Introducing Our New App – SnoreGym

Solutions

Introducing SnoreGym

From the makers of SnoreLab, SnoreGym is the exercise app for snorers. No, we’re not talking pushups and squats – SnoreGym works out your “snoring muscles”.

Weak muscles in and around the mouth are one of the main causes of snoring. This can be particularly true as we get older.

SnoreGym is here to guide you through a set of scientifically-studied workouts for your tongue, soft palate, cheeks and jaw – each with instructions, easy-to-follow animations and a rep counter to keep you on track.

By exercising and toning the soft parts of your upper airway you can reduce your snoring, sleep better and even combat sleep apnea.

How to use SnoreGym

SnoreGym will work best if used regularly. We recommend setting aside at least 10 minutes per day. SnoreGym has two workouts – a standard one for 5 minutes or a double workout for 10 minutes.

Everybody’s day is different, but we find our workouts are best done once in the morning and once in the evening before bed. A great way to keep up the regularity is to stick your workout onto an already established routine such as brushing your teeth. This also has the added benefit of a bathroom mirror – ideal for seeing if you are doing the exercises correctly!

Whenever you complete a SnoreGym workout, it is automatically added to your calendar so you can easily keep track of your progress.

Set yourself a daily target and reminders, and in time you should see your snoring improve. Remember you can always monitor your progress with our partner app, SnoreLab, where you can also link the two apps to sync your workouts automatically.

Scientific basis for SnoreGym

The concept of SnoreGym is based on some promising science. Multiple research teams have looked into the effectiveness of using mouth exercises to combat snoring and sleep apnea.

What are the studies?

When designing SnoreGym, we looked at a number of different studies.

Several of the studies compared groups performing the anti-snoring exercises with control groups performing “sham-therapy” as a placebo.

All of the studies evaluated subjects before the exercises and after 3 months performing them regularly.

Whilst most of the studies used sleep studies to objectively measure sleep statistics, research teams also used questionnaires to allow the subjects and their partners to subjectively evaluate their sleep quality and snoring.

You can read more about the individual studies into mouth exercises for snoring and sleep apnea in our dedicated article: The Science Behind SnoreGym.

Where do the exercises come from?

Throughout the published research into mouth exercises and snoring, a standard set of exercises has become established. We have adopted variations of these in SnoreGym.

The exercises have their roots in speech therapy and are designed to work out a diverse range of muscles in the tongue, throat, cheeks and jaw – muscles known to play a role in snoring.

Since the first experiments, the range of exercises has been trimmed down and refined, omitting some exercises. Despite this, results have shown to be consistent. This suggests that extensive exercises performed in excess of 30 minutes a day is not necessary to yield success.

Benefit #1 – Snoring reduction

In one study, after 3 months doing regular mouth exercises, 47% of participants reported not snoring any more [1].

Other studies have produced similar findings, some showing an average of 56% snoring severity reduction and 36% less time spent snoring.

Benefit #2 – Decreased sleep apnea severity

Much of the research into mouth exercises has focussed on people with mild-moderate obstructive sleep apnea.

Results consistently show participants cutting their sleep apnea severity score (AHI) in half, as well as spending less time at dangerous, low oxygen saturations. Many even change their sleep apnea classification for the better.

Benefit #3 – Improved sleep and less tiredness

In most of the research, participants were asked to complete the Epworth Sleepiness Scale before and after the trial. This is the standard way of measuring tiredness linked to sleep deprivation in people with sleep disorders such as sleep apnea.

Studies have demonstrated a consistent halving of the ESS score, as well as 85% of participants reporting feeling less tired.

One study found a 65% increase in the average amount of time spent in deep sleep [2].

Benefit #4 – Lessened partner disturbance

In several studies, objective measurements of snoring volume are backed up by subjective questionnaires – whereby partners of snorers are asked if the snoring is reduced.

Questioned partners report less disturbance thanks to a reduction in snoring and even indicate that fewer conflicts arise as a result of snoring.

20 Common Questions About Snoring Answered

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?

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.

5 Easy Habits to Stop Snoring Naturally

Diet & Lifestyle, Solutions

5 Easy Habits to Stop Snoring

Some snoring experts call snoring a habit [1]. Whilst you don’t consciously choose to snore, they argue that your habits in your waking life are creating the snoring habits in your sleep.

Conversely, there are lots of positive habits that are easy to adopt and can massively reduce your snoring. Here are SnoreLab’s top-5 easy lifestyle habits to stop snoring naturally without having to use any specialist, invasive remedies …

1. Eat earlier

Large, late evening meals can make your snoring worse. Therefore, we strongly recommend not eating anything for at least 4 hours before you go to bed. It’s working for lots of SnoreLab users and could very easily work for you too.

“For people who would like to control their snoring, eat your dinner early – at least 4 hours before bedtime. Keep the dinner light and use the app to monitor the difference. You will be amazed!” – user review, Google Play

Having a full belly can exert pressure on your chest and affect your breathing. 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.

Reflux is also a common symptom of eating late. The stomach takes several hours to empty properly. Lying down too soon after eating can allow the contents of the stomach to come back up with the help of gravity. As well as impacting the oesophagus, there is growing evidence to show reflux affects the airway which can exacerbate snoring [2].

 

SnoreLab’s 4-hour fast

Read more

2. Do mouth exercises

Exercising the airway muscles every day has shown to help people’s snoring problems.

We recommend slotting this into your daily routines, such as whilst you brush your teeth in the morning and evening.

Weakness in your airway muscles is known to worsen snoring. There is increasing amounts of research to show that exercising these muscles can have positive results for snoring and sleep apnea.

Try these five exercises which are proven to make a difference if performed consistently:

  • Slide the tip of your tongue backwards along your hard palate as far back as it will go.
  • Press your tongue flat against the roof of your mouth and suck it upwards.
  • Force the back of your tongue against the floor of your mouth whilst the tip remains in contact with the lower incisors.
  • Pull your cheek out with your finger, pull your cheek back inwards against the force of your finger using the muscles in your mouth.
  • Elevate your uvula by sounding and holding “aahh”.

 

SnoreLab’s full article on mouth exercises and snoring

Read

3. Short walk before bed

A short, low-intensity walk in the evening can have unexpected benefits for snorers.

Exercise is a great step towards combating snoring, but we aren’t recommending a massive physical effort here – simply moving around can be advantageous.

A recent study by scientists in Australia found that when people are sedentary in the evening, fluid accumulates in the legs. When a person lies down, this fluid can then migrate upwards to the tissue surrounding the airway which can worsen snoring [3]!

4. Shower or bathe

Showering or bathing before bed is great for normal sleep hygiene as it lowers your core temperature which prepares you for restful sleep. Steam can also help to humidify and soothe your airway – particularly helpful if your snoring is linked to nasal breathing difficulties.

