SCIENCE / SUMMARY / TÜRKİYE DATA

In Türkiye, is snoring or daytime sleepiness more closely linked to moderate and severe sleep apnea?

MULTICENTRE REGISTRY · CROSS SECTIONAL ■■□□ low evidence: a single point in time, sleep clinic patients only, symptoms reported by the patients themselves

Who: 15,579 records from centres in the national sleep apnea registry TURKAPNE (enrolling since October 2017) were screened; after removing repeated, faulty or incomplete records (2,864), 12,715 adults remained. People previously treated with a positive airway pressure device or an oral appliance were excluded. Participants had been referred for suspected apnea; they are not the general population.
What they did: Everyone had an attended full night polysomnography in the lab lasting at least seven hours. Symptoms were collected from the patients themselves through standard form questions, and daytime sleepiness was measured with the Turkish version of the Epworth scale. People with an AHI of 15 or more per hour were compared with the rest, and independent links were tested with stepwise logistic regression.
What they found: 8,393 people (66.0%) had moderate or severe apnea. In the model including all factors, male sex (OR 3.04), snoring (OR 2.35; 95% CI 2.12 to 2.62), breathing pauses seen by someone else (OR 1.86) and breathlessness at night (OR 1.26) were independently linked to moderate and severe apnea. The Epworth score had an OR of 1.007 (0.999 to 1.015), which was not significant. High sleepiness (Epworth 11 or more) was found in 25.8% of the moderate and severe group and 17.7% of the others; about three in four people with moderate or severe apnea did not report high sleepiness. Conditions such as high blood pressure and diabetes also lost their independent link in the full model.
Limits: As the authors note: a cross sectional design cannot show cause and effect; a sleep clinic sample may not generalise to the community; symptoms and conditions came from patient reports and physician records, so misclassification is possible; unmeasured factors cannot be ruled out; there was no later follow up visit. In addition: snoring here is the patient's answer to a question, not a measured recording. Funding: Turkish Thoracic Society. Conflicts of interest: three authors are editors of the journal; the authors state they were fully excluded from the review and decision process for this paper. No conflicts reported for the other authors.

What does this mean for you?

Not feeling sleepy during the day may not mean your breathing at night is trouble free. In this study, snoring and pauses seen by someone else said more than the sleepiness score. If these signs worry you, talking to a doctor is the right way to have them assessed. This is not advice.

Link to Nefesly: The Turkish basis for Nefesly focusing on night sounds, and for asking the Epworth questions once a month for tracking rather than using them on their own as a decision measure.
Reference: Balcan B, Pıhtılı A, Kıyan E, et al. Clinical Characteristics of Moderate-to-Severe Obstructive Sleep Apnea: A Cross-sectional Analysis of 12,715 Adults from the TURKAPNE Cohort. Thoracic Research and Practice. 2026;27(3):173-181. doi:10.4274/ThoracResPract.2026.2026-1-4 · Open access (CC BY-NC 4.0).
Why chosen: One of 15 sources selected from 403 candidates on the Türkiye and guidelines axis; a large apnea sample from 34 centres in Türkiye, based on lab sleep tests.
Summarised by: Nefesly, from the full text, 11 October 2026. Awaiting clinician check.
Copyright: Summarised from the full text, not translated from the abstract.