Snoring

Snoring

Is snoring dangerous?
Snoring is not a disease. In fact, it is so common that one could argue that it is almost normal.

Sleep apnoea. Loud snoring, however, may be a sign that the relaxed throat muscles are allowing the throat to become excessively narrow during sleep, and not enough air is getting through with each breath (Chest 2003;124:2309–23). Sometimes breathing stops altogether for 10 seconds or more, until the body’s arousal system makes it start again – this is called sleep apnoea syndrome. It is nine times more common in men than in women, particularly those who are overweight, and most sufferers are loud snorers. Men with a collar size of 43 cm (17 inches) have a 30% chance of suffering from sleep apnoea syndrome.

In sleep apnoea, you may wake up quickly with a feeling of choking or shortness of breath, or you may hardly wake at all, but just enough for the throat muscles to tone up and pull the throat open again. This can happen hundreds of times a night without you being aware of it. Not surprisingly, you will feel tired during the day because of the disturbed sleep and may be aware that sleep is not a refreshing experience. Your bed partner may notice that you are very restless during your sleep or that you seem to stop breathing for a few moments, with resumption of breathing signalled by sudden loud snoring.

To see if you are excessively sleepy in the day, check your score on the Epworth Sleepiness Scale. A total score between 0 and 8 is normal.

Epworth Sleepiness Scale

For each situation:

Score 0 if you would never doze off

Score 1 for a slight chance of dozing

Score 2 for a moderate chance of dozing

Score 3 for a high chance of dozing

Situation
Chance of dozing score

Sitting reading ........................................

Watching TV ........................................

Sitting (inactive) in a public place
(for example, at the theatre, at a meeting) ........................................

As a passenger in a car for an hour ........................................

Lying down to rest in the afternoon
if circumstances would permit ........................................

Sitting talking to someone ........................................

Sitting quietly after lunch (no alcohol) ........................................

In a car, while stopped for a few minutes in traffic ........................................

If you think sleep apnoea syndrome is a possibility, consult your doctor, who may refer you to a laboratory that has equipment for assessing disordered breathing during sleep.

High blood pressure (hypertension)and heart disease are more likely in people who snore – both men and women (Journal of American College of Cardiology 2000;35:308–13). This may partly be because many snorers are overweight. Another reason may be that with even moderate snoring your breathing is obstructed and you are not getting quite enough oxygen during sleep, and this has a knock-on effect on your cardiovascular system. Whatever the reason, if you are a snorer ask your doctor to check your blood pressure.

Daytime functioning. If you snore, you may be disturbing your own sleep (as well as the sleep of others). This can affect how well you function in the day. For example, students who snore tend to do badly in exams (Student British Medical Journal 1998;6:182).

Headache. People who have daily headaches are more likely to be snorers (Neurology 2003;60:1366-8). The reason for this is not clear.