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At least 217 records · Page 12Linked to original sources

Can singing exercises reduce snoring? A pilot study.

BACKGROUND: Snoring is not merely a common nuisance but has been identified as a risk factor for poor health. Last resort treatments for palate-based snoring are surgical - reducing the amount of soft palate and/or stiffening it by causing scarring. They carry a burden of risk and expense and have a high recurrence rate. OBJECTIVE: This pilot study was a first step in determining whether singing exercises could be used as a non-invasive treatment to increase muscle tone in the tissues of the throat and thereby reduce snoring. METHOD: The duration of snoring of 20 chronic snorers was recorded by voice-activated tape recorder for 7 nights both before and after treatment. The therapeutic intervention consisted of instruction in singing technique and singing exercises which subjects were directed to practice for 20 minutes a day for 3 months. Compliance was encouraged by a further visit and regular telephone follow-ups. RESULTS: Snoring was on average reduced, especially in subjects who performed the exercises accurately and consistently and who were not overweight. Those who did best, in addition, had no nasal problems and began snoring only in middle age. CONCLUSION: A further randomized controlled study focusing on this group would appear justified and is being planned.

Adult↗

Polysomnographic effects of nasal surgery for snoring and obstructive sleep apnea.

OBJECTIVE: It has been hypothesized that nasal obstruction causes an increase in negative pressure in the upper airway and induces an inspiratory collapse at the pharyngeal level. We used portable polysomnography (PSG) to assess the efficacy of nasal surgery for snoring and obstructive sleep apnea (OSA). MATERIAL AND METHODS: We reviewed 21 patients who presented with nasal obstruction and snoring. Septal surgery with or without inferior turbinectomy was performed. Each patient was assessed pre- and postoperatively using PSG. We measured the respiratory distress index (RDI), apnea index (AI), oxygen saturation index (OSI) and the duration of snoring. Selection criteria were an RDI of > 15 as determined by PSG and clinical nasal obstruction and a deviated nasal septum as determined by physical examination. RESULTS: Nasal surgery had the following effects: RDI decreased from 39 to 29 (p = 0.0001), AI decreased from 19 to 16 (p = 0.0209), OSI decreased from 48 to 32 (p = 0.0001) and the duration of snoring decreased from 44% to 39% (p = 0.1595). Snoring and OSA were completely relieved in 4 patients (19%) who did not require any additional surgical therapy. CONCLUSION: Snoring and OSA may be corrected merely by septal surgery in some patients, and secondary surgery (uvulopalatoplasty) may be considered after a thorough evaluation by means of postoperative PSG.

Adult↗

Prevalence and correlates of snoring and observed apneas in 5,201 older adults.

The objectives of this study were to describe the prevalence of snoring, observed apneas, and daytime sleepiness in older men and women, and to describe the relationships of these sleep disturbances to health status and cardiovascular diseases (CVD). A cross-sectional design was employed to study sleep problems, CVD, general health, psychosocial factors, and medication use. The subjects were participants in the Cardiovascular Health Study, which included 5,201 adults, aged 65 and older, who were recruited from a random sample of Medicare enrollees in four U.S. communities. Study measures employed were sleep questions, echocardiography, carotid ultrasound, resting electrocardiogram, cognitive function, cardiopulmonary symptoms and diseases, depression, independent activities of daily living (IADLs), and benzodiazepine use. Thirty-three percent of the men and 19% of the women reported loud snoring, which was less frequent in those over age 75. Snoring was positively associated with younger age, marital status, and alcohol use in men, and obesity, diabetes, and arthritis in women. Snoring was not associated, however, with cardiovascular risk factors or clinical CVD in men or women. Observed apneas were reported much less frequently (13% of men and 4% women) than snoring, and they were associated with alcohol use, chronic bronchitis, and marital status in men. Observed apneas were associated with depression and diabetes in women. In both men and women, daytime sleepiness was associated with poor health, advanced age, and IADL limitations. The conclusions of the study were that loud snoring, observed apneas, and daytime sleepiness are not associated cross-sectionally with hypertension or prevalent CVD in elderly persons.

Activities of Daily Living↗

Spontaneous baroreflex analysis in non-apneic snoring individuals during NREM sleep.