5. Sleep on your side

Switching to sleeping on your side is one of the most basic and effective ways to reduce snoring. This is because side-sleeping reduces compression of your airways.

If you often sleep on your back, there are multiple ways to shift yourself into a side-sleeping position:

Free, homemade hacks. The infamous “tennis ball therapy” or clever use of pillows are free ways to coax yourself into a healthier sleeping position. Learn all the hacks with SnoreLab’s guide.

Anti-snoring pillows. There are a number of different pillows designed to help you sleep in a healthier position. Explore the different types with SnoreLab’s full article on anti-snoring pillows.

Vibrating training devices. Positional trainers are devices that attach to your body and vibrate when they detect that you are sleeping on your back. This is the automated equivalent of a nudge in the ribs from a disturbed partner. Check out SnoreLab’s review of the Snooor wearable, a vibrating positional trainer.

Conclusion

Most snorers prefer to address their snoring naturally with lifestyle changes as opposed to using anti-snoring consumer remedies. One change on its own may not cure snoring, but the cumulative effect of multiple positive changes can certainly get you well on your way.

Stop Snoring with these Remedies to Help Nose Breathing

Solutions

Stop Snoring with these Remedies to Help Nose Breathing

Nasal blockage and mouth-breathing are very common causes of snoring.

If you have a blocked nose or persistently breathe through your mouth when you sleep, you might find you are snoring more as a result.

There are two types of mouth-breathing snorers:

  1. Snorers with a blocked nose
  2. Snorers with a clear nose who cannot sleep with their mouth closed

Thankfully, whether you have a blocked nose or simply keep opening your mouth in your sleep, there are multiple remedies that can help you.

 

Solutions for snorers with a blocked nose

There are lots of causes of a blocked nose. Allergies, colds, pollution, hormones and even the weather can give you a stuffy nose and make you snore as a result.

Thankfully, there are several ways to treat your blocked nose.

Nasal spray

Medicated nasal sprays work by reducing inflammation or constricting the blood vessels in your nose to create more space. There are several different types, some recommend for regular use, whereas others should only be used occasionally. In all cases remember to read the instructions.

Saline nasal sprays are non-medicated. Instead, they are a mixture of water and salt which moisturise your nasal passages to soothe inflammation and break down excess mucus.

To learn more about the different types of nasal spray and what is best for you, check out SnoreLab’s guide to nasal sprays for snoring.

Nasal dilator

Nasal dilators mechanically open your nasal passages. Internal dilators prop open your nostrils whereas external strips use a springboard action to pull open your nasal valves.

These have the advantage of being non-medicated and demonstrating benefits instantly. Each type has its relative merits so for more information about whether they are suitable for you, read our summary of nasal strips and dilators for snoring.

Neti pot

Neti pots are devices used to flush out your nasal passages. Often resembling a small teapot, you use these to pour salt water through your nasal cavity.

This undervalued snoring remedy reduces nasal congestion by:

  • Soothing inflamed tissue. Reducing inflammation widens the nasal passages.
  • Flushing out allergens and other potential irritants.
  • Breaking down and clears excess mucus.

Neti pots are made of different materials and need to be used and cleaned properly. Be sure to read our guide to buying and using neti pots.

Air purifier

Air purifiers can help snoring triggered by allergies and pollution.

These use internal fans to pull in the air and the harmful particles it contains. Once drawn inside the device, the particles are either trapped in a filter or are treated to stick to surfaces as opposed to floating around in the air.

There are many shapes, sizes and features, so check out our full article on air purifiers for snoring to get the best one for you.

Side note: Which of these remedies is most effective depends on the cause, so be sure to read our guide: “Snoring due to a blocked nose” to understand your snoring and the most appropriate solutions.

Solutions for mouth-breathing snorers

If you can breathe clearly through your nose, but frequently wake up with a dry mouth and a sore throat (and usually, some drool on the pillow!), it is likely that you sleep with an open mouth.

There are a number of different remedies to help you make the healthier, quieter switch to nasal breathing.

Mouth tape

Mouth taping holds your mouth closed to promote nasal breathing.

We recommend using specialist, medical-grade mouth tapes specifically designed for use on skin. This means they are safe to use and easy to remove.

A market leader in mouth taping is SomniFix mouth strips, as seen on ABC’s Shark Tank! SomniFix strips are hypoallergenic, can be painlessly removed without leaving a sticky residue, and have a small mesh vent to allow limited mouth breathing if necessary.

Mouth shield

Shields fit behind your lips but in front of your teeth to prevent mouth breathing. Products such as the SnoreLab recommended Somnipax Shield can also be custom moulded and have small holes to allow a little mouth breathing if necessary.

Chin strap

Chin straps are another effective, if a little cumbersome, way to keep your mouth closed at night. You usually wear these under your chin and around the top of your head.

Mouthpiece

Mouthpieces can be particularly effective if your snoring is has multiple causes. If mouth breathing plays a role but isn’t the sole cause, mouthpieces not only promote healthier nasal breathing but also bring jaw forward to tighten the slack airway tissue responsible for snoring.

There are many anti-snoring mouthpieces available. To understand how they work, the different types and what might be most suitable for you read SnoreLab’s overview of anti-snoring mouthpieces.

Tongue retainer

Similar to other anti-snoring mouthpieces, tongue retainers effectively block the mouth breathing route. In addition to this, they also work by holding your tongue forward to prevent it blocking your airway. We recommend the Good Morning Snore Solution for open mouth snorers whose tongues block their airway.

The science bit – mouth breathing vs. nasal breathing

Mouth breathing can cause snoring

You may notice that when you have a cold, you snore more. This is because with a nose full of nasties, you need to switch to mouth breathing.

Sleeping with an open mouth makes snoring more likely. This is due to several reasons:

Your airway is narrowed. An open mouth causes your throat to compress as your tongue falls further back into your airway and the open space behind your tongue and soft palate is reduced.

Inhaled air is turbulent. Directly inhaled air vibrates the soft tissues at the back of your mouth

Your airway dries out. This is because mouth breathing doesn’t humidify incoming air like nasal breathing does.

You are more susceptible to breathing in harmful things. Unlike nasal breathing, mouth breathing doesn’t trap allergens and bugs which can in turn worsen your snoring.

Why should you breathe through your nose?

Nasal breathing not only lowers your snoring risk but has other health benefits too:

Snoring reduction. Nasal breathing warms and humidifies incoming air, helping to prevent your airways drying out. It also channels air over your snoring noise-makers in a less turbulent way than mouth breathing does.

