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Snoring noise pollution—the need for objective quantification of annoyance, regulatory guidelines and mandatory therapy for snoring

P P Caffier et al 2007 Physiol. Meas. 28 25-40   doi: 10.1088/0967-3334/28/1/003  Help

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P P Caffier1, J C Berl1, A Muggli2, A Reinhardt1, A Jakob2, M Möser2, I Fietze3, H Scherer1 and M Hölzl1
1 Department of Otorhinolaryngology, Charité-University Medicine Berlin, Joint Facility of Free University and Humboldt-University, Campus Charité Mitte, Charitéplatz 1, D-10117 Berlin, Germany
2 Institute of Technical Acoustics, Technical University of Berlin, Einsteinufer 25, D-10587 Berlin, Germany
3 Interdisciplinary Center of Sleep Medicine, Charité-University Medicine Berlin, Joint Facility of Free University and Humboldt-University, Campus Charité Mitte, Charitéplatz 1, D-10117 Berlin, Germany
E-mail: philipp.caffier@charite.de

Abstract. Habitual snoring without episodes of apnea or hypoventilation and without respiratory related arousals is considered to be annoying and without any need for treatment. However, studies seem to suggest an enormous psychosocial impact of annoyance for the bed partner. Apart from subjective questionnaires there still exists no generally accepted mode of measurement that can describe snoring objectively. We therefore adapted methods developed for environmental medicine and established a new snore score using psycho-acoustic parameters. For quantification of snoring noise we conducted nocturnal measurements in 19 habitual snorers. Free-field snore sounds were acquired with two low-cost non-contact microphones and transferred to a PC (sampling frequency 11 kHz). The data were recorded, analysed and stored automatically using a MATLAB script. Following the analysis of sound characteristics and levels, the score was computed from relevant parameters containing the rating level (LR), maximum level, two percentile levels for frequent maxima (L5S; L1) and snoring time. The determined values substantially exceeded the prescribed limits defined by WHO noise guidelines, and mainly affected the equivalent continuous sound exposure level, rating level and the immission standard values of brief noise peaks, whose maximum was exceeded by up to 32 dB(A). The Berlin snore score illustrated the objective acoustic annoyance on a scale from 0 to 100. It allows inter-individual comparison and objectifies the need for therapy. The clinical applicability of evaluating the reduction of snoring after surgical therapy is discussed exemplarily. The presented measuring method was found to be suitable for quantifying snoring noise and can be easily integrated into existing polysomnographic applications. In the case of habitual snoring with objective evidence of psychosocially disturbing acoustic annoyance, health fund providers should assume the costs of mandatory medical therapy.

Keywords: snoring noise quantification, habitual snoring, psycho-acoustic parameters, snoring sound analysis, psychosocial annoyance, objective snore score

Print publication: Issue 1 (January 2007)
Received 23 July 2006, accepted for publication 27 October 2006
Published 17 November 2006

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