Some snoring is harmful and some isn’t – and this is how to tell the difference

Not all snoring is harmful so it helps to be able to recognise when it’s actually dangerous as it can sometimes cause a very serious lack of oxygen and life threatening sleep disorders. Over one third of the people who snore are believed to have obstructive sleep apnoea (OSA).

OSA Diagram

Overall it is estimated that 60% of men and 40% of women snore by the time they have reached their sixties and if they have OSA, then the primary sleep apnoea symptoms are pauses in breathing during sleep. They’re related to snoring and the resulting lack of oxygen to the brain during sleep.

Not all snoring however is connected to sleep apnoea. Loud breathing noises or ‘snoring’ can be described as a normal event. However sleeping with your mouth open and pauses in breathing may indicate a sleep disorder. If you sleep on your back, your tongue falls into your airway, and pauses in breathing can reach a duration of 10 seconds, and happen as many as 100 times in an hour.

The reason for your snoring stems from the relaxation of the throat muscles when you sleep. Less airway volume can mean that the relaxed throat vibrates when you breathe and this is the universal cause of snoring whether it’s harmful as described above or just ‘normal’ snoring.

In addition to snoring, other symptoms of OSA include:

  • Gasping for air whilst sleeping
  • Waking up with Morning headaches
  • Feeling extra tired during the day
  • Increased blood pressure
  • Irritability or mood swings

For optimal breathing, we should be breathing through our nose. Sleep apnoea is your body experiencing breathing dysfunction during sleep. Nasal breathing prevents oxygen deprivation and it acts to increase blood flow and deliver oxygen to the lungs.

The tongue is one of the main factors in snoring and sleeping with the mouth open. It can also reveal sleep apnoea symptoms. Your tongue contains and connects to one of the largest groups of muscles in the body and the muscles of the tongue support the airways with connections to the jaws, neck, and base of the skull. It also connects to the hyoid bone, which is a floating bone that supports your airway.

When you go to sleep, the primary muscles inside your tongue and your throat relax and for you to keep your airway open, support muscles for the throat must hold firm. The normal posture of the tongue is to sit against the top of your mouth. This position turns on the muscles that support the throat and the airways.

Sleeping with an open mouth is a sign your tongue is not supporting your airway. The tongue can then fall back into the airway, blocking normal breathing. Mouth breathing can also cause lack of oxygen and OSA.

Sleep disorders have become a bigger problem than ever and this was underlined this week by the NHS figures which reveal that the number of tests carried out by the NHS to diagnose people with sleep disorders across England has doubled in the past decade.

NHS data shows that 147,610 sleep diagnostic tests were carried out last year – compared with 69,919 in 2007-08. This is more than double.

Those with OSA usually manage it by either CPAP treatment, which involves wearing an oxygen mask at night, or by using custom-fitted oral devices that keep the airways open. It also helps to lose weight and in some more extreme cases people can have surgery to remove excess throat tissue.

Doctors attribute the rise in the number of sleep tests to a greater sense of overall public awareness about the wider health implications of not getting enough sleep. It is estimated that about 1.5 million people in the UK suffer from the condition, although doctors warn many people will have never been formally diagnosed.

“Sleep apnoea is a serious condition leading to other problems such as high blood pressure, which in turn can lead to strokes and heart attacks,” said Dr Stephen Bianchi from Sheffield’s Northern General Hospital. “We think about 2% of females, and 4% of males in the UK have significant sleep apnoea. We also suspect that 80% of those with the condition are unaware they have it.”

John Redfern


Sleep apnoea is a real danger to everyone and makes no exceptions

This was clearly shown on Friday evening when an announcement from the Los Angeles medical examiner’s office on Carrie Fisher’s cause of death raised the possibility of a lethal interplay of sleep apnoea, drug use and heart disease.

Star Wars - Carrie Fisher

Photograph of Carrie Fisher in Star Wars supplied for incorporation by Rex Features

Carrie Fisher was a well-known Hollywood actress and author who rose to fame in Star Wars playing one of the leading roles as Princess Leia. She collapsed on December 23rd on an 11-hour flight from London to Los Angeles and she died a few days later on December 27th.

