A/Prof. Dr Jack Gerschman

Nov 30, 2023

The Ultimate Research-Backed Guide to Treating Snoring

Do you regularly wake up your partner with your snoring?

Or perhaps it’s your sleep partner keeping you up at night?

Either way, if snoring is resulting in sleep deprivation and daytime tiredness, it’s high time you did something about it.But how exactly can you reduce or stop snoring?

Let’s explore.

Table of Contents

  • Introduction
  • Should you do something about your snoring?
  • What causes snoring?
  • Self-help home remedies
  • Medical devices and treatments
  • Other solutions and remedies
  • Next steps

Should you do something about your snoring?

Just in case you thought you were alone, snoring is actually extremely common. In fact, snoring occurs in approximately 40% of adults.

Sure, if you’re the partner of a snorer, this fact may be of little comfort to you at 3am when the ‘snore monster’ sleeping next to you emanates blood-curdling sounds loud enough to arouse you from an otherwise quiet slumber.

Nevertheless, it’s worth understanding it’s prevalence. You see, some people feel that there’s a stigma attached to snoring, which can inhibit their willingness to seek treatment. Understanding just how common it is can help normalise the condition and free up snorers to take action.

But just because you and/or your partner snore, doesn’t necessarily mean you have to do something about it. Here’s a simple test to determine if you should seek treatment:

If it’s negatively affecting your relationships and/or your health, it’s worth taking action.

RELATIONSHIP IMPACT

While snoring has likely been present since human life began, research has only recently unveiled its real impact.

Perhaps the most well-documented issue associated with snoring is its impact on relationships. For sleep partners, snoring can not only disturb their sleep and increase their daytime tiredness, it can place enormous strain on the relationship, with one partner often having to sleep in a different room.

Have you ever had to sleep in a separate room due to snoring? Is snoring putting the harmony of your relationship at risk? If so, it’s worth seeking treatment.

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HEALTH IMPACT

While relationship issues often garner the most airtime, the health risks of snoring can range from tiredness right through to death.

Here’s a list of some of the common health issues:

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  • Tiredness on waking/unrefreshing sleep
  • Excessive daytime sleepiness
  • Reduced quality of life
  • Gasping during sleep
  • Sore dry throat on waking Morning headache
  • Morning headache
  • Poor concentration
  • memory deterioration
  • decreased sex drive/impotence
  • irritability, personality changes
  • decrease in-job performance
  • anxiety and depression
  • increased risk of road, home and workplace accident

Are you or your partner experiencing any of these health issues? If so, seeking treatment is crucial.

What Causes Snoring?

In order to decide on the right solution to manage snoring, it’s important to understand what causes those disturbing nocturnal sounds.

So here’s a crash course in the science of snoring.

During normal breathing, air is drawn through the nose and passes over the soft tissues at the back of the throat, including the uvula, soft palate and the tongue.

When air cannot move freely through the throat, these ‘floppy’ tissues vibrate, producing a sound called snoring.During waking hours, the airways are held open by the tone of the muscles around them. Yet during sleep, these muscles relax.

In some individuals, the soft tissues may relax too much - they essentially begin to collapse - leading to obstruction of the airway.

To overcome this obstruction, snorers breathe harder, using their chest wall muscles and diaphragm. However, the harder one tries to breathe, the more the walls of the airways collapse.

Think of someone trying to suck through a straw which collapses as the effort to withdraw liquid is increased.

The result of this process is of course snoring.

But that’s not the end of the snoring story because there are a range of factors that can exacerbate the condition or make it more likely to occur.

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Here are some examples:
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A blocked or stuffy nose obstructs the nasal passages, thereby increasing the likelihood of snoring.

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Being a male. Yes, men are more prone to snoring than women as their nose and throat passages are typically smaller, making it more difficult for air to pass through the throat.

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Physical problems such as enlarged adenoids and a cleft palate may also exacerbate snoring.

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Your genetics can impact snoring. Nasal structures and tongue size, for example, may obstruct airflow and increase susceptibility to snoring.

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Various medications such as the muscle relaxant diazepam (Valium) can also increase muscle relaxation and therefore snoring.

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As your age increases, snoring may worsen as the throat becomes narrower, limiting airflow.

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Your sleep position also significantly affects snoring. When you sleep on your back, your muscles relax at the back of your throat causing your airways to become blocked.

