Causes of snoring and sleep apnoea
Snoring is caused by obstruction of the upper airway which consists of the nose, mouth and throat. Obstruction at any point along the airway can cause snoring. Nasal obstruction can, therefore, be implicated.
Often snoring is caused by vibration of the soft tissues at the back of the mouth and large tonsils may contribute to obstruction at this site. The size and shape of the jaw are also important as they control the back of the tongue which can collapse backwards when the patient is asleep causing obstruction and thus snoring.
Snoring is often made worse by muscle relaxants such as alcohol or sleeping tablets. Being overweight is also a significant factor as this causes obstruction to the airway by fat deposition around the airway in the neck.
Sleep apnoea is associated with loud snoring. It is caused by severe obstruction of the airway and is characterised by pauses in the patients breathing while asleep. The obstruction leads to poor oxygen uptake while the patient is asleep. The patient does not feel refreshed when waking and may fall asleep during the day. Chronic obstructive sleep apnoea may cause high blood pressure and heart disease and is a potentially life-threatening condition. It is also associated with poor concentration and loss of libido.
Treatment for snoring and sleep apnoea
This will depend on the cause of snoring or sleep apnoea in the individual patient. Treatment options include:
1. Lifestyle changes, for example, weight loss. Patients can be referred to a dietician if required.
2. Medical treatment, for example, treating rhinitis (see causes of nasal obstruction).
3. Mandibular splint. This is a device like a gum shield that maintains the position of the jaw while the patient is asleep and prevents the tongue from falling backwards.
4. Surgery. This may involve surgery to unblock the nose or tonsillectomy to remove large tonsils. There is a range of procedures specifically designed to combat snoring caused by vibration of the soft tissues at the back of the mouth. These can be done using a laser.
5. CPAP (Continuous positive airway pressure). This is a treatment for sleep apnoea and consists of delivering air, under pressure, using a mask in order to keep the patient’s airway open while they are sleeping.