Night Snoring Research Articles

Reasons for failure in surgical treatment of patients with rhonchopathy and obstructive sleep apnea syndrome

Purpose. To study specific approaches for selecting patients with rhonchopathy and obstructive sleep apnea syndrome for surgical treatment and to study laser surgical techniques applied on the soft palate so as to identify basic reasons of postoperative complications, soft palate function disorders and relapses of the disease with an even more aggressive course than before the surgery.Material and methods. In 2011–2020, 523 patients with rhonchopathy and obstructive sleep apnea syndrome, aged 23–78, were selected for surgical treatment. The authors discuss the obtained data after analyzing the effectiveness of used criteria for selecting patients for laser-assisted surgery on the soft palate, as well as after analyzing outcomes after laser sculptural uvulopalatoplasty performed in 309 patients. Reasons for insufficient effectiveness of surgery in some patients have been analyzed too.Results. After analyzing selection criteria, it has been found out that only 309 patients out of 523 (59.1 %) had no contraindications to laser sculptural uvulopalatoplasty, while 214 patients (40.9 %) had them. The discussed surgery was effective in 304 out of 309 operated patients (98.4 %) which has been confirmed with a complete and stable relief from night snoring and its complications for five or more years after the surgery. No effect was registered in 5 (1.6 %) patients because they absolutely ignored strict following the prescribed regimen, diet and other recommendations aimed to promote physiological healing of surgical wounds.Conclusion. The effectiveness of laser sculptural uvulopalatoplasty depends on a careful and adequate selection of patients for this surgery as well as on rational choice of laser light parameters; failures are due to inadequate selection of patients and their unwillingness to strictly follow recommendations in the postoperative period.

Orthodontics as a Therapeutic Tool for Managing Sleep Apnea: A Systematic Review

Background and Objective: sleep apnea is a disorder in which the person's breathing is interrupted periodically at night due to the physical blockage of the airway. Determining the best way to treat their sleep disorders requires careful studies, tests, counseling and various examinations. Orthodontics is the best way to get a patient to have oral equipment. The use of orthodontic equipment is a non-surgical and effective treatment for mild to moderate sleep apnea. The aim at this study is a systematic review and meta-analysis of orthodontics as a therapeutic tool for managing sleep apnea. Methods: At first, all the papers (n=112) related to keywords (orthodontics therapeutic tools and sleep apnea) were searched for English databases; Google, Google scholar, PubMed, Embase, CINAHL, PsycInfo, and Cochrane Database of Systematic Reviews covering the period from 2010 through 2019 was studied. Then, papers related to orthodontics therapeutic tools of sleep apnea were selected and analyzed (n=8).As a result to inclusion and exclusion criteria, papers related to orthodontics therapeutic tools of sleepapnea were found and analyzed (n=8). Predefined inclusion and exclusion criteria were: papers related to orthodontics therapeutic tools of sleepapnea, papers were English, papers were original and all the papers were free full text. Results: In the initial search, 112 papers were found that after reviewing the titles and abstract articles and removing repetitive and non-related ones, 26 possible related articles were investigated. Of these, 18 papers were omitted from the abstract because of lack of access to the original article and lack of sufficient information. Finally, 8 papers were included in the study. Data were collected based on study characteristics, measures of orthodontics therapeutic tools, prevalence rates and factors associated with sleep apnea. Orthodontics therapeutic tools for sleep apnea are very important and can play very significant role in health improvement. So, paying more attention to benefits of orthodontics therapeutic tools in sleep apnea is necessary. On important points is the orthodontist’s active role play in screening the patients for this disease and advice oral appliance therapy, if needed. Conclusion: The most effective treatment for sleep apnea and snoring is orthodontics therapeutic tools. Orthodontics therapeutic tools are effective treatments for sleep apnea, snoring and night snoring. Orthodontics therapeutic tools are low cost, easy to use, portable and need little maintenance.