In January, the medical examiner initially listed the cause of death as cardiac arrest, which is often confused with a heart attack. While a heart attack is a common cause of cardiac arrest, they are not the same thing. A heart attack occurs when a blockage stops blood flow to the heart, while a cardiac arrest, the sudden stoppage of the heart, is caused by a serious malfunction of the heart’s electrical system.

On Friday The Los Angeles County Department of Medical Examiner-Coroner said the cause of death was clearly caused by “sleep apnoea and other undetermined factors.”

Other findings in the autopsy included atherosclerotic heart disease and the use of multiple drugs, although the significance of the latter isn’t fully known, according to the announcement, which noted that the manner of Fisher’s death has been ruled “undetermined.”

The Greek word “apnea” means “without breath.” People with sleep apnoea stop breathing repeatedly during sleep, sometimes as often as 30 times an hour or more, for a few seconds to more than a minute each time. Most people who have it don’t know it, since the two main signs snoring, and snorting when breathing resumes, both occur during sleep although not everyone who snores has sleep apnoea.

A family member or bed partner is often the first to notice the signs, according to the National Hear, Lung, and Blood Institute (NHLBI) in the USA. Other signs include headaches or a dry mouth upon awakening; daytime sleepiness; an inability to concentrate; feeling irritable or depressed or having mood swings and waking up frequently to urinate, the NHLBI says.

The medical examiner did not specify what type of sleep apnoea Fisher had. Obstructive sleep apnoea, in which the upper airway collapses or becomes blocked repeatedly during sleep, is the more common, affecting an estimated 9% of women and 17% of men 50 and older, but fewer people younger than 50, according to the Heart Association. In central sleep apnoea, which is often related to certain medical conditions or medications, the airway isn’t blocked, but the brain fails to properly signal the breathing muscles. Snoring isn’t typically associated with central sleep apnoea but some people have both obstructive and central sleep apnoea.

If not diagnosed and treated, sleep apnoea can lead to serious, potentially fatal health problems. Population-based studies show that people with obstructive sleep apnoea have a significantly greater risk of heart arrhythmias, which can trigger sudden cardiac arrest, atherosclerosis, coronary heart disease, heart failure, high blood pressure, obesity, and type 2 diabetes, among other conditions according to the Heart Association.

Medication isn’t usually used to treat sleep apnoea, but the NHLBI lists several methods that can help open your airway while you sleep:

  • Being overweight or obese is the most common cause of obstructive sleep apnoea, so sometimes losing weight stops apnoea episodes.
  • If you smoke, quit.
  • Sleep on your side instead of your back.
  • If lifestyle changes aren’t enough, a custom-fitted mouthpiece made by a medically approved specialist can adjust your lower jaw and tongue to keep your airway open.
  • For moderate to severe sleep apnoea, a “continuous positive airway pressure,” or “CPAP” machine is often used. The CPAP machine blows air into your throat while you sleep, helping to keep your airway open.

NHLBI Statements are used courtesy of Forbes Media, New York.

John Redfern


Untreated Sleep Apnoea Could Cut 10 To 20 Years Off Your Life

The body and mind need sleep in order to function properly. Sleep apnoea, or constantly stopping and starting breathing at night, is one of the things holding millions of people back from sleeping properly.

Sleep Apnea

It often goes undiagnosed, but it comes with surprisingly apparent symptoms that can significantly worsen your quality of life and also shorten it.

If you look at some of the most commonly treated conditions in any country of the world right now such as high blood pressure, atrial fibrillation, erectile dysfunction, diabetes, anxiety, depression, and headaches – all of these can be medically associated with an obstructed airway.

Doctors say a healthier lifestyle including proper diet, exercise and weight loss can prevent sleep apnoea from occurring. However, if you’re experiencing multiple symptoms, you should speak with your physician.

