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PubMed2003

By the way, doctor. Three years ago, my husband went to a sleep clinic for his snoring. He was diagnosed with moderate sleep apnea and given a continuous positive airway pressure (CPAP) device. He has been sleeping like a baby ever since--and so have I. Here's my question: when he reapplied for life insurance, his rating went from super-preferred to borderline insurable. Is there that much risk, even though he faithfully wears his mask every night? I would warn anyone who has a snoring problem to get life insurance before going to the sleep clinic!

Explore the source record for details and available documents.

Fees and Charges↗
PubMed1998

Normative data on snoring: a comparison between younger and older adults.

Snoring is a common sleep-related behaviour. Increased body mass index (BMI), cranio-facial anatomical features, and older age have been linked to the occurrence of snoring. While mostly middle-aged populations have been studied for the occurrence of snoring and sleep-related breathing abnormality, this study was designed to assess the subjective report of snoring and the objective measurement of snoring at the two extremes of human age. The study design called for measurement of snoring in two age groups (college students; n=155 and older subjects; mean age 64.1 yrs n=134) with a mean age difference of 45 yrs. Snoring was assessed with a validated recording device. A validated questionnaire was used to subjectively assess snoring and obtain relevant sleep-related information. Students and older subjects differed in the self-report of snoring. While 83% of students reported "never" or "rarely" snoring only 35% of older subjects fell into these categories. Measurement of snoring during sleep revealed that students spent more time during sleep with continuous snoring than older subjects. In older subjects, a reduction in continuous snoring was accompanied by an increase in apnoeic snoring. Subjective snoring frequency correlated with continuous snoring in students only. A positive family history of snoring increased the odds ratio for self-reported snoring but not for recorded snoring. It has been shown that snoring frequency can vary depending on age and that the congruency between perceived snoring frequency and recorded snoring is influenced by the age of an individual.

Adult↗
PubMed2005

Prevalence and association of snoring, anthropometry and hypertension in Korea.

OBJECTIVES: There is little data on the relationships between hypertension and snoring in Asians, whose anthropometrics and prevalence of diseases are different from Western populations. This study evaluated the prevalence and the factors associated with snoring in an adult Korean population (18 years). METHODS: The questions on snoring were divided into five Likert scales ["never" to "severe"(everyday)]. Subjects were divided into two mutually exclusive groups: moderate and severe groups of snorers considered habitual snorers, and never, sometimes and mild snorers considered the non-snoring group. We classified the severity of hypertension according to JNC 6. Independent variables included demographic and baseline characteristics, hypertension, anthropometrics, current medical history, medications and substance use. RESULTS: Overall prevalence of habitual snoring is 15.58% in males and 8.40% in females. The mean age, body mass index (BMI), both systolic and diastolic blood pressure, and anthropometric data, including neck, chest and abdominal girth, were significantly associated with the snoring group in both men and women. Neck length was only significantly shorter in females, not in males. Alcohol consumption rate was significantly higher in the snoring group of the men, but was lower in the snoring group in women. Smoking did not show any significant relationship with snoring and non-snoring groups in both genders. Snoring was significantly higher in the menopause group (odds ratio 2.8) than the premenopausal group. Fifty per cent in the snoring group and 33.08% in the non-snoring group were diagnosed as having hypertension. The prevalence of hypertension was significantly higher in the snoring group aged<40 years and was weakly significant in those subjects aged between 40 and 60 years in males. The prevalence of hypertension was significantly higher in the snoring group in those both aged<40 years and those aged between 40 and 60 years in females. Those aged>60 years old in both genders showed no significant differences in the prevalence of hypertension between snorers and non-snorers. The relationship between hypertension and snoring after adjustments for age, BMI, age, smoke and alcohol usage showed a dose-response relationship in both genders. CONCLUSIONS: This study showed the dose-response relationship between hypertension and snoring, even after adjustments for age, BMI, age, smoke and alcohol usage. Snoring significantly increased after menopause in women. Snoring had a significant relationship with neck length in females but not in males. There is a dose-response relationship between snoring and hypertension in both genders in those subjects aged<60 years old.

Adult↗
PubMed1995

Snoring, family history, and genetic markers in men. The Copenhagen Male Study.