Bidirectional Association Between Psoriasis and Obstructive Sleep Apnea: A Systematic Review and Meta-Analysis

The link between psoriasis and obstructive sleep apnea (OSA) has not been confirmed. We aimed to investigate the relationship between psoriasis and OSA. We conducted a systematic review and meta-analysis of case-control, cross-sectional, and cohort studies on the association between psoriasis and OSA. We searched MEDLINE and Embase for relevant studies on May 11, 2019. The Newcastle-Ottawa Scale was used to evaluate the risk of bias of included studies. We performed random-effects model meta-analysis to calculate pooled odds ratio (ORs) with 95% confidence intervals (CIs) for case-control and cross-sectional studies as well as pooled incidence rate ratio (IRR) with 95% CIs for cohort studies in association between psoriasis and OSA. A total of 4 case-control or cross-sectional studies and 3 cohort studies with a total of 5,840,495 subjects were included. We identified a significantly increased odds for OSA in psoriasis patients (pooled OR 2.60; 95% CI 1.07–6.32), and significantly increased risk for psoriasis in OSA patients (pooled IRR 2.52; 95% CI 1.89–3.36). In conclusion, our study identified a bidirectional association between psoriasis and OSA. Sleep quality should be inquired in patients with psoriasis. Respirologist consultation or polysomnography may be indicated for those presenting with night snoring, recurrent awaking, and excessive daytime sleepiness.

Особенности клинического состояния и медицинская реабилитация больных ишемической болезнью сердца, перенесших чрескожную транслюминальную коронарную ангиопластику с синдром апноэ-гипопноэ сна, в условиях реабилитационного центра

В статье приводятся материалы выявления частоты синдрома обструктивного апноэ-гипопноэ сна (СОАГС), изучения особенностей клинической картины состояния кардиореспираторной системы и психологического состояния больных ишемической болезнью сердца (ИБС) после чрескожной транслюминальной коронарной ангиопластики (ЧТКА), разработки и внедрения программы медицинской реабилитации больных с применением неинвазивной респираторной поддержки постоянным положительным давлением в дыхательных путях (СРАР–терапии). В работе применялись общеклинические, лабораторные, инструментальные и психологические методы исследования. Выявлено, что в 35,7% случаях у оперированных больных ишемической болезнью сердца встречается СОАГС. Показано, что применение комплексного клинико-психологического исследования больных ИБС с СОАГС после ЧТКА обеспечивает повышение эффективности их реабилитации (восстановление функциональных возможностей организма прооперированных больных), скорейшую их медицинскую реабилитацию и возврат к трудовой деятельности.

Magnesium Intake and Sleep Disorder Symptoms: Findings from the Jiangsu Nutrition Study of Chinese Adults at Five-Year Follow-Up.

(1) Background: In clinical trials, dietary magnesium use can improve insomnia symptoms. However, little is known about the association between dietary magnesium consumption and sleep disorder symptoms including daytime falling asleep, sleepiness and snoring at the population level. (2) Methods: We used data from 1487 adults aged 20 and above attending the Jiangsu Nutrition Study. At baseline in 2002, dietary magnesium was assessed by 3-day weighed food records. At follow-up in 2007, sleep disorder symptoms, including daytime falling asleep, sleepiness and snoring at night, were gathered using a sleep questionnaire. (3) Results: The mean intake of magnesium was 332.5 mg/day. In total, 5.3%, 13.2% and 35.7% of the subjects reported daytime falling asleep, daytime sleepiness, and snoring during sleep, respectively. Compared with the lowest quartile of magnesium intake, the highest quartile was associated with decreased likelihood of falling asleep (odds ratio (OR) 0.12 (0.02, 0.57)) in women but not in men after adjusting for demographic, anthropometric, lifestyle factors, hypertension, and overall dietary patterns. No associations were found between dietary magnesium intake and daytime sleepiness nor night snoring in either gender. (4) Conclusions: Dietary magnesium intake may have long-term benefits in reducing the likelihood of daytime falling asleep in women.

Predicting Obstructive Sleep Apnea with Periodic Snoring Sound Recorded at Home.

