As Australians become more aware of the impact poor sleep can have on their health, the concerns around snoring, often a symptom of a more serious sleep condition, can have people unnecessarily worried. It isn't always the case, said Melbourne respiratory physician Dr Nicholas Wilsmore.
"Snoring is very common; frequent loud snoring is reported by 24 per cent of men and 17 per cent of women. Frequent, loud snoring and breathing pauses in sleep are more often seen in middle age. Among those with frequent, loud snoring, 70 per cent report daytime impairment or other sleep-related symptoms," he said.
"While pretty much everyone who has sleep apnoea snores, not everyone who snores has sleep apnoea.
"Snoring alone is not necessarily indicative of sleep apnoea. There are a variety of other features which may add to a suspicion of having sleep apnoea, such as witnessed pauses in breathing during the night, waking up unrefreshed, being sleepy during the day or possibly having other medical conditions such as high blood pressure or irregular heart rhythms.
"This is not always the case however, and for some patients, especially if the snoring is very loud, or the patient is significantly overweight, then there should be a low threshold for considering further investigation for possible sleep apnoea.
"If the only complaint is that their partner says they are snoring, but beyond that their quality of sleep is fine and they're waking up refreshed and there are no other suggestions to indicate sleep apnoea, then simple snoring is a perfectly valid diagnosis," said Dr Wilsmore.
Intermittent snorers may experience snoring for a number of reasons including pregnancy, sleep deprivation, alcohol or other drug use, and nasal congestion in those suffering from colds and allergies.
Additionally, some people only snore on their back, and some medications make people more likely to snore such as sedatives, muscle relaxants and painkillers.
"I like to say that snoring requires two people: one to snore, and one to hear it! Some people may be very deep sleepers and their partner might snore, but they are completely unaware of it because it doesn't bother them. By the same token, some partners may be very light sleepers, and even mild snoring can disturb their sleep," he said.
Children however should never snore. Snoring is always considered abnormal in the paediatric population, and the consequences of untreated sleep apnoea in these patients is significantly worse than in adults.
"The benefit of diagnosing the problem in children is that it is often curative through tonsillectomy or throat surgery, as opposed to adults where surgery is not always an effective option," he said.
Dr Wilsmore said at the end of the day, snoring is only an issue if it's an issue: if a person is snoring but they are well-rested and their snoring is not disturbing their partner then any further issues may not come to light.
"Sometimes I'll have a patient come in to be investigated for sleep apnoea who says they don't snore, but the reliability of that testimony might be questionable, because it needs a second party to confirm it," said Dr Wilsmore.
Sleep apnoea occurs when the upper airway is obstructed, leading to the person to stop breathing multiple times within the night. It can have consequences such as waking unrefreshed, daytime sleepiness, decreased concentration and an increased risk of diabetes, high blood pressure, depression and heart disease.
Daytime sleepiness differs from fatigue, in that these people can doze off unintentionally. This can be dangerous for those who drive or operate machinery.
"Another sign of sleep apnoea we ask people about is if they have to get up during the night to go to the toilet - when you have sleep apnoea this over activates the sympathetic nervous system which promotes diuresis and contributes to people needing to urinate more frequently.
"Some older men who have been thought to have prostate issues have been treated for sleep apnoea, which often brings this need to go to the toilet in the middle of the night under control," said Dr Wilsmore.
People experiencing such issues should discuss these with their GP to see if they need to be further investigated for sleep apnoea or other sleep disorders. However, snoring alone does not necessarily indicate a problem.
"There are a number of options available for reducing snoring such as mouthguards and nasal devices that can work well for simple snoring," said Dr Wilsmore.
"Other options such as nasal strips and expiratory pressure nasal devices which go into the nostrils can be purchased in chemists or over the internet, and can also be effective for reducing the occurrence of snoring," he said.
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