Abstract
About 40% of the adult population is affected by snoring, which is closely related to obstructive sleep apnea (OSA) and can be associated with serious health implications. Commercial smartphone applications (apps) offer the possibility of monitoring snoring at home. However, the number of validation studies addressing snoring apps is limited. The purpose of the present study was to assess the accuracy of recorded snoring using the free version of the app SnoreLab (Reviva Softworks Ltd., London, UK) in comparison to a full-night polygraphic measurement (Miniscreen plus, Löwenstein Medical GmbH & Co., KG, Bad Ems, Germany). Nineteen healthy adult volunteers (4 female, 15 male, mean age: 38.9 ± 19.4 years) underwent simultaneous polygraphic and SnoreLab app measurement for one night at home. Parameters obtained by the SnoreLab app were: starting/ending time of monitoring, time in bed, duration and percent of quiet sleep, light, loud and epic snoring, total snoring time and Snore Score, a specific score obtained by the SnoreLab app. Data obtained from polygraphy were: starting/ending time of monitoring, time in bed, total snoring time, snore index (SI), snore index obstructive (SI obstructive) and apnea-hypopnea-index (AHI). For different thresholds of percentage snoring per night, accuracy, sensitivity, specificity, positive and negative predictive values were calculated. Comparison of methods was undertaken by Spearman-Rho correlations and Bland-Altman plots. The SnoreLab app provides acceptable accuracy values measuring snoring >50% per night: 94.7% accuracy, 100% sensitivity, 94.1% specificity, 66.6% positive prediction value and 100% negative prediction value. Best agreement between both methods was achieved in comparing the sum of loud and epic snoring ratios obtained by the SnoreLab app with the total snoring ratio measured by polygraphy. Obstructive events could not be detected by the SnoreLab app. Compared to polygraphy, the SnoreLab app provides acceptable accuracy values regarding the measurement of especially heavy snoring.
Highlights
Introduction iationsSnoring is an age- and gender-dependent phenomenon and affects 40% of the adult population [1,2]
Despite the duration dependent methodological differences described above, the percentage of total snoring assessed by SnoreLab was highly correlated with the snoring ratio measured by polygraphy (r = 0.754)
The best agreement between both methods was achieved in comparing the summed-up ratios of loud and epic snoring obtained by SnoreLab with the total snoring ratio measured by PG
Summary
Snoring is an age- and gender-dependent phenomenon and affects 40% of the adult population [1,2]. According to the International Classification of Sleep Disorders (ICSD-3), snoring is ranked among the sleep-related breathing disorders [3] and frequently acts as a symptom of obstructive sleep apnea (OSA) or the upper airway resistance syndrome (UARS) [2,4,5]. OSA has been associated with serious health implications like daytime sleepiness and increased risk of accidents, pulmonary hypertension, heart failure, stroke, diabetes mellitus and depression. Even non-apneic snoring is reported to be associated with daytime sleepiness, hypertension and carotid atherosclerosis [2]. Sleep-related disorders cause high economic costs: In Australia alone, inadequate sleep represented 4.6% of the national burden of disease [9]
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