Introduction to a Growing Concern
Experts estimate that dangerous sleep apnoea affects around 8 million people in the UK alone. Various factors, including evolution, obesity, and even the climate crisis, may contribute to this rising health issue.
When Matt Hillier was in his 20s, he went camping with a nurse friend who was surprised by his loud snoring.
“She basically said, ‘For a 25-year-old non-smoker who’s quite skinny, you snore pretty loudly,’”says Hillier, now 32.
Due to the common perception that sleep apnoea typically affects older, overweight individuals, Hillier did not seek medical advice immediately. It was only at age 30, after waking from a night of intense snoring with a racing heartbeat, that he consulted a doctor. Despite being young, active, and of healthy weight, a night study recording his snoring revealed moderate sleep apnoea. His condition was classified as supine sleep apnoea, the most common type, occurring when sleeping on his back and likely caused by throat muscle issues.
“It’s weird because I’m normally quite quiet and polite. So to hear recordings of me snoring like a rhinoceros grunting was a bit shocking.”He adds,
“I thought I was too young and healthy, and I had no family history. But I know my mum, sister and auntie are snorers. So it could be a genetic anatomical thing … we’ve all got bad throats.”
Over recent years, experts have observed what they describe as a snoring epidemic worldwide, which is more serious than commonly perceived. Snoring, often a subject of humor, can indicate underlying health problems. The UK Sleep Council estimates about 15 million snorers in the UK, and while occasional snoring is common, chronic and severe snoring appears to be increasing, influenced by factors such as pollution, rising temperatures, and obesity.
“Snoring still carries a lot of embarrassment and humour, so people tend to joke about it instead of seeking help,”says Professor Ama Johal, clinical lead at the British Snoring and Sleep Apnoea Association and consultant orthodontist.
“They don’t connect it with their general health or quality of life.”She emphasizes that chronic snoring can reduce sleep quality, leading to fatigue, low mood, poor concentration, and brain fog. It has also been linked to high blood pressure and cardiovascular issues.
Furthermore,
“The snoring epidemic reflects the tip of the iceberg of a more sinister condition – obstructive sleep apnoea – which affects an estimated 8 million people in the UK,”says Dr. Andrew Cheong, the only UK full-time sleep surgeon specializing in snoring and sleep apnoea. This condition causes breathing to stop during sleep, dangerously lowering oxygen levels and increasing risks of stroke and heart attack. It also raises the likelihood of road accidents, as sleep apnoea is linked to impaired alertness. Recent studies have begun to connect untreated sleep apnoea with dementia later in life.
“I tend to think of loud, regular snoring as an early warning light on the dashboard,”Johal adds.
Understanding Snoring and Sleep Apnoea
Snoring occurs when airways are partially blocked during sleep. As air passes through the nose, throat, and mouth, vibrating tissues such as the palate, tonsils, or tongue produce sounds ranging from heavy breathing to loud honks.
“Everyone snores in a unique way. It’s almost like a fingerprint,”Cheong explains.
Determining what constitutes loud snoring is subjective but often includes sounds audible through closed doors. Johal notes that snoring becomes serious when it disrupts sleep for the individual or others.
“Snoring and sleep apnoea share a common underlying mechanism and many of the risk factors are the same,”Johal adds. The key difference is whether breathing stops during snoring.
“Snoring becomes sleep apnoea when there are repeated pauses [apnoeas] or major reductions in airflow, usually with gasping or choking,”he says. Bed partners often describe sleep apnoea as breathing stopping followed by a snort.
Diagnosis requires a sleep study, which can be conducted at home overnight using devices that monitor heart rate, airflow, and oxygen levels. These studies also record the frequency of breathing interruptions per hour.
“Fewer than five and you’re a bad snorer. But five or more meets the threshold for a diagnosis of sleep apnoea,”Johal explains.
