Snoring Frequency Research Articles

Prospective study of sleep duration, snoring and risk of heart failure

ObjectiveTo investigate whether nighttime sleep duration and snoring status were associated with incident heart failure (HF).MethodsA prospective study was conducted based on Kailuan cohort including 93 613 adults free of...

Hemodynamic Impact of Snoring on Carotid Artery after Stent Implantation: The Role of Oscillation

Purpose Snoring is common in overweight and old patients treated by endovascular stenting. Studies have proved a correlation between snoring and carotid stenosis, thus, snoring after carotid artery stenting (CAS) might promote or worsen clinical performance. Methods This study tested this hypothesis by constructing a patient-specific carotid bifurcation model and numerically analyzing hemodynamic changes of the carotid artery under different snoring conditions. These conditions included small and large amplitude, low and high frequency, and different age groups. Results The results found that high amplitude snoring suppressed the disturbed flow at the stented segment, while the downstream region of ICA became more chaotic, accounting for in-stent intimal restenosis and thrombosis. Furthermore, local blood flow patterns of elder groups with snoring symptoms were more likely to be changed due to low-speed flow, increasing the possibility of vascular remodeling and thrombosis. Besides, increased snoring frequency hardly influenced the local disturbed flow. Conclusions Therefore, older adults should receive medical treatment actively after stenting for high amplitude snoring as soon as possible to avoid potential adverse events.

Neurological manifestations in patients and disease carriers in an Italian family with osteosclerosis.

Hereditary cranial hyperostosis is a rare disease never described in Italy, so the neurological manifestations in patients and carriers of the disease have been little studied. We describe the neurological and neuroimaging features of patients and carriers of the gene from a large Italian family with sclerosteosis. In this family, genetic testing detected the homozygous p.Gln24X (c.70C > T) mutation of the SOST gene in the proband and a heterozygous mutation in 9 siblings. In homozygous adults, severe craniofacial hyperostosis was manifested by cranial neuropathy in childhood, chronic headache secondary to intracranial hypertension, and an obstructive sleep apnea syndrome in adults. In one of the adult patients, there was a compressible subcutaneous swelling in the occipital region caused by transosseous intracranial-extracranial occipital venous drainage, a compensation mechanism of obstructed venous drainage secondary to cranial hyperostosis. Mild cranial hyperostosis causing frequent headache and snoring was evident in the nine heterozygous subjects. Multiple cranial neuropathies and headache in children, while severe chronic headache and sleep disturbances in adults, are the neurological manifestations of the first Italian family with osteosclerosis. It is reasonable to extend neurological and neuroimaging evaluation to gene carriers as well.

Association between self-reported snoring and metabolic-associated fatty liver disease: A cross-sectional analysis of the NHANES 2017–2018

BackgroundSnoring may play an important role in a variety of diseases, especially metabolic diseases. However, there are no reports on the relationship between snoring and the risk of metabolic-associated fatty liver disease (MAFLD). This study aimed to investigate the association between snoring and MAFLD. MethodsA cross-sectional analysis was performed based on the National Health and Nutrition Examination Survey (NHANES) 2017–2018. Self-reported snoring frequency was grouped into four categories (never, rarely, occasionally, and frequently). MAFLD was diagnosed based on the evidence of hepatic steatosis and any of the following three conditions: overweight/obesity, diabetes mellitus or metabolic dysfunction. Logistic regression with sampling weights was used to examine the association between snoring and MAFLD. ResultsA total of 5016 patients were included, and 50.14% of individuals had MAFLD. Compared with nonsnorers, those who snored frequently were associated with increased odds for MAFLD (odds ratio (OR): 1.376, 95% confidence interval (CI): 1.122–1.688, p trend <0.001). The subgroup analyses suggested that no significant interactions were found between snoring and other potential effect modifiers, including age, sex, body mass index (BMI), smoking status, chronic obstructive pulmonary disease (COPD) and hypertension. ConclusionSnoring was independently and positively associated with a higher prevalence of MAFLD, suggesting that attention to snoring may contribute to the early detection of MAFLD.

Correlation between snoring sounds and obstructive sleep apnea in adults: a meta-regression analysis

Snoring is a dominant clinical symptom in patients with obstructive sleep apnea (OSA), and analyzing snoring sounds might be a potential alternative to polysomnography (PSG) for the assessment of OSA. This study aimed to systematically examine the correlation between the snoring sounds and the apnea-hypopnea index (AHI) as the measures of OSA severity. A comprehensive literature review using the MEDLINE, Embase, Cochrane Library, Scopus, and PubMed databases identified the published studies reporting the correlations between and severity of snoring and the AHI values by meta-regression analysis. In total, 13 studies involving 3,153 adult patients were included in this study. The pooled correlation coefficient for snoring sounds and AHI values was 0.71 (95%CI: 0.49, 0.85) from the random-effects meta-analysis with the Knapp and Hartung adjustment. The I 2 and chi-square Q test demonstrated significant heterogeneity (97.6% and p<0.001). After adjusting for the effects of the other covariates, the mean value of the Fisher's r-to-z transformed correlation coefficient would have 0.80 less by the snoring rate (95%CI = -1.02, -0.57), 1.46 less by the snoring index (95%CI = -1.85, -1.07), and 0.21 less in the mean body mass index (95%CI = -0.31, -0.11), but 0.15 more in the mean age (95%CI = 0.10, 0.20). It fitted the data very well (R 2=0.9641). A high correlation between the severity of snoring and the AHI was found in the studies with PSG. As compared to the snoring rate and the snoring index, the snoring intensity, the snoring frequency, and the snoring time interval index were more sensitive measures for the severity of snoring.