BACKGROUND: No studies have attempted to examine the genetic influence on the habit of snoring. The aim of the present study was to examine whether an association existed between self-reported snoring and family history of snoring and a number of genetic markers. MATERIAL AND METHODS: The data were derived from a primarily cardiovascular disease cohort study of 3,387 men aged 54 to 74 years. A number of sleep-related questions were included. Some 3,308 men had given valid questionnaire information on snoring and whether they had their own bedroom due to snoring and were regarded eligible for the present study. Men who reported that they snored often or always were considered habitual snorers, and those who reported that they seldom or never snored were considered nonsnorers. We considered habitual snorers who reported that they had their own bedroom due to snoring to be a group with a presumably more severe form of snoring. Information about other health and lifestyle parameters was obtained from a comprehensive questionnaire. Four major blood groups were determined: ABO, Rhesus, MNS, and Lewis, together with complement C3. A saliva sample was taken for determination of ABH secretor status. RESULTS: There was a strong relationship between habitual snoring and family history of snoring among grandparents, parents, siblings, and children. Odds ratios were from 2.4 to 4.2, and all associations were significant (p < 0.05). In multivariable analysis, the factor which most strongly separated habitual snorers from nonsnorers, was self-reported habitual snoring among family members. Looking at habitual snorers only, the factors most strongly separating those with their own bedroom due to snoring from those without, were the Lewis blood group phenotype, Le(a+b-) (29.6 vs 18.8%; p < 0.001; age, 63.4 vs 62.1 years; p < 0.01), and selfreported family history of habitual snoring (35.2 vs 29.0%; p < 0.05). CONCLUSION: There was an overall strong association between habitual snoring and family history of snoring. Among habitual snorers, two genetic markers and age, were the only factors that separated men who had their own bedroom due to snoring from others. The results of this study indicate that snoring, to some extent, is hereditary.

Age Factors↗
PubMed2004

Snoring and atopic disease: a strong association.

The prevalence and factors associated with snoring and habitual snoring in Asian children are largely unknown. Our objectives were to evaluate the prevalence and factors associated with snoring and habitual snoring in preschool and primary school children in Singapore. A self-response questionnaire on snoring was administered to parents of children aged 4-7 years in randomly selected preschools and primary schools in Singapore. The overall response rate was 91.3% (nt = 11,114). Snoring and habitual snoring were reported in 28.1% and in 6.0% of the children, respectively. On multivariate logistic regression analysis, snoring was significantly associated with male gender, race, atopy (asthma, allergic rhinitis, or atopic dermatitis), maternal atopy (allergic rhinitis or atopic dermatitis), maternal smoking, and breastfeeding. Habitual snoring was significantly associated with obesity (odds ratio (OR), 3.75; 95% confidence interval (CI), 1.67-8.42), allergic rhinitis (OR, 2.90; 95% CI, 2.06-4.08), atopic dermatitis (OR, 1.80; 95% CI, 1.28-2.54), maternal smoking (OR, 2.22; 95% CI, 1.09-4.53), and breastfeeding (OR, 1.49; 95% CI, 1.11-1.98). Atopy was the strongest risk factor for habitual snoring, and the effect was cumulative. The odds ratio of a child with all three atopic diseases (asthma, allergic rhinitis, and atopic dermatitis) to have habitual snoring was 7.45 (95% CI, 3.48-15.97). In conclusion, snoring and habitual snoring are common in Asian children. Atopy is strongly associated with snoring and habitual snoring. We suggest that children who are significantly atopic receive additional attention during screening for snoring, habitual snoring, and other features of obstructive sleep apnea syndrome.

Child↗
PubMed1995

The acoustic properties of snores.

This study was undertaken in an attempt to characterize the acoustic properties of snoring sounds in the time and frequency domains, and to correlate between these properties and the mechanical events underlying their production. Three experimental set-ups were used: 1) Dog model--six mongrel dogs, in which partial upper airway obstruction was created by an implanted supraglottic balloon. Flow, supraglottic pressure, and snoring sounds were recorded during different degrees of obstruction. Fifteen to 20 snores from each dog (total 100 snores) were analysed. 2) Simulated human snores--Six simulated snores from each of four subjects were recorded in two locations (trachea and ambient) with simultaneous airflow, and their correlations examined. 3) Snoring patients--snores were recorded with an ambient microphone from nine subjects with "heavy" snoring and no obstructive sleep apnoea (OSA). Forty to 50 snores from each subject were analysed (total of 400 snores). The snoring sound was analysed in the time (time-expanded waveform) and frequency (power spectrum) domains. After analysing these snores, we were able to identify two dominant patterns which are distinctly different from each other: the "simple-waveform" and the "complex-waveform". The complex-waveform snore is characterized by repetitive, equally-spaced, train of sound structures, starting with a large deflection followed by a decaying amplitude wave. In the frequency domain, it is characterized by multiple, equally-spaced peaks of power (comb-like spectrum). Simple-waveform snores have a quasi-sinusoidal waveform, with a range of variants, and almost no secondary internal oscillations. Their power spectrum contains only 1-3 peaks, of which the first is the most prominent. We developed a mathematical representation of these waveforms, which is presented along with its implications. The complex-waveform snores result from colliding of the airway walls and represent actual brief airway closure. Simple-waveform snores are of higher frequency and probably result from oscillation around a neutral position without actual closure of the lumen.

