Preprint Article Version 1 This version is not peer-reviewed

Snoring: The Case for Molecular Tissue Oximetry

Version 1 : Received: 5 March 2019 / Approved: 7 March 2019 / Online: 7 March 2019 (10:19:48 CET)

How to cite: Hatch, G.M..; Ashbrook, L..; Prather, A.A.; Krystal, A.D.. Snoring: The Case for Molecular Tissue Oximetry. Preprints 2019, 2019030087 (doi: 10.20944/preprints201903.0087.v1). Hatch, G.M..; Ashbrook, L..; Prather, A.A.; Krystal, A.D.. Snoring: The Case for Molecular Tissue Oximetry. Preprints 2019, 2019030087 (doi: 10.20944/preprints201903.0087.v1).

Abstract

Snoring gets no respect.  It also gets little to no medical therapy.  Why is this?  How can something that is clearly pathological based on epidemiologic research not be diagnosed and treated with effective therapy?  The problem is the lack of a credible, objective index of pathology during snoring.  Pulse oximetry detects drops in arterial blood oxygen saturation (SpO2) associated with obstructive sleep apnea and hypopnea events in polysomnographic (PSG) testing.  When no desaturation is present, evidence of sleep disturbance is required to indicate the presence of pathology.  However, obstruction at the mild end of the continuum of sleep disordered breathing (SDB) can occur without producing a drop in SpO2 or sleep disturbance; in which case it is referred to as ‘primary snoring.’ Although statistically associated with co-morbidities of SDB, without there being a drop in SpO2 or sleep disturbance, primary snoring is not thought to be pathologic enough to warrant diagnosis or treatment.  One promising means of detecting the pathological processes associated with primary snoring is molecular tissue oximetry, which detects skin tissue oxygen need, vs. oxygen supply.   In cases of hypoxic challenge, regulatory mechanisms restrict blood flow to the skin to preferentially maintain blood oxygen supply to more vital organs.  As a result, molecular tissue oximetry of the skin is a more sensitive measure of inadequate breathing than pulse oximetry measuring blood oxygen saturation.  In this article we review molecular tissue oximetry technology and methodology and make the case that it is a promising tool for identifying pathology occurring in association with primary snoring.

Subject Areas

Tissue hypoxia; sleep disordered breathing; primary snoring; molecular tissue oximeter; tissue hyperoxia

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