Snoring is considered very normal — perhaps because it’s not uncommon. According to the National Sleep Foundation (NSF) in the U.S., about 10% of children, 25% of adult women, and 40% of adult men, worldwide, snore. Despite its prevalence, however, it is not common knowledge that snoring can be a sign of a more serious condition, one that puts an individual a risk factor for future heart problems. Considering this, it’s important to know more about it rather than dismissing it as a bed-time annoyance.

What causes snoring?

Snoring occurs as a result of the tissues in the airway relaxing, which narrows the airway and constricts airflow. This causes a vibrating sound. The degree of restriction of air in the nose, mouth, or throat determines the volume of snoring.

Why do some snore and others don’t?

Snoring depends on anatomy. For instance, men snore more than women because their air passages are naturally narrower than women’s — the smaller the airway, the more difficult it is for air to be able to flow normally.

Those who have enlarged tonsils — that is, a certain set of lymph nodes in the back of the throat — are more likely to snore, as these enlarged glands can constrict the airway. Colds and allergies make snoring more likely, too, because of the associated nasal congestion and swelling of the throat.

Being overweight can be another reason why people snore. Excess fat build-up on the neck can constrict the airway when lying down, thus causing the vibrating sound.

The NSF states snoring could also be a result of a sinus infection; or a deviated septum – when the thin wall that separates the right and left nasal passages is displaced to one side; or because of nasal polyps, when the soft and painless benign growths on the lining of the nasal passages constrict the airways.

What does snoring signify?

Experts say consistent snoring signals underlying health problems. One of them may be sleep apnea. Sleep apnea is a sleep disorder in which breathing repeatedly stops — sometimes for as long as a minute — and starts, a pattern that causes the loud snoring. Sleep apnea is linked to cardiovascular diseases because the sudden drops in blood oxygen levels that occur when breathing stops cause an increase in blood pressure. These pauses in normal breathing also strain the cardiovascular system, increasing the risk of heart failure, stroke or coronary heart disease. But here’s a point to note — NSF states, “while sleep apnea almost always causes loud and regular snoring, just because you snore doesn’t mean that you have sleep apnea.”

Still, according to a 2013 study, the risk of cardiovascular diseases can begin with snoring, even before it can become sleep apnea. The study found changes in snorers’ carotid arteries — the major blood vessels in the neck that supply blood to the brain, neck, and face — even among snorers without sleep apnea. These changes, the study mentioned, occur most likely due to trauma and subsequent inflammation from the vibrations of snoring.

“Snoring is more than a bedtime annoyance and it shouldn’t be ignored. Patients need to seek treatment in the same way they would if they had sleep apnea, high blood pressure, or other risk factors for cardiovascular disease,” Dr. Robert Deeb, the study’s lead author and a part of the Department of Otolaryngology-Head and Neck Surgery at Henry Ford, a not-for-profit healthcare provider, reported Science Daily. “Our study adds to the growing body of evidence suggesting that isolated snoring may not be as benign as first suspected. So instead of kicking your snoring bed partner out of the room or spending sleepless nights elbowing him or her, seek out medical treatment for the snorer,” added Dr. Deeb.

Who gets sleep apnea?

Per Harvard Health, although sleep apnea is known to affect more men than women. However, after menopause, women are at a higher risk of developing the condition than they are before menopause due to declining “levels of the hormone progesterone (which increases the number of breaths per minute).”

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“Yet even then, far fewer women than men are diagnosed with the condition. This may stem in part from women’s reluctance to admit they exhibit the hallmark symptom of sleep apnea,” Dr. Lawrence Epstein, associate medical director for the Sleep Clinic at Harvard University-affiliated Brigham and Women’s Hospital, told Harvard Health. “I think the key is for women to recognize that they snore because it can represent a medical problem and it can be addressed.”

While snoring is one obvious symptom of sleep apnea, Dr. Epstein said, women should also look out for drowsiness, morning headaches, or changes in mood as indicators of the condition. Often, the common signs to look out for sleep apnea include observing the consistency and volume of snoring. The NSF states those with sleep apnea snore loudly and as frequently — almost every night even though they are otherwise healthy, i.e., not have a cold tht could be blocking the airway and causing the snoring.

Is snoring and/or sleep apnea treatable?

Dr. Epstein suggests for all snorers that it’s always better to see a doctor, who can recommend a sleep study to determine any underlying problem and its severity. In a study like this, sensors are used to record the sleeper’s brain activity, heart rate, blood pressure, breathing, and other measurements. “A sleep study can first confirm that apnea is indeed the problem, and second, assess the severity of sleep apnea. That’s important because the symptoms aren’t good predictors,” Dr. Epstein said.

On an individual level, though, one of the ways to prevent sleep apnea, and to treat it if the condition has been diagnosed, is to make some behavioral and lifestyle changes — for instance, by losing weight. Harvard Health states, “people who are overweight are more likely to have extra tissue in the back of their throat, which can fall down over the airway and block the flow of air into the lungs while they sleep. Though losing weight is easier said than done, it can yield real results. If overweight and obese people lose weight, it would make both sleep apnea and other health problems [such as heart disease] go away. Losing just 10% of body weight can have a big effect on sleep apnea symptoms. In some cases, losing a significant amount of weight can even cure the condition.”

For other non-sleep apnea-related snoring, reducing the intake of alcohol and sedative drugs along with not smoking could help snorers and any bedfellows achieve a more restful night, the NSF recommends. It also mentions medical treatment for allergy, to open up the airways for non-restricted breathing.

“Snoring is generally regarded as a cosmetic issue by health insurance, requiring significant out-of-pocket expenses by patients. We’re hoping to change that thinking so patients can get the early treatment they need before more serious health issues arise,” said Dr. Deeb.