When Snoring Becomes a Clue to Future Health

More than just a noisy night

Most of us know somebody who snores. For many couples it simply becomes part of life. Elbows are deployed in the middle of the night. Strange clicking noises somehow seem to encourage the snorer to reduce the volume. Some couples even resort to separate bedrooms.

But sometimes snoring is the body's way of telling us something rather more important.

Like many areas of men's health, the challenge is recognising when a common nuisance has become a medical condition, and no longer a running family joke.

Why do we snore?

When we fall asleep, the muscles in the throat naturally relax.

As air passes through a narrowed airway, the soft tissues vibrate and produce the familiar sound we call snoring.

Many things can make this more likely.

Weight gain, particularly around the neck and abdomen.

Alcohol, especially in the evening.

Smoking.

Nasal blockage.

Sleeping on our back.

Increasing age.

Some men are simply born with narrower airways than others.

Simple snoring is extremely common. Of course, there have even been occasional reports of actual physical harm coming to the snorer from sleep-deprived partners and even neighbours, but otherwise it is not a particularly dangerous condition!

The important question is whether the airway is simply noisy, or whether it is repeatedly collapsing during sleep.

When snoring becomes sleep apnoea

Obstructive sleep apnoea (OSA) is very different.

Instead of simply narrowing, the airway repeatedly closes during sleep. Breathing stops, often for ten seconds or more, before the brain briefly wakes the body just enough to reopen the airway.

In my own practice I have seen men where this cycle happens dozens, sometimes hundreds, of times during a single night.

Most men do not know it is happening.

Their partner usually does. Modern wearable devices can also provide useful clues for those who sleep alone.

Partners, or even people in the next room, may describe loud snoring interrupted by long pauses in breathing, followed by gasping or choking before the snoring begins again.

It can be quite frightening to witness.

Why does it matter?

Sleep is not simply a period of rest.

It is when the body repairs itself. Hormones are regulated. Memories are consolidated. Blood pressure falls. The brain and cardiovascular system recover from the day.

Repeated interruptions prevent that recovery.

Untreated sleep apnoea is not simply about poor sleep. It affects almost every organ system in the body.

The result is often far more than tiredness.

Men with untreated sleep apnoea are more likely to develop high blood pressure, type 2 diabetes, irregular heart rhythms, stroke and cardiovascular disease. Many also experience poor concentration, morning headaches, low mood, irritability, reduced libido and erectile dysfunction. Falling asleep at the wheel becomes a significant risk.

Some simply describe feeling permanently exhausted.

Others have become so accustomed to poor sleep that they no longer realise how abnormal it has become.

It fits the same pattern

If you have read my previous blogs, these themes will already sound familiar.

Mental wellbeing.

Exercise.

Nutrition.

Weight.

Sleep.

These same themes appear repeatedly because they influence almost every aspect of our long-term health.

Sleep apnoea is no exception.

Excess weight, particularly around the neck and abdomen, is one of the strongest risk factors for obstructive sleep apnoea. Weight loss can dramatically reduce its severity and, particularly in men with milder disease, sometimes resolve it completely.

Mental wellbeing often determines whether we feel ready to make lasting lifestyle changes. Better nutrition and increased physical activity help us lose weight. As the weight comes down, sleep often improves, making further positive change easier.

The lifestyle that protects your metabolism also protects your sleep.

Could it be you?

Simple snoring is common.

Sleep apnoea is different. Yet it is much more common than most people realise and is at least twice as common in men as women. Our own bodies can provide clues too. A BMI over 30, a collar size of 17 inches or more, a waist above 102 cm and existing type 2 diabetes all increase the likelihood of sleep apnoea. None proves we have it, but combined with snoring and daytime tiredness they are good reasons to look more closely.

If your partner notices pauses in your breathing, gasping during sleep or exceptionally loud snoring, it is worth taking seriously.

For those who sleep alone, modern wearable devices such as the Apple Watch can sometimes provide useful clues. They cannot diagnose sleep apnoea, but they may detect repeated waking, breathing disturbances and poor sleep quality that should prompt proper medical assessment.

I rarely recommend technology for its own sake, but in this situation I have seen wearable devices help several patients recognise a problem. In more than one case, excessive sleepiness while driving led to investigation, a diagnosis of sleep apnoea and a remarkable improvement following treatment.

If you regularly wake feeling unrefreshed, struggle to stay awake during meetings, drift off in front of the television or feel sleepy while driving, your sleep deserves proper assessment.

Feeling sleepy behind the wheel is never normal. It deserves proper assessment.

Many men wrongly assume they are simply getting older.

A proper assessment

Like many conditions I have discussed in these blogs, snoring is not a diagnosis.

It is a symptom.

The important question is why it is happening.

A consultation allows us to discuss your sleep, your weight, alcohol intake, medication, blood pressure and general health. Simple questionnaires can estimate your risk and, where appropriate, a home sleep study or specialist assessment can confirm whether sleep apnoea is present.

The diagnosis is often much easier than people imagine.

The encouraging news

Sleep apnoea is one of the most satisfying conditions to treat.

Often relatively modest weight loss is enough to make a substantial difference.

Reducing evening alcohol, stopping smoking and improving sleep habits may also help.

Where symptoms are more significant, treatments such as CPAP, which gently keeps the airway open during sleep, can be genuinely life changing. Many men tell me they cannot remember the last time they felt so awake.

The right treatment depends on the individual, but effective treatment is available.

Looking after your future health

Most snoring is harmless.

Some is not.

Knowing the difference may improve not only your sleep, but also your blood pressure, metabolism, heart health, energy levels, concentration, mood and relationships.

I have become increasingly interested in the idea of long good health. Living longer is only a real benefit if we remain healthy enough to enjoy it. Recognising and treating sleep apnoea can make a remarkable difference to both the quality of our lives and, potentially, their length.

Your body may be trying to tell you something.

It is worth listening.

Dr Mick Watts MBBS MRCGP is a GP at Windsor Wellness Clinic with a particular interest in men's health, healthy ageing and lifestyle medicine.

This blog is written for general information and encouragement. It is not a substitute for personal medical advice. If you or your partner are concerned about loud snoring, pauses in breathing during sleep, excessive daytime sleepiness or persistent fatigue, please speak to your own GP or healthcare professional