MBBS, MS(ENT)
Director & HOD – Otorhinolaryngology (ENT), AIG Hospitals, Hyderabad
Sleep apnea is no longer just a “snoring problem.” It’s a serious airway disorder where your breathing repeatedly stops during sleep. While obesity, age, and genetics play a role, ENT-related factors often determine how bad your sleep apnea becomes — or whether your CPAP treatment succeeds.
Three major ENT-relevant triggers stand out:
Nasal Obstruction
Alcohol-related airway collapse
Positional factors (sleeping on your back vs side)
This blog breaks down these factors in a simple, engaging, and clinical way — perfect for patient education.
Your nose is the “front door” of your airway. When something blocks it, the entire breathing system downstream collapses under pressure.
When your nose is blocked, you automatically switch to mouth breathing, which:
Causes the tongue to fall backward
Reduces airflow velocity
Increases airway resistance
Makes snoring louder
Triggers more collapses in the throat
This combination worsens obstructive sleep apnea (OSA).
A crooked septum narrows breathing passages, especially while lying down.
Swollen nasal tissues reduce airflow and worsen nighttime congestion.
Soft tissue growths that block both nostrils and increase mouth-breathing.
Inflamed mucosa, sneezing, and post-nasal drip trigger congestion — worst during seasons or nights.
Thick discharge + mucosal swelling = restricted airflow and sleep disturbances.
A blocked nose can make CPAP feel:
Too forceful
Impossible to tolerate
Drying and irritating
Improving nasal airflow significantly boosts CPAP adherence.
Medical therapy: nasal sprays, antihistamines, saline irrigation
Minimally invasive procedures: coblation turbinoplasty, septoplasty
Advanced nasal airway reconstruction for severe cases
Many patients don’t realise how a nightcap dramatically increases the severity of sleep apnea.
Alcohol:
Relaxes throat muscles excessively
Makes the tongue fall backward
Reduces the brain’s arousal response (you wake up slower during an apnea)
Worsens snoring intensity
Lowers oxygen levels significantly
This leads to longer, deeper, and more dangerous apnea events.
Oxygen levels drop faster and take longer to recover.
Sleep becomes fragmented, causing daytime sleepiness.
Because CO₂ retention is worse with alcohol.
Strong spirits → quickest muscle relaxation
Wine → histamine release → nasal congestion
Beer → carbonation + volume → worsen reflux + snoring
Avoid alcohol 3–4 hours before bedtime
If you drink occasionally, maintain strict positional control and ensure consistent CPAP usage
ENT evaluation is crucial if alcohol worsens snoring
Your sleep position strongly influences how easily your airway collapses.
When you lie on your back:
Gravity pulls the tongue backward
Soft palate collapses toward the throat
The airway narrows significantly
Snoring becomes louder and more frequent
This is called Positional Obstructive Sleep Apnea (POSA).
People with small jawlines or retrognathia
Those with enlarged tonsils or a long soft palate
Nasal obstruction patients
People with high BMI
Wider airway space
Reduced snoring
Fewer apnea episodes
Better oxygen saturation
Higher vibration of the soft palate
Obstruction at the tongue base
More severe apnea episodes
Special sleep belts
Anti-snore pillows
Smart wearable sensors that gently vibrate to turn you on your side
In severe cases, ENT evaluation + tongue base procedures
Positional therapy is especially effective when combined with nasal correction.
An ENT evaluation focuses on identifying the exact anatomical location of obstruction.
Nasal endoscopy
Drug-Induced Sleep Endoscopy (DISE)
CT scan for sinus/nasal cavity
Polysomnography (sleep study)
3D airway imaging / cephalometry
Septoplasty
Turbinate reduction
Nasal valve repair
Allergy control
Uvulopalatoplasty
Tonsil reduction
Palate stiffening
Tongue base coblation
Epiglottis procedures
Expansion Sphincter Pharyngoplasty (ESP)
Hypoglossal nerve stimulation
Multi-level airway surgery
The goal is to create a stable airway that resists collapse even during deep sleep.
Daily saline rinse, allergen control
No “nightcap” before sleep
Even a 5–10% reduction improves airflow
Use positional devices if needed
Reduce screen time, fix bedtime routine
Especially important if nasal obstruction is present
Sleep apnea is not just caused by obesity or lifestyle.
Often, the true culprits are structural ENT issues — a blocked nose, a collapsible airway after alcohol, or poor sleep posture.
By correcting these factors, patients experience:
Reduced snoring
Better sleep quality
Improved CPAP tolerance
Higher energy levels
Reduced risk of heart issues
If you suspect any of these triggers, an ENT consultation can make a life-changing difference.
MBBS, MS(ENT)
Director & HOD – Otorhinolaryngology (ENT), AIG Hospitals, Hyderabad
With over 28 years of experience, Dr. Srinivas Kishore Sistla is one of Hyderabad’s leading ENT surgeons, specialising in nasal disorders, airway evaluation, sinus disease, ear drum repair, laryngoscopy, congenital ear problems, and sleep-related breathing disorders. His evidence-based, patient-focused approach has helped thousands of patients breathe better and sleep healthier.
Consultation Location:
AIG Hospitals, Gachibowli, Hyderabad
Department of Otorhinolaryngology (ENT)
Survey No:136, Plot No 2/3/4/5, Mindspace Rd, Gachibowli, Hyderabad – 500032
Phone: 040 4244 4222