02877nas a2200361 4500008004100000022001400041245008300055210006900138260001300207300001100220490000800231520194700239653001002186653000902196653001202205653001902217653002802236653001102264653001102275653000902286653001602295653002002311653001702331653002902348653001202377653001602389100001902405700001102424700001502435700001102450700001902461856003502480 2000 eng d a1073-449X00aDoes snoring predict sleepiness independently of apnea and hypopnea frequency?0 aDoes snoring predict sleepiness independently of apnea and hypop c2000 Oct a1512-70 v1623 a
Obstructive apneas and hypopneas during sleep are a well recognized cause of excessive daytime sleepiness. Snoring is also associated with excess sleepiness, although it is not known whether this reflects an independent effect of snoring or whether snoring is simply a marker for obstructive sleep apnea. To further explore the relation of snoring to sleepiness, we conducted a cross-sectional cohort study of community-dwelling adults participating in the Sleep Heart Health Study. The study sample comprises 2,737 men and 3,040 women with a mean age of 64 (SD 11) yr. Sleepiness was quantified using the Epworth Sleepiness Scale (ESS). Snoring history was obtained via a self-completion questionnaire. The respiratory disturbance index (RDI), defined as the number of apneas plus hypopneas per hour of sleep, was measured during in-home polysomnography. The ESS score increased progressively with increasing RDI, from a mean of 7.1 (4.2) in subjects with RDI < 1.5 to 8.8 (4.8) in subjects with RDI >/= 15 (p < 0.001). A progressive increase in ESS score was also seen across five categories of snoring frequency, from 6.4 (4.2) in current nonsnorers to 9.3 (4.8) in subjects who snored six to seven nights per week (p < 0.001). The prevalence of excessive daytime sleepiness, defined as an ESS score >/= 11, increased from 15% in never-snorers to 39% in those who snored six to seven nights per week. The relation of snoring to sleepiness was seen at all levels of RDI, with no significant change in the relation of snoring to ESS score after adjustment for RDI in multivariate models. The effects of snoring and RDI on sleepiness were little affected by adjustment for age, sex, race, body mass index, or questionnaire evidence of insufficient sleep time or nocturnal leg jerks or cramps. We conclude that both snoring and RDI are independently associated with excess sleepiness in community-dwelling, middle-aged and older adults.
10aAdult10aAged10aArousal10aCohort Studies10aCross-Sectional Studies10aFemale10aHumans10aMale10aMiddle Aged10aPolysomnography10aRisk Factors10aSleep Apnea, Obstructive10aSnoring10aWakefulness1 aGottlieb, D, J1 aYao, Q1 aRedline, S1 aAli, T1 aMahowald, M, W uhttps://chs-nhlbi.org/node/623