Category: Science

6 Common Myths About Sleep Apnea

Posted on by admin

Science, Sleep Apnea

6 Common Myths About Sleep Apnea

1. All loud snorers have sleep apnea

Most snorers don’t have sleep apnea. But most people with sleep apnea snore.

There is a positive correlation between snoring intensity and the severity of obstructive sleep apnea; that is, the louder you snore, the more likely you are to suffer from sleep apnea [1]. However, this does not mean that if you snore loudly you definitely have sleep apnea.

An apnea episode is defined by a period of no sound whatsoever. This is the part where your breathing has stopped. Therefore, sound profile alone is not a good predictor of sleep apnea and its severity.

 

SnoreLab’s insights into screening for, diagnosing and treating obstructive sleep apnea.

Read

2. Everyone with sleep apnea snores

This is less of a myth, and more of an almost-truth: up to 95% of people with obstructive sleep apnea snore [2]. It is rare to find someone with obstructive sleep apnea who doesn’t snore, though it does happen [3].

Importantly, you needn’t be a loud snorer to suffer from sleep apnea. Remember that an apnea episode is often characterised by a lengthy period of silence. You could still be suffering from sleep apnea even if your Snore Score is low.

This SnoreLab user has found an apnea episode (notice the long period of silence). However look at the chart – they are not a loud snorer!

 

 

However, central sleep apnea is not commonly associated with snoring.

Central sleep apnea is caused by the brain’s failure to regulate proper breathing during sleep. Here, the blockage is neurological as opposed to in your airway [4].

3. Only men get sleep apnea

Men are more likely to snore and have sleep apnea, but women can still suffer from both. It is estimated that twice as many men than women have sleep apnea [5]. Despite this, eight times more men are diagnosed with the condition.

The incorrect assumption of yesteryear was that for every sixty men who had sleep apnea, only one woman did. This false statistic came from a combination of heightened social stigma associated with female snorers and the fact that sleep apnea presents differently in women.

Sleep apnea’s severity is measured by counting the number of times breathing stops or is severely reduced during sleep. Women are less likely to experience complete airway collapse therefore tend to have a lower AHI score.

However, it is important to note that women aren’t necessarily experiencing less obstruction. Instead, they show more frequent episodes of longer, partial obstruction that can still cause the fatigue, daytime sleepiness and other health issues associated with sleep apnea [6].

 

Still, in a battle of the sexes, when it comes to snoring, men come out on top. SnoreLab’s article on the snoring differences between men and women.

Read.

4. I’m not overweight so I won’t get sleep apnea

Indeed, obesity is one of the strongest risk factors for developing sleep apnea, where 41% of people with a BMI over 28 have the condition [7]. However, because there are other risk factors associated with sleep apnea, you don’t have to be overweight to suffer from it.

Sleep apnea can also be caused by your genetics; whether that be a family history of sleep apnea or the shape of your airway. Chronic nasal congestion, drinking alcohol or taking sleeping pills, and even simply entering the menopause all confer an increased risk of developing sleep apnea.

5. Children don’t get sleep apnea

Despite snoring and sleep apnea commonly being associated with older people, studies have found that up to 4% of children experience sleep apnea, with some 12% of parents reporting that their child frequently snores [8].

Similar to the profile of adults with sleep apnea, overweight children and boys are more likely to develop the condition.

An increasing amount of research suggests that 25% of attention deficit disorder cases are linked to sleep fragmentation associated with sleep apnea [9].

Childhood obstructive sleep apnea is often due to the adenoids – glands in the back of the throat that disappear in adulthood, thankfully along with the apneas. Surgical removal of both the adenoids and tonsils often resolves childhood sleep apnea.

 

More about snoring’s link with age

Read

6. I’d know if my breathing stopped in the middle of the night

Not being able to breathe is an uncomfortable experience, so you’d think you’d remember it. Plus, the pauses in breathing that characterize sleep apnea are only relieved when your body kicks into action to open your airway, briefly waking you up. This awakening however, is below the threshold of conscious recognition; commonly referred to as a microarousal.

In some very severe cases of sleep apnea, patients have as many as one-hundred breathing pauses per hour, some as long as thirty seconds at a time. Yet they perceive a night of constant sleep and wonder why they feel so tired in the morning. Susan, a SnoreLab user thought that she may have mild sleep apnea at worst, her sleep study results showed she in fact had very severe sleep apnea. You can read Susan’s story here.

Whilst you are unlikely to identify your own apnea episodes, a partner can definitely be disturbed by them. If you are concerned about potential sleep apnea, ask your partner if they’ve ever heard your breathing stop in the middle of the night.

This question is often asked in sleep apnea screening questionnaires which you can do here.

Why Good Sleep is Important

Posted on by admin

Science, Sleep

Why Good Sleep is Important

The partner of a chronic snorer loses over an hour of sleep every night [1]. Good sleep can be hard to come by for all parties in a bedroom polluted with snoring, particularly if snoring transitions to sleep apnea.

But why does this matter?

Sleep can seem like a real waste of one third of your life; time spent doing apparently nothing when there’s so much else you could be doing. A lack of sleep however, spells a shortened life and one where your waking hours are severely blunted.

By staying awake and spurning sleep, more time is lost than is gained. We must accept that sleep is vital for health and survival.

Good sleep is healthy

Sleep seems to be a pretty inactive period. On the surface, our sincere lack of movement or responsiveness would indicate that our body is dormant. This isn’t so. It’s very active, just in a different way. During sleep, our bodies and brains are busily repairing, refreshing and rewiring.

If sleep were a miracle drug, everyone would pay a fortune for it as the list of benefits are nothing short of astounding. Sleep:

  • Reduces your risk of chronic physical, neurological and mental disorders
  • Enhances your defenses to infection
  • Diminishes food cravings helping to regulate weight
  • Forms new memories

Good sleep can even make you look better. Cortisol – a stress hormone – increases when we lose sleep and in turn decreases the production of collagen, a protein that gives your skin smoothness.

A study in Sweden asked volunteers to rate the attractiveness of people who had 8 hours sleep against those who had experienced 31 hours sleep deprivation. The sleep deprived people were perceived as less healthy and less attractive [2].

Bad sleep is damaging

The inverse of the advantages of good sleep is the damage that can be done with sleep deprivation. Indeed, multiple studies have shown that getting less than six hours of sleep per night significantly increases the likelihood of an early death [3].

In the short-term, the mental impairment from moderate sleep deprivation equates to the effects mild alcohol intoxication [4]. Extreme sleep deprivation has even been shown to cause hallucinations.

