Snoring is considered a common phenomenon, but in some, snoring could be a symptom associated with Obstructive Sleep Apnoea (OSA).
Doctors stress that good quality sleep is essential; uninterrupted sleep that leaves one feeling refreshed in the morning. But several factors can disrupt our sleep.
With World Sleep Day being observed on March 14, doctors emphasise the need to ensure good quality sleep, recognise symptoms of OSA that could impact individuals in more than one way and initiate treatment as early as possible. This year, World Sleep Day was on the theme “Make Sleep Health a Priority”.
Mathivanan Koushik Muthuraja, professor and senior consultant, pulmonary, sleep and lung transplant medicine, Sri Ramachandra Medical Centre, said that sleep is a very important aspect of a person’s health. “One-third of the day is spent on sleep. It helps in the normal functioning of the brain the next day, regulates body temperature and hormones. Sleep is important for every aspect of life as it recharges the body. Adults need a minimum of eight hours of uninterrupted sleep, while children tend to sleep longer, and start to sleep less as they grow older,” he said.
Snoring can be problematic
Insomnia, OSA and snoring are major sleep disruptors, he said, adding : “Many tend to ignore and overlook snoring, but we must remember that snoring occurs due to an obstructed airway. This could be due to a large tongue, excessive fat around the neck, facial and dental abnormalities.”
Snoring, he said, is considered a common phenomenon and people tend to think that if someone is snoring, they are having a deep sleep which is not true. “Snoring could be a symptom associated with OSA; 50% of snorers can have OSA,” he said.
Roshan Kumar, assistant professor, Department of Respiratory Medicine, Government Stanley Medical College Hospital, said, “There is normal habitual snoring that could be due to reasons such as nasal obstructions and nasal polyps. This may not impact routine life. Then, there is snoring due to OSA. Here, snoring is a symptom and impacts individuals in more than one way. It could affect their personal and professional lives.”
He added : “Mostly, people come to us with complaints of excessive daytime sleepiness, fatigue, inability to concentrate on work or at times, excessive snoring and waking up at night due to breathlessness. OSA is a medical condition and needs to be identified and treated. It may lead to other systemic issues as well. It may be interlinked to fluctuating blood pressure levels, cognitive impairment, and cardiovascular issues.”
There are certain myths about snoring, Krishnaveni Renganathan, World Sleep Society-designated international sleep specialist and consultant pulmonologist, allergy and sleep specialist, Medway Institute of Pulmonology, Chennai, added.
“Patients think their snoring might be due to tiredness or it can be prevented by sleeping in a lateral position. In general, the awareness that snoring could also impact one’s health is very low,” she observed.
The impacts of OSA on health
Where does the problem arise? Dr. Muthuraja explains: “In some persons, this obstructed airway can be serious as not enough air enters the lungs nor is enough oxygen delivered, depriving the cells, tissues and organs of oxygen. When the obstruction is severe, breathing can stop completely at night. This temporary cessation of breathing is what is called apnoea. Micro awakening of the brain could take place and the sleep gets interrupted. This sleep deprivation could impact in many ways including causing irritation, mood disorders and long-term impacts on memory. When the body is not getting sufficient oxygen, it puts the person at a high risk for stroke and heart attack. Metabolic syndromes such as diabetes and dyslipidemia and hypertension could worsen.”
Dr. Krishnaveni goes on to explain cortical arousal in OSA. “When the upper airway is obstructed, oxygen supply to organs such as the heart, lungs, brain, kidneys get reduced or completely stop, thereby sending a signal to the brain to open the airway. Individuals with sleep apnoea do not go to deeper stages of sleep and will usually wake up feeling tired, but which, in the long term, leads to anxiety, depression and cognitive decline,” she said.
Diagnosis includes a sleep study – polysomnography. “It looks at the brain activity, sleep pattern, quality of sleep, respiratory, cardiac monitoring and limb movement monitoring . There are four levels of sleep studies that are available . Level I PSG is done in a hospital setting under the supervision of a sleep technologist. Level 2 and Level 3 sleep studies can be done at home,” she said.
Dr. Muthuraja pointed out that the doctors identify patients and categorise them as having mild, medium and severe OSA.
What is the treatment?
Treatment includes lifestyle modifications, (diet modifications and weight reduction). “We have myofunctional therapy to strengthen the upper airway muscles. Mild OSA can be treated with mandibular advancement devices (in case of anatomical impairment). Continuous positive airway pressure (CPAP) remains the treatment of choice for moderate and severe OSA,” Dr. Krishnaveni added.
The need of the hour, according to Dr. Roshan, is to recognise symptoms as early as possible. “It is not only going to affect an individual but also their partner and family. It will have an impact on their profession especially when they are in jobs that require them to be alert, have a good memory, and in driving jobs. Hence, there is a need for early recognition and identification of symptoms and initiation of treatment,” he said.
“Good quality sleep is when a person has deep and uninterrupted sleep and feels refreshed when he/she wakes up. The quality of sleep need not depend on the duration of sleep. In the olden days, they used to say snoring is a sign of deep sleep, but it isn’t. So, let’s take snoring seriously before it’s too late,” he said.
Published – March 15, 2025 05:14 pm IST
