FOR many people, snoring is seen as merely a social issue , a source of complaints from a partner or embarrassment during trips and holidays. However, when it is persistent and loud, it may be the most obvious sign of a a medical condition with a significant impact on health: Obstructive Sleep Apnoea Syndrome (OSAS). OSAS occurs when, during sleep, the upper airway repeatedly collapses partially or completely. These obstructions cause pauses in breathing and a reduction in blood oxygen levels, leading to multiple brief awakenings throughout the night. Patients are rarely aware of these episodes, but they may notice that they wake up feeling tired, with the sensation of unrefreshing sleep, despite having slept for several hours. Themostcommon symptoms include loud snoring. breathing pauses observed by others, nighttime choking episodes, dry mouth upon waking, and morning headaches. During the day, excessive sleepiness, difficulty concentrating, persistent fatigue, irritability, and reduced work performance are common. In more severe cases, there is an increased risk of high blood pressure, cardiovascular disease, and metabolic disorders. It is important to emphasize that whenever snoring is present, sleep apnoea may also be present. For this reason, snoring should not be underestimated, particularly when associated with daytime fatigue or reports of breathing pauses during sleep. The treatment of sleep apnoea and snoring should be multidisciplinary, involving different specialties such as Pulmonology, Dentistry, Nutrition, and Otolaryngology. A thorough evaluation makes it possible to identify the factors contributing to airway obstruction and to define an individualized treatment plan for each patient. One of the central aspects in managing OSAS is weight control. Excess body weight is one of the main factors that worsen the condition, and weight loss can lead to significant improvement in svmptoms and in the severity of sleep apnoea. An ENT consultation allows for a detailed assessment of the structures of the upper airway , including the nose, nasal cavity, soft palate, tonsils, and base of the tongue , identifying anatomical changes that may contribute to snoring and sleep apnoea. In many patients, factors such as a deviated nasal septum, enlarged turbinates, enlarged tonsils, or excess tissue at the level of the palate promote airway collapse during sleep. Surgical correction of these alterations can improve airflow, reduce snoring, and, following appropriate evaluation, help decrease the severity of sleep apnoea. The most commonly performed procedures include nasal surgeries to improve nasal breathing and palate surgeries to reduce vibration and collapse of the structures at the back of the throat. The decision to proceed with surgery is made after a thorough consultation, taking into account symptoms, sleep study results, and each patient s anatomical characteristics. The goal is to determine whether surgical intervention will provide real benefit as part of a comprehensive treatment strategy. Surgery does not replace a broad and integrated approach to the condition. but it can be an important tool in appropriately selected patients, contributing to improved sleep quality, reduced snoring, and lower risks associated with sleep apnoea. At HPA, the Otolaryngology Department is dedicated to the evaluation and surgical treatment of sleeprelated breathing disorders, working closely with other specialties whenever necessary to ensure a comprehensive and personalized approach. If you snore loudly, if you have been told that you “stop breathing” during the night, or if you experience excessive daytime sleepiness, it is worth seeking medical evaluation. Snoring may be the first sign of a condition that should not be ignored , and when properly treated, it can lead to significant improvements in health and quality oflife. Il featureseportugalresidenti.com Nuno ONeill Mendes (ENT Specialist; Hospital Particular do Algarve = Alvor; Portuguese Medical Association No. 62933) Nuno O Neill Mendes