Since I am a sleep medicine physician, I am often asked the following questions related to snoring: Is my snoring a health problem? If I snore, does that mean I have sleep apnea? What’s the difference between snoring and sleep apnea anyway?
Snoring is very common though it’s hard to know for sure since there’s no standardized definition for it. A rough estimate is that one out of three individuals snore regularly. To answer the above questions about snoring, I’d like to first give an overview about what is happening in your body when you snore. When you breathe, air travels through the nostrils, the nasal passages, the back of the mouth, then the throat, then down into the windpipe, and then into the lungs. It then takes that same path in reverse when exhaled. When there’s crowding at some point or many points of that pathway, the airflow gets more erratic due to a flow dynamics phenomenon called the Bernoulli Effect. When you sleep, your muscles are more relaxed, including the muscles lining the throat. So that makes the throat floppier and more susceptible to irregular airflow. This irregular airflow causes the tissues in your airway to vibrate. Those vibrations create the sound waves one hears as snoring. The same process is occurring when you blow up a balloon and then let it go without tying off the end. When that balloon zooms around the room making a sputtering sound, it is because the elastic body of the balloon shrinks down to size and forces air through that narrow floppy plastic opening, which causes the plastic opening to vibrate and create sound waves.
If that’s what happens when you snore, what happens when you have sleep apnea? The name says it all: apnea means cessation of breathing. When you have sleep apnea, the airway narrowing progresses to a point where airflow is completely blocked and you stop breathing for a brief period of time, usually between 10 and 30 seconds. Those who have a bed partner with sleep apnea often describe to me the terrifying moment their partner goes from snoring loudly to being eerily silent. They find this disturbing because they can tell it means their partner is not breathing. A gasp for air inevitably occurs in 10-30 seconds (though it may take longer than that) and the snoring resumes.
Snoring and sleep apnea occur on a continuum of airflow limitation. With some narrowing of airflow, you’ll snore. As the narrowing gets worse, the snoring gets worse. If the narrowing gets severe, you get sleep apnea, which means you’re no longer snoring during those apnea episodes because you’re not breathing at all.
Just because you snore, it doesn’t mean you should be worried you have sleep apnea. You need to have other risk factors as well. A feeling of sleepiness during the day should make you wonder if sleep apnea is contributing to that. Another characteristic symptom is waking up gasping or others witnessing you choking during sleep. Also, the snoring in sleep apnea is typically at least as loud as the volume of normal talking. You can get a free sleep apnea risk report after creating a free account and filling out a brief online survey at www.renumasleep.com. Another free questionnaire can be found at stopbang.ca/osa/screening.
When a sleep study shows you snore but don’t have sleep apnea, this is called “simple snoring.” It is a matter of debate as to whether simple snoring poses a health problem. I’ve published and lectured on this topic, and after reviewing the literature it is my feeling that simple snoring is not a significant health concern. Perhaps this may change as the science and collective knowledge continues to grow. But for now, if the noise isn’t bothering anyone and there isn’t a concern for sleep apnea, snore away!
Bonus question: Why doesn’t the sound of our own snoring wake us up even when it can be as loud as a jackhammer?
What sleep topic should I write about next? Send suggestions to [email protected].
David Rosen, M.D. is a physician board certified in sleep medicine as well as other specialties. He is passionate about sleep health. He is also the co-founder and CEO of a digital health platform for sleep apnea care called Renuma.