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Snoring in adults

William C Frey, MD
James A Rowley, MD
Section Editor
M Safwan Badr, MD
Deputy Editor
April F Eichler, MD, MPH


Snoring is a sound produced by vibration of the soft tissues of the upper airway during sleep. It usually occurs during inspiration, but can also occur during expiration. Habitual snoring is common, occurring in 44 percent of males and 28 percent of females who are between 30 and 60 years of age in the general population [1]. Occasional snoring is almost universal [2].

Snoring is indicative of increased upper airway resistance and increased pharyngeal collapsibility. Snoring, particularly if loud and habitual, may indicate the presence of obstructive sleep apnea (OSA), a sleep disorder characterized by obstructive apneas and hypopneas that occurs when upper airway resistance is sufficient to disrupt sleep. Snoring can also be associated with conditions that narrow the upper airway, including obesity, nasal congestion, craniofacial abnormalities, hypothyroidism, acromegaly, and adenotonsillar hypertrophy. These conditions, in turn, may cause snoring without OSA, or snoring that occurs as a symptom of OSA. It is important to recognize the clinical features of conditions associated with snoring so that objective testing can be performed and treatment initiated, if indicated. (See "Overview of obstructive sleep apnea in adults".)


While the symptom of snoring is an acoustic phenomenon, the presence of snoring can indicate significant upper airway pathophysiology. Snoring is associated with upper airway narrowing, increased upper airway resistance, and pharyngeal collapsibility, which may range from mildly abnormal to severely elevated [3]. (See "Pathophysiology of obstructive sleep apnea in adults".)

At relatively low levels of upper airway resistance, there may be snoring without sleep disruption or symptoms of disturbed sleep.

As upper airway resistance increases, there is a compensatory increase in respiratory effort in order to maintain ventilation. The increased effort may be associated with transient arousals from sleep. Patients with these respiratory effort-related arousals were previously diagnosed with upper airways resistance syndrome (UARS) if the respiratory effort-related arousals were accompanied by symptoms of disturbed sleep [4,5]. However, UARS is no longer distinguished from obstructive sleep apnea (OSA), and such patients are now considered to have OSA [2]. (See "Polysomnography in the evaluation of sleep-disordered breathing in adults", section on 'Respiratory effort-related arousals'.)


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Literature review current through: Sep 2016. | This topic last updated: Jun 28, 2016.
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