Snoring isn't always harmless: sleep apnoea is the epidemic we're not talking about

The Hindu

4 days ago

It usually starts with a joke: 'you snore like a tractor' or even, 'your snores shook the walls.' But snoring can go beyond jokes and a bit of fun. Interestingly, a 2024 Tamil film DeAr centred around a newly-married couple, Deepika and Arjun, where oddly, the wife's snoring becomes a point of contention, used both in comedic and emotional strains. The film sensitively portrayed how something as common as snoring can affect not just sleep, but relationships, self-esteem, and daily functioning. It also underlined a deeper truth, which is that snoring is not merely a social nuisance, it could be a clinical red flag.
Often dismissed as being caused by exhaustion or stress, snoring could actually signal a more serious, widely underdiagnosed condition, medically termed Obstructive Sleep Apnoea (OSA). Across India, particularly in urban and semi-urban populations, we are witnessing a steep rise in OSA diagnoses, especially among younger, working adults. A growing body of research suggests that up to 20% of Indian adults are affected, with many unaware that they even have it. Sedentary lifestyles, increasing hours of screen time, disrupted circadian rhythms, weight gain, and poor sleep hygiene are all contributing to this silent epidemic.
What exactly is OSA?
OSA is a condition in which the airway repeatedly collapses during sleep, causing breathing to stop for several seconds. These pauses, sometimes a few hundred per night, cause drops in oxygen levels, frequent arousals, and poor-quality sleep. The result? The body wakes up feeling as though it never rested. Classic symptoms include loud snoring, choking during sleep, excessive daytime sleepiness, memory lapses, mood swings, and unexplained fatigue.
Over time, OSA raises the risk of hypertension, Type 2 diabetes, obesity, cardiovascular disease, and even stroke and cognitive decline. However, it's important to note that snoring is not always OSA, but nearly all OSA patients' snore. That makes habitual snoring, especially with other red flags—a clinical concern, not a joke!
So why are we missing it? In my practice, many patients arrive only after years of misdiagnosis or neglect. One 34-year-old executive came in with fatigue and poor focus, previously told by physicians that it was burnout. A sleep study revealed moderate OSA. After undergoing coblation-assisted tongue-base and palatal surgery, his symptoms reversed almost entirely within six weeks. This isn't a rare case, and it's representative of a larger trend. Unfortunately, many people still associate OSA with older or overweight individuals. But today, we are seeing younger patients in their 20s and 30s, many with lean body types, develop sleep disordered breathing due to airway anatomy, postural habits, and nasal obstruction. T
The role of surgical precision
While Continuous Positive Airway Pressure (CPAP) therapy remains the first line of treatment, not all patients tolerate it well. For select cases, especially those with anatomical causes of obstruction, surgical interventions offer long-term relief. I have recommended minimally-invasive surgical options that use advanced coblation technology to gently reshape and open the airway. Recent medical studies have shown that this approach, especially when combined with soft palate procedures, can significantly reduce snoring, improve sleep quality, and restore energy during the day. These outcomes aren't just clinical—they're transformational. Patients regain their energy, confidence, and quality of life.
Where do we go from here?
It is time we reframe snoring and poor sleep as early warnings. So, if you, or someone in your family, snores loudly, wakes up choking, or feels excessively tired despite a full night's sleep, don't wait. A simple sleep study could change the trajectory of your health. Bear in mind that sleep is not a luxury, it is the foundation for physical and mental well-being. Let's treat it that way.
(Dr. Karthik Madesh Ratnavelu is a senior ENT and head & neck surgeon at SIMS Hospitals, Chennai. [e-mail])