Your treatment plan
Your GP will usually advise you to make lifestyle changes, to see if these help your snoring (see below).
If these prove ineffective, there devices that can be fitted inside your mouth or nose that are designed to ease snoring.
Several surgical techniques can also be used to correct snoring. However, surgery for snoring is usually only available free of charge on the NHS if both of the following apply to you::
- There is evidence that it is having an adverse effect on your health or quality of life.
- You have tried all the other recommended treatment options without success.
Lifestyle changes
The following lifestyle changes may help you to stop snoring:
- losing weight (if you are overweight) – see the Live Well section about Losing weight for information and advice
- not drinking alcohol, particularly during the evening – see the Live Well section about Alcohol for more information and advice
- giving up smoking (if you are a smoker)
- taking regular exercise – this will help strengthen the muscles in your neck, which may help to prevent the airways in your neck and mouth from narrowing. See the Live Well section about Health and fitness for more information and advice.
If you feel that your medication may be contributing to your snoring, talk to your GP about it. They may be able to prescribe alternative medication.
However, do not stop taking any prescribed medication without first consulting your GP.
If your snoring is worse when you are sleeping on your back, stitching a pocket into the back of your pyjamas (between the shoulder blades) and putting either a golf ball or a tennis ball in the pocket may stop you sleeping on your back.
Ear plugs
If your snoring is not causing you any health problems but is annoying your partner, asking them to wear ear plugs during the night may be a cheap and effective way of resolving the issue.
Anti-snoring devices
Anti-snoring devices are devices that can help prevent snoring. With the exception of mandibular responding splints (see below), anti-snoring devices are not usually available on the NHS. However, they are available at many larger pharmacies.
The different types of anti-snoring devices are described below.
Nasal devices
If your snoring is mainly coming from your nose, you may benefit from using nasal strips or nasal dilators.
Nasal strips are small pieces of self-adhesive tape that are similar in appearance to sticking plasters. Before you go to sleep, you place the nasal strip on the outside of your nose. The strip pushes your nostrils apart, which can help prevent them narrowing during sleep.
A nasal dilator is a plastic or metal device that looks a bit like a nose ring. You place the dilator inside your nose before going to sleep and it pushes your nostrils apart while you are asleep.
Currently, there has not been much research to compare the effectiveness of each type of nasal device in treating snoring. For most people, the choice of which device to use is based on personal preference.
Oral devices
If your snoring is mainly coming from your mouth, you may benefit from chin strips or a vestibular shield. Chin strips are strips of tape that are placed under your chin. The strips help stop your mouth falling open while you sleep.
A vestibular shield is a plastic device that is similar in appearance to a boxer’s gum shield. It fits inside your mouth, blocking the flow of air into your mouth. This forces you to breathe through your nose which may prevent you from opening your mouth and snoring.
As with nasal devices, there is limited evidence regarding which type of oral device is more effective, so the choice will be down to your personal preference.
Mandibular repositioning splint (MRS)
If your snoring is mainly due to the base of your tongue vibrating, a mandibular repositioning splint (MRS) (also known as a mandibular advancement device) may be recommended.
A MRS is similar to a vestibular shield, but rather than keeping your mouth closed it is designed to push your jaw and tongue forward. This will increase the space at the back of your throat and reduce the narrowing of your airway that is causing your tongue to vibrate, resulting in snoring.
You can buy a MRS off the shelf for around £30 to £50, which should be suitable to use for most cases of simple snoring (snoring that does not cause any breathing difficulties).
However, if your snoring is associated with breathing difficulties, such as sleep apnoea, it is recommended that a MRS is made specifically for you by an orthodontist (a dental specialist) using impressions of your teeth and jaw.
The cost of a custom MRS will depend on the complexity of the device and the materials used, and can range from several hundred pounds to several thousand pounds. It is unlikely that you will be able to obtain a custom-made MRS free of charge on the NHS.
A MRS lasts about 18 months before it needs to be replaced.
Surgery
Surgery for snoring is usually regarded as a treatment of last resort, when all other treatment options have been tried and proven to be ineffective. Surgery is also not suitable for all cases of snoring. For example, it has limited effectiveness in treating nasal snoring.