It is a common problem among all ages and both genders, but don’t let snoring ruin your relationship or a good night’s sleep. Learn what causes snoring and how you can put it to bed with our expert advice.  If your partner has ever told you that you snore, bear in mind the danger you might be putting yourself in every single time that it happens. It may mean that you are suffering from obstructive sleep apnoea (OSA).

Some heavy, regular snorers have sleep apnoea, a condition where the airways become completely blocked during sleep with symptoms that include large pauses in breathing, leaving them waking-up gasping for air. Many heavy snorers tend to wake themselves frequently in sleep, with the resulting patchy sleep leading to daytime sleepiness. Regardless of whether it’s snoring or sleep apnoea, it can easily and quickly be prevented.

Even for those who sleep alone, snoring is no laughing matter. According to the National Sleep Foundation in the USA, regular heavy snorers are more likely to experience thickening or abnormalities in the carotid artery, which can lead to atherosclerosis; a hardening of the arteries that is known to trigger numerous vascular diseases.

Daytime grogginess, irritability and mood swings, problems concentrating and remembering, and an increased likelihood of car or other types of accidents are just some of the complications arising from interrupted, snore-ridden sleep. Since almost half of us regularly snore, isn’t it worth knowing what’s likely to be causing it, and what are the most effective measures of putting it to bed?

Products are available to open the airway. The C-PAP machine is one of the most recognisable treatments, and is used to prevent both snoring and sleep apnoea. Other less aggressive options include custom-fitted mouthpieces that reposition your jaw and open your upper airways so you can get more oxygen while you sleep. Other types that you can shape for yourself are easily available and both kinds are medically approved.

SleepPro oral appliances are not only rated by the NHS in Britain as the top performing products in their extensive regular tests, but are also issued directly to patients who consult many of their Specialist Sleep Clinics. The NHS results were published in the Lancet in 2014, but regular testing still continues to ensure the correct products stay at the top of their recommendation list – position that SleepPro still enjoys.

There at least 120 such oral appliances licensed in the US, for example, but all are variations of the original appliance and stick to the same principle. The prices vary greatly and is another reason stated by the British NHS for using SleepPro, as affordability is considered to be important too.

While Mandibular Advancement Appliances (MAD’s) can be bought over the counter, or online, it usually pays long-term to have a customised one made and fitted to your dental profile. It feels more comfortable, works better and lasts longer. Having a custom-made one can, in time, become much more cost effective, and more effective overall.

It’s vitally important to remember that OSA is a serious medical condition and it should never be ignored – but it should be prevented.

John Redfern


Research proves that you can’t be both ‘Fat’ and ‘Fit’

The new research was announced first at the European Congress on Obesity that took place last week in Portugal. The idea that people can be fat, but medically fit, is a myth, say those involved. Their early work, which is as yet unpublished, involved looking at the GP records of 3.5 million people in the UK for the 20 years from 1995 to 2015, but applies worldwide.
The term “fat but fit” refers to the theory that if people are obese, but all their other metabolic factors such as blood pressure and blood sugar are within recommended limits, then the extra weight will not be harmful.

Young Woman Measuring Her Waist

They tracked people who were obese at the start of the study (defined as people with a body mass index of 30 or more) who had no evidence of heart disease, high blood pressure, high cholesterol or diabetes at this point.

They found these people who were obese but “metabolically healthy” were at higher risk of developing heart disease, strokes and heart failure than people of normal weight.

Dr Mike Knapton, from the British Heart Foundation, said: “It’s not often that research on this scale and magnitude is able to clarify an age-old myth.

“These findings should be taken extremely seriously and I’d urge healthcare professionals to take heed.”

“What was new from this study for me is that it showed that people who were overweight or obese were at increased risk of heart disease even though they may have been healthy in every other respect.

“Just being overweight puts you at increased risk of heart attack and stroke.”

According to the British Heart Foundation, the normal heart health advice applies – not smoking, eating a balanced diet, exercising regularly and limiting alcohol intake – can all help keep people healthy. However other studies have suggested that is not always the amount of fat that matters but where the excess fat is carried on the body that can affect fitness and health. For example, weight around the middle may be more damaging than weight distributed evenly around the body.