The primary purpose of this study was to measure baroreceptor sensitivity (BS) during wakefulness and non-rapid eye movement (NREM) sleep in non-apneic snoring individuals. To achieve this purpose continuous and simultaneous measurements of snoring, oxygen saturation, sleep stages, arterial blood pressure and heart rate were obtained from seven non-apneic snoring subjects. After obtaining these measures, a computer program was employed to detect concomitant increases or decreases in systolic blood pressure and R-R interval duration during sequences of three or more consecutive beats that occurred during stage II and slow wave sleep (SWS). The values recorded from a given sequence were plotted and the slope of the regression line fit to the data was used as a measure of BS. The results showed that mean arterial pressure and heart rate during stage II and SWS of NREM sleep were not significantly different from wakefulness. In contrast, the BS measured during NREM sleep was significantly lower than values recorded during wakefulness. In addition, linear regression analysis showed that an inverse and significant correlation existed between snoring frequency and the decrease in BS during sleep. We conclude that the decrease in blood pressure and heart rate normally observed during NREM sleep in healthy non-snoring individuals is attenuated or abolished in non-apneic snoring individuals and that these cardiovascular alterations may be partially mediated by a decrease in BS.

Adult↗

Radiofrequency surgery of the soft palate in the treatment of snoring. A placebo-controlled trial.

STUDY OBJECTIVES: Recent publications have demonstrated a reduction in snoring with radiofrequency (RF) surgery of the soft palate. Yet so far, all published data has been based on non-controlled trials. DESIGN: Aim of this study was to assess the efficacy of RF surgery of the soft palate in a randomized, placebo-controlled trial. SETTING: Outpatients department at university hospital, department of otorhinolaryngology. PATIENTS: 26 patients with primary snoring (AHI < 15, BMI < 35). INTERVENTIONS: Patients were treated with temperature-controlled RF surgery of the soft palate under local anesthesia. In accord with a randomization protocol they received 2 sessions of RF surgery (total amount of energy: 3.300 Joule) or placebo (insertion of device needle without energy delivery). MEASUREMENTS AND RESULTS: Snoring was evaluated by the bed partner with 10 cm visual analogue scales. 23 patients completed the study; 12 received RF-surgery and 11 received placebo. Snoring scores did not change in the placebo group (8.4 +/- 1.6 to 8.0 +/- 2.3) while improving in the RF-group (8.1 +/- 1.3 to 5.2 +/- 2.4). The difference between the groups was statistically significant (p < 0.05). CONCLUSION: RF-surgery was significantly better than placebo, although the reduction in snoring was only moderate in our group of patients. This study underlines the necessity for well-controlled clinical trials in the treatment of snoring.

Adult↗

Snoring predicts hyperactivity four years later.

STUDY OBJECTIVES: Cross-sectional studies implicate snoring and sleep-disordered breathing as potential contributors to hyperactive behavior in some children. However, no prospective cohort study has demonstrated that symptoms of sleep-disordered breathing precede development of hyperactivity. PARTICIPANTS: Parents of 229 children aged 2 to 13 years, recruited at 2 general pediatrics clinics, completed initial and 4-year follow-up surveys. MEASUREMENTS: Surveys included a validated Pediatric Sleep Questionnaire about snoring, sleepiness, and overall risk of sleep-disordered breathing, and the hyperactivity index (expressed as a T-score) within the Conners' Parent Rating Scale. RESULTS: Thirty children (13%) were rated as hyperactive (hyperactivity index > 60) at follow-up. After adjustment for hyperactivity at baseline and stimulant use at follow-up, hyperactivity at follow-up was predicted by baseline habitual snoring (odds ratio = 4.4, 95% confidence interval [1.3, 14.7]) or loud snoring (4.5, [1.2, 17.5]) and by top-quartile composite scores for snoring (5.3, [1.7, 16.8]), sleepiness (3.0, [1.0, 9.4]), or sleep-disordered breathing (4.0, [1.4, 11.6]). CONCLUSIONS: This 4-year prospective cohort study shows that snoring and other symptoms of sleep-disordered breathing are strong risk factors for future emergence or exacerbation of hyperactive behavior. These findings support the hypothesis that untreated childhood sleep-disordered breathing contributes to development of hyperactivity.

Age of Onset↗

Response-contingent awakening in the modification of chronic snoring.

Loud snoring is a common sleep habit that has been shown to have adverse effects on both physical health and interpersonal relationships. Medical treatment for various organic causes is sometimes possible, but there are also many instances in which snoring appears unrelated to any specific organic etiology. The present report describes the successful use of a behavior modification program for the experimental control and suppression of snoring. Six chronic loud snorers participated in a 2-week treatment outcome study, in which a contingent-awakening procedure was systematically compared with a noncontingent control condition. Polysomnographic assessments before and after each phase of the experiment indicated the specific effects of the contingent awakening procedure on the suppression of snoring. The study also examined the relationship between snoring and other sleep parameters, and particularly the occurrence of respiratory obstruction before and after treatment. The implications of these findings for the treatment of chronic snoring are discussed.