Rising Interest and Technological Advances
Interest in snoring and sleep apnoea has increased recently, partly due to biohackers promoting sleep’s role in health and longevity. This has led to a market of quick fixes, such as nasal dilators claimed to widen airways and mouth tape encouraging nasal breathing. Sleep tracking devices like Fitbit and Apple Watch, along with apps such as SnoreLab, which rates snoring severity, have become popular. For some users, these tools reveal unexpectedly severe snoring, prompting efforts to address the issue. However, Cheong confirms that the rise in snoring and sleep apnoea is a genuine trend, not solely due to increased monitoring.
Genetics influence snoring and sleep apnoea risk, including factors like narrow nasal passages, jaw shape, tonsil and tongue size, and throat muscle relaxation during sleep. Age and body size also contribute, with prevalence increasing as the population ages.
“Like every other part of the body, as we age, the function and tone of the upper airway diminishes,”Cheong says.
“Everything becomes more floppy and lax, including the palate, tongue and throat.”By age 70, nearly half of people snore.
The UK population is also becoming heavier.
“For many patients, snoring often gets dramatically worse after even modest weight gain because it exacerbates the narrowing of the airway,”Johal notes. However, he cautions that many non-overweight individuals snore, and weight loss alone may not resolve the problem.
Environmental factors also play a role. Pollution, despite improvements, still reaches dangerous levels in some areas.
“There’s growing evidence that outdoor and indoor air pollution are linked with more habitual snoring. Traffic-related pollutants and fine particles irritate the upper airway, causing low-grade inflammation and swelling that narrow the nasal passages and throat,”Johal explains.
“Studies have shown higher rates of regular snoring in people living near busy roads and poor air quality.”
Higher temperatures in the UK may also increase snoring.
“Warm, stuffy bedrooms dry and irritate the nose and throat, promote congestion and fragment sleep, interrupting the sleep cycle, all of which make the airway more unstable and noisy,”Johal says.
A recent study from Flinders University in Australia predicts a rise in sleep apnoea cases over the next 75 years as a direct consequence of global warming. Researchers found that higher temperatures reduce sleep duration, quality, and depth—the stage where sleep apnoea worsens. They believe this will affect everyone, not only those with existing risk factors. Untreated sleep apnoea already costs the US economy an estimated $87 billion annually in lost productivity and sick days. Dr. Bastien Lechat, a senior researcher and co-author of the study, describes the link between sleep apnoea and temperature as
“striking.”He emphasizes that
“sleep is the third pillar of health, alongside nutrition and exercise, and is essential for physical and mental wellbeing.”
Social Factors and Personal Experiences
Recently, doctors have identified a form of “social apnoea,” where heavy snoring worsens on weekends or after social drinking.
“Alcohol depresses the muscles of the throat, so it becomes more floppy,”Cheong explains. Social smoking and late-night eating can also cause swelling and airway blockage, increasing snoring risk, although research is limited.
Ciara Bowdler, 32, from Kent, experienced this firsthand. After a housemate noted her loud snoring following a night out, she downloaded SnoreLab to record and analyze her snoring. Her initial score was 99, placing her in the top 15% of 15 million users.
“Of course, it was funny because snoring is funny to hear. But it was also embarrassing. Snoring is seen as such a male thing, and it just seems a bit gross. That’s what’s frustrating as a female. There’s a different stigma attached,”she says.
By tracking her diet and habits, Bowdler identified red wine, social smoking, and late-night takeaways as main triggers.
“God forbid a girl has a good time,”she jokes. By limiting wine intake to two medium glasses, eating earlier, and using nasal strips to widen her nasal passages, she reduced her snoring score to 14.
Challenges in Diagnosis and Gender Differences
Despite its prevalence, up to 90% of people with sleep apnoea in the UK remain undiagnosed, with health consequences estimated to cost billions annually.
“One of the most surprising things about sleep apnoea is how easy it is to live with it for years without realising, because the breathing interruptions happen while you sleep,”says Professor Esther Rodriguez-Villegas, director of the wearable technologies lab at Imperial College London and founder of a wearable medical device company.
