Category: Science

Are You a Seasonal Snorer?

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Causes, Science

Are You a Seasonal Snorer?

You may have noticed that your snoring gets worse at a particular time of year. If so, you could be a “seasonal snorer”.

Whether it’s a summertime allergy, a winter cold or changes in the weather, there’s plenty of reasons why you may be putting SnoreLab through its paces in January but scoring single digits in July.

Allergies

A leading cause of seasonal snoring is allergies, particularly dust allergies or the pollen allergy better known as hay fever. This is where your body launches into infection-fighting mode in reaction to harmless things.

As allergens get into the body mainly through the nose, this is the area that is most affected. Increased blood flow and release of inflammatory molecules makes your nose stuffy and forces you into noisier mouth breathing.

Allergy-related snoring isn’t just a summertime phenomenon. Whilst hay fever is at its worst during the warmer months (though there are types of pollen prevalent at other times of the year [1]), dust allergies are more likely to strike in winter as windows and doors stay closed trapping dust more readily.

These are some useful strategies to cleanse your environment of the allergens which could be triggering your snoring:

  • Shower before bed. Having a shower before going to bed will rid your hair and body of allergens that may have stuck to you throughout the day. It is also great for normal sleep hygiene as it lowers your body temperature, preparing you for sleep.
  • Wash bedding more often. It is also a good idea to dry laundry away from open windows if you suffer from hay fever.
  • Clean your surroundings. Pollen and dust can also stick to surfaces such as carpets and other soft furnishings. Thorough vacuuming can help, especially if your vacuum cleaner has a built in HEPA (high efficiency particulate air) filter, as this traps allergens.
  • Consider swapping-out soft furnishings. If your allergies are really affecting you and making your snoring intolerable, it might be time to get rid of the carpets and drapes/curtains in your home. The drastic measure could make drastic differences to your snoring.

Snoring related to allergies can also be effectively managed using these consumer remedies:

  • Neti pots. These use salt water to flush out allergens and soothe inflamed tissue.
  • Air purifiers. These are designed to remove allergens from the air.
  • Nasal sprays can be medicated or non-medicated. Both aim to reduce inflammation. Mast cell inhibitor sprays are a good preventative measure for hay fever sufferers.
  • Antihistamines are a type of anti-inflammatory medication commonly used by allergy sufferers.

A cold

The common cold is brought on by a range of viruses that attack the upper respiratory tract. This invasion coupled with your body’s own defense mechanisms cause your nose to swell and become blocked.

The science bit – why does cold weather increase the chance of the common cold?

Contrary to popular belief, the cold weather itself doesn’t directly make you ill. The colder temperatures simply make you more susceptible to viral infection. This is because we spend greater time indoors where infection can spread more easily. We also have less exposure to protective vitamin D and it is thought that cold weather can dampen the initial immune response when we encounter the common cold.

When your nose is blocked you have to make the switch to mouth breathing which can aggravate snoring. This is because open-mouth snoring narrows the airway and makes inhaled air more turbulent.

You can remedy your cold-induced snoring with:

  • Cold relief medication
  • Neti pots. These simple devices use salt water to soothe your nasal passages and clear excess mucus.
  • Nasal sprays. Anticholinergic nasal sprays are the best type for treating a runny nose, whereas decongestant nasal sprays can be an effective symptom reliever.

Temperature

A cool bedroom around 16°C (61°F) is said to be the ideal temperature for sleeping.

But does this affect snoring?

Scientists have looked into the impact of ambient temperature on sleep apnea severity. They have produced some interesting (and seemingly conflicting) results.

A retrospective study of over 7,000 people found that the average AHI during the warmer months was lower compared to during the colder winter months [2].

A second piece of research confirmed this. Patients with obstructive sleep apnea were split into three groups – one group of patients slept in a 16°C (61°F) room, another at 20°C (68°F) and the remaining at 24°C (75°F). The group in the coldest environment experienced the most apnea events. Confusingly, the same group scored the best in terms of alertness and also reported feeling the least sleepy of the three groups [3]!

Weather changes

Many people who suffer from joint pain claim they can tell when a weather front is moving in due to the atmospheric pressure changes [4]. There is also some evidence to suggest that weather and pressure can affect sleep apnea!

In a study in 2010, more than 500 patients with sleep apnea were observed – the weather was documented alongside the patients’ AHI scores.

When bad weather was rolling in and atmospheric pressure dropped, on average the patients’ sleep apnea worsened [5].

These findings have also been supported by other research into the effect of altitude and pressure on sleep apnea. A case report on a patient with sleep apnea in Colombia found that their AHI scores were greater when at higher altitudes where the atmospheric pressure is lower [6].

Humidity

There is evidence to suggest that breathing in dry air can aggravate the tissues in your nose and throat [7]. So whilst low-humidity is unlikely to be the outright cause of your snoring, it can cause irritation and inflammation which could worsen existing snoring.

Humidifiers can therefore be a useful addition to other anti-snoring measures. Further, they can provide relief from the symptoms of allergies and the common cold – other big causes of “seasonal snoring”.

SnoreLab’s guide to buying a humidifier

Read

Alternative Snoring Remedies: Quirky Cure or Quackery?

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Alternative Snoring Remedies: Quirky Cure or Quackery?

 

If you snore and have ever Googled how to stop snoring, it is likely that you know the standard snoring remedies. Most people are familiar with weight loss, nasal strips, mouthpieces or throat sprays. But what about pineapples? Electric shocks? Didgeridoos?

The internet is a big place full of lots of good stuff but also lots of nonsense. Before you accept an online post on the greatest new snoring cure as gospel, we’ve highlighted a few of the weirder ones. Are they quirky cures that could work wonders, or is it just a load of quackery?

Didgeridoo – quirky cure

It’s true – learning to play the didgeridoo or any wind instrument for that matter can really help you to snore less!

Snoring arises from weak upper airway musculature – tissue in the airway vibrates because it is slack and floppy. Playing wind instruments tones these upper airway muscles making them less likely to vibrate and make noise.

The science behind this novel technique is very positive. Twenty-five patients with moderate obstructive sleep apnea were signed up for didgeridoo lessons. Fourteen received tuition and did practice at home every day for four months. The other eleven – the control group – were put on a waiting list and carried on as normal.

Playing the didgeridoo is hard and requires strong mouth, tongue and throat muscles. At the end of the four months, the group who played the instrument showed some promising results improvements to their snoring [1]:

  • They were less sleepy throughout the day.
  • Their sleep apnea episodes reduced. Patients had a lower apnea/hypopnea index – 6.2 points fewer than the control group.
  • Their partners reported feeling less disturbed at night.

You needn’t sign up for (potentially expensive) music lessons to tone your airway muscles. Research has shown that doing some simple daily mouth exercises can have great benefits – reducing snoring, improving sleep apnea and giving you (and your bed partner) better sleep [2][3][4].

 

You can read more about these exercises and how they can help you in our dedicated article:

Mouth Exercises for Snoring

Pineapple plant – quackery

If this one seems far-fetched and wacky, that’s because it is. Unfortunately, pineapple plants in your bedroom will not help your snoring.

This campaign of misinformation started in 2017 when British supermarket chain Asda started selling pineapple plants with the bold claim that they’ll cure your snoring. They also said that the science is backed up by NASA.

The British tabloids and many less-than-reputable online sources jumped on this spikey bandwagon and started extolling the virtues of pineapple plants for snoring. The common theme in these articles was that pineapple plants give you more oxygen at night therefore you snore less and that NASA said so.

Where do we start with the problems in this story?

Okay, so it is true that pineapple plants are different to your ordinary houseplant. “Normal” plants photosynthesise during the day and respire at night. This means that during the day plants are taking in CO2 and giving out oxygen, whereas at night they are taking in oxygen and giving out CO2.

Pineapple plants employ CAM photosynthesis (crassulacean acid metabolism for those who are interested) and therefore do the opposite, giving out oxygen at night.

However, more oxygen is not going to make you snore less, nor is it going to improve sleep apnea. Contrary to what some say, CPAP – the gold standard treatment for sleep apnea – does not give you more oxygen. It simply gives you normal air. Further, even if oxygen were to improve snoring outcomes, the amount required would not be met by the meagre output from a single £10 houseplant.

But what about NASA? They’re reputable, right? In the 1980s, NASA did some studies into whether or not “interior landscape plants” could be used to mop up toxic molecules from the air [5]. The results were that, yes, to an extent they could (but far too many plants would be needed to have any noticeable benefit). Clearly not mentioned in this study (we checked) are pineapple plants.

