Snoring is not a good sign. In Nepal, there is a proverb saying, “happy people snore” we called it as a  sound sleep. Every people desire to get a sound sleep in life but in a hustling chase of our daily life, everyone hardly snores every night! So are we not getting ample amount of sleep? To tell you the fact it’s a total myth. Snoring is distress cry, a sign of impending danger from a person who is having trouble breathing thus we are blessed not to snore every night. But there are some people who snore daily it’s obvious that it annoys the person who sleeps aside a snoring person, often it becomes a matter of laugh, embarrassment and to a greater extent can cause a dispute in sacred marital bond, not only these snoring can lead to serious health issues.

But there are some people who snore daily and it’s obvious that it annoys the person who sleeps aside a snoring person, often it becomes a matter of laugh, embarrassment and to a greater extent can cause a dispute in sacred marital bond, not only these snoring can lead to serious health issues.

Sometimes any alteration in the position of sleep will alleviate snoring, this clearly explains the ongoing transient blockage of airway pathway and can be physiological phenomena but sometimes snoring can be associated with some serious medical condition that is obstructive sleep apnea.

While we sleep the normal tone of the muscle decreases, it becomes flaccid, the same phenomena are observed in pharyngeal muscle activity which leads to airway collapse followed by transient apnea, hypoxia (low oxygen concentration in body) and hypercapnia (high carbon dioxide concentration in body) thus our body compensates it by increasing the ventilatory effort leading to arousal of brain to drive for respiration which then immediately stabilize apnea will by building the tone of muscle in respiratory pathway, it’s a vicious cycle which keeps on repeating multiple episodes per night and this is the hallmark for Obstructive sleep apnea. During this person may feel uncomfortable and gasps for air or may change their position of sleep, though they are unaware of all these.

Obstructive sleep apnea occurs when there is obstruction in airway passage due to anatomical abnormalities either due to obesity, enlarged tonsils, deviated inner cartilage of Nose, enlarged adenoid, big tongue, consumption of sedatives, and also observed in people who smoke and consume alcohol or  whenever there is any obstruction in the airway passage or when the flow of air to lungs will be compromised .There are multiple episodes of apnea observed in a person suffering from OSA, which will ultimately lead to easy fatigability, day time somnolence, lack of concentration in work, loss of libido, in children attention deficit disorder, poor academic performance and failure to thrive have been noted. Parents usually yell at their child for not bringing good grades but they are unaware regarding the pathological course of OSA the child is going through , they keep on  saying my child is a lazy chap  he/she  always sleeps with  snoring (giggles) just like adults, so it is prime responsibility of parents to observe their children behavior and cognitive function and seek medical attention early rather than just pressurizing the children.

Not all snoring are obstructive sleep apnea, but when people snore with frequent arousal along with day time symptoms can be diagnosed as a case of obstructive sleep apnea(OSA). OSA is a serious disease if not addressed properly can lead to hypertension, heart failure, and many more complication but it’s unusual in Nepal when we call snoring as a disease, people tend to laugh as they consider it as a content sleeping.

We can manage OSA by altering our lifestyle, weight reduction, sleep position maneuvers i.e.  avoiding supine sleeping rather a lateral decubitus position will help to relieve any obstruction, avoiding alcohol or sedative drugs at night and early medical check up to screen out any pathology is utmost essential.

Thus snoring should not be always limited to the physiological process, we must consult with a doctor and rule out any pathological cause, early diagnosis and treatment will prevent the dreadful complication like cardiovascular disorder, hypertension, failure to thrive in children and other psychological and social problems.

Dr. Shadichhya Giri is associated with Healthy Nepal Community Foundation.