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Huang Z, Lobbezoo F, Vanhommerig JW, Volgenant CMC, de Vries N, Aarab G, Hilgevoord AAJ. Effects of demographic and sleep-related factors on snoring sound parameters. Sleep Med 2023; 104:3-10. [PMID: 36857868 DOI: 10.1016/j.sleep.2023.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/13/2023] [Accepted: 02/15/2023] [Indexed: 02/25/2023]
Abstract
OBJECTIVE To investigate the effect of frequently reported between-individual (viz., age, gender, body mass index [BMI], and apnea-hypopnea index [AHI]) and within-individual (viz., sleep stage and sleep position) snoring sound-related factors on snoring sound parameters in temporal, intensity, and frequency domains. METHODS This study included 83 adult snorers (mean ± SD age: 42.2 ± 11.3 yrs; male gender: 59%) who underwent an overnight polysomnography (PSG) and simultaneous sound recording, from which a total of 131,745 snoring events were extracted and analyzed. Data on both between-individual and within-individual factors were extracted from the participants' PSG reports. RESULTS Gender did not have any significant effect on snoring sound parameters. The fundamental frequency (FF; coefficient = -0.31; P = 0.02) and dominant frequency (DF; coefficient = -12.43; P < 0.01) of snoring sounds decreased with the increase of age, and the second formant increased (coefficient = 22.91; P = 0.02) with the increase of BMI. Severe obstructive sleep apnea (OSA; AHI ≥30 events/hour), non-rapid eye movement sleep stage 3 (N3), and supine position were all associated with more, longer, and louder snoring events (P < 0.05). Supine position was associated with higher FF and DF, and lateral decubitus positions were associated with higher formants. CONCLUSIONS Within the limitations of the current patient profile and included factors, AHI was found to have greater effects on snoring sound parameters than the other between-individual factors. The included within-individual factors were found to have greater effects on snoring sound parameters than the between-individual factors under study.
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Affiliation(s)
- Zhengfei Huang
- Department of Orofacial Pain and Dysfunction, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Department of Clinical Neurophysiology, OLVG, Amsterdam, the Netherlands.
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Joost W Vanhommerig
- Department of Research and Epidemiology, OLVG Hospital, Amsterdam, the Netherlands
| | - Catherine M C Volgenant
- Department of Preventive Dentistry, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Nico de Vries
- Department of Orofacial Pain and Dysfunction, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Department of Otorhinolaryngology - Head and Neck Surgery, OLVG, Amsterdam, the Netherlands; Department of Otorhinolaryngology - Head and Neck Surgery, Antwerp University Hospital (UZA), Antwerp, Belgium
| | - Ghizlane Aarab
- Department of Orofacial Pain and Dysfunction, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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De Meyer MMD, Vanderveken OM, De Weerdt S, Marks LAM, Cárcamo BA, Chavez AM, Matamoros FA, Jacquet W. Use of mandibular advancement devices for the treatment of primary snoring with or without obstructive sleep apnea (OSA): A systematic review. Sleep Med Rev 2020; 56:101407. [PMID: 33326914 DOI: 10.1016/j.smrv.2020.101407] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 07/17/2020] [Accepted: 07/30/2020] [Indexed: 02/07/2023]
Abstract
The aim of this review was to systematically evaluate the available scientific evidence on the benefit of mandibular advancement devices (MADs) in the treatment of primary snoring (PS). From 905 initially identified articles, 18 were selected. Papers that provided indirect information regarding obstructive sleep apnea syndrome (OSAS) and/or sleep breathing disorders (SBD) were included. Information was obtained on monoblock and duoblock appliances from the selected studies. The devices were most commonly able to achieve 50%-70% of the maximum mandibular protrusion. The frequently used outcome measurements were the apnea-hypopnea index, Epworth sleepiness scale, and oxygen desaturation index, which all yielded positive post-treatment results. The most common side effects were temporomandibular joint pain and excessive salivation, which improved with time. Our findings indicated that the use of MADs, even with varying designs, improved outcomes in all the reported patient populations (PS, OSAS, and SBD). Despite the lack of studies on PS, the available evidence supports the use of MADs for treatment of PS. Snoring should be treated from a preventive and psychosocial perspective to avoid progression to more severe diseases that could have a significant medical and economic impact.