Adult↗

Acoustic analysis of snoring sounds by a multidimensional voice program.

OBJECTIVES: This prospective study aimed to determine whether the acoustic characteristics of snoring sounds differed between simple snorers and patients with obstructive sleep apnea syndrome (OSAS) by using a multidimensional voice program (MDVP) that analyzes various aspects of voice. METHODS: Fifty-eight patients (48 men, 10 women) with a history of snoring were included in the study. All patients underwent conventional polysomnography (PSG). Twelve subjects were diagnosed as simple snorers and 46 subjects were diagnosed with OSAS. The mean body mass index (BMI) of simple snorers was 24.7 kg/m and that of patients with OSAS was 25.8 kg/m. Natural overnight snoring was recorded from each subject while they slept during PSG. Using the multiple token protocols of MDVP, 30 snores from each subject were analyzed automatically. For data analysis, four markers were used: peak frequency, soft phonation index (SPI), noise to harmonics ratio (NHR), and power ratio. RESULTS: The Mann-Whitney U test revealed significant differences between the SPI, NHR, and power ratio of simple snorers and patients with OSAS. Simple snorers had a high SPI value. OSAS-related snorers demonstrated a high NHR and low power ratio. CONCLUSIONS: MDVP can be used for snoring sound analysis as a noninvasive examination of sleep-related breathing disorders for differential diagnosis. However, a suitable option that is rapid and has an easy-to-use interface would be more advantageous for analyzing snoring sounds.

Diagnosis, Differential↗

Snoring and systemic hypertension--an epidemiological study.

The prevalence of snoring, overweight and systemic hypertension was estimated in a random sample of 4,064 Swedish men, aged 30-69 years. Of the responders, 15.5% complained of habitual snoring and 29.6% of occasional snoring. Although there was an age-related increase in the prevalence of snoring up to 60 years, habitual snoring was found to be mainly related to body mass index (BMI) (p less than 0.0001) but not to age. Altogether 299 men (9.3%) reported hypertension, 21.5% of whom were habitual snorers, compared with 14.9% of the non-hypertensives (p less than 0.01). The hypertensives were also more often overweight. Logistic multiple regression analyses showed that among subjects 40-49 years old there was an average increase in the predicted prevalence of hypertension from 6.5% among non-snorers to 10.5% of habitual snorers in the same weight group. For the whole study population, however, the increase was mainly dependent on age and BMI. Thus, the importance of habitual snoring for the prevalence of hypertension differs in various age groups.

Adult↗

The relief of snoring by nasal surgery.

Patients with nasal obstruction may also complain of snoring. It is uncertain whether surgery which relieves the nasal obstruction will also relieve the snoring. We have reviewed 126 patients who complained of both nasal obstruction and snoring and who underwent nasal surgery. Snoring was completely relieved in 39 patients (31%), was less loud in a further 72 patients (57%), unchanged in 11 and louder in 4. It occurred on fewer nights post-operatively in 61, on the same number in 24 and more frequently in 2. Patients who had nasal polypectomy as part of their nasal surgery obtained the greatest snoring relief. This study suggests that when snoring and nasal obstruction coexist nasal surgery should be considered as the first line of surgical treatment.

Humans↗

Is there a relationship between the degree of nasal obstruction and snoring?

The possible connection between snoring and nasal obstruction was studied in three groups of adult patients. In group 1, comprising 112 unselected patients, 36% snored, and 50% of the snorers suffered from nasal obstruction. The other two groups consisted of selected patients: group 2 (n = 41) and group 3 (n = 40) all of whom suffered from nasal obstruction. In group 2 nasal airway resistance was normal both before and after decongestant treatment, and in group 3 nasal airway resistance was pathologically high even after decongestant treatment. No difference was found between groups 2 and 3 regarding snoring. Sixty-six per cent in group 2 and 78% in group 3 snored. There was a correlation between snoring and the subjective nasal obstruction, but none between snoring and the degree of nasal obstruction expressed as nasal airway resistance.

Adult↗

Self reported snoring and daytime sleepiness in men aged 35-65 years.

