Determining the site of airway obstruction in obstructive sleep apnea with acoustic analysis of snoring sounds

前言：鼾声是阻塞性睡眠呼吸暂停患者最常见的主诉，因此，对鼾声的声学分析有助于确定阻塞性睡眠呼吸暂停患者的呼吸道阻塞部位。本研究的目的是评价鼾声分析在确定OSAS患者呼吸道阻塞部位中的作用。方法：本研究包括计划进行手术治疗的OSAS患者。为了确定鼾声部位，应与上呼吸道阻塞部位相同，在咽部手术前进行药物诱导睡眠时的内窥镜检查，并记录每个受试者的药物诱导鼾声。利用多维语音分析软件(MDVP)对受试者的15个鼾声进行自动分析。结果：药物诱导睡眠中鼾声的内窥镜检查结果和鼾声的声学特征显示：1)鼾声起源于腭扁桃体的峰值频率在1000 Hz左右；2)鼾声的位置(如阻塞部位)和鼾声特征与OSAS患者的呼吸方式有关。结论：鼾声的声学分析有助于确定阻塞性睡眠呼吸暂停患者呼吸道阻塞的部位，但需要进一步检查与呼吸途径相关的因素。

INTRODUCTION : Snoring is the most frequent complaint of patients with obstructive sleep apnea ; hence, the acoustic analysis of snoring sounds can be useful for identification of the site of airway obstruction in obstructive sleep apnea patients. The aim of this study was to evaluate the usefulness of acoustic analysis of snoring for identification of the site of airway obstruction in OSAS patients.METHODS : OSAS patients who were planned to perform surgical treatment were included in this study. To determine the snoring site, that should be same as the site of upper airway obstruction, the endoscopic examination during drug induced sleep was performed just before pharyngeal surgery and drug induced snore was recorded from each subject. Using a Multi-dimensional Voice Program (MDVP) that analyze various aspects of voice, 15 snores from each subject were analyzed automatically.RESULT : The findings of endoscopic examination during drug induced sleep and the acoustic characteristics of snoring sounds revealed that ; 1) the peak frequency of snoring originated from palatine tonsils were around 1000 Hz ; 2) the site of snoring(e.g site of obstruction) and sound characteristics of snoring were significantly changed with related to breathing methods of OSAS patients.CONCLUSION : The acoustic analysis of snoring sounds can be useful for identification of the site of airway obstruction in obstructive sleep apnea patients but further examination need to be performed with related to breathing routes.