Over a longer period, chronic sleep debt can do irreversible damage to the brain and rest of the body. Importantly, this increases the likelihood of a host of maladies:

  • Stroke
  • Anxiety and depression
  • Dementia
  • Weight gain
  • Heart disease
  • Reduced immunity
  • Cancer

Conclusion

Poor sleep is the underdog of public health. Problems like obesity, cancer and dementia are far more prominent in the public consciousness than problematic sleep is. If you consider that bad sleep has a hand in all of these conditions, you’ll appreciate the importance of getting a good night [5].

If snoring is having an impact upon the sleep quality of you or your partner, these nighttime noises definitely need addressing.

Do Men Snore More Than Women?

Posted on by admin

Science

Do Men Snore More Than Women?

Do men snore more than women? The short answer to this question is yes. There are sex differences when it comes to snoring.

Type snoring into a search engine and click on images. What do you see? Nine of the fifteen pictures on my screen showed men with mouths wide open whilst unfortunate women wrenched pillows over their ears to block out the sound. It’s a cliché, but one that is based on some truth.

Twice as many men snore than women, with roughly 40% of men reporting snoring versus 20% of women. That still means that 840 million women are regular snorers. Snoring is certainly not just a male problem, but there are differences. Let’s explore why and how.

Men’s airways are primed for snoring

The reason more men snore is partly down to their airway anatomy. Studies have found that there are crucial differences in the structure of men’s airways.

More soft tissue

Firstly, there’s more tissue in the noise makers themselves. Studies indicate that the male soft palate – a key player in generating snoring sounds – has a larger cross-sectional area. There’s basically more tissue available to flap around and make noise [1].

Male upper airway collapses more

Secondly, men’s upper airways are more prone to obstruction. The vulnerable area between the hard palate and epiglottis is larger in men. This means there is a greater amount of unsupported soft tissue that will relax whilst asleep [2].

Side note:

It is important to note that this has nothing to do with men having deeper voices. Whilst men’s vocal folds are indeed longer, they have more structural support and reside lower than the collapsible area associated with snoring. The area below the roof of your mouth and above the epiglottis is the soft, flappy area we are interested in.

Men gain fat on the neck

Finally, men put weight on the areas that can cause snoring. The chance of your airway collapsing is increased if there is more weight on your neck. An increased neck size and fat around the neck therefore puts you at greater risk of snoring.

We know that obesity is a great risk factor in snoring, but men and women distribute fat differently which influences snoring patterns. Men put on more weight around their neck and chest, whereas women tend to gain fat on their thighs, hips and buttocks.

Snoring is linked to male hormones

Testosterone is the main male sex hormone. Its primary duty is the maintenance and development of reproductive tissue, but it also plays a part in snoring.

Side note: what are hormones?

Hormones are produced in various glands and are the body’s chemical messengers. They travel in the blood and are a means of communication between different areas of the body, regulating the inner workings of cells.

Various studies have looked into the effects of testosterone on breathing during sleep, with a focus on sleep apnea. It has been linked to increased airway collapsibility and greater breathing instability, though the exact mechanism is still uncertain [3].

Indeed, raised testosterone in women is linked to disturbed breathing during sleep. Women with polycystic ovarian syndrome, a condition where testosterone levels are higher than they should be in women, have a greater risk of developing obstructive sleep apnea [4].

Female hormones protect from snoring

Whilst male sex hormones increase the chance of snoring, female sex hormones have a protective effect.

Steady ventilation

Progesterone, a hormone particularly high during pregnancy, promotes steady ventilation. This causes a less pronounced drop in airflow during sleep and makes the soft airway less prone to collapse [5].

Less relaxed tongue

Progesterone, alongside another key female hormone, estrogen, enhances the ability of a key muscle in the tongue to contract, reducing the likelihood of it falling back and causing a blockage [6].

Menopause increases the likelihood of snoring

As female sex hormones decline rapidly at the menopause, the likelihood of developing snoring or sleep apnea increases.

Incidence of snoring increases with age for both sexes, but in women, the onset of the menopause is a watershed moment when it comes to snoring and sleep apnea.

Artificially re-introducing female sex hormones via hormone replacement therapy (HRT) has been shown to reduce the occurrence of sleep apnea [4].

Obstructive Sleep Apnea is different between men and women

Sleep apnea is less common than habitual snoring but the relative proportions of men and women are roughly the same, with twice as many men suffering from the condition as women. However, eight times more men are diagnosed [7].

Some time ago, the sleep apnea ratio of men to women was thought to be as stark as 60:1. We are learning now that this is because of frequent misdiagnosis and the fact that women often exhibit an atypical form of the condition.

The severity of sleep apnea is measured by counting the number of instances where breathing stops (apnea) or is severely reduced (hypopnea). This measurement is called the apnea-hypopnea index (AHI). As women are less likely to experience complete airway collapse, they tend to have a lower AHI score.

Importantly, these women aren’t necessarily experiencing less obstruction. Women display more frequent episodes of longer, partial obstruction that still causes the fatigue, sleepiness and health issues associated with OSA.

Conclusion

With snoring, as with many dysfunctions in the body, there are things that are out of our control. Our sex is obviously the main one. Seeing where you fit into the profile of the 2 billion people worldwide who snore can help you understand your snoring better and be ready to take the next steps.

Sleep Apnea: Screening, Testing and Treatment

Posted on by admin

Science, Sleep Apnea, Solutions

Sleep Apnea: Screening, Testing and Treatment

Sleep apnea is a serious condition where your airway repeatedly closes during sleep, depriving you of oxygen until you gasp awake.

The combined effects of disturbed sleep and repeated bouts of low oxygen cause lots of problems for your physical and mental health. Despite this, many sufferers remain undiagnosed.

But how do you get diagnosed?

There are several steps towards understanding and addressing sleep apnea:

  1. Signs – know how to spot potential sleep apnea.
  2. Questionnaires – answer some questionnaires to assess your risk.
  3. Diagnosis – undergo a sleep study.
  4. Treatment – start treatment appropriate for the severity of your condition.

Signs of sleep apnea

Loud snoring alone does not necessarily mean you have sleep apnea. If you can’t tell where loud snoring ends and sleep apnea begins, ask yourself or your partner if you have any of the following:

  • Very loud snoring, with periodic silence followed by choking/gasping
  • Headaches and a sore throat in the morning
  • Excessive sleepiness in the daytime
  • Lack of concentration
  • Mood swings and changes in behaviour

Side note: Can SnoreLab identify sleep apnea?

