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At least 19 recordsLinked to original sources
PubMed2006

Acoustic parameters of snoring sound to compare natural snores with snores during 'steady-state' propofol sedation.

OBJECTIVES: To investigate the acoustic similarity between natural and sedation-induced snores. DESIGN: Prospective observational study. SETTING: University Hospital Aintree, Liverpool, UK. PARTICIPANTS: Twenty-one patients, who had already had overnight snore recordings, completed a pre-operative sleep nasendoscopic examination. Endoscopic examination of the upper aero-digestive tract was performed at sequentially increasing, steady-state sedation levels, using intravenous propofol administered according to a weight/time-based algorithm to predict blood and effect site (tissue) concentrations. At each sedation level at which snoring occurred, snoring sound was recorded. From these samples, snore files, comprising the inspiratory sound of each snore were created. Similarly, from natural snores recorded pre-operatively, snore files, comprising the inspiratory sounds of the first 100 snores with the patient sleeping in a supine position, were also created. MAIN OUTCOME MEASURES: Snore duration (s), loudness (dBA), periodicity (%) and energy ratios for the frequency sub-bands 0-200, 0-250 and 0-400 Hz. RESULTS: Snore loudness increased significantly (P < 0.0001), whilst energy ratios for frequency bands 0-200, 0-250 and 0-400 Hz all decreased significantly as sedation level increased (P < 0.001). A significant difference between natural snoring and snoring induced at the lowest sedation level was shown (P < 0.0001). Endoscopic examination was not tolerated at this sedation level. CONCLUSIONS: The acoustic characteristics of sedation-induced and natural snores are sufficiently different to recommend the need for further research to determine whether the technique of sleep nasendoscopy is, in fact, a valid predictor of outcome of snoring surgery.

Acoustics↗
PubMed1997

[Optical stimulation method (Snore-Stop) and tongue retainer (Snore-Master) without relevance in therapy of obstructive sleep apnea and snoring].

Recently intra- und extraoral devices are increasingly used in order to treat obstructive sleep apnea and snoring. We examined the value of an optically stimulating system ("eye-cover", Snore-Stop) and a tongue-retainer (Snore-Master) as treatment of the obstructive sleep apnoe or snoring. In case of the eye-cover is a microphone integrated, which detects acoustic signals (e.g. snoring). After detection of snoring optical stimuli are generated in front of the eyes. This is intended to induce an arousal of the patient, without awaking him, causing a change of body position and this reduces the snoring or apneas. For the examination of the eye-cover in 26 patients (23 men, 55.6 +/- 10.3 years) polygraphic studies were performed while sleeping one night with the eye-cover and one night without, respectively. Visual analogue scales (VAS) were used in order to measure quality of life and sleep and the adverse effects of the device. To examine the tongue-retainer 14 patients (13 men, aged 52.9 +/- 11.8 years) were measured polygraphically. Again the subjective scores were assessed using the VAS. The principle of the tongue-retainer is to create a hollow space in front of the teeth, in which the tongue is positioned. Fixation of the tongue in this ventral position is thought to enlarge the mesopharyngeal area in order to reduce the upper airway obstruction. For both devices the index of snoring, the apnea-hypopnea-index, the index of desaturation, the mean and minimal SaO2 and SaO2 < 90 % in % of the night did not change significantly. Furthermore the subjective perception of the patients concerning their quality of sleep and life did not change. Moreover, despite of an adequate adaptation-period the use of the tongue-retainer was associated with considerable adverse effects. Neither the eye-cover nor the tongue-retainer could improve the severity of obstructive sleep apnoe or snoring.

Adult↗
PubMed2003

Alcohol ingestion influences the nocturnal cardio-respiratory activity in snoring and non-snoring males.

Night time alcohol ingestion influences nocturnal breathing in patients with sleep apnea syndrome or respiratory diseases. To evaluate the influence of nocturnal alcohol ingestion on the cardio-respiratory activity of healthy men, 8 snoring and 13 non-snoring male subjects were measured for 3 nights after alcohol ingestion. Blood alcohol concentration was 0.0, 0.5 and 0.8%, respectively. During each night polysomnographic data were obtained and analyzed. The apnea-hypopnea index was significantly higher in snoring than in non-snoring participants and increased in both groups under the influence of alcohol. Non-snoring males showed a significant increase of hypopneas under nocturnal alcohol ingestion (0.96-1.65-2.06). Mean oxygen saturation (SAO(2)) was significantly higher in non-snoring compared to snoring males, and both groups showed a significant decrease (non-snoring: 96.06%-95.7%-95.52%; snoring: 95.54%-94.74%-94.53%). Snoring individuals had a significant decrease in SAO(2) during NREM4, whereas SAO(2) was reduced significantly in REM and NREM3 in non-snoring subjects. The nocturnal heart rate was significantly increased in both groups under the influence of alcohol. The study proves that snoring and non-snoring healthy males are affected by nocturnal alcohol ingestion. Under the effect of alcohol, these patients can develop signs of a sleep apnea syndrome, which should be considered clinically.

