Friday, August 26, 2016

Snoring and obstructive sleep apnea

Snoring is a common problem among men and women and is one of the cardinal symptoms of obstructive sleep apnea (OSA). With the explosion of smartphones and the emphasis on in-home monitoring, sleep researchers have attempted to use measurement of snoring to determine risk of obstructive sleep apnea. It has been difficult to do this because not all people who snore have obstructive sleep apnea. In addition, sleep researchers don't agree on an objective definition of snoring or an established threshold level of loudness. The quality of snoring is determined by multiple factors including the stage of sleep, body position, use of alcohol or other sedating medications, and upper respiratory tract illnesses such as a cold. There is significant variation of snoring from night to night for no apparent reason as well. Finally, snoring can be chronic throughout the night or periodic meaning that there are periods of silence between snoring episodes. The periodic snoring may be more suggestive of obstructive sleep apnea.

This study evaluated the diagnostic value of periodic snoring sounds measured during home sleep apnea testing. Subjects that were at risk for obstructive sleep apnea were sent home with a home sleep study monitoring kit and worn while they slept. The home sleep study kit has a built-in microphone that is located on the chest to detect the snoring sounds. the results showed a strong positive correlation between the percentage of periodic snoring and obstructive sleep apnea severity (AHI). The correlation was strongest for younger subjects, females, and obese subjects. The researchers discussed that some women do not get evaluated for obstructive sleep apnea because they do not know that they snore or are embarrassed to report snoring. In my clinic, I find this to be the case as well. Therefore measuring snoring at home while the patient is asleep many help sleep physicians to recommend formal diagnostic sleep studies to accurately assess female patients without a strong history of snoring.

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