There's no sound quite as annoying as that of a snore; it's right up there with the noise of a jackhammer or a baby crying. Anyone who has tried to sleep near a snorer will agree that the worst part about a snore is the silence in between when you think that it might have stopped ... only for it to start again.
Snoring affects 45 per cent of the population at one time or another and it is not just irritating for the bedfellows of snorers, it can also be dangerous for the snorer. In 2003, researchers at an Australian hospital made the link between chronic snoring and heart disease. Snorers often also suffer from fatigue as their sleep is disrupted, even if they are sleeping in a room by themselves; if they are sleeping in a bed with someone else, their sleep is also disrupted by being nudged or rolled over by their bedfellow. This is exemplified by the fact that habitual snorers often describe an overwhelming need to sleep in the afternoon.
So why do so few snorers seek help? The problem may lie in the bewildering array of snoring cures on the market. There are rings for your fingers that promise to cure snoring through acupressure, boxes that light up when they detect you snoring and alter your sleep patterns and laser operations, lotions and potions designed to tighten the throat muscles and clear the nose.
Treatments for snoring fall into two camps, the mechanical and the chemical. The British Snoring and Sleep Apnoea Association (BSSAA) believes that the most effective way to treat snoring is temporarily to alter the shape of the nose and mouth during sleep to stop the vibrations that make the snoring sound.
On its website, the Association sells nostril dilatory (springy semi-circular devices that prop the nostrils open), nasal strips (that also widen the airways), sticky strips to keep the mouth closed and the mandibular advancement device (MAD), which changes the position of the jaw during sleep.
The other method of treating snoring is chemically, with sprays and creams to tighten the throat muscles and clear the nose.
But embarking on a search for a treatment for snoring can be long and frustrating. People often give up after trying one or two treatments because they don't realise how idiosyncratic snoring is -- everyone snores in a different way for a different reason. A treatment that works for one kind will not work for another (see box). But the good news is, if you can correctly identify the cause of your snoring, there's every chance you can cure it.
"A lot of people try one thing and then, when that doesn't work, they give up and think that nothing will work," says Dr Neil Stanley, a sleep expert from Norfolk and Norwich University Hospital. "But few people realise that there isn't a cure-all and a lot of people try many different things before they find the treatment that works for them."
More recently, operations have been cited as an effective cure but Dr Stanley believes that surgery should not be undertaken lightly. "There are a number of operations that can be done. They all try to do the same kind of thing, which is to cut the flaps of skin in the airway. The success rates for this aren't exactly brilliant. I think in about 25 percent of people it works perfectly, in 50 per cent it makes no difference at all and in the rest it can make the problem worse.
Graham Newman, a retired marketing director, searched for a cure for his snoring for years. "I remember as a child that my father snored -- I think snoring has a lot to do with facial structure and so that maybe why I snore, too. My snoring only really became a problem when my children were young; my eldest is now 36 and the youngest is 30. When they were little my wife, Janet, would be up in the night with them and then she couldn't go back to sleep because I'd be snoring. I was in complete denial about it at first but in the end I tried a lot of the treatments because my wife is a deputy head teacher and it's an awful lot of work, with late nights and early mornings. She obviously wasn't getting enough sleep because of my snoring."
"The children used to tease him about his snoring, which didn't help" says Graham's wife, Janet. "But he realised that things were getting a bit difficult -- I was getting quite tired with having to work full time and not getting a full night's sleep made it worse. Usually if I fell asleep before he did I could sleep through but, as is the way with so many people, it's just something that you learn to put up with. You do find yourself getting a bit cross with the person who's snoring, and I did feel a bit cross with Graham but I would never tell him."
Graham tried many cures, including a device that gave him an electric shock whenever he snored. "About 20 years ago some guy came up with this wrist strap with a couple of electrodes attached to a thin wire in a box. It read your acoustic output and if you started making noise over a certain level, it would give you an electric shock. We're not talking masses of volts, but it was enough to give you a sting. Sometimes I woke up but at others it seems it was enough to give me a jolt and stop me snoring. But either the velcro would come off or I would lie on top of it and would get a massive smack in the chest, which would definitely wake me up."
Eventually the solution was a combination of treatments. Graham started using small strips that dissolve on the tongue and lubricate the tissue at the back of the throat, reducing the vibrations and the snoring sound. He also started sleeping with the window open and with fewer pillows. He doesn't drink within three hours of going to bed. "I do feel that I am sleeping better now, and feel more sprightly in the morning," says Graham.
Ben Hugo, a 29 year-old painter from south London, consulted the BSSAA in his search for a treatment for his snoring, which has become more of a problem since his girlfriend, Jo, moved in with him. "I suppose I've always snored. I've been on holidays with friends where we've been sharing a room and I've woken up buried under a pile of shoes and bottles that people have thrown at me during the night to shut me up. I've had flatmates who have complained that they can hear my snoring through the walls but I just thought that they were light sleepers. That sounds a bit unfair but if you can't hear yourself snoring, it's difficult to take responsibility for it."
Marianne Davey from the BSSAA discovered from talking to Ben that he suffers from general nasal stuffiness; he used to smoke and his girlfriend smokes in the house. They also have a cat, to which Ben might have a mild allergy. Davey recommended that Ben try nasal-decongestants.
"The decongestants worked really well," said Ben. "The other night I didn't take it before bed and that was the night that I snored. I'm finding it harder to get out of bed in the morning and I think that means I'm sleeping more deeply."
"We used to have arguments about Ben's snoring," says Jo, " mainly because I don't think that he realised how annoying it is so he'd be upset when I'd kick him in the middle of the night. I tried to suggest that he do something about it but he was a bit reluctant. The decongestant has worked well and we're both getting more sleep."
Sweet dreams: how to find a cure
Look in a mirror and press one nostril closed with a finger. With your mouth closed, breathe in through your other nostril. If the nostril closes, try holding it open with a finger of the other hand. If breathing is easier with the nostril held open you may suffer from nasal stuffiness. Any over-the-counter decongestant taken just before bed should work (but check that they don't contain caffeine); there also decongestants available specifically designed for snorers.
Open your mouth and make a snoring noise, then close your mouth and try to make the same noise. If you can only snore with your mouth open there are products which encourage you to keep your mouth closed when you are asleep available from www.britishsnoring.co.uk.
Make a snoring noise and then stick your tongue out as far as it will go and grip it between your teeth. Now try to make a snoring noise. If the snoring sound is quieter with your tongue in this position then you are what is known as a "tongue base snorer". A treatment for this is a mandibular advancement device, which is a mouth guard moulded to your jaw to keep your tongue in the right place during sleep.
In this type of snoring, the soft palate vibrates, making the snoring noise. There isn't a test for this, but if neither the nose nor the tongue test works, a palatal flutter might be the cause. Sprays and dissolvable strips that lubricate the tissues in the throat, such as the ones used by Graham Newman, can be bought over the counter.