More comfortable sleep. By treating the air, your nose prevents the frequent awakenings you may experience from having a dry mouth.

Better filtration. The mucus and many folds within your nasal cavities do a great job of trapping potentially harmful invaders such as allergens and viruses/bacteria. These, in addition to making you feel terrible, can worsen your snoring.

Proper ventilation. Nasal breathing reduces the chance of hyperventilation – over-breathing with frequent, shallow breaths. Proper ventilation leads to optimum oxygen/carbon dioxide balance, allowing for improved blood oxygen saturation [1].

Enhanced nitric oxide inhalation. Nitric oxide (NO) has often been termed “the mighty molecule” [2]. Produced in the nose and sinuses, nasal breathing helps push this molecule into the lungs where it can exert its benefits. Here, it expands your blood vessels to reduce blood pressure and the associated risks [3].

Obstructive Sleep Apnea Treatment

Sleep Apnea, Solutions

Obstructive Sleep Apnea Treatment

If you’ve been diagnosed with obstructive sleep apnea (OSA) or think you might have the condition, you may have questions about how to treat it.

There are several treatment options; the most effective way to treat your sleep apnea depends on the severity of your condition.

Generally, mild to moderate cases can be effectively managed with the same techniques used to treat primary snoring (i.e. non-apnea). Severe cases where your AHI is over 30 are best managed with CPAP.

In extreme cases where CPAP is not tolerated and there is a clear physical obstruction, surgery can also be an option.

This article explores the various methods that can be used to manage obstructive sleep apnea.

Each category has links to other useful SnoreLab articles on the subject.

Side note: what determines sleep apnea severity?

The severity of sleep apnea is split into mild, moderate and severe. These designations are based on how many times you experience apnea or hypopnea episodes per hour – your AHI score. This is where your breathing completely stops or partially stops for 10 seconds or more.

Make sure to read our article about sleep apnea diagnosis to understand sleep studies, the AHI score and classifying the severity of obstructive sleep apnea.

Making suitable lifestyle changes

If your sleep apnea is at the milder end of the spectrum, you can treat it by making some targeted lifestyle changes.

What is most effective depends greatly on what is responsible for your sleep apnea in the first place. Generally speaking, the following lifestyle changes have the most positive impact:

1. Lose weight

Your weight has a significant influence on your likelihood of developing obstructive sleep apnea. Simply put, the heavier you are, the more likely you are to suffer from OSA.

Side note: the statistics of weight loss and sleep apnea

Some epidemiological studies indicate that 70% of patients experiencing sleep apnea are obese, and 40% of obese people are suffering from sleep apnea [1].

Promisingly, research has demonstrated that losing 10-15% of your body weight can half the severity of your sleep apnea [2], and that losing 60% of body fat can eradicate sleep apnea for around 86% of obese people [3].

There’s no shortage of advice or 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.

Instead, be sure to check out SnoreLab’s SMART strategy for effective, sustainable weight loss and also have a read of our full article of the impact of weight on snoring and sleep apnea.

2. Stop smoking and reduce alcohol consumption

Smokers, and even passive smokers are more at risk of snoring and experiencing sleep disordered breathing [4][5].

Some studies have found that smokers are 2.5 times more likely to suffer from obstructive sleep apnea [6].

Quitting smoking has shown to reduce your likelihood of experiencing sleep disordered breathing [7]. This is because smoking contributes to greater inflammation and irritation in the upper airway which predisposes it to vibration and collapse [8].

Further, a nightcap is also not ideal for healthy sleep. Alcohol causes your muscles to relax – even more than they do normally when you fall asleep. It therefore increases the collapsibility of your airway and heightens the risk of experiencing apneas.

SnoreLab users amongst many others have found that reducing their alcohol consumption yields drastic reductions in their snoring and sleep apnea.

3. Alter your sleeping position

More than half of all obstructive sleep apnea cases are referred to as “position-induced” sleep apnea [9], where the severity of the condition is made worse by back-sleeping.

By sleeping on your back, your mouth has a tendency to fall open. This changes the shape of your upper airway and makes obstruction more likely.

Sleep apnea can therefore be massively reduced by switching to side-sleeping. There are many techniques you can use to make this change – be sure to check out our guide to sleeping position and snoring.

Anti-snoring mouthpieces

Whilst not recommended for severe cases of OSA, a mandibular advancement device (MAD) can be a good option for those with mild to moderate OSA, or those who do not tolerate CPAP.

MADs brings your lower jaw (mandible) forward (or advance it) to tighten the tissues in your airway that are prone to slackening and causing obstruction.

There are many different types of MAD available so finding the right one can be a bit confusing. To get the best quality we recommend getting a mouthpiece custom fitted by a dentist, though this can be quite expensive.

You can still find great quality mouthpieces without paying loads for a custom-made one. Have a read of our guide to anti-snoring mouthpieces so you know what to look out for when buying generic devices online.

If your tongue causes obstruction in your airway, a different type of mouthpiece called a “tongue retainer” can also be effective for mild to moderate OSA.

CPAP

CPAP stands for continuous positive airway pressure and is a treatment suitable for moderate to severe sleep apnea sufferers. It is the primary method for managing OSA and has a wealth of evidence to support its efficacy.

In most countries, it is only available with a prescription after confirmed diagnosis of sleep apnea.

A CPAP device uses a mask to force air into your nose and throat to keep your airways open.
CPAP does not give you more oxygen. Instead, it introduces a current of normal air that creates positive pressure; this props open your airway to stop it from collapsing.

Many people are fearful of CPAP. Users can also struggle with their devices, experiencing discomfort, claustrophobia and air leakage.

Despite its scary reputation, it’s important to know that CPAP can be a life-saving tool. There are measures you can take to get the most out of it and cope with any difficulties you may have.

 

SnoreLab’s guide to dealing with CPAP issues

Check out

Performing mouth exercises

Research has shown that exercising the muscles in your airway can have a positive impact on mild to moderate sleep apnea.

These techniques are adapted from speech and language therapy and consist of repeated movements in the tongue, cheeks, jaw and soft palate in order to increase muscular tone.

Several studies demonstrate that patients with sleep apnea can reduce their AHI scores and sleepiness by performing these exercises regularly [10] [11] [12] [13].

You can read about all of the evidence and also learn the 5 exercises we recommend.

Surgery

Surgery is usually a last resort only when other techniques to manage your sleep apnea have failed.

Whilst there is some research to show that surgery can produce positive outcomes for OSA, there isn’t enough evidence for surgery to be routinely recommended ahead of alternatives like CPAP.

