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


SNORERS ARE MORE AT RISK OF HEART ATTACK THAN SMOKERS OR THE OBESE

• STOP PRESS •

A major study has found that moderate snorers were at 4.8 times greater risk of death from heart attacks and far from just being an inconvenience, amusing, or a nuisance, snoring could be the important early warning of serious life-threatening health problems.

The research study from the USA, where they lead the world in research on sleep disorders, conclusively shows that snoring can cause a thickening of the arteries; a condition that leads on to brain haemorrhages, strokes and heart attacks. It very clearly showed that Snorers are more likely to have thickening or abnormalities in the carotid artery that supplies the brain with oxygenated blood.

Around a quarter of women and four in ten men are frequent snorers, although nearly half of us snore occasionally. Though it can interfere with our sleep – and that of our partners – it was not thought to cause any long-term health problems until recently.

American researchers claim the condition is as serious as having high blood pressure and urge snorers to seek medical advice.

After filling in detailed questionnaires about their snoring habits they were then given ultrasound scans to look at the thickness of their carotid artery and the evidence was conclusive. It was found that the inner layers of the artery walls were far thicker among the snorers than the other adults. It is thought that the thickening of the artery may be caused by the constant vibrations of the snoring which results in inflammation.

Henry Ford Hospital in Detroit, who led the research said: ‘Our study adds to the growing body of evidence suggesting isolated snoring may not be as benign as first suspected. Their recommendation is as follows:
‘Instead of kicking your snoring bed partner out of the room or spending sleepless nights elbowing them, seek out medical treatment for the snorer.

We are hoping to change the thinking so patients can get the early treatment they need, before more serious health issues arise. Snoring is more than a bedtime annoyance and it shouldn’t be ignored.’

By John Redfern