CLINICAL STUDIES
Snoring and risk of cardiovascular disease in women
Frank B. Hu, MD*,
Walter C. Willett, MD*   ||,
JoAnn E. Manson, MD  ||,
Graham A. Colditz, MD ||,
Eric B. Rimm, ScD* ||,
Frank E. Speizer, MD ||,
Charles H. Hennekens, MD¶ and
Meir J. Stampfer, MD* ||
* Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, USA
Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA
Channing Laboratory, Boston, Massachusetts, USA
Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA
|| Harvard Medical School, Boston, Massachusetts, USA
¶ School of Medicine, University of Miami, Miami, Florida, USA
Manuscript received May 5, 1999;
revised manuscript received August 16, 1999,
accepted October 18, 1999.
Reprint requests and correspondence: Dr. Frank Hu, Department of Nutrition, Harvard School of Public Health, 665 Huntington Avenue, Boston, Massachusetts 02115
Frank.hu{at}channing.harvard.edu
OBJECTIVES
To examine prospectively the association between snoring and incidence of cardiovascular disease (CVD) in women.
BACKGROUND
Whether snoring increases risk of CVD remains unclear; most previous studies have been small, not prospective and limited to men.
METHODS
Seventy-one thousand seven hundred seventy-nine female nurses 40 through 65 years of age and without previously diagnosed CVD or cancer at baseline in 1986 were followed up for eight years. Frequency of snoring was assessed using mailed questionnaires at baseline.
RESULTS
During eight years of follow-up, we documented 1,042 incident cases of major CVD events (644 coronary heart disease [CHD] and 398 stroke). Compared with nonsnorers, the age-adjusted relative risks (RRs) of CVD were 1.46 (95% confidence interval 1.23 to 1.74) for occasional snorers and 2.02 (1.62 to 2.53) for regular snorers. The age-adjusted RRs of CHD were 1.43 (1.15 to 1.77) for occasional snorers and 2.18 (1.65 to 2.87) for regular snorers. The age-adjusted RRs of stroke were 1.60 (1.21 to 2.12) and 1.88 (1.29 to 2.74), respectively. After further adjustment for smoking, body mass index (BMI) and other covariates, the positive association between snoring and CVD was attenuated but remained statistically significant (RRs of CVD were 1.20 [1.01 to 1.43] for occasional snorers and 1.33 [1.06–1.67] for regular snorers.
CONCLUSIONS
These data suggested that snoring is associated with a modest but significantly increased risk of CVD in women, independent of age, smoking, BMI and other cardiovascular risk factors. While further study is needed to elucidate the biological mechanism underlying this association, snoring may help clinicians identify individuals at higher risk for CVD.
|
Abbreviations and Acronyms
| | BMI | = body mass index | | CHD | = coronary heart disease | | CI | = confidence interval | | CVD | = cardiovascular disease | | MI | = myocardial infarction | | RR | = relative risk |
|
This article has been cited by other articles:
|
|
|
|
 
S. SHAFAZAND
Perioperative management of obstructive sleep apnea: Ready for prime time?
Cleveland Clinic Journal of Medicine,
November 1, 2009;
76(Suppl_4):
S98 - S103.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
V. K. Somers, D. P. White, R. Amin, W. T. Abraham, F. Costa, A. Culebras, S. Daniels, J. S. Floras, C. E. Hunt, L. J. Olson, et al.
Sleep Apnea and Cardiovascular Disease: An American Heart Association/American College of Cardiology Foundation Scientific Statement From the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing In Collaboration With the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research (National Institutes of Health)
Circulation,
September 2, 2008;
118(10):
1080 - 1111.
[Full Text]
[PDF]
|
|
|
|
|
|
|
V. K. Somers, D. P. White, R. Amin, W. T. Abraham, F. Costa, A. Culebras, S. Daniels, J. S. Floras, C. E. Hunt, L. J. Olson, et al.
Sleep Apnea and Cardiovascular Disease: An American Heart Association/American College of Cardiology Foundation Scientific Statement From the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing In Collaboration With the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research (National Institutes of Health)
J. Am. Coll. Cardiol.,
August 19, 2008;
52(8):
686 - 717.
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. M. Golbin, V. K. Somers, and S. M. Caples
Obstructive Sleep Apnea, Cardiovascular Disease, and Pulmonary Hypertension
Proceedings of the ATS,
February 15, 2008;
5(2):
200 - 206.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. Munoz, J. Duran-Cantolla, E. Martinez-Vila, J. Gallego, R. Rubio, F. Aizpuru, and G. De La Torre
Severe Sleep Apnea and Risk of Ischemic Stroke in the Elderly
Stroke,
September 1, 2006;
37(9):
2317 - 2321.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Arzt and T. D. Bradley
Treatment of Sleep Apnea in Heart Failure
Am. J. Respir. Crit. Care Med.,
June 15, 2006;
173(12):
1300 - 1308.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. Amatoury, L. Howitt, J. R. Wheatley, A. P. Avolio, and T. C. Amis
Snoring-related energy transmission to the carotid artery in rabbits
J Appl Physiol,
May 1, 2006;
100(5):
1547 - 1553.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Poulain, M. Doucet, G. C. Major, V. Drapeau, F. Series, L.-P. Boulet, A. Tremblay, and F. Maltais
The effect of obesity on chronic respiratory diseases: pathophysiology and therapeutic strategies.