Usually, to be considered for surgery, there are several requirements that will be assessed by an ENT (ear, nose and throat) specialist first:

  • A diagnosis of severe obstructive sleep apnea, confirmed by a sleep study
  • A clear physical obstruction that can be rectified by surgery
  • Failed treatment with alternative methods such as CPAP and mouthpieces
  • Evidence that the condition is severely affecting your quality of life

There are many types of surgery for snoring and not all are recommended for OSA sufferers.

To get an overview of the surgical interventions available and the important considerations when exploring surgical options, be sure to read our article on surgery for snoring and sleep apnea.

Conclusion

Obstructive sleep apnea can be managed via a number of different means. What is most effective depends on the causes of your condition and its severity.

Regardless of which treatment route you take, many countries have support groups for people with OSA.

These organisations aim to educate and provide support with all facets of OSA.

They give helpful information on living with the condition, provide practical support with CPAP and other treatments, fund and publish the latest research into sleep apnea as well as organising support meetings in person.

How Can SnoreLab Help My Snoring?

Solutions, Using SnoreLab

How Can SnoreLab Help My Snoring?

SnoreLab has helped many thousands of people address their snoring problems. But how?

The app isn’t designed to cure snoring, but instead gives you an understanding of your snoring problem to help you find a suitable solution to improve your sleep.

There are many effective ways to reduce snoring from specialist products to exercises, but different approaches work for different people. By measuring changes in your snoring intensity between nights with SnoreLab, you can try different methods and hopefully discover one which works for you.

Crucially, SnoreLab also allows you to hear what you sound like so you don’t just have to take your partner’s word for it! We find this can be a dramatic revelation which spurs you to take action.

Here, we’ll guide you through getting the most from SnoreLab so you too can take control of your snoring.

What is the Snore Score?

The Snore Score is SnoreLab’s unique measure of snoring intensity. More than simply reporting back a few volume readings, our Snore Score takes into account those different volumes and how long you spend at each level.

The Snore Score is different from snoring percentage which is a measure of the proportion of the night spent snoring. Therefore the Snore Score can exceed 100 – we have even heard cases of users scoring more than 300!

Should I be worried about my results?

If you’ve got a high score, this is no reason to panic.

Snoring is not necessarily harmful, at least physically speaking. If your snoring is putting a strain on your relationship with your bed partner, this is when it can become an issue; you don’t need a Snore Score to tell you this. But when does snoring become damaging to your physical health?

If snoring develops into obstructive sleep apnea, your physical health is at risk. This is because sleep apnea is a serious condition where your airway repeatedly closes whilst you sleep, depriving you of oxygen and putting stress and strain on your heart and other body systems.

Whilst louder snoring is a key sign of sleep apnea, a high Snore Score does not mean you have the condition.

If you are suffering from sleep apnea, you might already be aware of it based on your symptoms. Excessive daytime sleepiness, mood swings, never feeling fully rested after sleep, as well as headaches and sore throats are big red flags.

If you feel physically fine and your Snore Score is high, chances are, you have nothing to worry about.

What’s an average Snore Score?

The median Snore Score for our users is around 25. A score above 50 puts you in the “bad snoring” category, and if you’re above 100 you definitely need to find some solutions!

Everyone is unique, so whilst it’s not best practice to compare yourself to others, we believe a Snore Score of 10 or under is a good target as this is unlikely to disturb you or your partner.

So I’ve got a Snore Score – now what?

SnoreLab gets more effective over time when you have multiple sessions with many Snore Scores to compare to one another.

Your first night’s score is your benchmark. From here onwards, you can see how your score varies from night to night based on the changes you make.

SnoreLab works best when you keep track of anything that you think might impact upon your snoring …

1. Select applicable remedies and factors

If you’ve got some snoring remedies you want to test, or suspect certain factors could be triggering your snoring, make sure to select them at the start of your session.

When trying a new snoring solution, it’s important to see whether or not it works for you. Hopefully, you’ll start to see your Snore Scores declining. If you do, great; you’re well on your way to addressing your snoring problem. If not, this is still a result as it’s also important to know what doesn’t work.

There are things that you wouldn’t normally associate with snoring, like having a shower or bath before bed, or eating a heavy evening meal. When it comes to snoring, little things add up.

In time, you’ll hopefully see patterns start to emerge and you’ll have an idea of what can help.

2. Create your own tags and make notes

There are lots of different things that can help or hinder your snoring, some of them rather strange or unique to you. We don’t cover everything in our remedies and factors list, so why not add your own?

Anything that you think is relevant to your snoring and sleep quality is worth making a note of in SnoreLab, either by creating a custom remedy or factor or writing your own detailed notes.

Notes can be extremely helpful if you are trialling different foods in the evening, noticing certain symptoms, or making adjustments to things like head elevation, mandibular advancement or CPAP pressures.

It can also be useful to make retrospective notes on the night: if you woke up with a sore throat or headache, if you had to urinate multiple times during the night. Also remember to select a rest rating to see if your snoring correlates with how good you feel in the morning.

The more detailed you are, the better picture you can construct of your personal triggers and solutions.

Additional notes made on a session will appear in the Sleep Notes

3. Look at your trends

SnoreLab’s Trends page is where you can really see if the changes you make are helping your snoring or not. This is where all of your sessions, remedies and factors are summarised and collected into one view.

The top chart gives you the option to view your history of all measurements made in the SnoreLab, as well as the remedies you’ve used and the factors you’ve selected.

This screen contains a lot of information, so it’s best to explore it yourself. If you are experimenting with lots of different snoring aids, makes sure to select Remedies and compare the Difference. Red suggests the remedy isn’t working for you, green can mean you are on to a winner!

Here, in our Trends view, an anti-snoring mouthpiece is showing to reduce snoring the most with a wedge pillow coming second. These trends also suggest that nasal remedies probably aren’t working here.

Can SnoreLab tell me if I have apnea?

This is a question we get asked a lot. Some users have discovered sounds in their recordings that indicate apneic events, and have then found them useful in subsequent medical consultations. For many people, this has helped flag sleep apnea they weren’t aware that they had.

 

Obstructive sleep apnea

Read more

 

However, it’s important to note that the app is not an automatic sleep apnea detector.

Sleep apnea is defined by apneic events. These are periods during sleep where breathing stops for at least 10 seconds. Whilst this has a typical sound profile which SnoreLab could detect – normal breathing followed by at least 10 seconds of silence and then a gasp or choke – apneic events are not actually defined by sound.

An apnea is identified by measuring both breathing effort and airflow (or lack thereof). A drop in blood oxygen saturation helps to confirm this apneic event. This requires specialist equipment beyond the reach of a consumer app so can only be done in a sleep study.

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

Inconsistent snoring patterns with obvious pauses could indicate risky breathing periods. This was given to us by a SnoreLab user who went on to get a sleep apnea diagnosis.

