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Making war on snoring

Half of all Norwegians snore, and there are long queues for operations to cure the condition. But now, a little bit of Norwegian defence technology brings hope of shorter waiting lists.

Scientists and doctors in Trondheim have recently adopted a technology that was originally developed for military use: an earplug that acts both as hearing protector and communication system. The plug, which is known as Quiet Pro (previously Parat), consists of a built-in computer, a mini-loudspeaker, and internal and external microphones. Now it is ready to support the struggle against a quite different enemy than the one it was designed for – snoring!

Better diagnoses

“The aim of our studies is to develop a better tool for measuring snoring both during the diagnostic process and following a snoring operation,” says SINTEF acoustics scientist Tone Berg. For this purpose, the researchers use the earplug’s microphones, which are connected to recording equipment.

“Although we make use of only part of Quiet Pro here, it is still a unique tool that is capable of revealing the details of a patient’s snoring and breathing patterns by recording and analysing the sounds they make,” says Berg.

The project involves cross-disciplinary collaboration between SINTEF ICT, SINTEF Health Research and the Ear, Nose and Throat Department at St. Olav’s Hospital.

The equipment measures how much the patient snores, and the sound level of the snoring. Another aim is to show where the snores arise, a factor of great importance for determining where the surgical intervention should take place.

Doctors distinguish between two types of snoring; one of them is known as social snoring, and is capable of disturbing both snorers themselves and anyone sleeping near them. Social snoring can be cured by stiffening the soft palate, either by means of an implant or by a technique called diathermy, which uses a laser to stiffen the tissue. However, for some people a course of slimming is sufficient, since obesity is a common cause of snoring.

But snoring may also be indicative of a more serious condition known as obstructive sleep apnoea syndrome, which can interrupt breathing, make sufferers abnormally tired and increase the risk of cardiovascular disease. A breathing machine is usually required to cure this disease, but in some cases more advanced surgery may be required.

The researchers hope that the new measurement method will make examination and diagnosis simpler and more reliable, and give doctors better answers about what sort of surgery they should perform on each patient. The method will also reveal cases in which simple surgery would not help the patient.

“The technology will also give us an objective post hoc measure of the results of an operation. Today, some 15 - 30 percent of operations to cure snoring are failures,” says senior medical officer Ståle Nordgård.

Social problem

The earplug is thus potentially capable of producing important savings for hospitals and society in general.

Snorers are both less productive and less able to concentrate than non-snorers, and it is well known that snoring can be a nuisance for other people than the snorer himself, so that sleep problems are “catching”.

“Lack of sleep can be just as dangerous as alcohol in the bloodstream. For example, snorers are eight times as likely as non-snorers to be involved in a road accident,” says Nordgård who, together will his medical colleague Ketil Skjøstad, works half-time at NTNU on this and other research projects.

Cheaper and better

Today, many of the patients who are to be examined for the condition need to spend the night at St. Olav’s Hospital in Trondheim with a sonde inserted in their nose and down the oesophagus. The sonde is fitted with different types of sensors, and it measures pressure differences in the patient’s pattern of respiration, revealing just where in the throat the snoring problem arises. There are several potential locations. But this equipment is unpleasant to utilise, and may well disturb the patient’s sleep. The sensors also tend to move when the patients turns over in bed, which makes the measurements unreliable.

“What is unique about the new recording method is that the microphone stays in the same place, no matter how much a patient moves about in his sleep. Nor do the acoustics of the room affect the sound recordings, all of which simplifies home registration,” says Ketil Skjøstad.

No other systems on the market at present are capable of measuring sound in this way.

Objective measurement method

To date, the earplug has been tested on 22 people, in collaboration with an MSc student at NTNU. The subjects slept a whole night with both types of equipment fitted, in order to determine whether the earplug provided data that were as good as the scientists had hoped.

“What we found was that Quiet Pro gives us more information about patients’ snoring patterns than the old equipment. Now we know how much patients snore, how frequently and what level of sound they produce. This is particularly useful for measuring how successful an operation has really been,” explains Tone Berg,

The technique is so simple that it opens up the possibility of carrying out large-scale epidemiological studies of snoring. It will also be an excellent screening technique. The scientists still need to find out how detailed and accurate it is.

Further analyses are also needed to reach the goal of finding out just where in the airway snoring originates. The 22 snoring subjects did not provide the research team with sufficient information to answer this question. The subjects also slept more poorly than usual, both because the earplug need to be better adapted to the anatomy of the ear and because the patients were also sleeping with the old equipment fitted as well as the earplug.

Commercial potential

Operating to cure snoring has become a common, and usually effective, procedure, which can be carried out in only half an hour. The procedure suggests the possibility of an important international market for a technology that will simplify diagnosis and later tell surgeons how successful an operation has been. All over the world, more and more people are being operated for snoring, and the research team envisages a market for the earplug in both Europe and the USA.

Aase Dragland | alfa
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