Snoring & Sleep Apnoea

Snoring affects approximately 40% of adults and can be more than just a nuisance—it may signal a serious condition called obstructive sleep apnoea (OSA). At Melbourne Nose and Sinus, our ENT surgeons specialize in diagnosing and treating the underlying causes of snoring and sleep-disordered breathing.

Whether your snoring is disrupting your relationship, affecting your sleep quality, or potentially indicating sleep apnoea, we can help you—and your partner—sleep better.

What Causes Snoring?

Snoring occurs when air can't move freely through your nose and throat during sleep, causing surrounding tissues to vibrate. Common anatomical causes include:

Upper Airway Structures:

  • Nasal obstruction - Deviated septum, enlarged turbinates, nasal polyps

  • Large tonsils or adenoids - Blocking the airway

  • Long or thick soft palate - Narrowing the opening from nose to throat

  • Elongated uvula - Vibrating tissue at back of throat

  • Thick tongue base - Falling back and blocking airway

Contributing Factors:

  • Excess weight (neck fat narrows airway)

  • Alcohol consumption before bed

  • Sleep position (worse when sleeping on your back)

  • Nasal congestion from allergies or infections

  • Aging (throat muscles lose tone)

  • Smoking

  • Medications that relax throat muscles

What is Obstructive Sleep Apnoea (OSA)?

Sleep apnoea is a serious sleep disorder where breathing repeatedly stops and starts during sleep. "Apnoea" means a pause in breathing lasting 10 seconds or longer.

Types of Sleep Apnoea:

  • Obstructive Sleep Apnoea (OSA) - Physical blockage of the airway (most common)

  • Central Sleep Apnoea - Brain doesn't send proper signals to breathing muscles

  • Mixed Sleep Apnoea - Combination of both types

At MNAS, we focus on obstructive sleep apnoea, which is related to nasal and throat anatomy.

Recognising the Signs

Nighttime Symptoms:

  • Loud, chronic snoring

  • Gasping or choking during sleep

  • Pauses in breathing (witnessed by partner)

  • Restless sleep

  • Frequent nighttime urination

  • Night sweats

  • Dry mouth or sore throat upon waking

Daytime Symptoms:

  • Excessive daytime sleepiness

  • Morning headaches

  • Difficulty concentrating

  • Memory problems

  • Irritability or mood changes

  • Falling asleep at inappropriate times

  • High blood pressure

When to See a Specialist: You should see an ENT specialist if:

  • Your partner reports that you stop breathing during sleep

  • You feel excessively tired despite "sleeping" 7-8 hours

  • Snoring disrupts your or your partner's sleep quality

  • You have morning headaches

  • You have difficulty staying awake during daytime activities

  • You have high blood pressure

Health Risks of Untreated Sleep Apnoea

Sleep apnoea is not just about poor sleep—it has serious health implications:

Cardiovascular Risks:

  • High blood pressure

  • Heart disease

  • Stroke

  • Irregular heartbeat (arrhythmia)

Metabolic Issues:

  • Type 2 diabetes

  • Weight gain and obesity

  • Metabolic syndrome

Other Complications:

  • Increased accident risk (from drowsy driving)

  • Depression and anxiety

  • Cognitive impairment

  • Reduced quality of life

  • Relationship problems

The good news? Treatment can dramatically improve or eliminate these risks.

Diagnosis at MNAS

Comprehensive Evaluation:

  1. Medical History

    • Sleep patterns and symptoms

    • Snoring history

    • Daytime alertness

    • Medical conditions

    • Medications

    • Family history

  2. Physical Examination

    • Nasal examination - Check for obstruction

    • Oral examination - Assess tonsils, palate, uvula

    • Throat examination - Evaluate tongue position

    • Neck examination - Check circumference (risk factor)

    • Body Mass Index - Weight assessment

  3. Nasal Endoscopy

    • Detailed examination of nasal passages

    • Identify structural issues

    • Assess nasal valve function

  4. Sleep Study (Polysomnography)

    • Gold standard for diagnosing sleep apnoea

    • Measures breathing, oxygen levels, brain waves, heart rate

    • Can be done at home or in sleep lab

    • Determines OSA severity (mild, moderate, severe)

    • We arrange this testing and interpretation of results through https://www.sleepservices.com.au

Treatment Options

Treatment depends on snoring cause, severity, and whether sleep apnoea is present:

Medical/Conservative Treatment:

  1. Lifestyle Modifications

    • Weight loss (even 10% can improve symptoms)

    • Avoid alcohol before bed

    • Sleep position training (side sleeping)

    • Quit smoking

    • Treat nasal allergies

  2. CPAP (Continuous Positive Airway Pressure)

    • Gold standard treatment for moderate-severe OSA

    • Delivers pressurized air through mask

    • Keeps airway open during sleep

    • Highly effective but requires nightly use

    • We help with CPAP tolerance and fit issues

  3. Mandibular Advancement Devices (MAD)

    • Custom dental appliance

    • Moves lower jaw forward

    • Opens airway during sleep

    • Good for mild-moderate OSA or primary snoring

    • We work with specialized dentists

Surgical Treatment:

When anatomical issues contribute to OSA/snoring, surgery may help:

  1. Nasal Surgery

    • Septoplasty - Straighten deviated septum

    • Turbinate reduction - Reduce enlarged turbinates

    • Functional rhinoplasty - Repair nasal valve collapse

    • Improves nasal breathing and CPAP tolerance

  2. Palate Surgery

    • Uvulopalatopharyngoplasty (UPPP) - Remove excess throat tissue

    • Laser-assisted uvulopalatoplasty - Less invasive palate surgery

    • Reduces palate/uvula vibration

  3. Tongue Base Surgery

    • Radiofrequency ablation - Shrinks tongue base tissue

  4. Tonsillectomy

    • Removes enlarged tonsils blocking airway

    • Very effective when tonsils are primary cause

    • Can be combined with other procedures

Multi-Level Surgery: Many patients benefit from combination procedures addressing multiple sites of obstruction (nose, palate, tongue base).

What to Expect from Treatment

CPAP Therapy:

  • Improvement often seen first night

  • Takes 2-4 weeks to adjust to device

  • Follow-up ensures proper pressure settings

Surgical Treatment:

  • Success rates: 60-90% depending on procedure and patient selection

  • Recovery: 1-2 weeks off work for most procedures

  • Full effect seen at 3-6 months post-surgery

  • Some patients still need CPAP but at lower pressures

Long-Term Management:

  • Regular follow-up appointments

  • Repeat sleep studies to confirm improvement

  • Ongoing weight management

  • Treatment of allergies/nasal issues

Why Choose MNAS for Sleep-Disordered Breathing?

Specialized Expertise Our ENT surgeons have specific training in sleep surgery and understand the complex anatomy of the upper airway.

Comprehensive Approach We evaluate all potential sites of obstruction and create individualized treatment plans.

Collaborative Care We work closely with sleep physicians, dentists, and other specialists to ensure optimal outcomes.

Cabrini Hospital Access to state-of-the-art surgical facilities and overnight monitoring if needed.

 FAQs

  • Snoring occurs when the flow of air through the mouth and nose is partially obstructed during sleep. This obstruction causes the tissues in the throat to vibrate, producing the sound associated with snoring. Several factors can contribute to this airway blockage, including:

    1. Anatomy: The structure of a person's airway can play a significant role. Conditions such as enlarged tonsils, a thick soft palate, or a long uvula can increase the likelihood of snoring.

    2. Nasal Issues: Blocked nasal airways due to allergies, a deviated septum, or sinus infections can force airflow through the mouth instead, increasing the chance of snoring.

    3. Body Position: Sleeping on the back can cause the tongue to fall backward into the throat, leading to obstruction of the airway.

    4. Weight: Excess body weight, particularly around the neck, can put pressure on the airway, making it more prone to collapse during sleep.

    5. Age: As people age, their throat muscles may lose tone, which can contribute to increased snoring.

    6. Alcohol and Medications: Consumption of alcohol or certain sedatives can relax the muscles in the throat, leading to constricted airways.

    7. Sleep Apnoea: This serious condition, characterised by repeated interruptions in breathing during sleep, often leads to snoring. It requires medical assessment and intervention.

    Understanding the various factors that contribute to snoring can assist individuals in managing or reducing its occurrence.

