title: The Efficacy of Low-Level Continuous Positive Airway Pressure for the Treatment of Snoring.
abstract: OBJECTIVE
  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 significant 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 quantified 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.
  
  
  BACKGROUND
  ClinicalTrials.gov, identifier: NCT01949584.
authors.affiliation: Johns Hopkins Sleep Disorders Center, Center for Interdisciplinary Sleep Research and Education, Baltimore, Maryland.
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Guzman
authors.affiliation: Johns Hopkins Sleep Disorders Center, Center for Interdisciplinary Sleep Research and Education, Baltimore, Maryland.
authors.forename: Francis P
authors.initials: FP
authors.lastname: Sgambati
authors.affiliation: Johns Hopkins Sleep Disorders Center, Center for Interdisciplinary Sleep Research and Education, Baltimore, Maryland.
authors.forename: Huy
authors.initials: H
authors.lastname: Pho
authors.affiliation: Johns Hopkins Sleep Disorders Center, Center for Interdisciplinary Sleep Research and Education, Baltimore, Maryland.
authors.forename: Rafael S
authors.initials: RS
authors.lastname: Arias
authors.affiliation: Johns Hopkins Sleep Disorders Center, Center for Interdisciplinary Sleep Research and Education, Baltimore, Maryland.
authors.forename: Erin M
authors.initials: EM
authors.lastname: Hawks
authors.affiliation: Johns Hopkins Sleep Disorders Center, Center for Interdisciplinary Sleep Research and Education, Baltimore, Maryland.
authors.forename: Erica M
authors.initials: EM
authors.lastname: Wolfe
authors.affiliation: Johns Hopkins Sleep Disorders Center, Center for Interdisciplinary Sleep Research and Education, Baltimore, Maryland.
authors.forename: Tamás
authors.initials: T
authors.lastname: Ötvös
authors.affiliation: NeuroTrials Research, Inc., Atlanta, Georgia.
authors.forename: Russell
authors.initials: R
authors.lastname: Rosenberg
authors.affiliation: Doctors Community Hospital Sleep Center, Lanham, Maryland.
authors.forename: Riad
authors.initials: R
authors.lastname: Dakheel
authors.affiliation: Johns Hopkins Sleep Disorders Center, Center for Interdisciplinary Sleep Research and Education, Baltimore, Maryland.
authors.forename: Hartmut
authors.initials: H
authors.lastname: Schneider
authors.affiliation: Johns Hopkins Sleep Disorders Center, Center for Interdisciplinary Sleep Research and Education, Baltimore, Maryland.
authors.forename: Jason P
authors.initials: JP
authors.lastname: Kirkness
authors.affiliation: Johns Hopkins Sleep Disorders Center, Center for Interdisciplinary Sleep Research and Education, Baltimore, Maryland.
authors.forename: Philip L
authors.initials: PL
authors.lastname: Smith
authors.affiliation: Johns Hopkins Sleep Disorders Center, Center for Interdisciplinary Sleep Research and Education, Baltimore, Maryland.
authors.forename: Alan R
authors.initials: AR
authors.lastname: Schwartz
mesh_terms: D045422:Continuous Positive Airway Pressure / Q000379:methods*; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012913:Snoring / Q000628:therapy*; D016896:Treatment Outcome
keywords: CPAP; noise pollution; sleep; sleep apnea; snore