Mandibular advancement devices can help with sleep apnoea in a lot of cases. They are now also provided by the NHS. Find out how exactly they can help, and when they are provided by the NHS.

1. What is a mandibular advancement device?

A mandibular advancement device consists of connected medical-grade plastic arches that are worn on the teeth while sleeping. These push the lower jaw forwards, and with it the tongue and the base of the tongue. Mandibular advancement devices are therefore also referred to as lower jaw advancement devices. They keep the throat and airways clear. This counteracts a very common cause of snoring and sleep apnoea, namely limp base of the tongue slipping backwards into the throat area when sleeping, causing this area to be constricted or even closed.

The mandibular advancement devices can be made of either one or two components.

High-quality devices tend to be made of two components, whereas the entry-level models are usually monobloc devices.

This is not surprising. A comparison of the two device types shows that single-component devices have two key disadvantages compared to two-component devices:

• Firstly, the protrusion cannot be precisely adjusted. The protrusion is set by the user pushing his or her lower jaw forwards when adjusting the device. To change the protrusion setting, the entire adjustment process needs to be repeated. This can quickly lead to material fatigue. 
• Secondly, these devices often prevent any lateral movement of the jaw joints. This can quickly lead to jaw joint pain and tension.

Monobloc devices are, however, suitable if the snoring is caused by two factors at once, namely a constricted throat area plus vibrating soft palate tissue. This is because not only do they keep the throat area clear, but they also prevent mouth breathing that causes the soft palate tissue to vibrate. One key indicator of this type of snoring is the fact that snoring occurs in any sleeping position.

These mandibular advancement devices (two-component) are our customers’ favourites

2. How do mandibular advancement devices work?

Mandibular advancement devices are mainly used by people who snore when sleeping on their back, as well as for position-dependent obstructive sleep apnoea. The term “position-dependent” refers to snoring or obstructive sleep apnoea that occurs at least twice as often when the affected person is on their back compared to when they are on their side. 

This is caused by the fact that the base of the tongue becomes limp during sleep and then slips backwards to constrict or close the throat area. 

Mandibular advancement devices can help with this. They effectively prevent the tongue from being able to drop backwards into the throat during sleep by moving the lower jaw a few millimetres forwards, thereby applying a slight tension to the tongue muscle. This slight tension means that the tongue muscle is no longer able to drop backwards into the throat. The airways remain free, and you will be able to sleep without any dangerous breathing interruptions or annoying snoring noise.

The image below shows how this works:

Mandibular advancement devices are a recognised tool against position-dependent snoring and position-dependent sleep apnoea. The effectiveness of mandibular advancement devices against position-dependent obstructive sleep apnoea depends on the severity of the disorder:

• With minor and moderate sleep apnoea, mandibular advancement devices can reduce the number of breathing stops such that the sleep apnoea is no longer categorised as a disease. This is the case when there are fewer than five breathing stops per hour. 

• With severe sleep apnoea (more than 30 breathing stops/significant breathing reductions per hour), mandibular advancement devices can significantly reduce the number of breathing stops but are often not able to get this number to below five times per hour. This significantly reduces the severity of the sleep apnoea but the sleep apnoea is not suppressed. In this case, mandibular advancement devices are either used as an additional tool within CPAP therapy in order to reduce the amount of positive pressure that is required, or for patients for whom CPAP therapy is not a suitable option (therapy idea: reducing sleep apnoea is better than not treating it at all).

3. When can a mandibular advancement device be used?

According to our practical experience, there are two conditions that need to be met in order to use a mandibular advancement device:

• There should be ten healthy teeth in both the upper and lower jaws, i.e. a total of at least twenty teeth. 
• These teeth should be distributed in the mouth as follows: Five healthy teeth in both the left and right side of the upper jaw, as well as an additional five healthy teeth in both the left and right side of the lower jaw.

Mandibular advancement devices can also be worn if the user has:

• securely anchored bridges, partial crowns or full crowns (although not it these are unstable or in a poor condition) 
• securely anchored prostheses and implants (following clarification from a dentist if necessary)

The attending dentist should always be consulted before using a mandibular advancement device if the user

• has loose teeth or unhealthy upper and lower front teeth, 
• suffers from jaw pain, serious gum or jaw joint disease or other jaw complaints 
• has chronic asthma or epilepsy 
• wears braces. bite splints or aligners

4. What are the side effects of mandibular advancement devices?

As with most medical devices, side effects can also occur as a result of using mandibular advancement devices. These may take the form of tooth sensitivity, pronounced salivation or a change in the position of the teeth. Most side effects, however, are only temporary or are easy to fix.

5. How much does a mandibular advancement device cost?

This depends on the type of device. A fundamental distinction is made between devices that are produced by a dentist or dental technician (known as customised devices), and mass-produced, off-the-shelf devices:

• Customised devices produced by a dentist cost between around £1200 and £1500. 
• Off-the-shelf devices that are certified as medical devices cost between £50 and £150.

This considerable cost difference is down to the very different production methods used for these two types of devices:

• With customised devices, the first step involves creating an impression of the teeth in the upper and lower jaw (either in printed form in as a 3D scan). This impression is used to generate a model in the dental laboratory, which is in turn used to produce the mandibular advancement device. This is then adapted to the user’s teeth by the dentist. The protrusion is then set. 
• Off-the-shelf devices are mass-produced from plastic, which can normally be made malleable by being placed in a hot water bath. Once heated and soft, the device is placed on the dental arch and adapted to the teeth. These devices are therefore often referred to as “boil & bite” devices. The protrusion is then set either during or after the adjustment process.

6. Are mandibular advancement devices provided by the NHS?

Does the NHS cover the costs of mandibular advancement devices? As a general rule, a mandibular advancement device will only be provided by the NHS if the snoring is actually classed as a disease. If the snoring is not connected with breathing stops (known as simple snoring), it is not classed as a disease. In this case, the NHS will generally not cover the costs of a mandibular advancement device. 

If obstructive sleep apnoea has been diagnosed, on the other hand, the NHS will cover the costs of the mandibular advancement device.  

There are three key conditions for this NHS provision:

• An initial assessment of need and a prescription by a secondary care NHS consultant are requirements. 
• The patient’s oral health must have been assessed by a dentist. 
• The provided mandibular advancement device may take the form of a customised, laboratory-produced device (band 3), which is adjusted and monitored by a dentist. Off-the-shelf devices (band 2) are also provided by the NHS. The applicable dental charges must be taken into account.

Snoring mouth guards – our comprehensive guide

Snoring mouth guards are a popular way of preventing snoring and sleep apnoea. You can find out how they work in our guide.

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Mandibular advancement device comparison

All our mandibular advancement devices compared based on comfort, application, cleaning and much more.

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Snoring mouth guards or anti-snoring mouth guards are a popular way of preventing snoring and sleep apnoea. You can find out how they work, which snoring mouth guard is the right choice for you, and the expected costs in our guide.

How does a snoring mouth guard work?

One very common cause of snoring is that the base of the tongue becomes limp during sleep and then slips backwards to constrict or close the throat area. 

This is precisely where snoring mouth guards come in. They can take the form of either a single component or two combined plastic parts, and are worn on the teeth while sleeping.

The snoring mouth guard pushes the lower jaw forwards, and with it the base of the tongue. This keeps the base of the tongue away from the throat area.

The best snoring mouth guards

These five snoring mouth guards are the most popular among our SomniShop customers:

somnipax guard standard

Extremely comfortable high-end guard for small and medium-sized jaws

Here’s what SomniShop customers have to say about the somnipax guard standard:

+ An effective mouth guard that works perfectly (frequently measured by a snoring app or pulse oximeter)

+ Good alternative to CPAP machines for people with minor to moderate sleep apnoea

+ Comfortable guard, sits well in the mouth

+ The trial option (guard can be returned even after use for a surcharge) is great

– Replacement straps can only be bought as a set

What the professionals at SomniShop have to say about this snoring mouth guard:

Thanks to its flat design, the somnipax guard S is a very comfortable yet robust mouth guard. Good lateral movement due to the two-part design (important for the jaw joint), with 8 stages for precise adjustment. The high level of customer satisfaction speaks for itself. Please note: This mouth guard is too small for some people. You should therefore use the sizing information for the guard to check whether it will fit.

SomnoGuard AP2

Highly robust, tried-and-tested quality mouth guard for medium and large jaws

Here’s what SomniShop customers have to say about the SomnoGuard AP2:

+ Comfortable mouth guard that doesn’t particularly feel like having a foreign body in the mouth

+ Easy to clean

– Adjustment takes a bit of skill

– Not suitable for small jaws

What the professionals at SomniShop have to say about this snoring mouth guard:

Very sophisticated and exceptionally robust mouth guard, made in Germany. Suitable for medium to large jaws, very good lateral jaw joint movement. The mouth guard is very bulky due to its robust design, so it is not recommended for small jaws.

SomnoGuard 3

Individually adjustable divider to prevent simple snoring

Here’s what SomniShop customers have to say about the SomnoGuard 3:

+ Immediately stops simple snoring

+ Affordable mouth guard with very good and professional instructions

– Needs to be well-adjusted, due to the single-component design, the thermoplastic material can only be applied to the teeth from the outside and not from the inside

What the professionals at SomniShop have to say about this snoring mouth guard:

A single-component mouth guard that has been on the market for many years, with retaining grooves for a particularly good fit. As with the SnorBan, no lateral jaw joint movement, but counteracts two causes of snoring simultaneously (tongue base snoring and snoring independent of body position as a result of mouth breathing).

What criteria need to be considered when choosing a snoring mouth guard?

There are three key factors that need to be taken into account when choosing a snoring mouth guard: The size, the comfort and the protrusion adjustment.

Selecting the right size

By far the most important factor is the size. With tailor-made snoring mouth guards from a dentist, ensuring the right size isn’t a problem. But the significantly cheaper mass-produced mouth guards tend to be “one-size-fits-all”. The actual size may vary from mouth guard to mouth guard (like with clothing, where the same size, e.g. ‘Small’ is often different depending on the manufacturer). 

We therefore recommend using a clean piece of cardboard to compare the size of your jaw with the size of the mouth guard before making a purchase. There are three steps to this process:

Step 1: Cut out a square of clean, thick cardboard. This should be big enough that you can fit it in your mouth and bite down onto it. Some customers have used a Camembert instead of a piece of cardboard; this works too. 

Step 2: Put the piece of cardboard in your mouth and bite down onto it. You should then be able to see the impression of your jaw on the cardboard. If not: Repeat the process and bite down more firmly. 

Step 3: Place the piece of cardboard on a table and take hold of a ruler. Now measure the width of the impression at the back teeth, from the outer left-hand side to the outer right-hand side.

Step 4: Compare the measurement with the sizing information relating to the width of the particular snoring mouth guard. The width of the impression should be at least one millimetre larger than the specified width of the mouth guard.

This means that the mouth guard is very likely to fit.

Comfort

Two-component snoring mouth guards that consist of one part for the upper jaw and one part for the lower jaw tend to be a lot more comfortable. This type of mouth guard also allows for lateral movement of the jaw. With single-component mouth guards, this isn’t usually possible as the upper and lower jaw are enclosed in a single, immovable part. 

Less bulky materials also contribute to a more comfortable fit. The thinner and flatter the mouth guard, the more comfortable it tends to be (and therefore the more pleasant it is to use). To prevent teeth grinding, however, we nevertheless recommend robust and bulkier mouth guards such as the SomnoGuard AP 2. In this case, the mouth guards need to withstand particularly high stresses.

Protrusion adjustment

Precise protrusion adjustment is important for the effectiveness and comfort of a snoring mouth guard. In this area too, two-component snoring mouth guards are preferable to single-component guards. 

With single-component snoring mouth guards, the protrusion is set by stretching the lower jaw forwards to a greater or lesser extent during the adjustment process. This is generally an imprecise method, and the entire adjustment process has to be repeated in order to change the protrusion. 

The process is different with two-component snoring mouth guards. With these models, the protrusion is only set in a second step once the mouth guard has already been adjusted. It can be changed without having to re-adjust the mouth guard. This is particularly important when first starting to use the mouth guard: To begin with, you’ll need to keep changing the protrusion in order to find the right setting.

How effective are snoring mouth guards in general?

Snoring mouth guards are an effective tool against situation-dependent snoring and position-dependent minor and moderate sleep apnoea. This is recognised in multiple medical guidelines such as those published by the American Academy of Sleep Medicine and the National Institute for Health and Care Excellence. These guidelines recommend the use of a snoring mouth guard if CPAP therapy does not guarantee success or is rejected by the patient (referred to as second-line treatment). As part of a very complex meta analysis, the German independent Institute for Quality and Efficiency in Health Care found that snoring mouth guards are not inferior to CPAP therapy in the treatment of sleep apnoea.

How to get a snoring mouth guard?

There are various ways to get hold of a snoring mouth guard. Customised mouth guards are sold by dentists, who work closely with dental laboratories. 

Off-the-shelf mouth guards, on the other hand, are predominantly sold by specialist online providers.

The cost of snoring mouth guards

When it comes to costs, it’s important to distinguish between two types of mouth guards: customised mouth guards produced by dentists, and off-the-shelf mouth guards. Customised mouth guards cost between £1200 and £1500 depending on the system used and the costs charged by the particular dentist.

Off-the-shelf mouth guards, on the other hand, are much cheaper as they are mass-produced. They usually cost between £50 and £150. Sleep apnoea patients should be aware that the snoring mouth guard is actually CE-certified as a medical device This is generally not the case with extremely cheap snoring mouth guards, which tend to be single-component guards that are often made in China.

When a snoring mouth guard should not be used

A sufficiently good tooth condition is very important for using a snoring mouth guard. There are two practical key rules in this regard:

• There should be ten healthy teeth in both the upper and lower jaws (i.e. a total of at least twenty healthy teeth).
• The teeth should be distributed in the mouth as follows: Five healthy teeth in both the left and right side of the upper jaw, as well as an additional five healthy teeth in both the left and right side of the lower jaw.

Snoring mouth guards can also be used in the presence of securely anchored bridges, partial crowns or full crowns. If these are in an unstable or poor condition, the attending dentist should be consulted before using the snoring mouth guard.

Securely anchored prostheses or implants do not preclude the use of a snoring mouth guard (although this is not the case if they slack or loose).  

The attending dentist should always be consulted before using a snoring mouth guard if the user

• has loose teeth or unhealthy upper and lower front teeth
• suffers from jaw pain, serious gum or jaw joint disease or other jaw complaints
• wears braces, bite splints or aligners
• has chronic asthma or epilepsy

What are the side effects of a snoring mouth guard?

Snoring mouth guards can have side effects such as tooth sensitivity, pronounced salivation or a change in the position of the teeth. Most side effects, however, are only temporary or are easy to fix.

* Please note: Customer reviews collected mid-March 2023 from the German shop www.somnishop.com.

Mandibular advancement device guide – answers based on practical experience

Mandibular advancement devices can help with sleep apnoea in a lot of cases. They are now also provided by the NHS. Find out how exactly they can help, and when they are provided by the NHS.

Read more

Mandibular advancement device comparison

All our mandibular advancement devices compared based on comfort, application, cleaning and much more.

Read more

It doesn’t always take an expensive product to get snoring under control. There are also home remedies that can successfully combat snoring.How to cure snoring naturally ? Find out more about Grandma’s tips & tricks and how well such products really work!

Anti-snoring oil, anti-snoring sprays and mouthwashes

Anti-snoring oils are mostly vegetable based. The ingredients of these natural remedies for snoring problems are based on a mixture of different essential oils. The oils are employed in different manners: anti-snoring oils, anti-snoring sprays and mouthwashes. It is therefore either applied directly to the palate as a tincture, applied as a throat spray or diluted in with water and gargled.

The idea behind this is that the palate is moistened with a kind of artificial saliva and the essential oils it contains increase the tone of the tissue. If, for example, the soft palate is under tension, it can only be set into vibration by the flow of air, with difficulty. Snoring can be prevented in this way. Figuratively speaking, “the saw” is oiled with snoring oil.Whether such products based on essential oils actually work to stop snoring has not yet been scientifically proven. Nevertheless, the oils enjoy a certain popularity. As a rule less as sole anti snoring therapy, but rather supporting as a therapy for, mandibular advancement devices or nasal dilators. Especially in the case of problems resulting from nasal breathing (which often triggers nasal snoring), essential oils can have a positive effect and help to reduce snoring.

How to cure snoring naturally ? DIY essential oils for daily life

Mix a glass of olive oil with 50 grams of rue (also called common rue) in an airtight container. Let this mixture steep for two weeks in a darkened room. Then apply to the nose and neck before going to bed.

Essential oils to unblock the nose: Inhalation

A stuffy nose is often the cause of snoring. Inhalation therapy is a well-known household remedy for stuffy noses. Inhaling with a special inhaler is particularly gentle. This is available in pharmacies. It actively nebulises the water and the water vapour not only reaches the nose and upper respiratory tract, but also the lower respiratory tract and the bronchi. This is especially helpful for deep-seated coughs. If one does not want to acquire a device for inhaling, then there are also proven DIY alternatives available at home.

DIY – Inhaling as they did in the past

Pour 50 to 60 degrees Celsius hot water into a pot. Add essential oils. Eucalyptus, mountain pine, spruce needle or tea tree oils are suitable. Now bend your face over the pot and put a towel over your head. Breathe in the water vapour through your nose. Inhale for 10 to 20 minutes.

If you do not tolerate inhalation, you may want to use this method:

How to cure snoring naturally ? Fill a small bowl with water and add 20 drops of pure eucalyptus oil. Place the bowl next to the bed and enjoy a restful night. Alternatively, cut an onion in half and spread a pinch of salt over the halves. Place the plate with the onion near your head, eg. on the bedside table.

Waiting it out and drinking tea

Drinking tea – especially before falling asleep – can also alleviate snoring. Nettle, lime blossom, sage and arnica should be particularly suitable. Stinging nettle tea is especially recommended if snoring is caused by a pollen allergy, i.e. if the mucous membranes are swollen and you cannot breathe freely through your nose. Sage, on the other hand, is used for general respiratory problems.

Change your sleeping position

Grandma’s wisdom: Snoring is strongly related to the sleeping position.

On the one hand it’s about the orientation, i.e. whether on the back, the side or the stomach; on the other hand it’s also about the inclination. Even grandma endorsed positional therapy. In other words, whether one sleeps flat like a board or whether the upper body is in a slightly upright position. Sleeping on one’s back is more likely to be accompanied by snoring than sleeping on one’s side or on one’s stomach. However, this risk can be reduced by assuming a slightly upright sleeping position. It is sufficient for the upper body (from the pelvis upwards) to be elevated by a few centimeters. Because when you sleep more upright, the pressure on the tissue in the airways decreases. Swelling in the nasal and pharyngeal mucous membranes is reduced and this stops breathing from being hindered. In order to elevate the upper body, the artful arrangement of pillows can be helpful. A neck roll can also be used. The sleeping position can also be adjusted with particularly high-quality beds.

Important Information

Please note that you should not use natural products without consulting your doctor or pharmacist. Please therefore inform yourself thoroughly and discuss your snoring problem with the appropriate experts.

If no household remedy works, look at the following remedies and say goodbye to snoring: https://somnishop.co.uk/

Mandibular advancement device (MAD) purchasing guide

Advises you what you should pay attention to when buying a mandibular advancement device (MAD). We present different models and technical approaches here.

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Find the solution for your snoring with our free snoring test

Free of charge and takes only 3 minutes. Over 95,000 people have taken the test already.

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Nasal dilator purchasing advisor

What must you take into consideration when making a purchase? See all our nasal dilators presented here.

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A major cause of snoring is that the tongue slides back into the throat during sleep (so-called tongue snoring). Because of gravity, this only occurs when you sleep on the back. An anti-snoring pillows help you to sleep on the side. We look into that and tell you for whom they are great – and for whom not.

Stop sleeping on your back – Help for tongue-based snorers

When you snore while you sleep on your back, the cause is most often your tongue. When the tongue muscles relax, the rear part of the tongue – the base of the tongue – slides back into the throat. The reason for this is the gravitational forces that pull on the tongue: The tongue base narrows or obstructs the airways as it slides back. The air you breathe , however, has to pass through the constricted area. This results in turbulence ,which causes the surrounding tissue to vibrate . This process produces the sound we perceive as snoring. Dr. Hartmut Grüger (somnologist and chief physician at the Medical Center Düsseldorf, Germany) estimates that approximately 30% of all snorers are tongue-based snorers, i.e. the cause of their snoring is that the tongue falls back into the throat.

Anti-Snoring Pillow, Positional Therapy Belt or Anti-Snoring Backpack: Three Devices, One Approach

In such a case, positional therapy can help. Positional therapy includes all products that help you to sleep on your side or on your stomach. When lying on your back, gravity forces the base of the tongue to slide down your throat – this is not the case when you sleep on your stomach or on your side. It is important to keep in mind that positional therapy only helps for tongue-based snoring, i. e. only when you snore while lying on your back. When you are also affected by snoring when lying on your side, then positional therapy won’t help you. If you want to find out more about which product types might help you, then you should consider doing our snoring test.

The most popular positional therapy product is the anti-snoring pillow, followed by snoring vests and anti-snoring backpacks. Positional therapy products have a similar effect to your partner nudging you to make you turn over when you snore. The benefit of positional therapy devices is that with these sophisticated products, neither you nor your partner will wake up. All these positional therapy products are based on the principle of the “Princess on the Pea”. In other words, when you lie on the pea ( in this case, your back), the discomfort should cause you to roll onto your side.

How an Anti-Snoring Pillow Works

A typical anti-snoring pillow is elevated in the middle (it looks a little bit like the Swiss Matterhorn”), which also makes it uncomfortable to sleep on when lying on the back. Instead, the head automatically turns sideways, either to the left or the right so that you are forced to sleep on your side. Pillows that help stop snoring support the head, relieve pressure on the neck and ensure that your nights remain free of snoring. Most anti-snoring pillows are made of comfortable memory foam and have a nice, skin-friendly cover. One additional advantage of an anti-snoring pillow (in contrast to other positional therapy devices like a snoring belt) is that It is absolutely inconspicuous – there is nothing that makes it identifiable as a snoring aid! 

How Do Anti-Snoring Backpacks and Anti-Snoring Positional Therapy Trainers Work?

Positional therapy training devices: anti-snoring backpacks or sleeping vests both work on the same principle of providing an obstacle to prevent you from sleeping on your back To change sides you can roll over your stomach. This obstruction is provided either in the form of a cushion or a foam wedge.

With the help of waist and chest straps, these products can be individually adjusted, thus the fit is customised especially for you. The straps are usually padded so that they are comfortable to wear and do not cut the skin. The material chosen ensures that there is no heat build-up.

