Looking for the "facial features" of snoring. Why is snoring considered the culprit of many diseases?

After working in the diagnosis and treatment of snoring (obstructive sleep apnea-hypopnea syndrome, OSAHS) for a long time, I have a certain premonition about snoring. Sometimes, I can tell that a patient has severe snoring just by looking at his face, and he may not even come to see a doctor for snoring.

So some patients asked me: "Doctor, can you read faces? Can you tell if someone is snoring?" Of course, I am not a fortune teller, and I can't really read faces. But after being a doctor for a long time, I always have some experience to summarize, as if I have mastered the skill of "reading faces to identify diseases."

Snoring is a "small matter" that not everyone takes seriously. This seemingly minor disease often leads to serious consequences, but most people are not aware of it.

Many friends only discovered that their other diseases were related to snoring when they were asked whether they snore. I often see patients with chronic pharyngitis, tonsillitis, nasopharyngitis, and snoring, and I also often see patients with hypertension, diabetes, and coronary heart disease. They don't know that snoring may be the culprit.

Snoring is caused by sleep apnea at night and repeated hypoxia, so it can cause a series of various complications. As an ENT doctor, I will naturally associate these manifestations with it. Because snoring patients breathe with their mouths open at night, dry mouth is the most common symptom after a whole night's sleep cycle. In addition, severe snoring can sometimes cause reflux esophagitis. Most people sleep in a supine position, and the refluxed gastric acid can easily damage the throat mucosa. After waking up, they will find that swallowing saliva will cause a stinging sensation. Some patients usually have poorly controlled hypertension and diabetes, which is actually related to snoring and holding their breath at night. Long-term hypoxia causes hypercapnia and repeated stress reactions, and metabolic syndromes such as hypertension and diabetes follow. When we ask these patients whether they snore, they often do not realize the seriousness of snoring.

So how do I spot the signs of snoring? Or what are the "features" of people who snore?

The first is obesity, which may be the most intuitive feeling of everyone about snoring patients. Most adult snoring patients are male, and most of them are overweight. Many friends did not snore when they were young. After they gradually gained weight in middle age, their partners began to complain that their snoring at night was getting worse and worse, and sometimes they themselves did not know. It can be seen that weight gain is one of the common causes of snoring. Of course, for snoring, the location of obesity is also important. Generally, obesity in the neck, mandible and other parts has a significant impact on snoring. If you sleep on your back at night, the fat tissue in the neck and bottom of the mouth can easily further compress the airway in the throat and aggravate snoring.

Secondly, some patients are not necessarily obese, but often have a small mandible, commonly known as a "small jaw". In the outpatient clinic, I often encounter some snoring patients who do not seem to be fat but have a small chin, and many people are confused by this. In fact, this situation is not difficult to understand. Friends with small jaws have small space at the bottom of the mouth, short anterior-posterior diameter of the oropharynx, and the root of the tongue easily falls back, causing upper airway stenosis. Therefore, when I see friends with such faces, no matter whether they are fat or thin, I will ask them whether they snore at night.

In addition, when it comes to "face reading", there are many facial features that can be seen in snoring and even severe breath holding, such as complexion and lip color. Patients who snore severely at night will have purple or black lips and dark complexion due to lack of oxygen during sleep. Friends with this kind of face often have severe snoring.

In addition to adults, we pay more attention to the "face" when it comes to children's snoring. You may have heard of adenoid facies, which is a typical series of changes in facial bones and teeth and lips caused by long-term snoring and mouth breathing. Because the child's facial bones, especially the maxillary bones, are in a state of growth and development, this long-term state of open mouth can easily lead to deformities due to bone compliance growth. Eventually, adenoid facies appeared, manifested as protruding maxilla, uneven teeth, upturned lips, etc., so there is a saying that children who snore get uglier as they grow older. If you see a child with such a "face", you need to check and treat it quickly.

All "facial features" are, in the final analysis, subtle manifestations of disease. As an ENT doctor, I carefully observe and discover those subtle changes, find out the causes of the disease, and inadvertently help many people.