The Snoring Spectrum: Snoring Sound Intensity During Sleep

In: Snoring

11 Aug 2014

The relationships between snoring sound intensity and demographic factors, the BMI, gender, and age were examined. Univariate analyses revealed that the BMI and gender were significantly related to all sound intensity levels (Table 2). The BMI had a positive association with snoring sound intensity levels, with a Pearson correlation coefficient for the Leq, L1, L5, and L10 values, respectively, of 0.30, 0.29, 0.28, and 0.24 (p < 0.0001). Men were significantly louder snorers than women. The relationship between snoring sound intensity levels and the BMI remained statistically significant after controlling for gender (p < 0.001). No correlation was found between snoring sound intensity levels and age for the Leq, L1, L5, and L10 values, respectively: 0.08, 0.05, 0.01 and 0.06.
Snoring Sound Intensity During Sleep and Polysomnographic Results
The potential relationship between snoring sound intensity levels and the RDI was investigated. Patients with apneic snoring, defined as an RDI of > 10, generated significantly higher snoring sound intensity levels than patients with nonapneic snoring, defined as an RDI of < 10 (Table 3). The relationship between snoring sound intensity levels and the RDI was analyzed as a function of the reasons for polysomnographic referral. Patients referred with breathing stoppage as their chief complaint had significantly higher snoring sound intensity levels and RDI values than patients referred because of snoring or hypersomnolence (Table 4). Multivariate logistic regression analysis showed that snoring sound intensity levels were strongly associated with the RDI, even after controlling for demographic and clinical factors (Table 5). purchase antibiotics online

The relationships between snoring sound intensity and measures of sleep quality were analyzed (Table 6). Nonrapid eye movement sleep stages 3 and 4 were combined as slow wave sleep (SWS), and nonrapid eye movement sleep stages 1 and 2 were combined as light sleep (LS). The percentage of SWS for patients with an L5 value of > 55 dBA (high L5) was significantly higher than for patients with an L5 value of < 55 dBA (low L5). The percentage of LS for patients with an L5 value of > 55 dBA was similar to that found in patients with an L5 value of < 55 dBA. The percentage of SWS and LS for patients with an Leq of > 55 dBA (high Leq) was similar to that found in patients with an Leq of < 55 dBA (low Leq). Patients with high Leq or L5 values had significantly shorter periods of sleep latency. No significant differences in sleep efficiency were found between patients having high or low Leq or L5 values.

Table 2—Snoring Sound Intensity Measures by Gender

Sound Intensity Measure Male* Female* p Value
Leq, dBA 46.8 (46.2-47.3 43.8 (42.8-44.9) < 0.0001
No. of patients 891 247
L1, dBA 57.3 (56.9-57.8) 54.6 (53.6-55.6) < 0.0001
No. of patients 889 245
L5, dBA 51.6 (51.1-52.0) 49.6 (48.7-50.4) < 0.0001
No. of patients 849 221
L10, dBA 49.1 (48.6-49.5) 47.9 (47.0-48.8) < 0.0001
No. of patients 768 190

Table 3—Sound Intensity Measures for Suhjects With Apneic Snoring (RDI > 10) and Non-apneic Snoring (RDI < 10)

Sound Intensity Measure Nonapneic Snoring * (RDI < 10) Apneic Snoring* (RDI > 10) p Value
Leq, dBA 42.7 (42.0-43.4) 48.8 (48.7-49.3) < 0.0001
No. of patients 422 672
L1, dBA 53.4 (52.8-54.1) 59.2 (58.7-59.7) < 0.0001
No. of patients 419 672
L5, dBA 48.0 (47.4-48.6) 53.2 (52.7-53.7) < 0.0001
No. of patients 382 655
L10, dBA 46.0 (45.5-46.5) 50.4 (49.9-50.9) < 0.0001
No. of patients 327 606

Table 4—Sound Intensity Measures and RDI For Three Categories of Chief Complaint

Sound Intensity Measure Chief Complaint p Valuef p Valuej
Snoring Hypersomnolence BreathingStoppage
Leq, dBA 46.2 (45.3-47.2) 45.5 (44.4-46.6) 48.7 (47.3-50.0) 0.001 0.608
No. of patients 202 247 123
L10, dBA 47.4 (46.6-48.2) 48.9 (48.0-49.8) 50.9 (49.6-52.1) 0.000 0.033
No. of patients 182 197 112
L5, dBA 50.3(49.4-51.1) 50.9 (50.0-51.8) 53.7 (52.5-55.0) 0.000 0.444
No. of patients 198 226 118
L1, dBA 56.8 (55.9-57.6) 56.0 (55.1-57.0) 59.3 (57.9-60.6) 0.001 0.283
No. of patients 201 247 123
RDI 25.4(21.6-29.2) 31.8 (27.4-36.2) 46.7 (39.5-53.9) 0.000 0.101
No. of patients 195 232 122

Table 5—Multivariate Logistic Regression Statistics

Independent Variables RegressionCoefficient StandardError Significance, p Value Odds Ratio (95% CI)
Intercept -2.14 0.97 0.000
Leq a 38 1.24 0.28 0.000 3.44 (1.99-5.95)
Obese, BMI > 30 1.01 0.20 0.000 2.76 (1.87-4.06)
Gender, male 0.89 0.23 0.000 2.43 (1.54-3.83)
Age 0.03 0.01 0.000 1.03(1.01-1.04)
Percentage of SWS – 0.02 0.01 0.071 0.98 (0.96-1.00)
Sleep efficiency – 0.01 0.01 0.492 0.99 (0.98-1.01)

Table 6—Sleep Architecture Measures

Sleep Architecture Measure Leq, dBA L5, dBA
0-55* > 55* p Value 0-55* > 55* p Value
Sleep latency, min 12.6(11.4-13.8) 9.5 (7.3-11.7) 0.025 13.2 (11.8-14.7) 9.8(8.3-11.3) 0.004
No. of patients 1001 125 748 311
Sleep efficiency, min 78.8 (77.9-79.7) 79.4(77.1-81.7) 0.642 78.6 (77.5-79.7) 79.7(78.4-81.1) 0.821
No. of patients 1006 138 753 311
Percentage of SWS 9.5% (8.8-10.1) 8.6% (6.8-10.4) 0.327 10.1% (9.3-10.8) 7.5% (6.5-8.5) 0.011
No. of patients 1004 125 752 310
Percentage of LS 76.3% (75.5-77.0) 74.6% (72.2-77.1) 0.242 75.8% (74.9-76.7) 76.7% (75.3-78.1) 0.191
No. of patients 1006 125 753 312

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