Do you snore? Wake up feeling tired? Then you could be suffering from sleep apnea

A lot of snorers only decide to do something about their snoring, when a disgruntled bed partner puts the foot down and insists on tackling the matter.

Edel Hurley, practice manager at the Beacon Dental Clinic, says traditionally, the other main push factor is when people have to share holiday accommodation, finding themselves in close accommodation with others and stressed about the situation. However, this year, what’s prompting enquiries is a growing interest in the quality of our sleep, without travel and the usual social distractions more of us are honing in on sleep hygiene – having a bedroom environment and routine that promotes uninterrupted, quality sleep.

Edel says the Dental Sleep Medicine element of the Beacon Dental Clinic Practice is seeing a stronger demand in this area and she believes with lockdown and people being at home, they now have the time and perhaps have an incentive to investigate the reasons for snoring which may be causing restless and fragmented nights.

Creating a comfortable sleep environment means a decent mattress, going to bed at a regular time, having the room at the right temperature – but no matter how expensive cotton sheets are, having a bed partner who snores will render all other efforts meaningless. Snoring can be challenging in many houses – last year a study from Hastings Hotel Group questioned 8,500 people and found over four in ten complained it was their partner’s most annoying habit. It’s easy to dismiss, however, consistently not getting quality sleep can cause a lot of relationship distress and conflict.  

Snoring is caused primarily when the tongue, throat or airway vibrate as you breathe. It commonly happens due to muscles relaxation, airway narrowing when sleeping. As we age, the uvula, at the back of the mouth, can become floppier and the muscle tone of our airways decrease. This airway architecture can sometimes collapse inward, whilst we are relaxed and sleeping, causing noise, which we know as snoring, of varying degrees of amplitude.

In my case I only started snoring a couple of years ago and was inclined to scoff at my partner’s complaints until he made a video on his phone, with full permission and it was truly shocking to see myself flat on my back, mouth open and creating such noise.

I did some research and it seems, in my case, sleeping on my side makes a massive difference. I’ve learned sleeping on your back can cause the tongue to fall back, which partially restricts the airflow, with sleeping on your left-side, or your tummy, best for quiet slumber. I have a long pillow I used to use for breastfeeding which I place behind me, so it’s not easy to roll over, and if I do my partner can give me a light tap to upright me.

Edel says there is a type of inflated backpack, available on Amazon, slumber bump or similar and which helps keep you off back and on your side, which does work. There are also a lot of oral devices which don’t help in particular and it’s not a good idea to buy any oral device before getting a medical diagnoses first. In the States, sleep hygiene has been big over the past few years, and Idaho-based dentist and president of the American sleep and breathing academy, Erin Elliott, says Covid has brought even more of an interest in this area. Elliott advises people who snore to make some lifestyle changes first such as avoiding alcohol in the hours before bedtime and to keep weight near a healthy range.

“Alcohol can relax the muscles under the tongue and the condition can be exasperated if we are overweight ; we put weight on the tongue and neck and as the size of the airway decreases, air pressure increases, allowing for tissue vibration and snoring”.

“If obstructive Sleep Apnea (OSA) is not present – this is a serious condition where your airways become temporarily blocked as you sleep causing breathing to stop and the person to wake, snoring is simply the benign result of an obstructed airway and losing weight, avoiding too much alcohol and sleeping on your side make no difference, mouth appliances can help”.

“An oral appliance is a device that fits like a retainer and looks like a mouth guard. It supports your jaw and tongue to maintain an open upper airway”, she said. “By posturing the lower jaw forward the airway is opened up and the tissue is tightened so there is no more vibration of soft tissue or narrowing of the airway (which is snoring)”.

Good news that a device may help but Edel Hurley warns before one is fitted, a thorough assessment, evaluating the reasons for the snoring, which be determined by a multi- disciplinary medical team. “We had a recent patient referred by an ENT surgeon. The patient woke up every day feeling he had not slept and wanted to change this. Following a thorough assessment, he had a device fitted and it worked extremely well for him, most cases can be straightforward, however a comprehensive diagnosis is essential. Nothing should be overlooked as sleep presentations can be enormously varied”

“Patients who snore may not always have a disorder such as OSA (Obstructive Sleep Apnoea) however, people with OSA will always snore ; it is important to get a diagnosis to figure out the cause of the snoring”. The Epworth sleepiness scale and the STOP-Bang questionnaires are both used to diagnose obstructive sleep apnoea (OSA).

“Sleep apnea can be complicated and there are different types, however, with good assessment and management, there are treatments to best manage each individual presentation” she added. When we think of snorers we tend to conjure a stereotypical image of an elderly gentleman, overweight and deeply asleep, making extraordinary noise, oblivious to that noise. This however is untrue of the stereotype now, they see every shape, size, age and gender of person, presenting with sleep issues, snoring or otherwise.”

“While you are more likely to snore if overweight, I have seen many super fit marathon runners you would never imagine would have a snoring issue”  “In our experience we see males presenting at a ratio of 7:1 and most tend to be over 40. Clinical assessment and multidisciplinary management are key to accurate patient solutions, for optimal outcome. The snorer and the person kind enough to have them have something done about it, in our experience, are really happy and relieved with the outcome”.

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