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At least 289 records · Page 16Linked to original sources
PubMed1999

Body mass index less than 28 kg/m2 is a predictor of subjective improvement after laser-assisted uvulopalatoplasty for snoring.

OBJECTIVE/HYPOTHESIS: To investigate whether body mass index (BMI) can be used to predict subjective improvement of snoring after laser-assisted uvulopalatoplasty (LAUP). STUDY DESIGN: One hundred nineteen consecutive adult patients who had LAUP performed for socially disruptive snoring were contacted by mail 3 months after surgery and asked to complete a questionnaire with the following alternatives as to the effect of surgery on their snoring: no improvement (1); some improvement (2); moderate improvement (3); substantial improvement (4) and abolished snoring (5). Patients reporting to categories 3, 4, or 5 were referred to as responders and to categories 1 or 2 as nonresponders. Seventy patients (59%) completed the questionnaire. METHODS: A one-stage LAUP was performed with local anesthesia in an outpatient ear, nose, and throat clinic with a CO2 laser. Patients were divided into two categories with BMI above and below 28 kg/m2 at the time of surgery. RESULTS: BMI correlated significantly with subjective postoperative improvement. (R = 0.29; P < .02; Pearson's correlation test). Odds ratio (OR) for success by BMI less than 28 kg/m2 compared to patients with BMI greater than 28 kg/m2 was 4.8 (95% confidence interval [CI]: 1.48-15.53). CONCLUSIONS: BMI is a simple, yet important predictor of subjective reduction of snoring after LAUP and should be considered before performing such surgery.

Adult↗
PubMedDate not supplied

Snoring and the severity of coronary artery disease in men.

Previous studies have found associations between snoring, or polysomnographic documented sleep apnea, and hypertension, cerebral vascular disease, and myocardial infarction. The present study examined the relationship of coronary artery disease (CAD) and snoring. One hundred and twenty-two males with positive angiographic studies were compared with fifty-six men, matched in age and socioeconomic status, who had no known history of coronary heart, or other atherosclerotic, disease. The percentage of subjects reporting that they snore "usually" or "always/loudly" increased across the four CAD severity groupings (nonpatient controls = 19.6%, 1 vessel = 44.4%, 2 vessel = 41.9%, 3 vessel = 56.0%) with a p value of .005. Hypertension, body mass index, and pack years of smoking were found to be associated with both coronary artery disease severity and snoring. When these variables were controlled in a multiple regression analysis, the relationship of snoring and CAD severity remained significant at p = .050.

Coronary Angiography↗
PubMed1985

Effect of nasal surgery on snoring.

When 113 patients who had had nasal surgery for chronic obstruction were questioned about their snoring habits before and after operation, 42% said they had snored before nasal surgery. Of that group, 77% had either elimination or improvement of snoring after nasal surgery. Nasal obstruction is one of several factors contributing to snoring; surgery that relieves nasal airway impairment may also relieve or decrease the severity of snoring.

Airway Obstruction↗
PubMed2005

Snoring surgery: a retrospective review.

OBJECTIVE: To undertake a retrospective, questionnaire review of surgery for heavy snoring, to ascertain patients' perception of the procedure and its effect on their snoring. PATIENTS AND METHODS: A specifically designed postal questionnaire was sent to 261 patients who underwent snoring surgery at University Hospital Aintree, Liverpool, UK, between April 1993 and March 2000. One hundred ninety-three patients responded (73.9%), including 151 men and 42 women. Mean age was 49.0 years (range, 24-74 yrs). RESULTS: Twenty-two patients had a uvulopalatopharyngoplasty, 53 a traditional laser palatoplasty and uvulectomy, and 118 an uvulopalatal elevation palatoplasty. There was a 26% patient-reported postoperative infection rate. Morbidity regarding postoperative swallowing, pharyngeal sensation or voice change appeared minimal. Seventy-six percent scored postoperative pain as "moderate" or "severe," irrespective of the operation performed (P = 0.989). Thirty-seven percent of patients perceived an improvement in postoperative sleep quality. Twenty-four percent of patients reported no improvement in snoring after surgery. Forty-three percent reported an initial improvement that was not sustained for 2 years, whereas 34% of patients benefited from an improvement sustained for longer than 2 years, irrespective of the operation performed (P = 0.143). Only 47%, with hindsight, would have undergone surgery. CONCLUSION: These data highlight that snoring surgery has a high postoperative morbidity rate and a high failure rate. Research endeavors should be directed to the development of a strategy which enables reliable preoperative identification of patients' who enjoy sustained benefit postoperatively.

