When snoring becomes pathological and how to treat it

Snoring is defined as the noise produced by the vibrations of the respiratory structures, mainly during inhalation. When air passes through the airways, the typical noise develops, which can be very intense, especially if the structures are narrow or partially obstructed.

“This sound occurs because during sleep, the muscles of the throat relax and can narrow the passage of air. Occasional snoring is common and can be caused by various factors; for example, the sleeping position, alcohol consumption the night before bed, or nasal congestion,” says Dr. Sorrenti.

While simple snoring can be just a nuisance, pathological snoring is associated with more serious sleep disorders.

Pathological snoring is characterized by being persistent, loud, and often accompanied by episodes of apnea, which are brief interruptions in breathing during sleep. These apneas can last from a few seconds to several minutes and can occur numerous times throughout the night, compromising sleep quality and posing health risks.

“Pathological snoring occurs when the patient snores every night, causing disturbances not only to their partner but also personal issues related to sleep quality,” continues Dr. Sorrenti. “This type of snoring is particularly disruptive, with a volume that interferes with the rest of those sleeping nearby and has negative effects on the patient's own sleep.”

Although it is not necessarily accompanied by significant apnea episodes, pathological snoring can be associated with sleep fragmentation, leading to consequences such as:

• Non-restorative sleep
• Morning headaches
• Cognitive difficulties

“Sleep is essential for cognitive processes and the well-being of both body and mind. Therefore, disrupted sleep can lead to a decline in physical and cognitive functions in the long term,” emphasizes Dr. Sorrenti.

The causes of pathological snoring are numerous, but the main cause is linked to an anticipatory phase of Obstructive Sleep Apnea Syndrome (OSAS).

“Snoring is the primary symptom of sleep apnea; therefore, we can consider pathological snoring as an initial phase of Obstructive Sleep Apnea Syndrome that develops over the following decades,” explains the otolaryngologist.

Other, less common causes include:

• Obstructions of the airways: such as anatomical abnormalities like a deviated nasal septum or enlargement of the tonsils and adenoids.
• Aging: With age, the muscles of the throat tend to lose tone, increasing the likelihood of airway obstruction during sleep.

As we have seen, pathological snoring is not just a nighttime nuisance; it can have serious health consequences. Some of the main complications include:

• Obstructive Sleep Apnea Syndrome (OSAS): the most serious and common consequence of pathological snoring.
• Daytime drowsiness and cognitive problems. The specialist states: “Interrupted sleep can lead to poor sleep quality, resulting in daytime drowsiness, difficulty concentrating, irritability, and an increased risk of road and work-related accidents.”

The diagnosis of pathological snoring generally begins with a comprehensive clinical evaluation by a specialist in otolaryngology. The otolaryngological examination includes the patient’s medical history and, usually, more specific tests for an accurate diagnosis.

“The diagnosis of pathological snoring can indeed be made through a test called polysomnography, which highlights the presence of snoring associated with mild oxygen desaturation,” adds Dr. Sorrenti.

For an accurate diagnosis, it is essential to consult highly specialized centers: Villa Erbosa has a dedicated service for the diagnosis and treatment of Obstructive Sleep Apnea.

The treatment of pathological snoring depends on the underlying cause and the severity of the problem. The most common treatments include:

• The use of a mandibular advancement device, or orthodontic bite.
• Surgical intervention.

“The use of a mandibular advancement device is particularly indicated in cases of obstruction caused by the position of the tongue. However, this mobile device requires the patient to wear it every night, which can be uncomfortable and cause pain in the jaw joint,” outlines the otolaryngologist.

“Surgical intervention, on the other hand, can sometimes be a more definitive solution: removing or reducing the tissues that obstruct the airways can help the patient return to their daily routine more quickly. Surgical procedures may include:

• Removal of the tonsils.
• Reduction of the tissues of the palate or tongue.
• Correction of anatomical abnormalities such as a deviated nasal septum.”

Preventing pathological snoring is possible by adopting a healthy lifestyle and taking certain precautions:

• Weight control: maintaining a healthy weight can significantly reduce the risk of developing pathological snoring.
• Avoid smoking and alcohol.
• Ensure good nasal breathing without resorting to prolonged use of decongestant sprays, which can impair nasal function over time.