I read recently that the secret to a happy marriage isn’t regular sex or being able to make up after a row, it’s the ability to tolerate your partner’s most annoying habits, year after year after year. Full credit to my husband, then, who I am embarrassed to admit has endured more than ten years of me snoring.
I still find it hard to believe — and admit publicly — that most nights I inflict the most unladylike sounds on him, which range from resembling a faulty drill to a constipated warthog. But there’s no hiding from a surveillance app.
To see just how bad things have been getting for my husband I downloaded SnoreLab, one of several free phone apps that tracks and (mortifyingly) records your nocturnal noise levels. It showed that last Wednesday I snored for 49 per cent of the 7 hours 16 minutes I was asleep — half an hour of that “loudly”. On Thursday and Friday it was 20 per cent of the night, and on Saturday 35 per cent. Playing back the “audio evidence”, my phone broadcasts the regular growlings, bursting every so often into night-splitting harrumphs. Could that really be me? Often for two to three hours a night?
However, help could now be at hand in the form of a wearable device called a Zeus, which has been 15 years in development by the respiration and sleep experts at Guy’s and St Thomas’ NHS Foundation Trust and King’s College London. After three positive clinical trials, next month it will begin a £1.5 million trial across six NHS trusts, funded by the National Institute for Health and Care Research. The aim is for it to be endorsed as an NHS treatment for snoring and the more serious condition of obstructive sleep apnoea, which is at present treated with a cumbersome mask you strap to your face each night called a CPAP (continuous positive airway pressure) machine. This new device promises to be a lot less intrusive but will it work for me?
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First, what exactly makes some 41 per cent of the UK adult population — and yes almost as many women as men, even if they are less likely to admit it — snore? Snoring happens when the muscles that support our tongue and throat relax when we are asleep, causing our upper airway to narrow, explains Professor Joerg Steier, who led the Zeus team and is a consultant in respiratory and sleep medicine at Guy’s and St Thomas’. This narrowing makes the walls in our upper airway flutter or touch, causing a noise as air passes through with each breath.
“When we are awake the brain tells our muscles to keep that upper airway wide open, which is why we don’t snore in the day,” he says. “But in sleep, when we go into our ‘standby mode’, the activity that the brain uses to activate these muscles drops out and the walls are no longer supported.”
Contributing to the narrowing airway is the fact that our tongue tends to glide backwards as we relax and gets further pulled by gravity when we lie down, typically on our backs, which is the sleeping position most likely to result in snoring.
Loud snoring isn’t bad for us, Steier says, but if the walls touch enough that the airway closes, that becomes obstructive sleep apnoea.
“The air is blocked so you momentarily stop breathing, which then typically wakes you up,” Steier says. People with sleep apnoea will have their sleep broken many times a night — as many as 100 — which could lead to long-term health issues including chronic sleepiness, depression and cardiovascular health risks, according to Steier, who has spent the past 20 years researching treatments for it.
A 2023 Snoring and Sleep report found that almost half of men and a third of women snore. A separate YouGov survey in the UK found that women admit to snoring much less than men. And it gets worse with age: 77 per cent of 55 to 64-year-olds reportedly snore.
It’s also exacerbated by obesity and by the menopause, when women lose the elasticity in their muscles. Even just one glass of wine over dinner adds to the problem.
“Alcohol, even a small amount, makes us more relaxed and that means our muscles are more relaxed so the airway is more collapsible,” Steier says. “The amount of alcohol that would stop you driving a car is making it likely you start snoring.” This might explain why I was particularly noisy on Wednesday night, after going to a book launch, and on Saturday, after meeting friends in the pub.
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Until now the most common remedies are to try to lie on your side or front when you sleep, which helps to prevent the tongue shifting backwards, or to wear a mouthpiece that helps to keep the tongue forward. My desperate husband often nudges me in the night to turn over but if I do I sometimes even wake myself up with a great harrumph, I am not keen to wear a mouthpiece — my Invisalign night retainer is pain enough — let alone strap on a Darth Vaderish CPAP mask. Blowing pressurised room air into your upper airway to keep it open may be an effective treatment for sleep apnoea but 30 per cent of people who try the device get fed up with using it within a year, according to the Sleep Apnoea Trust (it estimates that as many as eight million people in the UK may have the issue to some degree).