Adult↗
PubMed1994

Nasal surgery for snoring.

Snoring is a common disorder usually presenting to otolaryngologists. Most patients who have any nasal symptoms would normally be offered nasal surgery, but there is a significant incidence of failure to control the snoring (approximately 25%). We analysed a group of patients, all having nasal surgery for snoring, with the aim of assessing whether any pre-operative factors would predict success or failure of the surgery. We found symptoms of excessively loud snoring, witnessed apnoeic episodes and hypersomnolence, or obstructive sleep apnoea diagnosed by overnight oxygen saturation measurements to be statistically associated with failure of nasal surgery to improve snoring.

Adult↗
PubMed1996

Snoring, apnoea and ENT symptoms in the paediatric community.

This study was designed to determine the prevalence of snoring and assess the extent of associated ENT symptoms in children up to 10 years of age. A questionnaire was presented to the parents of 245 children chosen at random from the General Practice list of the town of Frome, Somerset, UK. The prevalence of snoring was found to be 27%. This increased to 47% in the presence of an upper respiratory infection. Snoring was found to be significantly (P < 0.001) associated with a history of poor hearing, restless sleep, and having a cold. Less significant (P < 0.01) associations occurred with parental smoking, eczema, sleep talking, moving around the bed at night, sore throats, having a runny nose and mouth breathing. Snoring is a common symptom in children up to 10 years of age. Without evidence of other ENT disease the snoring child does not require referral to an ENT department for further investigation.

Child↗
PubMed2005

Correlates of habitual snoring and witnessed apnoeas in Busselton, Western Australia.

OBJECTIVE: The aim of this study was to identify potential body size, behavioural and respiratory risk factors for habitual snoring and witnessed apnoeas in a general population. METHODS: Correlates of these conditions were studied in a sample of 3,577 adults aged 25-74 years who participated in a comprehensive health survey in Busselton, Western Australia, during 1994/95. Logistic regression was used to assess associations after age and gender adjustment and also in multivariate models. RESULTS: The prevalence of both conditions was higher in men and rose with age. After controlling for age, gender and body mass index no additional body size variable remained significantly associated with witnessed apnoeas, whereas both waist-hip ratio and neck-height ratio remained significantly associated with habitual snoring. Among behavioural variables, smoking showed the strongest association, and among respiratory symptoms, asthma for habitual snoring and bronchitis for witnessed apnoeas had significant independent associations. CONCLUSIONS AND IMPLICATIONS: This study has confirmed obesity and smoking as key determinants of habitual snoring and witnessed apnoeas. It has also shown that a number of measures of obesity are independently related to habitual snoring and that asthma and bronchitis may also play a role, independently of obesity.

Adult↗
PubMed1987

Periodic breathing and hypoxia in snorers and controls: validation of snoring history and association with blood pressure and obesity.

Fifty-two men (aged 41-50 years) of whom 25 reported habitual and 27 of occasional or never snoring were examined clinically. Whole-night sleep recordings of body and breathing movements, snoring and blood oxygen saturation were made. Hypoxic events exceeding 4% from the baseline were counted. Ninety-three percent of those classified snorers by the recordings were habitual or occasional snorers, but 50% of those similarly classified non-snorers had reported habitual or occasional snoring. Four habitual snorers had abnormal breathing indices and polysomnography established obstructive sleep apnea syndrome (OSAS) in one. Thus, self-reported habitual snoring is a reliable OSAS-screening method. Estimated prevalence of OSAS based on this study is 0.4-1.4%. In multivariate regression analysis, the hypoxic events were explained by obesity and apneic events. The diastolic blood pressure level was best explained by obesity, but not hypoxic or apneic events or snoring history.

Adult↗
PubMed1990

Relation between systemic hypertension and sleep hypoxaemia or snoring: analysis in 748 men drawn from general practice.