Being overweight can exacerbate an existing milder snoring problem, because one of the primary causes of the turbulence in the throat is the narrowing of the airway due to neck fat. Losing weight can help alleviate the problem by reducing fat in the neck and helping to open the airway.

Technically, snoring is the sound of air turbulence in the back of the throat caused by a narrowing of the airway, and the sound of someone snoring is really the sound of someone who is having difficulty in breathing. The most frequent myth about snoring is that it is harmless or even humorous. Nothing could be further from the truth. It is widely recognised that snoring is a sign of a potentially life-threatening sleep disorder if not prevented or controlled. It also causes ‘snacking’ which is associated with sleep disorders generally.

Snoring is a common condition that can affect anyone, although it occurs more frequently in men and people who are overweight and because of this it has a tendency to worsen with age.

When trying to locate the cause or causes for your snoring, you need to be methodical because without identifying where the source of the problem lies, it may prove difficult to cure. The first thing to consider is body fat, as obese people are very likely to snore. In short, men are more prone to putting on fat in the neck area than women; fat which squashes the throat, leaving less room to breathe.

Products are readily available to open the airway. The C-PAP machine is one of the most recognizable treatments, and is used to prevent both snoring, and sleep apnoea.

It’s easier though to purchase and use an appliance that uses a method called boil-and-bite and shapes it to your dental profile, and SleepPro have a range of these that are both inexpensive and simple to use. You bite into it as you do a sports mouth guard and it keeps the jaw in a stable position.

Other options include custom-fitted mouthpieces provided by dentists, but these are very expensive, and the same custom-fitted alternatives can be bought online for much less. They are equally effective and have been thoroughly tested by the NHS who list the range of UK made SleepPro products as their top recommendation, and even issue them to patients.

Losing weight is the ideal answer but in the meantime help is available this way, and together they offer a great joint solution.

John Redfern


The problems faced by couples due to snoring

Snoring is a huge problem that results in one in three couples in the UK now opting to sleep apart to get a better night’s sleep. Do you find it hard to get a good night’s sleep because there is someone snoring alongside you? Millions of couples worldwide are familiar with this situation and suffer from disturbed sleep. In some cases, both partners in the relationship are snorers.

Depositphotos_22187801_sleeppro

While we sleep our bodies are hard at work recharging and optimising our body’s functions. A recent study found that those who slept less than seven hours a night on average were three times more likely to get sick and suffer major health issues than those who averaged at least eight hours.

A recent study has shown that 41.5% of the British adult population snores at some time or other in their week. So most likely, even if you don’t snore, your partner does, and sometimes both of you have the problem. As such, more than 30 million people have a regular and ongoing problem with snoring and usually, men snore much louder than women.

The National Sleep Foundation estimates that 90 million Americans snore, 37 million on a regular basis. While all ages and genders snore, twice as many men than women snore nearly every night and most of them go through life undiagnosed. If you have trouble sleeping at night, it could be more than just a noisy disturbing inconvenience. In fact, you could be suffering from a serious medical condition called sleep apnea.

The reasons why we snore are pretty straightforward. When you fall asleep the muscles in your neck and throat relax. They then go floppy and the airways narrow, meaning there is less space for the air to go through. The soft tissue in this smaller space vibrates and rattles as the air passes through.

Snoring is also a symptom of sleep apnea which results in dangerous oxygen deprivation, as the sleeper’s airway becomes blocked, and deprives the brain of oxygen, As result it is unable to reach the cells and tissues, and dangerous conditions occur due to low oxygen over a long period.

If this is an issue for you, then there is a kinder, and more effective solution than kicking the person next to you and waking them up, or moving out. After all, that’s pretty counterproductive, and one of the main reasons why snoring is listed as the third most important factor that contributes to divorce. The medically recommended solution also makes quitting the marital bedroom to get some sleep something that is no longer necessary.

NHS Choices clearly gives the following information on their website:

‘If your snoring is mainly due to the base of your tongue vibrating, a mandibular advancement device (MAD) may be recommended.