This is a question we get asked a lot. Some users have discovered sounds in their recordings that indicate apnea events, and then found them useful in subsequent medical consultations. But, it is important to note that SnoreLab is not a tool for sleep apnea screening. It is our goal to create a system to identify risky periods in your session using the tell-tale sign of silence followed by gasping or choking. That said, once we have created this, it will not be diagnostic. This is because sleep apnea is characterised by more than sound profile alone and requires a sleep study to be properly assessed.

Screening questionnaires

If you are showing the signs of sleep apnea, before getting more in-depth diagnostic tests, it is useful to assess your risk using some screening questionnaires.

Epworth Sleepiness Scale

Feeling excessively sleepy during the day is a key symptom of sleep apnea. Therefore, it is a good idea to measure your fatigue by using the Epworth Sleepiness Scale [1]. This questionnaire gives you a numerical score based on your self-assessed likelihood of falling asleep in certain scenarios. A score of sixteen or higher shows that you are very sleepy during the day.

 

Assess your sleep apnea risk with

the Epworth Sleepiness Scale

STOP-Bang questionnaire

The STOP-Bang questionnaire [2] is the favored screening tool in the medical profession [3]. It is straightforward, highly effective and considers more than tiredness alone. It is a set of eight questions with yes/no answers in a handy acronym, where each letter refers to a sleep apnea risk factor:

  • S – snoring
  • T – tired
  • O – observed breathing cessation during sleep
  • P – pressure, specifically high blood pressure
  • B – body mass index greater than 35
  • A – age
  • N – neck size
  • G – gender

 

Assess your sleep apnea risk with the STOP-Bang questionnaire

the STOP-Bang questionnaire

Berlin questionnaire

Similar to the STOP-Bang questionnaire, the Berlin questionnaire looks at several factors but clusters them into three categories [3]:

  1. Snoring – frequency, volume and observed apnea
  2. Tiredness – fatigue after sleep, tiredness throughout the day, sleeping whilst driving
  3. Cardiovascular fitness – blood pressure and BMI

If for two or more of these categories, you score two or above, you are at high risk of sleep apnea.

Diagnosis – sleep studies

Despite there being some prominent indicators of sleep apnea, getting reliably diagnosed means undergoing a sleep study.

The Apnea-Hypopnea Index (AHI)

It is the purpose of a sleep study is to identify and quantify sleep apnea, giving you a severity score. This score depends on how many times you experience the characteristic low-oxygen events. The apnea-hypopnea index (AHI) is this measurement [4], counting how many times you experience apnea or hypopnea in an hour:

  • Apnea episode – complete airflow blockage for at least ten seconds.
  • Hypopnea episode – at least 50% reduction in airflow for at least ten seconds.

Your AHI score relates to the severity of sleep apnea which is helpful when deciding how to treat it:

  • 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

Polysomnography at a sleep clinic

Because snoring sound alone is not a reliable indicator of sleep apnea, other qualities need measuring too. This is done via a procedure is called polysomnography (poly = many, somnus = sleep, graph = drawing/measurements) and is usually conducted by a trained professional at a sleep clinic.

Sleep might not seem likely once you have been wired up and attached to the various monitors. But by observing eye movements, brain activity, muscle activation, airflow, oxygen levels and heart rate, you can construct a detailed image of what is happening to your body whilst you sleep, and gain insight into your sleep apnea.

 

What happens in a sleep study

Find out more

Home tests

Although they are reliable, polysomnography tests in sleep clinics are impractical and expensive. Further, if you are lucky enough to get a referral for one, you’re likely to be waiting a while. Smaller scale tests done at home are therefore increasing in popularity.

Home testing uses portable devices with fewer parts, but importantly with enough measurements to get a good picture of your sleep apnea. Generally, they consist of:

  • Chest strap – monitors heart rate and chest expansion
  • Finger clamp sensor – uses infra-red to examine blood oxygen through your finger nail
  • Nasal tube – tracks your breathing
  • Audio unit – listens to your snoring patterns

If you are deemed to be at risk of sleep apnea, these kits can be supplied by your doctor. After performing the test at home, you return the kit for the results to be analyzed and a score to be generated.

Read Susan’s story, a SnoreLab user’s account of having a home sleep study to diagnose her severe obstructive sleep apnea.

Treating sleep apnea

The steps you take to improve your sleep apnea depend on the severity of your condition. If you suffer from mild to moderate sleep apnea, the techniques and consumer remedies you use to reduce normal snoring can still be very effective. Similar to so many other health issues, weight loss cannot be recommended enough.

If your condition is at the severe end of the scale, you are likely to be prescribed a device that keeps your airways open at night. This is called CPAP which stands for “continuous positive airway pressure”.

The device consists of a mask you fit over your face and an attached unit that draws in air. By introducing air into your throat and increasing air pressure, the soft parts of your throat are prevented from collapsing and causing obstruction.

With SnoreLab’s insights, you can read about the different types of CPAP mask and solving common issues with CPAP.

Conclusion

If you’re a loud snorer and find yourself feeling sleepy throughout the day, you may be suffering from sleep apnea without even knowing it. Being aware of the signs and using questionnaires is useful to assess your risk, after which it might be a good idea to present to your doctor.

With in-depth sleep studies that can be done at a specialist clinic or at home, you make that important step away from the masses of un-diagnosed people to become someone who understands their condition and knows what to do about it.

Overweight and Snoring: A Vicious Circle

Posted on by admin

Causes, Diet & Lifestyle, Science

Overweight and Snoring: A Vicious Circle

In this guide to bodyweight and snoring, we explore:

Being a snorer and being overweight are interchangeably linked. In other words, obesity can cause snoring and snoring can cause obesity.

Promisingly, weight loss is the most potent remedy for snoring. Dropping a few pounds can drastically reduce both normal snoring and sleep apnea.

 

Weight loss techniques for snorers.

Jump

 

SnoreLab’s SMART strategy for weight loss

Check out

Loud snoring is often a stepping stone towards sleep breathing disorders such as sleep apnea, and the link with bodyweight is clear.

Obesity, defined as a body mass index (BMI) value more than 30kg/m2, is the most significant risk factor for the development of sleep apnea. 70% of patients experiencing sleep apnea are obese, and 40% of obese people experience sleep apnea. The vast majority (95%) of people with obstructive sleep apnea are snorers [1].

How does being overweight make you snore?

Our weight is determined by our daily eating and exercise habits, with a degree of genetic predisposition. Where fat is distributed on our bodies dictates snoring.

Neck fat causes direct compression of the upper airway

Neck fat compresses the upper airway, particularly when lying down, making snoring much more likely.