If you are concerned about sleep apnea, make sure to read our articles on the condition, as well as checking your risk with some screening tests such as the Epworth Sleepiness Scale and the StopBANG questionnaire.

I don’t know why I snore – where do I begin?

If you have no remedies to test as you simply don’t know where to start with your snoring, SnoreLab’s insights can help.

There are some key causes of snoring and SnoreLab has loads of information on each (select each to find out more):

Every cause has different solutions. So whilst a mouthpiece may work for John Doe, it may not work for you.

Because snoring is more complicated than many of us appreciate, one thing alone might not completely cure your snoring.

To start investigating your triggers and solutions, make sure you’ve ticked the six key lifestyle factors that can help mitigate snoring:

  • Sleep on your side
  • Maintain a healthy weight
  • Sleep in a dust and pollen-free bedroom
  • Avoid cigarettes and alcohol
  • Stay hydrated
  • Practise good sleep hygiene

Do Nasal Sprays Work for Snoring?

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

Eating Late and Snoring? Try the Four Hour Fast

Diet & Lifestyle, Solutions

Eating Late and Snoring? Try the Four Hour Fast

“Many of my patients find that eating earlier alleviates their sleep apnea.” [1]

A lot of snoring fixes require perseverance before you start to see results. The SnoreLab-recommended “Four Hour Fast” is a free and easy life hack that can produce instant benefits for your snoring.

Put simply, we strongly recommend not eating anything at least 4 hours before you go to bed. It’s working for lots of SnoreLab users and could very easily work for you too.

Why should I try it?

Plenty of sources recommend not eating too late, but there is very little research into the effect of a large, late meal on snoring. However, anecdotally we have heard from our users and many other people that having a small evening meal with plenty of time to digest can drastically reduce their snoring.

“For people who would like to control their snoring, eat your dinner early – at least 4 hours before bedtime. Keep the dinner light and use the app to monitor the difference. You will be amazed!”

“SnoreLab is great to help me understand what influences my snoring: late food, fatty food, dehydration etc.”

“I’m a petite female side-sleeper who doesn’t smoke and rarely drinks alcohol, yet my highest snore score was 92 (16% epic, 19% loud!). With SnoreLab I was able to quantify my snoring and quickly narrow down the causes. My lowest scores (2 & 3) were nights I inadvertently skipped dinner! That 92? I ate a greasy burger and fries that day. I’ve been adjusting my diet and now my snore score is consistently under a 10 rather than 60-90.”

How eating late can contribute to snoring

1. Pressure and shortness of breath

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 this shortness of breath lingers until bedtime, the strained breathing can cause snoring.

2. Acid Reflux

Reflux literally means “backflow” and this is when acid from the stomach spills back up into the oesophagus and even the airway.

Reflux is a common symptom of eating late. The stomach takes several hours to empty properly. Lying down too soon after eating can allow the contents of the stomach to come back up with the help of gravity.

As well as impacting the oesophagus, there is growing evidence to support the notion of reflux affecting the airway [2][3][4] which can exacerbate snoring.

This “airway reflux” [4] can directly irritate and inflame the tissue responsible for snoring.

Acid reflux can also contribute to postnasal drip. This is simply excess mucus buildup at the back of the nose and throat. Severe postnasal drip can result in a sore throat and coughing which in turn contribute to worsened snoring [5].

Coughing is strongly linked to snoring as both are a result of airway irritation and inflammation [6]. Reflux is implicated in many people who experience chronic coughing and snoring as a result [7].

Reflux has also been associated with other upper airway issues such as hoarseness, difficulty swallowing and chronic throat clearing [1].

3. Certain ingredients can worsen snoring

Another thing to consider is the foods you eat and if they can impact upon your snoring.
Whilst the research into specific foods and their impact on snoring is sparse at best, there’s plenty of evidence regarding reflux and the foods to avoid.

High-fat foods slow digestion and relax the valve that separates the stomach and oesophagus. Acidic foods like including certain fruits and spicy ingredients are known to irritate the throat lining which can worsen snoring directly and indirectly through acid reflux [3].

Remember to use SnoreLab’s notes tool to keep track of certain foods if you suspect they play a role in your snoring.

In the long term

Whilst we are confident that many SnoreLab users will see instant results through eating an earlier evening meal, there is also plenty of long-term benefit to this eating pattern.

Most people agree that breakfast is the most important meal of the day, but many of those people continue to skip it. Eating less in the evening can be a great way to encourage eating more in the morning. This so-called “front-loading” of your diet can be an effective weight loss technique too.

Some sources speculate that this is due to enhanced fat burning or shifting metabolisms, but it is more likely to simply be an effective way of regulating your appetite and staying within calorific limits.

 

SnoreLab’s SMART strategy for effective weight loss in snorers

Have a look

Conclusion

Lifestyle is known to influence snoring. Increasingly, we are seeing the evidence that small life hacks can make big and important changes to our nightly noises. The Four Hour Fast is free, simple and can produce instant results for your snoring.

If you have a late evening meal, remember to select the “Ate late” factor in SnoreLab and see how it effects your score. Conversely, try the Four Hour Fast and you could very easily see your Snore Score cut drastically!

Let us know how you get on via support@snorelab.com, Facebook or Twitter.

Weight Loss for Snoring – SnoreLab’s SMART Strategy

Diet & Lifestyle, Solutions

Weight Loss for Snoring – SnoreLab’s SMART Strategy

It’s the piece of anti-snoring and general health advice that we often don’t need to be told: “lose some weight”.

This in itself is not advice. If it were that easy, weight wouldn’t be a problem for anyone. Whilst we are all aware of the great health benefits of losing weight, it’s a difficult thing to do.

In this guide, we’ll give you the safe and practical advice that can help you lose weight and reduce snoring. This can be condensed into SnoreLab’s five tips for losing weight and managing snoring the SMART way:

Substitute. Make your favorite meals healthier with smart ingredient substitutions. A key substitution is brown for white when it comes to bread, pasta and rice.

Move. The key to weight loss is expending more energy than you put in. Little activity efforts accumulate; take the stairs, set a step goal and integrate exercise into your every day.

Avoid. If you are serious about weight loss, some foods just need to go. If you eliminate one thing only, make that one thing sodas/fizzy drinks.

Reduce and Reward. The most obvious task: reduce your food intake. Also set goals, and when you reach a milestone don’t be afraid to reward yourself.

Think. Mindful eating is a great way to know when you’re full and to appreciate food.

Many scientists and doctors categorize snoring as a habit. As we know, one of the main things that causes snoring is excess weight, and increased weight is also the result of poor habits. Habits are hard to break out of. The best thing to do is to introduce new habits.