It’s designed to push your jaw and tongue forward. This increases the space at the back of your throat and reduces the narrowing of your airway that’s causing your tongue to vibrate, resulting in snoring.

You can buy a MAD for around £30-50, which is suitable for most cases of simple snoring (snoring that doesn’t cause any breathing difficulties).

However, if your snoring is associated with breathing difficulties, such as obstructive sleep apnoea, it’s recommended that you have a MAD made specifically for you by a specialist using impressions of your teeth and jaw.

The cost of a custom-made MAD will depend on the complexity of the device and materials used, and can range from several hundred pounds to several thousand pounds. It’s unlikely that you’ll be able to obtain a custom-made MAD free of charge on the NHS.

An MAD lasts about 18 months before it needs to be replaced.’

Source: NHS Choices

Following an extensive testing programme, the NHS published their findings in The Lancet and recommended SleepPro oral appliances as their number one selection to prevent snoring, along with mild to moderate sleep apnoea. Many patients acquire SleepPro products online after consulting their Hospital or Sleep Centre where special literature is made available that describes the product range available and they can arrange special prices.

These are all problems that couples who snore may have to cope with later in life when they should be relaxing, enjoying life, and ticking off their bucket list but it’s never too late to take action.

Peace will return to the bedroom and your relationship will be the winner.

John Redfern


80% of loud snorers who have sleep apnea don’t know they have it

Obstructive sleep apnea, often referred to as OSA, is characterised by loud snoring that occurs before a person stops breathing and is a condition that causes the throats of sufferers to close up while they sleep, meaning their brain has to continually wake them up from a deep sleep in order to reopen the throat muscles.

BBC Image

Watch this BBC NEWS film that describes Obstructive Sleep Apnea

The breathing pause can last a few seconds or several minutes and may happen many times during the night. It has been linked to daytime sleepiness and a host of other diseases.

Risk factors for sleep apnea include obesity, being over the age of 55, and smoking. Tests have proven that sleep apnea can be hereditary, and men outnumber women among those who are afflicted with the disease. Consequently, stopping smoking or taking dietary precautions prompting weight loss can reduce or even eliminate the effects of many sleep disorders. However, no age group is immune to a sleep disorder.

The overall number of people with OSA is known to be increasing due to major lifestyle problems such as more people now being overweight. Actual numbers are difficult to record as most cases go undiagnosed, but the increased number of nationwide Sleep Disorder Centres in the USA gives us a good idea of the growth of OSA. They have risen in total from 2.280 in 2010 to just over 2,850 in 2016. Their estimated revenue shows OSA is costing $7 billion per year, estimated to rise to $10 billion by 2020.

Similar figures exist for other countries but the economic impact of sleep apnea extends beyond the economic revenue for those who are treated the disease. The annual economic burden of undiagnosed sleep apnea in the USA is about $149.6 billion, according to the American Academy of Sleep Medicine. This includes nearly $87 billion in lost productivity, $26 billion in car crashes and $6.5 billion in workplace accidents.

Untreated sleep apnea leads to a host of other serious health problems including hypertension, heart disease, diabetes and depression. As a result, undiagnosed sleep leads to $30 billion a year in increased health care costs. The AASM estimates if everyone who suffers from sleep apnea received treatment, it would create a savings of just over $100 billion.

Chronic sufferers are advised to use CPAP machines every night when they sleep and this involves wearing a mask that fits over their nose, or their nose and also their mouth. The device increases air pressure in a patient’s throat, prevents the airway from collapsing, and eliminates obstructed breathing.

However a high number of patients struggle to adjust to CPAP machines and use other approved medical solutions and treatments such as an oral appliance that shifts the lower jaw forward opening airways during sleep. This Mandibular Adjustment Device (MAD) will successfully address the problem of obstruction of the airway and restore normal sleep.

As said earlier, men have a higher risk of sleep apnea, but recent studies are finding that women who have experienced menopause have the same risk as men. Weight and genetics also have an impact.