Many questionnaires that assess your risk of sleep apnea ask your neck size. This isn’t something that many people tend to associate with snoring but it certainly plays a role. A value exceeding 16 inches is a watershed, where your weight is probably a major player in your snoring.

Midriff fat causes indirect compression of the upper airway

Being overweight and snoring isn’t just about neck fat. Central obesity, where fat is found around the midriff and chest, also worsens snoring and sleep apnea.

Belly fat pushes your diaphragm up (a phenomenon mirrored in pregnant women, another sub-group of snorers), and fat on your chest compresses the ribcage. Both of these shrink the volume of your lungs. Lower lung capacity restricts airflow, air that is needed to keep some shape in the throat to prevent collapse.

Men are more likely to snore due to their fat distribution

Distribution of fat differs between the sexes, which goes some way to explaining why more men snore than women. Women usually gain body fat peripherally: on the thighs, hips and buttocks.

Central fat on the neck, chest and abdomen is a pattern far more common in men, making them more likely to snore.

After menopause, fat distribution in women changes, making central weight gain and snoring more likely.

How can snoring make you overweight?

Everyone knows that overeating and under-exercising makes us overweight. What is less well known is that snoring itself can facilitate weight gain.

This is because sleep deprivation caused by snoring or sleep apnea changes our habits and our appetite.

A classic example of this is someone who is tired during the day due to a poor night’s sleep, drinking high-sugar soft drinks to stay alert.

Poor sleep saps our energy. We can’t always catch up on sleep when we like, so instead we fill that energy void with food, particularly foods with plenty of sugar. Here, we think we are hungry but are actually just sleep deprived.

Under-exercising is a symptom of the fatigue and tiredness that come from bad sleep. If you aren’t sleeping properly, how ready for exercise do you really feel?

This is the snoring-obesity cycle.

Snorers and their partners lose sleep, so are less inclined to exercise and more inclined to eat lots of carbohydrate-rich foods. This spells weight gain. More weight means more snoring. More snoring produces worse sleep and more exhaustion, which in turn is mitigated by overeating and under-exercising [2].

 

A perfect storm

No aspect of health is an island. The body is a hugely complex, interlinked network of systems where every action has a host of reactions. Snoring and weight gain work in a vicious cycle but not in isolation; both factors suck in more health problems as the cycle spirals out of control.

Even without being overweight, low oxygen episodes in sleep apnea put strain on the heart and blood vessels. Coupled with obesity, a perfect storm is brewing that can lead to heart troubles, stroke and diabetes amongst many other maladies.

The benefits of weight loss

Now let’s look towards a positive, snoring-free future. Somehow you must break the cycle. When you do, the results are often astounding.

Many studies have looked into the effect of weight loss on disturbed sleep breathing. They have found that many people can half the severity of sleep apnea by losing only 10-15% of their bodyweight [3].

But why stop at 10-15%? Further weight reduction has hugely dramatic effects on sleep and snoring. Another study found that following bariatric surgery (a procedure to reduce the size of the stomach) where there was 60% body fat reduction, apnea episodes stopped entirely in 86% of people [4].

So how do you break the cycle?

Research has shown that people getting poor sleep are far less likely to lose weight. Fatigue and stress from sleep debt makes people disinclined to stick to diet and exercise regimes [5]. So how do you break the cycle?

Ideally, you need a combined approach of effective weight loss techniques, well suited snoring remedies and good sleep hygiene.

1. Weight loss techniques for snorers

There’s no shortage of advice and special diets when it comes to losing weight. It can all be a bit confusing and overwhelming. No single technique works wonders for everyone, and drastic solutions are rarely stuck at for very long. Try a combination of the following, sustainable methods to start you on your way to weight loss:

Front load your diet

This is another way of saying eat more in the morning and less in the evening. Nobody agrees why, but weight loss seems to be enhanced when people have smaller evening meals. At SnoreLab, we’ve heard from many users who say that skipping their evening meal massively helps their snoring.

Low carbohydrate diet

Reducing your carbohydrate intake – that’s sugar and starch – can help you lose weight very quickly. This can be achieved with smart substitutions of ingredients.

Don’t eat too soon before bed

Indigestion can cause reflux and discomfort that disrupts sleep. Eat earlier, get better sleep and feel readier to lose weight. SnoreLab’s Four-Hour Fast could stop your snoring tonight!

Eat little and often

Big meals make you feel sluggish. Feel better and more active by eating smaller portions throughout the day.

Slow down

There is a natural delay in digestion, so we can be physically full before our brain realises we are, causing us to overeat. By taking our time when we eat, not only do we stop sooner, but we also enjoy food more.

 

Read more about these tactics in detail with

SnoreLab’s SMART way to lose weight

2. Snoring remedies well-suited to overweight people

Snoring remedies can be very effective if they are correctly matched to the snorer. Due to the nature of their snoring, there are certain remedies that are better suited to overweight people:

Mouthpieces 

Your mouth falls open when you sleep if neck fat has decreased the muscular tone in your neck. Use a mouthpiece to bring your jaw forward to stop your tongue falling back and causing airway obstruction. Anti-snoring mouthpieces vary greatly, be sure to check out our guide to anti-snoring mouthpieces.

Positional therapy 

This is another way of saying: sleep on your side! The combined effect of being overweight and sleeping on your back can make snoring very bad. There are many ways to change your position, from specialised pillows and vibrating training devices, to simple hacks like attaching a tennis ball to your back.

 

Recommended products to help you sleep on your side

See

Wedge pillow 

If you can’t sleep on your side, slight head elevation with a wedge pillow has shown to be extremely effective in reducing snoring, particularly for overweight people.

CPAP 

This is the remedy of choice for sleep apnea, and can be very effective in reducing snoring and improving sleep.

Mouth exercises

Reducing weight-related snoring needn’t just involve exercising your body, many snorers see massive improvements when performing various mouth and throat exercises.

 

Mouth exercises for snoring

Read more

Remember to use SnoreLab to tag the remedies and factors you use so you can see how they are affecting your snoring. Also make note of how well you have slept each night, and if any changes you’ve made have had an impact.

3. Good sleep hygiene

Set yourself up for a great night’s sleep by practising good sleep hygiene. This isn’t about personal cleanliness (though showering/bathing does indeed help) but is about preparing your mind and body for sleep. Follow these useful tips:

  • Have regular bed times.
  • Aim for seven to eight hours of sleep.
  • Make sure your room is dark.
  • Mentally declutter with gentle activity like reading a book.
  • Avoid alcohol and caffeine.
  • Avoid napping too soon before bedtime.
  • Have a cool bedroom.
  • Take a shower or bath before bed.
  • Don’t force sleep if it isn’t forthcoming.