So where did the “NASA-backed science” claim come from? Really, it seems to have been plucked from the thin air of space.

Tennis ball – quirky cure

Those who have done a bit more research into snoring cures may be familiar with this remedy. Taping a tennis ball to your back at night is a great way of stopping you from sleeping on your back – a position where you are much more likely to snore.

There is lots of research into snoring, sleep apnea and your sleeping position. More than half of sleep apnea cases are referred to as “position-induced”. Sleeping on your back makes you far more likely to snore or experience sleep apnea. Here, your jaw recedes, your tongue falls back, and weight on your neck compresses your upper airway. All of these disturb airflow and cause vibration or complete blockage.

Purposefully obstructing back-sleeping is not a new snoring cure. Soldiers in the American War of Independence and in the First World War were sometimes ordered to sleep with their rucksacks on. This was to prevent them from snoring and giving away their position to their enemies.

Today, “tennis ball therapy” or TBT (it has actually been giving its own acronym in scientific journals) is a popular “alternative” snoring treatment [6]. This is because side sleeping can improve snoring outcomes hugely.

The tennis ball is the most famous but isn’t a requirement for promoting side-sleeping. Anything that impedes back-sleeping can help. There are even dedicated sleeping backpacks you can wear at night which are a little more comfortable and also provide some support.

Shock bracelets – quackery

Once you’ve been awoken by a minor electric shock, it is indeed true that you aren’t snoring anymore. However, you also aren’t sleeping. This is not reason enough to suggest that shock bracelets are a sensible anti-snoring measure.

The idea of shock bracelets is to condition you out of bad habits. This is all very well if the habit is consciously controlled – which snoring is not. Some argue that snoring is a voluntary habit [7] but this misses a crucial middle step – our voluntary lifestyle choices impact upon the involuntary action of snoring. Simply put, you can’t just “learn” to stop snoring with negative reinforcement as this is not tackling the root cause of the snoring itself.

 

You can read more on the topic of snore alarms in our article:

Do Snore Alarms Work?

A note on “alternative medicine”

Notable omissions from our “quackery” classification are acupressure rings and things with magnets. There are a lot of these “alternative medicine” products on the anti-snoring market – some snorers swear by them, others swear at them in online reviews.

These two reviews for exactly the same product illustrate how polarised opinion is on alternative medicine remedies

This is a divisive topic, and whilst we don’t explicitly recommend them we’ll stop short of calling these quack cures.

Yes, the evidence (conventionally speaking) is lacking and most users will see no improvement whatsoever, but it is undeniable that there are some people who benefit from these alternative snoring cures.

We don’t know why these remedies work for some people; some as-of-yet-undiscovered physiological process, or maybe just a placebo? Uncertainty of the mechanism doesn’t mean that it should be dismissed entirely.

Getting philosophical, it could perhaps be that we simply don’t have the scientific tools or knowledge to understand or measure what these remedies can do for some of people. It is naïve to think that modern knowledge and science is the endgame in our understanding. After all, before the advent of the telescope (and even some time after) it was the conventional wisdom amongst the best scientific minds that the sun revolved around the earth.

One thing that is undeniable however is the statistics. Many more people will benefit from the conventional anti-snoring approaches. If you snore and are looking for a cure, maybe try weight loss and side sleeping before shoving a magnet up your nose.

Have you had a positive experience with an alternative snoring cure? We’d love to hear from you! You can contact us on Facebook, Twitter or support@snorelab.com

20 Common Questions About Snoring Answered

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Science, Solutions

20 Common Questions About Snoring Answered

Snoring is more complicated than you might think. Because snoring is perceived as an embarrassing habit, it is not often talked about. Therefore, many people have questions about their snoring: what it is, why it’s happening and what to do about it. These are a selection of the most common questions people have about their nighttime noises …

What is snoring?
Why do I snore?
Is my snoring a problem?
What can I do to stop snoring?
My partner snores. What can I do?
What is OSA?
If I snore loudly, do I have OSA?
What does AHI mean?
How can I find out if I have OSA?
What happens in a sleep study?
How can sleep apnea be treated?

What is CPAP?
I am a back-sleeper – how can I sleep on my side?
My nose is blocked and making me snore – what’s causing it?
Do nasal sprays work?
Is an anti-snoring mouthpiece right for me?
Why do men snore more than women?
My child snores. Is this normal?
Is snoring genetic?
Are there different snoring sounds? If so, what do they mean?

What is snoring?

Snoring is the sound of the soft palate and other soft tissue in the upper airway vibrating. This can include the uvula, tonsils, adenoids, nasal turbinates and other surrounding tissue.

These vibrations happen when air can’t move freely through your airway which causes the floppy soft tissue to flap and make noise.

Read the full article: What is Snoring? – An Introduction

Why do I snore?

Snoring is caused by a combination of different factors which vary from person to person. The most common reasons for snoring include:

Is my snoring a problem?

If your snoring is disrupting your sleep or your partner’s sleep, or has a potential to become obstructive sleep apnea, then it is problematic and needs addressing. There is disagreement in the medical world as to whether normal, habitual snoring (non-apnea) is physically harmful.

What can stop me from snoring?

There is no single remedy that works for all snorers. Finding a solution to your snoring requires an understanding of what is causing you to snore. Common snoring remedies include:

My partner snores. What can I do?

To manage a partner’s snoring and get some more sleep, there are approaches to solve the problem, and some others to simply cope.

Solving the problem:

  • Let them know they snore. Snorers often aren’t aware of their snoring problem. Highlighting it as an issue can motivate them to make a change.
  • Share lifestyle solutions. Often, snoring can be remedied with positive diet and lifestyle changes. These are more likely to be successful if done as a couple.
  • Prop. Sleep back-to-back to prevent your partner from rolling onto their back.
  • Observe and understand their snoring triggers. As the non-snorer, you are in the unique position of being able to see and hear the differences that the snorer may be oblivious to.

Coping with the problem:

  • Get a head start to bed.
  • Sleep separately. This is a solution that many couples cite as the saviour of their marriage. Set aside that same time to enjoy each other’s company, before eventually doing the sleeping part in separate rooms.
  • Use earplugs. A simple multipack of foam earplugs will do the trick, but also shop around for ones that are sleep-specific.
  • Get a white noise machine. This doesn’t block the snoring sound, but instead masks it as the snoring frequencies blend in with the frequencies coming from the white noise machine.
  • Change how you react to the snoring. The mindfulness approach is about changing the way you perceive your partner’s snoring. Try to emotionally detach from the snoring sound and instead treat it like your own personal soundscape.

Read the full article: What Can You Do If Your Partner Snores?

What is obstructive sleep apnea (OSA)?

Apnea simply means “no breathing”. Sleep apnea is a serious condition where your airway repeatedly closes during sleep, depriving you of oxygen until you gasp awake.

The “obstructive” part refers to the fact that airway obstruction is the reason for apnea. Central sleep apnea is a different condition whereby the brain cannot properly regulate normal breathing patterns during sleep.

Read the full article: What Is Sleep Apnea?

If I snore loudly, do I have sleep apnea?

Whilst loud snoring is a key sign of sleep apnea, it does not mean that you definitely have the condition. 95% of people with obstructive sleep apnea (OSA) snore, but not all snorers have OSA.

Read the full article: Is It Snoring Or Sleep Apnea?

What does AHI mean?

AHI stands for “apnea-hypopnea index” and is a measurement of the severity of sleep apnea. It gives a value for the number of apnea/hypopnea events per hour, which is where breathing fully/partially stops for over 10 seconds.

  • 0-5 events per hour – normal
  • 5-15 events per hour – mild sleep apnea
  • 15-30 events per hour – moderate sleep apnea
  • 30+ events per hour – severe sleep apnea

How can I find out if I have sleep apnea?

Firstly, look out for the key signs and symptoms:

  • Loud snoring with periodic choking/gasping
  • Excessive sleepiness
  • Difficulty concentrating
  • Headaches and sore throat in the morning
  • Frequently waking twice or more to urinate
  • Mood changes
  • Dry mouth/chapped lips upon waking
  • Lowered sex drive
  • Acid reflux

Secondly, do some screening tests:

  • STOP-Bang. This questionnaire assesses how many of the key risk factors for sleep apnea you have.
  • Epworth Sleepiness Scale. This is a test to see if you are showing signs of excessive sleepiness by asking your likelihood of falling asleep in certain day-to-day scenarios.

