Snoring vs Sleep Apnoea: When Should You See a Specialist?
Simple snoring is noisy but generally harmless. Obstructive sleep apnoea (OSA) is different: it involves repeated pauses in breathing during sleep and is linked to serious health risks including heart disease, stroke, and chronic fatigue. You should see a specialist if your snoring is accompanied by witnessed breathing pauses, gasping, or excessive daytime sleepiness.
What Is the Difference Between Snoring and Sleep Apnoea?
Snoring occurs when air flows past relaxed tissues in the throat, causing them to vibrate and produce sound. Most adults snore occasionally, and simple snoring on its own is not a medical condition. It is more common in men, people who are overweight, and those who sleep on their back.
Obstructive sleep apnoea (OSA) is a medical condition where the airway repeatedly collapses or becomes blocked during sleep. Each episode, called an apnoea, lasts at least 10 seconds and can occur dozens or even hundreds of times per night. The brain briefly wakes the person to reopen the airway, fragmenting sleep and reducing oxygen levels.
The key differences:
| Feature | Simple Snoring | Obstructive Sleep Apnoea |
|---|---|---|
| Breathing | Continuous, no pauses | Repeated pauses and gasping |
| Oxygen levels | Normal | Drop repeatedly overnight |
| Daytime sleepiness | Unusual | Common and often severe |
| Health risk | Low (lifestyle impact) | Heart disease, stroke, diabetes, depression |
| Treatment urgency | Elective | Medically recommended |
Health Risks of Untreated Obstructive Sleep Apnoea
OSA is far more than a nuisance. When the airway collapses repeatedly during the night, the body's oxygen levels drop and the heart is placed under stress. Over time, untreated moderate to severe OSA is associated with:
- Cardiovascular disease: high blood pressure, heart failure, atrial fibrillation, and increased risk of heart attack
- Stroke: untreated severe OSA increases the risk of stroke significantly
- Type 2 diabetes: OSA contributes to insulin resistance independent of weight
- Motor vehicle accidents: drowsy driving from fragmented sleep is a leading cause of preventable road accidents
- Mental health: depression, anxiety, and cognitive impairment are commonly seen in untreated OSA
Research from Australian sleep health bodies estimates that OSA affects roughly 9 percent of Australian adults, with the majority remaining undiagnosed.
How Is Sleep Apnoea Diagnosed?
The standard diagnostic test for sleep apnoea is a sleep study, also called polysomnography. There are two types:
- Home-based sleep study. A portable device is worn overnight at home that monitors breathing, oxygen levels, and heart rate. Suitable for most suspected cases.
- In-lab polysomnography. An overnight study at a sleep clinic with more detailed monitoring, including brain activity. Used for complex cases or when home study results are inconclusive.
The study produces an Apnoea-Hypopnoea Index (AHI), which counts the number of breathing pauses per hour of sleep. Mild OSA is defined as 5 to 15 events per hour, moderate is 15 to 30, and severe is above 30.
Your GP can arrange a sleep study, or you can be referred to an ENT specialist or sleep physician for assessment. At Central Sydney ENT, our surgeons work closely with sleep physicians to coordinate diagnosis and treatment.
Treatment Options
CPAP Therapy
Continuous positive airway pressure (CPAP) is the gold-standard treatment for moderate to severe OSA. A mask worn during sleep delivers a gentle stream of air that keeps the airway open. CPAP is highly effective but requires nightly use. Some patients find the mask uncomfortable or struggle with compliance.
Mandibular Advancement Splint
A custom-fitted dental device that holds the lower jaw forward during sleep, preventing the tongue and soft tissues from collapsing into the airway. Suitable for mild to moderate OSA and for patients who cannot tolerate CPAP.
Surgery
ENT surgeons play a central role in managing OSA, particularly for patients who cannot use CPAP or have anatomical causes of airway obstruction. Surgical options include:
- Uvulopalatopharyngoplasty (UPPP): trimming excess tissue from the soft palate and throat to widen the airway
- Septoplasty and turbinate reduction: correcting nasal obstruction to improve airflow and CPAP tolerance
- Tongue base procedures: reducing tongue base collapse using radiofrequency ablation or other techniques
- Tonsillectomy: removing enlarged tonsils that are narrowing the airway
- Multilevel sleep surgery: combining procedures at multiple levels of the airway in a single operation for maximum benefit
Before recommending surgery, your ENT surgeon may perform a drug-induced sleep endoscopy (DISE): a brief procedure where a flexible camera is used to identify the exact sites of airway collapse while you are sedated. This helps tailor the surgical plan to your anatomy.
When Should You See an ENT Specialist?
Consider a referral to an ENT surgeon if you experience any of the following:
- Your partner has witnessed you stop breathing or choking during sleep
- You wake up feeling unrefreshed despite getting enough hours of sleep
- You experience excessive daytime sleepiness, difficulty concentrating, or morning headaches
- You have been diagnosed with OSA but cannot tolerate CPAP
- You have nasal obstruction, enlarged tonsils, or other structural issues that may be contributing
Central Sydney ENT has six FRACS-qualified ENT surgeons experienced in the full range of sleep surgery techniques, consulting across seven Sydney locations. Our surgeons include Dr Arjuna Ananda, Dr Sam Hwang, and Dr Jareen Ebenezer. Ask your GP for a referral, or call (02) 9747 3199.