Most people discover they snore only after someone else tells them. While snoring can disturb others, it may also indicate a more serious health issue, such as sleep apnea.
Dr. Faisal Zahiruddin, a pulmonologist and sleep medicine specialist at Houston Methodist, explains that snoring is not the only symptom associated with sleep apnea. He states, “Sometimes a snore is just a snore. And while it can be a symptom of obstructive sleep apnea, it’s not the root problem. The real issue is the dynamic airway collapse and inadequate ventilation that occurs.”
Sleep apnea is defined as brief interruptions in breathing during sleep. There are two types: obstructive and central. Obstructive sleep apnea (OSA) is more common and occurs when airways relax excessively during sleep, leading to partial collapse and reduced oxygen intake. This condition affects millions of people in the United States and globally. Central sleep apnea results from the brain failing to signal proper breathing patterns and is less common.
Risk factors for OSA include increasing age—especially adults over 50—family history, certain anatomical features like a narrow upper airway, poor diet, sleeping position, being overweight, and neck circumference.
Symptoms beyond snoring include excessive daytime tiredness due to disrupted sleep, waking up during the night for unclear reasons or because of difficulty breathing, morning headaches, feeling unrested upon waking, and mood changes such as depression or irritability.
If untreated, obstructive sleep apnea can have serious health consequences including an increased risk of sudden cardiac death as well as higher rates of heart attacks and congestive heart failure in those with moderate to severe forms of the condition. Studies also suggest that repeated disruptions in sleep caused by apnea may accelerate biological aging.
Diagnosis typically involves a polysomnogram conducted in a sleep laboratory where various physiological parameters are measured overnight to determine an individual’s “apnea hypopnea index”—the number of times per hour that breathing stops or becomes shallow. Less than five incidents per hour is considered normal; higher numbers indicate mild to severe cases. Home-based tests are available but provide less detailed information and cannot definitively rule out the condition if negative.
“Our sleep lab has top of the line mattresses, cable TV — all the things you might have in your own bedroom,” says Dr. Zahiruddin.
Lifestyle modifications such as losing weight or changing sleeping positions can reduce symptoms for some individuals. Dr. Zahiruddin emphasizes: “The lifestyle change that is most impactful in obstructive sleep apnea is weight gain and loss… Though people who are in great shape can have obstructive sleep apnea, the condition becomes more prominent and more likely with increasing weight.”
Medical treatment options focus on maintaining open airways during sleep:
– Continuous positive airway pressure (CPAP) therapy uses a mask connected to a machine that provides gentle air pressure throughout the night.
– “The more the CPAP machine is used, the greater the health benefit,” says Dr. Zahiruddin.
– “Most people don’t have trouble acclimating to the CPAP device,” he adds. “In fact, many patients come back to me and say they’ll never sleep without it again.”
Alternatives include dental appliances for mild cases or surgery to correct anatomical obstructions such as deviated septum or enlarged tonsils/adenoids. For those unable or unwilling to use CPAP or undergo surgery—and who meet specific criteria—a hypoglossal nerve stimulator implant may be an option; this device helps keep airways open by stimulating tongue muscles during each breath at night.
To qualify for this implantable device treatment, patients must have moderate to severe OSA with particular anatomical characteristics and maintain a body mass index under 40.
