Snoring vs Sleep Apnea: Symptoms, Differences, and When to Worry

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 As we age, snoring often becomes more noticeable. Anyone who has shared a bed with a snorer knows how disruptive it can be, and it can be surprising to discover that you are the one making all the noise.

The British Snoring and Sleep Apnoea Association estimates that 41% of UK adults snore, affecting 10.4 million men and 4.5 million women. However, snoring is more than just a nuisance; it can be a sign of a potentially serious condition called sleep apnea.

What is

Sleep Apnea?

Sleep apnea is a disorder characterized by pauses in breathing during sleep.

There are two main types: obstructive sleep apnea (OSA) and central sleep apnea (CSA). According to Prof. Guy Leschziner, neurologist at Guy's and St Thomas' Hospitals in London, professor of neurology and sleep medicine at King's College London, and the author of The Nocturnal Brain: Nightmares, Neuroscience and the Secret World of Sleep, CSA is less common and related to central nervous system signals, often linked to heart failure and brain abnormalities. OSA, the more prevalent form, involves a physical obstruction of the airway.

According to Dr. Aditi Desai, the president of the British Society of Dental Sleep Medicine, "Not everyone who snores has sleep apnoea, but most people who have sleep apnea do snore."

What are the Symptoms of Sleep Apnea?Individuals with obstructive sleep

apnea may experience:

  • Gasping or choking

    sensations that cause them to wake up

  • Headaches, dry mouth, or sore throat

    upon waking

  • Facial and jaw

    pain (according to Dr. Desai)

Prof. Leschziner explains that each airway obstruction causes a partial awakening until normal breathing resumes. While individuals may not always be aware of these awakenings, those with sleep apnea can experience them multiple times per night, even exceeding one hundred times per hour in severe cases. Frequent nighttime urination and heart palpitations may also occur.

The most significant risk associated with sleep apnea is daytime fatigue, which can lead to falling asleep in dangerous situations. Prof. Leschziner notes that sleep apnea has been implicated in numerous traffic accidents, including the Selby rail crash.

Sleep apnea can also contribute to weight gain, although obesity is also a primary cause of OSA, creating a cyclical relationship, according to Prof. Leschziner.

What Factors Increase the Risk of Developing OSA?

  • Being

    overweight or obese

  • Being male

  • Older age

  • Difficulty breathing through the nose

  • Having a small jaw or large tonsils

  • Smoking

Can Sleep Apnea Be Cured?Treatment options for sleep

apnea include:

  • Avoiding sleeping on your back

  • Using an APAP or CPAP machine

  • Using a mandibular advancement device

  • Surgery

Some individuals find that simply changing their sleep position from their back to their side is sufficient. Special belts and pillows are available to help maintain a side-sleeping position.

More severe cases may require specialized interventions. Prof. Leschziner identifies the APAP machine, a mask connected to a machine that delivers positive pressure to keep the airway open, as the "gold standard" treatment. This device is a more modern and targeted version of the CPAP machine.

A common drawback of APAP and CPAP machines is their cumbersome nature and the noise they generate, which can affect both the user and their sleep partner. Prof. Leschziner acknowledges that some individuals struggle to adapt to APAP machines, which can feel like breathing into a strong wind, leading to low adherence rates.

Can Over-the-

Counter Treatments Help?

Nasal strips and decongestants may help reduce snoring, but Prof. Leschziner cautions that they are unlikely to significantly alleviate OSA, as the condition involves the back of the throat in addition to the nose.

Dr. Desai suggests that over-the-counter mouthguards may provide temporary relief but emphasizes that they are not custom-fitted and therefore not optimal.

What Happens if

Sleep Apnea Remains Untreated?

A study published in JAMA in August 2023 indicated that the reduced blood oxygen levels caused by interrupted breathing during sleep can negatively impact cardiovascular health.

This finding supports existing research linking sleep apnea to metabolic syndrome, a cluster of risk factors for heart disease that includes high blood pressure, elevated LDL cholesterol, high blood sugar levels, and increased waist circumference.

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