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CC BY-NC-ND 4.0 · Sleep Sci 2022; 15(04): 463-470
DOI: 10.5935/1984-0063.20220068
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Correlation between snoring sounds and obstructive sleep apnea in adults: a meta-regression analysis

Jui-Kun Chiang
1   Dalin Tzu Chi Hospital, Family Medicine - Chiayi - Taiwan
,
Yen-Chang Lin
2   Nature Dental Clinic, Dental department - Puli - Taiwan
,
Chih-Ming Lu
3   Dalin Tzu Chi Hospital, Department of Urology - Chiayi - Taiwan
,
Yee-Hsin Kao
4   Tainan Municipal Hospital (Managed by Show Chwan Medical Care Corporation), Family Medicine - Tainan - Taiwan
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Objective Snoring is a dominant clinical symptom in patients with obstructive sleep apnea (OSA), and analyzing snoring sounds might be a potential alternative to polysomnography (PSG) for the assessment of OSA. This study aimed to systematically examine the correlation between the snoring sounds and the apnea-hypopnea index (AHI) as the measures of OSA severity.

Material and Methods A comprehensive literature review using the MEDLINE, Embase, Cochrane Library, Scopus, and PubMed databases identified the published studies reporting the correlations between and severity of snoring and the AHI values by meta-regression analysis.

Results In total, 13 studies involving 3,153 adult patients were included in this study. The pooled correlation coefficient for snoring sounds and AHI values was 0.71 (95%CI: 0.49, 0.85) from the random-effects meta-analysis with the Knapp and Hartung adjustment. The I [2] and chi-square Q test demonstrated significant heterogeneity (97.6% and p<0.001). After adjusting for the effects of the other covariates, the mean value of the Fisher’s r-to-z transformed correlation coefficient would have 0.80 less by the snoring rate (95%CI = -1.02, -0.57), 1.46 less by the snoring index (95%CI = -1.85, -1.07), and 0.21 less in the mean body mass index (95%CI = -0.31, -0.11), but 0.15 more in the mean age (95%CI = 0.10, 0.20). It fitted the data very well (R [2]=0.9641).

Conclusion A high correlation between the severity of snoring and the AHI was found in the studies with PSG. As compared to the snoring rate and the snoring index, the snoring intensity, the snoring frequency, and the snoring time interval index were more sensitive measures for the severity of snoring.

Snoring - Obstructive Sleep Apnea (OSA) - Polysomnography (PSG)

Disclosure statement

The authors declare no conflict of interest.




Publication History

Received: 28 July 2021

Accepted: 07 February 2022

Article published online:
01 December 2023

© 2023. Brazilian Sleep Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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