Substitute

Keep eating the types of food you love with smart ingredient substitutions.

Milk chocolate ⇒ Dark chocolate

Chocoholics the world over rejoiced at the news that chocolate is actually quite good for you. This statement comes with some caveats: chocolate’s benefits depend on the amount you eat, the cocoa content and the type of chocolate.

Dark chocolate has more of the original cocoa than milk chocolate which is diluted with more sugar and milk powder. The cocoa is rich in anti-oxidants, chemicals that promote healthy blood vessels [1].

White flour ⇒ Brown flour

We don’t recommend eating too much of foods containing wheat flour, but when you do, make sure it’s brown. White flour is more processed that brown, involving the removal of much of the original wheat grain. This means a reduced nutritional content. Brown bread and pasta are higher in fiber and are lower GI, meaning there is a slower increase of blood glucose after eating, keeping hunger at bay effectively [2].

Additionally, brown flour is higher in fiber which aids digestion and takes a little longer to chew. Chewing for a bit more is a great way to subconsciously lower your intake and to better recognize when you are feeling full.

Rice ⇒ Cauliflower rice

Cauliflower is more nutritionally diverse than rice, has fewer calories per portion and is high in fiber. Make the blender your friend and blitz the cauliflower.  As well as a healthier rice alternative, cauliflower works well in healthier tortillas, pizza bases, mash and hummus.

Cauliflower rice is unbelievably easy to make; simply blitz it to a rice consistency in a food processor, pour it into a heat proof bowl and cover with film. Pierce the film and microwave for seven minutes.

Potatoes ⇒ Root vegetables

Potatoes have a lot of starchy carbohydrates. Many diets would have you believe that carbs are bad. This isn’t true. Carbohydrates are a necessary energy source that keeps us alive [3]. That said, it’s often a good idea to reduce your intake to lose weight.

Mashed swede or celeriac is a good alternative to mashed potato. Roasting parsnips and sweet potatoes are lower-carb, tasty potato alternatives. Vegetable crisps are also growing in popularity as a potato chip substitute.

Other vegetables that can easily slot into potato-esque roles are kohlrabi, turnip and mooli.

These are just a few examples we’re particularly fond of. There’s a multitude of great substitutions promoted by many diets.

Move

The key to weight loss is expending more energy than you put in.

Little bits of activity add up

Exercising to lose weight can start with small efforts. As long as it’s more than what you currently do, you are going to expend more energy than before and make yourself more likely to lose weight.

Take the stairs instead of the elevator, walk up escalators, walk just that little bit faster between appointments. These small efforts over time can add up to make a big difference.

Step counting

Setting a daily step goal is a great way to give you a quota of physical activity to aim for every day. There are of host of smart watches and pedometers available, many at a very reasonable price point for the features they have.

The concept of 10,000 steps originated in 1960s Japan, introduced by a pedometer manufacturer looking to profit from the success of the 1964 Tokyo Olympics. It has since been adopted as the benchmark for healthy daily exercise [4].

Just as important as the number of steps is their intensity; 5,000 brisk steps are more effective than 10,000 slow ones.

Integrate exercise into daily routines

Lots of people argue that they just don’t have the time available in the day to exercise. The key to exercising in a busy life is to integrate it into your normal routine. Commuting by bike can sometimes be quicker than car or public transport, particularly in slow-moving, congested cities.

If you use public transport, getting off a few stops early is a great way to slot a brisk walk into your working day. This is also good for your mental health; a great way to clear your mind and relax before you start work.

Many of us work at desks. See if a standing desk is something that can be incorporated into your workplace. Also use your lunch break to your advantage, either with a fast walk or even some dedicated gym time. Many workplaces offer subsidized gym memberships. Finding a coworker with similar exercise ambitions is a great way to keep each other motivated.

Find exercise that you enjoy

The assumption with exercise is that you need to put in the hours flogging yourself on a treadmill or exercise bike, entering a purgatory of pain and boredom.

This doesn’t have to be the case. If you enjoy those things, hooray, you’re well on your way to successful weight loss. If not, find something that you do enjoy. With a world of information at your fingertips online, it’s never been easier to discover a wealth of organized activities in your local area.

Avoid

There are some foods that simply cannot be integrated into healthy weight loss and need to be avoided altogether.

We know there are plenty of other unhealthy foods out there that certainly aren’t recommended as part of any good weight loss strategy, but here are our top three foods that just need getting rid of:

  • Sodas/fizzy drinks. Low calorie sodas don’t necessarily mean low sugar, and the low sugar ones aren’t much better often being laced with additives that provide no nutritional benefit whatsoever.
  • Sugary breakfast cereals. These frequently attempt to promote themselves as healthy. Whilst their claims of multigrain ingredients and high fiber might be true, these benefits simply don’t outweigh the costs of the eye-wateringly high sugar content.
  • Processed meats. More saturated fats, cholesterol and salt compared to unprocessed meat make this a big reg flag.

Reduce and Reward

The importance of eating less cannot be stressed enough.

Many diets promote their methods with the promise of “not having to resort to calorie counting”. Unfortunately, the concept of calorie counting is THE way to lose weight. Put simply, you need to eat less energy than you expend in order to lose weight. This means reduction of what goes in. You should reduce:

  • Portion sizes
  • Added sugar. Some SnoreLab users have seen instant reductions in their snoring when reducing their sugar intake. Read Richard’s story here.
  • The main offenders – bread, pasta, rice, foods with added sugar and non-lean meats.
  • How often you eat meals out

Making big cut backs is hard. To make things easier, it’s important to have something to aim for, which is where the second “R” comes in: reward.

Part of achieving a big goal is recognizing and rewarding the milestones along the way.

Many people who have successfully lost a lot of weight stress the importance of “nudge therapy”.

This is a technique whereby you positively reinforce good behaviors. By giving yourself a reward when you reach a key milestone, you help yourself to stay on that positive trajectory.

Importantly, these rewards shouldn’t include food rewards where you can easily relapse into bad habits. Some examples include a new item of clothing you’ve had your eye on, an evening out, or maybe even some new equipment for your new-found sporting activity.

Think

The practice of “mindful eating” is one of the most important steps you can make towards losing weight.

Sometimes, weight loss isn’t so much about changing what you eat, as it is about how you eat.

Here are the key “Think” tactics that can make you eat better and eat less:

1. Eat slower

Eating too fast is a great way to overeat [5]. This is because once we start eating, there’s a delay between being full and feeling full. The hormones that tell us we are satisfied take time to arrive in the brain [6].

