When snoring becomes a death sentence
By Shahista Namale
In many African households, the rumbling sound of a sleeping relative who snores is met with laughter and a sense of satisfaction — proof, as the common saying goes, that the person is truly enjoying their rest.
But according to leading pulmonologists at Makerere Lung Institute, that cultural comfort may be costing lives.
Speaking during a special public lecture commemorating World Sleep Day in Kampala, Dr. Ivan Kimuli a specialist in sleep medicine, warned that snoring must no longer be dismissed as harmless.
“Snoring is the most common and most visible sleep-related breathing disorder,” Dr. Kimuli told an online audience of clinicians, students and health professionals. “And it is frequently dismissed as normal or harmless. But it could be a warning sign of underlying disease.”
Snoring occurs when the muscles of the upper airway — including the tongue — relax during sleep and partially block the passage of air. As air forces its way through the narrowed space, it causes the surrounding tissues to flutter and vibrate.
That vibration is the snore.
According to Dr. Kimuli, approximately 20% of women and 40% of men snore. Of those who snore, roughly one in three may have a more serious underlying condition: Obstructive Sleep Apnea (OSA) — a state in which the airway doesn’t just narrow but collapses entirely, causing the sleeper to stop breathing altogether.
“When the tongue falls back completely and blocks the airway, the individual stops breathing,” he explained. “The brain then detects falling oxygen levels and jolts the person partially awake to restart breathing. This happens repeatedly throughout the night — sometimes more than 30 times an hour — without the person ever knowing it.”
The consequences of untreated obstructive sleep apnea reach far beyond a tired morning. Each episode of stopped breathing triggers a cascade of physiological stress: oxygen drops, the nervous system surges into high alert, and the blood vessels are repeatedly strained.
Over time, this nightly assault on the body contributes to some of the most serious chronic diseases in Uganda and across Africa.
Dr. Kimuli listed the complications as high blood pressure, heart disease, stroke, type 2 diabetes, depression, and — critically in a country with high road traffic fatalities — accidents caused by drivers falling asleep at the wheel.
“Untreated sleep disorders have contributed significantly to heart diseases, accidents, and low productivity,” he said.
Dr. Kimuli also highlighted a link that many patients and even some clinicians overlook: if you are being treated for high blood pressure or an irregular heart rhythm and the medication is not working as expected, obstructive sleep apnea may be the reason your body is not responding optimally to treatment.
While anyone can develop sleep apnea, Dr. Kimuli identified a cluster of risk factors particularly relevant to Uganda.
Men are more commonly affected than women — a difference linked to the protective role of estrogen in maintaining muscle tone in the upper airway. However, this gap narrows significantly after women reach the age of 60 as estrogen levels decline.
Obesity is a growing risk factor as Uganda urbanises. Alcohol consumed within two to three hours of bedtime acts as a muscle relaxant and can trigger or worsen airway collapse. Sleeping pills — which many Ugandans are increasingly turning to — carry the same risk.
Smoking, structural features such as a small chin or deviated nasal septum, large tonsils in children, and sleeping flat on one’s back all compound the danger.
External influences such as shift work as well as watching screens late at night can reduce the body’s natural sleep hormone.
The good news, is that obstructive sleep apnea is treatable. Options range from simple lifestyle changes to advanced medical devices, depending on severity.
Lifestyle changes are the first line of defence. A weight loss of more than 10% of body weight has been shown to meaningfully reduce OSA severity. Avoiding alcohol and sleeping pills, quitting smoking, and sleeping on one’s side rather than the back can each make a significant difference. Wedge-shaped pillows can prevent a person from rolling onto their back during the night.
Continuous Positive Airway Pressure (CPAP) therapy is the gold-standard medical treatment. A mask worn over the nose and mouth connects to a small machine that continuously pushes pressurised air into the airway, preventing it from collapsing. “It keeps the airway continuously positively pressured,” Dr. Kimuli explained.
“People breathe better, sleep better, and their cardiovascular risk falls.”