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Affiliation(s)
- Micheline M D De Meyer
- Oral Health in Special Needs, Sleep Breathing Disorders, Oral Health Sciences, Ghent University Hospital, Gent, Belgium; Department of Dentistry, Radboud University Medical Center and Radboud Institute for Health Sciences, Nijmegen, the Netherlands; Department of Pneumology, UZ Brussels, Brussels, Belgium; Faculty of Dentistry, University of Concepción, Concepción, Chile; Department of Educational Sciences EDWE-LOCI, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium; Department of Materials, Textiles and Chemical Engineering, Faculty of Engineering and Architecture, Ghent University, Belgium.
| | - Olivier M Vanderveken
- Department of Ear, Nose, and Throat, Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium; Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | | | - Luc A M Marks
- Special Care in Dentistry, Oral Health Sciences, Ghent University Hospital, Gent, Belgium
| | | | - Andrés M Chavez
- Faculty of Dentistry, University of Concepción, Concepción, Chile
| | | | - Wolfgang Jacquet
- Special Care in Dentistry, Oral Health Sciences, Ghent University Hospital, Gent, Belgium; Department of Oral Health Sciences ORHE, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium; Department of Educational Sciences EDWE-LOCI, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium; Department of Materials, Textiles and Chemical Engineering, Faculty of Engineering and Architecture, Ghent University, Belgium
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Smardz J, Wieckiewicz M, Gac P, Poreba R, Wojakowska A, Mazur G, Martynowicz H. Influence of age and gender on sleep bruxism and snoring in non-apneic snoring patients: A polysomnographic study. J Sleep Res 2020; 30:e13178. [PMID: 32871629 DOI: 10.1111/jsr.13178] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 07/21/2020] [Accepted: 08/03/2020] [Indexed: 12/11/2022]
Abstract
The present study aimed to assess the influence of gender and age on snoring and sleep bruxism in non-apneic snoring patients. Adult participants with clinical suspicion of snoring and with no other significant medical history were recruited. Single-night video polysomnography was performed to detect snoring and sleep bruxism. Finally, 137 snoring non-apneic participants were included. Statistical analysis of gender groups showed that the total snore index and snore train were significantly higher in men than in women. Men also presented severe bruxism, with significantly more frequent episodes and higher bruxism episodes index scores. The correlation analysis showed the presence of significant linear relationships in the supine sleep position between age and snore index, snore index in non-rapid eye movement 2 (N2) sleep stage, and snore train. The analysis of groups separated according to the criterion of third age quartile showed that the average, maximum and minimum audio volume in the non-supine sleep position was significantly higher in the older group. The analysis of groups separated according to the criterion of median age showed that the bruxism episode index and bruxism phasic episodes were significantly higher in the younger group. Thus, it can be concluded that both age and gender influence snoring and sleep bruxism. Snoring and sleep bruxism seem to be more intensive in men. Older patients seem to snore more in N2 sleep and the supine sleep position and present lower bruxism episodes, especially the phasic type. The results of the present study indicate the need for further research on this topic to establish the possible relationship between snoring and sleep bruxism.
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Affiliation(s)
- Joanna Smardz
- Department of Experimental Dentistry, Wroclaw Medical University, Wroclaw, Poland
| | - Mieszko Wieckiewicz
- Department of Experimental Dentistry, Wroclaw Medical University, Wroclaw, Poland
| | - Pawel Gac
- Department of Hygiene, Wroclaw Medical University, Wroclaw, Poland
| | - Rafal Poreba
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Wroclaw, Poland
| | - Anna Wojakowska
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Wroclaw, Poland
| | - Grzegorz Mazur
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Wroclaw, Poland
| | - Helena Martynowicz
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Wroclaw, Poland
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Rana M, August J, Levi J, Parsi G, Motro M, DeBassio W. Alternative Approaches to Adenotonsillectomy and Continuous Positive Airway Pressure (CPAP) for the Management of Pediatric Obstructive Sleep Apnea (OSA): A Review. Sleep Disord 2020; 2020:7987208. [PMID: 32695520 DOI: 10.1155/2020/7987208] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 06/09/2020] [Indexed: 12/21/2022]
Abstract
Continuous positive airway pressure (CPAP) is considered first-line treatment in the management of pediatric patients without a surgically correctible cause of obstruction who have confirmed moderate-to-severe obstructive sleep apnea (OSA). The evidence supports its reduction on patient morbidity and positive influence on neurobehavioral outcome. Unfortunately, in clinical practice, many patients either refuse CPAP or cannot tolerate it. An update on alternative approaches to CPAP for the management of OSA is discussed in this review, supported by the findings of systematic reviews and recent clinical studies. Alternative approaches to CPAP and adenotonsillectomy for the management of OSA include weight management, positional therapy, pharmacotherapy, high-flow nasal cannula, and the use of orthodontic procedures, such as rapid maxillary expansion and mandibular advancement devices. Surgical procedures for the management of OSA include tongue-base reduction surgery, uvulopalatopharyngoplasty, lingual tonsillectomy, supraglottoplasty, tracheostomy, and hypoglossal nerve stimulation. It is expected that this review will provide an update on the evidence available regarding alternative treatment approaches to CPAP for clinicians who manage patients with pediatric OSA in daily clinical practice.
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Neruntarat C, Khuancharee K, Shoowit P. Er:YAG laser for snoring: a systemic review and meta-analysis. Lasers Med Sci 2020; 35:1231-1238. [DOI: 10.1007/s10103-020-02987-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 02/21/2020] [Indexed: 12/16/2022]
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