Why is Snoring on the increase everywhere?

No one wants to be a snorer, and many are concerned that doing so will keep others awake at night. But new YouGov research in the UK reveals it’s now actually abnormal not to snore, after the age of forty at least.

snore night

Overall 45% of people admit to being snorers. This ranges from 22% amongst 18-24 year olds to 55% amongst over 60s. Not only does the tendency to snore increase with age but also it is also more likely to do so if you are a man, as data shows that 51% of men snore compared to 40% of women.

The majority of couples over the age of 40 include a snorer. 55% of 40-59 year-olds say their partner snores, and 57% of those over-60. Among the group of men who were aged over 60, almost two-thirds were snorers.

In Australia, similar figures from the Sleep Health Foundation show that between 33 and 45 per cent of Aussies have poor sleep patterns that are often due to heavy snoring, and these lead to fatigue and irritability – putting them at risk of low productivity, damage to their mental health, unsafe driving and behavioural problems.

Director of the Sleep Health Foundation, Dr David Hillman said: “Just like obesity, smoking, drinking too much and not exercising enough, sleep problems cause real harm in our community.”

It’s getting worse in Australia too. The study found that the numbers of sleep problems among Australians are 5 to 10 per cent higher than when the Sleep Health Foundation published its last survey on sleep health in 2010.

What causes snoring?

Snoring is caused by the soft tissue in your head and neck vibrating as you breathe in during your sleep. The soft tissue it can affect includes nasal passages, the soft palate, the base of the tongue and the tonsils.

As you get your nightly rest, the airways in your neck and head relax and narrow, which increases the speed at which you breathe. This also changes the air pressure in your airways, which in turn causes the soft tissue to vibrate, causing the snoring sound. The vibrations that happen during snoring are thought to weaken blood vessels and muscles in the head and neck. This further reduces the ability of the airways to keep open, meaning snoring is likely to be more frequently and even louder.

Some people snore so loudly that it can be heard in the next room and wakes up other members of their household. Others snore every single night and are virtually unable to sleep without making a noise. However, some people snore very infrequently and it only affects them if they are suffering from a cold or flu.

Does anything make snoring worse?

There are certain factors that can make snoring even worse because they cause the airways to narrow even further when a person is asleep and one of the main factors is obesity. A person with a neck circumference more than 17 inches sees extra pressure applied on the airways. In addition, drinking alcohol and smoking cigarettes is also known to cause the airway to narrow, which in turn increases the risk of snoring.

Meanwhile certain sedatives and anti-depressants have shown to have the same affect on the airwaves as smoking and alcohol. Common allergies can also exacerbate snoring as substances such as pollen can cause the nose to become blocked.

Is there a cure for the snoring?

Although snoring can be treated to improve the effects there is no complete cure – but it can be prevented and significantly lessened as a problem. There’s a great deal of information available online which helps but some people will go to see their GP when their snoring starts to affect their sleeping patterns or is causing major problems in their relationship. Although it may surprise you, it is well documented that snoring is the third most important cause of divorce. In its most dangerous form, snoring can be one of the main symptoms of obstructive sleep apnoea; something we’ve described in detail in our previous articles.

A chronic snorer should try changing their lifestyle first and lose weight, but there is also a range of medically approved anti-snoring devices available that help to minimise snoring, including mouth guards of various types that vary in type and cost to suit the individual and the degree of the problem.

John Redfern


What keeps us awake at night?

Wherever you live in the world, the media focus this week has been on sleep and the dangers when it is interrupted, but particularly if by snoring and obstructive sleep apnoea. In this week’s article we’re taking a quick world tour to review what has been said and to see if it differs country by country.

Woman Awake In Bed Suffering With Insomnia

Snoring is noisy, and a real nuisance, and it can take many forms. However it is pri­mar­ily caused by vi­bra­tions of the soft palate and other tis­sue in the mouth, nose and throat that be­come par­tially blocked at night.

De­pend­ing on the lo­ca­tion of the block­age, you might be a nose snorer, a mouth snorer, a throat snorer, or even a tongue-base snorer where your tongue drops to the back of your throat at night, caus­ing an ob­struc­tion. But fortunately there’s an appliance available to prevent snoring in all its forms. As well as all the different types of oral appliances, the Chin support strap is popular and there are even small Nasal dilators – venting appliances that fit inside the nostrils to keep them clear and open at night when asleep.

Starting with the UK, a new survey revealed that most people wake up three times a night, and a worrying 11% wake-up between seven and 10 times.

Discomfort and back pains wake19% of us, whilst bad dreams or nightmares affect 11% of us and another 6% say they have experienced anxiety about bills and work which has kept them from a good night’s sleep. Seventeen per cent of us are disturbed by our partners and most complaints from this latter group are related to noisy snoring by their bedmate.