Administration, Oral↗
PubMed1994

Changes in snoring characteristics after 30 days of nasal continuous positive airway pressure in patients with non-apnoeic snoring: a controlled trial.

BACKGROUND: A study was performed to evaluate the effect of discontinuation of nasal continuous positive airway pressure (NCPAP) treatment on snoring characteristics. METHODS: Eighteen non-apnoeic snoring subjects were randomly allocated to either a no treatment control group or an NCPAP treatment group. The control group was studied twice (baseline and day 30 of follow up). In the NCPAP group the level of NCPAP that abolished snoring was determined and part abolished snoring was determined and patients were placed on NCPAP every night for one month. A sleep study was performed on the first night without NCPAP after completing 30 days of treatment (follow up 1). A fourth polysomnographic study was performed 8-10 days after NCPAP was stopped (follow up 2) in six subjects. RESULTS: In both groups total sleep time (TST) and sleep architecture remained unchanged at the different visits. Baseline snoring characteristics in the two groups were similar. In the control group the mean (SE) number of snoring episodes/hour of sleep (snoring index) and the percentage of TST > 60 decibels (dB) were 380 (36)/h and 11.1 (2.0)% TST respectively at baseline, and was unchanged at follow up. In the NCPAP group the snoring index decreased from 387 (50)/h to 320 (57)/h after NCPAP therapy, but the % TSTS > 60 dB decreased from 10.3 (1.8)% to 7.4 (1.5)%. The snoring index and intensity returned to baseline values at follow up 2 (374 (74)/h, 9.8 (2.1)% TST). Changes in snoring characteristics could not be explained by changes in body position between the different sleep studies. CONCLUSIONS: NCPAP improves snoring but this effect is lost soon after stopping treatment.

Adult↗
PubMed2006

Snoring noise pollution--the need for objective quantification of annoyance, regulatory guidelines and mandatory therapy for snoring.

Habitual snoring without episodes of apnea or hypoventilation and without respiratory related arousals is considered to be annoying and without any need for treatment. However, studies seem to suggest an enormous psychosocial impact of annoyance for the bed partner. Apart from subjective questionnaires there still exists no generally accepted mode of measurement that can describe snoring objectively. We therefore adapted methods developed for environmental medicine and established a new snore score using psycho-acoustic parameters. For quantification of snoring noise we conducted nocturnal measurements in 19 habitual snorers. Free-field snore sounds were acquired with two low-cost non-contact microphones and transferred to a PC (sampling frequency 11 kHz). The data were recorded, analysed and stored automatically using a MATLAB script. Following the analysis of sound characteristics and levels, the score was computed from relevant parameters containing the rating level (L(R)), maximum level, two percentile levels for frequent maxima (L(5)S; L(1)) and snoring time. The determined values substantially exceeded the prescribed limits defined by WHO noise guidelines, and mainly affected the equivalent continuous sound exposure level, rating level and the immission standard values of brief noise peaks, whose maximum was exceeded by up to 32 dB(A). The Berlin snore score illustrated the objective acoustic annoyance on a scale from 0 to 100. It allows inter-individual comparison and objectifies the need for therapy. The clinical applicability of evaluating the reduction of snoring after surgical therapy is discussed exemplarily. The presented measuring method was found to be suitable for quantifying snoring noise and can be easily integrated into existing polysomnographic applications. In the case of habitual snoring with objective evidence of psychosocially disturbing acoustic annoyance, health fund providers should assume the costs of mandatory medical therapy.

Acoustics↗
PubMed1996

Acoustic analysis of snoring sound in patients with simple snoring and obstructive sleep apnoea.

