Excessive daytime sleepiness is related to habitual snoring in women.
- Snoring is an independent cause of excessive daytime sleepiness.
Malin Svensson, MD et al. Daytime sleepiness relates to snoring independent of the apnea-hypopnea index in women from the general population
In: Chest (2008 Aug) doi:10.1378/chest.08-0847
Objectives: The aim was to investigate the significance of snoring and sleep apnea on daytime symptoms in a population-based sample of women.
Method: From 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.
Results: Habitual 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.
Conclusions: Excessive 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.