Snoring (I): Daytime Sleepiness in Regular Heavy Snorers

doi:10.1378/chest.99.1.40

Chest

Volume 99, Issue 1, January 1991, Pages 40-48

https://doi.org/10.1378/chest.99.1.40 Get rights and content

Fifteen men, mean ( $\bar{x}$ ) age 44 years, were investigated. Their $\bar{x}$ body mass index was 21.9 kg/m², and all of them had a respiratory disturbance index below 5 and had good nocturnal oxygen saturation. The subjects were monitored several nights both with and without the following devices: a tight-fitting facial mask, a pneumotachometer, and an esophageal balloon. They were also monitored with and without nasal continuous positive airway pressure. The Multiple Sleep Latency Test was administered after three of the experimental nights (after the baseline nights and after the second nasal CPAP night). Determination of short EEG arousals during nocturnal sleep, which lasted 2 to 10 s, was performed. The relationship between short EEG arousals, the esophageal pressure nadir, and airflow decrease was investigated. We also determined the relationship between clinical reporting of decrease in daytime alertness and MSLT results, and the relationship between MSLT results and the frequency of EEG arousals. The monitoring indicated that heavy snorers may present significant increase in Pes nadir with abrupt decrease in flow leading to EEG arousals. The frequency at which EEG arousals occur has an impact on MSLT scores. Nasal CPAP improves MSLT scores and eliminates these respiration-related EEG arousals. Some heavy snorers without obstructive sleep apnea syndrome may be at a risk of having a decrease in daytime alertness. (Chest 1991; 99:40–48)

Section snippets

Entry Criteria

In order to be involved in the study, the patients had to be male adults and must have presented regular heavy snoring, confirmed by a roommate or bedpartner, for longer than a year. They had to have a very low incidence of obstructive sleep apnea during a one-night polygraphic recording RDI (<5), and they had to be willing to return for further polygraphic investigations.

Subjects

Fifteen men with a mean ( $\bar{x}$ ) age of 44.1 ± 12.7 years (range 21 to 69 years) participated in the study. Their $\bar{x}$

RESULTS

Table 2 presents age, BMI, and polygraphic results obtained during baseline night 1, baseline night 2, and CPAP night 2. It also indicates the RDI and the “arousal index” obtained on these nights. Total sleep time and “arousal index” on baseline night 2 with face mask were also calculated. As can be seen, there was a statistical difference between total sleep time obtained on baseline nights 1 and 2 (399.5 ± 15 vs 349 ± 21.5, p≤0.00001). On baseline night 2, total sleep time was reduced and

DISCUSSION

We have acknowledged above some of the limitations of the study. The equipment we used on one of the baseline nights is likely to disturb sleep, and results clearly indicate that it did. To obtain results that were as valid as possible, we had redundancy of measurements, and we based our MSLT comparison on the night with the least amount of disturbance. However, selection of this night (baseline night 1) implies that we shall have a lesser definition of the relationship between the increase in

ACKNOWLEDGMENTS

We are very grateful to John Remmers, Ph.D., of the University of Calgary, for his advice during our investigation. We thank Bita Nouriani and Ben Suh for their technical help.

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This study was supported by grant AG-07772 from the National Institute of Aging.

Manuscript received April 6; revision accepted June 12

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Chest

Snoring (I): Daytime Sleepiness in Regular Heavy Snorers

Section snippets

Entry Criteria

Subjects

RESULTS

DISCUSSION

ACKNOWLEDGMENTS

Chest

Chest

Snoring as a risk factor for cardiac and circulatory problems: an epidemiological study

Dynamics of pressure, airflow and noise production during simulated snoring

Am Rev Respir Dis

Correlation of structure and mechanics in pharyngeal obstruction during sleep

Flow limitation in snorers during sleep

Eur Resp J

Airway resistance and respiratory muscle function in snorers during NREM sleep

J Appl Physiol

Supraglottic resistance in snorers during wakefulness and sleep

FASEB

Characteristics of snoring in obstructive sleep apnea patients and healthy snorers during sleep

Eur Resp J