Eating slowly allows the natural processes of satiety (feeling fed) to take effect. Not only does this decrease the amount we eat, but it also makes us more likely to savor and enjoy our food. There are several techniques you can use to slow down your eating:

  • Eat with fewer distractions. This allows for mindful eating where you can appreciate and think about your food.
  • Put down cutlery between mouthfuls.
  • Aim for a certain number of chews per bite and move the food from side to side (this is also a great mouth exercise, another effective and natural way to combat snoring).
  • Dedicate an amount of time to meals.

If after a meal, you still feel those pangs of hunger, give it a little time and they are likely to go away.

2. Keep a food diary

Have you ever been sitting down, distracted and then found yourself eating without even intending to, simply because the food was there?

Writing down everything you eat makes you think twice. It is also a great way to keep track of portions, diet and trends in your eating habits.

3. Plan meals in advance

Poor eating habits come from poor planning. Often, the easiest foods to eat are the ones that are least healthy. Alongside your food diary where you write down the foods of your past, try to plan for the foods of the future.

Not only does effective planning mean you are likely to eat healthier, it can also cut down on food waste and save you a lot of time and money.

4. Think about when you eat

In the past, we have heard testimony and seen evidence that suggests people snore less and can lose weight when eating smaller meals in the evening.

“Front-loading” your diet – eating more in the morning and less in the evening – can be an effective weight loss technique. This is probably not to do with enhanced fat burning or slowed metabolism as some sources speculate. This technique is simply a better way to control your hunger to ensure you stay well within your calorie limits.

A word on special diets …

There’s no shortage of special diets that map out what foods you can and can’t eat. If adhered to, most of them will make you lose weight, many of them quite quickly. Some caution needs to be exercised with special diets, as eliminating an entire food group is not conducive to a healthy lifestyle.

Whilst most lack hard scientific evidence to back them up, some of the better-known diets are based on very sensible and well-researched concepts. There are some popular diets that we believe can be beneficial:

Calorie restriction diets

The principle of weight loss is to take in less energy than you are expending.

This concept is why calorie-counting diets are the only types of diet that have extensive scientific backing.

A calorie is a measurement of energy. By eating we take in energy; we expend energy through activity. If there is an imbalance between what goes in and what goes out, weight changes happen.

Counting calories isn’t glamorous but can be very effective. Safe calorie reduction is important. Whilst very low-calorie diets (below 800 per day) will make you lose weight fast, they aren’t sustainable and should only be done under medical supervision.

Exact numbers vary, but calorie reduction down to 1400 per day for women and 1900 for men should give you steady and healthy weight loss.

Importantly, your calorific intake should still be made up of healthy foods. Yes, 500 calories of fries still fulfill the criteria just as 500 calories of vegetables would, but you are likely to feel better and lose more weight by eating sensibly.

Paleo diet

This diet is based on only eating foods that were available during the pre-agricultural times of our hunter-gatherer ancestors. This means no wheat or cereals, very little dairy, but most crucially, no processed foods. Instead, the diet focusses on seeds, nuts, seasonal fruit and vegetables and meat.

As a concept, the paleo diet has a few flaws where even the strictest proponents can’t actually recreate these ancient diets by our modern standards. It also eliminates some extremely nutritious foods such as pulses and calcium-rich dairy.

But paleo-dieters stress that the diet is less gospel and more guidelines. The idea of no processed food alongside more vegetables, nuts and seeds is something to be encouraged.

Conclusion

The aim of SnoreLab’s SMART approach is to spread manageable changes across all aspects of your life. This is so that your weight loss tactics become new habits that not only help you lose weight, but help you to maintain that lower weight.

The best way to stop snoring, lose weight or achieve any other health-related goal is to approach it from many angles, using combinations of positive lifestyle changes.

This article is a diversion from our normal snoring themes. Most, if not all anti-snoring websites will recommend weight loss but then leave you hanging, abandoning you to trawl the internet and navigate through the vast quantity of misinformation and unhelpful strategies. Our SMART approach is based on forming new habits, making lots of changes that go beyond just your diet, but keeping them manageable and sustainable to not only lose weight, but to keep it lost.

Surgery for Snoring and Sleep Apnea

Science, Sleep Apnea, Solutions

Surgery for Snoring and Sleep Apnea

Surgery is perhaps the most drastic snoring remedy available and has the potential to be very effective for some people. There are a number of surgical interventions to reduce snoring and sleep apnea.

In this article, we summarise the different types of surgery for snoring and sleep apnea, as well as exploring some of the important considerations to be made before opting for surgery.

Some important considerations

Surgery should be a last resort

Surgical intervention should only be considered if other methods you have tried have failed.

Surgery is invasive and sometimes irreversible, so careful consideration should be given as to whether alternatives have been pursued to their full capacity.

Though it will usually be discussed in any consultation prior to surgery, some of the most effective methods of treating snoring are non-surgical and always worth mentioning. These include:

Surgery types vary and what is most suitable depends on YOU

There are several different types of surgery that can reduce snoring. Like non-surgical snoring remedies, there is no one solution that will work for everybody.

The most effective type of surgery depends on your snoring and what is causing it in the first place.

Your suitability will need to be assessed with a physical examination

For surgery to be effective to treat snoring, there must be a clear physical cause of snoring. This means you’ll need to undergo a thorough examination by an ENT (ear, nose and throat) specialist to identify the source of the snoring.

Initial examinations will include basic observations of your nose, tongue and throat. The procedure is also likely to involve flexible endoscopy.

Here, a flexible tube with a fibre optic camera is inserted into the nose and down the back of the throat to look for structural abnormalities.

Whilst this tube is in place, the examiner may ask you to recreate a snoring sound to help identify the tissue that is producing the noise.

You may have to undergo a sleep study first

It is important to distinguish between primary snoring and obstructive sleep apnea. This is because certain types of surgery are not recommended for obstructive sleep apnea (OSA) sufferers.

For that reason, if OSA cannot be ruled out after a physical examination, you may have to undergo a sleep study. This can be done either in a specialist sleep clinic or at home.

 

SnoreLab’s article on what to expect from a sleep study

Read

The benefits may not be permanent

The body has a remarkable way of adapting to change, and unfortunately this isn’t always a good thing.

Snoring surgery that addresses soft tissue works by causing intentional scarring to certain parts of the airway to stiffen them. Your body will automatically work to heal these scars, therefore whilst the snoring is reduced in the short term, you may find that it returns in the long term.

You could experience side effects

Whilst the side effect profile depends on the type of surgery you have, surgery will always involve breaking tissue which carries risks.

It is common for patients to experience some mild pain after surgical interventions.

Availability varies depending on where you live

Every country’s health system is different, and for that reason what is recommended, available and suitable in one location may not be so in another.

For example, pillar implants are considered suitable to treat mild-moderate obstructive sleep apnea in the USA but not in the UK [1].

