A Journal of Clinical Sleep Medicine study aimed to evaluate the diagnostic value of periodic snoring sound recorded at home to help diagnose obstructive sleep apnea.
Methods
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.
Results
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%.
It’s good to see a study done to test the correlation of snoring with OSA. The correlation they found was greater than 15 snoring events/hour.
When connected to obesity, their results indicated a very strong connection.
Snoring remains a significant feature of untreated OSA and cannot be ignored.
I think it is very important to EXPLAIN to new OSA patients that the technology, including both software and hardware of “CPAP” machines has undergone a revolutionary improvement in recent years.
Previous patients with OSA who could not tolerate CPAP will likely find that their new machine is much easier to acclimatize to. This has great implications in getting (previous) patients to successfully treat OSA, as well as new patients who heard “rumors” that CPAP is almost intolerable.
Great paper. I nhave some comments:
1- I think the term “prediction” is not appropriate here as subjects, at the time of measurements (snoring test), might or might not be OSA. In cardiovascular disease for example, we use the term “prediction” when the population studied is free from the disease at the baseline. My suggestion is to use “discrimination” instead of “prediction”
2- I would rather prefer to see the ROC curve for “snoring” as a continuous scale and compute the auc to be able to judge of the quality of discrimination.
3- the specificity of the test is very small: there are higher chance to qualify someone as OSA when in fact he is not. Isn’t this an issue?
Best wishes
Abderrahim Oulhaj