If these point to potential sleep apnea, consult a doctor. You may be referred for a sleep study. Sleep studies are the only way to reliably diagnose and quantify sleep apnea.

What happens in a sleep study?

A sleep study can be done in a specialist sleep clinic or at home. It is an overnight procedure where you are monitored to gain insight into what happens when you sleep.

You are observed with polysomnography (PSG) which simply means “many sleep measurements”. Therefore, you are connected to a variety of monitors to observe different facets of your sleep:

  • Blood oxygen levels – blood oxygen drops during apnea episodes.
  • Brain activity – to detect the micro-arousals that accompany apnea events and assess what stage of sleep you are in.
  • Muscle activity
  • Heart rate
  • Breathing rate and effort – to provide evidence of breathing interruptions.
  • Eye movement – helps to determine what stage of sleep you are in.
  • Sleeping position – gives some insight into what triggers sleep apnea.

Read the full article: What Happens in a Sleep Study?

How can sleep apnea be treated?

The best solution for sleep apnea depends on the severity of the condition.

Mild to moderate cases can often be treated with the same techniques and remedies used to manage primary snoring.

Severe cases – where your AHI is over 30 – are best managed with CPAP.

Im extreme cases where CPAP and other methods have failed, if there is a clear physical obstruction, surgery can also be an option.

Read the full article: Obstructive Sleep Apnea Treatment

What is CPAP?

CPAP stands for “continuous positive airway pressure” and is very effective in treating moderate to severe sleep apnea. CPAP does not give you more oxygen, instead, it gives a constant current of normal air that props open you airway to prevent it from collapsing and causing apneas.

The devices consist of a generator connected to a mask via a hose. They come in different shapes and sizes so are suitable for many different people.

I am a back-sleeper. How can I sleep on my side?

There are several ways you can train yourself to sleep on your side:

  • Tennis ball therapy. Tape or sew a tennis ball to the back of your pajamas to make sleeping on your back difficult.
  • Leaning against something to prevent you rolling over.
  • Specialist pillows. Special designs can encourage side sleeping
  • Vibrating training devices. These work like a gentle snore alarm, vibrating when it detects that you are sleeping on your back.

My nose is blocked and making me snore. What is causing it?

Having a blocked nose is one of the main causes of snoring. There can be many reasons for nasal blockage:

Read the full article: Snoring Due to a Blocked Nose

Do nasal sprays work?

Nasal sprays are a popular anti-snoring remedy. It is important to note that they aren’t suitable for all snorers. They will not work if you can already breathe properly through your nose.

There are several different types of nasal spray, each for different causes of nasal-related snoring.

Read the full article: Do Nasal Sprays Work For Snoring?

Is an anti-snoring mouthpiece right for me?

Anti-snoring mouthpieces can be a very effective snoring remedy. These devices work by positioning your lower jaw (your mandible) further forward (or advancing it).

At SnoreLab, we recommend mouthpieces for a number of different snorers:

  • People whose snoring has worsened with age
  • Overweight snorers
  • Back sleepers. This is because sleeping on your back makes your tongue more likely to fall back into your airway and cause an obstruction. Mouthpieces are still suitable for side and front sleepers.
  • Mild-moderate OSA sufferers
  • After drinking alcohol
  • Open-mouthed snorers
  • Snorers with a pronounced overbite

Like most snoring remedies, there are some people who should avoid using anti-snoring mouthpieces:

  • Those who wear dentures or a missing a significant number of teeth
  • People who have dental decay
  • Those who suffer from jaw ache
  • People with chronic nasal blockage
  • Epilepsy sufferers. Mouthpieces can break into small parts due to the strong biting down that can accompany severe seizures.

Read the full article: Buying Guide – Anti-Snoring Mouthpieces

Why do men snore more than women?

Roughly 40% of men snore, whereas only 20% of women snore. Men’s airway anatomy is more prone to snoring. This is due to an increased proportion of soft tissue and a predisposition to gain fat on the neck. Male hormones also enhance airway collapsibility whilst female hormones protect against it.

Read the full article: Do Men Snore More Than Women?

My child snores. Is this normal?

Just like adults, occasional snoring is normal and harmless for children. However, extra attention should be paid if your child snores 4 nights or more per week, and snores frequently through the night.

Look out for the following signs:

  • They snore more than 4 nights per week
  • They snore frequently throughout the night
  • The snoring is noisy
  • You can hear pauses in the child’s breathing
  • They often sleep with an open mouth
  • They have trouble waking up
  • There are behavioural issues and problems at school
  • You are told that they fall asleep at school
  • They are unusually irritable
  • They report having headaches or a sore throat.

Read the full article: Snoring and Sleep Apnea in Children

Is snoring genetic?

Importantly, there is no such thing as a “snoring gene”, but there is some evidence to suggest that snoring has a genetic link. Some features can be inherited from our parents that make us more likely to snore. These include:

  • Small nostrils
  • Receded chin (known as retrognathia)
  • Small jaw (known as micrognathia)
  • Narrow airway
  • Large tongue
  • Large soft palate
  • A propensity for weight gain

Read the full article: Is Snoring Genetic?

Are there different snoring sounds? If so, what do they mean?

Yes. Different types of snoring produce different sounds depending on where the obstructions and vibrations are. We are not yet able to use snoring sound alone to diagnose obstructive sleep apnea, but early studies have found that sleep apnea-related snoring has a higher peak frequency than habitual snoring.

Snoring and Sleep Apnea in Children

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Science, Sleep Apnea

Snoring and Sleep Apnea in Children

Just like adults, almost all children will snore occasionally.

The mechanics of snoring are no different in children. Inhaled air becomes partially obstructed which causes excess soft tissue in the upper airway to flap and make noise.

But how do you know if your child’s snores are normal or not?

Normal snoring vs. sleep apnea

We all snore occasionally, particularly if we are unwell. But 10% of children will snore on most nights. This is not normal and could be a sign of something more serious [1].

1-3% of children even experience obstructive sleep apnea (or OSA for short) [2]. This is where airway blockage leads to breathing pauses – a condition that has health implications beyond sleep.

Side note: what is the difference between snoring and sleep apnea?

Normal snoring (a.k.a. “habitual” snoring or “primary” snoring) does not involve breathing stoppage. This is usually benign. When a child has sleep apnea, their breathing stops for at least 10 seconds, generally followed by a big gasp or choke. Those with OSA often snore loudly, but importantly, not all loud snorers have sleep apnea.

Obstructive sleep apnea is problematic in children

Children need lots of healthy sleep for good physical, mental and emotional development. OSA disrupts sleep, therefore sleep deprivation is the biggest concern for children with sleep disordered breathing.

Studies have also linked the sleep fragmentation experienced with sleep apnea to ADHD [3]. Even without an ADHD diagnosis, sleep deprivation can affect children’s behaviour, focus and overall development.

What causes snoring in children?

The various reasons for snoring are the same in children as for adults. Sleeping position, being overweight and allergies can all be implicated in your child’s snoring.

To understand why your child snores, try to explore their triggers:

  • Are they sleeping on their back?
  • Could dust allergies be triggering their snoring? Are there a lot of soft toys in their room that could be collecting dust?
  • Does their snoring happen seasonally? If so, could they be suffering from hay fever? Understand the other signs of this seasonal pollen allergy.
  • Is your child’s face shape responsible? A pronounced overbite (retrognathia) reduces space behind the tongue and is a common anatomical cause of snoring.
  • Is your child overweight?
  • Are they ill? If so, their snoring should be short-lived.

Unlike in adults, the tonsils and adenoids are frequently cited as causes of snoring and sleep apnea. This is because the adenoids are regions of soft tissue that (usually) disappear after puberty. Further, tonsils reach their peak mass between 5-7 years – well before a child’s airway has reached its peak size. These are therefore key obstruction triggers in childhood snoring and sleep apnea.

When is a child’s snoring problematic? The signs to look out for

There are some key signs that can suggest that your child’s snoring is a cause for concern.

5 sleeping flags are:

  1. They snore more than 4 nights per week
  2. They snore frequently throughout the night
  3. The snoring is noisy
  4. You can hear pauses in the child’s breathing
  5. They often sleep with an open mouth.

It can be hard for you to identify these sleeping flags in your child; beyond a certain age, parents don’t usually share a room with their child.

