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This Article Full Text (PDF) All Versions of this Article: chest.08-0847v1 134/5/919    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Google Scholar Articles by Svensson, M. Articles by Lindberg, E. PubMed PubMed Citation Articles by Svensson, M. Articles by Lindberg, E.

Daytime sleepiness relates to snoring independent of the apnea-hypopnea index in women from the general population

¹Department of Surgical Sciences, Otorhinolaryngology, Head and Neck Surgery, Uppsala University, Sweden ²Department of Respiratory Medicine, University Hospital, Umeå, Sweden ³Department of Medical Sciences, Respiratory Medicine and Allergology, Uppsala University, Sweden

malin.l.svensson{at}akademiska.se

Abstract

ObjectivesThe aim was to investigate the significance of snoring and sleep apnea on daytime symptoms in a population-based sample of women.

MethodFrom the general population, 400 women, aged 20-70 years, were randomly selected, with over sampling of habitually snoring women. They were investigated with a full-night polysomnography and a questionnaire. The apnea-hypopnea index (AHI) was calculated, and women who acknowledged snoring loudly and disturbingly often or very often were considered habitual snorers.

ResultsHabitual snoring was independently related to excessive daytime sleepiness, OR= 2.28 (1.31-3.99), to falling asleep involuntarily during the day, OR= 2.11 (1.06-4.21), to waking up unrefreshed, OR= 2.14 (1.30-3.52), to daytime fatigue, OR= 2.77 (1.54-4.99) and to a dry mouth on awakening, OR= 2.00 (1.22-3.27) after adjustment for of AHI, age, body mass index (BMI), smoking, total sleep time, % slow wave sleep and % REM sleep. Apnea-hypopnea index 15 was only related to a dry mouth on awakening after adjustment for snoring, age, BMI, smoking, total sleep time, % slow wave sleep and % REM sleep, OR= 2.24 (1.14-4.40). An AHI of 5-15 was not related to any daytime symptom.

ConclusionsExcessive daytime sleepiness and daytime fatigue are related to habitual snoring independent of the apnea-hypopnea frequency, age, obesity, smoking and sleep parameters in a population-based sample of women, but not to the apnea-hypopnea index. This indicates that snoring is an independent cause of excess daytime sleepiness and not merely a proxy for sleep apnea.

Key Words: Sleep apnea • snoring • gender • symptoms