Some patients seek treatment after a partner complains about their loud snoring, or gaps in their breathing, but for those who live alone it might be tougher to diagnose.

Snoring is a common phenomenon, but some snorers may require medical treatment so they should look for the following key indicators that may indicate that they have sleep apnea. These include daytime fatigue, lapses into sleep during the day, and impairment of normal activity.

If snoring results in them having headaches in the morning, suffer from bouts of irritability, or have any of the other symptoms, or if it disturbs their partner, then they should seek to prevent this by using an oral appliance (MAD) which does not need a Doctor’s prescription, and do so immediately, and in severe cases they should seek out immediate medical advice.

John Redfern


New Guidelines for treating Obstructive Sleep Apnoea (OSA)

If you already suffer from sleep apnoea, or think that you or your partner may have this dangerous problem, and it remains undiagnosed for whatever reason, then the new rules that have been issued in the United States will have some real meaning for you.

The American College of Physicians (ACP) has published new clinical practice guidelines regarding the management and treatment of OSA in adults. It deals with the known detrimental effects of the problem, and discusses the limitations of the various available treatments. These findings endorse those of the AASM – the American Academy of Sleep Medicine but take recommendations further.

As ever, the USA is ahead of the UK in dealing with this huge problem, partly because it is so much more widespread in the community there. Much of this can be linked to obesity, a major problem in the USA, and which is rapidly becoming so here due to changes in our diet, lower exercise levels in youth, and sedentary occupations now being the largest group by far versus manual workers. Alcohol also often plays a significant role in the equation – mostly due to the high calorific intake and the effect that alcohol can have on sleep hygiene.

What is OSA?

OSA disrupts breathing during sleep, and this is usually as a result of the muscles and soft tissues in the throat relaxing and collapsing to block the airway. It can last for about 10 seconds or even more. It affects people of all ages, but particularly those of us in middle age, and particularly the elderly.

However, we believe that around 80% of cases remain undiagnosed. OSA is easy to treat but when left undiagnosed and untreated, is linked with a range of serious health concerns that include heart disease and stroke, diabetes and high blood pressure, called hypertension. Fatigue becomes a huge problem too.

Current approved treatments for OSA and sleep disordered breathing

OSA is a chronic medical disorder that requires immediate action, but also requires long term, and often lifelong. therapy. Obviously a healthier lifestyle will come high on the list from any GP but this will not stop the problem of your snoring immediately, and sometimes does not succeed at all.

As well as recommending weight loss in overweight and obese patients, it recommends and approves the following treatments as it is recognised that weight-loss intervention alone will not achieve the desired objectives.

Medical Treatments and Clinical Recommendations for OSA

CPAP Mask wearer

  • Continuous Positive Airway Pressure (CPAP) is recommended for more serious sufferers but it is readily identified that many patients reject this treatment for various reasons, particularly having to wear a mask for such long periods of time, claustrophobia, having a dry mouth, or the associated discomfort of the mask amongst others.
  • It is still however strongly recommended for chronic sufferers if acceptable.

Sweet dreams

  • Mandibular Advancement Devices (MAD’s or Splints) are fully recommended as a primary treatment route and a strong option in many cases versus CPAP. They are more readily accepted than masks and have many distinct advantages over them including, ease of wear, instant results, high rates of effectiveness and also being inexpensive by comparison – even bespoke mouthpieces or the now available self-fit versions which are highly adjustable compared to the standard oral appliance – although this may be the best starting point.
  • Strongly recommended by ACP for less severe versions of OSA.

Snoring Surgery

  • Surgery however is not listed in the ACP’s summarized recommendations, but the guideline does specifically discuss its role as a treatment for OSA. It highlights that surgical procedures, which are intended for sleep-disordered breathing, are not as effective as either CPAP or using MAD’s. Currently success rates vary greatly and can be as low as 20%, as well as it sometimes requiring several procedures.
  • Not currently recommended by ACP to American Physicians.