Positional therapy devices help you to modify your behaviour and sleeping positions. As a result, they have the same effect as positional exercises would have. If they are continuously worn over several months, the brain becomes accustomed to sleeping on the side. Once this has been achieved , you no longer need to wear an anti-snoring backpack or a positional therapy belt, because you have become used to sleeping on your side and therefore automatically adopt this position.

There are many tips for “homemade” positional therapy devices on the internet. Among these is the “tennis ball” technique: it involves sewing a tennis ball into the back of the pyjamas, which is supposed to prevent you from sleeping on your back. If that seems uncomfortable to you, it’s because it really is! You also risk sleeping on your back regardless of the tennis ball, because pyjamas are generally too large for the tennis ball that is  sewn into the back, to stay in place.

Positional Therapy – Great Treatment for Position-Dependent Sleep Apnoea

Even in the treatment of pathological snoring, especially obstructive sleep apnoea syndrome (OSAS), positional therapy has a significant role to play. If you suffer from position-dependent obstructive sleep apnoea (POSA), positional therapy can be a great first-line treatment (and a good alternative to continuous positive airway pressure or CPAP / CPAP machines). Please note that this is, however, only the case when your OSAS is position-dependent, i.e., you only snore when you sleep on the back. When you experience breathing interruptions when you sleep on your side, then  an anti-snoring pillow or a positional therapy belt will not help you. 

Our final warning: If you suffer from mild to moderately severe OSAS, these products usually have the same effect on the apnoea-hypopnea-index (AHI) as CPAP-therapy has. The number of breathing interruptions (apnoeic episodes) that occur per hour could be reduced to less than five. In case of severe OSAS, positional therapy will usually not reduce the AHI enough. We therefore recommend the use of positional therapy training devices in mild to moderate sleep apnoea cases. An anti-snoring pillow like the Posiform might also be suitable for the treatment of mild sleep apnoea. 

Please note: this information cannot replace medical advice. Before you embark on any form of  treatment, we advise you to consult your doctor.

Unfortunately, it is still a widespread misconception that there is a universal solution to stop snoring. But this is not the case! It may be that some swear by nasal dilators and others are convinced by anti snoring mouthpieces (mandibular advancement devices). But products that are used to stop snoring in one person can be completely ineffective in the next. So, what can be done to stop snoring? You have to find out why you snore! Once you understand the cause of your snoring, the solution is in sight. Learn more about the four main snoring culprits, namely; the tongue, the mouth, the nose and flaccid pharyngeal tissue (in the throat).

Here is an illustration of the different causative factors of snoring:

Tongue
Snoring

Mouth
Snoring

Nasal
Snoring

Throat
Snoring

Causes of snoring in adults: often it is the tongue

What exactly is the problem?

When it comes to snoring, the tongue always comes into play when you sleep on your back. Snoring in the supine position is in most cases triggered by the tongue and is therefore called tongue-based snoring or tongue snoring. Approximately 30 percent of all snorers are affected by this form of snoring, according to an estimate by Dr. Hartmut Grüger (sleep physician, Düsseldorf).

This is due to gravity, i.e. simple physics. When the tongue muscles relax during sleep, the rear part of the tongue (“base of the tongue”) slides backwards into the throat, when one sleeps on one’s back, and narrows or blocks the airways there. However, when breathing in and out, the air must pass through this narrowed section. Turbulence occurs at this point and the air is accelerated. The turbulence causes the surrounding tissue to vibrate and produce the snoring noise.

In figurative terms, tongue snoring can best be compared to an avalanche that buries a tunnel entrance. The slack tongue muscle is the avalanche that covers the respiratory tract (“tunnel”). If the airways (“the tunnel entrance”) are partially buried, only little air can flow through the opening.

When the airways are completely buried, no air can circulate at all. This is the case with obstructive sleep apnea syndrome (OSAS), which is often caused by tongue-based snoring.

Anatomical features may also contribute to tongue-based snoring, such features include having a receding chin or a large tongue. However, the latter is only responsible for snoring in very rare cases (an estimated 2 percent of snorers).

People with a receding chin, usually have a normal-sized tongue, however, there is simply too little place in the lower jaw and it therefore has to find a resting place further back in the throat. Thus it protrudes into the respiratory tract. A large tongue is often caused by tissue enlargement at the base of the tongue, for example, by the tonsils. This is what tongue-based snoring sounds like .

Stop snoring – help for tongue-based snorers

When a tongue-based snorer sleeps on your side or lie on your stomach at night, they stop snoring. Here, unlike in the supine position, there is no gravity that draws the tongue into the throat. If you have difficulty getting accustomed to a position that prevents positional snoring (snoring caused by sleeping on the back), positional therapy products such as pillows, vests or sleeping belts and backpacks can also help you stop snoring .

An anti snoring mouthpiece, or mandibular advancement device, tackles the problem of tongue snoring from a different perspective. It is placed in the mouth at night and gently pushes the lower jaw forward. The musculature in the lower jaw is placed under slight tension and prevents the tongue from sinking back into the throat. This is also an effective method to stop snoring.

What is the main cause of snoring: most often it is the mouth

What is the problem?

The most common snoring trigger is tissue vibration in the pharynx. In more than 40 percent of snorers (according to some studies the proportion is even higher) this is the sole cause of the snoring, in many other cases it is considered to be a concomitant cause of snoring. Mouth-based snoring occurs exclusively during mouth breathing, i.e. when one breathes through the mouth during sleep.

The problem results in is the transition area from the oral cavity to the oropharynx (opening from the mouth to the throat). As the name suggests, this transition is anatomically a narrow place. However, the airflow must pass through this area when you breathe through the mouth.

If tissue structures such as; enlarged tonsils, redundant posterior tonsillar pillars (so called “webbing”), a flaccid, drooping soft palate and elongated uvula, or fat (adipose) deposits are present in this area, they may result in turbulence and vibrations occurring during respiration, which causes snoring. This is what snoring sounds like  when the tonsils are enlarged.

If the palate and the soft palate have a normal shape and size, a constriction could still occur, namely, if the base of the tongue and thus also the tongue are raised (“stand higher”). The transition from the palate to the throat is then also narrowed.

In children, polyps are often the cause of snoring. Polyps are benign growth of the mucous membrane of the nose, which can additionally constrict and narrow of the entrance to the nasopharynx (the transition area from the nasal cavity to the throat).

Mouth-based snoring can also occur if there is no narrowed point in the oropharynx (transition from oral cavity to throat). This is the case if the tissue of the palatal arch (especially the soft palate) or the muscles in its vicinity no longer have sufficient tone (so-called tonus). The air passing by then causes it to vibrate slightly.

This phenomenon occurs particularly frequently with a flaccid soft palate or uvula. This flaccidity or lack of tone, can be caused by tissue weakness, but it can also be result of alcohol consumption which results in the muscles of the soft palate becoming particularly slack during sleep.

Picture a sail fluttering in the wind. This is what this mouth-based snoring sounds like .

Stop snoring – when snoring originates in the mouth?

It is important to note that breathing through one’s mouth is not considered to be a natural way for humans to breath. It is considered to be natural and of physiological benefit to breath through the nose. If you find it easier to breathe through your mouth at night rather than through your nose, it is an indication that there is a problem with your nasal breathing. In this case, the first thing you should do is to improve your nasal breathing or make it possible at all, for example by using a nasal dilator or by having your nasal passages surgically cleared in order to stop snoring.

However, if you continue to breathe through your mouth unconsciously, despite the fact that your nasal passages are free, then an anti snoring mouth guard is the right choice for you. It prevents you from breathing through your mouth and ensures that the mouth is closed during the night, thus effectively helping you to stop snoring. An alternative to the mouth guard would be a chin strap that keeps the mouth closed from the outside. However,the drawback of the chin strap is that it is not suitable for beard wearers or people with sensitive facial skin, as the fabric of the chin strap is sometimes irritates the facial skin.

What causes snoring? The nose is almost always involved

What exactly is the problem?

The nose can trigger grunting noises at night in two ways: it can cause both nasal snoring and mouth-based snoring.

When the nose leads to “real nasal snoring”:

If the nasal passages are constricted or misaligned, the respiratory resistance increases. A negative pressure forms in the upper respiratory tract. The tissue contracts in the entire area of the respiratory tract and constricts it, causing air turbulence and vibrations.

These vibrations trigger the snoring noise. In many cases, the seat of this form of snoring in the lower part of the so-called nasopharynx or on the side of the palate facing the throat. These tissue areas can best be stabilized with an anti snoring oral brace to prevent snoring.

Nasal snoring can best be compared with a whistling kettle. As with a kettle, air must escape through a narrow point. When one snores, air is “pulled” through a narrow place by negative pressure. We experience the turbulences and oscillations as rattling / snoring.

When the nose triggers or promotes mouth snoring:

If nasal breathing is impaired, this can also trigger mouth snoring. We have already explained the typical chain reaction that results in mouth snoring, i.e. the body does not get enough air through the nose. Thus the brain automatically switches to breathing through the mouth and due to concomitant factors (flaccid tissue in the area of the palate) mouth snoring occurs.

Everyone probably knows this old “classic” only too well, just think back to the last time you had a cold!

However snoring ultimately occurs – the essential prerequisite for resting at night is to free the nasal passages. Dr. Robert Pavelka (ENT specialist) estimates that this alone improves snoring in around 40 percent of patients treated

Stop snoring – what can be done about snoring if it originates in the nose?

The reasons for impaired nasal breathing can be temporary or permanent. Temporary problems with nasal breathing usually occur as a result of a classic cold – in the form of swelling or inflammation of the mucous membranes. Allergic reactions to animal hair, pollen or house dust have the same affect. Nasal dilators can help because they widen the nasal opening and thus improve the airflow through the nose. For allergy sufferers, there are special nasal dilators with built-in air filters.

If, on the other hand, nasal breathing is permanently impaired, the anatomy of the nose must be examined more closely. The “usual suspects” in this case are polyps, enlarged nasal concha or a deviated nasal septum. Often only a surgical intervention can help here. However, an experienced ENT physician should clarify whether this step makes sense and really provides the sought after results, i.e. can prevent snoring.

What causes snoring? Flaccid tissue in the pharynx

What exactly is the problem?

Flaccid tissue in the pharynx (throat) is very rarely the cause of simple, non pathological snoring. It occurs when the muscular tone (tonus) of the pharyngeal side walls is weak and the walls contract when air is sucked in during breathing. The tissue weakness can occur in the entire area of the oropharynx and hypopharynx. This is what this type of snoring, due to flaccid tissue in the oro-and-hypopharynx sounds like !

Throat-based snoring is rarely the cause of primary snoring, but it is one of the most common causes of pathological snoring (obstructive sleep apnea). Non-positional sleep apneas (sleep apnea not caused by sleeping on one’s back), are the most common form of OSAS. 65% of OSAS can be attributed almost exclusively to tissue weakness in the airways (in many cases caused by obesity). To put it in a nutshell, pharyngeal snoring rarely remains harmless – when it occurs, tissue weakness in the airways usually leads not only to tissue flutter, but directly to partial or complete obstruction of the airways and thus to sleep apnea.

Snoring in the throat can be compared to a vacuum cleaner hose. If an obstacle gets caught in the suction nozzle (= breathing through the nose is impaired), the vacuum cleaner hose contracts (= airway narrows) and funny noises occur in the hose (= snoring).

Stop snoring – what to do if you are a throat snorer?

One of the main problems with pharyngeal snoring is the negative pressure in the upper respiratory tract, which is caused by nasal constrictions. So what can one do about snoring if the nose is also involved? – The first thing you should do is make sure that your nasal passages are clear. Either by using a nasal dilator or, in case of permanent problems , by seeking surgical intervention (polyp removal, reduction of the nasal concha, straightening of the nasal septum etc.).

If the flaccid tissue lies in the upper area of the oral cavity i.e. at the back of the mouth, a special oral brace therapy (RonchAP) can help. It causes a slight tension in the pharyngeal tissue and reduces its tendency to vibrate. If the tissue problem is lower down in the pharynx, i.e. near the larynx, pharyngeal snoring is often accompanied by partial or complete closure of the airways. In mild to moderate cases of this type of sleep apnea, an EPAP (expiratory positive airway pressure) device, i.e. a nasal valve from Provent or Theravent, can help. It is, however recommended that you seek medical advice before resorting to this form of treatment. In severe cases, CPAP (constant positive airway pressure) therapy is the treatment of choice.

Finally, targeted training of the pharyngeal tissue can also improve the situation, tone the muscles and stop snoring, the use of a product such as a Faceformer facilitates this.

Conclusion: stop snoring now

In short, snoring is caused by the following problems: restricted nasal breathing (resulting in a strong build-up of negative pressure in the upper airways), increased breathing through the mouth, or decreased muscle tone in the mouth and throat. In the vast majority of cases, however, it is precisely the interaction of these three factors that triggers snoring. Therefore, all constrictions of the upper respiratory tract can be considered to be root cause of snoring.

The various causes of snoring and the interplay between them is very well illustrated in this short video.

Tongue-Based Snoring – Test

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Open Mouth Snoring Test

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Snoring is percieved to be a man’s problem. It is a fact that there are more men that snore than women. In addition, snoring is almost a taboo topic for women – after all, it’s not exactly a lady-like subject. But studies and statistics show that women snoring is more common than you might think. So, what really helps women stop snoring? Is their snoring caused by the same factors that cause men to snore? We will answer that and give you an overview of snoring aids for women – from the snoring mouthpiece which is optimized for the size of the female jaw to small nasal dilators.

Facts and Figures

The proportion of women snoring increases sharply with their age. While women snoring is barely represented among the under 30 year-olds (~ 5%), the proportion of female snorers in the age group of 30-50 year-olds is already rising significantly to 15-20%. From menopause onwards, snoring affects almost as many women as men (~40%). In comparison to women, snoring is much more prevalent in younger  men, but there are only moderate increases in the number of men that start snoring as they get older.

The fact is that snoring is not uncommon among the female population. However, it is often difficult for women to talk about snoring. This is a problem, because snoring can conceal dangerous diseases such as sleep apnea. That’s why snoring women should swallow their pride and at least consult a doctor.

Cause of Women Snoring

In General

Do women snore differently? Yes and no. The reason why women snore is often the same as that of men. The airways are constricted, vibrations are triggered in the pharyngeal cavity, which then leads to snoring. An unhealthy lifestyle can make the problem worse. Being overweight, alcohol consumption, smoking and certain medications for example, facilitate the constriction of the respiratory tract and promote the loss of pharyngeal muscle tone.

Hormones Are to Blame

Ein Faktor, der bei den Damen eine größere Rolle spielt, ist der Östrogenspiegel. Das weibliche Sexualhormon Östrogen wird in den Eierstöcken gebildet, sorgt vor allem für die Reifung der Eizellen und hilft beim Knochenaufbau. Außerdem hat es Einfluss auf den Serotoninspiegel.

Estrogen

A major factor that plays a role in women snoring is their estrogen levels. The female sex hormone estrogen, which is formed in the ovaries, first and foremost ensures that the ovum matures properly and supports bone formation. Additionally, estrogen also influences serotonin levels.

Serotonin

Serotonin, a neurotransmitter in the brain – also known as one of the endorphins – is, among other things, relevant to maintaining muscle tension. If there is less estrogen available, then levels of serotonin go down as well. As a consequence, muscle tone decreases and the airways become more lax during the night, which makes them more prone to collapse.

Menopause

This explains why the rate of women snoring rises sharply after menopause sets in. During menopause, the ovaries cease activity and no longer produce estrogen, or hardly any. Women who suffer from premature ovarian failure (POF) for instance, are already estrogen-deficient at an early age, which means they already have an increased risk of snoring at a younger age.

Combined oral contraceptive pill (COCP)

Younger women begin to snore when they start taking the birth control pill. This is closely linked to the hormonal balance, which is disturbed in the short run by the hormones in the pill. After a few days, however, the hormone balance returns to normal. This should also cause the snoring to fade. If that isn’t the case, it makes sense to think about switching to a different medication.

Snoring During Pregnancy

About one out of four woman snore during pregnancy. This might be caused by coughs and colds during pregnancy or simply the weight increase.

Snoring Tips

Balanced Diet

In order to bring your estrogen levels into balance, adequate nutrition is an important factor. A low-carb diet is ideal for that purpose, in which case you should consume foods rich in carbohydrates only once in a while. Products that contain plenty of vitamins and omega-3 fatty acids should be eaten more often (this includes vegetables and fish).

Behavioural Therapy

If women snore because of their unhealthy lifestyle, then there may be quite a few things that can be done to improve the situation. It is important, that one gives up a few inconvenient habits, though.

Those who do sports on a regular basis and who abstain from smoking cigarettes and alcohol consumption have already mitigated their risk profile considerably.

Schnarchtest

If the snoring issue cannot be dealt with that easily or because changing your lifestyle is not doable, there is still hope! There are many other means to tackle snoring. Nevertheless, for that purpose you still have to first find out from what type of snoring you are suffering. Our snoring test can help you with that. Our test provides you, not only, with an analysis of your snoring causes but also with specific recommendations on what will help you stop your snoring.

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In the case of tongue-based snoring the tongue’s muscle falls into the pharyngeal cavity and blocks the airways there. This leads to the typical snoring noise in the throat region. Does this apply to you? The tongue snoring test can easily and quickly shed light on it:

That’s how the tongue snoring test works

Open your mouth and create a snoring sound. This should be fairly easy to do. Now stick your tongue out as far as possible, gently bite on it with your teeth (such that you “clamp” the tongue lightly) and try to make the same snoring noise again. When this doesn’t work or when the snoring sound has subsequently become markedly weaker at least, then there is a strong likelihood that you suffer from tongue based snoring.

Video: tongue snoring test

Remedies for snoring:

There are a range of different solutions against tongue-based snoring. All of them have in common that they prevent the rear part of the tongue from falling back into the throat or the airways in that area, respectively.

The most prevalent form of therapy is the use of a mandibular advancement splint. The device slightly displaces the lower jaw forward and puts the whole musculature in the area around the mandible and the throat gently under tension. The tongue’s muscle is also tensed up and prevented from falling back into the throat.

Position therapy or the therapy for supine position prevention pursues a different approach. With this form of therapy, the patient is prevented from sleeping on his back. Since the tongue base almost exclusively falls back into the throat when you sleep in a dorsal position, thus narrowing the respective airways, the issue with tongue-based snoring can also be effectively dealt with by correcting the sleeping position. Position therapy comprises backpacks, vests or belts, which are worn during the night and which keep you away from sleeping in a supine position.

Practicing with the Dragon Pearl on the other hand, focuses on conditioning, which means that specific behavioral patterns are trained. The purpose here isn’t to prevent a certain tongue position with the help of equipment. Instead, the aim is to “re-program” the body’s motion behavior through consistent training, such that within a few months you’re able to hold the tongue in the front mouth area during sleep without the use of a training device.

Tongue-base snoring isn’t the issue? Then you should check if you’re perhaps a mouth snorer or a nasal snorer. Or seek advice from our experts and do the snoring test.

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Snoring in children is a quite common phenomenon. Studies have shown that about half of all children snore occasionally. As a result their sleep is not as restful as it should be and this can have some negative consequences. In addition, children often snore for different reasons than adults. Here is some advice on how you can prevent your little ones from snoring.

Studies  have shown that about half of all children snore occasionally and about 9% snore every night. Even 6% of infants snore at night. In contrast to adults, however, snoring in children is always an indication of an irregularity that should be clarified medically.

In many cases, polyps in the nasal passages are responsible for snoring – the child does not get enough air through the nose and unconsciously breathes through their mouth instead, which leads to snoring. Often snoring is caused by enlarged adenoids (pharyngeal tonsils). They constrict the airways and can also trigger snoring. If these causes remain untreated, this can lead to serious health problems in the long run.

In extreme cases, misdirected air currents can lead to growth disorders of the nasal passages and the oral cavity over the years, and thus lay the foundation for pathological obstructive sleep apnea syndrome (OSAS) in adults. OSAS, on the other hand, rarely occurs in infants. However, the diagnostic criteria for OSAS in children are much lower than in adults, two episodes of apnea (pauses in breathing) per hour are considered excessive, whereas up to 5 are considered normal for adults.

Sleep little child, sleep!

Everyone needs sleep. In the first stages of baby development, sleep is even the most important activity of the brain. The sleep cycles in newborns are still very irregular, but nevertheless important for processing what they have experienced. That is why newborns sleep between 10.5 and 18 hours a day!

When children snore – what can one do?

Snoring in children is a quite common phenomenon. Studies have shown that about half of all children snore occasionally. As a result their sleep is not as restful as it should be and this can have some negative consequences. In addition, children often snore for different reasons than adults. Here is some advice on how you can prevent your little ones from snoring.

Studies have shown that about half of all children snore occasionally and about 9% snore every night. Even 6% of infants snore at night. In contrast to adults, however, snoring in children is always an indication of an irregularity that should be clarified medically.

In many cases, polyps in the nasal passages are responsible for snoring – the child does not get enough air through the nose and unconsciously breathes through their mouth instead, which leads to snoring. Often snoring is caused by enlarged adenoids (pharyngeal tonsils). They constrict the airways and can also trigger snoring. If these causes remain untreated, this can lead to serious health problems in the long run.

In extreme cases, misdirected air currents can lead to growth disorders of the nasal passages and the oral cavity over the years, and thus lay the foundation for pathological obstructive sleep apnea syndrome (OSAS) in adults. OSAS, on the other hand, rarely occurs in infants. However, the diagnostic criteria for OSAS in children are much lower than in adults, two episodes of apnea (pauses in breathing) per hour are considered excessive, whereas up to 5 are considered normal for adults.

Sleep little one, sleep!

Everyone needs sleep. In the first stages of baby development, sleep is even the most important activity of the brain. The sleep cycles in newborns are still very irregular, but nevertheless important for processing what they have experienced. That is why newborns sleep between 10.5 and 18 hours a day!

This also makes it clear that it is particularly important for toddlers that their sleep is also rejuvenating. If this is not the case, for example because the child not only snores but also suffers from interruptions in breathing, there is a danger that it will not be optimally supplied with oxygen. When a child does not get enough sleep, it can impair his physical and mental development. The consequences can be many and varied, ranging from being underweight ( because the child has to breathe in against increased resistance during sleep and thereby consumes a lot of energy) to concentration problems ( because sleep is disturbed and the child is overtired). The latter can quickly affect performance at school. The proportion of children with poor school performance among snorers (approx. 30%) is almost twice as high as among non-snorers (approx. 16%).

Since the brain is still in the process of development at a young age, the lack of oxygen at night can lead to learning and development delays, especially in children who suffer from OSAS.

When children snore – what can one do?

Polyps

The reasons why children snore are mostly anatomical. Abnormalities of the upper respiratory tract, such as nasal polyps are a common reason for snoring in children. These are benign growths of the nasal mucous membrane that constrict nasal passage. However, these easily removed by means of a small operation.

