Why Do I Snore or Grunt When I Exhale?

Most people are familiar with snoring that happens when breathing in, but some patients notice something different—grunting, puffing, or snoring sounds when breathing out during sleep. While this type of noise is less common, it’s often a sign that airflow is meeting resistance in the upper airway.

For many patients, especially those who don’t feel well-rested despite “normal” sleep studies, expiratory snoring can be an important clue that something deeper is going on.

What Causes Snoring or Grunting on Exhale?

Snoring on exhalation usually occurs when the airway becomes partially narrowed during sleep, and air is forced through that narrowed space as you breathe out. Unlike classic snoring, the mechanics are a bit different.

Below are the most common causes we see in clinical practice.

1. Partial Upper Airway Narrowing During Exhalation

As you fall asleep, especially during deeper sleep stages, muscles that normally keep the airway open begin to relax. This can cause narrowing in areas such as:

• The soft palate
• The uvula
• The tongue base
• The side walls of the throat

When you exhale, pressure from the lungs pushes air through this narrowed space, creating:

• A low-pitched grunt
• A short snore-like vibration

This pattern is commonly seen in mild obstructive sleep apnea (OSA) and upper airway resistance syndrome (UARS).

‍2. Soft Palate or Velopharyngeal Flutter

In some people, the soft palate vibrates as air exits the throat rather than when air is drawn in. This type of sound:

• Is often worse when sleeping on the back
• May come and go through the night
• Is usually noticed more by a bed partner than the sleeper

Patients often describe it as “puffing,” “chuffing,” or “breathy grunting.

3. Tongue Base or Retroglossal Airway Narrowing

If the tongue falls backward during sleep, airflow resistance can occur throughout both inhalation and exhalation. This is more common in people with:

• Nasal blockage
• A smaller or recessed jaw (retrognathia)
• Increased neck circumference
• TMJ or airway crowding patterns

As air exits the airway, resistance can produce audible expiratory sounds.

4. Increased Breathing Effort (Compensatory Response)

When airflow is restricted, the brain may subconsciously increase breathing effort to maintain airflow. This can lead to:

• Forced or audible exhalation
• Sleep disruption without full apneas
• Frequent micro-arousals

This pattern is frequently seen in early or mild sleep apnea and patients with fragmented sleep but normal oxygen levels.

5. Nasal Obstruction (A Contributing Factor)

Nasal blockage alone usually does not cause expiratory snoring, but it can make the problem worse by:

• Forcing mouth breathing
• Increasing throat turbulence
• Worsening soft palate vibration

 Common nasal contributors include:

• Deviated septum
• Enlarged turbinates
• Chronic nasal congestion or rhinitis

When Is Snoring on Exhale a Bigger Concern?

You should consider medical evaluation if expiratory snoring is accompanied by:

• Excessive daytime sleepiness
• Non-restorative or restless sleep
• Morning headaches
• Dry mouth or sore throat upon waking
• Witnessed pauses, gasping or choking
• Hypertension or heart rhythm issues

These symptoms can point to clinically significant sleep-disordered breathing, even when oxygen levels appear “normal.”

Why This Is Sometimes Missed on Sleep Testing

Expiratory snoring and airway resistance are often under-recognized, especially on basic home sleep studies. This is because:

• Oxygen levels may stay normal
• The issue is driven by repeated arousals, not drops in oxygen
• UARS and subtle obstruction can be overlooked

This is especially relevant for patients with:

• Chronic fatigue
• Migraines or morning headaches
• TMJ or airway-focused orthodontic issues 

These patients often have clear symptoms of sleep disruption but may have been told their sleep study was “normal” or showed only “mild” findings.

What Can Help Stop Snoring on Exhale?

Treatment depends on the cause and severity of symptoms, but may include:

• Positional therapy (side sleeping)
• Improving nasal airflow
• Oral appliance therapy
• Airway-focused evaluation by an ENT or sleep specialist
• In-lab sleep testing if symptoms persist 

Early evaluation often prevents progression to more severe sleep apnea.

Snoring Treatment and Sleep Doctor in Schaumburg, Rockford, IL & South Bend, IN

Snoring or grunting on exhalation during sleep is not just a harmless habit. In many cases, it reflects partial upper airway obstruction and increased breathing effort that disrupts sleep quality long before oxygen levels drop.

At Exhale Sinus, we help patients in Schaumburg and Rockford, Illinois, and South Bend, Indiana, identify the underlying cause of snoring and sleep-related breathing problems and create personalized treatment plans focused on long-term airway health.

If you or your bed partner has noticed unusual breathing sounds during sleep, or if you’re waking up tired despite a full night’s rest, a proper airway evaluation can provide clarity and real relief.