The acoustical and perceptual features of snore-related sounds inpatients with obstructive sleep apnea sleeping with the dynamic mandibular advancement system MATRx plus®.

Abstract

The effect of snoring on the bed partner can be studied through the evaluation of in situ sound records by the bed partner or unspecialized raters as a proxy of real-life snoring perception. The aim was to characterize perceptual snore events through acoustical features in patients withobstructive sleep apnea (OSA) with an advanced mandibular position. Thirty-minute sound samples of 29 patients withOSA were retrieved from overnight, in-home recordings of a study to validate the MATRx plus® dynamic mandibular advancement system. Three unspecialized raters identified sound events and classified them as noise, snore, or breathing. The raters provided ratings for classification certainty and annoyance. Data were analyzed with respect to respiratory phases, and annoyance. When subdividing perceptual events based on respiratory phase, the logarithm-transformed Mean Power, Spectral Centroid, and Snore Factor differed significantly between event types, although not substantially for the spectral centroid. The variability within event type was high and distributions suggested the presence of subpopulations. The general linear model (GLM) showed a significant patient effect. Inspiration segments occurred in 65% of snore events, expiration segments in 54%. The annoyance correlated with the logarithm of mean power (r = 0.48) and the Snore Factor (0.46). Perceptual sound events identified by non-experts contain a non-negligible mixture of expiration and inspiration phases making the characterization through acoustical features complex. The present study reveals that subpopulations mayexist, and patient-specific features need to be introduced.