Skip to main content
Top
Published in: European Archives of Oto-Rhino-Laryngology 7/2010

01-07-2010 | Miscellaneous

The influence of nocturnal alcohol ingestion on snoring

Authors: Randolf Riemann, Ralf Volk, Alexander Müller, Michael Herzog

Published in: European Archives of Oto-Rhino-Laryngology | Issue 7/2010

Login to get access

Abstract

Nocturnal alcohol ingestion is known to increase obstructive sleep apnea. It is assumed that snoring also increases under the influence of alcohol although only few data are available to support this hypothesis. The aim of this study was to investigate the influence of nocturnal alcohol ingestion on the properties of snoring. Twenty healthy male reported non-snorers (n = 10) and snorers (n = 10) underwent night-time polysomnography at three randomly assigned nights with a blood alcohol concentration (BAC) of 0.0, 0.5 and 0.8‰, respectively. Snoring events were recorded by a room and body contact microphone simultaneously. Loudness and incidence of snoring were calculated and correlated to the total sleep time (TST), body position and sleep stages. Snorers revealed an increase of the apnea-hypopnea-index (AHI) under increasing BAC, whereas no decrease in the nocturnal SAO2 was detected. Non-snorers had no increase in the AHI but a decrease in SAO2. Snoring individuals revealed a dose-dependent increase of incidence (TSI) and loudness (LSI) of snoring with regard to the TST. The TSI increased by a factor of 1.6 at 0.5‰ BAC and by 4.2 at 0.8‰ BAC compared to the 0.0‰- BAC-night. The LSI increased threefold at 0.5‰ BAC and 14-fold at 0.8‰ BAC. Snoring increased to a bigger extent in a supine position compared to non supine and during REM stage as well as Non REM 3/4 stage. Non-snorers did not present any effect of alcohol on the snoring properties with regard to TST, body position and sleep stage. The results indicate that nocturnal alcohol ingestion affects individuals with a reported history of snoring to a greater extent than non-snorers. Non-snorers did not turn into snorers under increasing alcohol influence. The recommendation, to avoid alcohol intake prior to sleep, gains of special clinical importance for individuals already snoring.
Literature
1.
go back to reference (1995) AARC-APT (American Association of Respiratory Care-Association of Polysomnography Technologists) clinical practice guideline. Polysomnography. Respir Care 40:1336–1343 (1995) AARC-APT (American Association of Respiratory Care-Association of Polysomnography Technologists) clinical practice guideline. Polysomnography. Respir Care 40:1336–1343
2.
go back to reference Bertram CD, Muller M, Ramus F, Nugent AH (2001) Measurements of steady turbulent flow through a rigid simulated collapsed tube. Med Biol Eng Comput 39:422–427CrossRefPubMed Bertram CD, Muller M, Ramus F, Nugent AH (2001) Measurements of steady turbulent flow through a rigid simulated collapsed tube. Med Biol Eng Comput 39:422–427CrossRefPubMed
3.
go back to reference Feldstein A (1978) The metabolism of alcohol: on the validity of the Widmark equations, in obesity and in racial and ethnic groups. J Stud Alcohol 39:926–936PubMed Feldstein A (1978) The metabolism of alcohol: on the validity of the Widmark equations, in obesity and in racial and ethnic groups. J Stud Alcohol 39:926–936PubMed
4.
go back to reference Friberg D, Ansved T, Borg K, Carlsson-Nordlander B, Larsson H, Svanborg E (1998) Histological indications of a progressive snorers disease in an upper airway muscle. Am J Respir Crit Care Med 157:586–593PubMed Friberg D, Ansved T, Borg K, Carlsson-Nordlander B, Larsson H, Svanborg E (1998) Histological indications of a progressive snorers disease in an upper airway muscle. Am J Respir Crit Care Med 157:586–593PubMed
5.
go back to reference Friberg D, Gazelius B, Hokfelt T, Nordlander B (1997) Abnormal afferent nerve endings in the soft palatal mucosa of sleep apnoics and habitual snorers. Regul Pept 71:29–36CrossRefPubMed Friberg D, Gazelius B, Hokfelt T, Nordlander B (1997) Abnormal afferent nerve endings in the soft palatal mucosa of sleep apnoics and habitual snorers. Regul Pept 71:29–36CrossRefPubMed
6.
