Sleep apnea and snoring are closely related sleep-related breathing disorders that affect airflow during sleep and can have serious long-term health consequences if left untreated. While snoring alone may be benign, it often represents partial airway obstruction and can be an early warning sign of obstructive sleep apnea (OSA), a condition characterized by repeated episodes of complete or partial upper airway collapse during sleep.

Obstructive sleep apnea occurs when the muscles of the throat relax excessively during sleep, causing narrowing or blockage of the airway. This leads to intermittent pauses in breathing, oxygen desaturation, and repeated arousals from sleep. Common anatomical contributors include enlarged tonsils, elongated soft palate, thickened uvula, tongue base collapse, nasal obstruction due to deviated septum or turbinate hypertrophy, and obesity-related airway narrowing. Central sleep apnea, which is less common, results from impaired brain signaling to breathing muscles.

Symptoms of sleep apnea are often more noticeable to bed partners than to the patient. Loud, habitual snoring, choking or gasping during sleep, restless sleep, and observed breathing pauses are classic features. Patients commonly experience excessive daytime sleepiness, morning headaches, poor concentration, memory problems, irritability, and reduced work performance. Children with sleep apnea may present with hyperactivity, learning difficulties, bedwetting, or poor growth rather than sleepiness.

Diagnosis begins with a comprehensive ENT evaluation focusing on the upper airway, nasal passages, oral cavity, and neck structures. A detailed sleep history is essential. Definitive diagnosis is made through sleep studies, either in-laboratory polysomnography or validated home sleep testing, which measure breathing patterns, oxygen levels, heart rate, and sleep stages.

Management of sleep apnea and snoring is individualized based on severity, anatomical findings, and patient factors. Lifestyle modification, including weight reduction and sleep position adjustment, plays a foundational role. Continuous positive airway pressure (CPAP) therapy remains the gold standard for moderate to severe OSA, but tolerance varies. ENT-directed treatments address anatomical obstruction and may include nasal surgery, tonsillectomy, uvulopalatopharyngoplasty, or tongue base procedures. Oral appliances may be suitable for selected patients.

Untreated sleep apnea is associated with hypertension, heart disease, stroke, diabetes, and increased accident risk. Early ENT-led diagnosis and treatment significantly improve sleep quality, overall health, and long-term outcomes.