Clinical significance of snoring

Habitual snoring, nocturnal apnea, and excessive daytime sleepiness are leading symptoms of the obstructive sleep apnea syndrome. However, simple snoring without apnea is a more common and normal phenomenon. In certain habitual snorers increased upper airway resistance during sleep may lead to sleep fragmentation and hypersomnolence even in the absence of frank apnea; this condition is termed upper airway resistance syndrome. There is no convincing evidence that snoring in the absence of sleep apnea is an independent risk factor for cardiovascular disease. The evaluation of symptomatic snorers includes a specific history and physical exam, followed by a sleep study if treatment is considered necessary. The choice of treatment modality for snoring is guided by the individual needs and symptoms of the patient. Weight loss, nocturnal application of continuous positive airway pressure, or intraoral appliances which hold the mandible in protrusion during sleep are non-surgical treatment options. According to the patients' subjective assessment conventional or laser-assisted uvulo-palato-pharyngoplasty (UPPP) has a high cure rate for snoring. However, objective documentation of the effect of these interventions on measured snoring noise is scant.