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Your diet and associated weight gain is a key factor. As one increases in weight, there is more fatty tissue in the nose and throat. This can cause obstruction of the airway, nasal congestion, more vibration and more severe snoring.

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If you suffer from colds, flu or allergies, it may block your nasal passages and increase snoring.

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Smoking and drinking. Aside from all of the other negative health effects of smoking and drinking alcohol, they can also increase snoring.

If some of these factors sound familiar to you, you may be wondering what you can do about them.

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Rule out more serious conditions

Snoring can be a sign of a more serious sleep disorder or condition. So in order to address your snoring, your first step is to rule out more serious coexisting conditions and sleep disorders, which may require different or additional treatments.

For example, snoring can in some cases be a sign of obstructive sleep apnea, which is associated with cardiovascular risks, neurovascular risks, risk of work and motor vehicle accidents and mortality. For this reason, it is recommended to speak with a licensed medical or dental practitioner about whether you have sleep apnea and what treatment options are appropriate for your specific situation.

Self-help home remedies

In consultation with your doctor, you can then begin to explore the myriad snoring solutions available. They range from simple self-help strategies to more complex solutions administered by health professionals. Here are some research-based, self-help strategies to get you started on your journey to stop snoring:

Sleep position

Remember: While some people will snore in any position, for others sleeping on one’s side can help.

If you find it difficult to stay on your side throughout the night, researchers have tested a host of strategies to keep you there, including taping a tennis ball to your back, which causes you to wake up when you roll onto your back.

There are also pillows designed to prevent you from sleeping on your back. For some people, these techniques can even result in ‘training’ you to sleep on your side naturally, without assistance.

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Strengthen your throat muscles

We don’t often think about exercising or building up our throat muscles when we’re pumping weights at the gym. But it might be just what you need to reduce your snoring. Building up and toning your throat muscles can reduce the flabby muscles in your throat and therefore the vibrations that cause snoring.

Exercises like placing your tongue on one side for 30 seconds and then one the other side for a further 30 seconds can be a useful daily addition to your morning or evening regime. Similarly, touching the top front of your teeth with your tongue and moving it sideways on a daily basis may also assist.

Believe it or not, there’s even evidence to show that singing exercises and playing a didgeridoo (an Australian Native Aboriginal wind instrument) or bagpipes regularly may further reduce snoring by strengthening your throat muscles.

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Lose weight

It’s hardly news to suggest that weight loss is good for your health, particularly given the well- known link between obesity and heart disease.

But given the impact of increased weight on snoring, losing weight through regular exercise and a healthy, balanced diet may also mean a better night’s sleep.

Conversely, if you gain weight it is very likely to make your snoring worse.

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Manage your allergies

It may not be possible to simply switch off your allergies at will. But if they’re blocking your nasal passages and affecting your snoring, it’s important to consult your doctor to discuss whether there are any medicines or treatments that can assist.

For example, a nasal decongestant, such as an antihistamine spray, can be used for a limited time. Similarly, having a humidifier in your bedroom can improve the air quality and reduce snoring.

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Stop smoking and drinking

If you smoke or drink regularly, reducing your intake or stopping all together can have a significant positive impact on your snoring.

If you find it difficult to avoid alcohol or quit smoking, speak with your doctor about the various programs available to assist you.

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Medical devices and treatments

In addition to self-help strategies, there are a range of medical devices and treatments available to help manage snoring.

Here’s an overview of some of the common options.

CPAP (Continuous Positive Airway Pressure)

A CPAP machine uses a hose and mask or nosepiece to deliver constant, steady air pressure. While CPAP is typically prescribed as the ‘gold standard’ for sleep apnea sufferers, more severe cases of snoring may also benefit. CPAP devices must be prescribed by a Respiratory Sleep Physician, so you’ll need to speak to your doctor for a referral to determine if this is suitable for you.

The benefit of CPAP is that, if you wear it, it has a high success rate. The downsides are that many people find it uncomfortable to wear, and it’s often a very costly process.

Custom Oral Appliances

Custom oral appliances are usually fitted in the mouth following a measurement of the mouth and teeth by a Dentist. They’re used to prevent the airway from collapsing by bringing the lower jaw forward, thereby opening the airway. For this reason, they’re often termed Mandibular Advancement Devices (MAD) or Splints (MAS).

While they’re often prescribed for people with mild to moderate sleep apnea, they can also be prescribed for snoring sufferers.