As well as these tactics, be sure to have a look at SnoreLab’s SMART approach to weight loss and snoring reduction.

Conclusion

If you are overweight and snoring, you may find yourself in a cycle that is difficult to break free from. With effective weight loss techniques, well suited snoring remedies and good sleep hygiene, you can start to lose weight, stop snoring, and gain so much more.

Body Clock: Sleep, Light and Melatonin

Posted on by admin

Science, Sleep

Body Clock: Sleep, Light and Melatonin

Have you ever wondered why you feel sleepy at night and awake in the day? This daily fluctuation is your natural body clock working correctly. Humans are naturally diurnal, meaning that we are meant to be active whilst it’s light, and should go to sleep when it’s dark.

Eyes and the brain

Our eyes don’t work very well in the dark, so it makes sense that we use this time to sleep and recover. Our feelings of sleepiness or wakefulness are dictated by light and what it does to our brains.

When light hits the back of our eyes, a cascade of information zips through the brain, telling a small gland deep in its center to stop the release of an important hormone, melatonin. When light diminishes at night the brakes are taken off. This hormone, sometimes nicknamed “the vampire hormone”, is now released in abundance and sets up our bodies for sleep. Melatonin lowers our blood pressure and body temperature, telling us that now is the time to go to bed [1][2].

Synchronization

Unfortunately, our internal body clock isn’t perfectly matched to the celestial clock of the Earth. Whilst the Earth does a full rotation in twenty-four hours, our body clock exceeds this by about fifteen minutes. Left to its own devices, our brains would switch between nocturnal and diurnal every month [2].

Light and melatonin brings our rhythm back in line with the day/night cycle of our planet. Artificial light can also influence melatonin release which is why SnoreLab uses darker colors.

Jet lag

Now consider long-haul flights, something that nature and evolution didn’t take into consideration. When we travel to a different time-zone, despite changing the clocks on our watches and phones, our body clock takes a bit more time to reset.

With the different patterns of light in far-flung destinations we can slowly coax our clock into synchronizing with our location. In the meantime, we have to put up with the uniquely miserable phenomenon of jet lag.

Let’s imagine we’ve travelled east, it’s 11pm local time but our body is convinced it’s only 4pm. We are not ready for sleep just yet but we try to force the issue, eventually falling asleep at 2am local time. Time to wake up at 7am for an important meeting, but internally, it’s midnight – time to sleep. But now we’ve got to get up and face the day perpetually in a state of groggy under-functionality.

Every day we are in this new environment, the new light pattern we are exposed to brings our rhythm back in line by about an hour. It will therefore take roughly seven days to fully get over this seven-hour difference [3].

Age

Jet lag isn’t the only shift in our internal cycle. Melatonin’s daily pattern changes throughout life. During adolescence, its release is delayed to later in the night which is why teenagers go to sleep and wake later. As we age, melatonin production diminishes, meaning we wake up earlier and generally sleep less [2].

Conclusion

Light, or lack thereof, is vital for good sleep hygiene, and good sleep hygiene keeps exhaustion and snoring at bay. When you set SnoreLab before bed, make sure it’s the last thing you do with your phone at night.

Oropharyngeal Exercises for Snoring – What’s the Evidence?

Posted on by admin

Science

Oropharyngeal Exercises for Snoring – What’s the Evidence?

Introduction

Snoring occurs when the muscles in your upper airway relax, restricting airflow which in turn causes these tissues to vibrate and make sound.

Conventional snoring remedies treat the symptom, not the cause. Whilst they may stop the sound in the short term, they don’t address the root of the problem – weak muscles in the airway.

Increasing volumes of research are highlighting that snorers don’t need to be committed to a snoring remedy that they switch on or wear for the rest of their lives, but rather, they can incorporate inexpensive and effective techniques into their daily lives to stop snoring without artificial assistance.

Using techniques adapted from speech and language therapy, various research groups have employed the use of a set of oropharyngeal exercises which address weaknesses and develop muscular tone in the tongue, soft palate, throat, cheeks and jaw. This is with a view to reducing snoring, decreasing the severity of sleep apnea, mitigating disturbance of bed partners and producing better sleep and quality of life [1].

In this article, we summarise their findings.

Effects of Oropharyngeal Exercises on Patients with Moderate Obstructive Sleep Apnea Syndrome – Guimaraes et al, 2009 [2]

Overview of study

Kátia Guimaraes is a speech and language therapist from Brazil and is one of the first people to propose that oropharyngeal exercises can produce positive outcomes for obstructive sleep apnea [3].

This study uses an exercise regime that has become the basis for many subsequent experiments (though now, usually somewhat redacted). It is the first of its kind, has a robust design and is the most extensive.

Study design

Patients selected for the study met the following criteria:

  • Aged 25-65
  • BMI under 40
  • Previous diagnosis of moderate obstructive sleep apnea (AHI 15-30) via a sleep study

Guimaraes and colleagues designed a randomised-controlled trial. This means that as well as getting some patients to perform the prescribed exercises under scrutiny, another group of patients were given “sham therapy” and nasal irrigation as a control. The sham therapy consisted of simple deep breathing exercises and had to be performed with the same frequency as the study group’s exercises. This is a similar concept to a placebo in a drug trial.

The study group

The study group of sixteen patients were given a set of exercises designed to work out a variety of muscles. These exercises included:

  • Tongue brushing
  • Sliding tip of the tongue back along hard palate
  • Sucking tongue against roof of the mouth
  • Forcing tongue down into the floor of the mouth whilst the tip stays in contact with the lower front teeth
  • Pursing lips
  • Sucking movements with the cheek
  • Using cheek muscles to pull against a finger
  • Elevation of soft palate

These exercises were repeated daily including a once weekly supervised session with a speech pathologist. The duration of the study was three months.

In addition to the exercises themselves, patients also supplemented their therapy with bilateral chewing (using both sides of the mouth to chew) with a focus on correct tongue, teeth and lip positioning.

Patients in both groups underwent a sleep study before starting their treatment and again after the three months. Polysomnography was conducted by professionals blind to the group allocation of the patients.

The patients in both groups also used the Epworth Sleepiness Scale (0-24) and answered questions about perceived snoring frequency and intensity (0-4).

