Snoring is a common and embarrassing sleep complaint. Photo / 123RF
Snoring is a common and embarrassing sleep complaint. Photo / 123RF
By Nick Harding
Mike Dilkes is the patron saint of snorers: a clinical beacon guiding us poor souls suffering interrupted sleep, harangued by sharp-elbowed loved ones and the butt of many a joke.
But snoring is not funny. It ruins relationships, destroys careers and, in its most extreme form, it can kill; which is why Dilkes, consultant ENT surgeon at London's Hospital of St John and St Elizabeth, wants us to wake up and smell the coffee.
Snoring is an epidemic with real public health consequences. Left untreated it can develop into sleep apnoea, which causes blood oxygen levels to plummet and is associated with impotence, loss of concentration, poor memory, diabetes, hypertension and, most worrying of all, heart attacks in the middle of the night. A not-so-silent killer.
Around 40 per cent of men over 30 snore, of which two per cent have sleep apnoea. Almost two thirds of men over 65 snore, with 10 per cent suffering sleep apnoea. Not that it is exclusively a male problem, as a fifth of women snore too, and the figures are likely to be much higher as social stigma drives snorers underground.
Controversially, particularly for those of us who declare we can't help it, Dilkes argues that it is a voluntary habit, much like drinking or smoking.
A short series of exercises could help snorers to break the habit. Photo / 123RF
"Not a habit you may choose to have, but one you can choose to stop," he clarifies.
To which end, he has come up with a revolutionary solution: a tongue and throat workout designed to tone up the structures in the neck that cause snoring.
While not a cure for those snorers who have physiological conditions such as nasal injuries or enlarged tonsils, the workout will help most to stop or to at least reduce decibel levels. Given the average snore is 60 to 100 decibels, comparable to a household vacuum cleaner, any reduction in volume will be music to tired ears.
The workout is split into three sets of three exercises, each designed to work a specific part of the mouth and neck - the tongue, the soft palate and the lower throat.
Tongue curls
These involve curling your tongue backwards in the mouth towards the soft palate then bringing it forward to touch the back of the upper teeth.
Open wide and say ahhhh...
Mouth stretches tighten the soft palate as you stretch your mouth open as wide as you can, while 'ahhh'-ing for 20 seconds.
Squeal!
Exercising the lower throat, or oropharynx, involves poking out your tongue as far as it goes, taking a deep breath and making a high-pitched noise (similar to gargling with air) for 30 seconds.
The workout takes no more than five minutes and for those too lazy to try the full programme, there is a two-minute short-cut exercise.
Dilkes, a genial, laid-back surgeon who has lasered hundreds of soft palates, spent years developing the workout and studied the structures of the throats of cadavers to finely tune his ENT knowledge. The exercise programme is now included in his short book, which could well become the snorer's bible.
I went to see him after another night in the spare room and an ultimatum from my wife, Stephanie. My snoring journey started suddenly and mysteriously about five years ago. I'm 47, fit, a healthy weight, a non-smoker and a moderate drinker. I have tried chin straps, sprays, a mouldable mouth-guard and even a strap-on sound monitor designed to deliver electric shocks when it registers a snort. All to little effect.
"Loss of muscle tone," nods Dilkes. "As you've aged, you've reached that threshold. The workout should help you considerably. Snoring is caused because everything collapses at night when it relaxes. You can stop things collapsing by increasing their tone."
Traditionally, there are three options to treat snoring, depending on the causes. Surgery can help by unblocking noses, reducing the size of tonsils or tightening the soft palate. Equipment such as a mandibular advancement device or positive airway pressure mask can be fitted; the former pulls the lower jaw forward, the latter pushes air down the throat to keep it open.
Despite the number of sufferers, treatments for snoring are under-researched. Photo / 123RF
"The third [option] is to tell people to lose weight," says Dilkes, who also runs the Healthhub medical centre in London's Herne Hill. "It struck me that all three were difficult to go through and in many cases were treating the symptom, not the cause, which is below the soft palate at the back of the tongue. When that area gets obstructed, it causes turbulent airflow which makes the palate flap around. If you stop that obstruction, you stop everything.
"I looked at the tongue, the soft palate and the pharyngeal musculature to see what exercises could legitimately improve the tone of them, just like you'd exercise your quads if you were going skiing."
Snoring, it transpired, had been under-researched, given the number of sufferers and the health implications.
"If you're an ENT surgeon you specialise in worthwhile, life-saving cancer surgery or cochlear implantation, that's where the kudos is. But if you are a snoring surgeon, you are not taken that seriously, despite the huge amount of evidence that snoring develops into sleep apnoea and that will shorten your life," says Dilkes.
The workout he devised has been refined through trial and error.
"It was not practical to do clinical tests because it is so multifactorial. The exercises are the best we can get and it was natural to put it in book form to make it accessible for people."
And wacky as it sounds, it appears to work. After meeting Dilkes I started the programme and noticed a marked improvement within two weeks. Most importantly, so did Stephanie. Be warned however, it is best done in privacy as it is neither silent or dignified.
Dilkes, meanwhile, is ready for some flak for pinning the blame on snorers, themselves.
"Many people are predisposed to being a snorer by their own failings, particularly in terms of lifestyle, so it is a habit, in that respect," he argues. "The fact is, for those people, if they lose weight, stop drinking alcohol, get a bit fitter and do the exercises they will stop snoring.
Having saved relationships, careers and even lives by curing snorers, Dilkes is hopeful that the condition will start to be taken more seriously.
"I would argue for public health messages and awareness," he says. "Hopefully exercising your throat will become something people do every night after brushing their teeth. Plus, if your wife sees that you are making a real effort, she is more likely to cut you some slack."
The all-in-one shortcut | Max Dilke's quick workout to combat snoring
Start with your mouth open as wide as it can go and tongue protruding out forwards as far as it will go. Whilst holding these two positions begin moving the extended tongue in an up, down, side to side movement.
After two revolutions of these movements, begin humming the National Anthem in as deep a pitch as you can and continue until the end of the song or for at least two minutes, whichever comes first.
