Is It Snoring Or Sleep Apnea?

Snoring and obstructive sleep apnea are strongly linked – so how can you tell the difference?

It is normal to have a high Snore Score or be told you snore and then worry if it might be something more serious.

Some important things to consider are:

Normal snorers don’t stop breathing

Not everyone who snores has sleep apnea – nearly everyone who has sleep apnea snores

If untreated, snoring can become sleep apnea


What is the difference between normal snoring and sleep apnea?

95% of people with obstructive sleep apnea (OSA) snore, but not all snorers have OSA [1]. Both snoring and OSA are the results of improper airflow through your upper respiratory tract. So what is the difference?

Normal snorers, better known as “primary snorers”, don’t stop breathing. Around 30% of the world snores (40% of men and 20% of women).

Conversely, people with OSA experience apneas – this is where breathing stops for 10 seconds or more. This puts strain on various systems in the body and can increase the risk of a number of disorders including stroke, diabetes, cancers and heart conditions.

Obstructive sleep apnea affects around 1-2% of the population, though it is thought that many more people are undiagnosed.

The factors that put you at risk of OSA also make snoring more likely, so how can you spot OSA over primary snoring?

What are the signs of OSA?

There are a number of symptoms which suggest you may be suffering from OSA:

  • Excessive sleepiness in the daytime

Side Note: What constitutes excessive?

We might all get a little sleepy during the day, but excessive sleepiness is where you are barely able to stay awake in a variety of day-to-day situations – not just a warm, dimly lit room with a belly full of lunch!

  • Persistent headaches in the morning
  • Sore throat upon waking up
  • Mood swings and difficulty concentrating

Whilst you may also experience these symptoms occasionally as a primary snorer or even a non-snorer, a persistent combination of all or most of them should be seen as a red flag.

Another crucial sign of OSA is if you have been observed gasping or choking in your sleep. For people who sleep alone, this can be very hard to recognise. This is where SnoreLab can help. So …

Can SnoreLab tell me if I have OSA?

This is a question we get asked a lot. However, it’s important to note that SnoreLab is not an automatic sleep apnea detector.

It is true that sleep apnea often has some very distinctive sounds – normal breathing followed by at least 10 seconds of silence and then a gasp or choke.

Whilst SnoreLab could detect this typical sound profile, sleep apnea is defined by apneic events and such events are not actually defined by sound.

An apnea is a period during sleep where breathing stops for at least 10 seconds.

Apnea is therefore identified by measuring both breathing effort and airflow (or lack thereof). A drop in blood oxygen saturation also helps to confirm this apneic event. Measuring this requires specialist equipment beyond the reach of a consumer app.

In SnoreLab, you can search your session for risky sounds using Full Night Recording mode to ensure that every sound and event is captured.

Some users have used this feature to discover sounds in their recordings that suggested apneic events. They have then found them useful in subsequent medical consultations. For many people, SnoreLab has helped flag sleep apnea they weren’t aware that they had.

How can I find out if I have OSA?

So if SnoreLab can flag sleep apnea but can’t diagnose, you may be wondering how to get a reliable idea of whether or not you have OSA.

There is a three step process to investigate potential OSA …

1. Do some screening tests

If your suspicions and symptoms are pointing to sleep apnea, check your risk by answering some screening questionnaires.

These are surveys that evaluate various symptoms and physical features to give you a risk score.

The Epworth Sleepiness Scale asks questions on your likelihood of falling asleep in certain scenarios like watching television or sitting in a meeting. Your answers can range from “Will never fall asleep” to “Very likely to fall asleep”. A score above 16 indicates excessive sleepiness and a risk of sleep apnea.

Take the Epworth Sleepiness Scale questionnaire

The StopBANG questionnaire looks beyond sleepiness at your weight, sex, age and snoring. The series of 8 yes/no questions helps to calculate your relative risk of sleep apnea.

Answer the StopBANG questionnare

2. Seek medical help

Armed with the symptoms, completed screening tests and some suspicious SnoreLab recordings, it is time to visit your doctor to investigate your potential sleep apnea in more detail.

These pieces of evidence is often enough to convince your doctor that a specialist referral is necessary. Many SnoreLab users have shown their recordings to their doctors …

“Made my doctor finally understand. I finally got the help I needed.”

“This app saved my life! Realized how bad my snoring was, saw a doctor to find out I have sleep apnea.

“MD wrote a prescription for me at a sleep study clinic. Interesting to see bad my snoring really is.”

Here, you could see an ENT (ear, nose and throat) specialist and/or be scheduled onto a sleep study.

3. Undergo a sleep study

A professional sleep study is the only way to get a reliable and quantifiable diagnosis of OSA.

During a sleep study, many measurements are taken to build up a picture of what is happening to your body during sleep. This not only helps to detect potential OSA, but also looks for other sleep disorders.

A sleep study can be performed in a specialist clinic or at home. To find out more about what to expect from home and clinic sleep studies, read SnoreLab’s article What Happens in a Sleep Study or have a look at Susan’s story – a firsthand SnoreLab user account of having a sleep study.

Is primary snoring nothing to worry about?

So if you know that you don’t have OSA and instead simply snore, great. But this is not a reason for complacency. Primary snoring should not be considered normal, harmless or inevitable.

Whilst primary snoring itself may not present a direct, short-term health risk to you, if you share a bed, the disturbance and sleep deprivation for your partner can have health implications for them.

There is also evidence to suggest that primary snoring is a slippery slope towards OSA and other conditions.

Obviously, the factors that put you at risk of sleep apnea (weight, sleeping position, sex, anatomy) also predispose snoring. But now, scientists are now discovering that the very action of snoring itself can increase the risk of developing sleep apnea.

One recent study found that primary snoring is linked to nerve damage in the muscles of the upper airway. This results in swallowing difficulties for snorers and makes obstruction more likely [2].

Conclusion

Primary snoring and obstructive sleep apnea can often get confused and incorrectly used interchangeably. Not all snorers have obstructive sleep apnea, but almost all OSA sufferers snore.

Whilst primary snoring is not directly harmful in the short term, it can be a slippery slope to future OSA.

It is important to understand your sleep apnea risk and to identify the factors that are making you snore.

References

  1. Hoffstein V, et al. Snoring: is it in the ear of the beholder? Sleep 1994; 17(6): 522-526. https://www.ncbi.nlm.nih.gov/pubmed/7809565
  2. Shah F, et al. Axon and Schwann Cell Degeneration in Nerves of Upper Airway Relates to Pharyngeal Dysfunction in Snorers and Patients With Sleep Apnea. Chest 2018; 154(5): 1091-1098. https://doi.org/10.1016/j.chest.2018.06.017

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