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Journal SLEEP: Snoring linked to cardiovascular disease, increased health-care utilization

March 03, 2008

WESTCHESTER, Ill. - Loud snoring with breathing pauses is associated with an increased risk of cardiovascular disease and increased health care utilization, according to a study published in the March 1 issue of the journal SLEEP.

The study, authored by Marta Novak, MD, PhD, of the Institute of Behavioral Sciences at Semmelweis University in Budapest, Hungary, focused on interviews with 12,643 Hungarian individuals. Interviews were carried out in the homes of the participants and questions about snoring were asked.

According to the results, loud snorers had 40 percent greater odds of having hypertension, 34 percent greater odds of having a heart attack and 67 percent greater odds of having a stroke, compared with people who do not snore, after statistical adjustment for age, sex, body mass index, diabetes, level of education, smoking, and alcohol consumption. Quiet snoring was associated only with an increased risk for hypertension in women. Loud snoring was also associated with increased use of health care resources (emergency visits and hospitalization).

"Our findings suggest that loud snoring with breathing pauses carries a significantly increased risk for cardiovascular disease and is close to obstructive sleep apnea syndrome (OSAS) on the spectrum of sleep disordered breathing, therefore this simple question may identify high risk individuals whom may benefit from a sleep study," said Istvan Mucsi, MD, PhD, of Semmelweis University and Humber River Regional Hospital and Faculty of Medicine at the University of Toronto in Canada, co-author of the study.

Snoring is a sound made in the upper airway of your throat as you sleep. It normally occurs as you breathe in air. It is a sign that your airway is being partially blocked.

About one half of people who snore loudly have obstructive sleep apnea (OSA). OSA happens when the tissue in the back of the throat collapses to block the entire airway. This keeps air from getting in to the lungs. It occurs because the muscles inside the throat relax as you sleep. Gravity then causes the tongue to fall back and block the airway. It can happen a few times a night or several hundred times per night.

Light snoring may not disrupt your overall quality of sleep. But many people with severe snoring and OSA are sleepy during the day. They find that they are still tired even after a nap.

Almost everyone is likely to snore at one time or another. It has been found in all age groups. Estimates of snoring vary widely based on how it is defined.

Habitual snoring has been found in about 24 percent of adult women and 40 percent of adult men. Both men and women are more likely to snore as they age. Men, however, become less likely to snore after the age of 70.

Snoring is more common in people who are overweight. There is a greater amount of fat in the back of the throat that vibrates as they sleep. Nasal obstruction raises the risk of snoring.

It has also been shown to increase during pregnancy. Snoring appears to run in families. Your likelihood of snoring may also increase with the following present factors:

* Drinking alcohol

* Using muscle relaxers

* Using drugs

* Smoking

It is recommended that adults get between seven and eight hours of nightly sleep.

The American Academy of Sleep Medicine (AASM) offers the following tips on how to get a good night's sleep:

* Follow a consistent bedtime routine.

* Establish a relaxing setting at bedtime.

* Get a full night's sleep every night.

* Avoid foods or drinks that contain caffeine, as well as any medicine that has a stimulant, prior to bedtime.

* Do not bring your worries to bed with you.

* Do not go to bed hungry, but don't eat a big meal before bedtime either.

* Avoid any rigorous exercise within six hours of your bedtime.

* Make your bedroom quiet, dark and a little bit cool.

* Get up at the same time every morning.

American Academy of Sleep Medicine