Snoring, a symptom which may indicate the presence of the obstructive sleep apnoea syndrome (OSA), is also common in the general population. Recent studies have suggested that the acoustic characteristics of snoring sound may differ between simple snorers and OSA patients. We have studied a small number of patients with simple snoring and OSA, analysing the acoustic characteristics of the snoring sound. Seventeen male patients, 10 with OSA (apnoea/hypopnoea index (AHI) 26.2 events x h(-1)) and seven simple snorers (AHI 3.8 events x h(-1)), were studied. Full night polysomnography was performed and the snoring sound power spectrum was analysed. Spectral analysis of snoring sound showed the existence of two different patterns. The first pattern was characterized by the presence of a fundamental frequency and several harmonics. The second pattern was characterized by a low frequency peak with the sound energy scattered on a narrower band of frequencies, but without clearly identified harmonics. The seven simple snorers and two of the 10 patients with OSA (AIH 13 and 14 events x h(-1), respectively) showed the first pattern. The rest of the OSA patients showed the second pattern. The peak frequency of snoring was significantly lower in OSA patients, with all but one OSA patient and only one simple snorer showing a peak frequency below 150 Hz. A significant negative correlation was found between AHI and peak and mean frequencies of the snoring power spectrum (p<0.0016 and p<0.0089, respectively). In conclusion, this study demonstrates significant differences in the sound power spectrum of snoring sound between subjects with simple snoring and obstructive sleep apnoea patients.

Acoustics↗
PubMed1999

The snoring spectrum: acoustic assessment of snoring sound intensity in 1,139 individuals undergoing polysomnography.

STUDY OBJECTIVES: To quantify the snoring sound intensity levels generated by individuals during polysomnographic testing and to examine the relationships between acoustic, polysomnographic, and clinical variables. DESIGN: The prospective acquisition of acoustic and polysomnographic data with a retrospective medical chart review. SETTING: A sleep laboratory at a primary care hospital. PARTICIPANTS: All 1,139 of the patients referred to the sleep laboratory for polysomnographic testing from 1980 to 1994. INTERVENTIONS: The acoustic measurement of snoring sound intensity during sleep concurrent with polysomnographic testing. MEASUREMENTS AND RESULTS: Four decibel levels were derived from snoring sound intensity recordings. L1, L5, and L10 are measures of the sound pressure measurement in decibels employing the A-weighting network that yields the response of the human ear exceeded, respectively, for 1, 5, and 10% of the test period. The Leq is a measure of the A-weighted average intensity of a fluctuating acoustic signal over the total test period. L10 levels above 55 dBA were exceeded by 12.3% of the patients. The average levels of snoring sound intensity were significantly higher for men than for women. The levels of snoring sound intensity were associated significantly with the following: polysomnographic testing results, including the respiratory disturbance index (RDI), sleep latency, and the percentage of slow-wave sleep; demographic factors, including gender and body mass; and clinical factors, including snoring history, hypersomnolence, and breathing stoppage. Men with a body mass index of > 30 and an average snoring sound intensity of > 38 dBA were 4.1 times more likely to have an RDI of > 10. CONCLUSIONS: Snoring sound intensity levels are related to a number of demographic, clinical, and polysomnographic test results. Snoring sound intensity is closely related to apnea/hypopnea during sleep. The noise generated by snoring can disturb or disrupt a snorer's sleep, as well as the sleep of a bed partner.

Adult↗
PubMed1988

[A simple procedure for quantitative and time coded detection of snoring sounds in apnea and snoring patients].

A simple technique for time-encoded recording of snoring sounds is presented. An electronic circuit connected to a stereo cassette recorder via cord remote control will start the recorder when the sound pressure of the snoring sound surpasses a preset level. The snoring sound is recorded on one track of the cassette recorder. The other track is used for the time code. Every 120 seconds the tape recorder is switched on by the electronic circuit and a short high level signal is recorded. The time interval between two time coding signals equals the snoring time. Analysis of the time coding signals is performed by an A/D converter installed in a Personal Computer. The converter amd accompanying software are used to calculate the duration of the intervals between the coding signals. The results are displayed graphically where sleeping time is plotted against snoring time (Fig.2). The length of each bar equals the snoring time in seconds for each 120 second interval. Snoring periods can be recognised at a glance and the snoring pattern can be evaluated. Three cases studies are presented demonstrating the performance of the technique. A 39-year-old female with nonpathological snoring (Fig.2), a 45-year-old male with heavy and regular snoring (Fig. 3) and a 36-year-old male with a full-blown Pickwickian Syndrome (Fig. 4). This patient's response to nasal cPAP is demonstrated in Fig. 5.

Adult↗
PubMed2006

A snore extraction method from mixed sound for a mobile snore recorder.

This paper presents a snore recorder that can separate snores from their delayed mixtures. This is useful to study the snore sounds of individuals when these sounds occur in a normal in-home sleeping environment, where two people are sleeping together and both produce sounds. Based on methods for blind source separation, we give a snore separator that solves the blind delayed source separation problem and provide a performance index to monitor its convergence. The separated snores can be analyzed to detect symptoms of sleep apnea prior to polysomnography or as a monitoring device after polysomnography has been performed. Experimental results show good performance of the snore separator.