The cost-effectiveness of diagnosing obstructive sleep apnea (OSA) could be improved by using a preliminary screening method among subjects with no suspicion of other sleep disorders. We aimed to evaluate the diagnostic value of periodic snoring sound recorded at home. We included 211 subjects, aged 18-83 (130 men), who were referred to our laboratory for suspicion of OSA, and had a technically successful overnight polygraphy, measured with the Nox T3 Sleep Monitor (Nox Medical, Iceland) with a built-in microphone. We analyzed the percentage of periodic snoring during the home sleep apnea study. Apnea-hypopnea index (AHI) ranged from 0.1 to 116 events/h and the percentage of periodic snoring from 1% to 97%. We found a strong positive correlation (r = 0.727, p < 0.001) between periodic snoring and AHI. The correlation was slightly stronger among female, younger, and obese subjects. The best threshold value of the periodic snoring for predicting an AHI > 15 events/h with as high sensitivity as possible was found to be 15%. There, sensitivity was 93.3%, specificity 35.1%, and negative predictive value 75.0%. According to our results, it is possible to set a periodic snoring threshold (15% or more) for the subject to advance to further sleep studies. Together with medical history and prior to more expensive studies, measuring periodic snoring at home is a simple and useful method for predicting the probability of OSA, in particular among women who are often unaware of their apnea-related snoring.

Acoustic analysis of whole night snoring events in habitual snoring children

Acoustic analysis of whole night snoring events in habitual snoring children

Automatic Detection of Whole Night Snoring Events Using Non-Contact Microphone

ObjectiveAlthough awareness of sleep disorders is increasing, limited information is available on whole night detection of snoring. Our study aimed to develop and validate a robust, high performance, and sensitive whole-night snore detector based on non-contact technology.DesignSounds during polysomnography (PSG) were recorded using a directional condenser microphone placed 1 m above the bed. An AdaBoost classifier was trained and validated on manually labeled snoring and non-snoring acoustic events.PatientsSixty-seven subjects (age 52.5±13.5 years, BMI 30.8±4.7 kg/m2, m/f 40/27) referred for PSG for obstructive sleep apnea diagnoses were prospectively and consecutively recruited. Twenty-five subjects were used for the design study; the validation study was blindly performed on the remaining forty-two subjects.Measurements and ResultsTo train the proposed sound detector, >76,600 acoustic episodes collected in the design study were manually classified by three scorers into snore and non-snore episodes (e.g., bedding noise, coughing, environmental). A feature selection process was applied to select the most discriminative features extracted from time and spectral domains. The average snore/non-snore detection rate (accuracy) for the design group was 98.4% based on a ten-fold cross-validation technique. When tested on the validation group, the average detection rate was 98.2% with sensitivity of 98.0% (snore as a snore) and specificity of 98.3% (noise as noise).ConclusionsAudio-based features extracted from time and spectral domains can accurately discriminate between snore and non-snore acoustic events. This audio analysis approach enables detection and analysis of snoring sounds from a full night in order to produce quantified measures for objective follow-up of patients.

Diagnosis and treatment of snoring and sleep apnea syndrome

Aim. To assess the effectiveness of modern methods of diagnosis and surgical treatment of night snoring. Methods. Conducted was polysomnography in 117 patients suffering from snoring at night. In the case of evident signs of obstruction, patients were offered surgical treatment. Results. Out of 117 people with snoring polysomnography revealed obstructive sleep apnea syndrome: in 35 - mild form, 11 - moderate severity, 1 - severe. In 69 patients benign snoring was revealed, which does not lead to a decrease in blood oxygen saturation. Simultaneous complex surgical treatment was performed in 38 patients who according to polysomnography revealed upper airway obstruction. The obstruction was eliminated by endoscopic surgical correction of the intranasal structures and the nasopharynx, and minimally invasive uvuloplasty using the method of radiofrequency coagulation. Postoperatively the patients received local medications biclotymol (hexaspray), fusafungine (bioparox), rinsing of the pharynx with antiseptics. Positive effect (disappearance of snoring) was achieved in 29 patients after an average of 1.5-2 months after surgery, in 6 patients with obstructive sleep apnea syndrome of the II and III degree of severity and co-morbidities the episodes of apnea and hypopnea decreased significantly. In 3 patients with recurrent polypous rhinosinusitis secondary to bronchial asthma (2 patients) and encephalopathy (1 patient), surgical intervention (endoscopic polysinusotomy, radiofrequency uvuloplasty) did not achieve the desired effect and the patients were referred for conservative treatment. Conclusion. The method of polysomnography and surgical treatment strategy of night snoring meet the modern requirements and in most cases have shown to be effective.