Small children, large tonsils

In early childhood, the body’s immune system works overtime. The lymphatic pharyngeal ring is often the body’s first line of defence against germs that enter the body through the mouth or nose. It is made up of palatine, pharyngeal and lingual tonsils. The pharyngeal or palatine tonsils are especially prone to enlargement (hyperplasia) in childhood. This results in narrowed airways and causes snoring. A child with enlarged, almond shaped tonsils often needs to have them surgically removed, in order to improve their general health.

Obesity

Being overweight promotes snoring, when someone is overweight there are increased fatty deposits all over the body, including in the tissue of the pharynx (throat). This causes the airways to become even narrower.

Smoking

The proportion of snorers is also higher among children who smoke passively. Smoking damages the mucous membranes in the mouth and throat, inflammation and swelling can occur. This also negatively affects breathing and increases the risk of snoring.

A visit to the paediatrician

If you notice that your child snores frequently, you should discuss this with your doctor at your next visit. He or she can examine your child and, if necessary, refer him or her to an ENT specialist who will initiate the necessary therapy. This topic should also be dealt with routinely in your child’s preventive check-ups. Therefore, ask if there are typical symptoms that have not yet been addressed. Many problems such as concentration difficulties, hyperactivity and daytime fatigue are known to be associated with snoring (and in extreme cases, sleep apnea) in children.

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Waking up in the morning with a tense neck or back – who hasn’t experienced this before? Other complaints can also develop due to wrong sleeping positions, though. One’s sleeping position can, for example, influence snoring, heartburn and plantar fasciitis.

The most common sleeping position is on the side: at least 57 percent start the night in this position, 17 percent lie on their backs and 11 percent on their stomachs.

However, very few people sleep in the same position all night. Most people change their sleeping position during the night. Men usually sleep with 2 pillows and women with an average of 4 pillows.

However, the sleeping position should not be chosen arbitrarily, but according to each persons individuals requirements and complaints. Because only with the right sleeping position can your problems be alleviated and only then will you be able to experience a restful sleep again. Here you can find out how to sleep when you…

… have shoulder pain

What to do when you have shoulder pain? If possible, do not sleep on the side of the painful shoulder. The best sleeping position for you is the supine position (on your back). If you want to sleep on the side of the non-painful shoulder, place a large pillow at hip height and place your arm on it – almost as if you were hugging someone. A special side sleeper pillow can be helpful here.

To relieve the pain and promote healing, you can also wear a shoulder brace while sleeping. The brace is designed to be worn during sleep and works through a combination of light heat therapy, with your own body heat, and pleasant micromassage. If both shoulders are affected by the pain, a double shoulder brace is recommended. An even better effect can be achieved by additionally using a gel that relieves muscle and joint pain.

… have back pain

It’s best to sleep on your back! Because in the supine position the body weight is distributed most evenly over surface of the body. The majority of experts therefore recommend that sleeping on your back is the best solution for back pain. To maintain the natural curvature of your body, you can put a pillow under your knees or a rolled up towel under your back.

If sleeping on your back is out of the question, or if you need to sleep on your side for some reason, you should put a pillow between your knees for extra support. This is also good for people with hip and knee problems. A foetus-like lying position can also help with spinal canal stenosis.

In addition to correct positioning and support from various pillows, you can also combat back pain during sleep with a sleeping bandage. It is designed for use at night and combines a light heat therapy (based on the reflection of one’s own body heat) with a micromassage. If the pain occurs in the upper part of the back, a cervical vertebrae brace helps. For lower back complaints, a belt for back pain the right choice. An even better effect can be achieved by additionally using a gel that relieves muscle and joint pain.

… have neck pain

For neck problems it is important that the neck is held in a neutral position when lying on the mattress. If possible, you should not sleep on your stomach. It is also better to use only one pillow instead of sleeping with several. Your pillow should be under your shoulders. A rolled up towel can also support the neck.

The best way to get restful sleep with neck pain is with an orthopaedic neck support pillow. These special pillows keep the head in a relaxed position while you sleep. The cervical and thoracic spine is relieved, tension is effectively relieved. 

If you have problems with your neck, you should also consider whether a sleeping bandage can help you to alleviate the discomfort. If you have problems “only” with your neck, a neck support can help. If the complaints extend from the neck to the upper back area, then a cervical vertebrae brace would be more advisable. An even better effect can be achieved by additionally using a gel that relieves muscle and joint pain.

… suffer from tongue-based snoring

How to stop snoring? If you suffer from position-dependent sleep apnea or are a tongue-based snorer, it is best to sleep on your side or on your stomach. In this case the tongue slides back into the throat, which then triggers snoring or apnea. Sleeping in a lateral (on the side) or prone (on the stomach) position prevents your tongue from sliding back into your throat. If you sleep on your back, naturally gravity will have an effect and the tongue will tend to slide backwards into the throat. If it is difficult for you to avoid lying on your back, during sleep – for example, because you repeatedly unconsciously roll over into this sleeping position, while sleeping – then positional therapy could help you. Special backpacks, vests and pillows make sleeping on your back virtually impossible and force you to sleep on your side or stomach.

… suffer from heartburn

Two principles apply to heartburn: First, definitely sleep on the side and secondly, sleeping on the left side is better than sleeping on the right. The reason for this lies in the human anatomy. The oesophagus is quite in the middle of the body, but the stomach is on the left side. In people who sleep on the right side, the stomach is above the esophagus – the acidic gastric juice can easily flow up the esophagus and cause heartburn. When sleeping on the left side, on the other hand, the stomach and stomach contents are lower than the esophagus. As a result, gastric juice rarely flows into the esophagus. One hardly experiences heartburn.

… suffer from heel spurs

Pain in the middle of the plantar surface of the foot.

A heel spur is a spine-like ossification at the calcaneal bone, whereby there are two different forms. If the ossification occurs on the lower side of the heel bone, i.e. on the sole of the foot, it is called a plantar calcaneal spur. This form occurs more frequently than the so-called dorsal heel spur, in which an ossification forms at the rear end of the heel bone. A calcaneal spur on the soles of the feet is often accompanied by inflammation of the tissues of the plantar surface of the foot  due to the high stress caused by body weight.

If you suffer from this problem, it is important that you lie with your your feet and ankles lie in a comfortable position while you sleep. Therefore, do not wrap your blanket too tightly around your foot and it is also best to rest them on a soft cushion.

Irrespective of the correct position during sleep, it is also important to eliminate the physical strain that promotes further growth of the heel spur. For example, with a medical foot sling worn under the socks during the day.

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Snoring can be much more than just a relationship killer or an everyday problem. Here you will learn that you should consult a doctor if you suffer from apnea, i.e. lapses in breathing.Obstructive sleep apnea syndrome (OSAS), upper respiratory tract resistance syndrome (UARS) and central sleep apnea (CSA). Do you suffer from a sleep related breathing that causes snoring? We explain what these conditions are and offer advice and solutions. 

Defining: Abnormal snoring

Medicine classifies snoring as pathological if the development of noise is the result of, or accompanied by, a sleep related breathing disorder. This means that the body is not sufficiently or optimally supplied with oxygen during sleep. Here is a brief explanation of how these diseases differ from one another and what needs to be taken into account:

If the upper airways close completely during sleep, i.e. if the tissue in the airways collapses and prevents air from flowing through at all, it is referred to as complete obstruction or obstructive sleep apnea (OSA). A lapse in breathing occurs (apnea) – for a period that can last from a few seconds to more than a minute. During this time no air gets through to the lungs (and no air exits the lungs). The lungs actually “pump”, i.e. the affected person shows breathing movements ( their chest lifts and lowers) but they are unable to breathe. OSA is the most common form of sleep related breathing disorder.

Obstructive sleep apnea vs Obstructive sleep apnea syndrome – What is the difference?

Although the two terms are used synonymously – there is a subtle difference. Obstructive sleep apnea (OSA) is the disease, i.e. the obstruction of the upper respiratory tract during sleep that causes the partial pressure of oxygen in the blood to drop. Obstructive sleep apnea syndrome (OSAS), on the other hand, occurs when the main symptoms of snoring, i.e daytime sleepiness and loss of performance also occur in patients with OSA.

Hypopnea

If, on the other hand, only a partial closure of the upper respiratory tract occurs during sleep, a so-called partial obstruction or hypopnea is present. The tissue also collapses, but only partially. Part of the normal air flow sis still delivered to the lungs, resulting in shallow breathing. However, an oxygen deficiency can also occur here, because the affected person has to breathe in against a resistance during sleep.

Hypopnea syndrome vs. UARS (Upper Airways Resistance Syndrome) – what is the relationship between these diseases?

Hypopnea syndrome vs. UARS (Upper Airways Resistance Syndrome) – what is the relationship between these diseases?

Central Sleep Apnea

Central sleep apnea is a sleep-related respiratory disorder that don’t involve the upper respiratory tract. These primarily include central sleep apnea (CSA). For them, breathing comes to a standstill because the respiratory centre in the brain no longer responds to the respiratory muscles. In purely CSA the upper respiratory tract does not play a role. Therefore there are no snoring noises. Unlike obstructive sleep apnea, central sleep apnea does not involve breathing movements. There is a complete cessation in breathing, the lungs cease to function completely, and not even the chest moves! CSA, however, occurs very rarely.

Mixed forms of central and obstructive sleep apnea syndrome

A sleep related breathing disorder can also present itself in a mixed form. In mixed apnea, a longer central phase (complete respiratory arrest because the respiratory centre in the brain stops functioning) is followed by a short obstructive phase of apnea or hypopnea (because the airways also collapse as a result of respiratory arrest).

The complex sleep apnea syndrome (CompSAS) also falls into the category of mixed forms of sleep apnea. CompSAS patients initially show all symptoms of obstructive sleep apnea and are treated accordingly – often with CPAP therapy. This eliminates the obstruction of the upper respiratory tract. However, these patients then experience symptoms of central sleep apnea. According to a US study, CompSAS could be present in up to 15% of all obstructive sleep apnea syndrome patients.

Consequences of Apnea and Hypopnea

All forms of apnea and hypopnea have one thing in common: they can pose a real danger to the affected person – especially if they are not detected and treated at an early stage. According to studies, the known long-term risks for obstructive sleep apnea syndrome include high blood pressure, stroke and coronary heart disease.

The transitions between different forms of snoring and breathing-related sleep disorders are fluid.

This is why a “snoring career” can also develop dynamically. The simple snorer of today can, over time, become a upper airway resistance syndrome snorer and even end up suffering from obstructive sleep apnea syndrome. This “career development” is not a firmly established path, but it does happen.

What does apnea actually mean?

Apnea comes from the Greek ápnoia and means “non-breathing” (from pnea: ‘breathing’ / ‘breath’) and refers to a more or less prolonged interruption of breathing. In contrast to competitive apnea- or free-diving – where breathing is consciously stopped – sleep apnea causes unconscious, sudden lapses (apnea) in breathing during sleep. The correct pronunciation of apnea involves three syllables: “apˈniːə”.

Sleep Related Breathing Disorder

How do I know if my snoring is a health risk?

In order to assess whether you suffer from a sleep related breathing disorder and your snoring is a health risk, you need to find out what type of snorer you. There are different types of snorers and we will explain how you can recognise them. We also tell you how to stop snoring.

Obstructive sleep apnea (OSA Apnea)

OSA apnea occurs when the upper respiratory tract closes partially causing either mild OSA or moderate OSA or closes completely causing severe OSA during sleep at recurring intervals and the oxygen content in the blood drops as a result. We explain the causes and the potential treatment options, especially CPAP therapy.

Oxygen saturation

The critical point with OSA apnea is the so-called oxygen desaturation of the blood. Desaturation occurs when too little oxygen enters the lungs via the airways – in other words, when the airways are blocked. The longer the blockage occurs and the more extensive the blockage is, the less oxygen reaches the body and the lower the blood oxygen levels drops. In order to better assess how serious sleep apnea actually is, the medical profession has developed a measurement method and established threshold values.

Apnea-hypopnea index

The so-called apnea-hypopnea index (AHI) indicates how many apnea (complete breathing interruption) and hypopnea (partial breathing interruption) episodes, that last more than 10 seconds per episode, an affected person experiences, that result in an arousal (brief awakening) and / or cause a decrease in blood oxygen saturation levels per hour of sleep. To put it simply: How often does the affected person have to struggle for air in an hour of sleep? The values can then be used to assess the degree of oxygen desaturation of the blood and how severe the obstructive sleep apnea is.

Apnea occurs when airflow is reduced by at least 75% over a period of 10 seconds or more, compared to normal breathing, and results in a blood oxygen saturation level decrease of more than 4%.

Hypopnea occurs when airflow is reduced by 50-75% compared to normal breathing. Blood oxygen saturation levels are not necessarily affected.

Grading the severity of obstructive sleep apnea

On this basis, the American Society for Sleep Medicine (AASM) has established the following guidelines for determining the severity of obstructive sleep apnea:

What happens during an apneic episode?

Depending on the severity of the OSA apnea ‘’episodes’’ can occur many times per night and follow a recurring pattern. Initially, the muscles and tissue in the upper respiratory tract slacken during sleep. The flabby tissue slides back into the throat and narrows or closes the respiratory tract, thus blocking the airflow. No air (and therefore no oxygen) arrives in the lungs. As a result, the oxygen content in the blood begins to sink – the so-called oxygen desaturation begins. The body registers this reduction and reacts.

How does one start breathing again?

According to a study on arousal , due to a spontaneous wakening reaction, an arousal, – the affected person is startled without waking up completely. As a result, the muscles in the body tense up, this includes the muscles of the upper respiratory tract. The collapsed tissue in the respiratory tract tightens itself, the air can flow again and the oxygen content in the blood normalises. The person sleeps calmly again and the muscles begin to relax. The whole cycle starts all over again!

This sequence of (1) relaxation of the tissue resulting in apnea, (2) oxygen desaturation of the blood, (3) arousal reaction, (4) tightening of the tissue and (5) increase of blood oxygen saturation levels can repeated many times per night.

Position-dependent vs. non-position-dependent OSA apnea – What is the difference?

The first way OSA apnea occurs is tongue-based : the back part of the tongue muscle slides backwards into the throat, covers the opening of the oropharynx (throat) and blocks the airway. This form of OSA apnea only occurs while sleeping on the back, when the base of the tongue slides downwards due to gravity gravity. Thus it is called position-dependent OSA apnea. This form of OSA apnea represents approx. 35% of all OSA apnea patients.

Treatment options

Snoring mouthpieces or positional therapy (in the case of mild OSA to moderate OSA), or CPAP masks – if severe OSA is present – provide a remedy for this form of OSA apnea . In addition to these snoring aids, there is also the possibility of solving the problem with an implant, a so-called “tongue pacemaker”.

Other causes of OSA apnea

On the other hand, OSA apnea can occur when the tissue in the pharyngeal region slackens. At this point, the pharynx can be imagined as an elongated tube with muscles in its wall that keep it taut. If these muscles slacken, the tube collapses. Now no more air can flow through the tube. It results in the closure of the respiratory tract. This form of OSA apnea is called most common form.

EPAP vs CPAP Therapy

Mild OSA to moderate OSA forms of non-positional OSA apnea can treated either with EPAP (expiratory positive airway pressure) therapy or with CPAP therapy (continuous positive airway pressure therapy), but severe OSA can only be treated by means of CPAP therapy.

In order to achieve the optimal treatment result, it is important to know – among many other parameters – whether one’s own sleep apnea is position-dependent or not.

Consequences of OSA apnea

Once you have witnessed how dramatically a person suffering from sleep apnea has to struggle for air and oxygen during sleep, you will quickly understand that OSA apnea costs the body a lot of energy and drain it in the long run (here is a short YouTube clip  to illustrate this struggle for air). Instead of resting during sleep, the body has to work hard night after night. If this permanent stress remains untreated, it can have dramatic consequences for health.

Not just a lack of sleep

The constant arousal reactions prevent the affected person from reaching the deep sleep stage and thus from getting a restful nights sleep. One experiences daytime fatigue , exhaustion and a lack motivation to perform the following day. People who suffer from OSA apnea are often irritable, permanently feel tired and drowsy, which significantly reduces their quality of life. Personality changes and depression often occur. Their sex life also suffers due to declining libido. Affected men also often have a low testosterone level, which is accompanied by reduced sexual desire and erectile dysfunction.

High blood pressure

Chronic high blood pressure (hypertension) can be a possible long-term consequence of OSA apnea. Normally, blood pressure drops by 10 to 15 percent during sleep. In apneic snoring, however, the systemic blood pressure remains at, or even exceeds, the pressure level whilst awake. In this context, a USA study  has found that the chance of suffering from high blood pressure in a person with moderate OSA (AHI of 15 / h or higher) is almost 3 times higher than in a person with healthy breathing. As a result of the high blood pressure, other diseases can develop, because the high pressure strains the entire vascular system of the body. Cracks in and thickening and hardening of the vascular wall are potential consequences. High blood pressure is the main risk factor for arteriosclerosis, which in turn can lead to heart attacks, strokes and other vascular diseases.

Heart Failure

OSA apnea is also suspected of promoting the increased formation of deposits in the coronary arteries. A 2009 Canadian study  found a significant correlation between obstructive sleep apnea and the amount of deposits in the coronary arteries. In addition,OSA apnea could also have a negative effect on heart function.

Evaluations of the American Sleep Heart Health Study have shown that men with severe OSA apnea (AHI > 30) have an approximately 60% higher incidence of heart failure than patients with very low OSA apnea values (AHI < 5).

Stroke

In the course of evaluations of the Sleep Heart Health Study mentioned above, a possible link between OSA and stroke risk was also established. According to this OSA apnea-hypopnea study , the risk of stroke in mild OSA to moderate OSA patients (AHI 5-25) should increase by 6% with each additional AHI episode. In further obstructive and central sleep apnea studies  it was shown each (recurring) episode of breathing interruption (apnea) more per hour would increase the risk of a stroke by 6%. OSA apnea is also associated with cardiac arrhythmias. Finally, it is also suspected that OSA apnea promotes certain metabolic diseases, in particular diabetes mellitus. An oxidative stress study  has, however,  not yet concretely proven how the increased insulin resistance of OSA apnea patients is caused.

OSA apnea and driving – a highly dangerous combination!

There are numerous studies that have investigated the effects of OSA apnea on road safety. These studies show that OSA apnea patients are 2-3 times more likely to be involved in a car accident than healthy sleepers (other studies even show a 6-fold higher risk). Thus OSA apnea is not only dangerous for the affected persons themselves, but also for all other participants in road traffic. One more reason to take the disease seriously and to handle it responsibly.

How do I know if I have OSA apnea?

Only a doctor can give an unambiguous diagnosis of obstructive sleep apnea. However, there are a number of symptoms of which you, as a patient, need to be vigilant. You should consult a doctor (ENT / sleep specialist) for further clarification, if you

(1) suffer from marked daytime fatigue without any recognisable cause and

(2) snore loudly at night and have to gasp for air again and again (i.e. your breathing is interrupted), if you wake up repeatedly at night, if you have feel unrested after sleep or if your ability to concentrate is reduced.

Apneic snoring

Apneic snoring also has a specific sound pattern that can easily be recognised: There is an alternation between snoring and silence. The snoring itself is often very loud and disturbing and breathing is regularly interrupted (apnea) for several seconds during which the snorer stops breathing. The respiratory interruption often ends with a loud grunt when the body struggles for air and the airways open again.

Sleep amnesia

Whether an affected person can remember these “suffocation attacks”, however, is not a reliable indicator. This is because the affected snorer often only experiences breathing interruptions unconsciously, i.e. in most cases he does not wake up from them, but only briefly jerks awake up during sleep. Just because someone can’t remember suffering from breathing interruption during sleep doesn’t they don’t suffer from apnea.

Symptoms of OSA apnea

In addition, there are a number of other symptoms of OSA apnea that are not meaningful on their own. These include sleep without restorative value, morning headaches, dry mouth, reduced attention thresholds, confusion in the morning, mood swings, depression, high blood pressure, reflux of gastric fluid or sexual dysfunction ranging from a reduction in libido to impotence.

The golden rule: If you have evidence that you may be suffering from OSA apnea (OSAS), contact your family doctor or a specialist (ENT / sleep specialist) as soon as possible. OSA apnea is a serious condition and should be investigated by a doctor.

I suffer from OSA apnea – What can I do?

If you have been diagnosed with OSA apnea by a sleep laboratory or a sleep specialist, this is usually accompanied by a treatment recommendation. CPAP therapy is the standard recommendation in these instances. It still represents the therapeutic gold standard today, as all forms of OSA apnea can be effectively treated with it.

However, many patients perceive this therapy as a severe restriction of their quality of life or sleep. After all, one sleeps with a ventilation mask and is exposed to a continuous, motor-generated air flow. Because of these disadvantages, many patients discontinue therapy completely or do not use it regularly. Many are also looking for an alternative to CPAP therapy. These alternatives actually exist, but not for every form of OSA apnea! Here is an overview:

CPAP therapy alternatives

EPAP therapy

EPAP therapy (“nasal valves“) are available as an alternative to CPAP therapy for mild OSA and moderate OSA that are not position-dependent.

Mandibular advancement devices

In position-dependent OSA apnea , both mild OSA and moderate OSA can be treated with mandibular advancement devices (snoring mouthpieces) or positional therapy. Mandibular advancement devices (MADs) are worn at night and push the lower jaw forward. This prevents the tongue from sliding into the back of the throat.

Positional therapy

Positional therapy belts and vests make sleeping in supine position (i.e. on the back) totally uncomfortable and thus promote sleep in the lateral (i.e. on the side) and prone (i.e. on the stomach) position. In these sleeping positions, the tongue remains in its original position.

UAS stimulation therapy

Alternatively, an implant in the base of the tongue (UAS stimulation therapy of the upper respiratory tract) could be considered for position-dependent OSA apnea . By means of short electrical impulses, it prevents the base of the tongue from slackening during sleep and thus from sliding back into the throat and blocking the airway.

Do you suspect you suffer from OSA apnea

If you only suspect that you may be suffering from OSA apnea, you should seek medical advice. A doctor specialising in OSA apnea will advise you how to proceed. Generally you will be advised to participate in a home sleep study. You will be given a small box to take home with you, which records certain sleep and breath related body data and can be read by your doctor after a few days of use.

What happens if your suspicions are confirmed?

If the suspicion of OSA apnea is confirmed, a polysomnographic examination would follow. This means that you will spend one night a sleep laboratory, where a variety of data relating to your sleep and breathing behaviour will be measured. On the basis of this data (and previous medical examinations) the sleep specialist can then determine whether or not you are actually suffering from a breathing-related sleep disorder (the main case of which is: obstructive sleep apnea). You will then receive a diagnosis and therapy recommendation.

