Loud snoring and insomnia symptoms predict the development of the metabolic syndrome

December 01, 2010

DARIEN, IL - A study in the Dec. 1 issue of the journal SLEEP found that loud snoring and two common insomnia symptoms - difficulty falling asleep and unrefreshing sleep - each significantly predicted the development of the metabolic syndrome. The study emphasizes the importance of screening for common sleep complaints in routine clinical practice.

Results of multivariate logistic regression models show that the risk of developing the metabolic syndrome over a three-year follow-up period was more than two times higher in adults who reported frequent loud snoring (odds ratio = 2.30). This risk also was increased by 80 percent in adults who reported having difficulty falling asleep (OR = 1.81) and by 70 percent in those who reported that their sleep was unrefreshing (OR = 1.71).

Further analysis found that unrefreshing sleep was reduced to marginal significance with additional adjustment for loud snoring. However, when simultaneously entered in a statistical model, both loud snoring and difficulty falling asleep remained significant independent predictors of the metabolic syndrome.

"This is the first prospective study to show that a broader array of commonly reported sleep symptoms, including insomnia and sleep-disordered breathing symptoms, predict the development of the metabolic syndrome, a key risk factor for cardiovascular disease," said lead author Wendy M. Troxel, PhD, assistant professor of psychiatry and psychology at the University of Pittsburgh in Pittsburgh, Pa. "It was rather striking that the effects of difficulty falling asleep and loud snoring were largely independent of one another."

According to the National Heart, Lung, and Blood Institute, metabolic syndrome is a group of obesity-related risk factors that increases an individual's risk of heart disease, diabetes and stroke. A person with at least three of these five risk factors is considered to have metabolic syndrome: excess abdominal fat, high triglycerides, low HDL cholesterol, high blood pressure and high blood sugar.

Analyses of these five individual components of the metabolic syndrome revealed that loud snoring significantly predicted the development of high blood sugar (OR = 2.15) and low HDL cholesterol (1.92). Difficulty falling asleep and unrefreshing sleep did not predict any of the individual metabolic abnormalities.

Only loud snoring continued to predict the development of the metabolic syndrome after accounting for the number of metabolic abnormalities present at baseline. According to the authors, this suggests that loud snoring may be a causal risk factor cardiometabolic dysregulation.

The study involved 812 participants in Heart SCORE, an ongoing, community-based, prospective study of adults between 45 and 74 years of age. People who were classified as having the metabolic syndrome or diabetes at baseline were excluded form the study. During the three-year follow-up period, 14 percent of participants developed the metabolic syndrome.

Self-reported sleep disturbances were assessed using the Insomnia Symptom Questionnaire and the Multivariable Apnea Prediction Questionnaire. The development of the metabolic syndrome was unrelated to difficulty staying asleep and frequent awakening from sleep, which are two other insomnia symptoms that are commonly reported.

Apnea-hypopnea index (AHI), an average of the combined episodes of partial reductions (hypopneas) and complete pauses (apneas) in breathing per hour of sleep, was calculated in a subset of 290 participants who wore a portable monitor that measured nasal airflow. In an analysis of this subset, loud snoring remained an independent predictor of the development of the metabolic syndrome (OR = 3.01) even after adjusting for AHI, while difficulty falling asleep was reduced to marginal statistical significance.
-end-
More information about snoring is available from the American Academy of Sleep Medicine at http://www.sleepeducation.com/Disorder.aspx?id=26.

The study was supported by the Commonwealth of Pennsylvania Department of Health; and the National Heart, Lung, and Blood Institute and the Clinical & Translational Science Awards of the National Institutes of Health.

The peer-reviewed, scientific journal SLEEP is published monthly by the Associated Professional Sleep Societies LLC, a joint venture of the American Academy of Sleep Medicine and the Sleep Research Society. The AASM is a professional membership society that is the leader in setting standards and promoting excellence in sleep medicine health care, education and research.

For a copy of the study, "Sleep symptoms predict the development of the metabolic syndrome," or to arrange an interview with an AASM spokesperson, please contact Public Relations Coordinator Emilee McStay at 630-737-9700, ext. 9345, or emcstay@aasmnet.org.

American Academy of Sleep Medicine

Related Diabetes Articles from Brightsurf:

New diabetes medication reduced heart event risk in those with diabetes and kidney disease
Sotagliflozin - a type of medication known as an SGLT2 inhibitor primarily prescribed for Type 2 diabetes - reduces the risk of adverse cardiovascular events for patients with diabetes and kidney disease.

Diabetes drug boosts survival in patients with type 2 diabetes and COVID-19 pneumonia
Sitagliptin, a drug to lower blood sugar in type 2 diabetes, also improves survival in diabetic patients hospitalized with COVID-19, suggests a multicenter observational study in Italy.

Making sense of diabetes
Throughout her 38-year nursing career, Laurel Despins has progressed from a bedside nurse to a clinical nurse specialist and has worked in medical, surgical and cardiac intensive care units.

Helping teens with type 1 diabetes improve diabetes control with MyDiaText
Adolescence is a difficult period of development, made more complex for those with Type 1 diabetes mellitus (T1DM).

Diabetes-in-a-dish model uncovers new insights into the cause of type 2 diabetes
Researchers have developed a novel 'disease-in-a-dish' model to study the basic molecular factors that lead to the development of type 2 diabetes, uncovering the potential existence of major signaling defects both inside and outside of the classical insulin signaling cascade, and providing new perspectives on the mechanisms behind insulin resistance in type 2 diabetes and possibly opportunities for the development of novel therapeutics for the disease.

Tele-diabetes to manage new-onset diabetes during COVID-19 pandemic
Two new case studies highlight the use of tele-diabetes to manage new-onset type 1 diabetes in an adult and an infant during the COVID-19 pandemic.

Genetic profile may predict type 2 diabetes risk among women with gestational diabetes
Women who go on to develop type 2 diabetes after having gestational, or pregnancy-related, diabetes are more likely to have particular genetic profiles, suggests an analysis by researchers at the National Institutes of Health and other institutions.

Maternal gestational diabetes linked to diabetes in children
Children and youth of mothers who had gestational diabetes during pregnancy are at increased risk of diabetes themselves, according to new research published in CMAJ (Canadian Medical Association Journal).

Two diabetes medications don't slow progression of type 2 diabetes in youth
In youth with impaired glucose tolerance or recent-onset type 2 diabetes, neither initial treatment with long-acting insulin followed by the drug metformin, nor metformin alone preserved the body's ability to make insulin, according to results published online June 25 in Diabetes Care.

People with diabetes visit the dentist less frequently despite link between diabetes, oral health
Adults with diabetes are less likely to visit the dentist than people with prediabetes or without diabetes, finds a new study led by researchers at NYU Rory Meyers College of Nursing and East Carolina University's Brody School of Medicine.

Read More: Diabetes News and Diabetes Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.