Results

The findings from PSG comparisons before and after are as follows:

  • There were significant decreases in the severity of sleep apnea in the study group.
  • Average AHI in the study group significantly decreased from 22.4 to 13.7 – a 39% reduction.
  • Average AHI in the control group showed a non-significant increase from 22.4 to 25.9.
  • 62.5% of study group patients shifted their severity classification from moderate obstructive sleep apnea to mild or none.
  • The lowest recorded oxygen saturations improved for the study group: 83% at baseline, 85% after 3 months.
  • The lowest recorded oxygen saturations worsened for the control group: 82% at baseline, 80% after 3 months.

In addition to the objective, quantifiable findings from PSG analysis, patients and their partners also answered a series of questionnaires about snoring frequency and intensity, and sleepiness:

  • In the study group, snoring frequency and intensity significantly decreased from 4 to 3 and 3 to 1 respectively (in the control group, there was no change in snoring frequency and intensity).
  • In the study group, the Epworth Sleepiness Scale score significantly decreased from 14±5 to 8±6 (in the control group, there was no change in sleepiness).

Effects of Oropharyngeal Exercises on Snoring – Ieto et al, 2015 [4]

Overview of study

This study looked at the influence of exercises on primary snoring as opposed to obstructive sleep apnea. The subjects were described as being “a population poorly evaluated by the scientific community […] composed of middle-aged and overweight patients who were disturbed by snoring, were on average not sleepy and did not present severe OSA”. In short, unlike much of the research into sleep-disordered breathing, this research assesses the “normal snorers”.

There are fewer exercises in this study than used by Guimaraes et al [2], and the 5 exercises used in this study form the basis of subsequent work. Importantly, this study shows that big workout sessions weren’t necessary to have a positive effect. 3 short sets of exercises every day for 3 months was shown to reduce snoring.

Study design

Patients selected for the study met the following criteria:

  • Aged 33-59
  • BMI under 40
  • Complaints of primary snoring with recent diagnosis confirming such, or of mild-moderate obstructive sleep apnea (AHI 5-30)

Ieto and her team used a control group (20 subjects) as well as a therapy group (19 subjects). Each group was randomly allocated. The study duration was 3 months.

The patients underwent polysomnography at baseline and after the 3 months to objectively measure snoring. This was done by creating a “snore index” which assessed the number of times per hour the patient broke a threshold of 38 db.

Subjects also answered questions on sleepiness using the Epworth Sleepiness Scale and sleep quality using the Pittsburgh Sleep Quality Index before and after the study.

A set of 5 exercises were performed three times a day, each session taking roughly 8 minutes):

  • Push the tip of the tongue against the hard palate and slide backwards – repeat 20 times.
  • Suck the tongue upward against the hard palate and press – repeat 20 times.
  • Force the bottom of the tongue against the floor of the mouth whilst the tip maintains contact with the lower incisors – repeat 20 times.
  • Elevate soft palate and uvula whilst saying “ah” – repeat 20 times.
  • Use cheek muscles to pull against finger – repeat 10 times on each side.

In addition to these exercises, when eating, subjects were told to alternate bilateral chewing and swallowing pushing the tongue into the hard palate.

The control group performed a “sham therapy” of deep-breathing exercises as well as wearing nasal strips during sleep and performing nasal irrigation 3 times per day.

Results

Objectively measured snoring using the snoring index did not change for the control group but showed a significant decrease in the treatment group:

  • Frequency of snoring reduced by 36%
  • Total power of snoring reduced by 59%
  • The objective snoring reduction was corroborated by a significant subjective decrease in the perception of snoring by bed partners.

Whilst not the primary focus of this study, a decrease in average AHI was also observed for the small subset of snorers (8 subjects) recently diagnosed with moderate OSA from an average AHI of 25.4 to 18.1 (a reduction of 29%).

Oropharyngeal exercises in the treatment of obstructive sleep apnoea – Verma et al, 2016 [5]

Overview of study

Another study with its primary focus on obstructive sleep apnea, this study stands out due to the findings beyond snoring, particularly on sleepiness and sleep quality.

The types of exercise in this study are more extensive and require a greater investment of time and effort.

Study design

As a case report, this study has a less robust design as it is missing a control group who don’t receive the intervention under investigation.

20 patients with mild to moderate obstructive sleep apnea (AHI 5-30) were given a rigorous set of oropharyngeal exercises. These exercises were split into 3 grades of difficulty, with patients stepping up a grade for every month of the 3 month study. Each exercise had to be repeated for 10 reps, 5 times per day.

The Epworth Sleepiness Scale, subjective snoring questionnaires and full PSG were performed at baseline and after 3 months.

Results

After the three month trial, the researchers found the following:

  • 85% of patients in the study showed a significant reduction in sleepiness.
  • Patients spent on 1.6 hours in deep sleep, compared to 0.97 at baseline – a 65% increase.
  • The average snoring as measured on the snoring intensity scale (0-4, lowest to highest) decreased significantly from 2.8 to 1.7.
  • Significantly less time was spent at oxygen saturations below 90%.

The effects of oropharyngeal-lingual exercises in patients with primary snoring – Nemati et al, 2015 [6]

Overview of study

Similar to the study conducted by Ieto et al, this study addressed the effect of exercises on primary snoring – not obstructive sleep apnea.

In addition to their explorations of the impact on snoring intensity and frequency, Nemati and colleagues also took the interesting step to look at the psychological and emotional impacts of snoring – assessing the relationship between changes in snoring intensities and conflicts had with roommates.

Study design

Interestingly, all measurements from this study were obtained from roommates of the snorer. 53 snorers were assessed before and after 3 months of soft palate, tongue and facial exercises totalling 30 minutes per day, at least 5 times per week. This was done by asking their roommates to report on the severity their snoring using a sliding scale of 0 (no snoring) to 10 (unbearable snoring).

In part due to the lack of a control group, this study describes itself as “semi-experimental”. That said, a sample size of 53 is good.

Results

Before versus after the exercise intervention:

  • Average snoring severity significantly decreased from 7.01 to 3.09 – a 56% reduction.
  • This reduction in the severity of snoring had a significant relationship the number of conflicts with roommates.

The role of oral myofunctional therapy in managing patients with mild to moderate obstructive sleep apnea – Baz et al, 2012 [7]

This prospective study evaluated the effect of oropharyngeal exercises on 30 patients with mild to moderate obstructive sleep apnea.

The exercises – similar to those outlined by Guimaraes et al [2] – were conducted in twice weekly supervised sessions plus at home for 3-5 times a day for at least 10 minutes at a time.