More and more clinics, doctors and hospitals in the USA now recommend using oral appliance technology in the form of a mouthpiece to be used when sleeping and this is now becoming more accepted as a route here in the UK, particularly now that higher quality MAD’s are NHS Approved.

By John Redfern

 

 

 

 

 

 

 

 

 

 

 


Snoring mothers-to-be are linked to low birth weight babies

The British Press have covered this subject extensively this week based on the results of a new research study that has just been completed in the United States. The research was published in the journal ‘Sleep’.

Snoring can be more than just an annoyance to others who are trying to sleep in the same room. For pregnant women, snoring could indicate certain higher risks. Experts say that snoring may be a sign of breathing problems that could deprive an unborn baby of oxygen.

Snoring is often a key sign of obstructive sleep apnoea, which results in the airway becoming partially blocked, said the researchers, whose findings appear in the journal Sleep. This can reduce blood oxygen levels during the night and is associated with serious health problems, including high blood pressure and heart attacks. The experts stress sleep apnoea can of course be easily treated.

The study found that chronic snorers, who snored both before and during pregnancy, were two thirds more likely to have a baby whose weight was in the bottom 10%.

Newborn baby girl sleeping

They were also more than twice as likely to need an elective Caesarean delivery, or C-section, compared with non-snorers.

Dr Louise O’Brien, from the University of Michigan’s Sleep Disorders Centre, said: “There has been great interest in the implications of snoring during pregnancy and how it affects maternal health but there is little data on how it may impact the health of the baby.

“We’ve found that chronic snoring is associated with both smaller babies and C-sections, even after we accounted for other risk factors. This suggests that we have a window of opportunity to screen pregnant women for breathing problems during sleep that may put them at risk of poor delivery outcomes.”

Previous research has already shown that women who start to snore during pregnancy are at risk from high blood pressure and the potentially dangerous pregnancy condition pre-eclampsia.

More than a third of the 1,673 pregnant women recruited for the new US study reported habitual snoring. They were also more than twice as likely to need an elective Caesarean delivery, or C-section, compared with non-snorers.

Scientists found that women who snored in their sleep three or more nights per week had a higher risk of poor delivery outcomes, including smaller babies and Caesarean births.

The very worst cases of sleep apnoea can be treated with CPAP (continuous positive airway pressure), which involves wearing a mask attached to a machine during sleep, which pumps oxygen to keep the airways open. Most other forms of sleep apnoea can be treated with the wearing of a simple snoring mouthpiece, similar to a gumshield that is worn for sports.

Dr O’Brien added: “If we can identify risks during pregnancy that can be treated, such as obstructive sleep apnoea, we can reduce the incidence of small babies, C-sections and possibly NICU (neo-natal intensive care unit) admission that not only improve long-term health benefits for the newly born but also help keep costs down.”

By John Redfern


Snoring can cause Women to put on weight

Lack of sleep affects food choices and if you don’t sleep well it can cause you to choose more high-calorie foods. So, not only does being overweight cause you to snore, it would appear that snoring causes you to gain weight too.

It’s obviously normal for a poor night’s sleep to affect you the next day and make you feel tired; if it’s a constant problem then it could have some wide-ranging effects on your health.

Several studies have suggested that a lack of sleep can increase the chance of weight gain and obesity. It may be that a lack of sleep affects hormones that help control our appetite, that people eat more calories to make up for the tiring effects of lost sleep, or that people who stay up late tend to sleep less overall and eat more calories during their extended waking hours.

Snoring and Weight gain

However, these are mostly theories, as few good-quality studies have explored the link between sleep, eating, and weight gain. To help fill this gap in what we know, researchers recruited 225 healthy, non-obese people (aged 22 to 50 years old) to live in a sleep laboratory for 12 to 18 days.

They randomly selected participants to have five nights of either:
Restricted sleep, with four hours in bed, from 4 a.m. to 8 a.m., or
Unrestricted sleep, with 10 hours in bed, from 10 p.m. to 8 a.m.