Therefore, it is important to also keep watch for these 5 flags whilst your child is awake:

  1. They have trouble waking up
  2. They are unusually irritable
  3. There are behavioural issues and problems at school
  4. You are told that they fall asleep at school
  5. They report having headaches or a sore throat.

If they are ticking many of these boxes, it is a good idea to seek advice and further investigation from a specialist.

Before a medical consultation, it is recommended that you start a sleep journal. This can help a specialist glean some insight into your child’s snoring. Focus on the 10 sleeping and waking flags above.

The logistics of listening to your child’s entire night of sleep are difficult if they are at the age where you aren’t sharing a room. This is where SnoreLab can be helpful.

Side note: is SnoreLab suitable for children; will my child’s privacy be protected?

Your child’s privacy is not at risk when using SnoreLab. We do not collect audio recordings and therefore cannot share or listen to any audio picked up by the app. We do collect some anonymised, non-audio data on the session – this cannot identify you personally and is nothing more than some numbers on a screen.

Further investigation – do children have sleep studies?

Yes, children have sleep studies too. A sleep study is a way of looking at how your child’s body behaves when they are asleep. This is the reliable way to understand their sleep disordered breathing.

The process is almost identical to adult sleep studies.

On the day of the sleep study, parents are encouraged to help make the process as normal as possible. This means sticking to normal routines, both before and after arriving at the hospital. If an afternoon nap is part of your child’s routine, then don’t deny them it.

To help make the hospital feel as comfortable and homely as possible, bring things from home that help your child to relax and sleep – whether it’s a toy, a blanket, a book or a film to watch before bed.

Your child will be “wired up” before the study starts. This involves attaching an array of monitors which can take up to an hour to set up. The key ones are:

  • Elastic chest bands. These sense the child’s breathing efforts.
  • Pulse/blood oxygen saturation monitor finger/toe clamp
  • Nasal cannula to assess airflow and look for breathing disruptions
  • Electrodes to monitor heart, brain and eye activity are less common in paediatric sleep studies but are still sometimes used.

Importantly, none of these attachments are painful and they should be attached in such a way to avoid any discomfort. Your child should have no problem sleeping with them on.

The technicians attaching these monitors are well-trained in dealing with children and allaying any fears and anxieties they may have. You as a parent can also play your part here too.

Paediatric sleep studies almost always have two beds set up – one for the child and one for the parent. Your presence should help your child relax and get the sleep needed to make the necessary measurements. People say that typically the child sleeps better than the parent!

Similar to adult studies, the session finishes around 6am. Results are analysed by specialists and will be communicated to you at a later date.

What can be done to treat children’s snoring and sleep apnea?

As with anyone’s snoring, what is the “best treatment” depends on the cause. Almost all snoring remedies apart from mouthpieces – if well matched to the cause – are suitable for children.

Surgery is recommended more for children than it is for adults. This is because children’s snoring is more likely to have a clear physical obstruction that can be corrected with surgery – namely by removing the adenoids and tonsils. Indeed, these procedures are performed more than a quarter of a million times per year in the USA alone [4]. It is generally very safe with only minor risks associated.

Such surgical interventions are usually very successful. Some research indicates that children’s stunted mental capabilities, often attributed to the sleep disturbance that accompanies sleep apnea, reverses completely 3 to 10 months after surgical removal of the adenoids [5].

Surgery is not always an option. If a child is diagnosed with OSA which cannot be managed with surgery or other measures, CPAP can also be used. Whilst CPAP can be quite a drastic change for a child to get used to, if presented and handled well by both the medical professionals and the parents, it can be extremely effective [6].

Further, it is speculated that another potential measure is doing nothing! Children develop and grow quickly so certain conditions can resolve themselves. Recent studies have shown that the non-intervention commonly referred to in the medical world as “watchful waiting” saw almost half of sleep apnea cases reversed within 7 months [7].

Conclusion

Snoring has similar causes in both adults and children and can therefore be managed in the same ways.

Occasional snoring is normal and harmless for children. However, extra attention should be paid if your child snores 4 nights or more per week, and snores frequently through the night [1].

Assess your child’s snoring with the following process:

  1. Is it caused by allergies? Does your child have any symptoms such as a runny nose; are there soft toys potentially trapping dust in their room?
  2. What position do they sleep in? See if side-sleeping reduces their snoring. You can also try elevating their head.
  3. Check if they are showing any of the 5 daytime signs of problematic snoring.
  4. If possible, make a sleep journal. Note how often they are snoring and its frequency per night. SnoreLab can help with some objective nighttime measurements.
  5. If these flags raise concerns, seek medical advice.

Human Evolution and Snoring

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Science

Human Evolution and Snoring

Snoring can be seen as an unfortunate by-product of human evolution. Specifically, our airway is a victim of speech and upright posture.

The human throat has too many functions to do any of them perfectly, and instead does everything adequately.

This small section of our body needs to be able to breathe, swallow and generate speech, switching between the three processes seamlessly – all whilst supporting a head with a heavy human brain.

There are bound to be conflicts of interest. Snoring is that conflict making itself known.

Here’s why you can (sort of) blame Darwin for your snoring problem …

Problem #1 – Speech

To breathe at optimal efficiency (and not snore) our airway would need to be a long, straight, rigid tube structure.

Unfortunately, this design is not compatible with generating speech which requires almost the exact opposite qualities. To achieve the diverse range of sounds unique to human speech, a flexible tongue and upper airway are required.

Perfect breathing and sophisticated speech are simply incompatible so a compromise is needed.

To vocalise beyond the grunts of our pre-human ancestors, some different facial characteristics are necessary. First, a longer neck to accommodate more sophisticated sound apparatus is required. This means more soft, muscular tissue unsupported by the harder structures of the skull. Such floppy tissue is snoring waiting to happen.

Our tongue works by shaping the sounds generated lower down the throat in the larynx. To do so, it has to sit further back in the mouth compared to other mammals. It therefore rests precariously close to the back of our upper airway and risks causing obstruction if it relaxes too much.

Problem #2 – Upright posture

By standing on two legs we need a precise center of gravity to keep us from toppling over. Evolution has achieved this with changes to hip structure, thigh angle and spinal curvature.

Additionally, our neck needs to be optimally positioned to support the skull and the heavy brain within. Hence, humans’ throats are more centrally located underneath the skull. This is contrary to other mammals, where the throat sits further forward in a nicely spacious neck.

Overall, there is less space to fit more material. These conditions are perfect for partial airway obstruction – the underlying culprit for snoring.

Problem #3 – Creature comforts

Having anatomy primed for snoring isn’t usually enough to condemn us to a lifetime of nocturnal noise. Instead, an obstruction trigger is needed. As humans have become more advanced, living in more comfort, we have introduced many potential obstructions.

The prime example of this is weight. In the developed world, humans now have ready access to food – sometimes too much of it. Excess weight around the neck and chest is one of the biggest causes of snoring.

Other uniquely human vices such as smoking and alcohol consumption set up snoring perfectly.

Why hasn’t natural selection rid us of snoring?

The concept of evolution and natural selection suggests that advantageous characteristics persist, whereas disadvantages disappear over time. This is known as “selection pressure”. Snoring is surely disadvantageous, so why hasn’t evolution gotten rid of it yet?

These days, being preyed upon isn’t something many humans have to worry about. Therefore, snoring and giving away your location in the vulnerable state of sleep is unlikely to see you snuff it at the hands of a hungry predator.

It is arguable that snoring confers an evolutionary disadvantage as it could be an undesirable quality in a mate – simply, snorers are less likely to find a partner and pass on their “snoring genes”.

 

Is snoring genetic?

Have a read of our article

In reality, this notion is clearly flawed. Snoring appears to confer no evolutionary disadvantage whatsoever.

Even if snorers couldn’t find partners, many snorers are late to the party – only snoring in older-age once they have had plenty of opportunity to pass on their “snoring traits”.

Hang on, other mammals snore too

It is true that humans aren’t the only snorers in the animal kingdom. Anything with soft tissue in its airway is prone to snoring – i.e. all mammals.

The internet is awash with cute videos of snoring animals. Further, we often get asked if SnoreLab will detect pets’ snoring.

Snoring amongst wild animals is poorly understood (do you really fancy sneaking up on a pride of lions at night to have a listen?) but it seems that snoring in animals tends to be at least in-part the result of domestication.

The most prevalent non-human snorers are animals where humans have had a hand in their creation – namely dogs bred with features that cause breathing difficulties (e.g. pugs and bulldogs).

