Put an end to snoring

For the majority of the 25 per cent of men and 15 per cent of women who snore, it is nothing more than an irritation - though it can result in sleep deprivation both for the snorer and their partner.

In more serious cases, however, snoring can be a genuine threat to health. It can be a symptom of sleep apnoea - a condition that causes people to stop breathing.

WHAT CAUSES SNORING?

People snore when air does not flow smoothly through the air passages, or when the soft tissues or muscles in the air passages vibrate.

During sleep, the muscles in the tongue, throat and roof of the mouth (the soft palate) relax, causing throat tissues to sag. This narrows the airway and the tissues vibrate or flutter during breathing, creating the sound of snoring.

The narrower the airway becomes, the greater the vibration and the louder the sound.

Snoring can be because of age: throat muscles become weaker as you get older and offer less support to the surrounding tissues. By the age of 60, 40 per cent of women and 60 per cent of men snore habitually.

Being overweight can also contribute, as throat tissues are less firm.

A low-set, thick, soft palate, or enlarged tonsils or adenoids (the spongy tissue between the back of the nose and throat) can also narrow the airway.

In addition, a long uvula (the triangular piece of skin that hangs from the soft palate and seals off the nasal passage when you drink or eat) can limit airflow and increase vibrations during breathing.

Other causes are nasal blockages caused by allergies or a deviated septum (when the partition between the nostrils is crooked), which can restrict airflow through the nose. This forces the person to breathe through the mouth, where more flabby tissue is located.

Alcohol and drugs (such as tranquillisers) that affect the central nervous system can also cause extreme relaxation of the throat muscles.

There are several degrees of snoring, ranging from heavy breathing to deep, reverberating, thunder-like noises capable of penetrating through walls. This type of snoring - which often causes the sufferer to wake themselves up several times during a sleep cycle - can indicate the more serious problem of sleep apnoea.

Sleep apnoea can cause the sufferer to stop breathing for several seconds and is associated with high blood pressure, strokes, cardiac arrest and unexplained nocturnal deaths.

Sleep apnoea occurs when the muscles in the soft palate, uvula, tongue and tonsils relax during sleep. This is the same process involved with normal snoring, but with sleep apnoea the airway narrows so much that it closes.

This causes a lack of oxygen to the brain, causing the body automatically to wake up.

Proper sleep may become impossible, resulting in severe fatigue. As a result, sleep apnoea in adults can increase the risk of serious health problems, such as heart failure, because it deprives the sufferer of adequate levels of oxygen, making the heart work harder than normal.

The condition is most common in middle-aged men, although women and children can suffer from it.

The most common cause for snoring and apnoea in childhood is enlargement of the tonsils and the adenoid tissue. Other causes can include a small jaw, Down's syndrome and abnormalities of facial development.

Diagnosis

If sleep apnoea is suspected, your GP should refer you to a sleep specialist, who will monitor you overnight in a sleep laboratory.

A variety of methods will be used to determine the seriousness of the condition, such as measuring oxygen in the blood, eye movements, the flow of air through the nose and mouth, and an ECG ( electrocardiogram) to measure any serious abnormal heart rhythms.

AVAILABLE TREATMENTS

If sleep apnoea is diagnosed, surgery may be suggested. The most common form is uvulopalatoplasty (LAUP), which removes excess tissue from the soft palate and uvula with a laser, so vibrations are decreased.

The procedure, which costs £1,400 privately, is performed under local anaesthetic and takes about 30 minutes. Depending on the severity of the symptoms, more than one session may be needed.

Somnoplasty, available on the NHS since 1998 and costing about £1,000 privately, is another popular procedure. It uses a special radio-frequency energy to shrink the tissue in the upper airway.

Under local anaesthetic, a tiny electrode is placed under the piece of skin causing the obstruction. The tissue it destroys is reabsorbed by the body and the obstruction shrinks within a few weeks.

Snoring caused by a nasal abnormality may need surgery to straighten the septum.

If the sleep apnoea is not considered a serious health threat, a uvulopalatopharyngoplasty (UPPP) can be performed under general anaesthetic to trim and tighten throat tissues. A treatment under trial, Snoreplasty, takes 15 minutes and involves the injection of sodium tetradecyl sulphate into the soft palate to shrink the obstruction. Patients can return home within a few hours.

If sleep apnoea is not diagnosed, lifestyle changes can reduce the noise and frequency of the snoring.

Non-surgical treatments

Over-the-counter treatments include nasal decongestants taken orally or applied as nose drops, and oral sprays that lubricate the throat.

Some sleep specialists advocate dental appliances to be worn at night, but consult your dentist first.

Chin- straps - £9.95 for a month's supply - prevent the mouth falling open and so help you breathe through your nose. Nasal dilators, from £6 for ten, help people with small or collapsing nostrils. Both are available from te British Snoring And Sleep Apnoea Association (01737 245638).

Lifestyle changes

Snoring is usually worse when you sleep on your back. By sewing a pocket into the back of a T-shirt and inserting a tennis ball, the snorer is encouraged to sleep on their side.

A healthy diet and exercise can also help, as can keeping the body in alignment by raising the head off the bed.