Hypopnea – Upper Airway Resistance Syndrome – Central Sleep Apnea

Sleep related breathing disorders are complex and have a disruptive effect on one’s daily life. The difference between the different types of sleep related breathing disorders; hypopnea syndrome, upper airway resistance syndrome and central sleep apnea are confusing, especially if you suffer from mixed apnea. We clarify the difference and offer advice on how  to treat these conditions so that you can lead a normal, productive life.

Hypopnea syndrome could be described as the “baby brother” of obstructive sleep apnea. It is a breathing-related sleep disorder during which only hypopnea occurs. In its pure form it occurs quite rarely, in most cases both apnea and hypopnea occur. Together, their interaction obstructive sleep apnea hypopnea syndrome (OSAHS), can have a similarly stressful effect as pure apnea. This circumstance also caters toward the most widespread method of measuring breathing-related sleep disorders, viz. the AHI (apnea-hypopnea index), since it does not differentiate between apnea and hypopnea, but only records the total number of episodes (or “incidents”).

How can I tell if I suffer from hypopnea?

Hypopnea and apnea are often difficult to distinguish. That is why what is said about obstructive sleep apnea syndrome also applies

(1) marked daytime drowsiness with no discernible cause, and
(2) loud night snoring combined with repeated gasping for air or you feel unrested after sleep or experience reduced concentration.

What can I do if I have Hypopnoea Syndrome?

In principle, the same recommendations apply as for obstructive sleep apnea.

Upper Airways Resistance Syndrome (UARS) is also a breathing related sleep disorder disorder. Put simply, it is right in the middle between simple, benign primary snoring and pathological obstructive sleep apnea (OSA). With upper airway resistance syndrome there are recurring so-called “incomplete obstructions” of the upper respiratory tract. This means that although the airways remain open at all times, they can narrow considerably and thus impair or reduce the flow of air. Upper airway resistance syndrome patients have no apnea (respiratory arrest), but a normal oxygen saturation in the blood. In other words, they are supplied with sufficient oxygen at all times. This is where upper airway resistance syndrome differs significantly from obstructive sleep apnea.

Spontaneous arousal reactions – The “littlest common evil”

Obstructive sleep apnea syndrome (OSAS) and upper airway resistance syndrome patients both suffer from spontaneous “arousals” at night. These waking reactions prevent a healthy structured sleep and thus lead to daytime fatigue and general exhaustion. When and how the arousal reactions occur differs in both diseases, however. While the upper airway resistance syndrome patient, who has a comparatively mild respiratory impairment, is shocked by the slightest amount of extra strain required to restore breathing to normal and thus suffers an arousal reaction. The Obstructive sleep apnea syndrome patient only reacts when they are suffering from a significant oxygen deficiency.

What triggers an arousal?

The trigger for the spontaneous arousal reaction in obstructive sleep apnea syndrome is the drop in the the oxygen saturation level of the blood. The brain registers this drop and counteracts it with the arousal reaction. In upper airway resistance syndrome, however, the trigger is an increased workload, the body registers that breathing has become more difficult. The reason for this is that the lungs have to breathe in against increased resistance caused by the narrowing of the upper respiratory tract. With upper airway resistance syndrome, however, the body is sufficiently supplied with oxygen at all times. Due to the frequent arousals, upper airway resistance syndrome patients show a persistently disturbed “sleep architecture”.

How is upper airway resistance syndrome diagnosed?

The diagnostic criteria for upper airway resistance syndrome are not standardised – partly because the disease of its own, partly because it is a variant of obstructive sleep apnea syndrome (“as part of a continuum between primary snoring and obstructive sleep apnea”). As a consequences of upper airway resistance syndrome,  the cardiovascular burden of upper airway resistance syndrome is considerable, because the affected person has to breathe in against a high resistance with upper airway resistance syndrome.

Breathing into a vacuum

Despite the bottleneck in the upper respiratory tract, the patient still has to inhale sufficient air and oxygen into the lungs – in other words, the body has to exert itself and increases breathing performance. As a result, the negative pressure (“vacuum”) in the chest increases (so-called negative intrathoracic pressure). This value can be as low as -100 mbar. This would correspond to the value that can occur with a complete airway occlusion in the context of obstructive sleep apnea.

Consequences of upper airway resistance syndrome

According to a upper airway resistance syndrome study  it is therefore also suspected that it leads to comparable pathological changes in the heart, circulation and sleep quality as obstructive sleep apnea syndrome. The high negative intrathoracic pressure (pressure in the chest) is also partly responsible for upper airway resistance syndrome patients suffering from increased reflux (reflux of gastric fluid).

Predisposing conditions

Upper airway resistance syndrome is comparatively common in patients of normal weight and young age. In addition, women are more often affected by upper airway resistance syndrome than by obstructive sleep apnea syndrome. Upper airway resistance syndrome also occurs more frequently in the third trimester of pregnancy. Because expectant mothers don’t only gain weight in the abdominal area, but also around the neck and throat area. Fatty deposits in the respiratory tract favour constrictions and impairments of breathing.

Evolution of upper airway resistance syndrome

Upper airway resistance syndrome can change to obstructive sleep apnea syndrome if you gain weight. It is to some extent a precursor to obstructive sleep apnea syndrome and can progress if not detected and treated.

How can I tell if I have UARS?

Unrecognised sleeping disorder

Upper airway resistance syndrome has the reputation of being an “unrecognised sleeping disorder”. The disease is by far not as well known as OSA and cannot be detected with a doctor’s standard diagnostic tools because it does not lead to breathing interruptions (apnoea) or to oxygen desaturation of the blood.

Home sleep studies do not deliver any significant results. UARS can only be tracked by using measuring methods that also register cyclic pressure changes within the chest (such as polysomnography analysis in a sleep laboratory). The typical respiratory event in patients with upper airway resistance syndrome is called RERA (respiratory effort-related arousal).

Differential diagnosis

If you suffer from the following complaints and obstructive sleep apnea has been ruled out, you should at keep upper airway resistance syndrome in mind differential diagnosis: excessive daytime drowsiness, fatigue and sleep fragmentation, people with upper airway resistance syndrome also battle to fall asleep and to sleep-through, they suffer from anxiety and experience gastric reflux.

It is also important to know that upper airway resistance syndrome patients do not always snore. They often attribute their excessive fatigue to stress or other external factors.

What can I do if I suffer from Upper airway resistance syndrome?

As with OSA, ventilation therapy using a CPAP device is the standard therapy for upper airway resistance syndrome. However, CPAP therapy is not well accepted by upper airway resistance syndrome patients because it makes the typically severe sleep problems of upper airway resistance syndrome patients even more difficult. This is why upper airway resistance syndrome very often uses alternative therapies. EPAP therapy (“nasal valves”) can be considered as an alternative for upper airway resistance syndrome in any position. People who suffer from position-dependent upper airway resistance syndrome responds well to treatment with snoring mouthpieces (mandibular advancement devices) or positional therapy.

In children with upper airway resistance syndrome, the removal of enlarged tonsils may be considered.

Central Sleep Apnea (CSA)

Central sleep apnea occupies a special position among the breathing related sleep disorders. It is not caused by narrowing or obstruction of the upper respiratory tract, but by damage to the respiratory centre in the brain. The central nervous system virtually “forgets” to activate the respiratory muscles and as a result respiratory arrest occurs. Respiratory control does not function reliably. People affected by central sleep apnea do not really “snore”, but they do experience breathing interruptions. This “silent” interruption of breathing is therefore often not registered by their bed partner. As a result many central sleep apnoea cases are not recognized and not treated.

Often respiratory arrests are also accompanied by an increased respiratory drive. The body wants to compensate the under supply by following up with increased breathing activity – which results in the patient breathing more intensely, than necessary. This periodic pattern of increasing and decreasing breathing effort and respiratory flow is characteristic for, so-called, Cheyne-Stokes Respiration, the best known form of central sleep apnea.

Central sleep apnea patients experience repeated arousal reactions during sleep and therefore suffer from interrupted sleep and, as a consequence, from daytime drowsiness, concentration difficulties and poor performance. Risk factors for central sleep apnea are cardiac insufficiency, renal insufficiency, circulatory disturbances of the brain or even life in high altitudes.

Central sleep apnea is primarily treated by treating or curing the underlying disease (heart failure, renal insufficiency etc). In many cases, this is done through drug therapy.

In the past attempts were made to correct the breathing pattern in Cheyne-Stokes respiration using ventilation therapy so that it corresponded to natural, constant breathing. However, recent studies (SERVE-HF) have shown that this practice produces the opposite effect. Instead of helping – i.e. increasing life expectancy and quality – the use of ventilation therapy led to a higher mortality rate of patients. The causes for this are not yet clearly understood, but it is possible that patients with heart defects need nocturnal apnea as a protective mechanism.

Central sleep apnea and obstructive sleep apnea can also occur together – as mixed apnea. The cause of respiratory arrest is always the lack of impulse from the central nervous system. This is followed by a physical collapse of the upper respiratory tract.

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Snoring without interruptions in one’s breathing is called primary snoring and considered harmless by many medical professionals. But even this simple snoring is not quite as trivial, because every form of snoring is, first of all, a sign of disrupted breathing behaviour and this should generally not be taken lightly. The consequences of snoring are wide-ranging: from halitosis (bad breath) and sleepless partners to the possible suspicion that snoring can increase the risks of having a stroke or somehow be associated with causing them. We will attempt to explain the consequences of snoring. At the end you will also find an overview of snoring aids – ranging from from anti snoring mouthpieces (mandibular advancement devices) and mouth guards to nasal dilators.

Defining the matter

From a medical perspective there are two types of snoring: simple snoring and pathological snoring.

Simple snoring is also called primary snoring or habitual snoring. It can either occur occasionally or become a constant nocturnal companion.

Not pathological, but not exactly healthy either

The “simple” form of snoring affects the majority of snorers and is harmless from a medical point of view. The defining criteria when classifying snorers into pathological and primary snoring categories is the amount of oxygen supply the body receives and the regulation of the circulatory system and the respiratory system during sleep. Primary snoring is not associated with such problems. There are no breathing interruptions during the night and the body’s oxygen saturation level remains unaffected.

Breathing in is quite exhausting!

Nevertheless, life as a habitual snorer can be accompanied by certain symptoms. First of all, the consequences of snoring are respiratory impairments. For example, if the body has to breathe against a resistance caused by an area of constriction or because of obstacles in the nasal passages which results in snoring (so-called nasal snoring). If the resistance is too great or if nasal breathing is permanently impaired, the body inevitably switches from natural, healthy nasal breathing to breathing through the mouth. As a result, many people begin to snore through their mouths (so-called mouth-based snoring).

Another form of respiratory impairment occurs when the tongue slides backwards into the throat during sleep and narrows the airways (so-called tongue-based snoring). The affected person still gets enough air to supply his body with sufficient oxygen, however, they clearly have to breath against a resistance. The result is that they tend to expend more energy during sleep and do not wake up feeling refreshed.

Bad breath and snoring – these two issues are as thick as thieves

Further consequences of snoring often manifest themselves in the oral cavity. It is a fact that snoring causes bad breath (halitosis). Halitosis is triggered by mucous membranes that are too dry, this often occurs because the mouth is open while snoring. The effect is comparable to having a cold; most people can relate to the unpleasant sensation of waking up with a bone-dry mouth which exudes an extremely unpleasant odour.

A dry mouth – or more precisely, dry mucous membranes in the mouth – can lead to the following problems:

• Dry mouth (xerostomia)
• White coating on the tongue and in the oral cavity
• Halitosis
• Swallowing difficulties
• Inflammation of the mouth and throat
• Infections of the respiratory tract and tonsillitis
• Increased plaque, tooth decay and gum disease
• Negative influence on digestion

How come a dry mouth leads to these problems? Dried-out mucous membranes are more susceptible to pathogens and inflammation develops as a result. In addition, the composition of the bacteria in the oral cavity, the so-called oral flora, changes. Putrefying bacteria gain control of your mouth and this is accompanied by unpleasant odours.

Nobody has ever slept well in a sawmill

In many cases, the typical soundscape of snoring during the night is not only annoying, but can also lead to very specific complaints; for the snorer themselves, on the one hand and for their affected partner, on the other hand. The British Lung Foundation conducted a study wherein they interviewed the partners of snorers. Basically the result of the study as, expressed in key words, was: “my partner snores and I can’t sleep”! Expressed in numbers; 41% of the women interviewed felt that the nocturnal noises of their partner were very disturbing. For men, on the other hand, it was only 24%. This may be due to the fact that women snore more quietly or to the fact that men generally sleep more deeply.

One of the consequences of snoring is the fact that around 70% of all those affected lose at least two hours of sleep per night as a result of their partner snoring.

The consequences of snoring

Too little sleep can lead to fatigue, daytime drowsiness and lack of concentration, as well as morning headaches and psychological problems. Those who get too little sleep because of snoring are not only annoyed and overtired, but are also at risk heart disease. For people who sleep a maximum of five hours a day, their risk increases 2.2 fold. Researchers say that it is possible that too little sleep leads to a disruption of the glucose metabolism and also increases blood pressure. These in turn are “ideal prerequisites” for the development of vascular diseases. However, the exact mechanism has not yet been fully clarified.

Not only does the snorer’s partner get too little sleep, but the snorer, themselves, also suffers from lack of sleep, as well, as their sleep is also disturbed, either by their own tendency to snore, by an annoyed partner waking them up or unconsciously due to an arousal reflex as a result of OSAS.

Stroke – no thank you!

According to recent studies, primary snoring is potentially an even more serious offender, because it could lead to an increased risk of stroke. A stroke is caused by circulatory disorders within the brain. In most cases, this is caused by incremental changes in the blood vessels over time, for example due to vascular calcification (arteriosclerosis). As a result the blood can no longer flow unhindered and the oxygen supply to the brain is insufficient, the brain is thus deprived of oxygen and it stops functioning.

In 2013, the Henry Ford Clinic in Detroit investigated the carotid arteries of primary snorers and was able to detect changes there that could lead to a stroke or cardiovascular disease. However, this study alone has not yet sufficiently proven that or how snoring can contribute to causing a stroke or even increase the risk of its occurrence. The other studies that have been initiated should provide more clarification. However, the results are not yet available.

You can also easily find out why exactly you snore and determine what type of snorer you are through the help of our snoring test and learn how to stop snoring at the same time.

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Anyone suffering from an allergy is all too familiar with the problem of having a blocked nose. Allergens such as pollen irritate the mucous membranes and cause them to swell, typically hay fever snoring and breathing difficulties set in. At night allergies often lead to hay fever snoring and shortness of breath. Special nasal dilators with small air filters can help. We explain how this works.

Allergies and snoring

If the airways in the nose are narrowed due to hay fever snoring is more common. For one thing, you breathe in against resistance. This means that the entire upper respiratory tract is under a slight negative pressure. Everyone knows the feeling, you breathe in, but there is no air in the lungs, instead the nose (and also the throat) contracts. These constrictions in the airways can then result in turbulence in the airflow, causing the tissue in the nasopharyngeal cavity to vibrate. This creates the well-known snoring sound.

On the other hand, if the airway resistance in the nose is too high, the body unconsciously switches to mouth breathing, after all, you don’t want to suffocate! In many cases, however, mouth breathing leads to mouth snoring. This is because the flow of air through the mouth passes the tissue of the palate and in particular the arches of the palate, causing them to vibrate. These oscillations lead to noises, which we perceive as snoring.

The problem described here affects allergy sufferers among us to a large extent, because allergies to pollen and grass, house dust or animal hair lead to swelling of the nasal mucous membranes. Less air can flow in and out through the nose and one suffers from hay fever and snoring problems. But why do allergies occur in the first place?

Hypersensitivity reaction: Allergies and snoring

Put simply, an allergy is nothing more than a hypersensitivity reaction to substances from the environment. In classical snoring hay fever, the body’s immune system experiences a hypersensitive reaction to tiny particles in the air, in addition to house dust or animal hair allergies. These particles are between 1 and 100 micrometers in size. The smallest particles measure just one thousandth of a millimeter.

These small substances, for example certain protein molecules contained in some pollen, reach the mucous membrane of the nose via the inhaled air. Here immune cells whose task is to fight foreign substances and invading pathogens, are located. In the case of an allergy, these cells trigger an immune reaction against the normally harmless particles of house dust, cat hair or pollen. The substances released by the defense cells cause, among other things, the blood vessels in the mucous membrane of the nose to dilate and increasingly fill with blood. This causes the mucous membranes to swell. The nose becomes blocked and produces more secretions and the airways are narrowed by the swollen nasal mucous membranes. Not only do sufferers have breathing problems during the day , but breathing at night is often impossible due to snoring allergies and nasal congestion.

The problem with allergies is that there is no treatment that can completely eliminate the hypersensitivity. The only really effective method would be to completely avoid the substance responsible for the snoring allergies. But this is not feasible for the majority of allergies.

Air filter: trap allergen particles

One way of dealing with the allergy is to prevent the microscopic particles from reaching the mucous membrane of the nose in the first place. If the immune cells in the mucous membrane do not come into contact with the allergen (i.e. the allergenic substance), they are not activated and the respiratory tract remains free.

Nasal dilators with a built-in air filter are a simple and inexpensive way of protecting the mucous membranes from allergen particles. Nasal dilators, usually consist of two interconnected plastic rings that are pushed into the nostrils. They serve to widen the nostril and thus improve the respiratory flow. Some models are combined with an air filter that filters the allergenic particles out of the air when inhaled so that they cannot reach the mucous membranes. There are two different approaches:

1. Imitating the function of the nasal hairs

The nose already has a natural filter system for filtering the air we breath viz. the nasal hairs. They are designed to trap foreign particles from the air we breathe. When exhaling, the warm, moist air coats the fine hairs in the nose with a wafer-thin film of moisture. The particles of dirt that are sucked into the nose from the ambient air the next time the patient breathes in then stick to this film. However, as we usually do not have whole tufts of hairs in the nose, but only a manageable number, this method is not always effective. Especially not with tiny particles, house dust and sebaceous particles from animal hair or pollen are only a few micrometers in size and are often not intercepted by the nasal hair alone.

However, you can try to enhance the “nasal hair effect” by using a nasal dilator with a fine foam filter built into it. The fine foam has a very large surface due to its grid or net structure and resembles a “dense thicket of hairs”. During exhalation, this surface is moistened and heated by the air flowing out of the lungs. The next time you breathe in, the particles that would otherwise escape the natural nasal hairs get caught in this much denser mesh. The advantage of the foam models is that nasal breathing is not affected. You can therefore continue to breathe relatively easily through your nose because the foam has no or very low airway resistance. In other words, one does not have the feeling one is breathing through a filter or against a resistance.

But this advantage is also the disadvantage of the method: Some allergenic particles escape from the filter system, so that one cannot expect 100% protection against pollen or house dust from the nasal hair imitations.

All in all, however, nasal dilators with foam filters are an excellent aid against snoring allergies. Above all, they do not restrict your ability exert yourself, for example your ability to do sports without getting too little air through the filter. This type of filter is the perfect anti snoring device, in this instance.

2. Real filters

Another method is the installation of a real, fine plastic filter in the nasal dilator. Depending on the filter strength, these filters allow virtually no particles to pass through, thus ensuring extremely pure breathing air. In some models, the filters are also statically charged, so that the allergens are almost attracted by it and get caught. The products are available with different filter thicknesses. Depending on which allergy you suffer from, you can choose the right filter for you. For example, pollen is usually smaller than particles of sebum on animal hair, which is why a finer filter is recommended for snoring hay fever.

Filter models offer the advantage that they protect the nasal mucous membrane very effectively against allergenic particles in the air. Fine filters are even able to trap smoke particles.

However, they do have the disadvantage that breathing through the fine net is more difficult because the air must first pass through the filter. The problem with this is the same as with an allergy-induced congested nose. One breathes in against a resistance.

What is important with nasal filters?

Regardless of whether you choose the foam version or the finer filter models, there are a few points to consider when using them:

Limited durability

Nose dilators have a limited service life. Some models can even only be used once. This is due to hygienic reasons: Nasal dilators come into contact with secretions, which are often full of bacteria when worn. The nasal dilator often becomes a breeding ground for pathogens.
On the other hand, the physical absorption capacity of the filters is limited. If a larger amount of particles has got caught in the filter, the incoming breathing air can no longer be effectively cleaned. Figuratively speaking, the filter is “full”. Therefore, you should change your nasal filter regularly or at least at the bare minimum, every three months. However, there are also filter models that have to be cleaned daily with water and/or alcohol so that bacteria have no chance to thrive.

Correct size

It is important to choose the right size when buying. The nasal dilator must fit well, otherwise it may feel uncomfortable when worn for long periods of time. In addition, the dilators are made of stable, moulded plastic. This means that although they can be bent and deformed, they always return to their original shape. If they sit uncomfortably, this can quickly lead to a sensation of pressure. There are therefore many models in different sizes. They differ in diameter and shape to suit every nostril. But there are also so-called “one size fits all” products, such as somnipax pure.

Acclimatisation period

Initially wearing the nasal filters can be perceives as a rather unusual experience. However, one gets used to the foreign body in one’s nose quite quickly and after a while users are not bothered by it, especially during sleep.

Increased secretion flow

The nose itself also recognizes the nasal dilator as a foreign body and sometimes tries to get rid of it by its own means. In this instance your nose may produce more secretions to flush out the unfamiliar plastic object.

If this becomes too unpleasant for you, you should simply remove the nasal dilator, blow your nose and insert it again.

Get clean air vs. good air

Especially with real filters, nasal breathing can be impaired. Since the filter is very fine, one is able to inhale less air through the nose. If you want to keep getting good quality air, you have to exert yourself more and breathe in and out more vigorously. This can be quite unusual in the beginning. One should try to prevent the body from seeking “the path of the least resistance” and switching to mouth breathing , because the filter loses its function as a result. One can train oneself to consciously breathe through one’s nose – especially if one does it right from the start.

The higher resistance makes the nasal filters unsuitable for use in sports. Here it is important that you get enough oxygen and a filter would only be a hindrance here. Even for use at night – keyword “how to stop snoring” – the air filter takes some getting used to. A foam filter might be more helpful in this instance.

Nasal dilator purchasing advisor

What must you take into consideration when making a purchase? See all our nasal dilators presented here.

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Positional therapy purchasing guide

Helps you make an informed buying decision when buying a positional therapy device, such as an anti-snoring vest or anti-snoring backpack.

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Mandibular advancement device (MAD) purchasing guide

Advises you what you should pay attention to when buying a mandibular advancement device (MAD). We present different models and technical approaches here.

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Mandibular advancement device guide – answers based on practical experience

Mandibular advancement devices can help with sleep apnoea in a lot of cases. They are now also provided by the NHS. Find out how exactly they can help, and when they are provided by the NHS.

