Snoring - Treating snoring

It's sometimes possible to treat snoring by making lifestyle changes. Further treatment is also available if this doesn't help.

Lifestyle changes

Lifestyle changes are usually advised by your GP as a first step to treat snoring. These include:

losing weight if you're overweight
not drinking alcohol – particularly a few hours before you go to bed
giving up smoking if you smoke
exercising regularly – this can help strengthen neck muscles, which may help prevent the airways narrowing

Talk to your GP if you feel your medication may be contributing to your snoring, as they may be able to prescribe alternatives. However, don't stop taking prescribed medication without first consulting your GP.

If your snoring is worse when you're sleeping on your back, you may find sleeping on your side beneficial. Wearing a top with a pocket stitched between the shoulder blades and putting a tennis or golf ball in the pocket can help keep you off your back when you sleep.

Ear plugs

If your snoring isn't causing you health problems but is affecting your partner, asking them to wear ear plugs during the night may be a cheap and effective way of resolving the issue.

Anti-snoring devices

If lifestyle changes don't help, there are a number of anti-snoring devices you can try that can help prevent snoring. These devices aren't usually available on the NHS, but they can be bought at many larger pharmacies.

The different types of anti-snoring devices are described below.

Nasal devices

If your snoring is mainly coming from your nose, you may benefit from using nasal strips or nasal dilators.

Nasal strips are small pieces of self-adhesive tape similar in appearance to sticking plasters. Before you go to sleep, place the nasal strip on the outside of your nose. The strip pulls your nostrils apart, which can help stop them narrowing during sleep.

A nasal dilator is a plastic or metal device that looks a bit like a nose ring. You place it inside your nose before you go to sleep and it pushes your nostrils apart while you're asleep.

There hasn't been much research comparing the effectiveness of each type of nasal device in treating snoring. For most people, their choice of device is based on personal preference.

Oral devices

If your snoring is mainly coming from your mouth, you may benefit from chin strips or a vestibular shield. Chin strips are strips of tape placed under your chin, which help stop your mouth falling open while you sleep.

A vestibular shield is a plastic device that looks similar to a gum shield. It fits inside your mouth and blocks the flow of air. This forces you to breathe through your nose, which may prevent you from opening your mouth and snoring.

As with nasal devices, there's limited evidence on which type of oral device is more effective, so the choice will be down to your personal preference.

Mandibular advancement device (MAD)

If your snoring is mainly due to the base of your tongue vibrating, a mandibular advancement device (MAD) may be recommended.

A MAD is similar to a vestibular shield, but it's designed to push your jaw and tongue forward. This increases the space at the back of your throat and reduces the narrowing of your airway that's causing your tongue to vibrate, resulting in snoring.

You can buy a MAD for around £30-50, which is suitable for most cases of simple snoring (snoring that doesn't cause any breathing difficulties).

However, if your snoring is associated with breathing difficulties, such as obstructive sleep apnoea, it's recommended that you have a MAD made specifically for you by a dental specialist (orthodontist) using impressions of your teeth and jaw.

The cost of a custom-made MAD will depend on the complexity of the device and materials used, and can range from several hundred pounds to several thousand pounds. It's unlikely that you'll be able to obtain a custom-made MAD free of charge on the NHS.

An MAD lasts about 18 months before it needs to be replaced.

Surgery

Several surgical techniques can also be used to correct snoring. However, surgery for snoring is usually only available free of charge on the NHS if:

there's evidence that snoring is having an adverse effect on your health or quality of life, and
you've tried all other recommended treatments without success

Surgery for snoring is usually regarded as a last resort, when all other treatment options have been tried and haven't worked.

Surgery also isn't suitable for most cases of snoring.

Surgery isn't usually recommended for people with sleep apnoea because there are more effective treatments available, such as using breathing devices to help with breathing.

Uvulopalatopharyngoplasty

Uvulopalatopharyngoplasty (UPPP) is used when it's been confirmed that soft tissue in your mouth (excluding your tongue) is responsible for your snoring.

During UPPP the surgeon will remove:

your uvula – the piece of tissue that hangs from the roof of your mouth
some of your soft palate
some excess tissue around the base of your throat

In some cases, your tonsils and adenoids may also be removed. Adenoids are small lumps of tissue at the back of the nose, behind the palate.

UPPP is carried out under general anaesthetic, which means you'll be asleep during surgery and unable to feel any pain or discomfort during the procedure. However, UPPP can cause considerable pain afterwards, which can sometimes persist for up to three weeks.

Removing your uvula can affect your ability to pronounce certain sounds, but it won't affect your ability to speak English. This is because the English language doesn't make use of any of the sounds made with the uvula (known as uvular consonants). However, you may find that your pronunciation of some words in other languages is affected by the operation.

UPPP completely cures snoring in about half of all people who have the procedure. Serious complications occur in an estimated 1% of cases. They include:

excessive bleeding
pneumonia (lung infection)
stroke
heart attack

Uvulopalatoplasty (UP)

Uvulopalatoplasty (UP), sometimes called laser-assisted uvulopalatoplasty (LAUP), is increasingly used as an alternative technique to UPPP because it carries a lower risk.

However, evidence suggests that UP may not be as effective as UPPP in the long term. UP can also cause considerable post-operative pain that lasts up to two weeks.

During UP, lasers or high-energy radio waves are used to burn away the uvular and some of the soft palate.

Soft palate implants

Soft palate implants can be used to treat snoring that doesn't cause breathing difficulties if it has been confirmed that the vibration of the soft palate is causing it.

During the procedure, a local anaesthetic injection is used to numb the roof of your mouth. Several implants made out of synthetic (man-made) material are injected into your palate, causing it to stiffen. This should help prevent to the soft palate vibrating while you sleep.

In 2007, the National Institute for Health and Care Excellence (NICE) published guidance about soft palate implants. It stated that there are no safety concerns over the use of implants, but people considering using them should be aware that there's limited evidence about whether they're an effective long-term treatment.

For more information, see the NICE guidance about soft-palate implants for simple snoring (PDF, 89kb)

Radiofrequency ablation

Radiofrequency ablation (RFA) of the soft palate is an alternative treatment to soft palate implants. It's used to treat cases where vibrations of the soft palate are responsible for snoring, and aims to stiffen the soft palate.

The procedure is carried out on an outpatient basis, which means you won't need to stay in hospital overnight. The roof of your mouth is numbed with a local anaesthetic and an electrode is implanted in the tissue of your soft palate, which delivers high-energy radio waves that shrink and harden the tissue. This makes it less likely to vibrate when you're asleep.

NICE guidance published in 2014 reported on a number of small studies that assessed the effectiveness of RFA. The researchers concluded that following the procedure there was an improvement in snoring and upper airway obstruction, which led to a lack of daytime sleepiness. The quality of life for both those affected and their partners also improved.

The guidance also states that there are no major safety concerns relating to RFA of the soft palate for snoring. However, evidence as to its long-term effectiveness is limited.

For more information, see the NICE guidance about radiofrequency ablation of the soft palate for snoring (PDF, 126kb)

Medication

Medication can't directly treat the symptoms of snoring, but it can be used to help treat some of the underlying causes.

For example, if allergic rhinitis (nasal irritation and swelling) is causing your snoring, an antihistamine nasal spray may help relieve your symptoms. Antihistamines are a type of medication that are very effective in treating allergic reactions.

Alternatively, if your snoring is particularly troublesome as a result of having a blocked nose, a short course of nasal decongestants may help. However, never use nasal decongestants for more than seven days in a row because it can make your symptoms worse.

Your GP can advise you on whether medication will help your snoring.