Mean tracheal sound energy during sleep is related to daytime blood pressure

Abstract

Study objectives: The pathological role of snoring independent of obstructive sleep apnea remains under debate. The authors hypothesized that snoring sound intensity, as assessed by mean tracheal sound energy (Leq) during sleep, is related to daytime blood pressure.

Design: Retrospective analysis of clinical records and polysomnography data.

Setting: Sleep laboratory at a national hospital in Japan.

Patients: Consecutive patients who underwent diagnostic polysomnography with suspicion of sleep apnea between January 2005 and December 2009 (n = 1,118).

Interventions: Not applicable.

Measurements and results: Leq was calculated from tracheal sound spectra recorded every 0.2 sec during polysomnography. Daytime high blood pressure (HBP) was defined as taking antihypertensive drugs or having a systolic blood pressure ≥ 140 mm Hg or a diastolic blood pressure ≥ 90 mmHg at the patient's first clinical visit. Patient age, sex, body mass index, apnea-hypopnea index, alcohol consumption, and smoking were considered as confounders. Leq during sleep was associated with HBP after adjusting for all confounding factors (n = 1,074, P = 0.00019). This association was demonstrated even in nonapneic nonobese patients (n = 232, P = 0.012).

Conclusions: The association between snoring intensity, as assessed by mean sound energy, and blood pressure suggests a pathological role for heavy snoring. Further study in a general population is warranted.

Keywords: Acoustics; hypertension; sleep apnea; snoring.

Figure 1

Equivalent tracheal sound pressure level (Leq) distribution in all subjects (n = 1,118).

Figure 2

Scatterplots showing the relationship between equivalent tracheal sound pressure level (Leq) during sleep and daytime blood pressure (n = 1,118). Closed circles and open circles represent blood pressure levels of subjects who did and did not take antihypertensive medication, respectively.