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Perhaps you are not aware of this, but not all snorers are alike. Snoring has many causes. Fortunately, there are also a number of different snoring aids hat are precisely suited to your snoring requirements. We can  roughly distinguish between the following different causes of snoring „nasal snoring“ (top snoring aid: nasal dilator), “tongue snoring” (appropriate snoring aid:  snoring mouthpieces / mandibular advancement devices (MADs), “mouth snoring“ (snoring aid of choice: mouth guards for mouth snoring) and “pharyngeal snoring” (suitable snoring aid: anti-snore braces). 

The good news is: You don’t need a medical degree to find out which type of snorer you are. We will give you all the advice you need to identify your type of snoring and find out what snoring aid really works for you. You should however excercise caution, , if in addition to snoring, you also experience sleep apnea / breathing interrruptions whilst sleeping.

Here you will get to know how to understand your down and sleep behaviour and snoring noises better: What helps for snoring and conversely, what leads to snoring. But you should be particularly cautious when your snoring is accompanied by breathing interruptions. Then there is no way around the visit of a ENT doctor or sleep physician. Sleep apnea is a serious disease which should always be treated by a doctor.

If you’re in a hurry, simply take our anti snoring test that helps determine what type of snorer you are. It will give you the quickest answer on the question: What stops my snoring?

The Nasal Snorer

Sound

With nasal snoring, the noise is a consistent, fluttery or rumbling, grunting sound. Yet it can also sound like the whistling of a kettle.

Self-Diagnosis

Determine whether nasal breathing is already impaired while awake – if so, then your snoring is most likely (also) the result of a nasal problem. Simply try our nose snoring test! Conversely, if you can breathe through the nose during the day without any issues, then it is unlikely that the cause of your snoring is related to your nose.

Nasal snoring often results in a dry mouth, bad breath or headaches.

Snoring Causes

Nasal snoring is caused by impaired nasal breathing, which can have several causes: There might be anatomical reasons (a deviated nasal septum) but quite often allergies or a cold are the cause. 

Snoring Aids

Nasal Dilator

Nasal dilators or nasal strips widen the nostrils and improve nasal breathing.

Nasal Irrigation

A nasal douche rinses mucous and secretions from the nose and is especially help with allergies or colds.

Surgical Procedures

are often inevitable in cases of severe anatomical restrictions of breathing (which can trigger strong snoring).

The Tongue Snorer

Sound

With tongue the snoring noise occurs in spurts. In many cases the tone is higher than the typical snoring sound. Here you can listen what snoring sounds like when your tongue is more voluminous than the average and obstructs the airways.

Self-Diagnosis

Find out if you only snore in a supine position (while sleeping on your back). If so, then in all likelihood you are affected by tongue snoring (also called “tongue base snoring”). Anatomical particularities, such as a retrognathic mandible (“receding chin”) or a very large tongue also indicate this type of snoring.

Snoring causes

Tongue snoring occurs almost entirely in a supine position (i.e. when you sleep on your back). When the muscles of the tongue relax, the rear part of the tongue – the base of the tongue – slides backwards into the throat and constricts or blocks the airways there.

Snoring Aids

Anti-Snoring MAD’s

Snoring mouthpieces gently move the lower jaw forward, thus preventing the tongue from sliding into the pharynx. What should you know, before buying a mandibular advancement device (MAD), though? Click here to find out!

Positional Therapy

Positional therapy includes products such as anti-snoring backpacks, anti-snore sleep belts or anti-snore pillows. They prevent you from sleeping on your back and keep you gently on the side.

The Mouth Snorer

Sound

With mouth snoring, the sound is evenly rumbling or fluttery noise. It reminds of the sound of a slack sail in the wind. Here you will find an audio sample  of mouth snoring caused by tonsils which are too large. In addition, you can hear a snoring sound  that is caused by the uvula here.

Self-Diagnosis

Find out whether you also snore with your mouth closed. If you only snore with an open mouth, you are a mouth snorer.

Try to make a snoring sound with your mouth open. If this sounds like your snoring noise at night, you are most likely a mouth snorer. However, you will need a partner  who can observe you to do this “test”.

Snoring causes

In the case of mouth snorers, the transition from the oral cavity to the throat is narrowed by flabby tissue. The breathing air causes the tissue to vibrate, resulting in the snoring noise.

Nasal breathing can also be a trigger for mouth snoring. If you don’t get enough air through your nose overnight, you automatically breathe through your mouth. Also, if the palatal tissue is weak, mouth snoring occurs.

Snoring Aids

Mouth Guard

The somnipax snoring aid prevents breathing through the mouth.

Nasal dilators

These snoring aids improve nasal breathing and, therefore, prevent you from breathing through the mouth.

Surgery

Tightens the tissue in the throat area (especially the soft palate).

The Throat (Pharyngeal) Snorer (with Breathing Interruptions / Apnea)

Sound

With throat snoring, snoring noise itself is very loud. This is followed by long phases of quietness (20 seconds or more). The noise is often also described as unrythmic.

Self-Diagnosis

You may suffer from throat snoring if you snore no matter which position you sleep in (prone-, supine- or lateral position) and at the same time you experience breathing interruptions at regular intervals, this indicates that you suffering from sleep apnea. Further indications for sleep apnea are irregular respiration, a high body mass index (>30) and one or more positive answers (= medium or high probability) in the Epworth-Sleepiness Questionnaire . Sleep apneas are dangerous and should always be examined by a medical professional.

Snoring causes

The tissue in the oral and pharyngeal cavity relaxes during sleep, sinks into the respiratory tract and blocks it. Breathing air cannot pass these constrictions or only with strong resistance. This leads to breathing stops. When the body notices these interruptions, it triggers a “start from one’s sleep” (so-called arousals). The muscles become tense and the airways are open again. This process repeats itself many times per night and leads to irregular breathing.

Snoring Aids

CPAP-Therapie

It consists of a respirator (CPAP), which is connected to a breathing mask via a hose. This therapy clears your airways with excess pressure and ensures constant breathing.

EPAP-Therapie

EPAP is better known under the brand name Provent. In this case two small ventilated plasters are placed over the nostrils. With these you can freely breathe in air. Exhalation on the other hand is slowed down. The result is that the airways start to inflate and remain open.

UAS-Therapie

Stimulation therapy of the upper airways (UAS) can also stop pharyngeal snoring. For that purpose, a tongue pacemaker is implanted underneath the tongue. It releases electric impulses. The muscles of the tongue base contract and the airways remain free from any obstruction.

Tongue-Based Snoring – Test

A simple exercise you can do at home

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Open Mouth Snoring Test

A simple exercise you can do at home

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Clear Nasal Passage – Test

A simple exercise you can do at home

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Mandibular advancement device guide – answers based on practical experience

Mandibular advancement devices can help with sleep apnoea in a lot of cases. They are now also provided by the NHS. Find out how exactly they can help, and when they are provided by the NHS.

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Does it matter if you breathe through your nose or through your mouth? It does! We explain the advantages of nasal breathing, describe how breathing is related to snoring and give tips on which snoring therapies help you breathe freely.

What happens when you breathe?

Breathing is a basic prerequisite for life. At rest, a person takes about 14 breaths per minute – completely automatically and unconsciously. With every normal breath, about half a litre of air is taken in, and with exertion this can even be ten times as much! Calculated on a daily basis, this amounts to 12,000 litres of air.

The respiratory process can roughly be summarized as follows: We inhale oxygen via the air around us, which diffuses into the blood via the pulmonary alveoli and is distributed to the target organs. Our cells are dependent on this oxygen. Only in this way can vital processes take place in our body, such as the generation of energy in the cells (cell respiration). In return, carbon dioxide is exhaled as a metabolic end product. This is the principle of the vital gaseous exchange.

Not all forms of breathing are alike

Air can enter the lungs in two different ways. On the one hand, it can pass through the nose, which is called nasal breathing.

If nasal breathing is not possible – for example, because the nose is congested or blocked – the air flows through the open mouth, past the tongue and palate, into the throat and further through the trachea into the lungs. This is called mouth breathing.

It is much healthier to breathe through the nose than through the mouth. Nasal breathing fulfils many functions that are important for the entire organism:

Filtering out foreign particles and pathogens

The inside of the nose, i.e. the nasal passages and nasal conchae, are lined with a very special mucous membrane, which has many microscopically small movable hairs (or cilia). These cilia prevent foreign particles such as dust and dirt particles as well as germs and pathogens present in the air from entering the airways. These foreign bodies are filtered and get caught in the small hairs. If something does inadvertently penetrate the nose, it is trapped by the mucous produced by the nose . The mucous fulfils a cleaning function, absorbs small impurities and particles and transports them towards the nostrils. In addition, special proteins and various enzymes are produced in the mucous membrane. They support the protective function and serve as defensive forces.

“Air conditioning” and humidification of the air

However, the nasal mucous membrane also fulfils an important purpose: it raises the air temperature almost to body temperature (approx. 34 degrees Celsius) and moistens it at the same time. Even at outside temperatures of -10 degrees Celsius, the air reaches over 30 degrees by the time it reaches the lungs. When it is cold, more blood flows into the erectile tissue in the conchae of the nose with the result that the mucous membrane of the nose swells. As the blood flows past this cushion of mucous membrane, the cold air is warmed up before it reaches the lower airways. Conversely, extremely hot and dry breathing air is cooled and enriched with moisture as it flows through the nose.

Better oxygen supply

After all, breathing through the nose has a definite advantage over breathing through the mouth in terms of oxygen supply: Nasal breathing leads to a 10 to 15 percent higher oxygen saturation of the blood. This means that our blood is enriched more strongly with oxygen and the organs are better supplied with this vital gas.

According to studies the reason for this is nitrogen monoxide (NO), which is formed in the paranasal sinuses and automatically transported into the lungs by nasal breathing. Nitric oxide has a number of important functions, including dilating the blood vessels and promoting blood flow to the alveoli. This allows more oxygen to be absorbed into the blood and transported to the organs. It also has a relaxing effect on the respiratory muscles and inhibits inflammation.

Nasal breathing and snoring

Problems with breathing through the nose can cause a snoring problem. If the nose is congested or misaligned – for example due to a cold or an anatomical feature such as polyps or the like – the respiratory resistance increases. One then has problems breathing in and out without difficulty. The resistances and constrictions lead to turbulences in the respiratory air flow. The surrounding tissue starts to vibrate as a result. We perceive the resulting noise as snoring.

In many cases, disturbed nasal breathing is also “only” one of the causes of the snoring problem. If the air supply through nasal breathing is insufficient during sleep, the body unconsciously switches breathing through the mouth. Open mouth snoring – a form of snoring in which the flow of air causes the palate tissue to vibrate, is promoted by oral breathing.Feel free to check out our simple nasal snoring test.

Snoring aids for unrestricted nasal breathing

Nasal dilators and nasal strips widen the nostrils and improve nasal breathing.

Nasal irrigation removes mucus and secretions from the nose and is particularly helpful for colds and allergies.

Snoring surgery is often unavoidable in cases of severe anatomical respiratory restrictions (e.g. deviation of the nasal septum, enlarged conchae, polyps).

Snoring remedies – Help for every snorer.

Nasal dilator purchasing advisor

What must you take into consideration when making a purchase? See all our nasal dilators presented here.

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Find the solution for your snoring with our free snoring test

Find the solution for your snoring with our free snoring test.

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Mandibular advancement device (MAD) purchasing guide

Advises you what you should pay attention to when buying a mandibular advancement device (MAD). We present different models and technical approaches here.

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How much sleep do you need to start the day fit and full of energy? There is a persistent belief that the ideal amount of sleep is at least 8 hours at night. However, the majority of the population sleeps between 6 and 7 hours per night only. Read how much sleep really is healthy!

If one believes medical studies on the subject of ideal amount of sleep, then you will find that seven hours of sleep is the optimal amount of sleep. The studies have also shown that as little as 20 minutes too little sleep can impair performance and memory. Sleep disorders therefore also manifest themselves in increased daytime fatigue, lack of concentration and bad moods. On the other hand, too much sleep is not good and is considered a risk factor for diabetes, obesity and cardiovascular disease.

The magic number: getting a restful sleep!

Probably the largest study on the how much sleep is necessary was undertaken by the University of California in San Diego with more than one million participants over a 6 year period.

The results provide the magic number for the perfect sleep: The test subjects who slept about 7 hours per night had a lower mortality rate than those who slept for shorter or longer periods. According to Dr. Kripke, who accompanied the study, everyone should try to get between 7 and 8 hours of sleep. One can call this value the optimal amount of sleep.

The study also found that our cognitive abilities improve when we sleep for at least seven hours. This means that after 7 hours we see and learn better, orientate ourselves and perceive things better and are even more creative. These skills deteriorate when one sleeps for more than 8 hours or less than 7 hours. In addition, the risk of diabetes and obesity increases for people who sleep more than 8 hours.

Age determines the ideal amount of sleep

However, don’t take 7 hour guideline for granted. The amount of sleep you need always depends on your age:

It is perfectly normal for people over 65 to be fully rested with 5 to 6 hours of sleep. School children between the ages of 6 and 13, on the other hand, need about 9 to 11 hours of sleep, because restorative sleep is particularly important at school age. During sleep, the brain stores and processes what it has learned. Teenagers should sleep 8 to 10 hours, as the adolescent body experiences extreme hormonal changes.

The recommended amount of sleep required per night of 7 hours is therefore aimed at adults between the ages of 18 and 64.

Expert tip: How to determine your how much sleep you need?

Find out how much sleep you need ! Because restful sleep depends heavily on the characteristics of your body. This is best done on holiday when you don’t have to get up at a specific time for at least 3 consecutive days at a time:

Go to bed when you are tired. Avoid alcohol and cigarettes in the evening. Sleep until you wake up without an alarm clock and feel well-rested. On all 3 days, count the hours you have slept. Determine a mean value that is as accurate as possible. This value shows you how many hours your body needs for a restful sleep, so that you can start the day rested and fit. If you encounter problems in determining how muc h sleep you need because you are plagued by a sleep disorders, a professional sleep consultant could prescribe sleep therapy for you.

Try to adhere consistently to these times – even outside of your holidays. To do this, you must create an optimal sleeping environment. Try not to sleep more than one or two hours more – especially on weekends. This will help you fall asleep better at night and get up easier in the morning.

But it’s not just the quantity of sleep that counts. The quality of sleep is also important; and you should do everything you can to ensure that you are able to have an undisrupted and relaxed sleep, as free from pain as possible. Disruptive factors can include snoring (both your own snoring and that of your bed partner), nocturnal pain (e.g. joint pain) or a disturbed sleep rhythm. Above all, snoring should not be taken lightly. Pathological snoring often manifests itself in the fact that the affected person wakes up completely exhausted, despite sufficient hours of sleep. Here, a snoring test (or alternatively a visit to an ENT doctor and potentially a home sleep study) and snoring aids such as an anti snoring mouthpiece (mandibular advancement device), an snoring mouth guard or nasal dilators can quickly improve your

How to stop snoring

Our top 5 tips

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Nasal dilator purchasing advisor

What must you take into consideration when making a purchase? See all our nasal dilators presented here.

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Mandibular advancement device (MAD) purchasing guide

Advises you what you should pay attention to when buying a mandibular advancement device (MAD). We present different models and technical approaches here.

Read more

Mandibular advancement device are also called mandibular advancement devices (MADs). They are used to prevent snoring – especially when the annoying noises occur mainly whilst lying on one’s back. This is called tongue-based snoring. In the following we introduce you to the basic idea, effectiveness and side effects of this product category – in addition we will give you a quick comparison of different mandibular advancement devices.

Basic idea

Snoring can have several causes. One of the most common causes is the tongue sliding back into the throat (oropharynx), where the tongue then obstructs the airways. Air turbulence and tissue vibrations cause snoring noises at the resulting constrictions.

This so-called tongue-based snoring usually occurs in patients whose tongue is particularly large or in whom the tongue does not fit in the traditional place in the mandibular arch (lower jaw). It then protrudes far back into the pharynx (throat).

This is the case, for example, if the patient has a receding chin or if the tissue under the tongue is enlarged (e.g. by so-called lingual tonsils). Another cause is that the tongue muscle simply becomes very slack during sleep and therefore slides far back into the throat.

This is where the man can be helpful. It puts the lower jaw under slight tension and pulls it forward (mandibular advancement). This also causes the tongue muscles and the tissue in the lower jaw area to become more toned so that it can no longer slide so far back into the throat, even when completely slack. The airways remain free and there is no snoring noise.

Effectiveness

Mandibular advancement devices can help with both simple, non pathological snoring and pathological snoring (obstructive sleep apnea, OSAS). However, snoring mouthpieces should only be used for mild-to-moderate forms of sleep apnea. There are numerous studies, which have tested the effectiveness of different mandibular advancement devices on people suffering from OSAS.

That the snoring mandibular advancement device is a particularly effective anti snoring device for certain persons or groups of persons cannot be unequivocally stated. In general, however, the use of a mandibular advancement device has proven to be more successful in women, persons with position-dependent OSAS (where the sinking tongue base is the trigger for snoring or apnea) and persons with a smaller neck circumference. The neck circumference is used here as an indicator of body weight.

The Mandibular advancement device is more effective in younger and more slender people, than in patients with a body mass index (BMI) of more than 30 or in persons older than 50. It is assumed that muscle tone generally decreases after this age and that the tension effect of the mandibular advancement devicee is no longer sufficient to compensate for this.

Side effects

About 70% of people who wear Mandibular advancement device as snoring aids experience short-term side effects such as muscle pain in the jaw, a dry mouth, increased salivation and changes in bite position. Even if pathological changes of the bite are very rare, regular dental check-ups at intervals of about six months are recommended.

In most cases, the side effects subside after a period of about four weeks. In about 30% of patients, however, they last longer.

Mandibular advancement device should not be used if you are missing more than 8 teeth per jaw (upper and lower), suffer from bacterial inflammation of the periodontium (periodontitis), have active caries or diseases of the temporomandibular joint.

If you would like to learn more about the different models and technical approaches, read on here.

How to stop snoring

Our top 5 tips

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Mandibular advancement device (MAD) purchasing guide

Advises you what you should pay attention to when buying a mandibular advancement device (MAD). We present different models and technical approaches here.

Read more

Mandibular advancement device comparison

All our mandibular advancement devices compared based on comfort, application, cleaning and much more.

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Nowadays there are numerous snoring apps for Android and iPhone – but how useful are they? We have tested over 15 snoring apps for you. Having done so, we are able to tell you which snoring apps can really help you to address your snoring problem.

For some time now there has been a series of smartphone apps to detect and evaluate snoring. These apps promise a variety of different functions to the user, but do they really deliver on their promises? These apps differ considerably both in the software used and thus also in their informative value.

1. Introduction – measuring, drowning out or training?

For our test we identified three groups of snoring apps that can be found on the app platforms of Google and Apple.

Snoring Analysis

By far the most important are those apps that record you snoring and measure the volume of your snoring. This enables the user to determine whether and how much he or she snores. The apps in this group (such as SnoreLab or SnoreClock), which we have rated highly, also allow users to compare snoring volume over several days.

“With the leading snoring apps you can therefore objectively judge whether the chosen anti-snoring remedy really helps”, says Dr. Hannes Wakonig, snoring expert at SomniShop. A simple comparison would suffice: “How loudly do you snore without an anti-snoring device compared to when you do. This can be measured within 2-3 nights”.

Snorers can also compare  the effectiveness of different snoring remedies within a short period of time and thus determine the most suitable solution for them. “This procedure is particularly recommended in cases where the cause of snoring is unclear. Unfortunately, this is still often the case despite all the progress in snoring diagnostics”, says Dr. Wakonig

Neutralising snoring sounds

In the second group are those apps that attempt to neutralise snoring sounds with soft music or noise. However, the snoring apps of this type that were tested, could not convince our testers of their effectiveness. We found general  apps aimed at helping you fall asleep with pleasant background music more convincing. However, even these apps are hardly able to neutralise snoring sounds.

Snorefree – innovative training approach

We also tested the new Snorefree App, which provides video training for snorers. It offers a promising approach, but requires great discipline from the user.

Apps deliberately excluded from the test

Excluded from our test are those English apps that only contain snoring sounds or short articles about snoring. These are optimised for common keyword searches, such as; ‘anti snoring’ or ‘snoring sounds’ , but usually do not offer the user any added value. In addition, these apps are packed with advertisements – some of which are of a very questionable nature.

We also generally advise against apps that wake  snorers up when they start snoring. This can lead to dangerous daytime tiredness and does not even begin to solve the snoring problem. We have therefore not tested such apps (e.g. the  Anti Snoring App).

Apps like Excluded  Eversleep or ESUN, for which you have to buy an additional device have also been excluded. Instead, we have concentrated on those apps that only require a smartphone.

2. Test group 1: Apps for snoring analysis

First of all we tested the apps that can be used to analyse snoring sounds. In this group SnoreLab was our best in test.

1. SnoreLab – Our best in test for snoring analysis

Added value for the user: Excellent (1.0). Very good snoring analysis. Detects possible snoring sounds well and classifies them very clearly into four categories. Snoring score allows comparison over several days. Concentrates on the most important noises during noise recording – therefore an evaluation is possible in only a few minutes (instead of hours). Allows one to record the anti-snoring aids used as well as any  influencing factors in an electronic diary each night. In the free version only noise samples are recorded, but this is usually sufficient.

Operating comfort: Excellent (1.3). Very clear user interface, attractive and clearly structured. Offers numerous options and good information about the tools available in the free version.  One negative point is that occasionally translation errors occur in foreign language versions.

Data protection: Satisfactory (4.0). Does not require an E-mail address to start. However, a specific privacy policy is missing.

Overall rating: Good (1.7). Very mature app for snoring analysis. Very well suited for testing how effective an anti-snoring device is. The very positive overall impression is only clouded by the missing privacy statement.

Freemium version: The free version was tested  (with in-app advertising). The ad-free paid version costs 9,99€ in the Google Play Store. It offers interactive analysis options, notably according to trends, a continuous recording of snoring and music to fall asleep to.

Rating Google Play Store : 4,5 ; 19378  reviews
Rating Apple App Store: 4,6 ; 5063  reviews

Number of Downloads Google Play Store: 1 Mio+
Number of downloads Apple App Store: 5 Mio+ (information from the developer)

Download-Link Google Play Store:
https://play.google.com/store/apps/details?id=com.snorelab.app

Download-Link Apple:
https://apps.apple.com/fi/app/snorelab/id529443604

2. SnoreClock

Added value for the user: Good (2.3). Shows the recorded volume in a noise diagram. Possible snoring noises are highlighted in red. You can quickly and easily refer back to a particular time in the recording history via a slider. The app also evaluates the snoring volume with a point value – but this is not classified in any further detail. Unfortunately, the free version does not allow you to record influencing factors or snoring aids used per night. A comparison is thus made difficult.

Operating comfort: good (1.7). Clear, sporty-looking watch design. Controls are intuitive and the app is clearly structured.  

Data protection: Excellent (1.0). No need to enter an E-mail address in advance. Privacy policy is short and easy to understand.