go back to reference Friel PN, Logan BK, Baer J (1995) An evaluation of the reliability of Widmark calculations based on breath alcohol measurements. J Forensic Sci 40:91–94PubMed Friel PN, Logan BK, Baer J (1995) An evaluation of the reliability of Widmark calculations based on breath alcohol measurements. J Forensic Sci 40:91–94PubMed
7.
go back to reference Gavriely N, Shee TR, Cugell DW, Grotberg JB (1989) Flutter in flow-limited collapsible tubes: a mechanism for generation of wheezes. J Appl Physiol 66:2251–2261PubMed Gavriely N, Shee TR, Cugell DW, Grotberg JB (1989) Flutter in flow-limited collapsible tubes: a mechanism for generation of wheezes. J Appl Physiol 66:2251–2261PubMed
8.
go back to reference Gleadhill IC, Schwartz AR, Schubert N, Wise RA, Permutt S, Smith PL (1991) Upper airway collapsibility in snorers and in patients with obstructive hypopnea and apnea. Am Rev Respir Dis 143:1300–1303PubMed Gleadhill IC, Schwartz AR, Schubert N, Wise RA, Permutt S, Smith PL (1991) Upper airway collapsibility in snorers and in patients with obstructive hypopnea and apnea. Am Rev Respir Dis 143:1300–1303PubMed
9.
go back to reference Godleski DA, Grotberg JB (1988) Convection-diffusion interaction for oscillatory flow in a tapered tube. J Biomech Eng 110:283–291CrossRefPubMed Godleski DA, Grotberg JB (1988) Convection-diffusion interaction for oscillatory flow in a tapered tube. J Biomech Eng 110:283–291CrossRefPubMed
10.
go back to reference Gold AR, Marcus CL, Dipalo F, Gold MS (2002) Upper airway collapsibility during sleep in upper airway resistance syndrome. Chest 121:1531–1540CrossRefPubMed Gold AR, Marcus CL, Dipalo F, Gold MS (2002) Upper airway collapsibility during sleep in upper airway resistance syndrome. Chest 121:1531–1540CrossRefPubMed
11.
go back to reference Grotberg JB (1986) Flow limitation and flow-induced oscillations. J Appl Physiol 61:377–378PubMed Grotberg JB (1986) Flow limitation and flow-induced oscillations. J Appl Physiol 61:377–378PubMed
12.
go back to reference Grotberg JB, Gavriely N (1989) Flutter in collapsible tubes: a theoretical model of wheezes. J Appl Physiol 66:2262–2273PubMed Grotberg JB, Gavriely N (1989) Flutter in collapsible tubes: a theoretical model of wheezes. J Appl Physiol 66:2262–2273PubMed
13.
go back to reference Herzog M, Riemann R (2004) Alcohol ingestion influences the nocturnal cardio-respiratory activity in snoring and non-snoring males. Eur Arch Otorhinolaryngol 261:459–462CrossRefPubMed Herzog M, Riemann R (2004) Alcohol ingestion influences the nocturnal cardio-respiratory activity in snoring and non-snoring males. Eur Arch Otorhinolaryngol 261:459–462CrossRefPubMed
14.
go back to reference Hoffstein V, Chaban R, Cole P, Rubinstein I (1988) Snoring and upper airway properties. Chest 94:87–89CrossRefPubMed Hoffstein V, Chaban R, Cole P, Rubinstein I (1988) Snoring and upper airway properties. Chest 94:87–89CrossRefPubMed
15.
go back to reference Hoffstein V, Mateika JH, Mateika S (1991) Snoring and sleep architecture. Am Rev Respir Dis 143:92–96PubMed Hoffstein V, Mateika JH, Mateika S (1991) Snoring and sleep architecture. Am Rev Respir Dis 143:92–96PubMed
16.
go back to reference Hoffstein V, Mateika S, Anderson D (1994) Snoring: is it in the ear of the beholder? Sleep 17:522–526PubMed Hoffstein V, Mateika S, Anderson D (1994) Snoring: is it in the ear of the beholder? Sleep 17:522–526PubMed
17.
go back to reference Issa FG, Sullivan CE (1982) Alcohol, snoring and sleep apnea. J Neurol Neurosurg Psychiatry 45:353–359CrossRefPubMed Issa FG, Sullivan CE (1982) Alcohol, snoring and sleep apnea. J Neurol Neurosurg Psychiatry 45:353–359CrossRefPubMed
18.
go back to reference Issa FG, Sullivan CE (1984) Upper airway closing pressures in snorers. J Appl Physiol 57:528–535PubMed Issa FG, Sullivan CE (1984) Upper airway closing pressures in snorers. J Appl Physiol 57:528–535PubMed
19.
go back to reference Jones AW, Neri A (1987) Reinvestigation of Widmark’s method for quantitative evaluation of blood-ethanol profiles: influence of alcohol dose and mode of drinking. Clin Chem 33:1469PubMed Jones AW, Neri A (1987) Reinvestigation of Widmark’s method for quantitative evaluation of blood-ethanol profiles: influence of alcohol dose and mode of drinking. Clin Chem 33:1469PubMed
