Patient information · ENT and sleep
Snoring and sleep apnoea
when snoring stops being a nuisance
Snoring alone is a social problem. Obstructive sleep apnoea — repeated collapse of the airway with pauses in breathing — is a medical one, linked to high blood pressure, stroke, diabetes and road accidents. It is common, substantially under-diagnosed, and very treatable.
Arrange assessment promptly if you have
- witnessed pauses in breathing, or gasping and choking awake
- falling asleep while driving, or feeling sleepy at the wheel — stop driving and seek advice
- morning headaches with unrefreshing sleep
- sleepiness with high blood pressure that is difficult to control
- sleep apnoea symptoms during pregnancy, or in a child who snores every night
There is a legal obligation to inform the DVLA if you have excessive sleepiness likely to impair driving, and you must not drive until it is controlled. This applies particularly to professional drivers. We can advise and provide documentation. Untreated apnoea multiplies accident risk several-fold.
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.
Snoring without apnoea
If a sleep study is normal, the measures that help are still worthwhile: sleeping on your side, raising the head of the bed, losing weight, avoiding alcohol within three hours of bed, treating nasal congestion, and dental devices. Surgery to the palate has a limited and unpredictable success rate and is not a first move.
Book an appointment if you snore with pauses, feel sleepy during the day, have hard-to-control blood pressure, or drive for a living. We provide ENT assessment of the nose and throat on site, and arrange home sleep studies and CPAP through our CQC-registered partners.
Sleep apnoea assessment and referral
Seven days a week, 9am–7pm, on Whitechapel Road.
Tower Bridge Hospital London
97–99 Whitechapel Road, London E1 1DT
WhatsApp 07903 284 189
info@mhwclinic.co.uk
Open Mon–Sat, 9am–7pm (closed Sundays until September)
In an emergency
Call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
When we are closed and it is not an emergency
Call NHS 111 or visit 111.nhs.uk.