Overall rating: good (2.0). A good snoring app, which is clearly structured and offers added value for the user.

Freemium version: The free version was tested. The ad-free premium version with additional storage and reporting functions costs 5.99€ (Android).

Rating Google Play Store: 4.1 ; 3796 reviews
Rating Apple App Store: 4,5 ; 2 reviews

Number of downloads Google Play Store: + 500 000
Number of downloads Apple App Store: n/a

Download-Link Google Play Store:
https://play.google.com/store/apps/details?id=de.ralphsapps.snorecontrol

Download-Link Apple:
https://apps.apple.com/fi/app/snoreclock-schnarchst-du/id673980122

3.  Do I Snore or Grind

Added value for the user: Good (2.0). In our test it reliably detected snoring sounds and was able to distinguish them from background sounds such as ambient noise or human voices. Evaluates the intensity of snoring with a snoring score and thus allows comparisons over several days. Also allows you to take other influencing factors such as smoking or stress as well as anti-snoring aids used into account and thus to better understand snoring causes through comparisons.

Ease of use: Satisfactory (3.0). Unfortunately, the app is only partially translated into languages other than English. A positive feature is the very detailed instructions on how to start the app and how best to place the mobile phone at night. The app runs smoothly and without any interruptions on our Android test system.

Data protection: Inadequate (5.0). The app requires you to enter your e-mail address right at the start. There is no privacy policy. The product loses points with us in this category.

Overall rating: Satisfactory (3.0). An overall useful app, whose value is significantly reduced by inadequate translations and poor data protection.

Rating Google Play Store: 4.2 ; 3811 reviews
Rating Apple App Store: 4.0 (1 note)

Number of downloads Google Play Store: 100 000 +
Number of downloads Apple App Store: n/a

Download link Google Play Store:
https://play.google.com/store/apps/details?id=com.bruxlabsnore&hl=de

Download link Apple:
https://apps.apple.com/fi/app/do-i-snore-or-grind/id1154925543

4. Goodsomnia

Added value for the user: Satisfactory (3.0). Provides simple functions for recording and analysing snoring functions. The results are clearly presented.

User comfort: Satisfactory (3.3). The app is in English only. It is clearly arranged and attractively designed. However, the app is strongly orientated towards the Goodsomnia products, several menu points are assigned to their operation.

Privacy: Inadequate (5.0). Mandatory entry of E-mail address and personal data at the very start. No clear explanation is given for why these are needed for snoring analysis. The privacy policy is missing.

Overall assessment: Satisfactory (3.3). Visually the app is quite appealing,  but it is clearly inferior to SnoreLab and SnoreClock.

Freemium version: The free version was tested. The premium version (Android) with additional reporting and cloud storage functions costs 1.49€ per month.

Rating Google Play Store: 3,8 ; 74 reviews
Rating Apple App Store: 4.4 ; 7 reviews

Number of downloads Google Play Store: 5000+
Number of downloads Apple App Store: n/a

Download-Link Google Play Store:
https://play.google.com/store/apps/details?id=com.goodsomnia.android

Download-Link Apple:
https://apps.apple.com/fi/app/goodsomnia-lab-snore-analysis/id1389951040

5. Snoring Analyzer

Added value for the user: Sufficient (4.3). Cannot distinguish snoring sounds from other background noises such as voices in our test. Allows for quick access to specific time periods via a slider. Noises are scored according to decibel units. Information about snoring aids is sometimes misleading or downright wrong (e.g. the app claims that a chin strap pushes the jaw forward – whereas this is not true).

Ease of use: Satisfactory (3.3). The app is in English only. However, the menu is clear and well structured, easy to use

Data protection: Inadequate (5.0). Requires entry of E-mail address right at the beginning. No privacy policy.

Overall rating: Sufficient (4,3). The app offers very little added value, especially compared to SnoreLab and SnoreClock.

Totally free app, no costs involved.

Rating Google Play Store : 3.0 ; 52 reviews
Number of downloads Google Play Store: 10000+

Download-Link Google Play Store:
https://play.google.com/store/apps/details?id=com.tcmardoc.snoringanalyzer

Download-Link Apple:
https://apps.apple.com/fi/app/the-snoring-analyzer/id1065508310

3. Test group 2: Neutralising snoring

1. SleepSation

Added value for the user: Sufficient (4.0). Users can choose between 6 different background noises (including ocean or forest sounds). The background noise becomes more intense as snoring volume increases. It is doubtful whether this app can really drown out snoring. To drown out snoring, the volume of the background noise must be very high – which can be very annoying. In addition, it takes some time for the volume to adjust to sudden snoring.

Ease of use: Excellent (1.3). Simple and clear user guidance, detailed help function. 

Data protection: Sufficient (4.0). No E-mail signup required at the beginning, but no privacy policy, either. 

Overall rating: Sufficient (4.0). Interesting approach to snoring, but we are not convinced of its effectiveness in practice. Incidentally, other, free sleep apps offer significantly more options and choices for falling asleep.

Freemium version: free version only available for 21 days, after that you need to purchase the premium version for about EUR 7 (price for Android version).

Rating Google Play Store: 3,6 ; 66 reviews

Number of downloads Google Play Store: 10000+

Download-Link Google Play Store:
https://play.google.com/store/apps/details?id=com.sleepsation

2. SnorEraser

Added value for the user: Insufficient  (5.0). According to self-promotion, this app should help reduce the sudden frequency peaks of snorers. For this purpose, it offers four different background noises that can be individually adjusted via filters. A good idea – but the sounds of the app reminded us of hot, hissing steam, which we found very annoying when falling asleep. 

Ease of use: Satisfactory (3.0). The app is available exclusively in English. The menu is easy to use and we found the full-screen advertising annoying. 

Data protection: Sufficient (4.0). No E-mail signup required at the beginning, but no privacy policy either. 

Overall rating: Insufficient (5.0). We very much doubt that one can fall asleep with this background noise. 

Freemium version: Free version is limited to about 24 hours, after that you have to buy a paid version. The price is relatively high at 35 USD.

Rating Google Play Store: 3.0 ; 20 reviews

Number of downloads Google Play Store: 1000+

Download-Link Google Play Store:
https://play.google.com/store/apps/details?id=com.pulp.snoreraser

Download-Link Apple:
https://apps.apple.com/fi/app/snoreraser/id1205377133

Conclusion: We strongly doubt that the apps available that are currently available on the market which promise to neutralise snoring really help. At best, they can serve as a general sleeping aid.

But then you are much better off with general sleep apps. In our test, we found the sleep apps “Sleep sounds” and “Sleepo”  to be far more effective.

These offer significantly better background noises, which can even be combined to create a customised sleep mix. They also have a timer that ensures that the soothing sounds end after a predefined time.

4. Anti-snoring training Apps

Instead of  analysing or neutralising snoring, are there options to stop snoring by means of training. This is what the SnoreFree App suggests. We tested the app.

Added value for the user: Excellent (1.3). Very good, individualised SnoreFree training – a gym for lips, tongue and throat (time required approximately 10-15 minutes per day). With the help of exercise videos the muscles are strengthened. These show which main anatomical muscle groups you are training (lips, front or back of tongue or throat), whether and which utensils are needed, the recommended training time for the exercise and the last personal rating. Exercises can be skipped at any time. Once the exercise has been carried out, it can be evaluated in order to adapt the training plan to your personal needs.

In the free version there are only 6 exercises available. To unlock more exercises, SnoreFree must be purchased (cost 7.50 – 9.99€ per month)

Ease of use: Excellent (1.3). Clear user interface, appealing and clearly structured. Videos and descriptive text help in performing the exercise.

Data protection: Satisfactory (3.0). Requires an E-mail address as well as first and last name information to start. In addition, gender and date of birth must be entered, according to the developer’s specifications, this is necessary to optimise individual training plans. Privacy policy and terms and conditions are available.

Overall rating: Good (1.7). The first snoring therapy app with logopaedic video training. The app addresses the root cause of snoring – namely the muscular tissue weakness in the mouth and throat. The tailored personal exercise regimes are easy to use and understand. A short introductory video by the developer of the app also provides information on snoring and explains the risks involved. Unfortunately, there is no clinical evidence to date on how effective the exercises are in combating snoring.

Freemium version: The free version has been tested (with only 6 exercises). The full paid version costs between € 7.50 and € 9.99 in the Google Play Store.

Rating Google Play Store: 4,2 (19 reviews)
Rating Apple App Store: 4,2 (5 rating)

Number of downloads Google Play Store: 1000+
Number of downloads Apple App Store: n/a

Download link Google Play Store:
https://play.google.com/store/apps/details?id=me.snorefree

Download link Apple:
https://apps.apple.com/fi/app/snorefree-schnarchen-stoppen/id1447127663

5. Our conclusion

Diagnostic apps such as SnoreLab or SnoreClock offer the user a clear added value: they help to better assess snoring and measure the effectiveness of anti-snoring products by means of a before/after comparison.

We do not recommend apps that try to neutralise the sound of snoring. It is doubtful that they are effective and, in our opinion, they can even add to the noise problem. 

The SnoreFree snoring training app offers a very interesting, new approach that can help address the causes of snoring. Although experience with it is still limited and it requires discipline and time, it is a very wholesome approach. In view of our positive experience with anti-snoring trainers like FaceFormer, we think it is promising and worth trying out.

This is how we conducted our tests

We downloaded the discussed apps from the Google Play Store in summer 2019 and tried them out for one or more nights. Our grading scale goes from excellent (1.0) to unsatisfactory (5.0). The final rating is based on our overall impression of the app and not on an arithmetic average of the sub-criteria; viz “added value for the user”, “ease of use” and “data protection”. The information on downloads and user ratings from Google Play Store and the Apple App Store were updated at the beginning of December 2019.

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Snoring occurs for different reasons. Yet, functioning and unimpeded nasal breathing is a prerequisite for a snore free night. If the nose is congested or misaligned, it may facilitate the emission of undesirable noises. We will show you different approaches to finding a solution to this issue – From nasal dilators through to nasal irrigation devices.

Nasal breathing

If the nose is congested or misaligned – for example, due to a mucosal swelling that often goes along with the common cold or due to an anatomical peculiarity such as nasal polyps, enlarged nasal conchae or a deviated nasal septum – airway resistance will increase. In other words, you will find it difficult to breathe in or out freely. Obstructions lead to turbulences in the flow of air within the nose, which in turn causes the surrounding tissues to vibrate. Physically, the mechanism is comparable to the effect of a whistling compressed air valve.

In many cases, impeded nasal breathing may not be the state that triggers snoring, but an important contributory cause. Because when you’re not able to breathe through the nose properly, you will automatically switch to mouth breathing. However,  breathing through the mouth not only is annoying due to the associated noise emission, but it also promotes open mouth snoring, which is a type of snoring where the flow of air causes the tissue of the soft palate to vibrate. Moreover, it increases the susceptibility to infections, this occurs because the air is not filtered as it is when you breathe through your nose. Bacteria and viruses that also float in the air remain unfiltered as they are inhaled and are then transported to the lungs, where they promote infections.

You should therefore make sure that the nose always remains free to ensure unimpeded nasal breathing.

Ways to keep the nose clear

Xylometazoline, is a substance that is used in nose sprays and can provide for short-term relief. It is frequently used when you have caught a cold.

Xylometazoline ensures that the small blood vessels in the nasal mucosae constrict.  The swelling of the mucous membrane starts to recede as a consequence thereof. As a result, the nose is no longer congested. Breathing air in becomes easier.  Such nasal sprays shouldn’t be taken for longer than a week, though, as they dry out the mucosa and may become habit forming. As an alternative, there are sprays that are made from sea salt and essential oils, which are also meant to bring about a reduction in swelling. They can be applied without any concerns. There are, however, hardly any scientific studies available to support their efficacy.

Nasal irrigation

Nasal irrigation or nasal lavage can be helpful, especially if you have caught a cold and to flush out excess nasal mucous out of the nasal cavity. The mixture of saline additives in water is believed to effect a reduction in the mucosa’s swelling.

The nozzle of the nasal douche is inserted in one of the nostrils. Afterwards, the water flows through the nose and comes out again through the other nostril. At the same time, the mucous that clogs up the nose, is secreted. What is more, nasal douches also help people who are allergic to pollen during periods of high pollen count.

Nasal dilators

Nasal dilators are also meant to widen and to keep the nostrils, as well as the anterior part of the nasal cavity, open. Unlike nasal strips the nasal airways are maintained from within. Nasal dilators are available in different designs. The most common ones are the wing shaped and tubular shaped cones. Apart from that, there are also special types and combinations thereof, such as the dowel-shaped dilators.

For those who suffer from allergies, nasal dilators help provide relief as well – because there are special nasal dilators, which have an integrated foam filter that filters breathing air during inhalation. It minimizes exposure to pollen, house dust and animal hair, which can be responsible for dry and irritated nasal mucosae.

A stent for the nose

AlaxoLito is a stent for the nose. Stents are predominantly used in vascular surgery in order to keep constricted arteries open. They are made of a fine metal mesh that forms a tunnel by gently expanding, by attaching to the vascular wall and widening the vessel in the process.

Of course the AlaxoLito is considerably larger than such a vascular stent, but the application principle is similar. Once the stent has been inserted into the nose, the metal mesh expands and widens the nasal airways. AlaxoLito can be put in the nose and removed again in the morning by the patient themselves. This aid is especially recommended for use in the case of enlarged nasal conchae.

Surgical procedure

An operation may also provide relief from snoring in the case of specific anatomical conditions affecting the nose. Correcting a deviated nasal septum or the excision of nasal polyps are examples of such a surgical procedure. An experienced ENT specialist should, however, carefully examine, whether such a step is advisable in your case and whether snoring issues can really be fixed this way or not.

In many instances surgery has proven to be successful without getting rid of the snoring problem. This can be explained by the fact that issues with nasal respiration only seldom trigger the occurrence of snoring. Improving nasal breathing therefore is mostly just the first step to finding a long-term solution.  An operation may be very helpful, but is normally not sufficient.

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There are a few synonyms for the word “nasal dilator”. You can, for instance, talk about nose vents or nose clips. But no matter what you call them, they are always used to gently widen the nostrils and keep them open. They are nasal snoring solutions because they keep the nasal airways clear, which allows you to breathe deeply and helps control snoring. 

Difficulties Breathing Through the Nose

Normally, people breathe through the nose. You certainly know from your last cold how annoying it can be if you cannot do that. However, there are many people with impaired nasal breathing but who not not have a cold.  You can find out if you are one of them by doing a nasal snoring test.

As far as nasal snoring solutions go, a nasal dilator is an excellent choice. It gently widens the nostrils and thus ensures that there is less airway resistance in the nose. In other words, breathing air can flow through the nose into the lungs more easily. Once the body notices that nasal respiration functions again, it will automatically switch to (the much healthier) nasal breathing.

Another method to solve the problem would be surgery of the nose. This is usually indicated when an anatomically significant problem exists, when nasal septum is deviated or nasal cavity is obstructed due to polyps or enlarged nasal concha.

If you don’t solve your nasal breathing problems, this can lead to snoring or intensify existing snoring.  This happens when the breathing air which streams through the mouth forces the tissue of the soft palate to vibrate. Mouth breathing is far more unhealthy than nasal breathing.

Different Types of Nasal Dilators

Technically, there are two different approaches provided by a nasal dilator in order to open the nostrils. Either it will have take the form of a small tube (cylindrical form) or that of a wing shape. While both forms are effective, there are notable differences: A Wing-shaped nasal dilator tends to be more effective but somewhat less comfortable a while tube-shaped nasal dilator is more comfortable, but somewhat less effective. Whatever the form, a nasal dilator will ensure that the nasal wings do not collapse. Should the nasal wings collapse, it would make nasal breathing very difficult, particularly when one breathes in deeply through the nose.

A Nasal Dilator is Very Versatile 

A nasal dilator helps, to control snoring. Nasal congestion or obstruction are major causes of  snoring, and these devices provide effective nasal snoring solutions. Moreover, a nasal dilator can also used in sports and for other strenuous activities.

• OSAS-patients:

  A nasal dilator can help people who suffer from obstructive sleep apnea syndrome by reducing the severity of their breathing pauses through better nasal respiration. They are, however, only suited as a supplement to other therapies (CPAP-therapy or snoring mouthpieces, for instance).

• Habitual (e. g. „primary“) snoring without anatomical significances:

  In the case of primary snoring, a nasal dilator may improve nasal breathing. They enhance nasal airflow and can prevent the airways from contricting. This would otherwise lead to air turbulence and vibrations in narrower areas.

• Persons with vestibular stenosis (nasal valve collapse):

  A vestibular stenosis is triggered by unstable nasal wings which collapse (sag) during inhalation – narrowed nostrils make it difficult to breathe through the nose. A nasal dilator can help address this problem very well and greatly improves nasal respiration. Alternatively, nasal strips may also prevent snoring very effectively.

• Persons with rhinitis:

  Patients that suffer from a chronic form of rhinitis (nasal congestion) or an allergic rhinitis (also known as hay fever) can help themselves by using a nasal dilator (or nasal strips). The inflammation causes the airways to narrow, which then leads to impaired airflow. A nasal dilator widens the constricted space. In these instances it may be beneficial to implement combined nasal snoring solutions. In addtion to the nasal dilator it may be helpful to also clean the nose with a nasal rinse / irrigation.

• Persons with allergies (pollen and dust allergy):

  Persons, who have a pollen or dust allergy, find effective respiratory support in a nasal dilator with an integrated breathing air filter. These nose vents come with a filter that absorbs pollutant particles, such as pollen, dust and smoke and keeps them away from your airways.

• Endurance athletes:

  It has been scientifically proven that improved nasal breathing enhances performance – by up to 30%. That’s why a nasal dilator is often used for endurance sports like jogging, cycling, hiking or climbing. Certain models are specifically designed for the needs of this target group.

Effective Nasal Snoring Solutions: The Nasal Dilator

On the question “How to stop nasal snoring”, a nasal dilator is one of the best nasal snoring solutions, but it is not always the right aid! A nasal dilator is the best way to prevent snoring caused by narrowed nasal airways, i. e. so-called nasal snoring. In the case of mouth-based snoring, a nasal dilator can be an excellent supporting device. Oral snoring can be fixed by using a snoring mouth guard (for mouth snoring). However, such a mouth guard can only be used if you can breathe freely through the nose – this can be ensured by using a nasal dilator. Combining a snoring mouth guard with a nasal dilator is almost a “classic” approach to control snoring.

Advantage: Nasal dilators come with very few side effects.

With cone-shaped nasal dilators, the side effects are limited to a slight mucous membrane irritations which should normally subside after a month at the latest. 

Nasal Dilator: Finding the Perfect Fit

If you are looking for a nasal dilator to control snoring that is also comfortable, you should choose the right size when buying it. One that is too big can quickly lead to an unpleasant feeling of pressure in the nose – patients then often stop using it. Conversely, it is too small, it won’t fit tightly enough and might, in many cases, fall out of the nose as you sleep at night. This can lead to huge frustrations (“It doesn’t work!”). But you do not need to experience these frustrations! It is a good idea to purchase a “starter-pack” of which includes different sizes, this way you are bound to find the nasal dilator that best fits you. Once you have found the size that best fits you, you can buy packages with the correct size for you, in future..

Last but not least: nasal dilators should be replaced every three months for hygienic reasons – even though the material is considerably more durable.

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There are two distinct causes for mouth or oral snoring. For one, it occurs when the transition area between the oral cavity and the throat is constricted by tissue, thus allowing breathing air to cause the respective tissue around the narrowed space to vibrate. On the other hand, mouth snoring also arises when tensions affecting the palatal arch, as well as the uvula are reduced and when the flow of breathing air causes the surrounding tissue to vibrate as it passes through the respiratory tract. Nocturnal mouth breathing and a dry mouth in the morning are a sign of mouth snoring.

Does this apply to you? Lay bare the facts regarding mouth snoring with the help of a simple test!

Mouth Snoring Test – that’s how you do it

The mouth snoring test is very simple to conduct:

Open your mouth and make a snoring sound. This should be easy to do.
Now try to replicate the same noise with your mouth closed. If this doesn’t work even though you snore at night, then it’s very likely that you’re a mouth snorer.

Another indication for mouth breathing is a dry mouth in the morning, for example. Bad breath may also point to nocturnal mouth breathing.

Video: open-mouth snoring test

Help with snoring in the case of oral respiration

Snoring Mouth Guard

The treatment of choice in the case of mouth snoring is the use of an snoring mouth guard. It looks like a boxer’s gumshield and prevents mouth breathing. This means that you’re forced to breathe through the nose again. This is better for your health though, and allows you to have a relaxing sleep. Yet, if you have problems with nasal breathing, you should consider combining the mouthpiece with the use of a nasal dilator.

Nasal Dilator

Aside from that, nasal dilators are also employed in the case of oral snoring. They facilitate nasal respiration, or in other words, enable you to breathe freely through your nose again . The nasal dilator creates the necessary condition to prevent the body from switching to oral respiration during sleep, which again is the reason why mouth snoring occurs.

Snoring Mouthpiece

Mouth snoring is not the issue? Then you should check if you’re perhaps a tongue-based snorer. (Snoring mouthpieces (mandiubular advancement devices) are a helpful aid against this) or a nasal snorer (A nasal dilator helps alleviate nose snoring). Or simply get expert advice by doing our snoring test.

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Unfortunately, there is no “single” way to stop snoring and therefore no universal answer to the question “ How to stop snoring ? ”  Snoring may have several causes and there are quite different solutions to address them. We will show you five medically proven snoring remedies against your snoring issue, with which you can prevent snoring.

Tip 1: Improve Nasal Breathing

Impaired nasal breathing is rarely the only reason for snoring. More often snoring occurs in the rear throat area (solution: snoring mouthpieces) or in the transient area between the oral and pharyngeal cavity (solution: snoring mouth guards). Nevertheless, impaired nasal breathing is one of the major snoring triggers. Simply put, you won’t be able to stop snoring when your nose is congested.

First Choice For Better Nasal Breathing – Use a Nasal Dilator

How to stop snoring? One possible way might be the through the use of a nasal dilator, also called a nose vent or snoring clip. This snoring aid improves nasal breathing and, in turn, stops nasal snoring. It consists of two small, soft plastic arches or tubules that are connected through a bridge (the form varies depending on the manufacturer). Every arch or tubule is gently pushed in a nostril. This expands and stabilizes the nasal entrance and the adjoining anterior part of the nasal cavity. The nasal passages cannot collapse or contract, even during strong inhalation. You start to breathe freely. In medical terms, the process of opening or widening is called “dilation”, which is why the snoring aids described are also sold under the term “nasal dilators”.

