Private snoring & sleep apnoea clinic in London, same-day ENT.

Telling them apart

• Simple snoring — noise without pauses, no daytime sleepiness, refreshing sleep.
• Obstructive sleep apnoea — loud snoring interrupted by silences, ending in a gasp or snort; unrefreshing sleep; waking with a dry mouth or headache; daytime sleepiness; poor concentration and irritability; needing to pass urine several times at night.
• A partner's account is often more informative than your own, since you will not remember the arousals.

What raises the risk

• excess weight, particularly around the neck — a collar size over about 17 inches is a useful marker
• male sex, and increasing age; risk in women rises sharply after the menopause
• a small or set-back jaw, large tonsils, or nasal obstruction
• alcohol in the evening, and sedative medicines, both of which relax the airway
• smoking, which inflames the upper airway
• an underactive thyroid, and sleeping on your back

Diagnosis

A sleep study is usually done at home with a small device worn overnight recording breathing, oxygen levels, heart rate and movement. It measures how many times an hour your breathing stops or becomes shallow, which grades severity and guides treatment. This is straightforward and does not require a hospital stay.

Treatment

• CPAP — a mask delivering gently pressurised air to hold the airway open — is the most effective treatment for moderate and severe apnoea. People often dread it and then describe the difference to their energy, concentration and mood as transformative. Getting the right mask matters enormously, and early support with fit and pressure is the difference between success and a machine in a cupboard.
• Mandibular advancement devices — custom dental splints holding the jaw forward — work well for mild to moderate apnoea and for snoring, and suit people who cannot tolerate CPAP.
• Weight loss has a direct and substantial effect; a 10% reduction meaningfully improves severity.
• Positional therapy if apnoea occurs mainly on your back.
• Treating nasal obstruction, and surgery for large tonsils, particularly in children.
• Reducing evening alcohol and sedatives, which is often underestimated.