“It’s also widely underreported because most people simply don’t recognise their symptoms as a sign of a medical condition. Many assume that tiredness, headaches, irritability or poor concentration are just part of modern life.”
Women constitute a significant portion of undiagnosed cases. Rodriguez-Villegas notes that women often underreport snoring symptoms and are less likely to seek help. Their symptoms tend to be quieter and less typical, with less dramatic snoring and gasping. Instead, they report fatigue, headaches, poor mood, fragmented sleep, and difficulty concentrating.
Mariana Sawyer, 58, from Luton, experienced these challenges. She felt exhausted for years, with worsening tiredness and occasional snoring after turning 50.
“It coincided with menopause, so it was really difficult to pinpoint what it was. I was also suffering from nasal problems, but knew this was very common with menopause,”she says. After her husband recorded her snoring, she was horrified by the deep, loud, hollow sounds with choking and gasping. She often woke with a dry mouth and white tongue from dehydration.
“I was probably a little bit in denial for a while. You don’t feel very good about yourself in menopause anyway. Throw this into the equation and it really wasn’t a nice time.”A sleep study revealed she was stopping breathing up to 27 times per hour due to sleep apnoea.
Treatment Options and Innovations
Currently, treatment options through the NHS are limited. Some patients may qualify for sleep surgery to improve airflow, but this is reserved for specific cases such as deviated septum or large tonsils. Johal notes that surgery outcomes are unpredictable and often a last resort.
The primary treatment is continuous positive airway pressure (CPAP) therapy, which delivers air through a mask during sleep. It is effective for many but can cause discomfort and compliance issues. CPAP has gained celebrity endorsements, but it is not perfect. Private purchase costs can be prohibitive, and some patients struggle with mask fit and air leakage.
Sawyer shares her difficulties:
“I have high cheekbones and none of the masks would fit. The air was blowing so violently, it was seeping out the sides, burning my eyes and creating an even worse sleep pattern.”
A new treatment gaining attention is hypoglossal nerve stimulation, known as the “sleep pacemaker.”
“It stimulates the hypoglossal nerve, which controls the tongue, and pulses it forward to unblock the airway. Patients can control the device with their smartphone. The nerve implants will be all the rage for the next decade because it’s a really big step forward,”Cheong says. For those ineligible for this, mandibular advancement devices—custom mouthguards that shift the jaw forward—may be alternatives.
Emerging Therapies for Snoring
Developments are also underway for heavy snoring. Myofunctional therapy involves exercises to strengthen muscles around the palate, throat, and tongue, akin to pelvic floor exercises for the mouth. SnoreLab’s companion app, SnoreGym, guides users through exercises such as “tongue curlers,” where the tongue is pressed against the roof of the mouth and slid backward. Early studies explore didgeridoo-style breathing and conch blowing to strengthen airway muscles.
Johal mentions positional therapy devices—wearable technology that gently nudges sleepers off their backs, as supine sleeping worsens snoring by allowing the jaw and tongue to fall backward.
Research is ongoing into a drug that increases upper airway muscle tone, potentially reducing snoring. However, it remains in clinical trials and may take at least eight years to reach the market.
Managing Snoring and When to Seek Help
In the meantime, lifestyle adjustments can help reduce snoring. Changing sleep position to avoid lying on the back and adjusting bedroom temperature may improve symptoms. Bowdler notes that avoiding triggers like late drinking and using nasal strips can significantly reduce snoring.
Experts advise that if snoring is very loud, frequent, or accompanied by symptoms such as restless sleep, daytime fatigue, headaches, or dry throat, it should be considered a medical issue warranting consultation with a general practitioner.
As Johal states, snoring is an early warning sign of personal health issues. The growing epidemic also signals broader environmental and societal challenges, reminding us that the way we treat the planet is already impacting human wellbeing in ways we are only beginning to understand.
