Specialties · Sleep medicine
Adult snoring and sleep apnoea: when to investigate
Loud snoring every night, waking up tired and feeling sleepy during the day are signs worth investigating. Obstructive sleep apnoea is the repeated interruption of breathing during sleep, and it has consequences for the heart, blood pressure and attention. The test that investigates it is a sleep study, carried out at Clínica Rhinus in the patient's own home.
Medically reviewed by Prof. Aline Bittencourt, MD, PhD, CRM-MA 7562 · RQE 1832 Updated on
What happens in snoring and apnoea?
During sleep, the muscles of the throat relax. If the passage is already narrow, air accelerates to get through and sets the tissues vibrating: that is snoring.
When the narrowing is greater, the passage closes altogether. Breathing stops for some seconds, blood oxygen falls, and the brain responds with a brief arousal — one the person never registers — to reopen the airway. That is an apnoea. Repeated dozens of times an hour, it fragments sleep all night long.
This is why the commonest complaint is not “I snore”. It is “I sleep eight hours and wake up as though I had not slept at all”.
What are the signs?
During the night:
- Loud snoring, on most nights.
- Pauses in breathing, observed by whoever sleeps nearby.
- Choking or waking short of breath.
- Restless sleep, several trips to the bathroom.
- A dry mouth on waking.
During the day:
- A sense of unrefreshing sleep.
- Sleepiness in passive situations: meetings, traffic, television.
- Morning headache.
- Difficulty concentrating, irritability, memory lapses.
Why does treatment matter?
Untreated obstructive sleep apnoea is associated, in the medical literature, with poorly controlled hypertension, arrhythmias, higher cardiovascular risk, metabolic changes and increased risk of accidents from sleepiness at the wheel.
Treatment is not about stopping snoring so as not to disturb the person sleeping alongside. It is about giving back nights in which the body actually rests.
How is it investigated at Clínica Rhinus?
| Step | What it answers |
|---|---|
| ENT consultation | The pattern of the symptom and the contributing factors |
| Airway examination and nasal endoscopy | Where the narrowing lies: nose, palate, tonsils, tongue base |
| Type IV sleep study, at home | Whether there is apnoea and how many events per hour of sleep |
| Associated clinical assessment | Weight, blood pressure, medications, habits |
What are the treatments?
The plan is built from where the obstruction lies and how severe the apnoea is. The most frequent paths:
- Behavioural measures. Weight loss where there is excess weight, avoiding alcohol in the evening, adjusting sleeping position, treating nasal obstruction, sleep hygiene.
- CPAP. A device that keeps the airway open with air pressure overnight. It is the reference treatment for moderate and severe apnoea.
- Oral appliance. A device that repositions the jaw during sleep, indicated in selected cases, together with a dentist experienced in the field.
- Surgery. On the nose, palate, tonsils or other structures, according to the point of obstruction identified.
None of these options suits everyone. The choice depends on the test findings, on severity and on what each person can realistically adhere to — and a treatment used every night is worth more than an ideal treatment on paper that stays in a drawer.
Sources: Brazilian Association of Otorhinolaryngology and Cervico-Facial Surgery (ABORL-CCF) · Flint PW, Francis HW, Haughey BH, et al. Cummings Otolaryngology: Head and Neck Surgery. 7th ed. Elsevier; 2020. · Bento RF, Bittencourt AG, Voegels RL. Seminários em Otorrinolaringologia. Fundação Otorrinolaringologia.
Frequently asked questions
Questions about sleep medicine
Does everyone who snores have apnoea?
No. Simple snoring, without breathing pauses and without daytime sleepiness, may be just snoring. Apnoea is a different condition, in which breathing stops for seconds, many times a night. Only a sleep study reliably distinguishes the two.
When is it time to investigate?
When snoring is loud on most nights, when someone reports pauses in breathing, when sleep does not restore, or when there is sleepiness while driving or in meetings. The test that confirms the diagnosis and measures severity is a sleep study.
What is a sleep study?
It is a recording of sleep that allows the number of breathing pauses per hour to be calculated. Clínica Rhinus performs the type IV version, carried out in the patient's home, with sensors that monitor oxygenation, airflow and heart rate. Where a case requires the full laboratory study, the patient is advised on referral.
Does losing weight cure apnoea?
Weight loss usually reduces the severity of apnoea in people who are overweight or obese, and it forms part of treatment. But it is not the only variable: there are slim people with apnoea, owing to the anatomy of the airway. The plan is built case by case.
Does surgery cure snoring?
It depends on where the obstruction lies. Where the nose is the main factor, treating nasal obstruction helps. Where the problem is at the palate, the tonsils or the base of the tongue, there are specific procedures. The choice follows the physical examination, endoscopy and the sleep study result, never the complaint in isolation.