OBJECTIVE: To establish whether a history of snoring or the degree of overnight hypoxaemia is an important independent predictor of systemic blood pressure. DESIGN: Prospective community based study of blood pressure in relation to overnight oxygen saturation, height, weight, and a questionnaire assessment of snoring, smoking, and alcohol consumption. Analysis was by multiple linear regression techniques and analysis of variance. SETTING: Small town outside Oxford, served by one group general practice of four partners. All measurements were made at home. SUBJECTS: The names of 836 men aged 35-65 were drawn at random from the general practitioners' age and sex register and the men then asked to participate; 752 (90%) agreed. MAIN OUTCOME MEASURES: Systolic, mean, and diastolic blood pressures and their association with age, obesity, alcohol consumption, cigarette consumption, snoring, and overnight hypoxaemia. RESULTS: Though systemic blood pressure correlated significantly with overnight hypoxaemia, this was due to the cross correlation with age, obesity, and alcohol consumption. No independent predictive effect of overnight hypoxaemia was found. Snoring was correlated with systemic blood pressure but not significantly so and also was not an independent predictor once age, obesity, and alcohol consumption had been allowed for. CONCLUSIONS: It is unlikely that snoring and sleep hypoxaemia from occult sleep apnoea are important causes of diurnal systemic hypertension when compared with age, obesity, and alcohol consumption. The increased prevalence of cardiovascular complications reported in snorers may be due to the confounding variable of obesity or to nocturnal rises in blood pressure that are not reflected in the daytime figures.

Adult↗
PubMed1991

Predictors and prevalence of obstructive sleep apnoea and snoring in 1001 middle aged men.

One thousand and one men, aged 35-65 years, were identified from the age-sex register of one group general practice. Over four years 900 men were visited at home and asked questions about symptoms potentially related to sleep apnoea and snoring. Height, weight, neck circumference, resting arterial oxygen saturation (SaO2), and spirometric values were also determined. All night oximetry was then performed at home and the tracing analysed for the number of dips in SaO2 of more than 4%. Subjects with more than five dips of 4% SaO2 or more per hour were invited for sleep laboratory polysomnography. Seventeen per cent of the men admitted to snoring "often." Multiple linear regression techniques identified and ranked neck circumference (r2 = 7.2%), cigarette consumption (r2 = 3.4%), and nasal stuffiness (r2 = 2%) as the only significant independent predictors of snoring. Together these account for at least a sixfold variation in the likelihood of being an "often" snorer. Forty six subjects (5%) had greater than 4% SaO2 dip rates of over five an hour and 31 of these had full sleep studies. Three subjects had clinically obvious and severe symptomatic obstructive sleep apnoea, giving a prevalence of three per 1001 men (0.3%; 95% confidence interval 0.07-0.9%). Eighteen men had obstructive sleep apnoea only when supine and in 10 the cause of the SaO2 dipping on the original home tracing was not elucidated. The greater than 4% SaO2 dip rates correlated with the history of snoring. Multiple linear regression techniques identified and ranked neck circumference (r2 = 7.9%), alcohol consumption (r2 = 3.7%), age (r2 = 1%) and obesity (r2 = 1%) as the only significant independent predictors of the rate of overnight hypoxic dipping. This study shows that snoring in this randomly selected population correlates best with neck size, smoking, and nasal stuffiness. Obstructive sleep apnoea, defined by nocturnal hypoxaemia, correlates best with neck size and alcohol, and less so with age and general obesity.

Adult↗
PubMed1993

Theory and measurements of snores.

Upper airway narrowing, collapsibility, and resistance are recognized predisposing factors for snoring and obstructive sleep apnea, but the mechanisms of their action and interaction are not known. We studied a simple theoretical model of the upper airways, consisting of a movable wall in a channel segment that connects to the airway opening via a conduit with a resistance. Inspiratory flow (V) through the channel segment causes local pressure changes due to viscous losses and the Bernoulli force that may overcome the elastic forces acting on the movable wall. The model predicts instability leading to upper airway closure over a wide range of parameter values. Increasing inspiratory V above a boundary, determined by values of upper airway resistance, segment compliance, length, width, and diameter, as well as gas density, leads to a dynamic airway closure. The mathematical model establishes the power relationships between parameters and provides physiologically realistic quantitative simulation of upper airway closure when values are adapted from literature and from radiographic measurements of upper airway motion induced by negative pressure. The rate of appearance of repetitive sound structures during snoring was favorably compared with the model's prediction of the time course of wall motion during collapse. V measurements during simulated snores revealed an asymmetric oscillatory pattern compatible with repetitive upper airway closure. We conclude that snoring may be modeled as a series of dynamic closure events of the upper airways. The model predicts that the width and length of the movable portion of the upper airways and the gas density are likely to affect the onset of snoring, in addition to other, previously recognized, parameters.

Acoustics↗
PubMed2006

Snoring-related energy transmission to the carotid artery in rabbits.

