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Are subjective assessments of snoring sounds reliable?

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Abstract

The aim of this study is to investigate whether snoring sounds can be reliably, i.e. reproducibly and comparably, assessed by the listener. This is an absolute prerequisite if an objective method is to provide a valid representation of subjective assessments of snoring sounds. Fifty-three subjects, both men and women, from different age categories assessed snoring sequences in terms of their annoyance level. This was done using a paired comparison model with ten sequences, once at original volume and once at adjusted peak level. In addition, assessments of 50 sequences were made using a visual analog scale (VAS). In the first paired comparison the assessments displayed very high consistency (K = 0.94) and high concordance (W = 0.83). The results showed very good agreement between the sexes (r s = 0.98), between different levels of snoring-related experience (r s = 0.99) and between different ages (r s = 0.98). At adjusted peak level there was also very high consistency (K = 0.91) although concordance was clearly lower (W = 0.50). The rankings in the two paired comparisons showed a high degree of correlation (r s = 0.81). The assessments on the VAS revealed good inter-rater reliability (α = 0.73) and a high degree of correlation with the result of the first paired comparison (r s = 0.93). Snoring sounds can be assessed in a reproducible and comparable manner in terms of their annoyance level. There are no gender-specific differences, and age-specific and experience-specific differences also appear to be negligible. While volume plays a dominant role, other characteristics of the sounds are also sufficient to permit an assessment.

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References

  1. Verse T, Hormann K (2011) The surgical treatment of sleep-related upper airway obstruction. Dtsch Arztebl Int 108:216–221

    PubMed Central  PubMed  Google Scholar 

  2. Singh V, Pandey S, Singh A, Gupta R, Prasad R, Singh Negi MP (2012) Study pattern of snoring and associated risk factors among medical students. Biosci Trends 6:57–62

    PubMed  Google Scholar 

  3. Virkkula P, Bachour A, Hytönen M, Malmberg H, Salmi T, Maasilta P (2005) Patient- and bed partner-reported symptoms, smoking, and nasal resistance in sleep-disordered breathing. Chest 128:2176–2182

    Article  PubMed  Google Scholar 

  4. Blumen MB, Quera Salva MA, Vaugier I, Leroux K, d’Ortho M, Barbot F, Chabolle F, Lofaso F (2012) Is snoring intensity responsible for the sleep partner’s poor quality of sleep? Sleep Breath 16:903–907

    Article  PubMed  Google Scholar 

  5. Savage CR, Steward DL (2007) Snoring: a critical analysis of current treatment modalities. Does anything really work? Curr Opin Otolaryngol Head Neck Surg 15:177–179

    Article  PubMed  Google Scholar 

  6. Pevernagie D, Aarts RM, de Meyer M (2010) The acoustics of snoring. Sleep Med Rev 14:131–144

    Article  PubMed  Google Scholar 

  7. Franklin KA, Anttila H, Axelsson S, Gislason T, Maasilta P, Myhre KI, Rehnqvist N (2009) Effects and side-effects of surgery for snoring and obstructive sleep apnea—a systematic review. Sleep 32:27–36

    PubMed Central  PubMed  Google Scholar 

  8. Stuck BA, Dreher A, Heiser C, Herzog M, Kühnel T, Maurer JT, Pistner H, Sitter H, Steffen A, Verse T (2013) S2k-guidelines “diagnosis and therapy of snoring in adults”: compiled by the Sleep Medicine Working Group of the German Society of Otorhinolaryngology, Head and Neck Surgery. HNO 61:944–957

    Article  CAS  PubMed  Google Scholar 

  9. Galetke W (2014) Primary snoring—harmless or not? Somnologie 18:75–79

    Article  Google Scholar 

  10. Kump K, Whalen C, Tishler PV, Browner I, Ferrette V, Strohl KP, Rosenberg C, Redline S (1994) Assessment of the validity and utility of a sleep-symptom questionnaire. Am J Respir Crit Care Med 150:735–741

    Article  CAS  PubMed  Google Scholar 

  11. Wiggins CL, Schmidt-Nowara WW, Coultas DB, Samet JM (1990) Comparison of self- and spouse reports of snoring and other symptoms associated with sleep apnea syndrome. Sleep 13:245–252

