Does Snoring Intensity Correlate with the Severity of Obstructive Sleep Apnea?

Abstract

Study Objectives: It is commonly believed that louder snoring is associated with more severe obstructive sleep apnea (OSA). We evaluated the association between snoring intensity and the severity of OSA to better understand this clinical correlation. We also investigated the relationships between body mass index (BMI), neck size, sleep stage, and body position with the intensity of snoring. Methods: Overnight polysomnography, including objective measurement of snoring intensity, in 1643 habitual snorers referred for evaluation of sleep apnea. Results: Sixty-five percent of patients were male; the cohort had a mean age of 48.7 ± 13.7 y and BMI of 30.9 ± 8.8 kg/m 2 . The mean apnea-hypopnea index (AHI) was 28.2 ± 26. The severity of OSA was graded as no OSA (AHI < 5), mild (AHI 5 to 15), moderate (AHI 15 to 30), severe (AHI 30 to 50), and very severe OSA (AHI > 50). Snoring intensity increased progressively across all 5 categories of AHI frequency and ranged from 46.3 ± 3.6 db in patients with AHI < 5 to 60.5 ± 6.4 db in those with AHI > 50. Furthermore, there was a positive correlation between the intensity of snoring and the AHI (r = 0.66, p < 0.01). Conclusions:The intensity of snoring increases as OSA becomes more severe.

Snoring intensity and excessive daytime sleepiness in subjects without obstructive sleep apnea

“…Due to its association with decreased quality of life for both snorers and their family members, snoring is an emerging healthcare issue . OSA, defined as an apnea‐hypopnea index (AHI) of 5 or more, is associated with other comorbidities, such as the metabolic syndrome, arterial hypertension, atherosclerosis, ischemic stroke, and excessive daytime sleepiness (EDS) . Snorers with an AHI of <5 are referred to as “simple” or “primary snorers” who do not meet the criteria for OSA, and therefore they are not routinely treated.…”

“…Snoring and OSA were found to be associated with EDS in several studies . In addition, louder snoring is correlated with the severity of both OSA and EDS . However, the relation between the intensity of snoring in simple snorers without OSA and EDS is less clear.…”

Associations of snoring frequency and intensity in pregnancy with time‐to‐delivery

“…[14][15][16]18 In non-pregnant populations, snoring intensity, defined as loud or as disruptive to others, has been shown to characterise the severity of disease, such that loud snoring correlates to objective measures of OSA severity. [21][22][23]34,35 Surprisingly, snoring intensity has been rarely measured in pregnancy. In a descriptive study of sleep disturbances in pregnancy among 195…”

“…In non-pregnant populations, snoring intensity has been correlated with OSA severity, measured with an overnight polysomnography, in a dose-response manner. [21][22][23] Little consideration has been given to snoring intensity in pregnancy. Furthermore, despite the inherent temporal property of gestational age at delivery, prior studies have rarely framed deliveries as time-to-event outcomes.…”

Dynamics of snoring sounds and its connection with obstructive sleep apnea

“…Irregular snoring and witnessed apneas are the major signals indicating OSA and there is an increasing amount of research trying to relate OSA with snoring patterns. Most methods in the literature try to establish a correlation between OSA and either the number of snore events or the wave features of the snore such as intensity, sound frequency, number of snore events, spectral density, or a combination of these features [12,13,14]. Recently, Cavusoglu et al [15,16] proposed the use of sequential properties of snoring episodes for OSA identification.…”