Most men stop snoring through a combination of losing weight, cutting alcohol in the evening and not sleeping on their back. Nasal strips, sprays and off-the-shelf splints rarely add much on top of that. And in a share of snorers the sound is not the problem but the symptom.
That last point is where this article comes from.
Snoring is the internet's most heavily monetised complaint. There is an enormous market of products promising to remove the noise, and almost no page in that market tells you when to stop buying things and call a doctor.
Why do you snore in the first place?
Snoring is vibration. During sleep the muscles in your throat slacken, the passage narrows, and the air forced past at speed sets the loose tissue of your soft palate and uvula vibrating. That sound is the snoring.
Anything that narrows that passage amplifies it. Fat around the neck, a blocked nose, a receding lower jaw, large tonsils, alcohol relaxing the muscles further, and lying on your back so your tongue falls backwards.
Men snore more often and more loudly than women, and that comes from the same anatomy that makes them prone to sleep apnea: a longer throat and fat that gathers around the neck sooner.
What actually helps against snoring?
The best-evidenced measures are weight loss, no alcohol in the hours before bed, and sleeping on your side. Those three act on the cause rather than on the sound. The table below sets out the best-known measures with an honest estimate of the evidence behind each.
| Measure | What it does | Strength of evidence |
|---|---|---|
| Losing weight | Less tissue around the airway, more lung volume when lying down | Strong |
| No alcohol before bed | Prevents extra slackening of the throat muscles | Strong |
| Sleeping on your side | Stops the tongue falling backwards | Reasonable, mainly for position-dependent snoring |
| Stopping smoking | Less irritation and swelling of the airway lining | Reasonable |
| Custom-fitted mandibular splint | Moves the lower jaw forward | Good, for confirmed apnea |
| Nasal strips and sprays | Widen the nasal passage | Weak, at best with nasal congestion |
| Anti-snoring throat sprays | Intended to damp the vibration | Weak |
| Off-the-shelf splint | Pushes the jaw forward without fitting | Weak, and a risk to your jaw joint |
Look at that right-hand column and you notice the free measures sit at the top and the purchased ones at the bottom. That is not a coincidence, and it is the exact reverse of what the search results suggest.
Kuna and colleagues showed in the Sleep AHEAD study that an intensive lifestyle programme produced a lower apnea index than the control group after four years, with the effect tracking how much weight actually stayed off. For how to approach that, see losing belly fat as a man.
Do nasal strips, sprays and anti-snoring splints work?
Nasal strips and sprays help when your nose is blocked and you are therefore breathing through your mouth. Then they solve a real problem. If you snore with a clear nose they do little, because the vibration sits lower in your throat.
Throat sprays claiming to damp the vibration have little evidence behind them. They are harmless, and if your partner sleeps more calmly that is worth something in itself, but do not count on a structural fix.
The splints warrant a warning. A custom-fitted mandibular advancement device is a serious treatment fitted by a specialised dentist or maxillofacial surgeon. A universal splint from a web shop moves the same jaw without anyone having looked at your teeth or your jaw joint.
More on how those two relate to each other and to CPAP is in sleep apnea device.
When is snoring sleep apnea?
The distinguishing detail is the silences. Ordinary snoring is an even sound running through the night. With sleep apnea the snoring is interrupted by silences of ten seconds or more, ending in a snorting or gasping breath.
Take two men of 50 whose partners describe equally loud snoring. In one, the sound runs evenly for 6 hours. In the other it falls silent 20 times an hour, for 15 to 30 seconds each time, each silence closing with a snort. Only the second has a reason to see a doctor.
The daytime complaints come on top. Sleepiness that does not lift after a lie-in, headache on waking, getting up several times a night to urinate, and blood pressure that stays high.
Chung and colleagues developed STOP-BANG in 2008 to structure that judgement. Eight questions on snoring, tiredness, observed stops, blood pressure, BMI, age, neck circumference and sex, of which three or more yes answers count as raised likelihood.
The Dutch Heart Foundation, Hartstichting, lists sleep apnea among the factors associated with high blood pressure and heart rhythm disorders, which makes it more than a noise issue. For a plain-language Dutch explanation, Thuisarts is the best starting point.
The full STOP-BANG list is in sleep apnea in men. How the investigation runs is in sleep study.
Could something else be behind it?
Yes. An underactive thyroid can make tissue in the throat swell and also produces fatigue and sluggishness, so the picture resembles apnea. A significant iron deficiency causes fatigue and restless legs. And chronic nasal congestion from allergy or a deviated septum keeps the mouth-breathing going.
That makes blood testing useful here, even though it proves nothing about your breathing. It brings into view the explanations you will not solve with lifestyle.
For men using testosterone there is one more thing: haematocrit runs alongside anyway, and testosterone from outside can affect breathing during sleep unfavourably in the early weeks. If your snoring got worse since you started, mention it.
You can have this measured yourself with the male hormone panel. The values are on TSH and haematocrit. The hormonal side is in poor sleep and your testosterone.
What it comes down to
Snoring rarely lets itself be bought away. The measures that work are the boring ones: less weight, no alcohol late in the evening, lying on your side. They cost nothing and they act on the cause rather than the sound.
What I would watch for is the moment your partner says you stop breathing for a bit. That is no longer a snoring problem.
Listen to the silences, not the sound. If you recognise them, or stay tired despite enough hours, raise it with your doctor and let blood rule out the other explanations in the meantime. The daytime symptoms are in sleep apnea daytime symptoms, the risk factors in sleep apnea causes.
Every blood test result includes a professional assessment from a BIG-registered doctor. For treatment decisions, discuss your results with your GP.
References
- Kuna ST, et al. Long-term effect of weight loss on obstructive sleep apnea severity in obese patients with type 2 diabetes. Sleep, 2013. PMID 23633746
- Pattipati M, et al. Continuous positive airway pressure vs mandibular advancement devices in the treatment of obstructive sleep apnea. Cureus, 2022. PMID 35251830
- Chung F, et al. STOP questionnaire: a tool to screen patients for obstructive sleep apnea. Anesthesiology, 2008. PMID 18431116
- Heinzer R, et al. Prevalence of sleep-disordered breathing in the general population: the HypnoLaus study. The Lancet Respiratory Medicine, 2015. PMID 25682233
Author
Caliberhealth
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