Snoring Treatments

The good news is that snoring really can be treated!

In recent years snoring has gone from being laughed at by the medical profession to being the subject of serious clinical studies.

Unfortunately, due to the lack of medical research in this field until recently, a lot of "quack" remedies are still being promoted. Some of these work occasionally, some don't work at all. There are still a lot of dodgy operators offering an unlikely cure and often bogus "money back" guarantees, especially on the internet.

So, you have a snoring problem. What can you do?

I'll group the possible approaches under Surgery, Lifestyle Modifications, Drugs and Devices

Surgery

to come...

Lifestyle Modifications

Lifestyle modifications involve somehow changing your physical body so it stops snoring, without reliance on any gadgets. Obviously if you can do this it's a good solution - you don't have to worry about carrying anything around with you, and you can just get on with sleeping. In summary : losing weight, not smoking, not drinking, not being old, and improving muscle tone around your throat are all likely to help.

Drugs

Drugs. Some people can stop their snoring by reducing inflammation around their airways. If you suffer a lot from hayfever, have persistent sinus irritation or other allergies, you may get some relief from a drug (natural or synthetic) with reduces the inflammation. There are also quite a few products around that don't work at all. I'll put up a page on drugs after I finish the Devices and Lifestyle Modifications pages.

Devices

Devices. The lifestyle modifications all take quite a while to do, and generally require ongoing effort to maintain. So if a lifestyle modification is not what you're after, or you just want an immediate cure to help you through while you work on a longer-term lifestyle modification, you'll need a gadget of some description.

First thing to do is find what sleeping positions you snore in. If you snore only on your back, attach something big and lumpy (tennis balls are good) to the back of a t-shirt and sleep in that. If you only snore on your front, attach the tennis ball to the front of the t-shirt. There is nothing simpler or cheaper.

If this causes other problems for you (like ongoing back pain due to the new sleeping position), or you snore in basically any sleeping position, have a look at your options below. There's a summary first, and then details and comments for each method.

Things that work for most people


Mandibular Advancement Devices (M.A.D.s)
Tongue Pullers
Surgery
CPAP

Things that work for some people


Nasal Expanders
Mouth blockers
Decongestant sprays
Sleep posture modification
Exercises
Chin holders (Sleepwizard)
Chin Lifters / Chin Pillows

Things that work for very few people


Accupressure devices
Pain inflictors
Magnetic things

Click the links above to see more detail, or just scroll down. This section isn't completely finished yet. Still working on it!

MANDIBULAR ADVANCEMENT DEVICES (M.A.D.s)
M.A.D.s are cheap, convenient, provide instant relief when they work, and work brilliantly for around 80% of snorers. So that should make trying a M.A.D your first choice. They come in two basic types
(1) the professionally fitted devices, costing around AUD$1200 to AUD$2000
(2) the do-it-yourself (DIY) devices, costing around $60 to $200
The professionally fitted devices are a bit better, but you can still get a great result with the DIY devices. Personally, I don't think the extra cost of the professionally fitted devices justifies the benefits. You can see a comparison between professional and DIY devices here

You can see a comparison of the various DIY devices here

TONGUE PULLERS
.
Tongue Pullers work on the same principle as M.A.D.s except they pull the tongue forward directly by gripping it somehow, rather than indirectly by moving the lower jaw forward.

The first pictured device is the Aveo Tongue Stabilising Device. It costs around AUD160.00 (December 07). It holds the tip of your tongue in a "suction bulb" at the front.
I've spoken to a few people who've tried this device and they all commented that it was very hard to get the suction right. Either they wouldn't poke their tongue in hard enough and it would slip out during the night, or they'd poke it in too far and wake up with an aching tongue in the morning. But I imagine you'd get better at using it with practice.

The second one is called the "MPowRx". Yep, "MPowRx". Don't blame me, I think it's silly too. You can find out a bit more at http://www.mpowrx.com but not very much. It seems to be only available in Canada, through dentists, and they don't say how much it costs.

Anyway this style of thing may be a good choice if you don't have enough teeth left to use a M.A.D., or you have very mobile teeth that start moving or just get really sore when you use a M.A.D.

SURGERY
Surgery is great in theory, but presently it seems to be a little hit-and-miss. I think there are a lot of good surgeons and some shockingly bad ones. If you get a good one, you'll be happy. If you don't, well, you'll be sad.

There are a lot of different surgeries that can be performed, depending on what is actually "wrong" and causing your snoring. For example, obviously surgery to your nose won't help if your snoring is caused by a long and droopy soft palate, but often this seems to be overlooked by surgeons who only know how to do one type of surgery. I recommend getting opinions from at least 3 independent surgeons before you go under the knife. If they all examine you thoroughly and recommend the same procedure, it's probably going to be the right one. If they don't agree, some time spent working out which surgeon is right would be a good investment.

