The effcacy of low-level continuous positive airway pressure for the treatment of snoring

Michelle A. Guzman, Francis P. Sgambati, Huy Pho, Rafael S. Arias, Erin M. Hawks, Erica M. Wolfe, TamÁs ÖtvÖs, Russell Rosenberg, Riad Dakheel, Hartmut Schneider, Jason P. Kirkness, Philip L. Smith, Alan R. Schwartz

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Study Objectives: To assess effects of low-level continuous positive airway pressure (CPAP) on snoring in habitual snorers without obstructive sleep apnea (OSA). Methods: A multicenter prospective in-laboratory reversal crossover intervention trial was conducted between September 2013 and August 2014. Habitual snorers were included if they snored (inspiratory sound pressure level ≥ 40 dBA) for ≥ 30% all sleep breaths on a baseline sleep study (Night 1), and if signifcant OSA and daytime somnolence were absent. Included participants then underwent a CPAP titration study at 2, 4, or 6 cm H2O (Night 2) to examine snoring responses to step-increases in nasal pressure, a treatment night at optimal pressure (Night 3), followed by baseline night (Night 4). At each pressure, snoring intensity was measured on each breath. Snoring frequency was quantifed as a percentage of sleep breaths at thresholds of 40, 45, 50, and 55 dBA. Sleep architecture and OSA severity were characterized using standard measurements. Results: On baseline sleep studies, participants demonstrated snoring at = 40 dBA on 53 ± 3% and = 45 dBA on 35 ± 4% of breaths. Snoring frequency decreased progressively as nasal pressure increased from 0 to 4 cm H2O at each threshold, and plateaued thereafter. CPAP decreased snoring frequency by 67% and 85% at 40 and 45 dBA, respectively. Intervention did not alter sleep architecture and sleep apnea decreased minimally. Conclusions: Low-level CPAP below the range required to treat OSA diminished nocturnal snoring, and produced uniform reduction in nightly noise production below the World Health Organization's limit of 45 dBA. Clinical Trial Registration: ClinicalTrials.gov, identifer: NCT01949584.

Original languageEnglish (US)
Pages (from-to)703-711
Number of pages9
JournalJournal of Clinical Sleep Medicine
Volume13
Issue number5
DOIs
StatePublished - 2017

Keywords

  • CPAP
  • Noise pollution
  • Sleep
  • Sleep apnea
  • Snore

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Neurology
  • Clinical Neurology

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