Objective snoring time and carotid intima‐media thickness in non‐apneic female snorers

Abstract

Controversy persists about whether snoring can affect atherosclerotic changes in adjacent vessels, independent of obstructive sleep apnea and other cardiovascular risk factors. This study examined the independent association between snoring and carotid artery intima-media thickness (IMT) in nonapneic snorers and nonsnorers. We studied 180 nonapneic snorers and nonsnorers undergoing in a full-night home-based sleep study. Snoring sound was objectively measured by a microphone. Based on snoring time across the night, participants were classified as nonsnorers (snoring time: 0%), mild snorers (1–25%), and moderate to heavy snorers (≥ 25%). We measured IMT on both common carotid arteries. The three groups were matched by age, body-mass index, cholesterol, blood pressure, and glucose levels, using weights from generalized boosted-propensity score models. Mean carotid IMT increased with increased snoring time across the night in women: nonsnorers (0.707 mm), mild (0.718 mm), and moderate to heavy snorers (0.774 mm), but not in men. Snoring during at least one fourth of a night’s sleep is independently associated with subclinical changes in carotid IMT in women only.

The Relationship between Simple Snoring and Metabolic Syndrome: A Cross-Sectional Study

“…The mechanisms underlying the relationship between simple snoring and MetS have not been clarified. Through direct mechanical injury to the endothelium and local initiation of proinflammatory response, snoring vibration transmission may accelerate the development of carotid atherosclerotic plaque and contribute to MetS [37–40]. The physiological disturbances caused by snoring increase the number of microarousals during sleep [22], which could disrupt the restorative value of sleep, increase the activity of the sympathetic nervous system, and have a harmful impact on the hypothalamic-pituitary-adrenal axis with consequent elevations in serum cortisol, ultimately contributing to metabolic dysfunction [13, 41–45].…”

Obstructive sleep apnoea and cardiovascular disease: a literature review

“…A study of 180 non-apnoeic snorers and non-snorers, based on full-night home-based polysomnography, showed that mean CIMT increased with increased snoring time throughout the night in women but not in men [ 51 ]. Therefore, because studies have shown a direct correlation between CIH and biomarkers, snoring could be an additional minor contributor in women.…”

Should patients with primary snoring be screened for carotid artery stenosis?

“…In a large study by Kim et al, 180 participants undergoing home‐based full‐night sleep studies had their snoring noises recorded via microphones. Based on snoring time as a percentage of total sleep time, patients were categorized as nonsnorers (0%), mild snorers (1% to 25%), and moderate to heavy snorers (more than 25% snoring time).…”