Epidemiological studies link habitual snoring and stroke, but mechanisms involved are poorly understood. One previously advanced hypothesis is that transmitted snoring vibration energy may promote carotid atheromatous plaque formation or rupture. To test whether vibration energy is present in carotid artery walls during snoring we developed an animal model in which we examined induced snoring (IS)-associated tissue energy levels. In six male, supine, anesthetized, spontaneously breathing New Zealand White rabbits, we surgically inserted pressure transducer-tipped catheters (Millar) to monitor tissue pressure at the carotid artery bifurcation (PCT) and within the carotid sinus lumen (PCS; artery ligated). Snoring was induced via external compression (sandbag) over the pharyngeal region. Data were analyzed using power spectral analysis for frequency bands above and below 50 Hz. For frequencies below 50 Hz, PCT energy was 2.2 (1.1-12.3) cmH2O2 [median (interquartile range)] during tidal breathing (TB) increasing to 39.0 (2.5-95.0) cmH2O2 during IS (P = 0.05, Wilcoxon's signed-rank test). For frequencies > 50 Hz, PCT energy increased from 9.2 (8.3-10.4) x 10(-4) cmH2O2 during TB to 172.0 (118.0-569.0) x 10(-4) cmH2O2 during IS (P = 0.03). Concurrently, PCS energy was 13.4 (8.5-18.0) x 10(-4) cmH2O2 during TB and 151.0 (78.2-278.8) x 10(-4) cmH2O2 during IS (P < 0.03). The PCS energy was greater than PCT energy for the 100-275 Hz bandwidth. In conclusion, during IS there is increased energy around and within the carotid artery, including lower frequency amplification for PCS. These findings may have implications for carotid atherogenesis and/or plaque rupture.

Animals↗
PubMedDate not supplied

Effects of adenotonsillar hypertrophy on snoring in children.

A prospective study was performed to evaluate the effects of adenotonsillar hypertrophy on snoring in children. Thirty male patients were grouped with respect to the severity of snoring and were evaluated in terms of the noise level of the snoring sound, the lowest arterial oxygen saturation, degree of palatine tonsillar hypertrophy, body mass index and cephalometric findings that included the adenoidal-nasopharyngeal ratio, the angle between the lines sella turcica/nasion and most posterior point of anterior maxilla/nasion, the angle between the lines sella turcica/nasion and most posterior point of anterior mandible/nasion, the posterior airway space, the distance from the sella to the nasion, lower face height and the distance from the basion to the posterior nasal spine. The noise level of the snoring sound, the lowest arterial oxygen saturation and the adenoidal-nasopharyngeal ratio showed a significant correlation with the severity of snoring, but the degree of palatine tonsillar hypertrophy and the body mass index failed to disclose any significant relationship.

Adenoidectomy↗
PubMed1991

Snoring and the risk of ischemic brain infarction.

To determine if a history of snoring is a risk factor for brain infarction, I conducted a case-control study of risk factors for ischemic stroke using 177 consecutive male patients aged 16-60 (mean 49) years with acute brain infarction. For each patient I chose an age-matched (+/- 6 years) male control. Arterial hypertension, coronary heart disease, snoring (habitually or often), and heavy drinking (greater than 300 g/wk) were risk factors in the stepwise multiple logistic regression analysis. The odds ratio of snoring for brain infarction was 2.13. By McNemar's test this association increased strongly if a history of sleep apnea, excessive daytime sleepiness, and obesity were all present with snoring (odds ratio 8.00). My study indicates that snoring may be a risk factor for ischemic stroke, possibly because of the higher prevalence of an obstructive sleep apnea syndrome among snorers than nonsnorers.

Adolescent↗
PubMed1994

Acute effects of transdermal nicotine on sleep architecture, snoring, and sleep-disordered breathing in nonsmokers.

