Characteristics of Snoring

Speech is an important characteristic that distinguishes human beings from lower animals.  A flexible, compliant airway is a requisite of speech articulation.  The good news is that human beings can speak.  The bad news is that humans can choke, snore and get apnea.

Snoring is caused by diffuse vibrations or fluttering of the flexible, compliant pharyngeal tissues during sleep.  Three conditions are necessary for snoring:  1) vibrating structure  2) flow limitation  
3) sleep.

Any membranous part of the upper airway from the nose to the vocal cords that lacks rigid support from cartilage or bone may vibrate or flutter.  Examples of such soft structures are the tongue, walls of the throat, uvula, tonsils, adenoids, and the soft palate.

Everyone seems to know a snore when they hear one but no scientific gold standard definition of a snore has been developed.  The working definition here is, “the harsh audible sound produced during obstructive sleep breathing.”  The diagnosis of snoring does not pose any difficult intellectual medical training.  The issue is evaluation of the medical consequences of the snoring for any individual.

Snoring usually occurs on inhalation but can also occur during exhalation.  Snoring can occur during exclusive nasal breathing, exclusive oral breathing, or during combined oronasal breathing.  Snoring can occur during apneas, hypopneas, UARS (upper airway resistance syndrome), or non-apneic sleep.

Snoring may be generated at multiple sites in the compliant, flexible human airway.  The health consequences of snoring range from none (benign clinical sign) to severe sleep disturbance and serious health consequences. 

There are no studies to date that validate electronic measurement of a sound scored as a snore by a sleep technician’s judgement, by a computer, or by the perception of a listener.  Perception of snoring is highly subjective.  Unique to snoring is that he complaint is usually initiated not by the sleeper but by the listener or sleep partner.

Snores are sounds of very complex spectral quality.  Snores may originate from multiple sites simultaneously.  Spectral analysis of different snores during any 30 second time interval show significant variation.  The spectral quality of a snore can vary from the beginning to the end of the snore.  Snores contain a large variety of frequencies.  There are no unique spectral characteristics that differentiate snores during an apneic episode from hypopneic or nonapneic snores.  Similarly there is huge variation in the spectral quality of snores from the first half and the last half of the night.  One cannot differentiate nose breathers from mouth breathers by the spectral quality of their snores.  In fact, no unique “spectral signature” has been found as being diagnostic of any snore, snore-type or snoring patient.

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