.

In most cases, a person suffering from sleep apnoea doesn't realise they are waking up but fragmented sleep prevents their brain getting enough rest and theyll feel unrefreshed in the morning and sleepy during the day.

Repeated blocking of the airways during sleep releases adrenaline and is bad for your heart, often leading to high blood presure, high cholesterol, and negative impacts on diabetes, Davies says.

 

Listen to Our Changing World's award-winning 2012 sleep apnoea documentary:

How do you know whether you have sleep apnoea?

Chat to your GP if the following three things are present, he says.

"If you are a snorer, if people have noticed you stopping breathing and especially if you are excessively sleepy during the day."

Senior man covers ears while wife snores

​​ Photo: 123RF

Treatment for sleep apnoea

If your condition is mild, treatment will likely be similar to snoring treatment – avoiding lying on back, avoiding alcohol before sleep and maintaining a healthy weight, Davies says.

He also recommends people try the AVEO Tongue Stabilising Device – a plastic sucker that pulls your tongue forward while you sleep.

"Not really something for the Tinder profile, but it does work."

The biggest problem with the AVEO is that many people don't like the way it makes them drool or causes ulcers.

"[But] if they can tolerate it, it's actually quite a good piece of kit."

For more severe sleep apnoea, a mandibular advancement splint (interlocking gum shield which pulls the jaw forward) can also be helpful.

Young man sleeping with a CPAP machine

Young man sleeping with a CPAP machine Photo: Jean-Paul Chassenet

And, when necessary, a CPAP machine. It delivers a bit of pressure so when your airway sags it will be pushed open slightly to stops the obstruction, Davies says.

It can be intimidating at first and earlier models used to be quite noisy, but the CPAP is getting increasingly quieter, smaller and more energy-efficient, he says.

About 70 percent of people he's tried on it were still on it after six months, he says.

 

More about snoring:

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