Association between self-reported snoring and hypertension: a systematic review and meta-analysis

Niu, Yirou; Sui, Xin; He, Yayu; Xi, Huihui; Zhu, Ruiting; Xu, Haiyan; Li, Yuewei; Zhang, Zhuo; Guo, Lirong

doi:10.1016/j.sleep.2021.10.016

Cited by 16 publications

(6 citation statements)

References 42 publications

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“…There are limited options to screen for hypertension risk in the first trimester and assessing whether a woman snores may be a simple strategy to identify HDP risk early in pregnancy. Research supports that self-reported snoring is related to higher blood pressure in the general population and our results are consistent with emerging research on pregnant populations associating self-reported chronic snoring with adverse pregnancy outcomes like HDP [ 30 , 31 ]. Known sleep-disordered breathing is associated with HDP, but much of the literature speaks to the risks in later pregnancy when sleep-disordered breathing becomes more pronounced due to the anatomic and physiological changes of later pregnancy [ 32 , 33 ].…”

Section: Discussionsupporting

confidence: 92%

Lifestyle and the hypertensive disorders of pregnancy in nulliparous women in the United States: a secondary data analysis of the nuMom2b

Mollard

Cottrell

2023

BMC Pregnancy Childbirth

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Background Hypertensive disorders of pregnancy are a leading cause of maternal and fetal morbidity and mortality and a significant risk factor for future cardiovascular disease development in women. This study aimed to explore lifestyle wellness-related variables and how they impact the risk of hypertension in pregnancy. Methods This is a secondary analysis of data from the prospective cohort study Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-To-Be (nuMoM2b). Data was collected through questionnaires, clinical evaluations, and medical records review at 8 academic medical centers in the United States. Four study visits were scheduled throughout the participant’s pregnancy (visits one–four): 60–136, 160–216, and 220–296 weeks gestation and birth. A series of statistical modeling and logistical regression were performed using 15 lifestyle variables related to sleep, nutrition, resilience, illness avoidance, and physical activity were selected as predictor variables with an outcome variable of hypertension. Results Of 9289 nulliparous participants considered for inclusion in our analyses, 1464 had any HDP during study participation, and 554 participants had complete data available for the study and were included in our final sample. Results were statistically significant at a level of p < 0.05. Of the sleep variables, snoring at visit 1 increased the risk of hypertension in pregnancy. Greater vegetable consumption reported at visit one decreased risks of hypertension in pregnancy. Physical activity reported at visit two and visit three were associated with decreased risk of hypertension. Physical activity reported at visit three combined with more hours of sleep each night, or through napping habit reported at visit one decreased hypertension risk. Increased fish oil consumption combined with more hours of sleep at visit one increased odds of hypertension in pregnancy. Conclusions Our results support that lifestyle wellness-related variables relating to sleep, physical activity and nutrition affect hypertension in pregnancy. The studied variables and others should be considered in future research and intervention development to reduce hypertension in pregnancy and improve maternal wellness.

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Section: Discussionsupporting

confidence: 92%

Lifestyle and the hypertensive disorders of pregnancy in nulliparous women in the United States: a secondary data analysis of the nuMom2b

Mollard

Cottrell

2023

BMC Pregnancy Childbirth

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“…An analysis from the European Sleep Apnea Database (ESADA) cohort demonstrates that some drug classes (beta-blockers in monotherapy or in combination) are associated with the better BP control in OSA patients depending on few clinical characteristics (age, gender, obesity) [253]. There is limited evidence on the association between habitual snoring at least four nights/week and around 1.5-fold increased incidence and prevalence of hypertension [254][255][256].…”

Section: What Is Known and What Is New?mentioning

confidence: 99%

Lifestyle management of hypertension: International Society of Hypertension position paper endorsed by the World Hypertension League and European Society of Hypertension

