Associations between recorded tracheal sound and guardian-reported snoring frequency and loudness in children.

OBJECTIVES

Sleep apnea is a major pediatric sleep health issue. Although many epidemiological studies rely on guardian-reported snoring as a surrogate for sleep apnea, the accuracy of such data remains unclear. This study examines associations between guardian-reported snoring and objective snoring parameters derived from tracheal sound measurements.

METHODS

This cross-sectional study analyzed data from 555 first- and second-grade Japanese elementary school children. Snoring frequency and loudness were reported by their guardians through questionnaires. Objective snoring data were derived from overnight tracheal sound recordings. Differences between subjective and objective measures were assessed using the Kruskal-Wallis test, followed by post hoc pairwise comparisons with the Dwass-Steel-Critchlow-Fligner test.

RESULTS

Children who "never" snored had the lowest median snoring-time ratio (percentage) of 0.50 (IQR: 0.30-1.10), while the ratio was 0.90 (0.40-2.00) for children who snored "1 night per week," 1.20 (0.40-4.60) for the "2 nights per week" group, and 2.70 (0.70-5.20) for the "≥3 nights per week" group. All snoring groups showed significantly higher ratios than the "never" group (p < 0.05). Similar trends were observed for the equivalent sound pressure level (Leq, dB) of tracheal sounds, which increased stepwise from 88.60 (86.30-90.70) in the "Mildly quiet" group to 89.10 (87.10-92.00) in the "Medium loud" group and 92.60 (88.60-95.20) in the "Loud" group.

CONCLUSIONS

Guardian-reported snoring frequency and loudness were significantly associated with objective measures based on tracheal sound. These findings support the validity of guardian reports in epidemiological studies of pediatric sleep health.