Validity and reliability of the Japanese version of the severity hierarchy score for pediatric obstructive sleep apnea screening

ObjectiveThis study aimed to evaluate the validity and reliability of the Japanese version of the severity hierarchy score (J-SHS) in the screening of pediatric obstructive sleep apnea (OSA) among Japanese community children. MethodsA total of 922 children from elementary schools in Tokyo were recruited. Their parents completed the J-SHS questionnaire, and the children underwent an overnight Tracheal Sound (TS) recording. The reliability of the J-SHS was assessed by Cronbach's alpha coefficients and Spearman's correlation. Construct validity was determined by factor analysis. The discriminative ability to diagnose OSA was evaluated by constructing ROC curves. ResultsFive hundred and seventeen children (51.8% male, mean age 7.1 ± 0.7 years) were included. Cronbach's alpha coefficient was 0.80. Factor analysis resulted in a two-factor structure, with factor loadings all above 0.4. A J-SHS score of >1.88 exhibited a 60% sensitivity, 93% specificity, and an area under the curve (AUC) of 0.78 for detecting an apnea-hypopnea index (AHI) of ≥5/h; a J-SHS score of >2.06 exhibited a 75% sensitivity, 84% specificity and AUC of 0.84 for detecting an AHI of ≥3/h among the children with a snoring frequency above two nights/wk. ConclusionThe J-SHS exhibits good performance as a screening tool providing a quick and straightforward approach for identifying Japanese children at risk for OSA.

Partial Glossectomy Combined With Radiofrequency Ablation for Macroglossia in Beckwith-Wiedemann Syndrome.

As the most common feature of Beckwith-Wiedemann syndrome (BWS), macroglossia may influence the quality of life, maxillofacial growth, and speech development of children. The retrospective study aimed to investigate the therapeutic effect of partial glossectomy combined with radiofrequency ablation (RFA) for macroglossia patients in BWS. A retrospective study was conducted in BWS-derived macroglossia patients who underwent partial glossectomy combined with RFA from May 2019 to January 2021. In total, 35 patients consisting of 17 males and 18 females met the inclusion criteria and underwent surgery by the same plastic surgeon. Demographic characteristics, BWS features, operation details, preoperative and postoperative outcomes, satisfaction evaluations, and subgroup analysis were collected and assessed. Of the 35 patients involved, the average age at the time of surgery was 14.05±8.08 months, and the average surgery duration was 48.17±6.72 minutes. Only 1 patient suffered ventral tongue wound dehiscence, and the rest of the patients did not develop any other complications. The severity and frequency of tongue protrusion, drooling, snoring, and feeding difficulty were significantly ameliorated. The patient's parents showed satisfaction towards the overall surgery, tongue's appearance, and tongue's motor function. Tongue's height decreased from 32.09±1.16mm before the operation to 29.29±1.33mm after the operation. The partial glossectomy combined RFA exerts a safe, effective and viable technique to treat BWS-derived macroglossia.

Association between snoring and insulin levels in the US population: a cross-sectional study.

Snoring may cause a number of problems such as tiredness, obesity, and even severe diseases, but the correlation between snoring and insulin secretion, which has important clinical significance, has rarely been studied. The objective of this study was to evaluate the correlation between snoring frequency and insulin secretion and discuss the potential mechanisms, thereby estimating the health condition of β-cells of individuals who snore. The analyses used data from National Health and Nutrition Examination Survey (NHANES) from 2015 to 2018. A regression analysis was performed for snoring frequency and insulin concentration, and then multiple regression analyses excluded various factors related to insulin secretion, including age, sex, race, body mass index (BMI), factors indicating patients' nutritional condition, and symptoms possibly implying obstructive sleep apnea. Subsequently, three hierarchical multiple regression analyses were carried out respectively based on sex, race, and BMI. After adjusting for confounding variables, snoring frequency was correlated with insulin concentration especially when snoring was at relatively high frequencies (e.g., more than 5 nights per week) (β = 1.77, 95%CI = 0.42-3.13, P = 0.010). The stratification analyses showed that high snoring frequency increased insulin secretion among women (β = 1.83, 95%CI = 0.05-3.62, P = 0.044), Hispanics (β = 3.28, 95%CI = 0.05-6.51, P = 0.047), and participants with BMI in the range > 30kg/m2 (β = 3.77, 95%CI = 0.52-7.03, P = 0.023). Our results suggest that snoring is likely to relate to an increase in insulin when severe, especially in women, Hispanics, and people with a BMI of more than 30kg/m2.