Snoring is dangerous if it’s obstructive sleep apnoea (OSA), which is one of a number of disorders that rob sufferers of recuperative sleep. If left untreated, it increases risk of high blood pressure, heart attack, stroke, and diabetes.

In the Republic of Ireland another survey found that one-third of people ‘get less than six hours sleep a night’, and the IKEA-commissioned survey also reveals that almost half of couples sleep back-to-back. I wonder why?

The survey was carried out among 1,000 Irish adults, selected to represent a wide range of areas and social classes.  A partner’s snoring is very likely to impact on someone’s sleep. Almost half of all of those who regularly share a bed claimed a partner’s snoring impacts negatively on their sleep.

Australia has the same problem and the Herald Sun reported that the nation is in the grip of a sleep deprivation “epidemic” with experts calling for quality shut-eye to be prioritised as a health issue with obesity and smoking.

This new research by the Australian Sleep Health Foundation has revealed a third of people are making mistakes at work because they’re fatigued while 20 per cent have fallen asleep at the wheel. The research, published in Sleep Health Journal, shows that 33 to 45 per cent of Australian adults sleep poorly or not long enough most nights leaving them fatigued and irritable.

More than 10 per cent of Australians were found to be sleeping less than five-and-a-half hours a night.

The research showed 21 per cent of men and 13 per cent of women had fallen asleep at work. Worryingly it found that sleeping issues and daytime symptoms of fatigue had increased by up to 10 per cent since similar research was conducted in 2010. Nearly a third of adults drive while drowsy at least once a month and 20 per cent have nodded off at the wheel.

Lead researcher Professor Robert Adams said: “The important of sleep is underestimated. We’ve known for 20 or 30 years that sleep problems are as important to health as things like diet, exercise, avoiding smoking and avoiding drinking but as a society we haven’t really acted on that fact”.

In North America, the problem is king size like much of the available fast food, and weight problems are regarded as a major cause of snoring. It is estimated that almost 80 million people snore in the USA alone, and a further 30 million are kept from restful sleep by obstructive sleep apnoea.

Untreated, severe obstructive sleep apnoea more than doubles the risk of dying from heart disease, the National Healthy Sleep Awareness Project warns in conjunction with American Heart Month in February.

According to the Project, there are five key warning signs and risk factors for sleep apnoea: snoring, choking or gasping during sleep, fatigue or daytime sleepiness, obesity (BMI of 30 or higher) and high blood pressure. Millions of people still ignore the facts and as a result remain untreated.

Wherever we are – we need to wake up to the problem – but do so in a different way to the way we are doing it now.

John Redfern


Do you ever wake up with sore teeth and a headache?

If so you could be grinding your teeth. Clenching and grinding, also know as bruxism, is often caused by stress and in many cases, although not all, it happens during the night while a person is asleep. It can cause severe damage to your teeth, jaw pain, earache and headaches.

SleepPro Nightguard

The problem is controlled by the muscles in your cheek that also happen to be incredibly powerful and can exert up to a massive 600 pounds of force per square inch in the back of your mouth, near the molars. So as you can imagine, this strong muscle can have a serious impact on your teeth.

As many as one in 10 people experience teeth grinding on a daily basis, with the condition being most at its peak between the ages of 25 and 44, and on top of this, many others do it periodically. Because it often occurs during sleep, most people are totally unaware that they grind their teeth. However, a dull, constant headache or a tender painful jaw is a definite symptom of bruxism.

Just like snoring or sleep apnoea, people often first learn that they grind their teeth from their partner who hears the grinding at night, although the most reliable way to diagnose bruxism is during a sleep study. It is often also associated with other sleep disorders such as obstructive sleep apnoea and you may suffer from both.

In addition to being detrimental to oral and dental health, the noise from bruxism is often disturbing for others. It can lead to headaches, jaw pain and daytime tiredness caused by the disruption to normal sleep brain-rhythms.

If left undetected, dental damage will usually occur, leading to tooth loss and gum disease. In some cases, chronic teeth grinding can result in a fracturing, loosening or even loss of teeth. The chronic grinding may wear teeth down to stumps. When these events happen, bridges, crowns, root canals, implants, partial dentures and even complete dentures may be needed as a result.

Not only can severe grinding damage teeth and result in tooth loss, it can also affect your jaw and jaw joints, result in earache, cause or worsen jaw joint disease (TMJ), and even change the appearance of your face.

Bruxism frequently occurs due to psychological factors including anxiety, stress and emotional problems. However it can be caused by a variety of other medical disorders (neurological and psychiatric disorders, substance abuse, and as a side-effect of medications). Bruxism can occur at any age, is often noted in children and adults, and there are no significant differences in bruxism rates between males and females.

Patients with bruxism usually experience cycles of improvement and worsening in their symptoms over time and although complex sleep testing in a clinic is not essential to diagnose sleep bruxism, a simpler form of sleep study is often very helpful to assess whether the bruxism is associated with another sleep or movement disorder such as sleep apnoea, restless legs syndrome, or periodic limb movement disorder.

