Dissociation between objectively quantified snoring and sleep quality
Author links open overlay panelKori E.MacarthuraT. DouglasBradleyabcClodagh M.RyanabcHishamAlshaera
a
Sleep Research Laboratory of the Toronto Rehabilitation Institute, University Health Network Toronto, ON, Canada
b
Sleep Research Laboratory of the Toronto General Hospital, University Health Network Toronto, ON, Canada
c
Department of Medicine of the University of Toronto, Toronto, ON, Canada
Received 30 April 2019, Available online 4 September 2019.
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https://doi.org/10.1016/j.amjoto.2019.102283Get rights and content
Abstract
Background
The impact of simple snoring on sleep structure and sleepiness has not been well described. In several studies, self-reported snoring was associated with increased daytime sleepiness. However, most studies did not distinguish patients with simple snoring from those with obstructive sleep apnea (OSA) using objective measures. We therefore evaluated the effect of objectively measured snoring on sleep structure and daytime sleepiness in patients with no or very mild OSA.
Methods
Subjects referred for suspected sleep disorders underwent polysomnography (PSG) during which breath sounds were recorded by a microphone. Those with an apnea-hypopnea index (AHI) <15/h were analyzed. Individual snores were assessed by a computer algorithm from which the snore index (SI) was calculated as the number of snores/h of sleep. Sleep stages and arousals were quantified. Daytime sleepiness was evaluated using the Epworth Sleepiness Scale (ESS) score.
Results
74 (35 males) were included (age, mean ± SD: 46.4 ± 15.3 years and body mass index: 29.8 ± 7.0 kg/m2). The SI was 266 ± 243. Subjects were categorized according to their SI into 3 tertiles: SI < 100, 100–350, and >350. Neither indices of sleep structure, arousals nor ESS score differed among SI tertiles (p > 0.13). There was no correlation between SI and any of these variables (p > 0.29). In contrast, the AHI was significantly related to frequency of arousals (r = 0.23, p = 0.048).
Conclusions
These findings suggest that simple snoring assessed objectively, is not related to indices of sleep structure or subjective sleepiness.
Abbreviations
AHIapnea-hypopnea indexArIarousal indexCVDcardiovascular diseaseESSEpworth Sleepiness ScaleOSAobstructive sleep apneaPcritcritical closing pressure of the upper airwayPSGpolysomnographyREMrapid eye movementSIsnore indexUARSupper airway resistance syndrome
Keywords
SnoringObstructive sleep apneaSleep structureApnea-hypopnea indexSnore indexSleep stages
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© 2019 Published by Elsevier Inc.
Author links open overlay panelKori E.MacarthuraT. DouglasBradleyabcClodagh M.RyanabcHishamAlshaera
a
Sleep Research Laboratory of the Toronto Rehabilitation Institute, University Health Network Toronto, ON, Canada
b
Sleep Research Laboratory of the Toronto General Hospital, University Health Network Toronto, ON, Canada
c
Department of Medicine of the University of Toronto, Toronto, ON, Canada
Received 30 April 2019, Available online 4 September 2019.
Show less
https://doi.org/10.1016/j.amjoto.2019.102283Get rights and content
Abstract
Background
The impact of simple snoring on sleep structure and sleepiness has not been well described. In several studies, self-reported snoring was associated with increased daytime sleepiness. However, most studies did not distinguish patients with simple snoring from those with obstructive sleep apnea (OSA) using objective measures. We therefore evaluated the effect of objectively measured snoring on sleep structure and daytime sleepiness in patients with no or very mild OSA.
Methods
Subjects referred for suspected sleep disorders underwent polysomnography (PSG) during which breath sounds were recorded by a microphone. Those with an apnea-hypopnea index (AHI) <15/h were analyzed. Individual snores were assessed by a computer algorithm from which the snore index (SI) was calculated as the number of snores/h of sleep. Sleep stages and arousals were quantified. Daytime sleepiness was evaluated using the Epworth Sleepiness Scale (ESS) score.
Results
74 (35 males) were included (age, mean ± SD: 46.4 ± 15.3 years and body mass index: 29.8 ± 7.0 kg/m2). The SI was 266 ± 243. Subjects were categorized according to their SI into 3 tertiles: SI < 100, 100–350, and >350. Neither indices of sleep structure, arousals nor ESS score differed among SI tertiles (p > 0.13). There was no correlation between SI and any of these variables (p > 0.29). In contrast, the AHI was significantly related to frequency of arousals (r = 0.23, p = 0.048).
Conclusions
These findings suggest that simple snoring assessed objectively, is not related to indices of sleep structure or subjective sleepiness.
Abbreviations
AHIapnea-hypopnea indexArIarousal indexCVDcardiovascular diseaseESSEpworth Sleepiness ScaleOSAobstructive sleep apneaPcritcritical closing pressure of the upper airwayPSGpolysomnographyREMrapid eye movementSIsnore indexUARSupper airway resistance syndrome
Keywords
SnoringObstructive sleep apneaSleep structureApnea-hypopnea indexSnore indexSleep stages
View full text
© 2019 Published by Elsevier Inc.
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