Domestic animals also have a higher chance of overeating and don’t face predation like their wild counterparts where snoring could be an evolutionary disadvantage.

Conclusion

So whilst snoring isn’t a uniquely human problem, the features that enable us to speak and walk on two feet have knock-on effects.

Modern humans are not an end-point; we are merely a snapshot in an evolutionary story with much history and an interesting future (which may or may not include snoring). For the time being, snoring seems to be here to stay – that is unless we can help!

Is It Snoring Or Sleep Apnea?

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Sleep Apnea, Science

Is It Snoring Or Sleep Apnea?

Snoring and obstructive sleep apnea are strongly linked – so how can you tell the difference?

It is normal to have a high Snore Score or be told you snore and then worry if it might be something more serious.

Some important things to consider are:

 

Normal snorers don’t stop breathing

Not everyone who snores has sleep apnea – nearly everyone who has sleep apnea snores

If untreated, snoring can become sleep apnea

What is the difference between normal snoring and sleep apnea?

95% of people with obstructive sleep apnea (OSA) snore, but not all snorers have OSA [1]. Both snoring and OSA are the results of improper airflow through your upper respiratory tract. So what is the difference?

Normal snorers, better known as “primary snorers”, don’t stop breathing. Around 30% of the world snores (40% of men and 20% of women).

Conversely, people with OSA experience apneas – this is where breathing stops for 10 seconds or more. This puts strain on various systems in the body and can increase the risk of a number of disorders including stroke, diabetes, cancers and heart conditions.

Obstructive sleep apnea affects around 1-2% of the population, though it is thought that many more people are undiagnosed.

The factors that put you at risk of OSA also make snoring more likely, so how can you spot OSA over primary snoring?

What are the signs of OSA?

There are a number of symptoms which suggest you may be suffering from OSA:

  • Excessive sleepiness in the daytime

Side Note: What constitutes excessive?

We often get asked if SnoreLab can use recorded snoring to find sleep apnea. It is important to note that SnoreLab is not an automatic sleep apnea detector.

We might all get a little sleepy during the day, but excessive sleepiness is where you are barely able to stay awake in a variety of day-to-day situations – not just a warm, dimly lit room with a belly full of lunch!

  • Persistent headaches in the morning
  • Sore throat upon waking up
  • Mood swings and difficulty concentrating

Whilst you may also experience these symptoms occasionally as a primary snorer or even a non-snorer, a persistent combination of all or most of them should be seen as a red flag.

Another crucial sign of OSA is if you have been observed gasping or choking in your sleep. For people who sleep alone, this can be very hard to recognise. This is where SnoreLab can help. So …

Can SnoreLab tell me if I have OSA?

This is a question we get asked a lot. However, it’s important to note that SnoreLab is not an automatic sleep apnea detector.

It is true that sleep apnea often has some very distinctive sounds – normal breathing followed by at least 10 seconds of silence and then a gasp or choke.

Whilst SnoreLab could detect this typical sound profile, sleep apnea is defined by apneic events and such events are not actually defined by sound.

An apnea is a period during sleep where breathing stops for at least 10 seconds.

Apnea is therefore identified by measuring both breathing effort and airflow (or lack thereof). A drop in blood oxygen saturation also helps to confirm this apneic event. Measuring this requires specialist equipment beyond the reach of a consumer app.

In SnoreLab, you can search your session for risky sounds using Full Night Recording mode to ensure that every sound and event is captured.

Some users have used this feature to discover sounds in their recordings that suggested apneic events. They have then found them useful in subsequent medical consultations. For many people, SnoreLab has helped flag sleep apnea they weren’t aware that they had.

This is one example of a sleep apnea event found on SnoreLab …

It is important to note however, this not all apnea events can be easily identified like the above.

Some users diagnosed with sleep apnea do not have very high Snore Scores. One user sent us a screenshot of their session with an apnea event playing with barely any sound detected at all …

How can I find out if I have OSA?

So if SnoreLab can flag sleep apnea but can’t diagnose, you may be wondering how to get a reliable idea of whether or not you have OSA.

There is a three step process to investigate potential OSA …

1. Do some screening tests

If your suspicions and symptoms are pointing to sleep apnea, check your risk by answering some screening questionnaires.

These are surveys that evaluate various symptoms and physical features to give you a risk score.

The Epworth Sleepiness Scale asks questions on your likelihood of falling asleep in certain scenarios like watching television or sitting in a meeting. Your answers can range from “Will never fall asleep” to “Very likely to fall asleep”. A score above 11 indicates excessive sleepiness and a risk of sleep apnea.

 

Epworth Sleepiness Scale questionnaire

Take

 

The StopBANG questionnaire looks beyond sleepiness at your weight, sex, age and snoring. The series of 8 yes/no questions helps to calculate your relative risk of sleep apnea.

 

StopBANG questionnare

Answer

2. Seek medical help

Armed with the symptoms, completed screening tests and some suspicious SnoreLab recordings, it is time to visit your doctor to investigate your potential sleep apnea in more detail.

These pieces of evidence is often enough to convince your doctor that a specialist referral is necessary. Many SnoreLab users have shown their recordings to their doctors …

“Made my doctor finally understand. I finally got the help I needed.”

“This app saved my life! Realized how bad my snoring was, saw a doctor to find out I have sleep apnea.”

“MD wrote a prescription for me at a sleep study clinic. Interesting to see bad my snoring really is.”

Here, you could see an ENT (ear, nose and throat) specialist and/or be scheduled onto a sleep study.

3. Undergo a sleep study

A professional sleep study is the only way to get a reliable and quantifiable diagnosis of OSA.

During a sleep study, many measurements are taken to build up a picture of what is happening to your body during sleep. This not only helps to detect potential OSA, but also looks for other sleep disorders.

A sleep study can be performed in a specialist clinic or at home. To find out more about what to expect from home and clinic sleep studies, read SnoreLab’s article What Happens in a Sleep Study or have a look at Susan’s story – a firsthand SnoreLab user account of having a sleep study.

Is primary snoring nothing to worry about?

So if you know that you don’t have OSA and instead simply snore, great. But this is not a reason for complacency. Primary snoring should not be considered normal, harmless or inevitable.

Whilst primary snoring itself may not present a direct, short-term health risk to you, if you share a bed, the disturbance and sleep deprivation for your partner can have health implications for them.

There is also evidence to suggest that primary snoring is a slippery slope towards OSA and other conditions.

Obviously, the factors that put you at risk of sleep apnea (weight, sleeping position, sex, anatomy) also predispose snoring. But now, scientists are now discovering that the very action of snoring itself can increase the risk of developing sleep apnea.

One recent study found that primary snoring is linked to nerve damage in the muscles of the upper airway. This results in swallowing difficulties for snorers and makes obstruction more likely [2].

Conclusion

Primary snoring and obstructive sleep apnea can often get confused and incorrectly used interchangeably. Not all snorers have obstructive sleep apnea, but almost all OSA sufferers snore.

Whilst primary snoring is not directly harmful in the short term, it can be a slippery slope to future OSA.

It is important to understand your sleep apnea risk and to identify the factors that are making you snore.

Do Nasal Sprays Work for Snoring?

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Science, Solutions

Do Nasal Sprays Work for Snoring?

Nasal sprays can be effective for snoring if you get the right type.

Snoring is often the result of a blocked or stuffy nose. Unblocking your nose can drastically reduce snoring, and a popular method is to use a nasal spray.

Not all nasal sprays are the same, and it’s important to match the appropriate type of nasal spray to your cause of nasal blockage.

 

Various causes of a blocked nose that can lead to snoring

Read more

 

In this guide, we’ll go through the different types of nasal spray available to give you the best chance of finding one that works for you.

Jump to the main types of nasal spray for snorers:

What’s blocking your nose and why does it make you snore?

If you breathe through a partially blocked nose, suction forces are created that can cause your throat to collapse and make your uvula and soft palate vibrate [1].

When your nose is fully blocked, you’ll start breathing through your mouth when you sleep – a common cause of snoring.

 

Why open mouth breathing is a leading cause of snoring

Find out

 

There are lots of causes of a stuffy nose, from colds and infections, hay fever and dust allergies to chronic nasal inflammation and non-allergic rhinitis. One type of nasal spray won’t cure all types of nasal blockage, so it’s important to know which one is which …

Different types of nasal spray

Side note: what does “topical” mean?