CPAP
CPAP stands for Continuous Positive Airway Pressure.

The idea is that if you pump air down a person's throat, this will keep their airway wide open and stop them snoring.

It genuinely works. Most people would find this a bit extreme as a cure for snoring, but I think it's a perfectly good solution. The machines are a lot quieter now than they used to be - previously it wouldn't have mattered if the person was snoring or not because you wouldn't have heard them over the din from the machine. A lot of people don't tolerate CPAP very well (they feel claustrophobic or just generally uncomfortable) and it can be difficult travelling with all that gear. But despite the problems it's still worth considering.

CPAP machines are the most popular treatment for Obstructive Sleep Apnoea, and that is what they are generally prescribed for. But if you have a good relationship with your doctor they'll probably help you get one for your snoring.

NASAL EXPANDERS
A B C
Nasal Expanders come in three main types, as illustrated above.

(A) little cups that you poke inside your nostrils

(B) elastic strips that you stick on the outside of your nose (they are springy and pull your nostrils open)

(C) scarey metal springs that you shove into you nose, like this :

These will work for a very small percentage of snorers. As far as I know, nobody snores because their nostrils are flapping around in the breeze, so these devices don't work that way. The way they probably work (on the rare occasions that they do) is as follows : when you inhale, you create a small vacuum in your throat, which tends to pull the walls of your airway inwards. The more constricted your nostrils are, the more pronounced this vacuum will be and the greater the tendency for your airway walls to move together (you can see an illustration of this if you suck air in through a straw and gradually cover the end with your finger. Once you have enough restriction at the end of the straw, it collapses). Now if your airway walls get too close together, some soft tissues will end up bridging across, somewhere in your airway. As air is forced through this area, noise will be produced. Voila! You are snoring.

Now the reason this only works for such a small percentage of people is that the amount of difference you can make to the inhalation vacuum by widening your nostrils is insignificant. Maybe, if you were just barely snoring (ie your inhalation vacuum was causing your airway to just barely collapse enough for you to snore the tiniest little bit) and you widened your nostrils as much as you could, your snoring might stop.

But these are pretty cheap, and a bit of fun (well, maybe it's just me that thinks that), so there's no real harm in buying some. At the time of writing this (Dec 07) you can buy the elastic strip type from chemists for around $12, and the plastic insertion type for around $12 on eBay. So as long as you don't really expect them to work, you won't be disappointed. And who knows, they may even work for you!

THINGS THAT WORK FOR SOME PEOPLE

There are a lot of other devices on the market that are only going to work for a very small percentage of people, or none at all. Here are my comments on them.

Note that the advertising for many of these devices claims "percentage effectiveness" in a rather misleading manner. Sometimes these are simply unethical lies where no clinical trial has been done, or sometimes they will conduct a trial but very carefully select subjects who are likely to be successfully treated with their particular method, and come up with an excuse to exclude people who are not. Also the measurements of "effectiveness" can be quite misleading. The only sensible measure is volume and frequency of snoring. Sometimes reports use "partner interviews" or even worse "clinician evaluation" which basically means the person running the trial just makes up whatever result they want.

Exercises
{comments coming}

Mouth blockers
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Decongestant sprays
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Sleep posture modification
{comments coming}

Chin holders (Sleepwizard)

{comments coming}

CHIN LIFTERS / CHIN PILLOWS
Chin Lifters aim to keep the chin up and away from the chest. This is usually done using a pillow that provides bulk under the chin.

There is some merit in this. With the chin raised as far as possible, the airway is as open as it can be. This position is used for resuscitation.

Unfortunately, to get a substantial airway opening effect you really need the chin quite high indeed - higher than most people could tolerate sleeping in, and certainly higher than most pillows achieve.

But still, you would get a slight improvement even with a small lift of the chin, so this would certainly work for a small percentage of people.

THINGS THAT WORK FOR VERY FEW PEOPLE

Acupressure devices These come in two types

devices that clip onto your septum like this

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and devices that apply pressure to one of your fingers like this

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Now, I have a lot of respect for acupuncture and while its results can't be easily explained by current western medical thinking, it's undeniable that acupuncture can produce some amazing results. But as for these little gadgets... I dunno... seems a bit unlikely to me.

Pain inflictors

This brilliant device gets strapped onto your wrist, and whenever it detects a noise it thinks might be snoring, it gives you a painful electric shock. How cool is that?? Obviously it won't actually stop your snoring (any more than repeated jabs in the ribs do) but it is certainly a lot more convenient for the non-snoring partner. If your partner buys you one of these, make sure you wait until they are asleep, then carefully transfer it to their wrist. That way, you can get a good night's sleep and your partner will always be awake to enjoy your snoring!

{Magnetic things
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