Can. Med. Assoc. J.,
April 25, 2006;
174(9):
1293 - 1299.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. Shivalkar, C. Van De Heyning, M. Kerremans, D. Rinkevich, J. Verbraecken, W. De Backer, and C. Vrints
Obstructive Sleep Apnea Syndrome: More Insights on Structural and Functional Cardiac Alterations, and the Effects of Treatment With Continuous Positive Airway Pressure
J. Am. Coll. Cardiol.,
April 4, 2006;
47(7):
1433 - 1439.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Arzt, T. Young, L. Finn, J. B. Skatrud, and T. D. Bradley
Association of Sleep-disordered Breathing and the Occurrence of Stroke
Am. J. Respir. Crit. Care Med.,
December 1, 2005;
172(11):
1447 - 1451.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. W. Peters
Obstructive Sleep Apnea and Cardiovascular Disease
Chest,
January 1, 2005;
127(1):
1 - 3.
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. A. Franklin, T. Gislason, E. Omenaas, R. Jogi, E. J. Jensen, E. Lindberg, M. Gunnbjornsdottir, L. Nystrom, B. N. Laerum, E. Bjornsson, et al.
The Influence of Active and Passive Smoking on Habitual Snoring
Am. J. Respir. Crit. Care Med.,
October 1, 2004;
170(7):
799 - 803.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. F. Quan and B. J. Gersh
Cardiovascular Consequences of Sleep-Disordered Breathing: Past, Present and Future: Report of a Workshop From the National Center on Sleep Disorders Research and the National Heart, Lung, and Blood Institute
Circulation,
March 2, 2004;
109(8):
951 - 957.
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. o-D. L. Lattimore, D. S. Celermajer, and I. Wilcox
Obstructive sleep apnea and cardiovascular disease
J. Am. Coll. Cardiol.,
May 7, 2003;
41(9):
1429 - 1437.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Young, P. E. Peppard, and D. J. Gottlieb
Epidemiology of Obstructive Sleep Apnea: A Population Health Perspective
Am. J. Respir. Crit. Care Med.,
May 1, 2002;
165(9):
1217 - 1239.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
W. K. Al-Delaimy, J. E. Manson, W. C. Willett, M. J. Stampfer, and F. B. Hu
Snoring as a Risk Factor for Type II Diabetes Mellitus: A Prospective Study
Am. J. Epidemiol.,
March 1, 2002;
155(5):
387 - 393.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
W. K. Al-Delaimy, J. E. Manson, W. C. Willett, M. J. Stampfer, and F. B. Hu
Al-Delaimy et al. Respond to "To Sleep, Perchance to Discover"
Am. J. Epidemiol.,
March 1, 2002;
155(5):
396 - 397.
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Saaresranta, P. Polo-Kantola, E. Rauhala, and O. Polo
Medroxyprogesterone in postmenopausal females with partial upper airway obstruction during sleep
Eur. Respir. J.,
December 1, 2001;
18(6):
989 - 995.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. B. Fogel, A. Malhotra, G. Pillar, S. D. Pittman, A. Dunaif, and D. P. White
Increased Prevalence of Obstructive Sleep Apnea Syndrome in Obese Women with Polycystic Ovary Syndrome
J. Clin. Endocrinol. Metab.,
March 1, 2001;
86(3):
1175 - 1180.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
P. E. Peppard, T. Young, M. Palta, J. Dempsey, and J. Skatrud
Longitudinal Study of Moderate Weight Change and Sleep-Disordered Breathing
JAMA,
December 20, 2000;
284(23):
3015 - 3021.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J.A. Harbison and G.J. Gibson
Snoring, sleep apnoea and stroke: chicken or scrambled egg?
QJM,
October 1, 2000;
93(10):
647 - 654.
[Full Text]
[PDF]
|
|
|
|
|
|
|
Snoring Increases Risk for Heart Disease in Women
Journal Watch Cardiology,
April 14, 2000;
2000(414):
8 - 8.
[Full Text]
|
|
|
|
|
|
|
Is Snoring Bad for a Woman's Heart?
Journal Watch Women's Health,
April 1, 2000;
2000(401):
16 - 16.
[Full Text]
|
|
|
|
|
|
|
Snoring a Risk Factor for Cardiovascular Disease in Women
Journal Watch (General),
February 18, 2000;
2000(218):
4 - 4.
[Full Text]
|
|
|
|