You will often see nasal sprays referred to as “topical”. This refers to the route of administration. Topical simply means that the drug is applied directly to the site it aims to treat, in this instance, the nose. This is the opposite to systemic administration, where the drug is usually swallowed or injected.

1. Antihistamine nasal sprays

In short, these are ideal for treating nasal blockage that arises due to allergy.

If your snoring is worse in the spring and summer when pollen spores cause hay fever, or if you’ve noticed dust in the home makes you stuffy and snore, then antihistamine sprays could work for you.

An allergy is when your body elicits an immune response – an infection-fighting tactic – to something non-infectious.

Histamine is a chemical inside the body that is released in high quantities in this immune response. Histamine and other chemicals rush to the site where allergens are detected (usually the nose and throat as this is the primary point of entry if breathing them in) and then bind to specific receptors to cause inflammation.

Antihistamines help to relieve your stuffy nose by reducing this inflammation via stopping histamine binding to other cells.

Summary: good for allergy sufferers, treats inflammation and runny nose, use when symptoms worsen.

Examples: azelastine, olopatadine

2. Steroid nasal sprays

Like antihistamines, these work by reducing inflammation. They can be suitable for treating allergies and non-allergic rhinitis or nasal polyps. Steroid nasal sprays are commonly prescribed to treat problematic snoring but can also be bought over-the-counter.


Side note – what is rhinitis?

Rhinitis simply means swelling in the nose. It is not a disease, but a term used to describe nasal symptoms including swelling, difficulty breathing and excess mucus. There are two categories of rhinitis:

  • Allergic rhinitis. This is an umbrella term for conditions like hay fever or nasal swelling experienced in response to other allergens.
  • Non-allergic rhinitis. This describes nasal symptoms caused by environmental factors including pollution and weather, infection and hormonal imbalance. This will sometimes be referred to as vasomotor rhinitis or idiopathic rhinitis. The cause is often vague.

The steroids in these nasal sprays are not to be confused with anabolic steroids used to build body mass. Nasal spray steroids are copies of naturally occurring hormones produced by glands above the kidneys.

Steroid nasal sprays reduce inflammation via several different mechanisms [2]. This includes stopping the function of a key enzyme which helps produce inflammatory chemicals in the body [3].

If prescribed steroid nasal sprays, remember that they are unlikely to provide instant relief and usually work after a few initial uses. If your nasal problems are chronic, you should use the spray regularly even if your symptoms improve.

Steroid nasal sprays don’t tend to produce any serious side effects and can be used by most people.

Summary: good general nasal spray for a variety of conditions, especially for people with chronic nasal inflammation, can be used long-term

Examples: mometasone, fluticasone, beclometasone

3. Anticholinergic nasal sprays

This type of nasal spray is best to treat a runny nose. They reduce the amount of mucus that your nose produces and are suitable for a variety of causes of nasal blockage from allergic to non-allergic.

Unlike antihistamines and steroid spray, anticholinergic sprays will not relieve the inflammation and congestion. The side effect profile is typically mild.

Anticholinergic sprays work by blocking receptors which ordinarily lead to activation of nasal mucus glands and hence mucus production [4].

Summary: good for snorers with a runny nose

Example: ipratropium bromide

4. Decongestant nasal sprays

Congestion in the nose is caused by dilation (expansion) of blood vessels, reducing the space for air to flow freely. Decongestant nasal sprays work by constricting these blood vessels to widen your nasal passages.

Decongestants can be very effective in relieving a blocked nose in the short term, and most can be bought over-the-counter. However they are not suitable for everybody. Children, pregnant or breastfeeding women and people with high blood pressure shouldn’t use decongestant nasal sprays (this is because constricting blood vessels further increases blood pressure).

Decongestants are suitable for short-term use: a few times a day for no longer than a week. This is because overuse of decongestants can cause rebound congestion where the spray starts to have the opposite effect and cause nasal stuffiness.

Summary: good for nasal blockage caused by short-lived problems like a cold, should only be used short-term to avoid rebound congestion

Example: pseudoephedrine

5. Mast cell inhibitors

This type of nasal spray is suitable for those who suffer from seasonal allergies and can predict when their symptoms will arise. Because mast cell inhibitors are preventative, they need to be used a couple of weeks before the onset of symptoms.

These sprays work in a similar fashion to antihistamines in that they stop mast cells (a type of immune cell) from breaking down and releasing inflammation-causing histamine.

Summary: suitable to long-term sufferers of hay fever who can time the onset of their symptoms

Example: cromolyn

6. Saline nasal sprays

Saline nasal sprays are non-medicated. Instead, they are a mixture of water and salt (sodium chloride) which moisturize your nasal passages to soothe inflammation and can also break down excess mucus.

This type of spray works in a very similar way to using a neti-pot, the only difference is the mode of delivery. Because saline nasal sprays are non-medicated (though do read the label, some are “combination” sprays containing some medication), they can be used by nearly everyone, including children.

Saline nasal sprays can also be used to make other snoring remedies work better. Steroid sprays don’t work well if there is a lot of mucus present. Using a saline spray first can help break up excess mucus, allowing medicated sprays to work more effectively. Saline sprays can also help to moisten your airways before using CPAP.

Summary: suitable for all and useful for soothing chronic nasal inflammation and clearing excess mucus, can be used as an adjunct to other remedies

Lesser-Known Snoring Triggers

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Causes, Science

Lesser-Known Snoring Causes

Snoring is often the result of a combination of factors. When trying to find your snoring triggers, it’s important to make note of anything that’s making your snoring worse.

However, there are things that you may not realise play a role in your snoring. Here, we explore the lesser-known factors that can make snoring worse.

Anatomy

Many snorers are victims of their anatomy. Humans are already predisposed to snoring due to some of the features that allow us to speak and stand upright. There are also some key anatomical qualities that make certain people more likely to snore than others …

Deviated septum

Sometimes inherited, sometimes caused by facial trauma, a deviated septum can cause problems with nasal breathing which brings on snoring.

This is where the cartilage that separates the cavities of the nose becomes bent out of shape, making one cavity smaller than the other.

Our noses go through a natural cycle, switching preference for a nostril to breathe through (to give the other one a rest). People with a deviated septum will often notice their nasal breathing difficulties coming and going throughout the day or more importantly – the night.

When breathing through the smaller side, airflow is disturbed and snoring ensues.

Septal deviation can often be corrected with a straightforward surgical procedure called a septoplasty.

Recessed jaw/overbite

Snoring can happen if your tongue falls back and blocks your airway. People with a small and recessed lower jaw are at greater risk of tongue snoring as they have less space in that part of their airway.

Mandibular advancement devices are popular anti-snoring products; these work by moving the jaw forward to prevent the tongue falling back. Unfortunately, these devices are often unsuitable for people with a pronounced overbite as they can cause them jaw pain.

Small nostrils

The nose is the body’s preferred breathing route. Having a stuffy nose or small nostrils can make nasal breathing turbulent or impossible. If impossible, you’ll have to mouth-breathe – a common cause of snoring. Even if you breathe through your nose but with some difficulty, extra suction forces are created which act upon your airway to make you snore.

Enlarged uvula, soft palate and tonsils

Your snoring risk increases dramatically if the actual “noise-makers” are larger than normal. The soft palate plus the connected uvula and tonsils (the soft part behind your palate at the top of your mouth and the tissue dangling from it) are often responsible for the snoring sound. Simply put, if there is more tissue, it is more likely to vibrate and make noise, especially seeing as more tissue narrows the airway.

Often, the solution for snoring caused by your anatomy is surgery. Whilst this can work for many people, it is not always possible or effective in the long term.

Large evening meal

Snoring is linked to your diet. However, it’s not just what you eat but also when you eat. We have heard from many of our users that reducing or even skipping their evening meal can drastically reduce their snoring.

It is thought that having full belly can exert pressure on your chest and negatively affect your breathing. This is because your lungs and diaphragm share space with your stomach and small intestine. When your stomach is very full, your diaphragm has less room to expand and contract.

This explains the shortness of breath people often feel after a particularly heavy meal. If shortness of breath lingers until bedtime, the strained breathing can worsen snoring.

A big meal too close to bedtime can also produce acid reflux, another factor that can make snoring worse.

 

SnoreLab’s Four-Hour-Fast

Try

Smoking

Smokers and even passive smokers are more at risk of snoring and experiencing sleep disordered breathing [1][2]. Some studies have found that smokers are 2.5 times more likely to suffer from obstructive sleep apnea [3].

