Question 1

As a layperson, almost everyone snores at one time or another. When does it become a problem, and how do we identify the right point to refer to an ENT?

Dr. Trisha Srivastava · Accepted Answer

It becomes a problem when it turns regular — daily snoring with mouth breathing and next-day tiredness, rather than a passing symptom during a cold or sore throat. It's an ignored symptom precisely because people say only their partner is disturbed. The referral triggers are: chronic nasal blockage affecting sleep, morning headaches, rising blood pressure in a young patient even if still technically normal, or snoring loud enough that family members are actively complaining. At that point it's time for a basic ENT exam to decide whether a sleep study or specific therapy is needed.

Question 2

Can you elaborate more on circadian rhythm and hormones in relation to sleep?

Dr. Trisha Srivastava · Accepted Answer

Stage 3 of non-REM sleep is when growth hormones are released, responsible for repairing the day's muscle wear and tear and, in children, for height and weight gain. If a patient isn't reaching stage 3 and stays mostly in light sleep, that reparative action doesn't happen and they feel tired the next day — in children, the consequence can be a genuine failure to grow as expected despite eating well.

Question 3

Can you elaborate more on the stages of sleep?

Dr. Trisha Srivastava · Accepted Answer

Every individual goes through 4 to 5 sleep cycles a night, each around 90 to 110 minutes, split into non-REM and REM sleep. Non-REM has three stages: N1 is the lightest — waking from it causes no brain fog; N2 and N3 together make up around 75% of total sleep, and it's in N3 that physical recovery, growth hormone release and cardiovascular recovery happen. REM follows, the dreaming stage, where memories are consolidated into long-term storage.

Question 4

How do patients find their way to your clinic for this problem?

Dr. Trisha Srivastava · Accepted Answer

It's a blend — mostly patients I've already treated referring others after a good outcome, some general awareness through social media, cross-referrals from other departments within Artemis, and GP referrals from outside the hospital, which make up roughly 20 to 30% of this OPD. GPs do a great job fixing the simple presentations themselves; it's when the problem isn't resolving that they refer on.

Question 5

Can taking wine at night help reduce snoring?

Dr. Trisha Srivastava · Accepted Answer

I haven't read that in any textbook or literature. Chamomile tea is said to calm the nerves and may help, and melatonin helps at night, but wine and alcohol generally disrupt sleep rather than improve it — alcohol causes dryness, and people often don't eat adequately alongside it, leading to a calorie deficit. If anything, it disrupts sleep rather than making it better.

Question 6

Can you compare CPAP and BiPAP?

Dr. Trisha Srivastava · Accepted Answer

A PAP machine is essentially an airway splint that sends a puff of air to open the blockage at the retropalatal or base-of-tongue level. CPAP delivers one continuous fixed pressure through both inspiration and expiration. BiPAP sets different pressures for each phase — for example 8 cm H2O on inspiration but only 4 cm H2O on expiration — which many patients who can't tolerate CPAP's constant pressure find more comfortable to breathe against.

Question 7

I've observed athletes complaining of lack of sleep after vigorous exercise. What is the relationship between vigorous exercise and poor sleep?

Dr. Trisha Srivastava · Accepted Answer

It could be related to the significant muscle wear and tear from extensive exercise, with the recovery process possibly interfering with sleep — but I have to be honest that I'm not certain about this specifically in athletes, and it would need further looking into.

Question 8

When people are very tired and sleep deeply, some who don't normally snore do snore that night. Is that physiological?

Dr. Trisha Srivastava · Accepted Answer

That's common, and it's physiological. After a hard day, tiredness itself can cause snoring that night, and that's fine — not every episode of snoring has to be branded a pathology. It's only when it becomes chronic and disrupts day-to-day life that it needs to be looked into.

Question 9

Can we say that snoring is more of a structural issue than a physiological one?

Dr. Trisha Srivastava · Accepted Answer

It's both. On the structural side, a blocked nose or another anatomical obstruction found on ENT exam explains the snoring directly — a very lean person with a badly deviated septum is the classic example, and fixing the septum sorts the problem. On the physiological side, obesity is a very common driver with no anatomical obstruction at all — soft tissue and neck fat simply collapse the airway during sleep, and lifestyle modification becomes the treatment rather than surgery.

The Science Behind Snoring

Questions Doctors Asked Dr. Trisha Srivastava