Snoring can be annoying, but is snoring bad for you?
Snoring is incredibly common and often one of the reasons people come to see me for advice, to reduce the noise of snoring and the impact it's having on their partner. But is snoring bad for you? Does it need to be treated if it's not causing your partner problems? The answer is not straightforward, as snoring is often a sign of a more significant problem sleep apnea. Snoring alone isn't associated with significant health problems but sleep apnea is, so it's important to measure whether sleep apnea is present to answer the question for people of whether snoring needs treatment.
Is it snoring, sleep apnea or both?
Snoring and sleep apnea are similar in that they both occur when muscles in the tongue and upper airway relax during sleep and cause either a partial or complete blockage of the airway. When the airway partially closes, enough to cause vibration in the back of the airway that results in snoring. Sleep apnea occurs when the airway gets even narrower, and either blocks completely or is narrow enough that breathing is more difficult, causing sleep to be disrupted. People or their partners aren't always aware of these disruptions, so just because a partner hasn't seen episodes of stopping breathing or people aren't aware of being awoken with difficulty breathing during sleep doesn't mean they don't have sleep apnea.
How do you differentiate snoring from sleep apnea?
That's the role of a sleep study. Unfortunately simpler measures like snoring apps, having your partner watch you or questionnaires can't reliably determine whether there is sleep apnea in addition to snoring. It's important to determine whether sleep apnea is present as it affects decisions about whether treatment is needed and the types of treatment. A sleep study also determines the severity of associated sleep apnea. One of the ways of determining this is a figure called the AHI or apnea hypopnea index. That's the number of times per hour that changes with breathing lasting 10 seconds or more interfere with sleep. A sleep study allows calculation of the AHI which helps to differentiate snoring from snoring that is occurring as part of sleep apnea.
In adults, snoring by itself isn't harmful, but sleep apnea is
If there is snoring, but no or very little sleep apnea seen on a sleep study, there is not strong evidence that it is bad for your health. Therefore, decisions about whether treatment is needed, depend upon whether snoring is disturbing a partner or others when staying with friends or family. In Western societies snoring is something people often don't tolerate, but in other cultures, snoring is often embraced. Dr Himanshu Garg of Aviss Health in Gurgaon, India says that "in India snoring is seen as a sign of sound sleep and a stress free life."
Sometimes people are aware of waking themselves with snoring and become disturbed by it, which is another circumstance under which I'll recommend snoring treatment. There is also a very mild form of sleep apnea, upper airway resistance syndrome (UARS), which can cause people to feel more tired that usual. Although UARS isn't associated with significant health risk, if people are feeling tired as a result of UARS I'll usually recommend treatment. There are a range of treatment options for snoring that are discussed in this post.
When there is significant sleep apnea associated with snoring, treatment decisions are guided more by health risk. Left untreated, sleep apnea can have significant short and long term effects including:
- Increased risk of accidents at work or driving
- Increased risk of depression
- Increased risk of stroke
- Increased risk of high blood pressure
- Increased risk of coronary heart disease or heart failure
Persistent snoring in children isn't normal
Although snoring by itself doesn't cause significant health problems in adults, it's a different story in children. Children who snored all the time during early childhood, not just when they have a cold, have lower academic performance in middle school compared to children who didn't snore. So, if you see your children snoring regularly it's important to discuss it with your doctor.