Smoking contributes to greater inflammation and irritation in the upper airway. This causes a swelling of the tissues which vibrate and make noise [4].

In addition to this, smokers experience a wealth of breathing difficulties including shortness of breath, reflux, dry throat, excess mucus production and nasal congestion – all of which are linked to snoring [5].

Dehydration

Being dehydrated, in addition to disrupting sleep, can also aggravate your snoring. Dehydration causes the mucus that lines your airways to become thicker than normal. This makes the opposing surfaces of your airway more likely to stick together and cause a noisy obstruction [6].

Climate

Via the same mechanisms as dehydration, living in a warm, dry environment can worsen snoring. Whilst it may not fix the snoring entirely, using a humidifier can really help.

Confusingly, for others, humid environments and changes in weather can also intensify snoring. This is often true if snoring is caused by chronic nasal conditions where inflammation responds to changes in atmospheric pressure. Indeed, many snorers report louder snoring when a weather front is moving in!

Atmospheric pressure has even been seen to influence sleep disordered breathing, with lower pressures producing slightly increased obstructive apnea episodes [7].

Alcohol

Drinking alcohol causes your muscles to relax – even more than they do normally when you fall asleep. This increases the collapsibility of your airway and heightened resistance to incoming air which can aggravate snoring.

As well as helping your muscles relax, alcohol also dehydrates. This causes the mucus in your airway to become stickier.

Sedatives

These work in a similar way to alcohol in that they are depressants, helping your muscles relax which can produce snoring.

Sedatives are substances that have a calming or sleep-inducing effect and come in various guises. “Sedatives” doesn’t just refer to sleeping pills, other medications (such as for those for allergies) can have a sedating effect, as can some natural sedatives.

Excessive use of decongestant nasal sprays

Nasal sprays are a popular snoring remedy for people who snore due to a stuffy nose. There are various types and each work differently.

One type – decongestant sprays – work by constricting the blood vessels in the nose thus helping to expand the airway. If decongestant sprays are overused a “rebound effect” can occur where your nose becomes more stuffy. This is because of adaptations that occur in the nose in response to the spray [8].

What is Snoring? – An Introduction

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Causes, Science

What is Snoring? – An Introduction

Partial airway obstruction causes soft tissue to vibrate and make noise.

Nearly everyone snores at some point. Snoring can affect young and old, men and women, and people of all shapes and sizes. Roughly 40% of men and 20% of women snore – that’s over 2 billion inhabitants of planet Earth.

This habit is often shrugged off as annoying and embarrassing but otherwise nothing to be worried about. In reality, snoring can affect so much of life, having physical, mental and social repercussions.

But what is a snore?

Q. What is a snoring sound?

A. Vibrating soft tissue

Snoring is the sound of the soft palate and other soft tissue in the upper airway vibrating. This can include the uvula, tonsils, adenoids, nasal turbinates and other surrounding tissue.

These vibrations happen when air can’t move freely through your airway which causes the floppy soft tissue to flap and make noise.

Q. Why does snoring only happen during sleep?

A. Relaxation

When we fall asleep, many muscles in our body relax. This is true of the muscles in our airway.

Being still in our sleep prevents us from doing damage to ourselves and others by acting out our dreams or walking around when not fully conscious. Therefore our muscles – including those in our upper airway – are paralysed when we sleep.

Because we are lying down while we sleep, gravity compounds this relaxation to set up snoring – whether it’s your jaw falling open, your tongue falling back or your throat giving way to the weight around it.

All of us relax when we sleep – so why doesn’t everyone snore? Snoring occurs when this normal relaxation is added to abnormal airway obstruction.

Q. Why doesn’t air flow freely?

A. Obstruction at various places in the airway

Airflow becomes turbulent when there is an obstruction in the airway causing a partial blockage.

The obstruction can be in several areas in the upper airway, sometimes concurrently [1]:

Tongue. When this falls back, it can block your airway.

Soft palate. This is the soft tissue behind the harder roof of your mouth. Excess floppy tissue here stops air flowing freely.

Nose. The nose is the more efficient way of breathing, and when dysfunctional, mouth breathing ensues and heightens the risk of snoring. Breathing through a partially blocked nose can also create whistling and popping sounds, or even cause suction that collapses your airway.

Knowing your obstruction is the starting point in identifying what causes your snoring.

If you are lucky, there is one cause for your snoring. You can tackle this and sleep quietly. More often than not, multiple factors accumulate to cause your obstruction.

Q. What causes airway obstruction?

A. Many different factors can influence snoring

Understanding what causes your airway obstruction is vital for matching snoring solutions to you. This is what we strive to help with at SnoreLab.

The reasons for snoring are made of lifestyle factors that you can control PLUS physical traits that are beyond your influence.

Factors that you CAN control

Many lifestyle factors need scrutinising if you want to identify the causes of your snoring:

Bodyweight. The heavier you are, the more likely you are to snore as excess weight compresses your airway.

Sleeping position. Sleeping on your back is a big risk factor for snoring. This position allows gravity to compress your airway more than when you sleep on your side.

Allergies. Allergic reactions cause nasal blockage and airway inflammation. Allergy sufferers have trouble breathing through their nose and therefore have to switch to noisier mouth-breathing.

Alcohol. Depressant drugs like alcohol make muscles relax. Relaxed airway muscles are more prone to disrupting airflow.

Smoking. Cigarette smoke irritates the airways, causing inflammation which can lead to obstruction.

Common cold. Similar to allergies, colds mean stuffy noses and mouth-breathing.

Medication. Certain drugs used to control blood pressure, sleeping pills and even some medicated nasal sprays can increase nasal congestion and relax airway muscles.

Factors that you CAN’T control

Unfortunately, in some cases, the obstruction is simply a part of your anatomy and genes.

Certain face shapes predispose people to snoring. For example, those with a pronounced overbite have a recessed jaw which pushes the tongue further back into the airway, making it more prone to falling back and causing a blockage.

Age. Older people are more at risk of snoring. This is because as we age we lose muscle tone in much of our body – this includes the muscles of the airway.

Sex. Men are more likely to snore than women. This is due to several reasons including how fat is differently distributed, contrasts in male and female airway anatomy and hormones.

Hormonal balance. Some hormones are protective against snoring, whereas others confer heightened risk. Menopause is a time in many women’s lives where snoring starts for the first time. This is because of a decrease in hormones that help to prevent snoring.

Thankfully, these uncontrollable elements are usually associated with heightened risk but not a direct cause.

Conclusion

By understanding the basis of snoring you can gain better insight into what makes you snore. Just as snoring impacts upon your life, your lifestyle impacts upon your snoring.

There are many snoring remedies and solutions available, including products that enthusiastically tell you that this will stop you snoring. Many of them do work very effectively, but only if they are well matched to you and your snoring.

Understanding how your snoring works and finding your specific causes is the first step towards healthier, quieter nights.

Do Snore Alarms Work?

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Science, Using SnoreLab

Snore Alarms, Do They Work?

At SnoreLab, we frequently get asked “Can you create a snore alarm feature?” The answer is, yes, we could; it is a feature we are assessing the feasibility of. But introducing a snore alarm raises some more important questions for us and particularly you, the user:

  • Are snore alarms an effective solution in the long term?
  • Does behavioural conditioning work for snoring?
  • Does a snore alarm treat the root cause or is it just a quick fix?
  • Will most users find the snore alarm too annoying to stick to?

Put simply: do snore alarms work? Let’s discuss …

How is a snore alarm supposed to work?

The basis of a snore alarm is to introduce something unpleasant which makes you change your behaviour. This is a great example of negative reinforcement (or operant Skinnerian conditioning if you are into psychology).

Psychologist B.F. Skinner put a rat in a box which had a mild electric charge running through it. This rat ran around frantically until it found a lever that switched off the electricity, relieving it of its discomfort [1].

Using this example, you are the rat and the snore alarm is the electricity; the only way you can stop this unpleasantness is to press the lever, i.e. stop snoring.

This is where the model breaks down.

Pressing a lever is controllable and voluntary. But is stopping snoring a voluntary action?

Is snoring voluntary and can it be “learned” away?

Snoring is often described as a habit [2]. Using this reasoning, habits are behaviours, behaviours are learned and can be changed, therefore are voluntary. Or is it not that straightforward when it comes to snoring?

Snoring is the result of involuntary soft tissue relaxation which can be exacerbated by voluntary lifestyle choices.