An alternative to nasal dilators / nose vents are nasal strips. They are attached to the outside of the nasal bridge and gently widen the wing of the nose. They can be nearly as effective as nasal dilators. However, the adhesive on the strip’s may lead to allergic skin reactions. In addition, nasal dilators can be reused many times (while nasal strips are only for single use).

Quick Explainer: How A Stuffy Nose Causes Snoring

Just visualize the problem for a second: Your lungs are the vacuum cleaner, the airways are the suction hose and your nose is the vacuum cleaner’s suction nozzle. If the nozzle (nose) is clogged, it will lead to a strong vacuum in the suction hose (airways), since the vacuum cleaner (lungs) continues to suck in air. The vacuum cleaner’s hose may collapse in on itself and cause air turbulence along with funny noises. If your nose is congested, the same thing will happen to its airways! The nasal passages constrict, air turbulences arises, causing the tissue in the throat area vibrate and results in snoring noises.

Tip 2: Avoid Mouth Breathing

The most common cause for snoring is breathing through the mouth while you’re asleep. But mouth breathing not only triggers snoring, it is also rather unhealthy in comparison to nasal breathing. This makes it all the more important to do something against this kind of snoring.

How to Stop Snoring – Use a Snoring Mouth Guard for Mouth Snoring

The most effective way to tackle mouth snoring is the use of an snoring mouth guard (also called a mouth shield).

It prevents mouth breathing during sleep and allows your body to switch to the more restorative nasal breathing. The mouth shield is a dental mouthpiece whose form closely resembles a boxer’s gumshield. It is placed between the lips and teeth and gently anchored to the dentiture of the upper jaw. The mouth guard has a very slim design and a comfortable fit. It is large enough that it cannot be accidentally swallowed during sleep (so there is no risk of choking).

An alternative to a snoring mouth guard is a chinstrap. It consists of a strap that is put around the chin and fastened above the head. This puts the fabric under pressure since it is made from elastic material. The strap prevents the chin from dropping down during sleep, which would otherwise force the mouth to open. Chin straps come with two disadvantages: When you lie on your back, a chin strap is likely to push back your jaw to your throat area and narrow it. This can increase the snoring noise. Second, a chin strap cannot hinder you from breathing through the corners of your mouth (which is a common form of mouth breathing).

Quick Explainer: How Mouth Breathing Causes Snoring

Imagine for a moment that the tissue at the back of your mouth and throat is a ship’s sail. When the wind blows against the sail, the sail starts to flutter, causing a banging noise. For oral snoring this means: When the air (“the wind”) rushing through the mouth blows against the slackened tissue (“sail”), it will start to vibrate and produce the symptomatic snoring noise.

Background Knowledge: Why is Nasal Breathing Healthier than Breathing Through the Mouth?

Nasal breathing is the most natural and healthiest form of breathing. It is far more effective than mouth breathing in filtering out dust and dirt particles, germs and pathogens. Furthermore, nasal breathing always raises the air to body temperature before it reaches the lungs. When the outside air – on its way through the nose – is cold, it is warmed up, when it’s too hot, then the air is cooled down and contemporaneously moistened. In addition, nasal breathing increases oxygen saturation in your blood by up to 15%. Nasal breathing supplies the organs better with oxygen and the body can regenerate more easily: It will make it far easier for you to find restorative sleep. In contrast, mouth breathing can lead to dry mouth, mouth odor, inflamed mucous membranes and dental caries.

Tip 3: Sleep On the Side

The second most common cause of snoring is the tongue relaxing, falling back into the throat and constricting or blocking the airways while asleep. So what can you do against this type of snoring? Because this problem only occurs when sleeping on the back, there is an easy fix to it: Try sleeping on the side (ideal) or consider sleeping in a prone position. Positional therapy (position trainers) can facilitate the transition from sleeping on your back to sleeping on the side.

Position Trainers Can Help You to Sleep on the Side

Positional therapy encompasses all products that help you to sleep in a lateral or prone position. These are primarily anti-snore backpacks, positional sleep belts and bandages. A foam wedge or an air cushion is integrated in the rear part of these anti-snore backpacks and positional sleep belts, which renders it impossible to sleep comfortably in a supine position. For sleeping comfort it is important that the foam wedge’s contact area on the back is relatively small, so that you don’t sweat during sleep. Because wherever the foam material comes into direct contact with the skin or the pajama fabric, the air can barely circulate.

As an alternative to anti-snore backpacks , anti-snoring position trainers or snoring vests, you can also change the sleeping position with the help of a snoring pillow. Such snoring pillows are elevated towards the middle, which makes it difficult to sleep comfortably there. Therefore the head automatically and unconsciously moves to one side or the other as you sleep, which is why you ultimately sleep on the side.

Quick Explainer: How Sleeping on the Back Can Lead to Snoring

Imagine the tongue as a large avalanche. When there is an avalanche coming down the mountains and for example buries the entrance of a tunnel, you’re barely able to enter or leave the tunnel. With tongue snoring, it is similar. If the respiratory tract (“the tunnel entrance”) is buried by the relaxed tongue (“the avalanche”), that has fallen back into the throat, only a small amount of air can stream through the opening (=nobody can pass the entrance of the tunnel anymore). If the respiratory tract is completely buried, the air can no longer circulate. In the case of tongue snoring, this issue can occur when the airways are completely blocked and the patient suffers from an obstructive sleep apnea (OSA).

Tip 4: Adjust Your Jaw Position

A relaxed tongue is the second most common reason for snoring: When the tongue falls back into the throat, while sleeping on the back, this causes tongue snoring. In this case, moving the lower slightly forward can fix the problem. This mandibular advancement can be achieved with a mandibular advancement device (MAD), also called a  snoring mouthpiece.

Important: Comfortable Fit of Snoring Mouthpiece

Roughly speaking, snoring mouthpieces are broadly divided into two groups: monobloc mouthpieces and bibloc mouthpieces. Monoblocs consist of a single piece that can be custom-molded (by making an impression of your teeth). Monoblocs are rigid, i.e. once fitted, the mandibular advancement cannot be calibrated and they do not allow for lateral jaw movements. Biblocs consist of two separate pieces – one for each the upper jaw and the mandible. Each piece can be custom-moulded by making an impression of your teeth (and jawbone). The two pieces are connected with each other after the fitting is done, for instance, with flexible plastic bands. Biblocs allow for lateral movements which increases the wearing comfort significantly.

Both types of snoring mouthpieces (monoblocs and biblocs) gently move the lower jaw forward. This puts the tongue’s muscles as well as the tissue of the mandible and the pharyngeal cavity slightly under tension. The airways in the rear throat area widen, enabling breathing air to stream in and out without hindrance. Dentists refer to this protrusion of the lower jaw also as “advancement”, which is why these devices are also called “mandibular advancement devices”. With so much variety, here is some advice on how to choose the right snoring mouthpiece for you!

Tip 5: Exercise Your Palatal Tissue

Every form of snoring is also always accompanied by a tissue weakness. Relaxed tissue in the oral or pharyngeal cavity starts to vibrate when inhaled breathing air rushes over it. Of course, this is more likely to happen when the tissue is loose or unexercised, rather than toned. If you specifically promote muscle tone and tissue firmness, you can effectively reduce or completely stop the occurrence of snoring. There are a number of different kinds of exercise equipment and exercises.

Various exercise equipment for different forms of snoring

How to stop snoring, when it originates from the transition area between the oral cavity and the throat region (so called mouth snoring)? You should consider primarily strengthening the muscles around the lips and the mouth area. A near choice for that purpose would be the use of the FaceFormer method. With the FaceFormer, a tongue retention sleep aid, you can exercise and condition the muscles in the mouth region in such a way that you keep your mouth closed during the night. Moreover, with this device you exercise the musculature in the oral cavity and reduce the amount of loose tissue. If snoring occurs because your tongue falls back into the throat, the DragonPearl method may be the best choice of exercise. With this auxiliary means you can strengthen the tongue base and firm the tonsillar ring. The tongue’s musculature is unable to relax to the extent that it would fall back into the respiratory tract and block or constrict the supply of air in the throat area. This is how snoring can be prevented. Both exercise methods require patience and discipline to produce promising results.

Mandibular advancement device (MAD) purchasing guide

Advises you what you should pay attention to when buying a mandibular advancement device (MAD). We present different models and technical approaches here.

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Nasal dilator purchasing advisor

What must you take into consideration when making a purchase? See all our nasal dilators presented here.

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Helps you make an informed buying decision when buying a positional therapy device, such as an anti-snoring vest or anti-snoring backpack.

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Mandibular advancement device guide – answers based on practical experience

Mandibular advancement devices can help with sleep apnoea in a lot of cases. They are now also provided by the NHS. Find out how exactly they can help, and when they are provided by the NHS.

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You are looking for alternatives to classic anti-snoring devices (for instance, snoring mouthpieces)? Then these highly-focused stop snoring exercises are likely just the thing for you. But you are not doing squats or lunges! Instead, you are training your mouth and throat muscles – learn more about these exercises to stop snoring now.

Exercises

Exercising the mouth, throat and soft palate muscles can be very effective. A major reason for snoring is that the musculature and the tissue in the pharyngeal cavity loses tone. In extreme cases the respiratory tract collapses fully, thus leading to an airway obstruction: You cannot breathe during sleep.

Sleep Apnea

These pauses in breathing breathing, also called „apnea“ in medical jargon, can last up to 40 seconds or more. Once the brain notices that the supply of air has been interrupted, it triggers a spontaneous wakening reaction called an ”arousal”. As a result of this so-called “arousal”, you start to wake up from your sleep, the muscle tension improves and the respiratory tracts open – and  you get air again. Sleep apnea (OSAS) is a disease that has to be taken very seriously.

If you would like to avoid that the tissue in the throat area starts to relax, you should begin early on with keeping your mouth, throat and palatal muscles fit: This is exactly where targeted stop snoring exercises come in. 

In practice, various approaches have emerged – we present the most popular exercises to stop snoring.

Why Singers Aren’t Among the Snorers

Of course we don’t know for sure, but can you imagine Robbie Williams being a snorer?! Surely not! In all likelyhood the star is a calm sleeper. Because his profession – his singing – has a positive effect on his  throat musculature. British scientists (from the Royal Exeter Hospital ) carried out a study to determine whether singing is an effective snore therapy. The results are convincing: Singing on a daily basis can is one of the ways to stop snoring naturally, or at least reduce the severity, the frequency and the volume of snoring, thus improving sleep apnea symptoms.

The author Elizabeth Scott also describes the pronounced effect of singing on the palatal muscles. In her book “The Natural Way to Stop Snoring” she recommends singing a sharp „Ya“ or „Ye“ at regular intervals.

The choir director Alisa Ojay instead advises in her program “Singing for Snorers” to make „ung“-sounds, in which case the palate drops onto the tongue, and also “ga”-sounds, where the palate lifts itself up.

Say “Ahh”

The Brazilian physician Dr. Geraldo Lorenzi-Filho  pursues a different approach. He draws on mouth and throat exercises to stop snoring which were originally developed for speech-language therapies: For instance, you push back the tongue along the palate or lift up the soft palate and uvula, while you say “Ahh”. In 2015, he concluded a clinical study on his stop snoring exercises The frequency of snoring was reduced by 36% among the study participants. The snoring volume even dropped by 60%. The participants exercised three times a day with each session taking 8 minutes. However, the general significance of the study is rather limited: The study was kept rather small and only involved 39 patients.

Stop Snoring Exercises – Being an Aborigine Once in a Lifetime

A study involving the digeridoo was conducted by physicians from Zurich that was published in the British Medical Journal in 2006.

It is a traditional musical instrument used by the North Australian Aborigines. The Didgeridoo is blown with „flapping“ lips. Sound changes are caused by different movements in the mouth and throat. Sounds are created, for instance, by speaking words and making various noises or narrowing the oral cavity with the tongue, cheeks and the lower jaw. Laryngeal movements also have an influence on the sound generated by the didgeridoo. All these movements train the throat and oral muscles and effectively help against snoring.

Initial study

The study of the Swiss researchers included 25 patients with mild sleep apnea syndrome and disturbing snoring. They were divided into two groups: some respondents played didgeridoo regularly for four months and the others did not. The result was that didgeridoo players felt less tired during the day than the control group. The number of breathing stops at night had also decreased.

Follow-up study

A follow-up study demonstrated that didgeridoo playing helps prevent snoring by training the throat and mouth muscles. Photographs with 3D magnetic resonance imaging showed that fat deposits in the upper pharynx wall became smaller. In September 2017, the Zurich physicians Milo Puhan and Otto Brändli even received the Ig Nobel Prize for their investigations (the satirical Nobel Prize for curious research).

Although the didgeridoo is particularly effective against snoring, other wind instruments can be useful for snoring exercises, too.

Palate Workout by Harvey Flack

The British doctor Harvey Flack developed a training programme with exercises to stop snoring that specifically target the palatal muscles (relevant for mouth and tongue snoring). It counteracts age-related sagging of the palatal and jaw musculature. The workout includes special stop snoring exercises that should be done regularly before going to sleep. The good thing about it: You don’t need a lot of additional aids and appliances. You can do these exercises to stop snoring everywhere and at any time:

Stick a toothbrush or a pen between the teeth. Bite firmly for approximately 10 minutes.

Firmly press your tongue against the teeth of the lower jaw for a few minutes. The mouth remains closed.

Push the lower jaw backwards tightly for a couple of minutes. Withstand the pressure with the help of your jaw muscles and repeat the exercise.

Meanwhile there are even anti-snoring trainers on the market that can effectively support your throat muscle workout throudh specially designed exercises to stop snoring.

FaceFormer Trainer for Stop Snoring Exercises

The Face-Former therapy was invented by a German patholinguist, Dr. Berndsen. He designed a training device called FaceFormer. The FaceFormer exercises are designed to restore the capacity to sleep again without snoring – and without any additional anti-snoring devices. To be successful with this training, you need to do the exercises on a regular basis. If you do not have the discipline for that, then this training tool (as any other training tool) will not be a viable investment. 

FaceFormer workout

The FaceFormer training program should be applied three times a day for 7 minutes each over a period of 6 months. It includes exercises for training and relaxing the muscles. In that regard, the Face-Former is a real all-rounder: Not only the muscles of the mouth, throat and facial region are trained, but also brain activity and coordination are stimulated.

Anti-Snoring Trainer Dragon Pearl

The Dragon Pearl is an anti-snoring trainer made of medical-grade synthetics, which is worn in the mouth at night. The roundish part has to be pushed underneath the tongue. The mouth base muscles are trained by the permanent slight pressure stimulation of the ball element. These muscles are in charge of pulling the tongue forward.

Dragon Pearl training

With consistent training, the tongue’s muscles will be strengthened within a few week to such an extent that you will no longer need the anti-snoring trainer. At this point, the tongue is strong enough not to slide back into the throat.

Nasal dilator purchasing advisor

What must you take into consideration when making a purchase? See all our nasal dilators presented here.

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Positional therapy purchasing guide

Helps you make an informed buying decision when buying a positional therapy device, such as an anti-snoring vest or anti-snoring backpack.

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Mandibular advancement device (MAD) purchasing guide

Advises you what you should pay attention to when buying a mandibular advancement device (MAD). We present different models and technical approaches here.

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As if there weren’t enough problems during pregnancy – with water retention, mood swings, hot flushes – there is also an increased risk of snoring in pregnancy. About a quarter of pregnant women suffer from snoring during pregnancy, from the sixth month of pregnancy, onwards. We have compiled some helpful tips for you so that association of “pregnancy and snoring” do not become a problematic combination. In addition, we explain the causes of snoring in pregnancy and give women suggestions on how to get snoring during pregnancy under control – for example by using a nasal dilator for gestational colds.

Reasons for snoring in pregnancy

Not only does your baby bump grow

Ultimately, the reason for snoring during pregnancy is the weight gain. Not only does your baby bump expand, but so to does the neck. What really happens is that fatty deposits in the pharynx (throat) increase, causing the airways become narrower as a result. As a result the air you breathe can no longer pass through unhindered and it causes the flabby tissues in your throat to vibrate. This results in snoring. The best anti snoring advice is to stop lying on your back. There is a wide range of positional therapy products that can prevent you from sleeping in a supine position. They do not only maintain your airways, but also ensure a better blood flow to the unborn baby.

Gestational colds

Also the frequent “gestational cold” (or pregnancy rhinitis) can promote the development of snoring in pregnancy. Nasal dilators can help free the airways and prevent snoring.

About 30% of pregnant women are affected by a chronic cold. The reason for this is that the levels of the sex, hormones estrogen and progesterone, rise increasingly during pregnancy. They don’t just have an effect on the libido, but also on the nose. They cause mucous membranes in the nose to swell, as a result nasal breathing is impeded and leads to snoring during pregnancy.

Consequences of snoring during pregnancy

High blood pressure

High blood pressure can generally become a problem during pregnancy. The baby is supplied by the mother’s blood, more blood is produced overall during pregnancy and blood pressure consequently rises. Snoring can increase the pressure even further. In the worst case, pre-eclampsia could develop.

High blood pressure also causes kidney problems and water retention. In addition, it could cause placental abruption (where the placenta separates from the uterus too early), this can trigger a wide range of potentially dangerous and unwanted complications, including premature childbirth. In a study conducted by interviewing 502 women, Dr. Jennifer Santiago at the Presbyterian Hospital in New York, Department of Obstetrics and Gynecology, found that snoring in pregnancy increases a woman’s risk of preeclampsia two-fold when compared to woman who didn’t snore during pregnancy .

Obstructive sleep apnea syndrome (OSAS)

In most cases, snoring disappears shortly after childbirth. However, if your snoring during pregnancy becomes more severe, it is advisable to consult a doctor. There is a risk that the snoring is not completely innocuous and that it may be a result of sleep apnea syndrome, this can have serious consequences for the unborn child. The risk is particularly high if the expectant mother was already overweight before birth or she develops diabetes (gestational diabetes) during the pregnancy.

In obstructive sleep apnea syndrome (OSAS), the airways are partially or completely blocked during sleep for short periods (up to 30 seconds). As a result, breathing also stops. Only when the pregnant woman is startled and gasps for air due to a spontaneous wake-up reaction, a so-called “arousal”, does breathing resume and the situation normalises. The problem with an increased number of ”pauses” in breathing is that the oxygen concentration in the mother’s blood drops. Since the unborn child is also supplied by the mother’s blood via the placenta , it also experiences the effects of the possible oxygen deficiency, even more seriously than the expectant mother. The lack of oxygen can cause delays in the growth of the foetus. Due to these possible problems, pregnant women who suspect they have OSAS should seek medical advice immediately.

Upper Airways Resistance Syndrome (UARS)

Even if, despite the great resistance, breathing is still possible it can be an indication of Upper Airways Resistance Syndrome (UARS). The permanently increased effort required to breathe, and the risk of a non-optimal oxygen supply to which the pregnant woman is exposed in UARS can also increase the risk of preeclampsia. A visit to the doctor is therefore recommended.

Our tips: Snoring during pregnancy – what to do?

• Best sleeping position

  If you are snoring during pregnancy, sleep on your left side and avoid sleeping on your back. This promotes blood flow to the foetus and it also prevents the expectant mother’s tongue from sliding back into the pharynx (throat), thus obstructing the airways and leading to tongue-based snoring.

• Positional therapy

  What helps to prevent snoring in pregnancy? Among other things, positional therapy. Positional therapy includes snoring aids such as backpacks, vests or pillows that make sleeping on your back impossible. Before you use such a product, e.g. an anti snore pillow, to prevent you from sleeping in the supine position, please make sure that the straps do not restrict the foetus’s range of motion (check with your gynaecologist if necessary).

• Nasal dilator

  If you suffer from gestational colds, a nasal dilator can help you. Nasal dilators promote nasal breathing and thus ensure peaceful nights.

• Room temperature

  Ensure that the room temperature of your bedroom is not too high, this also reduces the tendency of the mucous membranes in the nose to swell.

• Snoring test

  Take the SomniShop snoring test to check if your snoring is not exclusively pregnancy related. Find out what type of snoring you suffer from.

• Blood pressure

  Have a doctor examine you, especially your blood pressure.

Nasal dilator purchasing advisor

What must you take into consideration when making a purchase? See all our nasal dilators presented here.

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Positional therapy purchasing guide

Helps you make an informed buying decision when buying a positional therapy device, such as an anti-snoring vest or anti-snoring backpack.

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Mandibular advancement device (MAD) purchasing guide

Advises you what you should pay attention to when buying a mandibular advancement device (MAD). We present different models and technical approaches here.

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A dry mouth is unhealthy and annoying. It brings with it unpleasant accompanying effects such as nocturnal mouth dryness, mouth odor or inflammation. Mouth breathing at night can cause snoring. Here you’ll find out why it is recommendable to “hold your tongue” at night and how you do that. You will also get an overview of effective means to stop mouth breathing and so too snoring. Mouth guards prevent you from opening the mouth during sleep. Nasal dilators ensure that you can breathe through the nose free of care.

There are two situations in which the body switches to oral respiration: When nose breathing is impaired and when the body becomes physically stressed. That is the case, for instance, when being demanded physically, such as when doing sports, being worked up or when coming under stress. Then regular nose breathing is, to some extent, not sufficient anymore to transport enough oxygen to the lungs. You start to breathe – in most cases unconsciously – through the open mouth.

Mouth breathing vs. nose breathing

Nose breathing

Nose breathing is the natural, physiological form of breathing. Every day, between 12,000 and 36,000 liters worth of breathing air flow through the nose (depending on body size and degree of effort). This is nearly equivalent to the filling content of an inflatable bouncy castle. Nose breathing prevents – to a greater extent than oral respiration – dust and dirt particles or even germs and pathogens from entering the body. Furthermore, nose breathing always brings the flow of breathing air to body temperature before it reaches the lungs. When the outside air is cold, it is brought to a higher temperature and when it’s hot outside, then the air is cooled down and moistened on its way through the nose.

Better oxygenation

In addition, nose breathing leads to a level of blood oxygen saturation that is up to 15 % higher. Nose breathing therefore allows for greater oxygen supply to the organs. The reason for this is nitrogen monoxide, also referred to as nitric oxide or nitrogen oxide, which is formed in the paranasal sinuses and which is automatically brought to the lungs as you breathe through the nose. Nitric oxide has a range of important tasks; it widens the blood vessels and facilitates the perfusion of pulmonary alveoli, among other things. As a consequence, more oxygen can be absorbed into the blood and transported to the organs. Body regeneration improves. Your sleep will also be of higher quality.

Stop mouth breathing or suffer the consequences

On the other hand, mouth breathing on a permanent basis leads to unpleasant accompanying effects. Most people don’t know that mouth breathing has severe consequences – negative consequences that is! Mouth dryness, in medical jargon called “xerostomia”, which is caused by incessantly having the mouth open, is quite disturbing. It doesn’t stop with “just” the inconvenient consequences. What is more, mouth breathing at night can cause tangible health issues. Mouth breathing at night, causes the thin salivary film that covers the teeth to dry out while you sleep. Yet, this salivary film fulfills an important protective function for the tooth surface. It flushes away bacteria and prevents the spreading of new bacteria on the teeth, which would otherwise lay the foundation for caries.