The healthcare system in your location may also affect whether or not you are eligible for snoring surgery. Because snoring is usually considered a trivial condition (though those that live with it would argue otherwise), state funded medical systems are reluctant to fund snoring surgery. Further, snoring surgeries may not be covered by certain insurance policies.

The different types of surgery

There are three main categories of surgery that can help to directly reduce snoring:

  1. Soft Tissue surgery.
  2. Maxillofacial surgery.
  3. Neural stimulation.

1. Soft tissue surgery

The least invasive option, this involves making changes to the soft noisemakers themselves.

Soft tissue surgery aims to remove or stiffen the flappy parts of the airway which vibrate and cause the snoring noise.

Other soft tissue procedures involve making changes to structures in the nose that can cause “downstream” snoring via nasal blockage.

Most types of soft tissue surgery are not recommended for OSA sufferers, though this does vary.

Usually, these procedures can be performed in an outpatient clinic under local anaesthetic (i.e. you are awake but cannot feel pain in that region).

Uvulopalatopharyngoplasty

Also known as UPPP or UP3, this surgery aims to open the upper airway by removing tissue from the uvula, soft palate and pharynx. If they are still present, it can also involve removal of the tonsils and adenoids (the latter usually disappearing in adolescence).

It is the most invasive form of soft palate surgery and must therefore be performed under general anaesthetic (i.e. you are unconscious).

Whilst UPPP is one of the few soft tissue procedures recommended for OSA, it is performed less often than it used to be. This is because less invasive techniques with lower side effect profiles have emerged. It has also fallen out of favour because UPPP can reduce the effectiveness of CPAP.

Laser-assisted uvulopalatoplasty

Using a similar principle to UPPP, as the name suggests, laser-assisted uvulopalatoplasty (LAUP) uses carbon dioxide lasers to stiffen and remove tissue from the soft palate and uvula to widen the airway [2].

Because of the enhanced precision of lasers, it is considered a safer alternative to UPPP.

This procedure is usually done under local anaesthetic in a clinic and is done over three to four separate sessions.

Despite it being said that LAUP is suitable to treat mild to moderate OSA, studies have not demonstrated consistent improvements for these patients [3].

Radio frequency ablation

Also known as “somnoplasty”, this type of snoring surgery uses radiofrequency energy to generate heat for creating controlled lesions in soft tissue. The basis here is that the lesions become scarred and retract, reducing the amount of flappy tissue and stiffening what remains.

This can be performed on different parts of the airway depending on where the blockage is, including the turbinates of the nose (folds of tissue in the nasal cavities), the soft palate and the base of the tongue.

A minimally invasive technique, it is performed under local anaesthetic in an outpatient setting [2].

Injection snoreplasty

In this snoring surgery, no tissue is removed. Instead, sodium tetradecyl sulphate, a chemical used to treat varicose veins, is injected into the soft palate in order to scar it.

Whilst there are advantages here in that it is minimally invasive and doesn’t involve the removal of tissue, this is a fringe therapy and won’t be recommended by many clinicians. This is because the evidence to support its effectiveness is somewhat lacking, with only a few studies with small sample sizes.

Pillar procedure

This popular outpatient procedure performed under local anaesthetic involves inserting three or four small polyester implants into the soft palate to increase its stiffness and reduce vibration.

The pillar procedure has shown to reduce snoring for many patients. However, studies indicate that their effectiveness starts to decline after they have been in place for more than one year [4].

Septoplasty

A slightly different procedure, this surgery involves straightening the nasal septum – the cartilage which separates the two nasal cavities.

A deviated septum is where this cartilage is bent. It is therefore more difficult to breathe through your nose. This causes you to make a switch to mouth breathing which is known to increase the risk of snoring.

A septoplasty is usually performed in an outpatient setting and has very few/rare complications and side effects.

2. Maxillofacial surgery

Maxillofacial surgery makes structural changes to the bones of the face, jaws and neck. This aims to increase the space in the upper airway.

They are quite serious procedures which need to be done under general anaesthetic and will involve a hospital stay.

hese procedures are further reaching that soft tissue surgery. As a result, maxillofacial surgery can have life-changing benefits for patients with severe obstructive sleep apnea.

Maxilla/Mandible Advancement

This simply refers to repositioning the bones of the jaw. It usually involves moving the lower jaw (mandible) forward. This is done by cutting the bone and holding it in a more advanced position with metal plates and screws.

A receded lower jaw reduces the airway space behind your tongue; moving it forward widens this space and makes obstruction less likely.

This surgery can be likened to a permanent version of what an anti-snoring mouthpiece is designed to do.

If necessary, surgery can also be performed to move both the upper (maxilla) and lower (mandible) jaws forward.

Whilst this surgical option is quite drastic and will involve a period of recovery, it is the only procedure that is considered curative for severe obstructive sleep apnea. In multiple published trials over the years, patients consistently show a decreased AHI and reduced sleepiness.

Because of the changes to the bones of the face, this surgery will often cause irreversible changes to your appearance (often, patients report, for the better).

Hyoid suspension

The hyoid bone rests in the upper part of your neck. It is the only bone in the body that doesn’t connect to any other bone (and is therefore referred to as a “floating bone”).

Anti-snoring surgery can be performed on the ligaments that hold the hyoid bone in place. This helps to move the base of the tongue forward to create more space in the airway.

3. Neural stimulation

This is an exciting, new type of surgery which involves electrical stimulation of the tongue muscles to keep the airway open. It is only ever performed on patients with obstructive sleep apnea.

The system usually consists of three small parts:

  • An electrode wrapped around one of the key nerves that stimulates the tongue to move forward.
  • A generator which creates the electrical impulse. This is implanted in the chest and can be switched off in the morning wirelessly via a remote.
  • A sensor which helps to synchronise the neural stimulation with inward breaths. This is implanted in muscles of the ribs but isn’t always included.

To be considered for neural stimulation surgery, you’ll need a diagnosis of obstructive sleep apnea with an AHI of 20-50 (i.e. moderate to severe) [5].

It is usually recommended only if CPAP has failed. As this is an emerging therapy with restricted approval and a limited number of surgeons trained to perform it, it is not an option available everywhere.

Conclusion

Surgery can be a very effective solution for some snorers and sleep apnea sufferers. However, like all snoring remedies, it isn’t suitable for everybody.

For surgery to work, there needs to be a clear physical abnormality that can be corrected.

Surgery should be a last resort only when other techniques to manage your snoring or sleep apnea have failed.

This article aims to give you insight into all of the different types of surgery available: the established techniques, the emerging procedures and those falling out of favour. It is important to note that what may be offered for you will depend on your symptoms, snoring causes, anatomy and the medical facilities where you live.

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