Charchar,

Prestes,

Mills

et al. 2023

Journal of Hypertension

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Hypertension, defined as persistently elevated systolic blood pressure (SBP) >140 mmHg and/or diastolic blood pressure (DBP) at least 90 mmHg (International Society of Hypertension guidelines), affects over 1.5 billion people worldwide. Hypertension is associated with increased risk of cardiovascular disease (CVD) events (e.g. coronary heart disease, heart failure and stroke) and death. An international panel of experts convened by the International Society of Hypertension College of Experts compiled lifestyle management recommendations as first-line strategy to prevent and control hypertension in adulthood. We also recommend that lifestyle changes be continued even when blood pressure-lowering medications are prescribed. Specific recommendations based on literature evidence are summarized with advice to start these measures early in life, including maintaining a healthy body weight, increased levels of different types of physical activity, healthy eating and drinking, avoidance and cessation of smoking and alcohol use, management of stress and sleep levels. We also discuss the relevance of specific approaches including consumption of sodium, potassium, sugar, fibre, coffee, tea, intermittent fasting as well as integrated strategies to implement these recommendations using, for example, behaviour change-related technologies and digital tools.

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“…In their meta-analysis, Niu. et al reviewed 11 studies and reported that snoring was associated with an increased risk of hypertension [ 30 ]. Moreover, a meta-analysis by Ma et al that included 40 studies with 966,652 participants reported a significant association between snoring and hypertension, with pooled ORs = 1.23, (95% CI = 1.15–1.31) and 1.75 (95% CI, 1.46–2.05) [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Snoring is associated with hypertension and diabetes mellitus among adults in north Sudan: a cross-sectional study

Bashir,

Elimam,

Elimam

et al. 2024

BMC Public Health

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Background Different levels of association between snoring, hypertension, and diabetes mellitus (DM) are reported. There are few published studies on this topic in African countries, and no investigation was conducted in Sudan. This study aimed to assess the prevalence and factors associated with snoring and the association between snoring, hypertension, and type 2 DM (T2DM) in northern Sudan. Methods A community-based cross-sectional study using a multistage sampling technique was conducted in four villages in the River Nile state of northern Sudan from July to September 2021. Sociodemographic characteristics were collected using a questionnaire. Body mass index (BMI) was measured using standard methods, and a multivariate analysis was conducted using the Statistical Package for the Social Sciences® (SPSS®) for Windows, version 22.0. Results Of the 384 adults, 193 (50.3%) were males and 191 (49.7%) were females. Of the adults, 38 (9.9%) were underweight, 121 (31.5%) had average weight, 113 (29.4%) were overweight, and 112 (29.2%) were obese. One hundred and six (27.6%) adults were snorers. Multivariate analysis showed that increasing age (adjusted odds ratio [AOR] = 1.02, 95% confidence interval [CI] = 1.01‒1.04), increasing BMI (AOR = 1.04, 95 CI = 1.01‒1.08), obesity (AOR = 2.0, 95% CI = 1.10‒3.69), and alcohol consumption (AOR = 2.32, 95% CI = 1.14‒4.74) were positively associated with snoring. Of the 384 adults, 215 (56.0%) had hypertension. Multivariate analysis showed that increasing age (AOR = 1.04, 95% CI = 1.02‒1.06), increasing BMI (AOR = 1.08, 95% CI = 1.04‒1.13), female sex (AOR = 1.7, 95% CI = 1.08‒2.73), and snoring (AOR = 1.69, 95% CI = 1.02‒2.82) were positively associated with hypertension. One hundred and six (27.6%) adults had T2DM. Multivariate analysis showed that increasing age (AOR = 1.03, 95% CI = 1.01‒1.05) and snoring (AOR = 1.78, 95% CI = 1.09‒2.91) were associated with T2DM. Conclusion Around one-fourth of the adults in Northern Sudan are snorers. Snoring is more common among obese adults. Snoring is associated with increased odds of hypertension and T2DM. Adults who snore must pay close attention to their blood pressure and blood glucose levels to prevent hypertension and DM.

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Association between self-reported snoring and hypertension: a systematic review and meta-analysis

Cited by 16 publications

References 42 publications

Lifestyle and the hypertensive disorders of pregnancy in nulliparous women in the United States: a secondary data analysis of the nuMom2b

Lifestyle and the hypertensive disorders of pregnancy in nulliparous women in the United States: a secondary data analysis of the nuMom2b

Lifestyle management of hypertension: International Society of Hypertension position paper endorsed by the World Hypertension League and European Society of Hypertension

Snoring is associated with hypertension and diabetes mellitus among adults in north Sudan: a cross-sectional study

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