Snoring vs. Sleep Apnea: What’s the Difference?
Snoring is the sound a person makes during sleep when muscles and tissues in the upper airway — including the soft palate, uvula, and tongue — relax. The airway becomes crowded and narrow, causing air to flutter and vibrate these soft tissues as it passes through. Snoring in and of itself isn’t typically considered harmful, but sometimes snoring — especially loud, frequent snoring — can be a sign of obstructive sleep apnea.
Obstructive sleep apnea is a sleep disorder in which the airway transiently narrows so much that it obstructs breathing. This happens multiple times a night and causes a drop in blood oxygen levels and disrupts sleep, as the person generally wakes up or passes into a lighter sleep stage to resume breathing.
Sleep apnea is associated with a host of long-term health effects. Simple snoring is thought to have fewer health consequences and may not require treatment unless it’s disrupting sleep for others in your household.
Some people with OSA experience longer periods of partially restricted breathing, called upper airway resistance syndrome (UARS). UARS is more common in thin females, and it can be harder to diagnose. However, UARS does cause sleep disruption and it requires treatment just like regular OSA.
Conversely, some people with sleep apnea don't snore. For example, if the airway is completely closed, there is no snoring.
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When Does Snoring Mean Sleep Apnea?
If you snore loudly and frequently, there’s a good chance you have obstructive sleep apnea. However, not everyone who snores has OSA. Snoring is more likely to indicate sleep apnea if you snore loudly on a majority of nights and you also have other symptoms, such as:
- Unrefreshing sleep
- Excessive daytime sleepiness
- Waking up gasping or choking
- Frequent awakenings (more common in females)
- Waking with a dry mouth or sore throat
- Lapses in breathing during sleep, as observed by a bed partner
- Morning headaches
- Mood swings
- Memory and concentration problems
- Nocturia (frequent nighttime urination)
- Bruxism (teeth grinding)
- Nocturnal heartburn
- Heart palpitations
- Night sweats
How Do You Know if You Have Sleep Apnea?
The only way to know if you have sleep apnea is to do a sleep study. Before ordering a sleep study, your doctor will conduct a careful assessment to gauge how likely it is that you have OSA.
They’ll start by asking you questions about your symptoms, medical history, and pertinent risk factors. They’ll check to see if you have anatomical features that obstruct your airway, such as:
- Obesity
- Nasal congestion
- Deviated septum
- Nasal polyps
- Narrow palate
- Large tongue
- Large tonsils
- Receding chin
- Thick neck
If your doctor thinks it’s likely you have OSA, they’ll send you for a sleep study. Sleep studies are traditionally performed in a lab with a technician on-hand. The sleep study tracks your heart rate, breathing patterns, and brain waves, to identify when your sleep is interrupted by breathing pauses, as well as eye movements, muscle tone, leg movements, EKG, respiratory effort, and oxygen levels.
In straightforward cases, you might be able to do your sleep apnea test at home. Home sleep studies, like the one offered by Sleep Doctor, use simple, easy-to-wear sensors to monitor breathing patterns, oxygen levels, and heart rate while you sleep in your own bed. These tests are convenient and can help diagnose obstructive sleep apnea, though they may not capture as much detailed information as an in-lab sleep study. If a home sleep apnea test is inconclusive, in-lab testing is recommended to definitively assess the condition.
Based on the data collected during your sleep study, you’ll get an AHI (apnea-hypopnea index) score, which confirms the presence of sleep apnea and determines severity:
- Mild sleep apnea: 5 to 14 breathing events per hour
- Moderate sleep apnea: 15 to 29 breathing events per hour
- Severe sleep apnea: 30 or more breathing events per hour
How Is Sleep Apnea Treated?
OSA treatments aim to keep the airway open in order to stabilize breathing. Many OSA treatments also work for snoring, although they might not be covered by health insurance plans if you don’t have sleep apnea.
- CPAP therapy: CPAP therapy delivers pressurized air through into the airway while you sleep. Considered the gold-standard OSA treatment, CPAP therapy effectively improves breathing during sleep and reduces daily symptoms.
- Oral appliances: Two categories of oral appliances can be used to treat OSA. Mandibular advancement devices (MADs) resemble a mouthguard and gently position the lower jaw forward to open up the airway. Tongue-retaining devices (TRDs) use suction to hold the tongue forward and prevent it from falling back into the throat.
- Hypoglossal nerve stimulation: Hypoglossal nerve stimulation, also known by the brand names Inspire or Genio, uses an implanted device like a pacemaker for the tongue to deliver electrical signals to the nerve that controls the tongue. This moves the tongue forward, which prevents it from blocking the throat.
- Surgery: People with an obvious anatomical feature restricting airflow, such as large tonsils or nasal polyps, may benefit from surgery to correct these features. Surgery comes with risks, and the benefits may not be permanent. Also, surgery may mask sleep apnea by eliminating snoring but not the underlying cause, so it’s wise to schedule follow-up sleep studies.
- Weight-loss medication: Zepbound (tirzepatide) is the first FDA-approved medication for OSA and obesity. By promoting weight loss, it can help reduce weight-related OSA symptoms.
- Lifestyle changes: Lifestyle changes that help reduce OSA symptoms include getting regular exercise; avoiding smoking, alcohol, and sedatives; and maintaining a healthy body weight.
- Sleep position: Many people find that breathing worsens when sleeping on their backs. Switching to side sleeping or elevating the head by 20 to 30 degrees may help cut down on symptoms.
When to See a Doctor
You should see a doctor if you snore loudly and have other symptoms of sleep apnea, such as unrefreshing sleep. If you sleep with a partner, it’s a good idea to bring them along to your appointment. They can share information about your snoring and breathing patterns during sleep.
People who identify as a woman or were assigned female at birth may experience symptoms such as morning headaches, anxiety and depression, night sweats, bruxism, insomnia, or restless sleep rather than snoring and obvious breathing problems. Ask your doctor about sleep apnea if you meet the criteria for sleep apnea in women.
Frequently Asked Questions
Can you have sleep apnea without snoring?
It’s possible to have sleep apnea and not snore. Obstructive sleep apnea without snoring is more common in people assigned female at birth and people who have previously had upper airway surgery.
Is obstructive sleep apnea the same as snoring?
Obstructive sleep apnea isn’t the same as snoring. Snoring is the sound produced by air passing through the airway, while OSA is a medical condition in which disrupted breathing affects sleep quality. However, if you snore, it’s possible you might have obstructive sleep apnea. The only way to know for sure is to do a sleep study.
Does CPAP stop snoring?
CPAP therapy helps open up the airway and as a result, it’s an effective treatment for snoring. However, most insurance companies only cover the cost of CPAP for sleep apnea and not for snoring on its own. Lifestyle changes like side sleeping, avoiding alcohol before bed, using nasal decongestants, and working towards a healthy weight may help cut down on snoring.
You may also be able to reduce snoring with upper airway exercises called myofunctional therapy or nasal dilator strips. These treatments aren’t sufficient to fully treat sleep apnea, so they should only be used if you’re positive you don’t have OSA.
Do I need a sleep study if I snore?
A sleep study is the only way to diagnose sleep apnea. If you snore loudly on a regular basis, and especially if you have other symptoms of sleep apnea, tell your doctor. They can decide if you need a sleep study to rule out sleep apnea or another medical condition.