The medical team behind the new Zeus device — which has been developed in conjunction with an award-winning British biomedical engineering company, Morgan Innovation and Technology — hope snorers will find their invention unobtrusive enough to wear easily at night. It is shaped like a tiny boomerang and you attach it under your chin with a sticky pad before you go to sleep. It’s not the most glamorous of bedroom accessories but then there’s little glamour in turning into a warthog of a night.
The Zeus works by using a mini Tens machine (short for transcutaneous electrical nerve stimulation) to deliver small electrical impulses to stimulate the genioglossus muscle that holds the tongue in place, with the aim of keeping it toned. “The initial thought was that it doesn’t take a lot for the brain to keep the upper airway in shape when we’re awake but this tone falls away when we fall asleep,” Steier says. “So we thought if we could maintain that tone, we won’t even need a big contraction of the muscles. We just need enough to keep the upper airway in shape. And how do we do this? Could we use electrical stimulation?”
Tens machines are used to help relieve back pain, period and labour pain, and arthritis by stimulating targeted muscles to improve blood flow. In the Zeus, stimulation is directed under the jaw. It is also possible to stimulate the genioglossus muscle via an implant linked to the hyperglossal nerve but, Steier says, “We wanted to find a way to stimulate this muscle without the need for surgery.”
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To operate it you adjust tiny knobs embedded in it until you can feel the vibrations but not to such an extent that they keep you awake. The device then waits 20 minutes for you to fall asleep before starting up. Until it is endorsed as a NHS medical treatment, it is on sale for £250.
So did it help me? In truth my experience has not been the slam dunk my husband prayed for. On the first night, it fell off while I was asleep — it turns out that night cream will stop it sticking, which may be a deal breaker for a lot of women. Although according to Nigel Clarke, CEO of Morgan Innovation and Technology, in the long term electrical stimulation may help to tone the neck, which would be quite the bonus. On the second night I had higher hopes, drifting off to the feeling of tiny buzzes in my jaw. However, I woke to find that my SnoreLab score was still terrible — I’d snored for an hour and a half, 20 minutes of that loudly. “Like a drunken sergeant,” as my husband put it. Oh, the mortification. And how disappointing.
In the three clinical trials during its development, 60 per cent of a total of 109 patients found that the technology lowered their sleep apnoea. Meanwhile, in an additional 2022 trial with 17 patients, conducted by the sleep charity Hope2Sleep, 82 per cent said that it helped them to reduce their snoring. And in a 2024 clinical trial on 48 sleep apnoea patients in a Dorset County Hospital NHS Trust, 84 per cent reported better quality of sleep. So far 1,500 devices have been sold worldwide, with fewer than 5 per cent being returned under a money back guarantee, Clarke says.
Dr Allie Hare, consultant in sleep medicine at the Royal Brompton Hospital and co-founder of the specialist Grace Sleep clinic, also believes the device “is a helpful addition to the treatment options for snoring and milder forms of sleep”.
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So was I doing something wrong? Steier says that the device works best if the reason you snore is that your tongue is moving backwards and blocking your airway. But if it’s being blocked by other issues, such as the vertical walls losing their tone, then pulling the tongue back may not make a difference. Maybe I am one of those cases. Or was it simply operator error?
For the subsequent four trial nights, I stuck it a bit further under my chin and it certainly seemed to work better — my snore scores for those nights were significantly lower. One morning my husband said he thought I’d left to sleep in another room as our bedroom was so uncharacteristically quiet. It’s not perfect but, while my SnoreLab app has replayed some continued grumblings, it’s now more creaky door than full warthog. I think we’d take that.
And despite the way it looks, it is fairly easy to get used to wearing it once you’ve faffed about with sticky pads and remembered to charge it every day, so I’m prepared to persevere. After all, research by Zeus suggests that in snoring households, 28 per cent of partners end up sleeping in separate rooms. We’re not at that stage yet. The Zeus may look like a passion killer but if my husband can have his nights back, I’m sure we can work around it.
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