Snoring is a common problem, faced by many people and almost everyone experiences it at some time or the other. Sleep apnea is a sleeping disorder, which may present itself with snoring as the main symptom but can have a much deeper impact on your health. How to differentiate between the two? Do all snorers have sleep apnea? How to identify sleep apnea snoring? The answers to all these questions are given here.
Here are some frequently asked questions related to snoring and sleep apnea. This can clearly explain the similarities and differences between the two.
Do All Snorers Have Sleep Apnea?
As sleep apnea has long-lasting health effects, it is believed to be a more serious condition than snoring. Do all snorers have sleep apnea? This is a very common question in the minds of snorers and their near ones, so that necessary treatment can be done. It is, therefore, necessary to understand both snoring and sleep apnea in detail.
- Snoring is a sound produced when you are sleeping. It is due to the vibration of the respiratory structures, which is caused due to obstruction of the respiratory passages when you breathe while sleeping. Snoring is a sign that the airways are being obstructed in some way. This is very common and can occur in anyone due to various reasons. The severity of snoring, other associated factors, its impact on your sleep quality or performance and the way it affects you, determines the need for treatment of snoring.
- Sleep apnea, on the other hand, is a sleeping disorder. While it has other types, the obstructive sleep apnea (OSA) is the commonest one. Sleep apnea can affect your health in many ways. Sleep apnea, not only causes snoring but also causes your breathing to stop for a while when you are sleeping.
- In most cases of obstructive sleep apnea, the tissues at the back of the throat collapse and the muscles of the upper airways relax. This causes partial or complete obstruction of the airways. As the air passages get blocked, it limits the amount of air reaching your lungs. This makes you breathe with a loud noise, as the air passes through the obstructed passage and the surrounding tissues vibrate.1
- The mechanism of obstruction and vibration of tissues is common in snoring and sleep apnea. However, the difference in sleep apnea is that there are episodes in which the breathing momentarily stops due to inadequate intake of air. This results in reduced oxygen supply, which triggers the brain. It awakens you to breathe loudly again and continue breathing with snoring for a while. This cycle of snoring with a pause in your breathing followed by breathing and snoring continues while you sleep. You may not be aware of each awakening but it leaves you with an unrefreshing sleep when you wake up the next morning.1 This feature is typical of sleep apnea is not seen in people who snore without sleep apnea.
- While snoring can just disturb your partner, sleep apnea can disturb your partner and your sleep, thus affecting your health. Obstructive sleep apnea can result in nocturnal hypoxemia or reduced oxygen supply during the night when you are sleeping, particularly in severe cases.2 Studies suggest that it can increase the risk of cardiovascular disease, hypertension, stroke, metabolic diseases, diabetes, and even cancer.2
Thus, while people with snoring and sleep apnea, both experience snoring, a temporary stoppage of breathing occurs only in sleep apnea.
Do all snorers have sleep apnea? The answer is no. All snorers need not have sleep apnea. Snoring can have other causes too, one of which is sleep apnea. But not all snorers need to have sleep apnea. Similarly, sleep apnea presents with a host of symptoms, a prominent one of them is snoring. But snoring in sleep apnea can be much louder, more annoying, associated with other complaints and can severely affect your sleep and health.
Snoring is the simple obstruction of the air passage, which makes noise when breathing during sleep. Obstructive sleep apnea is a sleep-related breathing disorder, characterized by the periodic narrowing and obstruction of the airway during sleep.3 This results in periodic stopping of breathing and reduced supply of oxygen, which is more serious than just snoring due to obstruction.
Thus, while most people with sleep apnea are snorers, all snorers do not have sleep apnea. However, some people may have sleep apnea without obvious snoring or their snoring may not be easily identifiable, especially if the partner is a heavy sleeper. In such cases, other symptoms of sleep apnea and the effects seen on the performance may help to identify the condition.
What Are The Other Causes Of Snoring?