The advantage of these devices is that they’re customised to the mouth of wearers and can be effective for some people. The downside is that they’re typically expensive, require fitting by a dentist, and can result in jaw pain, temporomandibular joint disorders and permanent changes to the face and bite due to significant jaw advancement.

Non-custom Anti-snoring devices

Most non-custom oral appliances operate according to similar mandibular advancement principles to their more expensive ‘customised’ cousins. Their advantage is typically their reduced cost compared to customised devices. However, they can still result in jaw pain and permanent bite/facial changes.

The Happy Sleep Anti-Snoring Mouthpiece is a non-custom, oral appliance. However, unlike most devices, which operate by advancing the lower jaw, the Happy Sleep mouthpiece only advances the jaw minimally, to avoid over-extending the jaw & permanently changing the bite.

It’s flexible jaw support flap holds the jaw together, preventing the lower jaw from dropping during sleep. Most critically, its breathing airway is designed to enhance nasal breathing, which has been shown to reduce snoring and a range of other conditions.

Ear Nose and Throat surgery

Another option is ear, nose and throat surgery. Studies suggest that surgery should only be considered as a last resort, after having tried other treatments.

Surgery is typically performed by an Ear, Nose and Throat Surgeon or a facio-maxillary surgeon.

While there are many surgical options, surgery is tailored to the area of obstruction in each particular patient, which could be anywhere in the upper respiratory tract, including the nose, tongue, and throat. Some of the most common surgical methods include:

  • Nasal surgery (to reduce obstruction in the nose eg. septoplasty and turbinate reduction).
  • UPPP or uvulopalatopharyngoplasty (removal of excess tissue from the soft palate and pharynx, as well as tonsil removal, to keep the area open).
  • Soft palate implants (the Pillar Procedure, which includes placing rods into the soft palate to stiffen it)
  • Hyoid advancement (repositioning of The hyoid bone in the neck where the muscles of the tongue base and pharynx attach, in order to expand the airway).
  • Tongue advancement (advancing one of the main tongue muscles, the genioglossus, limiting the tongue’s backward fall during sleep).
  • Tongue base reduction (reducing the amount of tissue from the tongue base through the application of radio-frequency waves or direct excision).
  • Lower jaw advancement (enlargement of the upper airway through advancing the upper and lower jaw bones by up to 10-12mm, stabilised with titanium plates).
  • Tracheostomy (creating a passageway for air to get to the lungs directly from the trachea in the neck, bypassing any potential sites of obstruction from the upper airway).

Other solutions and remedies

While the above treatments are the most well-researched, a plethora of new solutions continues to emerge each year.

Some examples include:

Nasal Strips

Nasal strips dilate the nostrils and increase airflow via a strip that sits across the bridge of the nose and pulls the outside of the nostrils apart. This can help people with nasal congestion to reduce snoring.

Nasal dilators

Another option that is used to treat nasal congestion, nasal dilators dilate the nostrils and increase airflow via a clip that exerts pressure and expands the nostrils from the inside.

Chin straps

Typically made of stretchy material, chin straps assist in keeping the jaw and mouth shut, forcing snorers to breathe through the nasal passage.

New solutions will undoubtedly continue to appear on the market. While some may be beneficial in treating snoring, check to ensure they’ve been developed by experts in the field and are backed by research to demonstrate their efficacy.

Next Steps to Eliminate Snoring

If haven’t yet seen a licensed medical practitioner to assess your situation, that’s your first step.

Then, consider some of the simple, self-help solutions - you may be surprised what a difference some simple behavioural and lifestyle changes can have on your snoring.

If you’re looking for a more effective solution, but are not worried about cost or comfort, then CPAP or a custom oral appliance may work to stop snoring.

If you’d like an effective, comfortable and cost-effective solution to treat snoring, try the research-based, dentist-designed Happy Sleep mouthpiece today.

ABOUT THE AUTHOR

Dr Jack Gerschman,
Associate Professor

A/Prof. Dr Jack Gerschman is a world-renowned dentist and sleep medicine expert, combining over 35 years of medical, dental and academic experience and qualifications, providing world-leading technical guidance in the development, testing and roll out of the Happy Sleep device. He regularly presents at Dental Sleep Conferences & Global Summits, has published numerous articles and studies and is cited in Marquis Who’s Who of Medicine and The Stanford Who’s Who as a leading contributor in his field.