Snoring May Be Both a Symptom and a Cause of Sleep Apnea

Snoring vibrations may weaken throat muscles by disrupting cellular energy.

A new study suggests that snoring may do more than annoy a bed partner. The vibrations produced by loud, repeated snoring may help damage the throat muscles that keep the airway open during sleep, making collapse more likely over time.

Repeated snoring is a warning sign of obstructive sleep apnea, but what the new study suggests is that these nasal vibrations can be both a symptom and trigger for the disease.

In obstructive sleep apnea, the upper airway repeatedly narrows or closes during sleep, cutting airflow and forcing the body to struggle for breath. Snoring, choking or gasping during sleep are among its common warning signs, according to the NIH’s National Heart, Lung, and Blood Institute.

“The vibrations themselves may contribute to the disease process,” said Farhan Shah, an associate professor at Umeå University.

A Lab Model of Snoring

To test the idea, researchers at Umeå University built a laboratory system that exposed rat muscle cells to recorded snoring vibrations. They used a 30-second snoring sound from a patient, looped it through a vibration platform, and exposed the cells for 8, 12, 24 and 48 hours.

The result was cellular stress on several fronts.

After eight hours, the cells showed what the authors described as a near-collapse in mitochondrial respiration. In plain terms, the mitochondria — the cell’s energy-producing structures — struggled to use oxygen and produce energy. The cells also lost much of their ability to switch to glycolysis, a backup energy pathway that helps cells cope when mitochondrial function falters.

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By 48 hours, oxygen use had partly recovered. But the cells still could not properly ramp up their backup energy system under stress. That suggests the damage was not simply a temporary shock.

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The cells seemed to sense the snoring vibrations as a mechanical threat, as evidenced by the activation of genes that help cells detect pulling, pressure and vibration.

But the response did not translate cleanly into repair. Some genes told the cells to make more mitochondrial components, yet the machinery that edits RNA and turns those instructions into working proteins appeared disrupted.

What Patient Tissue Showed

The team then compared the lab results with upper-airway muscle biopsies from 19 long-term snorers, 15 of whom had obstructive sleep apnea, and five healthy controls.

The patient samples showed disorganized mitochondria, reduced activity of a key mitochondrial enzyme called cytochrome c oxidase, and fewer capillaries supplying muscle fibers. In the study, all patients had a history of snoring, with an average duration of 20 years.

Earlier, a 1998 study described histological signs of a “progressive snorers disease” in an upper-airway muscle, suggesting local muscle and nerve abnormalities could contribute to airway collapse. A 2018 Chest study by Shah and colleagues linked degeneration of nerves in the soft palate to pharyngeal dysfunction in snorers and sleep apnea patients.

The new work adds a cellular mechanism: vibration may injure the energy systems that keep those muscles functioning.

Not Proof Yet

The lab model used rat muscle cells rather than living human airway tissue, and that’s perhaps the study’s major limitation. The vibration pattern mentioned earlier came from one recorded snore. The human biopsy group was small and mostly male. The work also does not show that treating snoring will prevent sleep apnea.

Still, the findings push snoring into a different category. It may not be merely a symptom that appears after the airway has become unstable. In some people, chronic vibration may be part of the process that makes the airway more vulnerable. It’s like a feedback system where more snoring makes things worse, including the snoring itself.

The researchers also see a broader connection to vibration injuries. NIOSH has long warned that vibrating hand tools can cause vascular and nerve problems in workers, including numbness, pain and blanching in the fingers. The throat is not a hand, but the principle is similar: repeated mechanical force can leave biological marks in cells.

The findings were reported in the journal Mitochondrion.