Is your snoring a sign of something more serious?
Researchers have recommended introducing screening for obstructive sleep apnoea (OSA) in workplaces after findings from a new study suggested that the condition may carry significant financial costs for businesses.
The research, conducted by specialists in the UK and the US, examined the economic impact of OSA in both countries using data from the 2021 census. The team focused on working-age adults between 18 and 64, calculating losses by assessing absenteeism and reduced productivity at work.
In the UK sample, around 7% of working-age adults met the criteria for OSA, with estimated productivity losses reached as much as £4.22 billion annually, or £1,840 per worker each year.
Sleep apnoea is a condition in which breathing repeatedly stops and starts during sleep, and loud snoring is a key symptom, according to the NHS website.
In light of this new research, we spoke to some sleep specialists who regularly treat patients with the condition who have highlighted key signs that might indicate that your snoring could point to a more serious underlying problem.
What causes snoring?
Anatomy, lifestyle and physiology are the three main factors that can cause snoring, according to Dr Ryan Chin Taw Cheong, consultant ENT (ear, nose and throat) and sleep surgeon at Cleveland Clinic London Hospital and Cleveland Clinic Portland Place Outpatient Centre.
“If you have a structural narrowing of your nose or the back of your throat or the back of the tongue, that can actually increase the resistance of air flow when you breathe at night, which results in snoring sounds,” explains Cheong.
“Also, if you’re particularly overweight or you drink a lot of alcohol, the upper airway muscles can become more relaxed, and that can also increase the resistance of air flow, resulting in snoring.”
Furthermore, the ENT consultant and sleep surgeon also highlights how the way that your muscles relax at night, can also have an impact.
“In some patients, the way that the muscles of the tongue or the palate or the throat relaxes is excessive to the point of obstruction or narrowing, and that can also cause snoring,” adds Cheong.
What red flags might indicate that your snoring is something more serious, like sleep apnoea?
Choking episodes, gasping of air and/or pauses of breath
“If you witness any choking episodes or gasping of breath or pause of breath by your bed partner, or if you’ve experienced it yourself, that’s a potential red flag of sleep apnoea,” says Cheong.
Excessive daytime sleepiness
“The issue with sleep apnoea is that it causes really fragmented, poor-quality sleep, so you can’t get into these deep states of sleep that help you feel refreshed in the morning,” says Dr David Garley, GP and director of The Better Sleep Clinic. “So, if you wake up feeling unrefreshed, are sleepy throughout the day, and often struggle with concentration, memory and low mood, then you might want to consider talking to a professional about sleep apnoea.”
What are the risks of untreated sleep apnoea?
“The immediate effects are significant daytime sleepiness and disruption to your bed partner with snoring,” says Cheong.
However, there can also be significant health consequences.
“Untreated sleep apnoea has been associated an increased risk of strokes and heart attacks, increased risk of diabetes, high blood pressure, and there’s also been evidence to suggest that it can increase the risk of neurocognitive decline,” notes Cheong.
This consistent disruption of sleep can also have negative impacts on your mental health.
“If you think how bad you feel after one night of sleep, then you can see how years of bad sleep can have a really major impact on your health,” says Garley. “Some evidence suggests that around 20% of patients with sleep apnoea have depression.”
How is sleep apnoea diagnosed?
“There’s a risk assessment that you can do called STOP-Bang questionnaire [an 8-item, validated screening tool for obstructive sleep apnoea], but the diagnosis generally is carried out with a home sleep test,” says Garley.
“This usually involves wearing a medical watch-like devices on your wrist which have a chest and a finger sensor, which takes really detailed measurements on how you sleep.
“They’ll pick up the pauses in breathing, the drop in your oxygen levels, and also the activity of your fight-or-flight nervous system which gets activated by the pauses in breathing.”
How is sleep apnoea treated?
Several lifestyle changes are often recommended.
“Reducing your alcohol consumption is something lifestyle based that can be altered to reduce your risk of sleep apnoea,” says Cheong. “Making sure that your weight is within optimal range can also help.”
CPAP (continuous positive airway pressure) therapy is also a common treatment option.
“It’s a small box that sits on your bedside table that blows low pressure air through a tube that leads to a mask which sits either over your nose or over your mouth and nose,” explains Garley. “That gentle pressure holds your airway open from the inside, so that when you fall asleep and your airway narrows, the air pressure just keeps it open so you keep breathing freely and get to these deep states of sleep.”
Surgery or more advanced technologies are also available.
“More advanced technologies includes hypoglossal nerve implants, such as the Genio Nyxoah device, which go underneath the patient’s chin and stimulates the hypoglossal nerve to pulse the tongue forward to open up the airway at night,” says Cheong. “You can also have an operation on the palate at the back of the throat to open up the airway as well.”
