Information for Bedpartners who suffer from Snoring and Sleep Apnea

What the bedpartner should know and do.

The bedroom curse of snoring is common in Western society. Figures vary from 15% of the population, to a recent international study showing that 54% of patients in doctors' offices admitted to it. But it is reasonable to ask, does it matter? So what, if he or she snores? Put in ear plugs. Go elsewhere. They'll both survive.

But will they? Let us look at what we know for sure. Of those that snore every night most have some degree of sleep loss. The snoring prevents them from sleeping properly (probably 90% of their partners too!) Poor sleep causes daytime sleepiness, grumpiness, irritability, headaches, depression, poor sex drive, loss of concentration and memory, and accidents. In 17% of habitual snorers it is associated with apnoea, which is stopping breathing completely for over ten seconds; the result is blood pressure problems, strokes and heart attacks, on top of the symptoms of poor sleep. The chance of a heart attack in the next ten years, for example, is three to four times greater in the sleep apnoeic than a person without apnoea. The chance of a road accident is five times greater. So it’s just as much a "silent killer" as high cholesterol (perhaps more so).

Now persistent snorers don't naturally visit their doctors. Many don't even know they snore. The onus is on their PARTNERS to help them. How?

Step 1: tape record it. This is often a shock to the snoring partner but you will now have his attention. Reinforced with your solemn promise of a special treatment of your own that night (if he complies), go to

Step 2: take him and the recording to a doctor or institution with a special interest in sleep difficulties.

Step 3: play it to the doctor and tell him how much of the night he sounds like that. This will be embarrassing to your partner but gets it out of the closet - for good.

Don't be afraid that the doctor will laugh. He won't. Rather, he will show concern and sympathy for both of you. After all, the well being of the individual is profoundly impacted by the relationships he has with his closest and dearest. Nighttime separation is not conducive to health. Nor is sleep deprivation.

Often a simple non-invasive oxygen test (oximetry) done overnight at home will help at this point, especially if the snorer has symptoms of sleepiness by day or other indications of apnoea. Management will then depend on the doctor's impression of the seriousness.

Sometimes treatment is easy. Self-help measures such as weightloss (did I say easy?), longer hours in bed, reducing alcohol intake (leaving the pub a little earlier), avoiding overtiredness, and exercise alone may be enough. Yes - one study shows exercise even without weightloss can reduce snoring and apnoea. Or devices might help - pillows, nasal spreaders, mouth splints. Finally one may go to a specialist to discuss more serious treatment: sleeping with a machine, or surgery.

In general, apnoeics will need to sleep with a machine. Surprisingly, their partners are generally not unhappy about this. The air-blowing device keeps their airway open at night and they do not snore. The patient wakes up in the morning refreshed and delighted. Known as CPAP (continuous positive airway pressure), this apparatus is now acceptable to the vast majority of apnoeics and their partners. It is saving many relationships and many lives. Those few that cannot manage it can have surgery .

Snorers who are not apnoeics have a number of choices. They can use CPAP too but having no symptoms they do not quite have the same motivation to snuggle up with a mask every night. Usually they just want it "fixed". Well the good news is, most of them can be. Exactly how depends on the "level" of airway narrowing - nose, back of mouth, palate, or lower in the throat. This is why careful examination is critical to successful treatment. A tiny telescope passed through the nose reveals all.... painlessly (more or less).

Palatal surgery can be done in the office with laser or a radio-frequency probe these days. In selected patients, laser has approx a 90% success rate, and radio frequency about 65%. The Pillar Implant is probably about 88% successful in achieving bedpartner satisfaction for snoring, but is still a relatively new proceedure; its efficacy for Obstructive Sleep Apnea needs more determination, and long term results are unknown. Obstruction lower in the throat can be helped by tongue base radio frequency treatment in the office. Sleep apnea patients may under go the more extensive UPPP surgery in the operating room, sometimes with genioglossal advancement.

For us in B.C., perhaps the most scandalous part of this modern epidemic is the government's attitude to it. Of those who have normal oximetry many will still have apnoea.... the test is not good enough to pick it up in about 20%. These people need an overnight study in a special "sleep lab". There are three such labs in the lower mainland of BC. As a result there is a wait of several months for this test. How many road, work and personal accidents are happening to these waiting patients? How many heart attacks? Moreover, surgery is not paid for by MSP unless an overnight lab test (not just oximetry) shows apnoea. So those who cannot tolerate CPAP have no option but to wait for a year or else pay hefty bucks for private in-hospital surgery. This enlightened policy seems to have given us both non-preventive medicine and two tiers.

And there I had better stop. For more information, go to the Medical Info page on this website and do the Epworth Questionnaire for daytime sleepiness: if you or your partner are a snorer and score over seven, you or he are at risk and should make an appointment without delay. Even with a normal score, if snoring is interfering with sleep, medical consultation is advisable and help is available.

Written by Dr. Richard R.J. Smyth, M.B.B.S.,F.R.C.S(Eng), F.R.C.S Courtesy of the information lab, Sleep Surgery Centre Inc. © All rights reserved. January 27th, 2002; revised December 1st, 2006.

Sleep Surgery Centre Inc. 303 - 2963 Glen Drive, Coquitlam, Vancouver, B.C. Canada V3B 2P7
Tel: 604-941-2344 Fax: 604-941-2455 E-mail: info@sleepsurgerycentre.com