Mouth breathing at night

Mouth breathing at night results in nocturnal xerostomia and tooth decay in turn, promote the development of inflamed oral mucosal abnormalities, which can be extremely painful.

When the saliva dries out, it also alters the composition of bacteria in the oral cavity, the so-called oral flora. Putrefactive bacteria gain control over your mouth. This is accompanied by unpleasant smells. Regardless of whether you able to stop mouth breathing, you should definitely do something about a dry mouth – For example, by using adhesive tablets intended for addressing xerostomia.

Mouth snoring

Mouth breathing at night eventually increases the risk of snoring. Breathing air on its way through the mouth to the lungs passes an anatomical narrow passage, the oropharyngeal isthmus, also referred to as isthmus of the fauces. If tissue structures, such as excess mucosae, fat deposits or enlarged tonsils further constrict the respective area, it will lead to breathing air turbulences and vibrations – the snoring.

But even then, when no narrowing tissue structures exist, meaning that the size of the oropharyngeal isthmus is within reference range, it can come to mouth snoring. But this is only then the case, however, when the tissue of the palatal arch or the tissue surrounding the uvula for instance, relaxes or the “tonus” of which is no longer sufficient.

Picturing yourself the following can help you understand quite well how mouth snoring works: The loose sail of a ship. When the wind blows against the loose sail, it starts to luff and produce a flapping noise. For oral snoring it signifies: If mouth breathing air (“the wind”) blows against loose tissue (“sail”), it will then start to vibrate and produce the corresponding snoring noise.

Close your mouth and stop mouth breathing! – Aid against oral respiration

What can you do by yourself to prevent stop mouth breathing at night?

Despite clear nasal passages, you still continue to snore through the mouth? If that is the case, we recommend the use of an snoring mouth guard to stop mouth breathing at night. This mouth guard, also called a vestibular plate, in its form resembles a boxer’s gum shield and is fixed to the upper jaw at night. It makes sure that you keep your mouth closed during sleep, consequentially shutting off oral respiration and eliminating mouth snoring effectively as a result of this. A prerequisite for use is, however, that nose breathing functions properly, otherwise nocturnal air supply may be severely restricted here and there. To forestall problems with nose breathing, you can also combine the mouth guard with the use of a nasal dilator for example.

How does a snoring mouth guard work?

As already mentioned, the mouth guard is attached to the upper jaw – similar to dental braces. It is not firmly anchored to the teeth. Two air passages specially integrated in the somnipax mouth guard ensure that the pressure of breathing air in the oral cavity does not become so strong that you spit out the mouth guard „like a projectile with tremendous force“. To be exact, the excess pressure escapes through the openings in a controlled manner, without mouth breathing at night immediately setting in again.

Snoring mouth guards are safe and comfortable.

Should the mouth guard slip out of place during sleep – or if you feel that you don’t get enough air – you can simply remove the device from your mouth. The mouth guard has a very flat, elegant design, which means that it is barely constrictive and is comfortable to wear. At the same time, it is too big to be accidentally swallowed while you sleep.

Good to know: Mouth breathing at night is also a problem in connection with CPAP-therapy

Mouth breathing at night is not only an issue in the case of a simple – meaning non-pathological – form of snoring. Even when snoring is a symptom of a sleep related breathing disorder, mouth breathing can lead to complications when one is being treated with CPAP-therapy. Patients, who use a nasal mask or nasal pillow mask during CPAP-therapy, are often confronted with the problem that their breathing unconsciously switches to mouth breathing at night during sleep. The air inhaled through the nose escapes through the mouth, due to leakage, instead of going directly to the lungs, where it is needed.

This so called „mouth leakage“ can, in extreme cases, make CPAP-therapy ineffective, thus the patients again suffer from breathing interruptions (apnea). A snoring mouth guard can stop mouth breathing and, in this instance, mouth leakage too. It makes sure that your mouth remains closed, such that inspiration air is inhaled and exhaled through the nose in a controlled manner. CPAP-therapy can do its job effectively.

Open Mouth Snoring Test

A simple exercise you can do at home

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To describe snoring exactly is not so easy. The general term “snoring” is neither a medical, nor scientific term, but rather an everyday collective term for all rattling and grunting noises associated with breathing, that occur during sleep. The question “why do people snore” only is only of medical interest when what is often, very loud snoring, is a side effect of other illnesses, or a so-called sleep related breathing disorder. However, we want to explain to all those that affected what by this annoying phenomenon what the causes of snoring are and why these often very loud snoring noises occur.

Just heavy breathing or actual snoring?

Pathological snoring or purely very loud snoring?

In any case, medicine does not primarily focus on the intensity of snoring sounds, but on the causes of snoring. If the very loud snoring noises are the result of a sleep related breathing disorder, then doctors start taking interest! They look at what the underlying causes of the snoring noise and whether the underlying cause is pathological in nature. These special forms of pathological snoring are medically defined.

Sleep related breathing disorder

If the snoring noise arises because the airways in the back of the throat collapse or are misaligned and the snorer consequently experiences interruption in breathing, then this is such a sleep related breathing disorder. Medicine has further defined this particular form of snoring as obstructive sleep apnea syndrome (OSAS), which is similar to ” upper airway resistance syndrome” (UARS). These forms of pathological snoring are, however, relatively rare.

Primary snoring

In most cases, the snoring is not accompanied by a sleep related breathing disorder. Medicine does not define this non pathological area of snoring in more detail, but generally refers to it as “primary snoring” or “habitual snoring”. To put it simply: primary snoring is any vibration noise in the upper respiratory tract that does not lead to respiratory disturbance during sleep. Or even simpler: primary snoring is all that remains if you subtract the “bad” forms of snoring.

This “simple” form affects the majority of snorers, but is not as trivial as it may sound. After all, snoring always means disturbed breathing and sleeping behaviour. In addition, it can be accompanied by symptoms such as dry mouth and dry mouth can even result in damage to the teeth. There is even the suspicion (which has not been scientifically substantiated to date) that intense, primary snoring could be a risk factor for stroke.

Primary snoring in known by many different terms, sometimes it is called primary snoring, sometimes habitual snoring; but terms like benign snoring, continuous snoring, rhythmic snoring, non-apnoeic snoring or even harmless snoring are also used to describe it.

General causes of snoring

But why do people snore? What exactly happens inside the body, when we snore? Unfortunately, there is no one-size-fits-all explanation for this, because noise in the respiratory tract can develop at different points in the mouth, nose or throat. That is why there is not just one cause for snoring, nor only one type of snoring.

However, all types of snoring can ultimately be traced back to two major snoring causes: tissue weakness and the formation of negative pressure in the respiratory tract.

Flaccid tissue in the respiratory tract

Untoned muscles are not just an annoying problem associated with the abdomen, legs and buttock area, but also the mouth and throat! If the tissue in and around the respiratory tract lacks firmness and tone, snoring is promoted. People with general tissue weakness usually snore more often.

When the person is awake, the entire throat area is under muscular tension and wide open. During sleep, however, the tissue relaxes and slackens. It is even possible that the throat area collapses completely during the deep sleep phase. In this case, the pharyngeal walls fold in on top of each other.

Snoring due to vibration

The air which flows through the nose into the throat, sets the flabby tissue in motion and it begins to vibrate . This vibration results in annoying snoring noises. What happens is similar to the effect of a billowing curtain in front of an open window.

Creation of negative pressure in the respiratory tract

With each inhalation, the lungs generate a slight negative pressure in the respiratory tract. This is completely natural and necessary for breathing. This negative pressure causes the airways to contract slightly with each inhalation.

If the tissue in the mouth and throat is relaxed, i.e. slack, as it is whilst we sleep, it causes narrowing of the airways due to the negative atmospheric. Air turbulence, and thus vibrations, occur at the narrowed points. These vibrations become audible, often as very loud snoring noises.

The negative atmospheric pressure in the respiratory tract can be further intensified by narrowing of the nasal passage; this narrowing can be caused by polyps, enlarged nasal conchae or by a deviated septum. Free nasal breathing is therefore an important prerequisite for a peaceful night’s sleep, free from snoring.

Find the solution for your snoring with our free snoring test

Free of charge and takes only 3 minutes. Over 95,000 people have taken the test already.

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Advises you what you should pay attention to when buying a mandibular advancement device (MAD). We present different models and technical approaches here.

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All our mandibular advancement devices compared based on comfort, application, cleaning and much more.

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If you suffer from nasal congestion while you are awake, it most likely that you do when you are asleep too. This nightly nasal breathing problem is then often a (co-)trigger for snoring. Does this apply to you? Find out more about nose snoring with the help of a simple nose snoring test!

This is how you do the nasal snoring test

The nasal snoring test is very to do:

Step one

Stand in front of a mirror and keep one of your nostrils shut. Continue breathing through the nose. Make sure that your mouth remains closed. Does the covered nostril collapse? If that is the case, then nasal respiration is most likely impaired. Do the test with both nostrils consecutively.

Step two

Nehmen Sie nun ein frisches Streichholz und versuchen Sie vorsichtig mit dem Holz-Ende eines Ihrer Nasenlöcher zu weiten. Das andere Nasenloch halten Sie währenddessen geschlossen. Sollten Sie nun besser Luft bekommen als vorher, sind Sie vermutlich Nasenschnarcher. Das bedeutet, Ihre Nasenwege sind blockiert. Dadurch wird Ihre Nasenatmung behindert.

Video: nasal based snoring test

What helps stop nose snoring?

Nasal dilator and nasal strips

Through Nasal dilators and nasal strips the nostrils are gently widened, thus improving breathing capacity

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Nasal irrigation

An effective way to clear mucous and secretion from the nose is nasal irrigation. Nasal irrigation devices are particularly helpful if you have caught a cold or when you suffering from allergies.

ose snoring is not the problem? Then you should check if you’re perhaps a tongue-based snorer (Mandibular advancement devices / snoring mouthpieces are a helpful aid in this case) or a mouth-based snorer (Use an anti-snore mouthguard to alleviate oral snoring). Or simply ask our experts for advice and do the snoring test.

Tongue-Based Snoring – Test

A simple exercise you can do at home

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Open Mouth Snoring Test

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A common cause of snoring is the tongue sliding back into the back of the throat  during sleep. This problem only occurs when sleeping in on the back. Therefore, if you are a tongue-based snorer, you should avoid sleeping on your back. Positional therapy devices such as positional therapy vests or anti-snoring backpacks offer excellent support in this case. 

Positional Therapy – Helpful to tongue-based snorers?

Snoring when lying on the back is mostly due to tongue-based snoring. When the muscles of the tongue relax, the back part of the tongue – the base of the tongue – slides backwards into the back of the throat. Gravity is the main culprit. The base of the tongue then narrows or blocks the airways when it slides back. However, the airflow has to pass through these constrictions. This leads to turbulence, which causes the surrounding tissue in the throat to vibrate. This causes the familiar sound of snoring. for example.

According to estimations by the physician, Dr Hartmut Grüger (Clinic for Sleep Medicine, Düsseldorf), the tongue sliding backwards is to blame for the nocturnal snoring in about 30 percent of snorers.

Anti-snoring pillows, positional therapy vests or anti-snoring backpacks: many devices, one approach

Positional therapy can provide support for tongue-based snorers. It includes all products that prevent the snorer from sleeping on their back. When sleeping on the back, gravity pulls the base of the tongue backwards, towards the throat, but this does not happen when the snorer lies on the side or stomach. Positional therapy products include anti-snoring pillows, positional therapy vests or anti-snoring bandages. They are designed to take over the role of your partner, where your partner would otherwise push you to turn over on to your side, to stop you snoring. The only difference is that neither you nor your sleeping partner will wake up with these professional products. All these products are based on the “Princess and the Pea” principle. In other words, you should sleep as uncomfortably as possible when lying on the pea (in this case: on your back).

Important: Positional therapy only helps with tongue-based snoring, i.e. if you only snore when you are lying on your back. If you also snore when lying on your side, then positional therapy is not suitable for you. If you want to find out more about which product will help you, take our anti-snoring test. 

Some websites have tips on how to do create positional therapy aids for  yourself. For example, they say you can sew a tennis ball onto the back of your pyjamas. Not only does this sound rather uncomfortable, but it is! Especially for people with back problems, this method is not advisable. Moreover, there is a risk that you can still sleep comfortably on your back despite the sewn-in tennis ball. This is because  pyjamas are usually cut so loosely that the area with the sewn-in ball easily slides about. The situation is different with professional products. They prevent you from changing your sleeping position very gently, painlessly and without waking you up. A foam wedge or air cushion is sewn into the back of the positional therapy vests or anti-snoring backpacks, which prevents you from rolling onto your back.

The professional products can also be individually adjusted to the shape of your body by various abdominal and chest straps. The straps are padded so that they are comfortable to wear and do not cut into the skin. The material is chosen so that there is no heat build-up.

With the help of the positional therapy products, you can also change your sleeping position in a deliberate way. They then act like positional training. If the bandages, vests or backpacks are worn for several months, the brain becomes accustomed to sleeping on the side. Patients may then no longer need a belt at all because they have become accustomed to sleeping on the side  and automatically sleep in this position.

Positional therapy is also an option for alternate therapy in the treatment of pathological snoring (obstructive sleep apnoea). In the case of position-dependent OSAS, i.e. when the breathing interruptions are triggered by the back of the tongue sliding backwards into the back of the throat, causing severe obstruction of the airways when the patient sleeps on their back.

For mild to moderate OSAS, these products have the same effect on the apnoea-hypopnoea index (AHI) as CPAP therapy. The number of breathing interruptions per hour was reduced to less than five. 

Although positional therapy belts, vests and backpacks are more widely used – anti-snoring pillows and special side-sleeper pillows can also help prevent snoring.

These pillows have a central elevation (“which looks a bit like the Matterhorn”), and prevent the snorer from sleeping comfortably on their back. Instead, the head automatically rolls to one side or the other during sleep, forcing you to sleep on your side. The pillow supports the head, relieves the neck and ensures that you refrain from snoring.

A side sleeper pillow is made from comfortable memory foam and is covered with a pleasant, skin-friendly pillow case.

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There is a still a stigma attached to snoring. Once unmasked as a snorer, people often take the mickey out of you. Even more worrying, having a snoring partner is often considered a relationship killer. However, it is not only important for the sake of your partnership that one talks openly about snoring, the disturbing, often very loud snoring noises, can lead to health problems for both the snorer and their partner. Here is some guidance on how to approach this sensitive topic ,so that you don’t have to go as far as desperately googling “my partner snores and I can’t sleep” , while tossing and turning beside them.

Does the following statement apply to you: “My husband snores” or “My wife snores”? Then you are not alone! In every sixth partnership, a snoring partner is (often indirectly) the cause of arguments and relationship problems. We all know that a lack of restful sleep leads to an even worse mood. Thus arguments are almost inevitable. In addition, a lack of sleep can also cause health problems. According to a survey, 70 percent of all people whose partners snore lose about two hours of sleep every night.

Too little sleep can lead to fatigue and daytime sleepiness as well as morning headaches and psychological problems. Therefore, it is important to do something about and raise the topic of the nightly snoring nightmare.

Talk is cheap, but silence is golden?!

One’s initial reaction to a snoring partner is usually to find the simplest way to avoid being disturbed by their snoring. The spontaneous solution is usually to nudge them or wake them up. However, this is not optimal solution, as it also disturbs the snorer’s sleep rhythm, as well as that of their partner’s. Often earplugs or separate beds are considered as short term solutions, but in the long run they are not ideal. Ideally a compromise needs to be found and this requires an open discussion.

Tips for a constructive conversation when your partner snores

Who wants to hear that a night together is not restful? That your very loud snoring prevents others from the necessary peace and quiet they require for a revitalizing sleep? Therefore, the issue of snoring needs to be addressed in a very delicate manner.

1. Try not to make any accusations. They often lead to misunderstandings and are quickly dismissed. In many instances a partner will respond with, the sentence “I have never heard that I snore before”. Here, for example, you can suggest snoring apps that record your snoring partner.

2. It is however advisable and indeed very important that your partner is aware that they are being recorded and agrees to it. It is inadvisable to simply record their snoring without their permission and against their knowledge. Doing so could lead to your partner feeling betrayed.

3. Make it clear to your partner how much their snoring burdens you. Tell them that you no longer feel rested and can hardly sleep properly. Explain that their snoring can affect your health in the long term. After all, the disturbances caused by their snoring leads to a less than optimal sleep duration for you each night and that takes it’s toll in the long run!

4. Also, tell your partner that you are worried worried about their health. Snoring can be associated with sleep apnea syndrome (OSAS) or it can develop into a pathological form of snoring. Douglas Bradley, head of the Toronto Rehabilitation Institute and Toronto General Hospital Sleep Laboratory, estimates that one in five snorers will sooner or later become an OSAS sufferer. If you notice interruptions in your partner’s breathing whilst they snoring at night, this may be an indication that they suffer from OSAS.

5. Make constructive suggestions to improve the situation. For example, you could complete a questionnaire on sleep diagnostics on the Internet together. In addition to the general questionnaires that only distinguish between habitual snoring and OSAS, there are also those that offer individual suggestions for possible anti-snoring methods. Take this snoring test, to assess your snoring type and find a suitable solution.

6. Suggest sleep therapy. This includes, for example, not drinking alcohol before going to bed or eating a healthier diet and exercising. Such measures work best if you tackle them together.

7. Try finding suitable snoring aids together. You are welcome to have a look at the wide range of products that SomniShop offers.

8. Suggest visiting a doctor if you are unable to manage your snoring partner yourself.

Find the solution for your snoring with our free snoring test

Find the solution for your snoring with our free snoring test

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Although in principle anyone can become a snorer, there are a few factors that predispose you to the risk of snoring. Here you can read how high the snoring risks are and what you should avoid in order to be able to enjoy a good night’s sleep again.

Weight

One of the most important causes of snoring is obesity. Overweight people have fat deposits in their bodies. Everyone knows that. However, very few people are aware that fat accumulates in the mouth and throat. This additionally narrows the airway in the pharynx (throat) and thus promotes those annoying snoring noises. Pathological forms of snoring (obstructive sleep apnea, OSA) also develop as a result.

It is therefore not surprising that a US study from 2008 came to the conclusion that obesity (being excessively overweight) increases the risk of snoring and the potential of developing OSAS. In slightly to moderately overweight men, the prevalence of OSA was about 40 percent, and in severely overweight patients it was as high as 40 to 90 percent. This means that in the worst case, 9 out of 10 obese patients also had OSA. With a body mass index (BMI) of 30 and more, snoring or even OSA is very often an issue.

You can easily determine your BMI with the following formula:

Obesity often leads to tongue-based snoring, mandibular advancement devices or positional therapy vests or backpacks can help prevent snoring in this instance. As a result of obesity vibrations in the fatty tissue of the palate may also occur, which can often be prevented through a mandibular advancement device.

Alcohol

Does this sound familiar to you? Your partner does not normally snore. But as soon as they indulge in drinking alcohol, they saw down whole forests!

The explanation: Alcohol relaxes the muscles in the pharynx (throat) even more than sleep without alcohol. The tissue slackens a lot and produces vibrations as a result of the air that flows over these flabby tissues, this produced a noise which we perceived as snoring.

By the way, snorers who indulge in alcohol consumption have an increased risk that their primary snoring will develop into pathological snoring. According to a study alcohol lowers the respiratory activity of the upper respiratory tract, centrally

This could potentially reduce the elasticity of the tissue in this area and promote the collapse of the upper respiratory tract. However, this assumption has not yet been conclusively proven by studies .

Medication

There are medications that promote snoring and in extreme cases can even lead to obstructions of the respiratory tract (so-called sleep apnea). The active principle is similar to that of alcohol: the drug lowers the muscle tone in the pharynx. The passing flow of air causes the flabby tissue to vibrate and we perceive the frequency of the oscillations as snoring noise. The drugs that promote snoring are primarily sleeping pills and tranquilizers that contain substances such as benzodiazepines, barbiturates and antihistamines.

How to stop snoring? Take our snoring test or take a look at some of our most popular anti-snoring products.

Men’s business

Men snore more often and usually louder than women. A study by Semmelweis University in Budapest found that about 45 percent of all men over the age of 18 snore. The proportion of women snoring who snore is only 24 percent. This is due to the female sex hormones; the oestrogens. Oestrogen has an influence on the serotonin level. Serotonin, a messenger substance in the brain – also known as one of the happiness hormones – is important, among other things, for maintaining muscle tension. If less oestrogen is present, the serotonin level also decreases. This lowers muscle tone and results in slackening of the muscular walls of the airways during the night, which leads to them being more susceptible to collapsing.

However, this is only the case until menopause. After that, the oestrogen level drops and the snoring level rises in women. Similarly the rate of snoring among men also rises with advancing age: to just over 50 percent of the male population.

Sleeping Position

One’s sleeping position also has a determining effect on whether you snore or not. If you sleep on your back , the tissue in the pharynx (throat) slides backwards – thanks to gravity. Depending on your individual anatomy, the tissue (and also the base of the tongue, i.e. the most posterior part of the tongue muscle) can sag so far back into the throat that it impairs or completely interrupts the flow of air through the airways. In most cases this results in so-called tongue-based snoring. Mandibular advancement devices or positional therapy vests or anti-snore backpacks help with this type of snoring.

Anatomical Features

Snoring can also be facilitated by certain anatomical features. This is genetically determined. In the case of sleep apnea, this could lead to increased snoring risks and the higher likelihood of developing OSAS if there have already been cases of sleep apnea in the relatives. At any rate, a US study from 2009 tends to support this view .

The anatomical features that predispose one to snoring include constrictions in the mouth, nose and throat. The narrow spots are caused by enlarged body parts such as uvulas, soft palates and tongue muscles. An experienced ear, nose and throat specialist can therefore often make initial observations regarding the probable causes of snoring through a simple glance in the mouth.

Typical suspicions for mouth-based snoring are a thickened and prolonged uvula or palatine arches that extend deep into the throat, a so-called “slackened soft palate”.Indications for tongue-based snoring can be an above-average sized, muscular tongue or jaw misalignments such as a “receding chin” (so-called mandibular retrognathia). In the latter case, the lower jaw is conspicuously shifted far backwards and thus narrows the airways, especially when lying on the back.

Often also an obstructed nasal breathing leads to snoring, so-called nasal snoring. In many snorers, either the conchae are enlarged or the nostrils are too small. Last but not least, nasal polyps can also be the culprits. Nasal dilators can be a good solution for nasal snoring.

In summary, it can be said that the four big “culprits of snoring” are the mouth, nose, tongue and the sagging tissue in the throat.

Find the solution for your snoring with our free snoring test

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