Exploring the dynamics of snoring in relation to sleep stages: Implications for gender differences, sleep position, and upper airway collapsibility

Masaaki Suzuki; Yuichi Kawai; Yoshihiro Funayama

doi:10.1371/journal.pone.0295232

Exploring the dynamics of snoring in relation to sleep stages: Implications for gender differences, sleep position, and upper airway collapsibility

PLoS One. 2024 Jan 31;19(1):e0295232. doi: 10.1371/journal.pone.0295232. eCollection 2024.

Authors

Masaaki Suzuki^{1

2}, Yuichi Kawai¹, Yoshihiro Funayama²

Affiliations

¹ Dept. of Otorhinolaryngology, Teikyo University Chiba Medical Center, Chiba, Japan.
² Division of Sleep Medicine, Kaname Clinic, Tokyo, Japan.

Abstract

Objective: The purpose of this study was to determine the sleep stage during which isolated snoring occurs in children and adults, and to analyze changes after treatment of obstructive sleep apnea (OSA).

Methods: This retrospective study examined duration of snoring time and respiratory events during each sleep stage in adults and children who underwent polysomnography, had an apnea-hypopnea index (AHI) < 15/h and had snoring time ≥ 10% of total sleep time. Changes in duration of snoring time were also examined in adult patients after treatment with an oral appliance (OA).

Results: Snoring time was shown to be predominant during N3 and N2 sleep and less dominant during REM sleep in both children (n = 47) and adults (n = 93). These results were seen even in children with REM dependency. The percentage of snoring time during N3 sleep was more pronounced in women than in men among young adult patients aged < 40 years but was not significantly different between men and women overall. There were no significant differences in the percentage of snoring time in each sleep stage between young women with mild OSA and non-OSA. In children, there were no significant differences between boys and girls in the percentage of snoring time in any sleep stage. The percentage of snoring time during N3 was significantly higher sleep in the non-supine position than in the supine position in children, whereas no significant differences were noted between the supine and non-supine positions in any sleep stage in adults. OA treatment for adult patients (n = 20) significantly increased the percentage of snoring time during N3 sleep, although it significantly decreased AHI, total snoring time, and snoring time during N1 sleep and REM sleep.

Conclusions: Snoring presented exclusively during the N3 sleep stage, especially in young women with mild OSA, and in children with OSA, especially in the non-supine position. Snoring time during N3 sleep increased during OA treatment for OSA.

Copyright: © 2024 Suzuki et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

MeSH terms

Child
Female
Humans
Male
Retrospective Studies
Sex Factors
Sleep
Sleep Apnea, Obstructive*
Sleep Stages
Snoring*
Supine Position
Young Adult

Grants and funding

This was not an industry-supported study. All authors have indicated no financial conflicts of interest. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.