Acoustics↗
PubMed1996

Comparing perceptions and measurements of snoring.

The difficulty in measuring and quantifying snoring using objective criteria is that snoring is first and foremost of a subjective perception by a listener. To test the subjective perception of snoring and to compare it with objective measurements, we studied 25 patients referred to our laboratory because of snoring. All had full nocturnal polysomnography including measurements of snoring. Snoring sounds were recorded on paper and simultaneously stored on audiotape. The technologist scoring the polysomnogram counted the number of snores during a 20-minute segment. Two other technologists, unaware of the objective snoring count, listened to the audiotape and also counted the number of events that they perceived as snores. In 11 of 25 patients there was good agreement (within 25%) between the two listeners and the objective snore count. In another 7 of 25 patients there was good agreement between the listeners, but the objective snore count differed > 25%. In the last group of seven of 25 patients the difference in subjective snore counts perceived by both listeners was > 25%. The agreement between both listeners in judging snoring severity was moderate (weighted Cohen's kappa (w) = 0.49). We conclude that perception of snoring is highly subjective. We speculate that investigations studying consequences and treatment of snoring must employ either more sophisticated properly validated methods to measure snoring or alternatively resort to measurements of the underlying physiological abnormalities responsible for snoring, such as elevations in upper airway resistance.

Adult↗
PubMed2005

Snoring imaging: could Bernoulli explain it all?

STUDY OBJECTIVES: To identify upper airway changes in snoring using CT scanning, to clarify the snoring mechanism, and to identify the key structures involved. PARTICIPANTS: Forty patients underwent CT examination of the head and neck region according to snoring habits; patients were classified into non-snoring (n = 14), moderately loud snoring (n = 13), and loud snoring (n = 13) groups. DESIGN: Comparative analysis. MEASUREMENTS: Using CT images, areas, the anteroposterior and transversal distances of the pharyngeal space at different levels, and the thickness and length of the soft palate and uvula and their angle against the hard palate were measured; evidence of impaired nasal passages was noted; the extent of pharyngeal inspiratory narrowing was the ratio between the area at the hard palate level and most narrow area; and expiratory narrowing was the ratio between the area behind the root of the tongue and the most narrow area. RESULTS: Greater pharyngeal inspiratory narrowing (p = 0.0015) proportional to the loudness of snoring (p = 0.0016), and a longer soft palate with uvula (p = 0.0173) were significant for snoring. Impaired nasal breathing was significantly related (p = 0.029) only to the loud snoring group. The body mass index and age of snoring persons were also significantly higher. CONCLUSIONS: Snoring is associated with typical changes that can be revealed by CT scanning. Greater pharyngeal narrowing is the most important factor. Given the "Venturi tube" shape of the pharynx, the Bernoulli pressure principle plays a major role in snoring. The key structure in snoring is the soft palate: it defines the constriction and is sucked into vibrating by negative pressure that develops at this site. Its repetitive closures present an obstruction to breathing, producing the snoring sound, and should therefore be the target for causal treatment of snoring. Obstacles in the upper airway that increase negative inspiratory pressure could not be confirmed as important for the development of snoring, although they may increase its loudness.

Biophysical Phenomena↗
PubMed2006

Snoring and daytime sleepiness as risk factors for hypertension and diabetes in women--a population-based study.

