Could your loud snoring be trying to tell you something?

In India, loud snoring is often the butt of family jokes, dismissed at dinner tables or on train journeys. Yet behind the humor lies a public health crisis. Obstructive Sleep Apnea (OSA), in which breathing repeatedly stops during sleep, is estimated to affect 104 million Indians. The fallout is severe: higher cardiovascular risk, fatal road accidents, and widespread fatigue.

A 2023 systematic review and meta-analysis in Sleep Medicine Reviews finds that roughly 11% of Indian adults suffer from OSA, with prevalence of 13% in men and 5% in women. Moderate-to-severe OSA affects 5% of adults, translating to nearly 104 million Indians, of whom 47 million have serious forms. Despite its scale, OSA remains dangerously underdiagnosed.

The trivialization of snoring is more than a quirk—it’s a barrier to timely care. “In India, joking about snoring prevents families from recognizing it as a warning sign," Dr Harish Chafle, senior consultant chest physician and sleep disorders specialist at Gleneagles Hospitals, Parel, Mumbai explains. Western nations medicalize snoring faster, but stigma and underdiagnosis persist everywhere. Dental sleep medicine specialist Dr Nupur Jhunjhunwala pushes the point: “Snoring is not a marker of restful sleep—it is a warning sign that airflow is obstructed. People who snore, who feel persistently lethargic, or who fall asleep easily during the day—whether while driving, sitting, or even chatting after lunch—should all be evaluated for sleep apnea."

Consider the case of Amit Srivastava, a 31-year-old IT professional from Lucknow. “My snoring habit was often pointed out by family. I ignored it, thinking it was stress or low immunity. But I began falling asleep anywhere—during meetings as early as 11.30am in the morning, when I should have been alert. Doctors kept telling me to focus on nutrition. Finally, a dentist I saw for a toothache mentioned sleep apnea. That changed everything."

Pulmonologist Dr Tanvi Bhatt of Zynova Shalby Hospital, Mumbai, sees the dismissal of sleep as part of a cultural blind spot. “Indian society tends to treat sleep as a routine biological need rather than recognizing it as a vital marker of health," she says. Patients rarely ask about apnea directly; they stumble on the diagnosis while seeking help for diabetes, hypertension, or cardiac issues. Urban India also faces what Bhatt calls a “lifestyle paradox." Fitness apps and gyms flourish, yet obesity, stress, and erratic schedules climb. “This paradox undermines the very wellness efforts people pursue," she says, pointing to surging cases of apnea and insomnia.

PYSICAL ATTRIBUTES THAT CAN CAUSE APNEA

Anatomical and structural factors can cause obstructive sleep apnea (OSA) in individuals. This includes:

1. Obesity: Excess fat around the neck, tongue, and throat narrows the airway.
2. Large tonsils or adenoids, that are common in children, can block airflow.
3. Nasal obstruction in the form of deviated septum, chronic sinusitis and nasal polyps.
4. Craniofacial structure, i.e. small lower jaw, receding chin, high palate, or an enlarged tongue can reduce airway space.
5. Thick neck circumference with greater soft tissue around the airway.

Dr Chafle attributes nearly half of India’s OSA burden to lifestyle—obesity, poor sleep hygiene, chronic stress. The rest stems from genetics or anatomy, leaving some vulnerable regardless of lifestyle. Sleep apnea is not gender-neutral. Women often present with atypical symptoms—fatigue, insomnia, mood changes—easily misattributed to stress or hormones. “This delays diagnosis and denies many women timely treatment in India," says Chafle. Cases in children are equally startling.

Jhunjhunwala recalls a nine-year-old misdiagnosed with ADHD. “He struggled in school, couldn’t keep up in sports, and became breathless quickly," she says. A sleep study revealed severe apnea. “Once treated, his academics improved, his athletic ability returned, and there were no ADHD signs. This was a misdiagnosis rooted in unrecognized sleep apnea." The case shows how oxygen deprivation can mimic behavioral disorders. It also underscores a dentist’s role in spotting risks early. “Dentists are uniquely placed to notice skeletal issues or underdeveloped jaws that can cause airway problems later," she explains. “Intervening early can even prevent sleep apnea—but only if dental professionals are trained in sleep medicine."

TREATING THE CONDITION

Even with a diagnosis, however, OSA treatment faces hurdles. Continuous Positive Airway Pressure (CPAP) machines – which use a single pressure setting to keep the airways open – remain the gold standard, but compliance is low in India. “This is due to lack of awareness, stigma, and cost," says Chafle. Bhatt adds that discomfort, embarrassment, and poor follow-up worsen the problem. Sustained engagement, she argues, is key to adherence. Dentists offer another option: custom oral appliances that reposition the jaw. “Advancing the lower jaw enlarges the airway and allows more air to pass during sleep," explains Jhunjhunwala. “For many, it can be a viable alternative to CPAP—though it requires specialized dental training."

Meanwhile, an August 2025 study from Eternal Heart Care Centre and Research Institute in Jaipur, India, suggests that regular shankh (conch shell) blowing may improve moderate obstructive sleep apnea (OSA). Over six months, participants practicing forceful, sustained exhalations through the shell experienced a 34% reduction in daytime sleepiness, better sleep quality, and fewer apnea events compared with those doing a sham deep-breathing exercise. Researchers credit the effect to strengthening muscles of the upper airway, including the throat and soft palate.

Tanisha Saxena is a Delhi-based independent journalist. She writes stories that are on the intersection of art, culture and lifestyle.