Not just a nuisance: The truth about snoring

We’ve all heard people complain about their partner or housemate’s loud snoring. 

But snoring is more than just annoying – it may be a sign of medical issues that need attention.

What is snoring?

Snoring is one of the most common sleep disorders – studies have found that roughly 25% to 50% of adults snore regularly.

That familiar rumbling sound of snoring is essentially your airway rattling under pressure, explains Dr Vivian Govender, an ENT specialist at Mediclinic Midstream. “Humans are designed to be nasal breathers. So, when you breathe through your mouth, it means there is an obstruction to your nasal airways. Mouth breathing causes the surrounding soft tissues of the oral cavity to vibrate.”

What causes snoring?

“Snoring is often caused by a combination of factors,” says Dr Govender. “This why a one-size-fits-all solution rarely works.”

The cause often lies in the three key levels of the upper airway, he explains:

1. The nose, where issues such as a deviated septum, large turbinates, nasal polyps, allergies, or inflammation (such as sinusitis or hay fever) can restrict airflow. “When air struggles to pass through the nasal passages freely, it creates mouth breathing that leads to snoring.”
2. The nasopharynx, the area at the back of the nose. “Here, snoring may be caused by enlarged adenoids or a growth, both of which can narrow the airway and disrupt normal breathing during sleep.”
3. The oropharynx, the region at the back of the mouth and throat. “A soft or floppy soft palate or uvula, enlarged tonsils, and issues at the base of the tongue are common culprits. They can partially collapse or vibrate during sleep, producing the characteristic sound of snoring.”

Other contributing factors:

• Age. The muscles in your throat weaken as you get older and are more prone to collapsing during sleep
• Weight. Excess fatty tissue around the neck can compress your airway, making obstruction more likely
• Alcohol. This can relax the soft palate and throat muscles, causing them to collapse more easily during sleep.
• Sleep position. Sleeping on your back can cause your tongue to fall back, narrowing your airway.
• Smoking. Irritates and inflames the tissues of the nose and throat, increasing congestion and swelling

The health risks: why you shouldn't ignore snoring

“Many people think snoring is normal and harmless, but it isn’t,” says Dr Govender. “Persistent loud snoring can be a warning sign of obstructive sleep apnoea (OSA). This is a serious condition where your airway repeatedly collapses completely during sleep, causing breathing to stop for seconds at a time.” Left untreated, OSA can have a dangerous impact on your health.

• Cardiovascular disease. OSA is strongly linked to high blood pressure, irregular heart rhythms, heart attack and stroke.
• Type 2 diabetes. Disrupted sleep affects insulin sensitivity and glucose metabolism
• Daytime fatigue. Poor sleep quality can lead to concentration problems and memory issues.
• Mental health. Chronic sleep deprivation is associated with an increased risk of anxiety and depression
• Relationship strain. Your partner will also suffer significant sleep disruption.

“Even without OSA, habitual snoring that disrupts sleep quality is worth investigating and treating,” says Dr Govender. 

ENT treatments for snoring: What can be done?

• Treating nasal obstruction. If the problem is in the nose, treatment may include nasal sprays for allergies or inflammation, septoplasty (surgery to correct a deviated septum), or removal of nasal polyps.
• Tonsil and adenoid removal. Enlarged tonsils or adenoids are a common structural cause of snoring, especially in children and younger adults.
• Palate and throat procedures. Surgery to tighten or reduce the soft palate and uvula (uvulopalatopharyngoplasty or UPPP) can reduce throat vibration.
• Continuous positive airway pressure (CPAP). A CPAP machine delivers pressurised air through a mask during sleep to keep the airway open. “This isn’t a surgical procedure but can be very claustrophobic and unaesthetic for the wearer,” says Dr Govender.
• Mandibular advancement devices. These custom mouthguards, sometimes provided by sleep clinics, move the lower (mandible) jaw forward during sleep to prevent airway collapse. “In extreme cases, a maxillofacial surgeon may surgically move the lower jaw forward,” Dr Govender says.

“Surgery saved my relationship”

Matome Mogashoa, an IT specialist in Johannesburg, says getting medical help for his snoring was a game-changer for his relationship. “My partner couldn’t stand my snoring anymore – it had started to affect her quality of life and put a strain on us. I eventually sought help when she made me sleep in the spare room.”

Following a scope and CT scan, Magashoa was diagnosed with a deviated septum. “I recently underwent a septoplasty and sinus flush and have never felt better,” he says. “My breathing has improved so much, and I recover much faster after an intense workout at the gym. Even better, my snoring is so much softer and continues to improve as I heal!”

Don’t accept snoring as an unavoidable fact of life, say the experts. With the right assessment and treatment, most people can sleep and breathe far more peacefully. If you or someone you love snores regularly, talk to your GP or an ENT specialist today.