Algorithms↗
PubMed1989

[Radiocephalometric findings and duration of snoring in habitual snoring and obstructive apnea syndrome].

In 11 patients with chronic snoring and 12 subjects with obstructive apnoea syndrome the percentage of snoring duration above a preset sound pressure level during one night's sleep was correlated with the radiocephalometric data. Cephalometric distances PAS, PM-Pg, MP-H and angles SNA and SNB representing measures for posterior airway space, size of soft palate, relative position of hyoid bone and relative position of maxilla and mandibula were evaluated. Each patient showed pathological deviations from normal values in at least one of the cephalometric parameters. A significant correlation between snoring duration and a single cephalometric distance could not be found. However, an index combining pathological deviations from all three cephalometric distances showed a highly significant correlation with snoring duration (p less than 0.01 - Fig. 11), as did deviations from normal values of angle SNB (p less than 0.03 - Fig. 10). Our findings indicate that snoring and obstructive apnoea syndrome are not only caused by neurologic dysregulation, and that in addition specific craniofacial anomalies are prerequisites for the development of the disease. For the first time it is demonstrated that these anomalies exist in chronic snorers as well as in apnoeic patients. Our findings support Lugaresi's hypothesis that heavy snoring and obstructive apnoea syndrome are based on the same defect and differ in severity only.

Adult↗
PubMed1995

Overnight pulse oximetry in snoring and non-snoring children.

The effect of snoring on overnight pulse oximetry recordings in the paediatric community was investigated. A random sample of 222 children up to 10 years of age from the town of Frome, Somerset, UK, had overnight pulse oximetry performed in the home environment. The oximetry recordings obtained from 58 snoring and 164 non-snoring subjects were compared. No clinically relevant difference in oxygen saturation level could be detected between these two groups of children. In conclusion, snoring in children up to 10 years of age is common, 11% often snore. It is not associated with hypoxia as measured by overnight pulse oximetry. This would suggest that surgical intervention for the symptom of snoring alone is not indicated.

Child↗
PubMedDate not supplied

Patients' and cohabitants' reports on snoring and daytime sleepiness, 1-8 years after surgical treatment of snoring.

A follow-up study was performed with the aim to evaluate all individuals surgically treated by the uvulopalatopharyngoplasty (UPPP) or laser uvulopalatoplasty (LUPP) method from a whole county in Sweden, 1-8 years after surgery, by assessing snoring occurrence and daytime sleepiness, as experienced by the patients and their cohabitants. Questionnaires were mailed to all operated people (n = 457) and were returned by 91% (346 men, 69 women) preoperatively diagnosed as habitual snorers (n = 255), cases of obstructive sleep apnea syndrome (n = 110) and unspecified snorers (n = 48). In addition 345 bedpartners participated. For outcome of surgery, no significant differences in diagnoses or sex were found. Improvement in snoring occurrence was reported by 89.6% of the patients, confirmed by 92% of the cohabitants (r = 0.84, p < 0.01). The remaining snoring occurrence was significantly dependent on the surgical method and the time after operation. Excessive daytime sleepiness (EDS) was experienced by 73.3% of the patients compared to 67% reported by the cohabitants. Of 415 patients operated on, 18% were free from snoring and 25% were free from EDS. Individuals with a shorter time since surgery reported less snoring. The UPPP method gave a significantly better result than LUPP for the symptom 'snoring'.

Adult↗
PubMed2006

Snoring source identification and snoring noise prediction.

This paper investigates the snoring mechanism of humans by applying the concept of structural intensity to a three-dimensional (3D) finite element model of a human head, which includes: the upper part of the head, neck, soft palate, hard palate, tongue, nasal cavity and the surrounding walls of the pharynx. Results show that for 20, 40 and 60Hz pressure loads, tissue vibration is mainly in the areas of the soft palate, the tongue and the nasal cavity. For predicting the snoring noise level, a 3D boundary element cavity model of the upper airway in the nasal cavity is generated. The snoring noise level is predicted for a prescribed airflow loading, and its range agrees with published measurements. These models may be further developed to study the various snoring mechanisms for different groups of patients.

Computer Simulation↗
PubMed1998

The value of sedation nasendoscopy: a comparison between snoring and non-snoring patients.

Sedation or sleep nasendoscopy is a widely-used investigation in snorers presenting to otolaryngologists in the UK, despite its non-physiological basis. The presence or absence of snoring and its site of generation were compared between a group of 205 snorers and another of 126 non-snorers. Snoring was produced at nasendoscopy in 45.3% of non-snorers but could not be produced in 18.1% of snorers. There was no significant difference in the site of sound production between the two groups and although the noise produced by the non-snoring group was quieter, this difference was not significant.

Adult↗