BACKGROUND: It has been suggested that snoring alone, without conventional sleep apnoea or hypopnoea, may disrupt sleep and produce substantial daytime hypersomnolence. This study addresses this potential relationship. METHOD: Eight hundred and fifty men, aged 35-65 years, drawn from one general practice were visited at home and asked a range of questions potentially related to sleepiness, snoring, and sleep apnoea; these included inquiries about alcohol and cigarette consumption, nasal stuffiness, shift work, hypnotic or other drug use, and medical diagnoses. In addition, measurements of height, weight, and overnight arterial oxygen saturation were made. The relation between snoring and sleepiness, with allowance made for potentially confounding variables, including sleep apnoea, was assessed by multiple logistic regression. RESULTS: Positive answers to all questions about sleepiness were correlated significantly with self reported snoring. After potentially confounding variables and any sleep apnoea had been controlled for, positive answers to four questions about inappropriate drowsiness or sleepiness were independently related to snoring. For example, the odds ratio of admitting to "having almost had two or more car accidents while driving due to sleepiness" was 5.8 (95% confidence intervals: 2.7-12.5) in an "often" snorer. CONCLUSIONS: Although epidemiological associations such as this do not prove a causal relation, the study suggests that snoring (without classical sleep apnoea) may sometimes reduce sleep quality sufficiently to produce substantial daytime drowsiness.

Adult↗

Comparing pressures required to abolish snoring and sleep apnea.

OBJECTIVE: Snoring and obstructive sleep apnea share similar pathogenesis and similar response to treatment with continuous positive airway pressure (CPAP). The purpose of this study was to compare pressures required to abolish apneas (POSA) with pressures required to abolish snoring (PSNOR). DESIGN: Cross-sectional, nonrandomized cohort study. SETTING: Sleep disorders clinic at St Michael's Hospital - a tertiary referral centre and a teaching hospital of the University of Toronto, Toronto, Ontario. POPULATION STUDIED: Unselected consecutive 441 patients with confirmed sleep apnea who were undergoing a CPAP titration study in the sleep laboratory. INTERVENTIONS: Nocturnal polysomnography using CPAP titration protocol, which required incremental increases in pressure until snoring and apnea were abolished or a maximum pressure of 16 cm H2O was attained. PSNOR and POSA were recorded and compared. RESULTS: Mean (+/- SD) pressures required to abolish snoring and apnea were: PSNOR 8.3+/-2.57 cm H2O and POSA 7.9+/-2.72 cm H2O (P<0.0001). In 75% of patients, the PSNOR was within +/-1 cm H2O of the POSA; in 92%, it was within +/-2 cm H2O; and in 97%, it was within +/-3 cm H2O. CONCLUSIONS: Empirically increasing pressure by 2 cm H2O in patients on CPAP who continue to snore may abolish snoring and apnea without the necessity of another titration study.

Adolescent↗

Genetic factors in self-reported snoring and excessive daytime sleepiness: a twin study.

Subjects in this study included 1,560 intact male-male twin pairs (818 monozygotic [MZ], 742 dizygotic [DZ]) of mean age (+/- SD) 74.2 +/- 2.8 yr. The Epworth Sleepiness Scale (ESS) was used to assess daytime sleepiness and standardized questionnaires assessed snoring. Multivariate genetic model fitting was used to estimate the contribution of genetic and nongenetic (environmental) influences to the variation and covariation of obesity with snoring and daytime sleepiness. In this sample, 26% were habitual snorers, 18% reported excessive daytime sleepiness (ESS > or = 11), and 29% were obese (body mass index [BMI] > or = 28). By using structural equation modeling, we estimated that genetic factors accounted for 64% of the variance in obesity, 40% of the variance in daytime sleepiness, and 23% of the variability in self-reports of snoring. We found a significant genetic correlation between obesity and snoring and between obesity and excessive daytime sleepiness (EDS), although for the most part the genetic variance in snoring and sleepiness was nonoverlapping with the genetic variance for obesity. We conclude from these data that self-reported symptoms of snoring and daytime sleepiness in older men have a genetic basis that is largely independent of genes associated with obesity.

Aged↗

Association of habitual snoring with glucose and insulin metabolism in nonobese Korean adult men.

Habitual snoring is associated with cardiovascular morbidity and mortality, and metabolic abnormalities such as impaired glucose homeostasis. Many studies were performed in obese Western populations. The purpose of this study was to examine the association of habitual snoring with glucose and insulin metabolism in nonobese Korean men who were free of diabetes and hypertension. A total of 2,719 men ages 40-69 years from the Korean Health and Genome Study participated in this study. Information of snoring frequency was obtained by a questionnaire and glucose and insulin levels during oral glucose tolerance test were measured. Repeated measures analysis of variance detected significant differences in the changing patterns of glucose and insulin levels at 1 hour and 2 hours between habitual snorers and nonhabitual snorers, whereas there were no significant differences in fasting blood glucose and insulin levels. Multivariate logistic regression analyses revealed that habitual snoring was independently associated with elevated 1-hour and 2-hour glucose levels and a 2-hour insulin level, respectively. The present data suggest that habitual snoring may affect glucose-insulin metabolism, independent of diabetes and hypertension, even in nonobese Korean middle-age men. Further prospective studies are needed to examine the causal relationship between habitual snoring and insulin resistance or glucose intolerance.