After the three months of therapy, patients showed some very positive, statistically significant changes:

  • 47% of patients reported not snoring any more.
  • Only 40% (compared to 100% at baseline) reported still experiencing excessive daytime sleepiness. This was reflected on the Epworth Sleepiness Scale with an average decrease from 16.4 to 9.27.
  • Average AHI reduced from 22.27 to 11.53.
  • Time spent at an oxygen saturation below 90% was halved.

Effect of speech therapy as adjunct treatment to continuous positive airway pressure on the quality of life of patients with obstructive sleep apnea – Diaferia et al, 2013 [8]

Speech and language therapy techniques underpin anti-snoring exercises. This study looked at the effectiveness of speech therapy in addition to the more conventional treatment of CPAP for obstructive sleep apnea.

In a nicely robust study design, there were four groups of similar sample sizes:

  • Speech therapy alone (n = 27)
  • Sham therapy alone (n = 24)
  • CPAP alone (n = 27)
  • Combination of CPAP with speech therapy (n = 22).

Speech therapy alone was shown to drastically reduce the average AHI for these patients (28.0 to 13.9). When supplemented with CPAP, the average reduction was even more marked, dropping from 30.4 (just over the “severe” threshold) to 3.4 (below the “mild” threshold).

In terms of sleepiness, speech therapy alone showed comparable results to using CPAP alone. The sham therapy control showed no difference in either sleepiness or AHI.

Other studies

The aforementioned studies have shown that a clearly defined set of exercises, repeated over time can produce very positive outcomes in terms of snoring reduction and reduction of sleep apnea severity amongst other facets like sleep quality and partner disturbance.

We believe this structured approach is ideal for working into your daily routine. However, the evidence extends beyond these sets of exercises.

Research groups have shown that you can work out your snoring muscles via other means. It could even be said that these earlier studies inspired the research into oropharyngeal exercises fo snoring. These techniques combat snoring via the same mechanisms as the prescribed exercises, so their findings are certainly worth a mention.

Can Signing Exercises Reduce Snoring? – Ojay and Ernst, 2000 [9]

Alise Ojay, a choir director, singer, composer and research fellow at the University of Exeter in the UK developed a series of singing exercises for a group of 20 snorers.

The group sung these songs for 20 minutes a day for three months. These songs weren’t the typical tunes you might hum to yourself, but were instead focussed on projecting strong vowel sounds with exaggerated mouth movements.

Ojay’s team saw significant improvements in the snoring of those who consistently sung. More in-depth studies have since confirmed Ojay’s findings, showing improvements in sleepiness, frequency and volume of snoring for a larger group of 93 patients in a recent randomised controlled trial [10].

Ojay continues to advocate singing as a therapy for snoring with her “Singing for Snorers” CDs.

Didgeridoo playing as an alternative treatment for obstructive sleep apnea syndrome – Puhan et al, 2006 [11]

In this small but well-known study, 25 patients with moderate obstructive sleep apnea (AHI 15-30) were randomised to 2 groups. The study group of 14 patients were given didgeridoo lessons for four months and told to practice regularly at home. The remaining 11 were left on a waiting list as a control.

Playing the didgeridoo is hard and requires strong mouth, tongue and throat muscles. A different and fun activity, adherence to the “treatment” was high, patients averaging 5.9 days a week of practice for 25.3 minutes per day.

Compared to the control group, the didgeridoo group showed on average less sleepiness (3 points less on the Epworth Sleepiness Scale), reduced OSA severity (reduced AHI score by 6.2) and disturbed the sleep of partners less.

Conclusion

The studies mentioned are the best examples of using oropharyngeal exercises to combat snoring and sleep apnea, but are non-exhaustive. There have been plenty of other case reports that have produced positive outcomes [1].

The studies in this article used the same time span of three months, and subtly varied the types of exercise and the time spent doing them. Despite this heterogeneity, the results are consistent and can be summarised as follows:

  • Oropharyngeal exercises reduce snoring both objectively and subjectively.
  • Exercises reduce the severity of obstructive sleep apnea, often changing the classification from moderate to mild or even none.
  • Subjective feelings of tiredness significantly reduce after consistently performing these exercises, with some studies objectively measuring greater time spent in deep sleep.
  • Partners report feeling less disturbed and conflicts arising from snoring reduce.

Snoring Glossary

Posted on by admin

Science

Snoring Glossary

AHI – Stands for “Apnea Hypopnea Index” and is the way of measuring the severity of sleep apnea. This is a count of the number of times you experience apneic or hypopneic episodes in one hour. READ MORE

Allergic reaction – This is an immune response to something non-infectious, e.g. pollen or pet dander.

Allergic rhinitis – Nasal inflammation/blockage caused by an allergic reaction.

Anticholinergic nasal spray – A type of nasal spray which blocks the action of the neurotransmitter acetylcholine, which in certain areas of the body can activate nasal mucus glands. This type of spray provides relief from a runny nose. READ MORE

Antihistamine – A type of medication used to block the action of histamine, a prominent chemical released during allergic reactions. Antihistamines usually come in nasal spray or pill form.

Apnea – Literally translates to “no breathing”.

Apneic episode – A period of 10 seconds or more where your breathing stops during sleep. The number of these in an hour helps to generate the AHI. READ MORE

Arousal – Waking up. Frequent arousals are indicative of sleep apnea.

BMI – Stands for “Body Mass Index” and is a measure of healthy body size based on the relationship between your height and weight. It is calculated by dividing your weight in kilograms by your height in metres squared.

BPA-free – Refers to plastics that do not contain the industrial chemical bisphenol A. Whilst not explicitly harmful, it has been shown to bind to certain hormone receptors in the body.

Buccinator – One of the largest muscles in the cheek. Exercising these muscles can help to reduce snoring.

Central sleep apnea – A condition where breathing periodically stops during sleep due to the brain’s faulty regulation of breathing muscles.

CPAP – Stands for “Continuous Positive Airway Pressure” and is the most favoured treatment for moderate to severe sleep apnea. CPAP machines consist of a generator, a hose and a mask which introduces a continuous flow of air into the airways to prevent them from collapsing.

Decongestant nasal spray – A type of nasal spray that constricts the blood vessels in the nose to open the nasal passages. If overused, decongestants can cause rebound congestion. READ MORE

Deviated septum – A condition where the cartilage that separates the two nasal cavities is misaligned. This can make one nostril harder to breathe through than the other. READ MORE

ECG – Stands for “electrocardiogram” and is a way of measuring the activity of the heart. These measurements are usually taken during a sleep study.

EEG – Stands for “electroencephalogram” and is a way of measuring the electrical activity of the brain. These measurements are usually taken during a sleep study.

ENT – Stands for “ear, nose and throat” and usually refers to a medical specialism/professional.

