Why these women all snore – and how admitting it could save their lives
THe POPULAr image of a snorer is an overweight man who’s possibly had a drink too many. But snoring is far more common among women than many might realise — there is one female snorer for every two men who snore, according to the British Snoring and Sleep Apnoea Association.
A snore occurs when the soft tissues in the nose and throat vibrate excessively as we inhale — it’s more likely to occur if you breathe through the mouth, as this increases the vibrations.
As well as being embarrassing, snoring can have potentially serious health implications.
‘Since women are generally mortified about being told they snore, few will seek help,’ explains Michael Oko, a consultant ear nose and throat surgeon and head of obstructive sleep apnoea services at United Lincolnshire Hospitals NHS Trust.
‘But in some cases snoring can be a sign of an underlying health issue such as enlarged tonsils. And in extreme cases, this can be potentially fatal.’
Here, five women snorers tell their story, while Mr Oko suggests possible causes and practical solutions.
TINY NOSTRILS CAN MAKE YOU SNORE
PhOTOGRAPhER Josie Rowlands, 38, is divorced and lives in North Wales with her children, Daniel, 17, Jake, seven, and Minnie, five. A fOrMer boyfriend once videoed me snoring and I was horrified by the noise. I don’t think it’s anything to do with my weight — I’m 9st, 5ft 8in, and a size 8.
But I’ve always wondered if my small nostrils were the cause. People have always made a joke of the fact that mine are quite small — at least half the size of other people’s — and actually they do cause issues for me.
I always find myself breathing through my mouth, which can leave me out of breath when I run. If I get even a slight cold or a touch of hay fever, I struggle to breathe through my nose.
I had tonsilitis often as a child and was told my adenoids — the tissue between the back of the nose and the throat — were a problem, too. I don’t sleep well, and most nights I wake up around 2am and it takes half an hour to drop off again. EXPERT VERDICT: The anatomy of the nose can have a lot to do with whether a person snores. If Josie has narrow nostrils that collapse as she breathes in, then she will definitely snore and be forced to mouth breathe.
And as she has small nostrils the anatomy of the inside of the nose will be smaller, too, which can also contribute to snoring because her nose may be more easily blocked.
Adenoidal problems will only compound t hings — enlarged adenoids can block the airflow at the back of the nose.
Josie’s hay fever may make the snoring worse. With small nostrils, it won’t take much for the inside of her nasal passage to swell, then she will have to breathe through her mouth. She should limit allergens in her bedroom by keeping it clean and wiping down surfaces, rather than dusting, to avoid the spread of dust, pollen and mites.
Wearing an anti- snoring nose clip could help — these are worn inside the nostrils to splay them outwards.
THE RISKS OF BEING A DEEP SLEEPER
DEBORAh JOsEPh, 55, a GP, lives in Manchester with her husband, howard, 55, a businessman. she has three children. I’ve always been a deep sleeper. As a 12-year-old, I once fell off the top of a bunk bed and slept right through it. As a junior doctor on call, I could sleep through my bleeper. I’ve even slept through our burglar alarm.
I only became aware of a real problem with snoring about seven years ago. My husband was constantly being woken up by my snoring, which would leave him feeling very tired.
I was astonished — I only weigh 8 st and do lots of exercise, including having sessions with a personal trainer, as well as cycling, walking and spinning classes. And I don’t smoke.
As a doctor, I wondered if it might be sleep apnoea — where you repeatedly stop breathing at night because the tissues in the airways collapse (this can make you snore).
I saw an ear, nose and throat (eNT) surgeon and had overnight monitoring to check my heart rate and oxygen intake, and any breaks in breathing while I slept, but the results were normal.
I knew there was a possibility that the shape of the jaw or palate could have an impact on snoring. So I was referred to a maxillofacial specialist, who found that my palate was very narrow, the source of my problem.
He made me a mandibular advancement device (MAD), a piece of plastic worn at night which holds the lower jaw and tongue forward. This creates more space at the back of the throat and stops the tongue rolling back, preventing any blockage.
It’s not the most comfortable or romantic thing to wear, but it does seem to stop my snoring. And at least my husband can have a peaceful night. EXPERT VERDICT: If the palate is too narrow, long or soft, it can affect the flow of air and cause snoring.
It’s good that Deborah persisted in finding out the cause. This isn’t just so she could rule out sleep apnoea, which can lead to heart disease and stroke, but also because snoring gets worse over time if left untreated, regardless of the cause.
The airway is like a vacuum cleaner, and if you keep sucking on soft tissue it will get longer and stretchier. Being a heavy sleeper would have compounded her snoring, as it is during our deepest sleep that snoring is most likely to occur. The airways become floppier and so more prone to obstruction.
Mandibular advancement devices, if fitted properly, are successful in 70 per cent of cases. But if Deborah finds it persistently uncomfortable, she could consider surgery to improve the narrow areas by cutting part of the soft palate and taking the tonsils out to widen the back of the throat.
No operation is without risk, so Deborah would have to consider whether her quality of life was suffering enough.
HOW HRT MAY HELP MENOPAUSAL SNORERS
RAChEl BRAsTOCk, 54, a business leadership consultant, lives in Clevedon, somerset, with her husband, Andy, 52, an equestrian photographer. I’ve BeeN a snorer for as long as I can remember, but it’s never disturbed my own sleep and it only really became a problem when, four years ago, I had to have a hysterectomy, which sent me into early menopause.
It was around then that my husband said my snoring got a lot worse; he
often decamps to the spare room. If I sleep in a warm room — in a hotel or where there is an air conditioning unit — my snoring is a lot worse.
I’m about a stone overweight (I’m a size 16). But I do a lot of yoga, Pilates, aqua aerobics and, since we live by the sea, walk a lot. So I don’t think of myself as one of those unfit, flabby people who seem to snore.
