Is Snoring Dangerous?

It really depends on whether the subject suffers from simple noisy snoring or whether they have progressed to a more serious condition. This is best explained by understanding what is happening when a patient snores.

Individuals snore because the "upper airway" becomes narrow during sleep. Whilst awake small muscles keep the upper airway open, but once asleep, especially if the snorer has a narrow airway, these muscles relax and the breathing passage narrows. At a critical point the airway becomes so narrow that the airflow becomes turbulent and this causes the soft tissue to vibrate. Snoring commonly disturbs the bed partner that can lead to serious disharmony.

A more serious situation arises if the airway narrows more, to a point where significant effort is required to pull air into the lungs. This is known as Upper Airway Resistance Syndrome. The problem arises when the snorer enters the REM sleep phase that makes one feel refreshed the next day. The airway really narrows and the snorer has to work hard to breathe. Unfortunately, this effort disturbs sleep and causes an arousal. The snorer comes out of the deep restorative sleep to a lighter plane of sleep. As result the subject misses out on some of the refreshing sleep and may start to feel tired during the following day. There is also an impact on the heart rate and blood pressure during sleep, causing both to rise.

The next stage is more serious still being Obstructive Sleep Apnoea (OSA) - apnoea is cessation of breathing - when the airway gets blocked altogether during deep sleep. The chest still moves trying to suck air in, hence the pressure in the chest becomes so negative that the snorer may get heartburn as acid is sucked up the gullet from the stomach. Because no air is getting into the lungs the oxygen level in the blood starts to fall. As the brain constantly monitors what is happening in the body it recognises the problem and wakes the subject but not to full consciousness commonly by involuntary movement of the arms or legs, snorting or choking. In soneone suffering from OSA this can occur 50-60 times per hour. As a result deep restorative sleep is not obtained and the subject wakes up feeling as though they have had no sleep at all. OSA sufferers may also wake several times during the night thinking that they need to empty their bladder.

Excessive daytime sleepiness is bad enough in itself. The subject is unable to concentrateand may fall asleep at times during the day making the liklihood of a driving accident more real. It is for this reason that the DVLA require OSA sufferers to stop driving until they are treated. However, this is not the worst news. Research into OSA has demonstrated that the repeated falls in oxygen levels are linked to the development of high blood pressure, heart disease, strokes and diabetes. Untreated OSA is a killer and needs to be taken seriously. Patients suffering (or causing suffering) from snoring who wish to investigate the problem would initially fill in a short questionnaire prior to a clinical consultation. At this visit an assessment of severity is undertaken. Indication of mild or no OSA but with snoring can be treated immediately with a Mandibular Advancement Splint (MAS) which is a laboratory constructed device attached to upper and lower teeth which pulls the lower jaw forward by only 2-3 millimetres. This is normally sufficient to keep the airway open during sleep and ensures refreshing sleep.

For patients who indicate a moderate to severe OSA we will refer to a sleep clinic for an overnight sleep assessment. Our nearest clinic is at Papworth. The NHS does not generally treat simple snoring due to shortage of funds but may offer sleep tests for patients who are suspected of suffering from OSA, however, there is commonly a long waiting time for an appointment and a further delay for treatment. To avoid waiting for a consultation an assessment machine can be sent directly to your home with instruction how to do the test. The current cost of this is £190 + VAT. We can arrange for this at the practice.

Further information about the MAS can be found on the Solutions4snoring website - www.solutions4snoring.com