Snoring

Snoring is the sound emitted from the upper airway of your throat during sleep and comes from loose, relaxed tissues that vibrate while breathing. The sound emitted may come from the soft palate, tongue or both. Snoring is an indication that there is resistance through the airway. Snoring, pauses in breathing, gasping or snorts are strong indications of airway obstruction in sleep, but the severity of snoring is a poor predictor of the actual severity of obstructive breathing during sleep. Although snoring is an indicator for sleep apnea, it is not necessarily experienced by all patients with this disorder. Approximately one out of every two heavy snorers will develop this condition.

Upper Airway Resistance Syndrome

Upper Airway Resistance Syndrome (UARS) represents a progression of disease bridging the transition from “benign snoring” to obstructive sleep apnea. This progression may take years or decades to occur. As patients age or gain weight, snoring or upper airway resistance may increase, leading to “snore arousals”. Snoring begins to cause many brief awakenings during sleep without affecting the blood oxygen levels, however it prevents the individual from achieving “good” sleep. In patients with UARS, the sleep quality is generally disrupted to the point of causing clinical consequences such as difficulty initiating or maintaining sleep (insomnia), non-refreshing sleep, or excessive daytime sleepiness. Because of the very brief nature of the many arousals triggered by snoring, patients with UARS are typically unaware of these awakenings and generally do not know that they may be snoring if it were not for the witnessed reports from a bed partner or family member.

Not all patients with UARS have audible snoring. Some patients may have an increase in respiratory effort during inhalation or inspiration because of an anatomical limitation to the airway such as from an enlarged tongue base, which may be heard as “heavy breathing” instead of snoring. The increased effort to inhale can lead to EEG (brain wave) arousals and has been referred to in the sleep medicine field as “respiratory effort-related arousals” (RERAs). For this reason, an absence of snoring does not imply an absence of obstructive breathing in sleep. Those individuals, however, may have other symptoms such as a dry mouth upon awakening, morning headaches, symptoms of insomnia or daytime sleepiness