title: Snoring intensity and excessive daytime sleepiness in subjects without obstructive sleep apnea.
abstract: Snoring and excessive daytime sleepiness (EDS) are major obstructive sleep apnea (OSA) symptoms. Snorers with apnea/hypopnea index < 5 are designated "simple snorers" and do not meet OSA criteria. This study aimed to explore a possible association between snoring intensity and EDS defined as Epworth Sleepiness Scale (ESS) scores ≥ 11 in non-OSA subjects.
  
  
  
  Prospective cohort study.
  
  
  
  From a total of 2,225 subjects who underwent polysomnography (PSG), 307 simple snorers qualified for the study and were assessed for snoring intensity and ESS score. The correlation between PSG-based snoring intensity measurements and ESS score was evaluated. A prediction model for EDS was derived using multivariate logistic regression.
  
  
  
  Subjects with EDS tended to be male and of heavier body habitus. Although both genders exhibited similar snoring intensities, men had higher ESS scores than women. A strong linear correlation was demonstrated between the maximal snoring intensity and the ESS score. Maximal snoring sound and male gender were shown to be predictors of EDS, with odds ratios of 1.93 (95% confidence interval [CI]:1.63-2.26, P < .001) and 3.70 (95% CI: 1.29-12.5, P = .01), respectively.
  
  
  
  In a population of non-OSA subjects referred to a PSG study, snoring intensity was associated with EDS in both men and women. A positive linear correlation was observed between snoring intensities and ESS scores. Additional studies are needed to further consolidate the evidence regarding the implications of simple snoring for public health.
  
  
  
  2b Laryngoscope, 126:1696-1701, 2016.
authors: Institute of Pulmonology and Department of Medicine B, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors: Or
authors: O
authors: Kalchiem-Dekel
authors: Institute of Pulmonology and Department of Medicine B, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors: Roi
authors: R
authors: Westreich
authors: Clinical Research Center, Soroka University Medical Center, Beer-Sheva, Israel.
authors: Adi
authors: A
authors: Regev
authors: Clinical Research Center, Soroka University Medical Center, Beer-Sheva, Israel.
authors: Victor
authors: V
authors: Novack
authors: Clinical Research Center, Soroka University Medical Center, Beer-Sheva, Israel.
authors: Mordechai
authors: M
authors: Goldberg
authors: Institute of Pulmonology and Department of Medicine B, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.|Division of Respirology, Department of Medicine, University of Toronto and University Health Network, Toronto, Ontario, Canada.
authors: Nimrod
authors: N
authors: Maimon
mesh_terms: D000328:Adult; D006970:Disorders of Excessive Somnolence / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive; D012913:Snoring / Q000150:complications*
keywords: Epworth Sleepiness Scale; Simple snoring; excessive daytime sleepiness; polysomnography