For many people, this is a familiar complaint from a spouse or family member. The usual response is to turn to the other side, adjust the pillow and go back to sleep.
But persistent, loud snoring can sometimes be more than an inconvenience. In people who are overweight or obese, it may be one of the signs of Obstructive Sleep Apnoea (OSA), a condition in which the airway repeatedly becomes blocked or narrowed during sleep.
As Dr. Shivanshu Misra, a bariatric and metabolic surgeon, I often discuss this connection with patients because sleep problems can easily be overlooked when the main concern is obesity.
When Snoring Is More Than Just Snoring
Snoring happens when air passes through a narrowed airway and causes surrounding tissues to vibrate.
With OSA, the situation is different. The airway can become sufficiently narrow or blocked to interrupt normal breathing. These episodes can happen repeatedly through the night.
The person may not know that this is happening.
A partner may notice loud snoring followed by silence, gasping or a sudden change in breathing. The person experiencing it may simply wake up tired the next morning and assume they did not sleep well.
This is one reason Dr. Shivanshu Misra says that persistent snoring deserves a closer look when it occurs alongside obesity, daytime sleepiness, morning headaches or witnessed pauses in breathing.
Why Is Obesity Connected With OSA?
There is a well-established relationship between obesity and obstructive sleep apnoea.
Excess body tissue, including tissue around the neck and upper airway, can contribute to narrowing of the breathing passage. When the muscles relax during sleep, the airway may become even more vulnerable to obstruction.
This does not mean every person with obesity will develop OSA, and it does not mean everyone who snores has sleep apnoea.
But when the two occur together, it is worth asking whether the snoring is connected to an underlying breathing problem.
What About the Heart?
Sleep apnoea affects breathing repeatedly during the night. These interruptions can cause changes in oxygen levels and put additional stress on the cardiovascular system.
OSA has been associated with conditions such as high blood pressure, abnormal heart rhythms and cardiovascular disease.
It is important to make one distinction. Snoring itself does not mean that a person will have a heart attack. The concern is untreated OSA and the cardiovascular risks associated with the condition.
For patients who are already dealing with obesity, high blood pressure or other cardiovascular risk factors, persistent symptoms should not simply be ignored.
Can Losing Weight Help?
Yes, weight loss can improve OSA in many people with obesity.
Reducing body weight can decrease the amount of excess tissue around the upper airway and may reduce the frequency and severity of breathing interruptions during sleep.
Research has found improvements in sleep apnoea following significant weight loss. A 2023 systematic review and meta-analysis covering 32 studies and 2,310 patients found that bariatric surgery was associated with reductions in body mass index and the apnea-hypopnea index, which is used to measure the severity of OSA.
Weight loss does not guarantee that sleep apnoea will disappear completely. Some patients continue to have OSA even after substantial weight reduction and may still require sleep assessment or treatments such as CPAP.
That is why the patient's progress needs to be followed after treatment.
Where Does Metabolic Surgery Come In?
For patients with severe obesity who have not achieved adequate weight loss through lifestyle measures, metabolic or bariatric surgery may be considered when medically appropriate.
The primary purpose is to achieve significant and sustained weight loss. Improvements in obesity-related conditions can follow, and OSA is one condition that may improve with substantial weight reduction.
The decision to undergo surgery is individual. BMI, existing medical conditions, previous attempts at weight management and the patient's overall health all need to be considered.
Dr. Shivanshu Misra has spent years working in bariatric and metabolic surgery, with his work extending beyond the operating room into academic research and surgical education.
He has more than 56 national and international peer-reviewed publications and has contributed as a co-author to eight books in the field of metabolic surgery. His published work covers areas including bariatric procedures, long-term surgical outcomes, complications, metabolic health and minimally invasive surgery.
In 2022, Dr. Shivanshu Misra was awarded the Best Young Bariatric Surgeon of India, adding to his academic and professional work in the field.
This background is important because obesity treatment requires an understanding of what happens before, during and after surgery. Weight loss is one part of the process. The health conditions connected with obesity also need attention.
When Should You Get Your Snoring Checked?
Occasional snoring is common. But it is worth speaking to a doctor if loud snoring is accompanied by:
● Pauses in breathing during sleep
● Gasping or choking at night
● Excessive daytime sleepiness
● Waking up tired despite getting enough hours of sleep
● Morning headaches
● High blood pressure
● Obesity
A doctor may recommend further evaluation, including a sleep study, depending on the symptoms.
The important thing is not to diagnose yourself based on snoring alone.
Listen When Someone Says You Snore
Often, the first person to notice a possible sleep problem is not the patient. It is the person sleeping next to them.
A comment such as “You stop breathing in your sleep” or “Your snoring has become much louder” should not automatically be dismissed.
For Dr. Shivanshu Misra, conversations around obesity are also conversations about the health problems that can accompany it. Sleep apnoea is one of them.
If obesity and persistent snoring are present together, it may be time to look beyond the noise and find out what is actually happening during sleep.
Sometimes, the complaint about your snoring is the first clue that your body needs attention.
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/