Epiglottis – literally translating to “near the tongue”, this is a moveable piece of cartilage in the throat which separates the windpipe from the oesophagus. It marks the lower boundary of the oropharynx, the area of concern when it comes to snoring.

Epworth Sleepiness Scale – A popular screening test for sleep apnea to assess how tired you are feeling. It asks you the likelihood of falling asleep in certain scenarios. A score of 16 or more shows that you are very sleepy. TAKE THE TEST

FDA approved – This refers to a medical product that has passed safety/efficacy criteria set by the US Food and Drug Association.

Hard palate – The roof of your mouth.

Histamine – A chemical released by immune cells in the blood in response to allergens. It causes inflammation at the site of its release.

Hyperpnea – The process of increasing the rate of breathing. This is usually a normal physiological process in response to increased oxygen demand as in exercise.

Hypopnea – Literally means “low breathing”. This is a feature of obstructive sleep apnea where breathing is partially blocked.

Hypopneic episode – A period of 10 seconds or more where your breathing is markedly reduced without ceasing alltogether. The number of these in an hour helps to generate the AHI. READ MORE

Inflammation – The body’s response to injury or infection. It consists of the flooding of immune cells and inflammatory chemicals to an area to heal it and produces swelling, redness and itching.

Lateral sleeping – Sleeping on your side. This is an effective way to reduce the likelihood of snoring. READ MORE

MAD – Stands for “Mandibular Advancement Device” and refers to a mouthpiece designed to advance your lower jaw (mandible) forward to tighten airway tissue and prevent your tongue blocking your airway.

Mast cell inhibitor nasal spray – A type of nasal spray for allergy sufferers. They are best used before the onset of symptoms. They work by preventing the release of histamine from a specific type of immune cell, a mast cell. READ MORE

Mouth exercises – Exercises for the tongue, cheeks, soft palate, uvula and all associated muscles in the oropharynx. These are based on exercises developed in speech pathology. READ MORE

Nasal cushion/pillow – A type of CPAP mask that uses two cushioned pads directly on the nostrils as opposed to fitting over the entire nose. READ MORE

Nasal dilator – Usually made of silicone, these are small pieces of material that fit inside your nostrils to widen them and prevent them from collapsing so as to improve airflow through the nose. This can help reduce snoring is you experience partial nasal blockage. READ MORE

Nasal irrigation – The process of flushing your nasal passages with salt water to break down excess mucus and soothe inflamed tissue.

Nasal mask – A type of CPAP mask that fits over the entire nose. READ MORE

Nasal polyps – Benign growths of excess tissue in the nasal cavities as a result of chronic nasal inflammation. This can inhibit nasal breathing and cause snoring as a result.

Nasal strips – A plaster-like strip of material with rigid bands that sticks to the bridge of your nose. This is designed to open your nasal valve to enable easier breathing through the nose. This can help reduce snoring is you experience partial nasal blockage. READ MORE

Nasal valve – The narrowest part of the nasal cavity. This can easily become blocked and lead to snoring.

Neti pot – A pot used for nasal irrigation to help snoring caused by a blocked nose. They can be ceramic, steel or plastic. READ MORE

Non-allergic rhinitis – Nasal inflammation caused by non-allergic factors. This can be due to a number of causes.

NREM – Stands for “non-rapid eye movement” a period of sleep that includes the deepest sleep, NREM 4. READ MORE

Obstructive sleep apnea – The condition where breathing repeatedly stops during sleep due to complete or partial blockages in the upper airway. READ MORE

Oxygen saturation – A measurement of the proportion of haemoglobin in red blood cells that has oxygen attached compared to total haemoglobin. A normal range is from 94-99%.

PSG – Stands for “polysomnography” which literally translates to “many sleep measurements”. PSG is performed in a sleep study to investigate sleep disorders and includes measuring heart activity, brain activity, breathing effort and blood oxygen saturation amongst many other factors. READ MORE

Positional therapy – Methods used to change people’s sleeping position with a view to reducing their snoring or sleep apnea.

Post nasal drip – Mucus dripping from the nasal cavities down the back of the throat.

Pulse oximetry – The process of measuring blood oxygen saturation. This is usually done by shining infrared light through the fingernail via a specialised finger clamp.

Rebound congestion – The congestion side effect experienced with overuse of nasal decongestants.

Reflux – Literally meaning “backflow” this describes the movement of stomach acid back up the oesophagus. This can sometimes manifest as “airway reflux” which can inflame the airway and worsen snoring.

REM – Stands for “rapid eye movement”, a period in sleep where the eyes are moving quickly from side to side. This is a lighter stage of sleep where most dreaming is done. READ MORE

Retrognathia – A recessed lower jaw. This is an inherited anatomical trait that can predispose snoring as it reduces the space in the upper airway. READ MORE

Rhinitis – Nasal inflammation; includes swelling, sneezing and excess mucus.

Rhinitis medicamentosa – (See “Rebound Congestion”)

Rhinorrhea – A runny nose.

Saline – A mixture of salt and water. This is often used for nasal irrigation in a spray or a neti pot.

Screening test – Questionnaires used to assess your risk of a condition, in this case, obstructive sleep apnea.

Sleep apnea – A condition where you repeatedly stop breathing in your sleep (see Obstructive Sleep Apnea and Central Sleep Apnea).

Sleep hygiene – The practise of good sleeping habits to give you as restful sleep as possible. This includes things like keeping your room dark and at a certain temperature, showering before bed and not eating too much before sleeping.

Sleep study – A test done in a specialist clinic or at home to help diagnose potential sleep disorders such as sleep apnea (see PSG).

Soft palate – The soft tissue behind and below the roof of your mouth, but above the uvula.

Steroid nasal spray – A type of nasal spray that reduces nasal inflammation. Can be suitable for treating allergic and non-allergic rhinitis, as well as reducing the size of nasal polyps. READ MORE

Stertor – A respiratory sound, a snore.

StopBANG – An eight question screening test to assess your risk of obstructive sleep apnea. TAKE THE TEST

Supine sleeping – Lying on your back. READ MORE

TMD/TMJ – Stands of “temporomandibular joint disorder”, the jaw pain sometimes experienced with anti-snoring mouthpieces if not fitted correctly.

Tongue retainer – A type of snoring mouthpiece that uses suction to hold the tongue forward to prevent it causing an obstruction in the airway. READ MORE

Topical – Refers to a medication applied directly to the site where its effects are desired, e.g. a topical nasal spray.

Uvula – The dangling tissue at the back of the throat.

Privacy Preference Center

Privacy Preferences