The aim of this study was to analyze whether snoring and excessive daytime sleepiness (EDS), the main symptoms of obstructive sleep apnea syndrome (OSAS), are associated with hypertension and diabetes in women. A random sample of 6779 women aged 20-99 years answered questionnaires on sleep disturbances, daytime symptoms and somatic diseases. The women were categorized into four groups: "no EDS or snoring" (reference group), "snoring but no EDS", "EDS but no snoring" and "snoring and EDS". Prevalences of hypertension and diabetes were lowest in the reference group (8.7% and 1.6%, respectively) and highest among women with both snoring and EDS (hypertension: 26.3%, diabetes: 5.8%). In a multivariate model adjusting for age, body mass index, smoking, physical activity and alcohol dependency, "snoring and EDS" was a risk factor for hypertension (adjusted OR 1.82 (95% CI 1.30-2.55)) while isolated snoring or EDS was not. "Snoring and EDS" was more closely related to hypertension among women aged <50 years (adj. OR 3.41 (1.78-6.54) vs. 1.50 (1.02-2.19), P=0.01). For diabetes, both "EDS but no snoring" and "snoring and EDS" were risk factors and the associations were most pronounced in women aged >50 years (adj. OR 2.33 (1.28-4.26) for "EDS but no snoring" and 2.00 (1.05-3.84) for "snoring and EDS"). We conclude that the combination of snoring and EDS is a risk factor for hypertension and diabetes in women. For hypertension, the risk is partly age dependent and, for diabetes, EDS without snoring is a risk factor of similar magnitude. These differences might indicate differences in pathophysiologic mechanisms underlying the association between sleep-disordered breathing and hypertension and diabetes respectively.

Adult↗
PubMed2000

Reported snoring--does validity differ by age?

Snoring is a major sign of obstructive sleep apnoea syndrome. Despite the frequent number of studies based on subjective reports of snoring, self-reported snoring has hardly been validated at all. In some previous epidemiological studies, a significant association between snoring and cardiovascular morbidity and mortality was found only below the age of 50-60 y. This study was performed to investigate whether this is due to a decrease in the validity of reported snoring with increasing age. In a population-based study, 2668 men aged 40-79 y answered a questionnaire including questions on snoring. Those who reported loud and disturbing snoring often or very often were regarded as habitual snorers. Without taking account of reported snoring, an age-stratified sample of these men was selected and their snoring was measured using a microphone for 1 night. Significant snoring was defined as recorded snoring sounds for >/= 10% of the night. The participants were divided into younger (age 40-59, mean +/- SD: 51.8 +/- 4.6 y, n=132) and older (age 60-79, 67.7 +/- 5.4 y, n=99) age groups. When analysing the validity of reported snoring, no significant differences were found between the younger and older age groups in terms of specificity [younger: 82% (95% CI 74-90%), older: 88% (81-95%)] or sensitivity [younger: 40% (26-54%), older: 35% (17-53%)]. These data indicate that, in men aged 40-79 y, the validity of reported snoring is similar in different age groups. The lack of an association between reported snoring and cardiovascular disease at higher ages can, therefore, not be explained by a decrease in the validity of reported snoring.

Age Factors↗
PubMed1991

Snoring and sleep architecture.

The purpose of this study was to examine whether snoring adversely affects sleep architecture and sleep efficiency, and thus may account for the frequent complaints of daytime tiredness and fatigue expressed by heavy snorers. We recruited eight self-confessed heavy snorers and six self-confessed nonsnorers. All subjects had full nocturnal polysomnography, including continuous monitoring of snoring, which was quantified by counting the number of snores per hour of sleep (snoring index), the number of snores per minute of snoring time (snoring frequency), maximal and mean nocturnal sound intensity (dBmax and dBmean, respectively). We found that even the self-confessed nonsnorers snored lightly, with significantly smaller frequency and index than the heavy snorers. Sleep architecture was similar in both groups. Distribution of snoring among the sleep stages differed for light and heavy snorers: light snorers snored uniformly throughout all sleep stages, whereas heavy snorers tended to snore more during slow-wave and REM sleep. Snoring frequency and snoring index were similar during all sleep stages in light snorers, but they were higher during slow-wave sleep in heavy snorers. Wakefulness time after sleep onset and sleep efficiency correlated significantly with the snoring index. We conclude that although snoring does not affect sleep architecture in general, it influences sleep efficiency and wakefulness time after sleep onset; this may have an adverse effect on daytime function of heavy snorers.

Adult↗
PubMed2002

Sound frequency analysis and the site of snoring in natural and induced sleep.