Snoring is a symptom of an underlying problem. One of the commonest causes of snoring is obstructive sleep apnea. Some of the other common causes of snoring are obstruction of air passages due to enlarging glands like swollen tonsils or adenoids. This is very common in children but can occur in adults too. Snoring mostly also occurs due to your sleeping position. When you sleep on your back, due to gravity, the throat muscles or the tongue get relaxed easily, thus blocking the airways. Excessive fat deposition around the neck, weight gain, obesity too cause easy obstruction of air passages, leading to snoring. Certain medicines that cause muscle relaxation, intake of alcohol are other causes of snoring.
Most of these conditions can be treated with lifestyle changes, medications, while some like swollen tissues may require surgery.
What Are The Symptoms Of Sleep Apnea?
The common symptoms of obstructive sleep apnea include non-refreshing sleep, fatigue, daytime sleepiness, nocturia, morning headache, irritability and memory issues.3 It can also affect your work performance, risk of injuries and motor vehicle accidents. Some may experience difficulty in concentration and mood changes. Snoring, silent pauses and gasping sounds are mostly present in obstructive sleep apnea, but it varies from person to person. Some other symptoms and signs help differentiate obstructive sleep apnea from snoring. Identifying these additional symptoms that suggest obstructive sleep apnea is important.
How To Identify Sleep Apnea Snoring?
Sleep apnea snoring may present with snoring that occurs from other causes. But it also presents with other associated complaints. It is necessary to understand these symptoms to be able to identify sleep apnea snoring.
Other symptoms that help to identify sleep apnea snoring include:
- Choking at night or waking to gasp for breath
- Sleep maintenance insomnia or difficulty in staying asleep
- Nighttime reflux
- Night sweats
- Nocturia – waking up at night to pass urine although there is not much intake of liquid at night
What Conditions Can Cause Obstructive Sleep Apnea?
Some risk factors are considered while assessing the possibility of sleep apnea snoring. A typical adult with obstructive sleep apnea is overweight or obese male or a postmenopausal female presenting with excessive daytime sleepiness and the loud snoring at night when sleeping.4
Based on physical appearance and examination, some studies have reported that people sleep apnea snoring, may have larger than average neck circumference, crowded oropharynx, large tongue, and retrognathism, which is a condition in which the lower jaw is positioned further at the back than the upper jaw.4 Some studies also suggest that patients with refractory atrial fibrillation, resistance hypertension and history of stroke must be screened for sleep apnea, even if there are no symptoms.4 People with metabolic disorders, diabetes, and heart disease are considered at greater risk of sleep apnea snoring.
In children, obstructive sleep apnea can present with loud snoring at night, increased hyperactivity than the sleepiness and may also have academic difficulties. In children, apart from other symptoms, restless leg syndrome with frequent movement of legs while sleeping and secondary nocturnal enuresis may be seen. Physical features of those are the risk of obstructive sleep apnea include adenoid or tonsillar enlargement, hypo nasal speech, and high arched palate.4 Children with orofacial abnormalities and hypotonia must be evaluated properly. Some of these conditions can cause snoring, but if the conditions are severe, they can result in obstructive sleep apnea. If left untreated, these can become serious not only causing sleep apnea but its complications too. Hence, it is best to identify people with such conditions, as their risk of sleep apnea is high.
While these are just some of the features of people possibly having obstructive sleep apnea, the final diagnosis depends on the evaluation. A proper history of symptoms, medical evaluation, relevant investigations, and scans help to diagnose the condition. Note the symptoms that help identify sleep apnea snoring and seek medical advice, as appropriate. Timely diagnosis and treatment can help control the conditions and prevent further complications.
Thus, we can conclude that not all snorers have sleep apnea and not all who have sleep apnea necessarily snore. The best way to identify sleep apnea snoring is to look for symptoms specific to obstructive sleep apnea. The way you feel about waking up the next morning, during the day, your mood and your work performance help guide the difference. Normally, snoring does not affect your quality of sleep or cause fatigue the next day, it just produces sounds and can disturb your partner. But sleep apnea can cause a complete stoppage of breathing and gasp for breath, along with loud snoring.
Nevertheless, both snoring and sleep apnea need treatment depending on their causes. As snoring can also be due to other medical conditions and respiratory problems, leaving it untreated can be harmful. Sleep apnea, if left untreated can be even more harmful to your health. Hence, it is necessary to evaluate the severity of sleep apnea and receive timely treatment.
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