UNC Health Care

Snoring vs. Sleep Apnea – Is There a Difference?

Nobody likes to share a bed with a snorer. It’s funny at times, but it’s mostly a sleep stealer and sometimes even a marriage strainer. Turns out it might be even more serious than that.

Snoring is a major symptom of a serious condition called sleep apnea, characterized by interrupted breathing throughout the night. It’s a disorder that carries serious long-term health consequences.

“Snoring is a marker of the airway being narrow, so it can be a sign of something more sinister, like clinical sleep apnea.”

“Snoring is a marker of the airway being narrow, so it can be a sign of something more sinister, like clinical sleep apnea,” says Adnan Pervez, MD, pulmonologist and joint medical director of the REX Sleep Disorders Center.

Quiz yourself to find out what you know about snoring, sleep apnea and how to tell the difference between the two.

Sleep apnea has consequences that simple snoring does not.
TRUE Both snoring and sleep apnea can disturb your sleep and your partner’s, but sleep apnea causes even more problems. It causes a person to wake up many times during the night, often gasping for air. This leads to daytime fatigue and reduced functioning. Sleep apnea is associated with heart disease, stroke and obesity, and it can result in accidents because sufferers are sometimes too tired to safely operate vehicles.

Sometimes snoring is no big deal.
TRUE, BUT … Snoring can be an isolated phenomenon—that is, someone can snore and not have sleep apnea. But some people who snore might have apnea and not know it, because the nighttime disturbances and daytime fatigue are subtle, Dr Pervez says. It’s possible to have minor symptoms and still have bad enough apnea that treatment is required. Plus, some research indicates that people who snore have higher blood pressure.

When we snore, the noise comes mostly from the nose.
FALSE When you’re awake, the muscles in your throat are engaged to keep your airway open. When you fall asleep, those muscles relax, and the soft tissues in the mouth and neck tend to collapse inward, creating an obstruction to the flow of air. To overcome the reduced flow, the person may unconsciously try harder to breathe. Snoring is the sound of that soft tissue fluttering in response to airflow. The nose is a stiff structure, so it doesn’t vibrate.

If you’ve got heart disease, you’re more likely to have sleep apnea.
TRUE Sleep apnea is related to several cardiovascular problems and other medical conditions, though the evidence for some associations is stronger than for others. There is a strong link between sleep apnea and heart arrhythmias (disorders of irregular heartbeat). Sleep apnea is also a risk factor for stroke and can affect insulin resistance, leading to diabetes.

Sleep apnea is also a risk factor for stroke and can affect insulin resistance, leading to diabetes.

People with sleep apnea die because they can’t breathe in the middle of the night.
MOSTLY FALSE The potentially fatal consequences of sleep apnea, such as heart disease, generally occur over time. When someone with sleep apnea stops breathing during sleep, the body senses it and steps in. “Your brain wakes you up so you can take a breath,” Dr. Pervez says. However, it’s possible for a drop in oxygen to cause immediate death in someone suffering from advanced heart disease or another severe condition. The risk of death also depends on the severity of sleep apnea.

The most common type of sleep apnea is obstructive sleep apnea.
TRUE That’s what we’ve been discussing here: a blocked upper airway causing frequent wake-ups. A much less common type is called central sleep apnea, when the airway is open, but the brain does not send a signal to breathe. This type is sometimes seen in people with advanced heart disease or neurological disorders. Often, it consists of pauses in breathing or slow breathing followed by periods of rapid breathing.

If you don’t snore, you don’t have sleep apnea.
FALSE Most people with sleep apnea snore, but it’s possible to have sleep apnea without its most well-known symptom. Snoring is a natural response to reduced airflow and low oxygen levels, but not everyone’s body responds that way. Also, you may snore and not know it, especially if your bed partner is a heavy sleeper or you sleep alone.

There are many oral medications to treat sleep apnea.
FALSE You don’t take a pill to cure sleep apnea. (Though sometimes medicines, such as decongestants, can help symptoms.) Treatment consists of a device such as a continuous positive airway pressure (CPAP) machine, which is a mask on the face that delivers pressurized air to keep the airway open. CPAPs are the gold standard, but there are other options, such as dental devices that adjust the position of the jaw or tongue. In some cases, surgery can help. But for people with sleep apnea who are overweight, dropping pounds may be the best place to start. “Weight loss has the potential to cure sleep apnea,” Dr. Pervez says. “It can at least make it better.”

Sleep apnea is unlikely to get better, even with treatment.
FALSE Sleep apnea treatment combined with weight loss is often effective, Dr. Pervez says. He’s seen the major difference it can make in his patients’ lives. “They had this overwhelming sense of tiredness and fatigue and a mental fog, and when that lifts, it can be a night-and-day difference.”

We can help you figure out if it’s just snoring or sleep apnea. Find a doctor near you or learn more about our sleep disorder services in Orange County and Wake County. You can also take our free online SleepAware assessment to find out if you’re at risk for a sleep disorder.

Adnan Pervez, MD, is a sleep medicine physician with REX Pulmonary Specialists and joint medical director of the REX Sleep Disorders Center.