The aim of this study was to compare the snoring sounds induced during sleep nasendoscopy, and to compare them with those of natural sleep using sound frequency spectra. The snoring of 16 subjects was digitally recorded during natural and induced sleep, noting the site of vibration during sleep nasendoscopy. Patients with palatal snoring during sleep nasendoscopy had a median peak frequency at 137 Hz (118 snore samples). The peak frequency of tongue-base snoring was 1243 Hz (10 snore samples), and simultaneous palate and tongue was 190 Hz (six snore samples). The median power ratios were 7, 0.2 and 5 respectively. The centre frequencies were 371, 1094 and 404 Hz respectively. Epiglottic snores had a peak frequency of 490 Hz (five snore samples). Comparison of the induced (n = 118) and natural (n = 300) snore samples of the 12 palatal snorers showed a significant difference in both the power ratio and centre frequencies (P = 0.031 and P = 0.049). The peak frequency position was similar (P = 0.34). Our results indicate that induced snores contain a higher frequency component of sound, not evident during natural snoring. This is consistent with an element of tongue-base snoring. Although there is good correlation generally, sleep nasendoscopy may not accurately reflect natural snoring.

Endoscopy↗
PubMed2004

Popular snore aids: do they work?

OBJECTIVE: The study goal was to critically evaluate 3 popular noninvasive treatments for snoring: an oral spray lubricant applied before bedtime, a nasal strip designed to maintain nasal valve patency, and a head-positioning pillow. STUDY DESIGN: Prospective, randomized blinded clinical trial of 3 popular noninvasive snore aids using objective acoustic snoring analysis and subjective patient and bed-partner questionnaires in 40 snoring patients. A digital recorder allowed snoring analysis with data collected in the home environment over 1 week. RESULTS: There is neither objective nor subjective benefit to the use of tested popular noninvasive snore aids. Palatal snoring, palatal loudness, average loudness of snoring, averaged palatal flutter frequency, and respiratory disturbance index did not significantly change when comparing the 3 snoring aids with no treatment. Subjective comments and complications are reviewed as well. CONCLUSION: This is the first prospective comparison trial of popular noninvasive snoring aids. There is no significant objective or subjective snoring improvement in the anti-snoring aids studied compared with the use of no aid. SIGNIFICANCE: Outcome studies aid in verifying or refuting claims made by popular noninvasive snore aids.

Double-Blind Method↗
PubMed1998

A 10-year follow-up of snoring in men.

STUDY OBJECTIVES: Little is known about the natural development of snoring, and this survey was conducted to study the development of snoring in men over a 10-year period. DESIGN: Population-based prospective survey. SETTING: The Municipality of Uppsala, Sweden. PARTICIPANTS AND MEASUREMENTS: In 1984, 3,201 randomly selected men aged 30 to 69 years answered a questionnaire on snoring and sleep disturbances. Of the 2,975 survivors in 1994, 2,668 (89.7%) answered a new questionnaire with identical questions to those used at baseline. Questions about smoking habits, alcohol, and physical activity were also added. RESULTS: Habitual snoring was reported by 393 men (15.0%) in 1984 and by 529 (20.4%) 10 years later. In both 1984 and 1994, the prevalence of snoring increased until age 50 to 60 years and then decreased. Risk factors for being a habitual snorer at the follow-up were investigated using multiple logistic regression with adjustments for previous snoring status, age, body mass index (BMI), weight gain, smoking habits, and physical activity. In men aged 30 to 49 years at baseline, the predictors of habitual snoring at the follow-up, in addition to previous snoring status, were as follows: persistent smoking (adjusted odds ratio, 95% confidence interval) (1.4, 1.1 to 1.9), BMI 1984 (1.1, 1.02 to 1.1/kg/m2) and weight gain (1.1, 1.03 to 1.2/kg/m2). Among men aged 50 to 69 years, after adjustments for previous snoring status and age, weight gain was the only significant risk factor for developing habitual snoring (1.2, 1.05 to 1.4/kg/m2). CONCLUSIONS: In men, the prevalence of snoring increases up to the age of 50 to 60 years and is then followed by a decrease. Weight gain is a risk factor for snoring in all age groups, while smoking is mainly associated with snoring in men <60 years of age.

Adult↗
PubMed1998

Effect of the external nasal dilator Breathe Right on snoring.

