The Frequency and Energy of Snoring Sounds Are Associated with Common Carotid Artery Intima-Media Thickness in Obstructive Sleep Apnea Patients

Abstract

Obstructive sleep apnea (OSA) is a known risk factor for atherosclerosis. We investigated the association of common carotid artery intima-media thickness (CCA-IMT) with snoring sounds in OSA patients. A total of 30 newly diagnosed OSA patients with no history of cardiovascular diseases were prospectively enrolled for measuring mean CCA-IMT with B-mode ultrasonography, body mass index, metabolic syndrome, 10-year cardiovascular disease risk score, high-sensitivity C-reactive protein, and homocysteine. Good-quality signals of full-night snoring sounds in an ordinary sleep condition obtained from 15 participants were further acoustically analyzed (Included group). All variables of interest were not significantly different (all p > 0.05) between the included and non-included groups except for diastolic blood pressure (p = 0.037). In the included group, CCA-IMT was significantly correlated with snoring sound energies of 0–20 Hz (r = 0.608, p = 0.036) and 652–1500 Hz (r = 0.632, p = 0.027) and was not significantly associated with that of 20–652 Hz (r = 0.366, p = 0.242) after adjustment for age and sex. Our findings suggest that underlying snoring sounds may cause carotid wall thickening and support the large-scale evaluation of snoring sound characters as markers of surveillance and for risk stratification at diagnosis.

Numerical study of dynamic glottis and tidal breathing on respiratory sounds in a human upper airway model

“…8). This finding is consistent with the characteristics of stenotic-typed snoring that generates an irregular sound and peak frequencies over 500 Hz [64]. Considering the sine-dynamic case in particular, the peak frequencies occur in the range of 200–300 Hz (Fig.…”

“…Considering the proximity of the sound source to the carotid artery, chronic laryngeal snoring can initiate or aggravate the carotid artery wall thickening. Moreover, carotid atherosclerosis is significantly associated with snoring sound energy from 0 to 20 Hz [64]. This study predicted the highest sound pressure levels in this range, which are 10–20 dB higher than those of other frequencies, as shown in Figs.…”

“…The carotid artery atherosclerosis has been shown to be strongly affected by sound frequencies from 652 to 1500 Hz, which accounts for snoring originated at the larynx and tongue base [64, 65]. In this study, relatively high sound pressure energy was predicted over 650 Hz.…”

Snoring and carotid artery disease: A new risk factor emerges

“…A recent study by Lee et al found that snoring sounds may cause carotid wall thickening, as shown by ultrasound measurement of CCA intima‐media thickness . In fact, the specific frequencies of 0 to 20 Hz and 652 to 1,500 Hz correlated most with CCA intima‐media thickening, which suggests that the etiology of the thickening is likely more complex and multifactorial.…”

Assessment of atherosclerotic plaque activity in patients with sleep apnea using hybrid positron emission tomography/magnetic resonance imaging (PET/MRI): a feasibility study

“…Acute physiological consequences of OSA, such as intermittent hypoxia, swings in intrathoracic pressures, and repetitive arousals leading to sympathetic activation are some of the proposed mechanisms by which OSA may contribute to an accelerated rate of endothelial dysfunction, oxidative stress, and atherosclerosis over time [43]. Exposure to chronic snoring vibrations may also trigger an inflammatory cascade leading to endothelial damage, thus contributing to early development of atherosclerosis [44–47]. By relieving some of the acute physiologic consequences of OSA, CPAP therapy may thereby eliminate some of the triggers leading to accelerated atherosclerosis and vascular inflammation overtime.…”