During the day, people had regular meals and could also eat at other times, as food was always available in the kitchen. What food they ate and their weight were closely monitored, so the researchers could compare the two groups to see whether restricted sleep increased the chance of weight gain.

What did we learn?
People who had restricted sleep consumed more calories than those who had unrestricted sleep.
All of the extra calories – around 550 per day on average – were from food consumed between 10 p.m. and 4 a.m.
When eating late at night, people also got more of their calories from higher fat foods than at other times of the day.
On average, people with restricted sleep gained nearly a kilo of weight, while those with unrestricted sleep gained only one-tenth of a kilogram.

How reliable is the research?
This was a good-quality study. However, it’s worth noting it only included people who were healthy, fairly young, and not obese. So it’s not clear whether these findings will definitely apply to other groups of people. Also, the participants weren’t able to exercise during the study and might not have had access to all the foods they usually ate. These things might have had an effect on the findings.

What does this mean for me?
It provides good evidence that restricted sleep can increase how many calories you eat and leads to weight gain, at least in the short term. If you tend to stay up late and/or get little sleep, it may be especially pertinent to you as after 10 p.m. was when people typically got their extra calories, rather than during the day.

By John Redfern


Snoring, sleep apnoea, and sleep loss in women

Snoring, and sleep apnoea in particular, were both generally considered to be conditions predominantly affecting men but we now know this not to be the case, with the ration of men to women estimated at approximately 2:1. Since sleep apnoea is mainly a problem that is self-reported , men were more likely to seek help for this and heavy snoring, even if prompted to do so by their partner.

Approximately 50% of women snorers are believed not to report their symptoms to their GP, mostly due to being embarrassed. Some studies show that as many as 90% of more severe cases go undiagnosed in women, and women have a tendency not to report apnoea events, choking or restless sleep, whereas most men did report these matters.

Treatment however can be both simple and inexpensive and it can prevent major health problems in later life. Sufferers are often put off by the thought that the treatment most used historically was CPAP, where air is forced via a mask into the lungs throughout the whole night. More recent thinking is to recommend the use of an oral appliance for mild and moderate cases of sleep apnoea.

Sleep apnea in womenComparison showing Continuous Positive Airway Pressure (CPAP and an Oral Appliance (MAD)

The contrast is shown in the photography above where one patient is using a mask

for CPAP and the other an oral appliance – just distinguishable in the inset, with the result that this method is now much more appealing to those who suffer – both men and women. This treatment, although not quite so effective, works very well.

Snoring often results in a disturbed night and it is very common to hear a comment such as – “I barely slept last night. I just couldn’t get comfortable” – or – “I tried to fall asleep, but my mind kept racing.”

Sleep, and the lack of it, is a common talking point, and disturbed sleep generally is much more common in women than men. A woman’s experience of sleep loss is different and sometimes feminine factors are involved that may cause and maintain sleep difficulties. However, focusing on quality sleep is important to help prevent many aspects of both physical and mental health.

Disruption of sleep leads not only to daytime sleepiness, but memory lapses, weight gain, headaches, irritability and poor work performance overall. It can also contribute to psychological disorders such as depression and for the more severe cases, there’s an increased risk of high blood pressure, premature heart disease and stroke.

It’s not an area to neglect.

The best solution is an approach on several fronts including exercise, reduced alcohol consumption, healthy eating and treatment for the sleep apnoea or heavy snoring which will stop the snoring immediately whilst other things take time.

There are several treatment solutions including surgery, CPAP (Continuous Positive Airways Pressure) a full-face mask which works by stopping the airways from collapsing, or a mandibular advancement device, like a sports mouth-guard, that holds the lower jaw slightly forward, making more space to breathe.

Many women now opt for the mouthpiece. It’s easy to wear, quite comfortable, non-claustrophobic unlike the mask, and doesn’t create dryness of the mouth, which CPAP has a tendency to do. Mouthpieces are easily acquired as they are non-prescription, but some are NHS Approved, which is preferable, and they will bring you immediate results.

SleepPro now have a special product in their range dedicated to women only – the only oral appliance technology company to do so.

By John Redfern