Adult↗

Snoring and hypertension: a 10 year follow-up.

In many cross-sectional studies an association has been found between snoring and hypertension. However, differing results have been obtained when confounding factors have been taken into account. To establish whether snoring is a risk factor for developing hypertension, a population-based, prospective survey was performed. In 1984 and 1994, 2,668 males, aged 30-69 yrs at baseline, answered questionnaires concerning sleep disturbances and somatic disease. Of the habitual snorers in 1984, 12.5% reported that they had developed hypertension during the period, compared with 7.4% of the remaining subjects (p<0.001). In a multiple logistic regression model persistent snoring, i.e., reported habitual snoring in both 1984 and 1994, was found to be an independent predictor for the development of hypertension among males aged 30-49 yrs (odds ratio 2.6, 95% confidence interval 1.5-4.5) after adjustments for age, body mass index (BMI), weight gain, smoking, alcohol dependence, and physical inactivity. Among the subjects aged 50-69 yrs in 1984, no association between snoring and development of hypertension was found. Although based only on reported data, the results indicate that persistent snoring is an independent risk factor for the development of hypertension among males aged <50 yrs. Prospective surveys, including whole-night sleep recordings, are needed to establish whether this is due to a higher prevalence of obstructive sleep apnoea syndrome among snorers or whether nonapnoeic snorers with increased upper airway resistance also have an increased risk of developing hypertension.

Adult↗

The effect of unilateral and bilateral nasal obstruction on snoring and sleep apnea.

The purpose of this study was to compare apnea and snoring in patients with different patterns of nasal resistance: normal, high unilateral, and high bilateral. The authors examined 683 unselected patients referred for evaluation of snoring and possible sleep apnea. All patients had determination of nasal resistance (performed during wakefulness in the seated posture) and nocturnal polysomnography including quantitative measurement of snoring. Analysis of variance showed no significant difference in apnea and snoring indices among the three nasal resistance groups (normal, high unilateral, and high bilateral). Furthermore, there was no significant difference in the frequency of patients with different severity of apnea and snoring among the three groups. It is concluded that 1. unilateral and bilateral elevation of nasal resistance may lead to equally severe snoring or apnea; 2. there is no direct relationship between awake seated nasal resistance measurement and sleep disordered breathing; and 3. measurements of supine nasal resistance during sleep may be required to elucidate the relationship between sleep-disordered breathing and nasal obstruction.

Airway Resistance↗

Comparison of snoring measured at home and during polysomnographic studies.

Snoring characteristics depend on several factors (sleep position, sleep architecture, breathing route) that can be influenced by changes in sleep habits and by the presence of the different probes and electrodes during polysomnographic studies. Our objective in this study was to compare the characteristics of snoring in the home environment with those of the sleep laboratory where most conventional studies are carried out. Fourteen nonapneic snorers were subjected to three night recording sessions within a two-week period, two at home and one in the sleep laboratory. To eliminate any sleep interference by the apparatus, breathing sounds were recorded with two microphones symmetrically placed on either side of the bed, the signal being preamplified and stored on a VHS hi-fi video recorder. The recorded signal was analyzed by using a spectrum analyzer (real time analyzer) and an equalizer to correct for acoustic resonances of the bedrooms. A snoring event was defined as a breathing sound with a sound pressure level (SPL) greater than 60 dB SPL. The snoring index (number/sleep hour) and the sound intensity of each event were automatically determined. The total sleep time (TST) was similar for the two home recordings (6.8 +/- 0.2 and 7.0 +/- 0.2 h, respectively, mean +/- SEM), but it was significantly shorter during the hospital study (6.0 +/- 0.3 h). The snoring indices obtained at home were 141.4 +/- 33.3 and 144.1 +/- 41.2/h and not statistically different from those obtained during the hospital recording (209.1 +/- 41.5/h). The percentage of TST spent above 60 dB SPL was significantly greater during the polysomnographic study (4.3 +/- 1.2 percent) than during the home recordings (2.5 +/- 0.7 and 2.9 +/- 1.0 percent, respectively). We conclude that the severity of snoring may be overestimated during polysomnographic recordings.

Adult↗