Snoring Sounds Predict Obstruction Sites and Surgical Response in Patients with Obstructive Sleep Apnea Hypopnea Syndrome

Abstract

Snoring sounds generated by different vibrators of the upper airway may be useful indicators of obstruction sites in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). This study aimed to investigate associations between snoring sounds, obstruction sites, and surgical responses (≥50% reduction in the apnea-hypopnea index [AHI] and <10 events/hour) in patients with OSAHS. This prospective cohort study recruited 36 OSAHS patients for 6-hour snoring sound recordings during in-lab full-night polysomnography, drug-induced sleep endoscopy (DISE), and relocation pharyngoplasty. All patients received follow-up polysomnography after 6 months. Fifteen (42%) patients with at least two complete obstruction sites defined by DISE were significantly, positively associated with maximal snoring sound intensity (40–300 Hz; odds ratio [OR], 1.25, 95% confidence interval [CI] 1.05–1.49) and body mass index (OR, 1.48, 95% CI 1.02–2.15) after logistic regression analysis. Tonsil obstruction was significantly, inversely correlated with mean snoring sound intensity (301–850 Hz; OR, 0.84, 95% CI 0.74–0.96). Moreover, baseline tonsil obstruction detected by either DISE or mean snoring sound intensity (301–850 Hz), and AHI could significantly predict the surgical response. Our findings suggest that snoring sound detection may be helpful in determining obstruction sites and predict surgical responses.

Snoring sound energy as a potential biomarker for disease severity and surgical response in childhood obstructive sleep apnoea: A pilot study

“…4 Obstructions other than surgical sites (adenoid and palatine tonsils), such as tongue base, lingual tonsil and supraglottic obstruction, may cause surgical non-success. 19,20 In our previous study, 7 Therefore, further studies with a larger sample size with the extended age spectrum and drug-induced examinations are warranted to confirm our results and inferences. SSE of high frequency is a potential biomarker for severe OSA, and analysis of this specific SSE may help to predict surgical success and monitor surgical outcomes.…”

“…Obstructions other than surgical sites (adenoid and palatine tonsils), such as tongue base, lingual tonsil and supraglottic obstruction, may cause surgical non‐success . In our previous study, a snoring sound of 850‐2000 Hz was related to tongue base obstruction in adulthood OSA, and Xu reported that a snoring sound >800 Hz was related to lower level obstruction in adulthood OSA. Accordingly, there may be a link between high‐frequency snoring sounds and lower level obstructions.…”

“…In other words, patients with high SSE of 801‐1000 Hz had a higher chance of surgical non‐success. Therefore, this non‐contact, non‐invasive, inexpensive technology of snoring sound analysis may have the potential to be a promising tool to screen for severe OSA in children, predict surgical success, and monitor surgical response as in our previous studies on adults with OSA …”

“…[4][5][6] Acoustic analysis of snoring sounds represents a non-contact, non-invasive, inexpensive technology which has been reported to be able to indirectly locate the sites and degree of upper airway obstructions during sleep. 5,7 The presence of a higher snoring sound energy (SSE) of high frequency (851-2000 Hz) in adults with OSA has been reported to be a warning sign of severe OSA and to indicate the need for urgent OSA management. 4 However, the association between SSE and OSA is still unclear in children.…”

Dynamic Drug-Induced Sleep Computed Tomography in Adults With Obstructive Sleep Apnea

“…The procedure used for drug-induced sleep in a CT room unit equipped with standard anaesthetic monitoring (oxygen saturation, non-invasive blood pressure, and electrocardiography) was similar to our previous reports 36 37 . Despite drug-induced sleep has been proven its safety in severe OSA patients 38 , we closely monitored the occurrence of mean arterial pressure <65 mmHg, oxygen saturation <90%, and persistent apnea.…”