A Multicenter, Prospective Study of a Novel Nasal EPAP Device in the Treatment of Obstructive Sleep Apnea: Efficacy and 30-Day Adherence

Evaluate the efficacy of a novel device placed in the nares that imposes an expiratory resistance for the treatment of obstructive sleep apnea (OSA) and evaluate adherence to the device over a 30-day in-home trial period. One diagnostic and 3 treatment polysomnograms were administered in a Latin-square design to identify the optimal expiratory resistance to be used during the 30-day in-home trial. Subjects had repeat polysomnography with the prescribed device at the end of the 30-day trial. Multicenter study. Participants (N=34; age 27 to 67) with a baseline apnea-hypopnea index (AHI) > or =5. The AHI was reduced from 24.5 _ 23.6 (mean +/- SD) to an average of 13.5 +/- 18.7 (p < 0.001) across initial treatment nights. The AHI was 15.5 +/-+/- 18.9 (p = 0.001) for the prescribed device at the end of the 30-day trial. Of 24 subjects with an AHI > 10 at baseline, 13 achieved an AHI < 10 on the initial treatment nights; 10 had a similar response on the final treatment night. Percent of the night snoring decreased from 27.5 +/- 23.2 to 11.6 +/- 13.7 (p < 0.001) on initial treatment nights and 14.6 +/- 20.6 (p = 0.013) at the end of the trial; Epworth Sleepiness scores decreased from 8.7 +/- 4.0 at baseline to 6.9 +/- 4.4 (p < 0.001) at the end of the trial; the Pittsburgh Sleep Quality Index improved from 7.4 +/- 3.3 to 6.5 +/- 3.6 (p = 0.042). Mean oxygen saturation increased from 94.8 +/- 2.0 to 95.2 +/- 1.9 (p = 0.023) on initial treatment nights and 95.3 +/- 1.9 (p = 0.003) at the end of the trial. Sleep architecture was not affected. Participants reported using the device all night long for 94% of nights during the in-home trial. Treatment with this novel device was well tolerated and accepted by the participants. An overall reduction in AHI was documented; however, therapeutic response was variable among the participants. Further research is required to identify the ideal candidates for this new therapeutic option in the management of OSA.

Heavy Snoring as a Cause of Carotid Artery Atherosclerosis

Previous studies have suggested that snoring and obstructive sleep apnea hypopnea syndrome may be important risk factors for the development of carotid atherosclerosis and stroke. However, it is not clear if snoring per se is independently related to the risk of developing carotid atherosclerotic plaque. Observational cohort study. Volunteer sample examined in a sleep laboratory. One hundred ten volunteers (snorers and nonsnorers with only mild, nonhypoxic obstructive sleep apnea hypopnea syndrome) underwent polysomnography with quantification of snoring, bilateral carotid and femoral artery ultrasound with quantification of atherosclerosis, and cardiovascular risk factor assessment. Subjects were categorized into 3 snoring groups: mild (0%-25% night snoring), moderate (> 25%-50% night snoring), and heavy (> 50% night snoring). N/A. The prevalence of carotid atherosclerosis was 20% with mild snoring, 32% with moderate snoring, and 64% with heavy snoring (P < 0.04, X2). Logistic regression analysis was used to determine the independent effect of snoring on the prevalence of carotid and femoral atherosclerosis. After adjustment for age, sex, smoking history, and hypertension, heavy snoring was significantly associated with carotid atherosclerosis (odds ratio 10.5; 95% confidence interval 2.1-51.8; P = 0.004) but not with femoral atherosclerosis. Heavy snoring significantly increases the risk of carotid atherosclerosis, and the increase is independent of other risk factors, including measures of nocturnal hypoxia and obstructive sleep apnea severity. Considering the high prevalence of snoring in the community, these findings have substantial public health implications for the management of carotid atherosclerosis and the prevention of stroke.

