Association between Snoring and Common Co-morbid Medical Conditions

Objectives: Habitual snoring is common in both men and women. Obstructive sleep apnea (OSA) is associated with a higher prevalence of conditions such as coronary artery disease (CAD) and stroke. We hypothesized that snoring may share some of these risks.

Methods: The 2012 Behavioral Risk Factor Surveillance System survey addressed demographic factors, comorbidities, and the snoring status of respondents in 4 states, namely Alaska, Nevada, Oregon and Puerto Rico. Data from 17,492 adults (≥ age 18 years) respondents was analyzed. A chi square test for categorical variables and t-test for continuous variables was used. Logistic regression analysis was used to study the association between comorbidities and snoring. Statistical analysis was performed using SAS 9.4 for Windows (SAS Institute, Inc., Cary, NC, USA).

Results: Snoring was reported by 47% male and 53% female respondents. Snorers were older (54.3 +15.4 years’ vs 50.7 +19.5 years, p <0.001), of male gender (46.8% vs 35.1%, p <0.0001), had a BMI in the overweight to obese range (p<0.0001) and were more likely to be current or former smokers (46.0% vs. 35.9%, p < 0.0001) as compared to non-snorers on bivariate analysis. After controlling for age, BMI and smoking, snoring was associated with a higher odds ratio of CAD/angina, asthma, Asthma-COPD overlap syndrome, arthritis and depression on multivariate analysis, as compared to non-snorers.

Conclusion: Snoring is associated with a higher prevalence of common comorbid medical conditions. Whether co-morbidities are caused by undiagnosed OSA or factors unique to snoring will require prospective, long term interventional studies.