This clinical trial was designed to evaluate the efficacy of the external nasal dilator Breathe Right (nasal strip) on snoring. The assessment of snoring intensity and duration as well as the sleep quality without the Breathe Right nasal strip and after application was performed in 30 out-patients with primary habitual snoring. An all-night polysomnographic investigation including registration of a17-channel EEG, EMG, respiration parameters such as breathing efforts and nasal/oral air flow, snoring vibrations, ECG, oxygen saturation, etc. was conducted in the sleep laboratory of Pro Science Private Research Clinic GmbH. The drug-free strip Breathe Right was able to reduce the maximum snoring intensity (maximum snoring vibration) throughout the night (p = 0.02, sign test), especially during the superficial sleep (sleep stage 1 and 2). The snoring intensity remained almost unchanged during slow wave sleep (SWS) and REM. In comparison with the baseline the maximum snoring intensity was reduced during the second treatment night in 22 of the 30 investigated snorers. The differentiation between snorers with and without obstructive sleep apnea and between mild and heavy snorers allowed to state that especially the snorers without apnea and the time in bed, TIB) can achieve a reduction of the maximum snoring intensity using the strip. Moreover, the number of snores per hour TIB (snoring index, SI) was reduced after application of the nasal strip for the snores with an intensity greater than 20 dB (p = 0.02, sign test). The sleep architecture remained almost unchanged, although the nasal strip led subjectively (SF-A questionnaire) to an improvement of sleep quality. The overall estimation of the subjective efficacy rating revealed that 17 of 30 patients (second treatment night) needed a certain period of time to accustom to the nasal strip. After that they could breathe easily, slept well and felt recuperated in the following morning. No adverse events were observed after adhesion of the nasal strip, except for one patient, who had the sensation as if they needed to sneeze for a short time after the first application of the nasal strip. Consequently, Breathe Right is a safe and easily applied noninvasive method to reduce the maximum snoring intensity, especially in habitual mild snorers.

Adult↗
PubMed1995

Epidemiological aspects of snoring and hypertension.

Previous studies have reported a great difference in snoring prevalence in different populations. In a recent study on men and women 20-45 y old, living in Sweden (Uppsala, Gothenbourg), Iceland (Reykjavík) and Belgium (Antwerp), data concerning snoring, etc., were collected using the same questions and scales in all the countries. In all four areas the prevalence of snoring was the same: 5% of men and 2-3% of women reported snoring every night. In all areas snoring was positively correlated with age, male sex and body mass index. It was therefore assumed that the previous difference in snoring prevalence is probably an artifact of different methodologies. The connection between snoring and systemic hypertension has been much disputed during the last decade. The high prevalence of hypertension in the sleep apnoea syndrome has been explained by obesity/age/male gender/sleep apnoea and/or snoring. In one recent study snoring did not contribute independently to the prediction of hypertension, while other studies indicate that snoring is an independent risk factor for hypertension. After reviewing some of the epidemiological literature it was found that these studies are bound to identify almost entirely different subgroups of the population as snorers since the prevalence of snoring is rated on different types of frequency scales with words like 'never', 'often' or the number of nights per week. The questions used are also different. In general it can be stated that the smaller the proportion of the population identified as snorers the more often there is a statistically significant association with hypertension. The relationship between snoring and hypertension is considered to be unclear due to the different research methods used, and to the uncertain role played by confounding factors such as obesity. There is a need for population-based, prospective, studies with more uniform definitions of the term 'snoring' based on objective measurements of upper airway resistance during sleep, together with haemodynamic studies.

Journal Article↗
PubMed2006

Snoring significance in patients undergoing home sleep studies.

OBJECTIVE: To analyze the impact of snoring, independent of obstructive sleep apnea syndrome on patients referred for home sleep studies and to report a new technology for the reporting of snoring, using sophisticated sound collection and noise-canceling technology. STUDY DESIGN AND SETTING: A retrospective statistical review of consecutive anonymous data compiled from questionnaires and digital data of snoring loudness and duration measured at the upper lip during unattended home sleep studies in 4,860 patients referred for snoring and sleep-disturbed breathing. RESULTS: A strong relationship exists between a history of snoring and complaints of daytime sleepiness (80%), obesity (73%), and chronic fatigue (78%) (all yield P<0.001). By contrast, only 42% to 48% of patients without these symptoms complain of snoring. In 3 multiple-regression analyses, the percent of time snoring, average loudness, and peak loudness are all significantly predicted by the apnea hypopnea index (all P<0.003), body mass index (all P<0.001), and age (P=0.014). Daytime sleepiness was strongly predicted by percent time snoring (P=0.014), weakly by average loudness (P=0.046), and not at all by peak loudness (P=0.303). CONCLUSION: By using a pair of microphones placed at the upper lip, one that samples breath sounds and the other ambient sound and artifact noise, the NovaSOM QSG measures snoring while canceling ambient noise. The clinical impact of snoring on the patient as well as the bed partner, independent of obstructive sleep apnea syndrome, is an unrecognized factor in sleep-disturbed breathing. SIGNIFICANCE: Measurable criteria to define snoring are suggested. Snoring loudness is not measured in most laboratory Polysomnograms. EBM RATING: B-3b.

Adolescent↗