Primary snoring and obstructive apnea of childhood associated symptoms: prevalence, screening and familiar attitude

Primary snoring is characterized by absence of apneas. Obstructive sleep apnea syndrome (OSAS) is characterized by upper respiratory tract obstruction that alters ventilation and sleep. Permanent night snoring is the most important risk factor. To know the primary snoring prevalence and OSAS associated symptoms in children of Cordoba. To determine if physicians ask parents about this syndrome and if parents are encouraged to ask about it. Study design was cross-sectional, population was formed by children that assist to health centers of Cordoba, age ranged from 2 to 11 years. A survey was used to detect snoring presence and associated symptoms. Physicians administer the survey to parents and tutors. Snorer was classified in: permanent, usual, and rare snorer. 1541 survey, snoring prevalence of 9.47%. We compare the permanent snoring group (PS) against the others (US+RS). 55 children (37,67%) were permanent snorers. 51% present respiratory pauses. 13% was strongly moved during a pause. In 74,6% cases, snoring did not motivated physician visit and in 78,8% physician had not asked about snoring in the patient screening. We found similar prevalence of snorers than bibliography. 51% of snorer's parents observed respiratory pauses during sleep. Daily and nigthy symptoms presence related to snoring was associated with a meaningfully frequency to the permanent snorers group. It is remarkable the poor importance attributed to this syndrome by physicians and family. It is believed that because of this syndrome frequency, simple diagnosis and solution, physicians should ask about it in patient screening.

Treatment of Severe Snoring With a Combination of Pseudoephedrine Sulfate and Domperidone

Pharmacologic treatment of severe snoring has not been considered to be of great value. The objective of this study was to determine whether the combination of a nasal decongestant and a prokinetic drug would decrease or eliminate severe snoring. Thirty healthy individuals whose sleeping partners reported that the patients had severe nightly snoring entered an open-label trial of 60 mg of pseudoephedrine and 10 mg of domperidone at bedtime for 30 days. Each night's snoring was scored on a diary by the sleeping partner. At the end of the open-label trial, a subset of subjects whose snoring had recurred were randomized to one or both placebo-controlled trials, either 60 mg of pseudoephedrine sulfate plus 10 mg of domperidone or to 30 mg of pseudoephedrine sulfate plus 10 mg of domperidone. In another placebo-controlled trial, the drug combination was compared with each component. In the open-label trial, 493 of 772 evaluable subject-nights were free of snoring; another 232 nights were scored as mild snoring. In the placebo-controlled trials, low-dose therapy caused a reduction in snoring, and high-dose therapy even a greater reduction in snoring. The drug combination was more effective than either agent alone. Treatment with a prokinetic agent plus a nasal decongestant reduced or eliminated severe snoring in the majority of subjects treated.

Bird face deformity secondary to bilateral temporomandibular joint ankylosis

This paper describes our experience in the treatment of 10 patients with bilateral longstanding temporomandibular joint ankylosis occurring during the active growth period and causing severe bird face deformity. The clinical manifestations were: (1) upper airway obstruction in the form of either severe night snoring or obstructive sleep apnoea; (2) inability to open the mouth and (3) severely convex facial profile. Surgery consists of simultaneous release of the ankylosed joints, advancement of the mandible and insertion of posterior mandibular costochondral graft struts. A Le Fort I osteotomy was performed concomitantly in marked deformities to help in the restoration of the posterior facial height. Dramatic improvement in the airway, facial profile and jaw function were obtained by this programme.

Prevalence of every night snoring and obstructive sleep apnoeas among 30-69-year-old men in Bologna, Italy.

An epidemiological survey of the prevalence of snoring and sleep apnoeas was performed on 3479 30-69-year-old men living in Bologna, north-east Italy. First a postal questionnaire was sent. It was returned with appropriate answers by 1170. A 20% random sample of those who did not answer were invited by telephone to return the questionnaire. Among these groups 119 (10%) and 19 (5.6%) respectively answered that they always snored. A random sample of 40 every-night snorers were studied by polysomnography. Based on the frequency of every-night snoring and the results of polysomnography we estimated that the minimal prevalence of sleep apnoea among 30-69-year-old men was 2.7% considering an apnoea + hypopnoea index of 10 or more pathological. According to the Lugaresi classification we had a 2.5% prevalence of heavy snorers' disease (HSD) Stage 1 or higher. These figures indicate that obstructive sleep apnoea during sleep is a major public health problem.