In many cases, your oral healthcare provider can provide you with an occlusal appliance, like a sports mouth guard, to be worn at night in order to protect your teeth from damage, and these occur in several forms.

One of the most common ways to protect your teeth from wearing down and even fracturing due to constant grinding and clenching, and reduce the subsequent pain, is to wear an ‘occlusal appliance’ which is simply a name for a protective night guard.

These are normally custom-made so that they fit perfectly over either your top or your bottom teeth. Simpler versions also occur that are suitable for milder, infrequent episodes of bruxism. Both are quite inexpensive and the custom-made version comes in several helpful options to suit you.

Other more advanced mouthpieces, called mandibular advancement devices, or MAD’s, are also regularly used to stop teeth grinding.

However, these are most commonly used when a sleep disorder like sleep apnoea is the most likely cause. They’re also bespoke made specifically to fit your jaw and are usually worn over both the top and the bottom teeth. The purpose of this is to bring your bottom jaw forward and this keeps the airway open, preventing snoring and episodes of sleep apnoea, as well as stopping you grinding your teeth.

John Redfern

 


Obstructive Sleep Apnoea WHAT YOU NEED TO KNOW

Ill man sitting on his bed

What is OSA?

Obstructive sleep apnoea, or OSA, is a dangerous sleep disorder that makes patients stop breathing repeatedly. So if you snore heavily, or have severely disturbed sleep where you gasp for air, then don’t ignore it because it will get worse and not go away. Lots of cases go undiagnosed because many people simply aren’t aware they have OSA, although their partners will be.

 Anyone with OSA has repeated episodes of partial or complete obstruction of the throat when sleeping. This blockage of the pharynx or upper airway often causes heavy snoring as well. These airway obstructions will cause you to stop breathing for a period of 10 seconds up to a minute or more, and blood oxygen levels fall as a result.

Sleep will then be briefly interrupted for as little as 3 seconds and this allows breathing to start again, but with a disruption to your sleep. This can happen hundreds of times a night in the worst cases but you may not know. Most cases of OSA go untreated and it may be your partner who is more aware of your problem than yourself.

What are the key symptoms of OSA?

You will probably toss and turn a great deal as you have these episodes where your breathing stops. In addition, you may find yourself waking up often during the night, sometimes gasping or choking, although this does not always happen. However, even if there are few awakenings overnight, your sleep is disturbed and will not be refreshing because of this. As the day goes on, you may struggle to stay awake, especially in the afternoon. Grumpiness and other mood changes are common in untreated OSA.

Your OSA affects other people too

Snoring can keep a bed partner awake and sometimes people in other parts of the house. Some partners even try to stay awake to make sure that the person with OSA starts breathing again after a breathing pause. It worries them greatly when breathing stops. Lack of sleep may also make people who are living with a person with OSA more grumpy and irritable as well as the individual themselves. OSA is a problem for the whole family.

Should you worry if you have symptoms of OSA

There is strong evidence that people with untreated moderate to severe OSA have other health problems. If you have OSA, you are more likely to have high blood pressure and other cardiovascular disease than someone without it. Each time you stop breathing, your blood pressure may go up and over time, this may also contribute to high blood pressure during the day (hypertension). There is also real evidence that having OSA, particularly if it is severe it may increase the risk of diabetes, heart attack, stroke or depression. Treating sleep apnoea may reduce these risks considerably.

How is obstructive sleep apnea diagnosed?

Signs and symptoms such as snoring, obesity, observed breathing pauses and sleepiness during the day might suggest that a person has OSA. The best way to be really sure is by having a simple sleep study and this can easily be done at home. This measures sleep, breathing and oxygen levels.

How is obstructive sleep apnea treated?

For people with a very mild level of OSA, and few symptoms, losing weight, decreasing the amount of alcohol consumed in the evening or adjusting the sleeping position may be all that is needed. Most people have more OSA episodes sleeping on their backs. Using a simple oral appliance to stop snoring and keep the airway open will help.

However, for those with moderate or severe OSA, much more active treatment is often required. This is particularly so if daytime tiredness is present or there is a background of heart disease, stroke or high blood pressure that has been difficult to control. The two most commonly used treatments for moderate to severe OSA are continuous positive airway pressure (CPAP) where a mask attached to an oxygen supply is worn all night, or using a medically approved bespoke oral appliance.

Many people find CPAP difficult and uncomfortable to use, and in those cases the medical advice is to use a mouthpiece instead rather than not have preventative treatment of any form at all. The mouthpiece is designed to move the lower jaw forward which helps to keep the airway open. This mandibular advancement device fits over both the upper and lower teeth and these devices are being used more and more for the treatment of snoring and mild to moderate forms of sleep apnea.

The important thing, having identified the problem, is treating it without delay.

John Redfern