Our awake habits: diet, exercise, alcohol, smoking and general health heavily influence our sleeping “habit” of snoring.

Put simply, snoring is the symptom, not the cause. We don’t snore because we feel like doing so, but snore as a consequence of some other things that we can control.

The best way to remedy something is to treat the root cause, something which in general, snore alarms don’t do.

Snore alarms treat the symptom, not the cause, and could be ruining your sleep

One thing is certain, snore alarms do stop snoring – indeed, at that very instant. Unfortunately, this is probably because they stop sleep too.

Over the years, a number of gadgets and devices have been created that give you an unpleasant prompt, and at that moment, they do stop your snoring [3].

But this is because it disrupts your sleep so much that you stay in lighter sleep, or are even prevented from sleeping altogether. Being awake is the best remedy for snoring!

When considering using a snore alarm, remember why you want to stop snoring in the first place. Presumably, it is so you and your partner can achieve better, healthier sleep. Are frequent awakenings really the best way to go about this?

There is very limited evidence for snore alarms

Trawling through the science of snoring prevention, we found only one article – written in 1983 with a tiny sample size of 3 people (!) – which reported that snorers had successfully “learned” to stop snoring after being exposed to a snoring alarm.

These snorers were subjected to 7 nights of beeps that sounded when they snored. This would only cease once they flicked a switch. On the eighth night with no alarm, their snoring was less compared to before the alarm therapy [4].

The fact that this is the only evidence (not successfully replicated in the 36 years since) and that a sample size of 3 is hardly scientifically robust, makes us seriously doubt the feasibility of treating snoring with an alarm.

A history of snore alarms

Over the last 50 or years, there have been a number of devices that never made it to the anti-snoring market that were designed to listen to snoring and alert their user.

Initially, multiple inventors aimed to condition people by:

“imparting an electric shock to a sleeper when he snores of sufficient magnitude to awaken him, and ultimately, to condition the sleeper against snoring”.

Needless to say, the idea didn’t catch on and rest assured, shock collars is not something we are considering at SnoreLab.

An “Electronic Snore Depressor” from 1967 – one of many designs that, quite rightly, hasn’t stood the test of time

 

Another patent described itself as an “instructional device for snorers”.

This gadget, designed in 1970, used a microphone to listen for snoring much like SnoreLab does. It then used the snoring sounds to trigger a pre-recorded message which would play through an earpiece connected to the central receiver (something along the lines of “Oi you, stop that snoring now”).

The expression on this snorer’s face tells you all you need to know about how it felt to sleep with this device from 1970!

 

This struggled to gain traction as users became tangled in the wiring when turning over in their sleep. Though sleep therein was presumably not forthcoming after having disturbing messages played in their ear.

Improvements were made by other inventors in 1983 – realising that repeatedly waking the user wasn’t the best idea – with the creation of a wireless version that would “produce an irritating sound, enough to stimulate but not wake”. Products based on the same concept exist today.

Other inventors went a step further and intentionally woke snorers with convoluted behavioural conditioning systems. This required snorers to actively shut off an unpleasant alarm – a choice of “intense beams of light projected at the sleeper’s head”, a pillow buzzer, a vibration, an electric shock or all of the above.

Once the snorer had successfully shut off the aversive stimulus, positive reinforcement would ensue and an M&M was dispensed via the “reward chute”!

Electric shocks, flashing lights and M&Ms – the anti-snoring revolution/torture of 1975

 

Never has the line between snoring human and lab rat been so blurred as with this bizarre blend of negative and positive reinforcement.

We challenge any snorer to put up with this for more than one night!

Snore alarms available today

Snore alarms still exist, and there is a demand for them. And though they are very rarely recommended as a first line anti-snoring solution, some people swear by them.

Still flying the flag for negative reinforcement is Snoree (though upon last check, the product wasn’t available), a Polish company who manufacture a buzzer which sounds when snoring is detected.

Being hidden in the dusty corners of the internet with a dearth of customer reviews suggests that not many people find this device particularly useful.

At SnoreLab, we even experimented on ourselves, triggering a flashing light when snoring was detected. This simply gave us horrible nightmares before waking us up in a state of utter confusion!

Sound and light always have the unfortunate side effect of waking up a non-snoring partner too. So nowadays, most snore alarms work via vibration.

Vibrating anti-snore trainers can be found easily on Amazon and elsewhere online. Rarely do they get good reviews; when they do, it comes with an admission that sleep is seriously disrupted:

“It does what it claims by stopping your snoring, but this can mean a very disturbed night for the wearer.”

Recent valiant attempts were made by some sleep monitoring apps using a connection to a smart watch. This would vibrate when the app detected snoring. It was much anticipated but ran for only two months before being hastily removed.

Its demise may have been well received by some:

“I had to remove the watch in the middle of the night so I could finally get some sleep. The darn thing woke me up all night. I slept for two minutes at a time all night, because as soon as you enter deep sleep, you start snoring and the app kicks in and wakes you up. Thanks, but no thanks.”

However, many users were sad to see the feature go and swore it made a difference:

“What happened to the snore alarm? My husband was finally able to return to the marital bed because this mode would gently nudge him to roll over when he snored.”

This last line, “gently nudge him to roll over when he snored” is crucial. Here, the alarm wasn’t simply teaching him not to snore. It was treating the cause – sleeping position. This is when snore alarms CAN work.

When snore alarms CAN work

We don’t really think you can just learn to stop snoring. The evidence simply isn’t there. That is, unless you can learn to change the habit that makes you snore in the first place.

Snore alarms can be useful if they, like in the aforementioned review, force you into making a change that influences your snoring, such as to your sleeping position.

Positional Trainers

Positional trainers are atypical snore alarms in that they don’t react to your snoring per se. Instead, as the name suggests, they react to your sleeping position.

These small devices attach to your body (usually the chest) and vibrate when they detect that you are sleeping on your back. This does create a subconscious prompt for you to roll onto your side, and in time, you do it naturally.

 

The importance of sleep position for snorers

Read more

The evidence for their effectiveness is growing, showing promising results for mild obstructive sleep apnea with results even comparable to anti-snoring mouthpieces [5].

There are a few available, but often not to the consumer. Positional trainers are usually prescribed for mild-moderate sleep apnea cases; obtaining one without a prescription can be very expensive.

Snooor is the new kid on the block, available as a consumer remedy at a very affordable price point.

Smart Nora

Another interesting snore alarm concept has been championed by Smart Nora, which listens for snoring and moves your head.

Moving the head when snoring is detected isn’t a new idea. An inventor in 1963 came up with a system of microphones and plungers to shake and jolt a snorer’s head to wake them up.

A head-moving snore detector from 1963. Thankfully, Smart Nora – a modern lookalike – doesn’t aim to wake you up like this device does

Thankfully, Smart Nora go for a subtler, gentler approach. Instead of intending to punish and wake the snorer to get them to “learn” to stop snoring, Smart Nora reacts to snoring by addressing its fundamental feature – a relaxed airway.

When Smart Nora’s “pebble” unit detects snoring, it wirelessly sends information to the pump which inflates the expander under your pillow. This gently moves your head which brings back some much-needed muscular tone to your airways to nip snoring in the bud.

 

Smart Nora system

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Conclusion

Given the history and the evidence, we don’t think that snore alarms are the best way to address your snoring problems.

The wisdom of yesteryear dictated that you can simply learn to stop snoring through behavioural conditioning. This is only true if the cause of your snoring is something in your behaviour – and importantly, something that can be instantly modified to good effect, i.e. sleeping position.

Here, snore alarms can be extremely useful, the automated equivalent of a nudge in the ribs from a bed partner to get you to turn over. This is why we haven’t ruled out a SnoreLab snore alarm yet.

However, in the vast majority of correspondence we’ve had with our users relating to their snoring, SnoreLab users don’t sleep on their back. In these cases, an alarm cannot address the underlying physiology that makes you snore.

An alarm cannot train your allergies away or correct a deviated septum, it can’t make you lose weight or hold your tongue base out of your airway.

At SnoreLab, our aim has always been to treat the cause, not the snoring symptom, by giving you the insight into your triggers to better understand what the solutions may be.

This article is an opinion piece, something we have given careful consideration based on the evidence we have seen. Do you disagree? Have you used a snoring alarm to good effect? We’d love to hear from you. Please contact us on Twitter, Facebook or via our support inbox on support@snorelab.com

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