Many people will snore. All snorers don’t have sleep apnea. Spectrum of disease; snoring, apneic spells, choking sensation, if it goes to too much severity, you get a sleep disordered breathing, excessive daytime sleepiness then we call it obstructive sleep apnea and the spectrum is obviously hyperventilation where you have a central component to it. Snoring will be there if you have any upper respiratory infection or viral infection or allergic rhinitis, or you take allergic antihistamines or decongestants. This is just snoring. Anything more than that snoring is affecting your quality of life and it has more of nocturnal symptoms like suddenly breathing stops in the night time or heart rate variability happens too much and oxygen falls frequently. When it starts affecting your day time symptoms, you feel unrefreshed in the day time and you feel fatigue and tired and excessive daytime sleeping. Based on the diagnostic criteria once you have the apneahypopnea index of more than 5 then we call it as sleep apnea in adults. So sleep apnea requires treatment based on the severity. If it is mild we have a dental and other modalities of treatments like weight reductions, positional therapies and lifestyle modifications. There are certain surgeries available if there is any mechanical problem especially in a pediatric age group and if it is severe they need a positive airway pressure therapy or a CPAP therapy. So sleep apnea or snoring has to be distinguished. All snoring doesn’t require a screening for sleep apnea. If somebody is having snoring and they have daytime symptoms based on Epworth sleepiness scale. Different types of questionnaires are there. Stop bang questionnaire and many other scoring systems are there. If somebody is having snoring and choking sensations and if they are having daytime symptoms then we suspect obstructive sleep apnea. So sleep apnea and snoring are a spectrum. It may start up with snoring and end up having sleep apnea if at all your weight increases and other risk factors develops.
