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Risk Factors Associated With Snoring in Women With Special Emphasis on Body Mass Index: A Population-Based Study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. (Lungmedicin och allergologi)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. (Lungmedicin och allergologi)
2006 (English)In: Chest, ISSN 0012-3692, E-ISSN 1931-3543, Vol. 129, no 4, 933-41 p.Article in journal (Refereed) Published
Abstract [en]

STUDY OBJECTIVES: Habitual snoring may be regarded as an indicator of sleep-disordered breathing, and the health consequences of sleep-disordered breathing are well-known. The aim of this study was to analyze the risk factors associated with habitual snoring in a large sample of women, with special emphasis on the determinants of snoring in women with different body mass index (BMI) levels.Design and setting: A cross-sectional, epidemiologic, population-based study was performed by using a postal questionnaire that was sent to a randomly selected sample of 6,817 women >/= 20 years of age in Uppsala, Sweden. RESULTS: The total prevalence of self-reported habitual snoring was 7.6%. There was a clear age dependence, with the highest prevalence of habitual snoring (14%) occurring between the ages of 50 and 59 years. Self-reported habitual snoring was related to BMI, neck circumference, and smoking >/= 10 cigarettes a day, after adjusting for possible confounders. When analyzing the influence of different risk factors in separate BMI groups, the results varied among the groups. The influence of alcohol dependence on snoring frequency was only significant in women with a BMI of < 20 kg/m(2), while physical inactivity was only associated with habitual snoring in women with a BMI of >/= 30 kg/m(2). CONCLUSIONS: The prevalence of self-reported habitual snoring in women was strongly dependent on age and BMI. The importance of other risk factors differed depending on BMI, with alcohol dependence being associated with self-reported snoring in lean women, whereas physical inactivity was a risk factor for self-reported snoring in women with a high BMI.

Place, publisher, year, edition, pages
2006. Vol. 129, no 4, 933-41 p.
Keyword [en]
snoring women, body mass index
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-97945DOI: 10.1378/chest.129.4.933ISI: 000236901000019PubMedID: 16608941OAI: oai:DiVA.org:uu-97945DiVA: diva2:173073
Available from: 2009-01-23 Created: 2009-01-23 Last updated: 2010-12-28Bibliographically approved
In thesis
1. Snoring and Sleep Apnea in Women: Risk Factors, Signs and Consequences
Open this publication in new window or tab >>Snoring and Sleep Apnea in Women: Risk Factors, Signs and Consequences
2008 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Obstructive sleep apnea syndrome (OSAS) is characterized by snoring, apneas and excessive daytime sleepiness (EDS). Obesity is a risk factor for snoring and sleep apnea, but data on other factors in relation to obesity are ambiguous. Symptoms of sleep apnea in women have not been fully elucidated. OSAS is an important risk factor for cardiovascular disease (CVD). A common feature in patients with CVD and sleep apnea is an increase in systemic inflammation.

From the general population 7,051 women ≥ 20 years answered a questionnaire on snoring and sleep disturbances. Habitual snoring was found in 8% of the total population, and influenced by age, obesity and smoking. The highest prevalence (14%) was found in women 50-59 years. In lean women, alcohol dependence was associated with snoring, while physical inactivity was a risk factor for snoring in obese women.

Further, 230 snoring women and 170 women regardless of snoring status were investigated with polysomnography, blood sampling and anthropometric measurements. Of these, 132 participants underwent an ocular and endoscopic examination of their upper airways. Several findings in the upper airways characterised normal-weight women with an apnea-hypopnea index (AHI) ≥ 10. In women with BMI of > 25, no pharyngeal characteristics predicted sleep apnea.

When adjusting for age, obesity, smoking, AHI and sleep parameters, several aspects of daytime sleepiness correlated to snoring independently of AHI (EDS, falling asleep involuntarily during day, waking up unrefreshed and fatigue). No symptoms correlated to AHI independently of snoring.

Blood samples were analysed for systemic inflammation (CRP, TNFα, IL-6, myeloperoxidase (MPO) and lysozyme). Strong correlations were found between obesity and inflammatory markers. AHI and nocturnal hypoxia correlated to all markers except MPO. When adjusting for age, obesity and smoking, only IL-6 and TNFα were independently associated with nocturnal hypoxia.

In conclusion, age and obesity influence the prevalence of snoring and sleep apnea in women from the general population. Other risk factors differ according to BMI. Daytime symptoms are independently related to snoring per se. Despite a strong correlation between obesity and inflammation, an independent relationship between sleep apnea and inflammatory markers was found.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2008. 60 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 412
Keyword
snoring, sleep apnea, women, general population, risk factors, daytime sleepiness, inflammation, pharynx
Identifiers
urn:nbn:se:uu:diva-9515 (URN)978-91-554-7383-9 (ISBN)
Public defence
2009-01-30, Skoog salen, ing 78-79, Akademiska sjukhuset, Uppsala, 13:00
Opponent
Supervisors
Available from: 2009-01-23 Created: 2009-01-23Bibliographically approved

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