Snoring and carotid artery disease: A new risk factor emerges

Deeb, Robert; Smeds, Matthew R.; Bath, Jonathan; Peterson, Edward L.; Roberts, Matthew M.; Beckman, Nanette; Lin, Judith C.; Yaremchuk, Kathleen

doi:10.1002/lary.27314

Cited by 24 publications

(18 citation statements)

References 13 publications

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“…Selfreported snoring was demonstrated to be related to subclinical atherosclerosis, 7 high-risk carotid plaque features, 50 or bilateral carotid artery stenosis. 51 However, some research…”

Section: Discussionmentioning

confidence: 99%

Snoring Sound Characteristics are Associated with Common Carotid Artery Profiles in Patients with Obstructive Sleep Apnea

Chuang¹,

Liu²,

Wang³

et al. 2021

NSS

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Background: Obstructive sleep apnea (OSA) and snoring have been reported to be modifiable risk factors for thick carotid intima-media thickness (CIMT) and carotid atherosclerosis, which are closely linked to cardiovascular disease. Methods: This cross-sectional study prospectively recruited 70 participants with OSA and without a history of carotid artery disorder, who primarily sought surgical Intervention. OSA and snoring were assessed with the Epworth Sleepiness Scale, Snore Outcomes Survey, polysomnography, and snoring sound recording. The carotid arteries were evaluated with ultrasonography and divided into three types of carotid artery profiles (normal carotid artery, thick CIMT, or significant carotid atherosclerosis). Multivariate linear/logistic/categorical regressions were performed with the forward selection approaches/logistic least absolute shrinkage and selection operator, as appropriate. Results: Normalized snoring sound energy (301-850 Hz) was independently associated with the carotid intima-media thickness (regression coefficient [β] = 0.01, standard error [SE] = 0.004, P = 0.03; R 2 = 0.067) and type of carotid profile (β = 0.40, SE = 0.09, P < 0.001; R 2 = 0.156). Normalized snoring sound energy (4-300 Hz) (β = −0.10, SE = 0.04, P = 0.01) and female sex (β = 1.90, SE = 0.94, P = 0.04) were independently related to the presence of carotid stenosis (R 2 = 0.159). The optimal regression model of the type of carotid artery profile included normalized snoring sound energy (301-850 Hz) (β = 0.33, SE = 0.14, P = 0.03), snoring time (β = 0.26, SE = 0.13, P = 0.047), female sex (β = 0.26, SE = 0.13, P = 0.047), and increased age (β = 0.20, SE = 0.10, P = 0.04) under the control of the Snore Outcomes Survey score, 3% oxygen desaturation index, snoring sound energy (4-1500 Hz), normalized snoring sound energy (851-1500 Hz), cigarette smoking, and hyperlipidemia (R 2 = 0.427). Conclusion:Our findings suggested that snoring sound characteristics are associated with carotid artery profiles among early OSA patients who cannot be noticed by ultrasound because organic changes of the carotid artery have not yet started. Future studies are warranted to verify the clinical significance of the results.

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“…Selfreported snoring was demonstrated to be related to subclinical atherosclerosis, 7 high-risk carotid plaque features, 50 or bilateral carotid artery stenosis. 51 However, some research…”

Section: Discussionmentioning

confidence: 99%

Snoring Sound Characteristics are Associated with Common Carotid Artery Profiles in Patients with Obstructive Sleep Apnea

Chuang¹,

Liu²,

Wang³

et al. 2021

NSS

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“…This meta-analysis, confirmed that CIMT was higher in OSA patients compared to healthy controls (SMD = 0.810 CI: 0.676-0.943; P < 0.001) with a fair correlation between AHI and CIMT (R = 0.389; 95% CI: 0.315-0.459; P < 0.001). Further studies published after these two metaanalyses deserve to be reported [55][56][57][58][59][60][61][62][63][64]. A total of 206 adults newly diagnosed with OSA (AHI of 15-75 events/h) and 53 controls with AHI < 10 were studied by Kim et al [55].…”

Section: Carotid Atherosclerosismentioning

confidence: 99%

Targeting subclinical organ damage in obstructive sleep apnea: a narrative review

et al. 2020

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Subclinical abnormalities in cardiac and vascular structure reflect the adverse effects triggered by a variety of risk factors on the cardiovascular (CV) system thereby representing an intermediate step in the cardiovascular continuum; such alterations are recognized as reliable markers of increased cardiovascular risk in different clinical settings including obstructive sleep apnea (OSA). The mechanisms underlying subclinical organ damage (OD) in the OSA setting are multifactorial. Hypoxemia and hypercapnia, induced by repeated collapses of upper airways, have been suggested to trigger a cascade of events such as activation of the sympathetic tone, renin-angiotensin-aldosterone system leading to endothelial dysfunction, vasoconstriction, myocardial and vascular remodeling, and hypertension. Furthermore, coexisting non-haemodynamic alterations such as increased oxidative stress, release of inflammatory substances, enhanced lipolysis and insulin resistance have been reported to play a role in the pathogenesis of both cardiac and extra-cardiac OD. In this article we reviewed available evidence on the association between OSA and subclinical cardiac (i.e., left and right ventricular hypertrophy, left atrial dilatation) and extracardiac organ damage (i.e., carotid atherosclerosis, arterial stiffness, microvascular retinal changes, and microalbuminuria). This association is apparently stronger for cardiac and carotid subclinical damage than for other markers (i.e., arterial stiffness and retinal changes) and mostly evident in the setting of severe OSA.

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“…Поширеність апное складає 5-7% в популяції старше 30 років. Поширеність простого хропіння у чоловіків середнього віку знаходиться в діапазоні 25-50% [1], тоді як значне порушення дихання уві сні зачіпає до 8% чоловіків і 3% жінок (данні недавнього проспективного дослідження населення "Спляче серце " (6441 осіб) [2].…”

Section: оглядиunclassified

The effects of nasal breathing on the development of snoring and apnea

Yaremchuk

2020

OTORHINOLARYNGOLOGY

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Since the nose is the entrance gate of the upper airway, its stuffiness can contribute to sleep disturbance. The results of a number of case-control studies have shown that nasal congestion frequency associated with snoring and mild OSA. However, there is no strong correlation between the degree of nasal obstruction and the severity of OSA. Randomized controlled trials have shown that in patients with rhinitis, both allergic and non-allergic, the use of nasal steroids can improve sleep quality and may be useful for patients with mild OSA, but they themselves are not an adequate treatment. Surgical correction of nasal breathing disorders also reduces the apnea index and improves sleep quality.

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Snoring and carotid artery disease: A new risk factor emerges

Abstract: 2b Laryngoscope, 2018.

Cited by 24 publications

References 13 publications

Snoring Sound Characteristics are Associated with Common Carotid Artery Profiles in Patients with Obstructive Sleep Apnea

Snoring Sound Characteristics are Associated with Common Carotid Artery Profiles in Patients with Obstructive Sleep Apnea

Targeting subclinical organ damage in obstructive sleep apnea: a narrative review

The effects of nasal breathing on the development of snoring and apnea

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