Snoring

Snoring is when a person makes a snorting or rattling noise when they're sleeping.  It happens when the soft tissue at the back of the mouth, nose or throat vibrates when the person is breathing in and out.

Snoring is very common. Approximately 40% of the population of England snore. It can effect people of all ages, including children, although it is more common in men and people between the ages of 40-60.

Known reasons for snoring:

• obesity
• drinking alcohol
• smoking

The grades of snoring

Grade one 

Known as simple snoring. It's when a person snores frequently and the sounds they make isn't particularity loud. That person's breathing is unaffected which means they won't experience any significant health problems related to their symptoms. Their snoring could cause problems on a personal level if it irritates their partner.

Grade two

This is where a person snores on a regular basis. People with grade two snoring may experience mild to moderate breathing difficulties when sleeping because the snoring causes their airways to become narrow. This can affect the quality of a persons sleep, which can make them feel tired and sleepy during the day.

Grade three

Is a person who snores every night, very loudly. A lot of people with Grade three snoring have the related condition known as obstructive sleep apnoea (OSA). This is where a person's airways become partially or totally blocked for about 10 seconds. The lack of oxygen causes the person to come out of a deep sleep and into a lighter state of sleep, or to have a brief period of wakefulness, in order to restore normal breathing. Repeated episodes of this can occur throughout the night making the person very sleeping the next day. This may have an impact on their day-to-day activities.

Snoring: What's the treatment like?

Usually your GP will suggest you make some lifestyle changes to see if they help your snoring, such as:

•  losing weight (if you're overweight)
• not drinking alchohol
• giving up smoking
• regularly exercising to strengthen the muscles in your neck to help prevent the airways in your neck and mouth from narrowing.

If lifestyle changes prove ineffective then there are devices that can be fitted inside your mouth or nose that are designed to ease snoring.

Nasal devices: If your snoring mainly comes from your nose, you could benefit from using nasal strips or nasal dilators. Nasal strips are small strips of self-adhesive tape that looks similar to a plaster. You place them on the outside of your nose before you go to sleep and the strip pushes your nostrils apart. This helps prevent them narrowing while your asleep.

Nasal dilator: Is a plastic or metal device that looks a bit like a nose ring. You put the dilator inside your nose before you go to sleep and it pushes your nostrils apart while your asleep.

Oral devices: If the snoring is mainly coming from your mouth you could benefit from chin strips or a vestibular shield. Like the nasal strips, chin strips are strips of tape that are put under your chin. The strips helps stop your mouth falling open while you sleep.

A vestibular shield is a plastic device that looks similar too a gum shield. It fits inside your mouth, blocking the flow of air into your mouth. This forces you to breathe through your nose which could prevent you from you opening your mouth and snoring.

Mandibular repositioning splint (MRS): If your snoring is mainly due to the base of your tongue vibrating, a mandibular repositioning splint (MRS) could be recommended. This is similar to using a vestibular shield, but rather than keeping your mouth closed 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 is causing your tongue to vibrate, making your snore.

You can buy an MRS off the shelf, however, if your snoring is associated with breathing difficulties like sleep apnoea, it is recommended that one is made for you by an orthodontist.

They last about 18 months before it needs to be replaced.

There are also several surgical techniques that can also be used to stop snoring. However, surgery for snoring is not always available on the NHS. If there is evidence that snoring is have an adverse effect on your health or quality of life, and you've tried all other recommended treatment without success, then you will qualify to be treated on the NHS.

Surgery for snoring is regarded at being the last resort, when all other treatment options have been tried and have proved in effective.

Surgery is not suitable for all cases of snoring, for example, it has limited effectiveness in treating nasal snoring. It is also not recommended for people with sleep apnoea as there are more effective treatments available, such as using breathing devices.

Types of surgery:

• palate implants
• radiofrequency ablation of the soft palate

Uvulopalatopharyngoplasty (UPPP) - Is when it is confirmed that the soft tissue in your mouth is responsible for your snoring. Your uvula (the tissue that hangs from the roof of your mouth), some of your soft palate, some excess tissue around the base of your throat and in some cases, your tonsils and your adenoids are removed.

Uvulopalatoplasty (UP) - Is used as an alternative technique to UPPP as it carries a lower risk. Although UP may not be as effective as UPPP in the long term.  Lasers or high-energy radio waves are used to burn away the uvular and some of the soft palate.

Soft palate implants - are used to treat simple snoring that does not cause breathing difficulties. Local aesthetic is used to numb the roof of your mouth so that several implants made out of synthetic material are then injected into your palate, which causes it to stiffen. This should stop the soft palate vibrating while your sleep.

Radiofrequency ablation - This is an alternative treatment to soft palate implants, used to treat causes where vibrations of the soft palate are responsible for snoring. The roof of your mouth is number with local anaesthetic and an electrode is implants in the tissue of your soft palate. The electrode will then be used to deliver high-energy radiowaves that will shrink and harden the tissue of the soft palate. This should make it less likely to vibrate.

Snoring: What about after?

UPPP can cause a considerable amount of pain afterwards which can sometimes last up to three weeks. It is successful in completely curing snoring in about half of all the people who have the procedure.

UP can also cause considerable pain post-op that can last up to two weeks.

Soft palate implants have not been proven to be good long term.

Radiofrequency ablation has not been proven to be good long term.

Snoring: Are there any risks or side effects?

Removing you uvula can affect your ability to pronounce certain sounds.

Serious complications consist of excessive bleeding, pneumonia, stroke, and heart attack. All are rare.