Previous research has suggested that nicotine may be therapeutically useful in the treatment of sleep-disordered breathing. The development of transdermal nicotine delivery systems has allowed us to test the overnight effectiveness of nicotine. Twenty nonsmoking subjects (10 men, 10 women) were recruited on the basis of a history of habitual snoring that was confirmed by overnight laboratory monitoring. Subjects were then randomized (double-blind crossover design) to receive either placebo or an active patch that delivers 11 mg of nicotine over a 24-h period. Patches were applied at 6 P.M. and removed at 6 A.M. the following morning, at which time venous blood was obtained for determination of serum nicotine concentrations. Polysomnography was performed using standard techniques to assess sleep architecture and sleep-disordered breathing. Snoring was monitored with a sound-level meter and quantitatively analyzed to determine the snoring index (SI) (number of snores per hour of sleep) and mean and maximum snoring intensities. The age of the subjects was 46.9 +/- 11.4 yr (mean +/- SD) and their mean body mass index (BMI) 33.3 +/- 4.6 kg/m2. A mean nicotine level was nondetectable with placebo and 7.8 +/- 2.3 ng/ml with wearing of an active patch. Nicotine decreased total sleep time (TST) by 33 min (p < or 0.01), sleep efficiency from 89.7 to 83.5% (p < or = 0.01), and percent rapid eye movement (REM) sleep from 18.8 to 15.1% (p < or = 0.01), and prolonged initial sleep latency (ISL) from 6.7 to 18.2 min (p < or = 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Cutaneous↗
PubMed1999

Correlates of the "don't know" response to questions about snoring.

Many persons say that they "don't know" whether they snore. The purpose of this study was to investigate the prevalence and correlates of such responses in an elderly population. Subjects were 1715 members (1,155 men, 560 women) of a previously defined cohort (Western Group Collaborative Study) followed prospectively since 1960-1961 with a current mean age of 75.9 (SD = 4.3) for the men and 71.4 (SD = 5.3) for the women. We collected survey questionnaires and reviewed medical records. Results indicated that risk factors for the "don't know" response in this population were similar to those for frequent snoring and included: male sex, higher Body Mass Index, smoking, and use of sinus medication. Between 28 and 44% of the cohort answered questions about snoring with a "don't know" response. These data are compatible with the interpretation that subjects may disavow knowledge of their own snoring and suggest that future studies consider the "don't know" response to questions about snoring as a response of potential interest.

Aged↗
PubMed1992

The effect of snoring on mean arterial blood pressure during non-REM sleep.

The purpose of this study was to examine the relationship between snoring and mean arterial blood pressure during sleep. This was accomplished by performing continuous, all-night, simultaneous measurements of snoring, oxygen saturation, sleep stages, and arterial blood pressure in a group of eight snorers and five nonsnoring control subjects. The results were analyzed to determine whether changes in mean arterial blood pressure during non-rapid-eye-movement (non-REM) sleep are different in snorers from those in nonsnorers and whether they are related to nocturnal hypoxemia. Both groups were similar with respect to their anthropometric parameters and sleep architecture. Oxygen saturations during different stages of non-REM sleep were similiar within each group. However, the analysis of variance revealed that among snorers mean arterial blood pressure increased slightly during slow-wave sleep, whereas the nonsnorers reduced their blood pressure by 17.4 +/- 3.7% compared with wakefulness values. We also performed multiple linear regression analysis for the entire group of 13 subjects using the change in mean arterial blood pressure relative to wakefulness as the dependent variable and snoring frequency and mean arterial oxygen saturation as the independent variables; the results demonstrated that only snoring frequency, and not oxygen saturation, correlated significantly with the change in mean arterial blood pressure. We conclude that snoring may influence variation of blood pressure during sleep, preventing the normally observed reduction of arterial blood pressure associated with slow-wave sleep.

Adult↗
PubMed2002

Snoring detection during auto-nasal continuous positive airway pressure.

A bench study using an artificial lung model was performed to evaluate the snoring detection sensitivity of six (commercially available) auto-nasal continuous positive airway pressure (NCPAP) devices. Snoring was simulated by a loudspeaker connected to the lung model and abruptly activated during 1 s of each inspiratory period to induce pressure oscillation. The oscillation frequencies chosen were 30, 60, 90, and 120 Hz. For each frequency, the amplitude of the pressure oscillation produced by the loudspeaker was adjusted to find the threshold at which the auto-nCPAP devices detected snoring. Differences in pressure-amplitude thresholds of up to three-fold were found across auto-nCPAP devices. A randomized clinical study to compare the effects of the least sensitive (Virtuoso LX; Respironics, Nantes, France) and one of the most sensitive, (Goodknight 418A; Malinckrodt, Nancy, France) devices, in two groups of six patients with obstructive sleep apnoea syndrome was then conducted. Goodknight 418A was more sensitive than Virtuoso LX for detecting snoring (mean +/- SD 92 +/- 11% versus 50 +/- 39% respectively, p = 0.03). To conclude, striking differences exist between auto-nasal continuous positive airway pressure devices in sensitivity for detecting snoring.

Humans↗