    CAS  PubMed  Google Scholar 

  12. Kühnel T, Glas S, Herzog M, Gassner H, Rohrmeier C (2014) Psychosocial burden caused by snoring. Somnologie 18:80–86

    Article  Google Scholar 

  13. Hoffstein V, Mateika S, Anderson D (1994) Snoring: is it in the ear of the beholder? Sleep 17:522–526

    CAS  PubMed  Google Scholar 

  14. Hoffstein V (1996) Snoring. Chest 109:201–222

    Article  CAS  PubMed  Google Scholar 

  15. Bortz J, Lienert GA, Boehnke K (2008) Distribution-free methods in biostatistics. Springer Medizin, Heidelberg

    Google Scholar 

  16. Kendall MG (1962) Rank correlation methods. Griffin, London

    Google Scholar 

  17. Hayes AF, Krippendorff K (2007) Answering the call for a standard reliability measure for coding data. Commun Methods Meas 1:77–89

    Article  Google Scholar 

  18. Lombard M, Snyder-Duch J, Bracken CC (2002) Content analysis in mass communication: assessment and reporting of intercoder reliability. Hum Commun Res 28:587–604

    Article  Google Scholar 

  19. Griefahn B, Scheuch K, Jansen G, Spreng M (2004) Protection goals for residents in the vicinity of civil airports. Noise Health 6:51–62

    CAS  PubMed  Google Scholar 

  20. Ising H, Kruppa B Health effects caused by noise: evidence in the literature from the past 25 years. Noise Health 6:5–13

  21. Cathcart R, Hamilton D, Drinnan M, Gibson G, Wilson J (2010) Night-to-night variation in snoring sound severity: one night studies are not reliable. Clin Otolaryngol 35:198–203

    Article  CAS  PubMed  Google Scholar 

  22. Franklin KA, Janson C, Gíslason T, Gulsvik A, Gunnbjörnsdottir M, Laerum BN, Lindberg E, Norrman E, Nyström L, Omenaas E, Torén K, Svanes C (2008) Early life environment and snoring in adulthood. Respir Res 9:63

    Article  PubMed Central  PubMed  Google Scholar 

  23. Kühnel TS, Hein G, Hohenhorst W, Maurer JT (2005) Soft palate implants: a new option for treating habitual snoring. Eur Arch Otorhinolaryngol 262:277–280

    Article  PubMed  Google Scholar 

  24. Ellermeier W, Mader M, Daniel P (2004) Scaling the unpleasantness of sounds according to the BTL model: ratio-scale representation and psychoacoustical analysis. Acta Acustica United Acustica 90:101–107

    Google Scholar 

  25. Dreher A, Rader T, Patscheider M, Klemens C, Schmidt M, Baker F, de La Chaux R (2009) The annoyance of snoring. Eur Arch Otorhinolaryngol 266:293–296

    Article  PubMed  Google Scholar 

  26. Ellermeier W, Eigenstetter M, Zimmer K (2001) Psychoacoustic correlates of individual noise sensitivity. J Acoust Soc Am 109:1464–1473

    Article  CAS  PubMed  Google Scholar 

  27. Rohrmeier C, Herzog M, Haubner F, Kuehnel TS (2012) The annoyance of snoring and psychoacoustic parameters: a step towards an objective measurement. Eur Arch Otorhinolaryngol 269:1537–1543

    Article  PubMed  Google Scholar 

  28. Dalmasso F, Prota R (1996) Snoring: analysis, measurement, clinical implications and applications. Eur Respir J 9:146–159

    Article  CAS  PubMed  Google Scholar 

  29. Herzog M, Schmidt A, Bremert T, Herzog B, Hosemann W, Kaftan H (2008) Analysed snoring sounds correlate to obstructive sleep disordered breathing. Eur Arch Otorhinolaryngol 265:105–113

    Article  PubMed  Google Scholar 

  30. Herzog M, Schieb E, Bremert T, Herzog B, Hosemann W, Kaftan H, Kühnel T (2008) Frequency analysis of snoring sounds during simulated and nocturnal snoring. Eur Arch Otorhinolaryngol 265:1553–1562

    Article  PubMed  Google Scholar 

  31. Lee BW, Hill PD, Osborne J, Osman E (1999) A simple audio data logger for objective assessment of snoring in the home. Physiol Meas 20:119–127

    Article  CAS  PubMed  Google Scholar 

  32. Beck R, Odeh M, Oliven A, Gavriely N (1995) The acoustic properties of snores. Eur Respir J 8:2120–2128

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

The authors are grateful to Eric Siegel for programming the software for sound sequence playback.

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Correspondence to Christian Rohrmeier.

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Rohrmeier, C., Fischer, R., Merz, AK. et al. Are subjective assessments of snoring sounds reliable?. Eur Arch Otorhinolaryngol 272, 233–240 (2015). https://doi.org/10.1007/s00405-014-3211-3

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  • DOI: https://doi.org/10.1007/s00405-014-3211-3

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