For many couples, this is a familiar conversation. One person complains about the noise, the other turns to the other side and goes back to sleep. Most of the time, nobody thinks much more about it.
But persistent, loud snoring can sometimes point to a sleep-related breathing problem, particularly when it occurs in someone who is overweight or obese.
One condition doctors look for in such cases is Obstructive Sleep Apnoea (OSA). During sleep, the upper airway can become narrowed or blocked, causing breathing to stop or become restricted for short periods. These episodes may happen several times during the night, and the person may not realise they are occurring.
The Person Snoring May Not Know There Is a Problem
This is one of the difficulties with sleep apnoea.
A patient may sleep for seven or eight hours and still wake up tired. They may feel sleepy during the day, develop morning headaches or have difficulty concentrating. Meanwhile, their partner may have already noticed loud snoring, gasping or pauses in breathing during the night.
In my practice, I often ask patients whether anyone has noticed changes in their breathing while they sleep. It is a simple question, but the answer can provide useful information.
Snoring alone does not mean that someone has OSA. But persistent loud snoring, especially when combined with other symptoms, should not simply be dismissed.
Why Is Obesity Connected With Sleep Apnoea?
There is a clear relationship between obesity and OSA.
Excess tissue around the neck and upper airway can make the breathing passage narrower. During sleep, when the muscles supporting the airway relax, the passage can become more prone to obstruction.
This can result in repeated interruptions in breathing.
That is why Dr. Shivanshu Misra believes sleep should be part of the conversation when patients with obesity report loud or persistent snoring.
The question is not simply, “Why do I snore?”
It is also, “Is my breathing being affected while I sleep?”
What Does This Have to Do With the Heart?
Sleep apnoea does not just affect sleep.
Repeated interruptions in breathing can cause changes in oxygen levels and place additional stress on the cardiovascular system. OSA has been associated with conditions such as high blood pressure, abnormal heart rhythms and cardiovascular disease.
This needs to be understood correctly. Snoring itself does not mean that someone is going to have a heart attack. The concern is the underlying sleep apnoea and the cardiovascular risks associated with it.
For someone who already has obesity, high blood pressure or other health concerns, persistent symptoms deserve proper evaluation.
Can Losing Weight Help?
Weight loss can improve OSA in many people with obesity.
As body weight decreases, there may be less excess tissue around the upper airway, which can reduce the tendency of the airway to become obstructed during sleep.
Research has also found improvements in OSA following bariatric surgery. A 2023 systematic review and meta-analysis covering 32 studies and 2,310 patients found reductions in BMI and the apnea-hypopnea index after bariatric surgery.
But there is an important point patients should understand: weight loss does not guarantee that sleep apnoea will disappear completely.
Some patients continue to have OSA even after significant weight loss and may require further evaluation or treatment.
Where Does Metabolic Surgery Fit In?
For people with severe obesity who have not achieved sufficient weight loss through non-surgical measures, metabolic or bariatric surgery may be considered when medically appropriate.
The purpose of surgery is to achieve significant and sustained weight loss. As weight decreases, several obesity-related health conditions may improve. Sleep apnoea can be one of them.
The decision to undergo surgery is individual. A patient’s weight, medical conditions, previous attempts at weight management and overall health all need to be considered.
My work in metabolic surgery has included both clinical practice and academic research. I have contributed to more than 56 national and international peer-reviewed publications and have been a co-author of eight books in metabolic surgery. In 2022, I was recognised as the Best Young Bariatric Surgeon of India.
These experiences have reinforced the importance of looking at obesity as a medical condition that can affect different parts of a patient’s health, including sleep.
So, Should You Get Your Snoring Checked?
Occasional snoring is common. But loud and frequent snoring deserves more attention when it comes with:
- Pauses in breathing during sleep
- Gasping or choking at night
- Excessive daytime sleepiness
- Waking up tired despite adequate sleep
- Morning headaches
- High blood pressure
- Obesity
If these symptoms are present, speak with a doctor about whether an evaluation for sleep apnoea is appropriate.
A sleep study may be recommended depending on the symptoms and clinical assessment.
Listen to the Person Sleeping Next to You
Often, the first person to notice a possible sleep problem is the person sharing your bed.
If your partner says that your snoring has become louder, that you stop breathing for periods during sleep, or that you frequently gasp at night, it is worth paying attention.
For Dr. Shivanshu Misra, treating obesity involves looking at the health problems that can accompany it. OSA is one of those conditions.
You do not need to assume that every snore is a medical problem. But when snoring becomes persistent and is accompanied by other symptoms, finding out what is happening during sleep can be a sensible first step.
This article is intended for general awareness and does not replace an individual medical consultation, diagnosis or treatment plan.
For more info visit: https://drshivanshumisra.com/
By Dr. Shivanshu Misra
“Your snoring is getting louder.”