    When we breathe in, the side walls of the upper airway are kept open. However, if there are narrowings or the walls are weaker, then collapse can occur. Think of the scenario when you blow underneath a sheet of paper that is on a table - it lifts and flutters. However, if you blow gently or lift the paper further from the table or change it to a piece of card, the fluttering reduces. When we think about snoring, a blocked nose due to a deviated septum or polyps can impact airflow and result in snoring. Other factors including weight, and the structure of the palate, facial structure and palate can also contribute to snoring symptoms

  • Snoring is the sound produced during sleep when airflow through the mouth and nose is partially obstructed. It typically occurs when the soft tissues in the throat relax and vibrate as air passes over them. This can happen for a variety of reasons, including anatomical factors like the size and shape of the airway, nasal congestion, or obesity, which can lead to excess tissue in the throat.

    Snoring can have different implications for health. In some cases, it is benign and may simply be a nuisance to sleeping partners. However, loud and frequent snoring can indicate a more serious condition known as obstructive sleep apnoea (OSA), where breathing is repeatedly interrupted during sleep. This condition can lead to increased risks of cardiovascular issues, daytime fatigue, and other health concerns.

    Lifestyle factors such as sleeping position, alcohol consumption, and smoking can also contribute to snoring. Treatments may range from conservative approaches, like changing sleep positions or weight management, to medical interventions, including the use of continuous positive airway pressure (CPAP) devices or surgical procedures in more severe cases. Understanding the underlying causes of snoring is important, particularly if it disrupts sleep quality for the individual or their partner.

    Snoring means that the walls of the upper airway are vibrating and thus making sounds.

  • Snoring can become a significant issue when it disrupts not only the snorer’s sleep but also the sleep of others in close proximity. While occasional snoring is common and generally not a cause for concern, habitual loud snoring can indicate underlying health problems and can lead to various complications.

    For many, snoring may be a sign of obstructive sleep apnoea (OSA), a condition where breathing temporarily stops during sleep. This can result in fragmented sleep, excessive daytime fatigue, and increased risk of cardiovascular issues. Individuals with OSA may experience loud snoring, gasping, or choking during sleep, which can alert bed partners to the problem.

    In addition to health risks, snoring can cause relationship strain. Partners may struggle to find restful sleep, leading to irritability and decreased productivity during the day. This stress can accumulate over time, affecting overall relationship satisfaction.

    Treatment options for problematic snoring vary based on the severity and underlying causes. Simple lifestyle changes, such as altering sleep positions, reducing alcohol consumption, or maintaining a healthy weight, may help alleviate snoring

    Snoring more often causes issues for a partner and can sometimes be loud enough that they need to sleep in another room.

    However, snoring can be associated with blockage of the breathing passage resulting in pauses in breathing termed sleep apnoea. When this is significant, individuals may suffer from excessive tiredness and difficulty in concentration. However, it can also have negative health impacts on the heart and lungs by placing them at increased strain.

  • Snoring can often be managed and, in some cases, cured depending on the underlying cause. Here are some common approaches to consider:

    Lifestyle Changes

    1. Weight Management: Excess weight, particularly around the neck, can contribute to snoring. Losing weight may help reduce or eliminate snoring.

    2. Sleep Position: Sleeping on one's back can cause the tongue to fall back into the throat, leading to snoring. Sleeping on the side can alleviate this issue.

    3. Avoid Alcohol: Alcohol relaxes the throat muscles, increasing the likelihood of snoring. Reducing alcohol intake, especially before bedtime, can be beneficial.

    Medical Interventions

    1. Nasal Strips or Nasal Dilators: These can help to open nasal passages and improve airflow, reducing snoring.

    2. Continuous Positive Airway Pressure (CPAP): For individuals with obstructive sleep apnoea, a CPAP machine can help keep airways open during sleep.

    3. Dental Devices: Mandibular advancement devices can reposition the jaw and tongue to keep the airway open.

    Surgical Options

    In some cases, surgical interventions might be necessary. These can include procedures to remove excess tissue in the throat or nasal passages. However, surgery is typically considered after other treatments have been tried.

    Conservative measures including weight loss and changing sleep position to sleep more on your side, nasal sprays or splints that adjust the position of your jaw may be helpful. If sleep apnoea is suspected, consideration is given to a formal investigation to confirm its presence and severity. In these cases, initially a modality called CPAP may be tried which involves wearing a mask at night that helps keep the airways open.

    If simple measures are not beneficial, then addressing blockages in the nose through a septoplasty, turbinoplasty or sinus surgery are considerations. If this is not needed or not effective , then surgery on the palate, tonsils or tongue can be considered. Click this link to direct you to more information about surgery for the tonsils and palate.