20.
go back to reference Krol RC, Knuth SL, Bartlett D Jr (1984) Selective reduction of genioglossal muscle activity by alcohol in normal human subjects. Am Rev Respir Dis 129:247–250PubMed Krol RC, Knuth SL, Bartlett D Jr (1984) Selective reduction of genioglossal muscle activity by alcohol in normal human subjects. Am Rev Respir Dis 129:247–250PubMed
21.
go back to reference Lugaresi E, Coccagna G, Cirignotta F, Farneti P, Gallassi R, Di Donato G, Verucchi P (1978) Breathing during sleep in man in normal and pathological conditions. Adv Exp Med Biol 99:35–45PubMed Lugaresi E, Coccagna G, Cirignotta F, Farneti P, Gallassi R, Di Donato G, Verucchi P (1978) Breathing during sleep in man in normal and pathological conditions. Adv Exp Med Biol 99:35–45PubMed
22.
go back to reference Roehrs T, Merlotti L, Petrucelli N, Stepanski E, Roth T (1994) Experimental sleep fragmentation. Sleep 17:438–443PubMed Roehrs T, Merlotti L, Petrucelli N, Stepanski E, Roth T (1994) Experimental sleep fragmentation. Sleep 17:438–443PubMed
23.
24.
go back to reference Scrima L, Broudy M, Nay KN, Cohn MA (1982) Increased severity of obstructive sleep apnea after bedtime alcohol ingestion: diagnostic potential and proposed mechanism of action. Sleep 5:318–328PubMed Scrima L, Broudy M, Nay KN, Cohn MA (1982) Increased severity of obstructive sleep apnea after bedtime alcohol ingestion: diagnostic potential and proposed mechanism of action. Sleep 5:318–328PubMed
25.
go back to reference Scrima L, Hartman PG, Hiller FC (1989) Effect of three alcohol doses on breathing during sleep in 30–49 year old nonobese snorers and nonsnorers. Alcohol Clin Exp Res 13:420–427CrossRefPubMed Scrima L, Hartman PG, Hiller FC (1989) Effect of three alcohol doses on breathing during sleep in 30–49 year old nonobese snorers and nonsnorers. Alcohol Clin Exp Res 13:420–427CrossRefPubMed
26.
go back to reference Ulfberg J, Carter N, Talback M, Edling C (2000) Adverse health effects among women living with heavy snorers. Health Care Women Int 21:81–90CrossRefPubMed Ulfberg J, Carter N, Talback M, Edling C (2000) Adverse health effects among women living with heavy snorers. Health Care Women Int 21:81–90CrossRefPubMed
27.
go back to reference Virkkula P, Bachour A, Hytonen M, Malmberg H, Salmi T, Maasilta P (2005) Patient- and bed partner-reported symptoms, smoking, and nasal resistance in sleep-disordered breathing. Chest 128:2176–2182CrossRefPubMed Virkkula P, Bachour A, Hytonen M, Malmberg H, Salmi T, Maasilta P (2005) Patient- and bed partner-reported symptoms, smoking, and nasal resistance in sleep-disordered breathing. Chest 128:2176–2182CrossRefPubMed
28.
go back to reference Watson PE, Watson ID, Batt RD (1981) Prediction of blood alcohol concentrations in human subjects. Updating the Widmark Equation. J Stud Alcohol 42:547–556PubMed Watson PE, Watson ID, Batt RD (1981) Prediction of blood alcohol concentrations in human subjects. Updating the Widmark Equation. J Stud Alcohol 42:547–556PubMed
29.
go back to reference 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 13:245–252PubMed 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 13:245–252PubMed
30.
go back to reference Wilson K, Stoohs RA, Mulrooney TF, Johnson LJ, Guilleminault C, Huang Z (1999) The snoring spectrum: acoustic assessment of snoring sound intensity in 1, 139 individuals undergoing polysomnography. Chest 115:762–770CrossRefPubMed Wilson K, Stoohs RA, Mulrooney TF, Johnson LJ, Guilleminault C, Huang Z (1999) The snoring spectrum: acoustic assessment of snoring sound intensity in 1, 139 individuals undergoing polysomnography. Chest 115:762–770CrossRefPubMed
Metadata
Title
The influence of nocturnal alcohol ingestion on snoring
Authors
Randolf Riemann
Ralf Volk
Alexander Müller
Michael Herzog
Publication date
01-07-2010
Publisher
Springer-Verlag
Published in
European Archives of Oto-Rhino-Laryngology / Issue 7/2010
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-009-1163-9

Other articles of this Issue 7/2010

European Archives of Oto-Rhino-Laryngology 7/2010 Go to the issue