I just have this annoying habit — well, it’s annoying for other people! EXPERT VERDICT: Snoring is twice as common f or women after the menopause — which is why it is a problem for Rachel now.
It’s due to fluctuating levels of hormones — oestrogen, for example, can affect the nasal lining, causing it to swell (it’s not clear why, though it has been suggested it might have a knock- on effect on histamine, a chemical the body releases in response to injury and which causes inflammation). This can lead to nasal blockage or stuffiness which will cause snoring.
Hormone replacement therapy (HRT) may help. Some studies found modest improvements in snoring and sleep apnoea with oestrogen alone, while others had better improvements with both oestrogen and progesterone (some had no improvement).
Being overweight could be compounding Rachel’s situation. As we gain weight, fat can be deposited in the neck, tongue and soft tissues. This extra padding leads to narrowing of the airways (passages that lead up the nose, down the throat and to the windpipe), causing snoring.
Rachel should try to sleep in as much fresh air as possible, so she should have the window open.
The nose is a very sophisticated and sometimes temperamental airconditioning system, so it’s important to reduce exposure to irritants such as dust mites, which could cause the nasal lining to swell, forcing you to mouth breathe and snore.
SLEEP ON YOUR BACK? YOU’LL SNORE MORE
Lucy BaLLard, 22, works in marketing and lives with her boyfriend in Bournemouth. To look at, I’m probably the opposite of the stereotypical snorer. I’m female, tall — over 5ft 9in — and slim. And I’m only 22; you normally associate snoring with older people.
But my boyfriend frequently complains about the noise I make in my sleep — strong but steady gasps. I suppose it’s a lady-like snore!
I do have some health issues. Since I was 13 I’ve suffered with scoliosis, a curvature of the spine.
The most comfortable way for me to sleep is on my back with a pillow under the middle of my back. I’ve always wondered if the scoliosis might be to blame.
I also have very large tonsils. I know this because I had an issue with bad breath several months ago and my doctor told me it was from food getting stuck in my tonsils, which are bigger than average. I didn’t think it was worth having them out, as I don’t suffer from tonsilitis.
What has helped is wearing the Goodnight anti-snoring ring on my finger. Apparently this focuses on two acupressure points on the little finger, which are said to help make breathing easier. According to my boyfriend, I snore less now.
I also know my snoring gets much worse after a heavy meal or a few glasses of wine. But these can be hard to resist — even if they do cause problems in the bedroom!
EXPERT VERDICT: For people who snore, male or female, it gets much worse when they sleep on their backs. This is because of the effect of gravity on the tongue. When we lie back, the tongue falls back and narrows the airways.
lucy could try lying on her side with a rolled- up pillow snugly packed in front of her and one behind, so that her back still feels supported. Her large tonsils will also contribute to snoring, since they narrow the airways. But unless lucy wants to have her tonsils removed — which could be painful and involve some risk, as with any surgery — she’d be better off looking at other aspects of her lifestyle. She should avoid drinking alcohol in the evening. Alcohol relaxes the muscles of the throat (sedatives and some antidepressants can have a similar effect, which is why taking sleeping pills can increase snoring).
I don’t know of any scientific evidence to suggest acupressure helps snoring.
THE CONDITION THAT CAN KILL
Kath hope, 54, lives in hull with her husband, John, 57, a train guard. the couple have two children. I’ve been a life-long snorer. even as a child, my sister couldn’t sleep in the same bedroom as me.
In adult life, I would sometimes wake up literally gasping for breath — which was most alarming. I thought it might be my snoring that was waking me. But since I wasn’t overweight — I’m a size 12 and like to keep fit — I couldn’t work out why I was snoring so badly.
A few years ago I started feeling tired and washed out all the time and would sometimes need to nap during the day. So I saw my GP. He diagnosed stress and anxiety (I had a busy job running a music school) and prescribed antidepressants.
But I was still exhausted and lacking in concentration, so I had blood tests for conditions such as an underactive thyroid, anaemia and even leukaemia, which was terrifying.
eventually, I was referred to an eNT consultant, who diagnosed obstructive sleep apnoea. Although I was relieved to know what the problem was, I was stunned to hear that the condition could affect the heart and even be fatal.
I realised my mother must have had it, too — her snoring would make the house vibrate. She died of a heart attack at just 49 — if only we’d known about sleep apnoea.
I now use a special machine at night that’s like a mask and delivers air via a tube through my nose: this continuous pressure prevents the airways from collapsing.
It’s caused sores on my nose bridge, but special creams and covers have helped with this.
My husband, John, says it has changed our lives, as he can now sleep in peace. I have since set up a website — hope2sleep.co.uk — to raise awareness of sleep apnoea and support sufferers. EXPERT VERDICT: obstructive sleep apnoea is a potentially life-threatening sleep disorder which affects 4 per cent of middle-aged men and 2 per cent of middle-aged women. It occurs when the upper airway walls relax, narrow and collapse during sleep, so the patient repeatedly stops breathing. This explains why kath was waking up struggling for breath.
left untreated, it can lead to heart disease, stroke and diabetes. This is because the body responds to the dropping l evels of oxygen by releasing adrenaline — which raises your blood pressure, glucose levels and increases your heart rate.
lots of things contribute to the condition, including weight gain and genetics — you may come from a family with, say, small jaws, which results in narrower airways. It’s more common in the over-50s and those with a neck circumference of more than 40cm.
Thankfully, kath has been diagnosed. But it’s vital to see a GP if you suspect a problem — if you wake up snorting or choking, for example. Studies have shown that if left untreated for 12 years, 35 per cent of severe cases can lead to heart attack or stroke and 15 per cent can be fatal.