Do snoring sounds arouse the snorer?
Do snoring sounds arouse the snorer?
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DOI：
10.5665/sleep.2546
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发表时间：
2013-04
期刊：
影响因子：
5.6
通讯作者：
N. Chirakalwasan;Deborah L. Ruzicka;J. W. Burns;R. Chervin
中科院分区：
文献类型：
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作者：
N. Chirakalwasan;Deborah L. Ruzicka;J. W. Burns;R. Chervin
呼吸周期相关的脑电图（EEG）变化（RCREC），特别是δ和σ频率，被认为反映了微妙的呼吸到呼吸的吸气微觉醒，这种微觉醒与阻塞性睡眠呼吸暂停（OSA）的呼吸功增加有关。我们想知道打鼾的声音是否会产生这些微觉醒，并调查耳塞是否会影响RCREC，预计会改变打鼾的感觉。设计随机对照试验。一个经过认证的学术睡眠实验室。成人（n = 400）因疑似OSA转诊。干预受试者被随机分配到使用耳塞或不在诊断多导睡眠图的夜晚。结果203名参与者被随机分配使用耳塞。在控制潜在混淆后，耳塞使用与δ EEG频率（0.5-4.5 Hz）的RCREC较低相关，尽管在其他频率下不相关（P = 0.048）。男性使用耳塞的影响大于女性（交互作用项P = 0.046），非肥胖受试者可能大于肥胖受试者（P = 0.081）。然而，根据睡眠技术专家评定的呼吸暂停严重程度或打鼾程度，使用耳塞对delta RCREC的影响没有显著差异（P > 0.10）。结论：这项随机对照试验是第一项研究，表明通过耳塞调制的打鼾声音的感知可以影响睡眠期间的皮层脑电图。然而，影响幅度小，对除δ以外的EEG频率的RCREC缺乏影响，以及呼吸暂停严重程度或打鼾突出度的影响调制的缺乏表明打鼾的感知不是RCREC的主要解释。
STUDY OBJECTIVES Respiratory cycle-related electroencephalographic (EEG) changes (RCREC), especially in delta and sigma frequencies, are thought to reflect subtle, breath-to-breath inspiratory microarousals that are exacerbated in association with increased work of breathing in obstructive sleep apnea (OSA). We wondered whether snoring sounds could create these microarousals, and investigated whether earplugs, anticipated to alter snoring perception, might affect RCREC. DESIGN Randomized controlled trial. SETTING An accredited, academic sleep laboratory. PATIENTS Adults (n = 400) referred for suspected OSA. INTERVENTIONS Subjects were randomly assigned to use earplugs or not during a night of diagnostic polysomnography. RESULTS Two hundred three of the participants were randomized to use earplugs. Earplug use was associated with lower RCREC in delta EEG frequencies (0.5-4.5 Hz), although not in other frequencies, after controlling for potential confounds (P = 0.048). This effect of earplug use was larger among men in comparison with women (interaction term P = 0.046), and possibly among nonobese subjects in comparison with obese subjects (P = 0.081). However, the effect of earplug use on delta RCREC did not differ significantly based on apnea severity or snoring prominence as rated by sleep technologists (P > 0.10 for each). CONCLUSIONS This randomized controlled trial is the first study to show that perception of snoring sounds, as modulated by earplugs, can influence the cortical EEG during sleep. However, the small magnitude of effect, lack of effect on RCREC in EEG frequencies other than delta, and absence of effect modulation by apnea severity or snoring prominence suggest that perception of snoring is not the main explanation for RCREC.