Surgery is not usually recommended for people with sleep apnoea because there are more effective treatments available, such as using breathing devices to help with breathing. See Sleep apnoea – Treatment for more information.
In cases where there are obvious anatomical problems that are contributing towards snoring, such as having large tonsils, the recommended surgical option may be to correct the problem by removing the tonsils. Otherwise, there are four main types of surgery that are used to treating snoring. These are:
- uvulopalatopharyngoplasty (UPPP)
- uvulopalatoplasty (UP)
- palate implants
- radiofrequency ablation of the soft palate
However, these types of surgery are not usually available on the NHS. They are described below.
Uvulopalatopharyngoplasty (UPPP)
Uvulopalatopharyngoplasty (UPPP) is a surgical technique that is used when it has been confirmed that the soft tissue in your mouth (excluding your tongue) is responsible for your snoring.
During UPPP the surgeon will remove:
- your uvula – the piece of tissue that hangs from the roof of your mouth
- some of your soft palate
- some of the excess tissue around the base of your throat
- in some cases, your tonsils and your adenoids (small lumps of tissue that are located at the back of the throat, above your tonsils)
UPPP is carried out under general anaesthetic, which means that you will be asleep during surgery and unable to feel any pain or discomfort.
However, UPPP can cause considerable pain afterwards, which can sometimes persist for up to three weeks.
Removing your uvula can affect your ability to pronounce certain sounds. However, this will not affect your ability to speak English because the English language does not make use of any of the sounds made with the uvula (known as uvular consonants).
Removal of the uvula will affect your ability to pronounce certain words in other languages, such as French (the "ree" sound in the word Paris) or Spanish (the "ju" sound in the Spanish word enjuto, which means "dry").
UPP is successful in completely curing snoring in about half of all people who have the procedure. Serious complications occur in an estimated 1% of cases. They include:
These can cause death in an estimated 1 in 500 cases.
Uvulopalatoplasty (UP)
Uvulopalatoplasty (UP) is increasingly being used as an alternative technique to UPPP because it carries a lower risk.
However, evidence suggests that UP may not be as effective as UPPP in the long term. UP can also cause considerable post-operative pain that lasts up to two weeks.
During UP, lasers or high-energy radio waves are used to burn away the uvular and some of the soft palate.
Soft palate implants
Soft palate implants can be used to treat simple snoring (snoring that does not cause any breathing difficulties) when it has been confirmed that the vibration of the soft palate is causing it.
During the procedure, a local anaesthetic injection will be used to numb the roof of your mouth. Several implants that are made out of synthetic material are then injected into your palate, causing it to stiffen. This should help prevent the soft palate vibrating while you sleep.
In 2007, the National Institute for Health and Clinical Excellence (NICE) released guidance about soft palate implants. They stated that there are no safety concerns regarding the use of implants, but people who are considering using them should be aware that there is limited evidence about whether they are an effective long-term treatment.
Radiofrequency ablation
Radiofrequency ablation of the soft palate is an alternative type of treatment to soft palate implants. It is used to treat cases where vibrations of the soft palate are responsible for snoring.
During radiofrequency ablation, the roof of your mouth will be numbed with local anaesthetic and an electrode will be implanted in the tissue of your soft palate. The electrode will then be used to deliver high-energy radio waves that will shrink and harden the tissue of the soft palate. This should help to make it less likely to vibrate when you are asleep.
NICE guidance for radiofrequency ablation is similar to the guidance for soft palate implants. There are no obvious safety concerns about the procedure, but there is currently limited evidence as to the long-term effectiveness of the treatment.
Medication
There are no medications available that can directly treat the symptoms of snoring, but there are some that can help treat some of the underlying causes.
For example, if allergic rhinitis (nasal irritation and swelling) is responsible for your snoring, an antihistamine nasal spray may help relieve your symptoms. Antihistamines are a type of medication that has proved to be very effective in treating allergic reactions.
Alternatively, if your snoring becomes particularly troublesome as the result of having a blocked nose, a short course of nasal decongestants may help. However, never use nasal decongestants for more than seven days in a row because it can make your symptoms worse.
Your GP will be able to advise you about whether medication will be able to help with your snoring.