Short report: relationship between self-reported sleep characteristics and falls-associated fractures in elderly individuals: a population-based study

ABSTRACT Currently, the data for effect of sleep on falls-associated fractures in elderly individuals are still limited. This current study was aimed to assess the link between self-reported sleep characteristics and falls-associated fractures in elderly individuals. This study included a total of 20,497 participants from National Health and Nutritional Examination Survey (NHANES) 2005–2008, and 6,174 participants aged 45 years and older were identified. Self-reported sleep characteristics and conditions of falls-associated fractures of individuals were obtained via the method of personal questionnaires. In a total of 610 participants with exact history of fractures, 168 individuals with falls-associated fractures were identified, and the prevalence was 27.5%. The mean age of falls-associated fractures group was (72.1 ± 8.8) years, and the female (P < 0.001) occupied a higher proportion. Factors of living alone (P = 0.003), combined with hypertension (P = 0.003) and osteoporosis (P < 0.001), sleeping less or more (P = 0.009), and frequent snoring (P = 0.007) were linked to falls-associated fractures. Compared with sleep duration of 6 to 8 h/night, sleep duration of ≤4 h/night (odds ratio [OR] 1.858, 95% confidence interval [CI] 1.115–3.094) and of ≥9 h/night (OR 1.932, 95% CI 1.195–3.123) were related to an increased risk of falls-associated fractures. Collectively, our nationwide data noted that sleep characteristics were closely related to falls-associated fractures in elderly individuals, and a longer sleep duration may exhibit a protective effect against the falls-associated fractures, but it should be limited within 9 h/night.

Development and Evaluation of a Pillow to Prevent Snoring Using the Cervical Spine Recurve Method.

Snoring lowers the quality of sleep, causing many secondary diseases. In response, various types of preventive devices were manufactured, but most of them were far from actual snoring prevention by only sensing snoring and giving feedback. In this study, we proposed a new method to prevent snoring by adjusting the posture during sleep by widening the oropharynx space. An increase in the oropharynx area was confirmed through the expansion of the cervical spine, and a dedicated pillow that can extend through an angle of up to 20° was manufactured. Through this developed method, it was possible to easily extend the cervical spine angle in a supine position to the user, and the frequency of snoring was then tested. As a result, it was confirmed that by using the pillow with an expansion angle of 20° or more, snoring did not occur. Furthermore, looking at the evaluation results of the subjective levels of satisfaction, sleep-related items received an average of 5.9 or higher, and function-related items received high scores with an average of 5.7. We can confirm that the reliability of performance evaluation will be dramatically improved if the scope of the subject group is expanded to include various body types, ages, and genders and conduct performance evaluations for each group.

Association between snoring frequency and male serum testosterone: Findings from the 2015–2016 National Health and Nutrition Examination Survey

BackgroundThis study aimed to assess the association between snoring frequency and male serum testosterone levels. MethodsWe analyzed data from the 2015 to 2016 National Health and Nutrition Examination Survey. Snoring frequency was relied on self-report, and was divided into never, rarely (1–2 nights a week), occasionally (3–4 nights a week), or frequently (5 or more nights a week) groups. Multivariable analysis controlling for age, race, waist circumference, total cholesterol, diabetes, and hypertension was used to evaluate the association between snoring frequency and male serum testosterone. Furthermore, we performed the subgroup analyses stratified by age and waist circumference. ResultsOur analysis included 1900 participants. In the fully adjusted model, only frequent snoring was inversely associated with male serum testosterone (β −0.053, 95% CI -0.101 to −0.006, P = 0.028); According to the subgroup analysis stratified by age, only in 40–59 years group, frequent snoring was inversely associated with male serum testosterone in the fully adjusted model (β −0.113, 95% CI -0.196 to −0.031, P = 0.007). As for the subgroup analysis stratified by waist circumference, our results showed only in the waist circumference ≥102 cm group (abdominal obesity), frequent snoring was inversely associated with male serum testosterone (β −0.133, 95% CI -0.216 to −0.05, P = 0.002). ConclusionsFrequent snoring (5 or more nights a week) is inversely associated with male serum testosterone levels, especially in those aged 40–59 years and those with abdominal obesity.

0551 Movement Parasomnias in a Community Sample: Associations with Sleep Health and Mental Health

Abstract Introduction Movement-related parasomnia symptoms are associated with several sleep disorders and are associated with adverse health, mental health, and social outcomes. Current literature lacks data regarding parasomnia prevalence in the general population. This study examined prevalence of these symptoms and correlates in a community-based sample. Methods Data were from the Sleep and Healthy Activity, Diet, Environment and Socialization (SHADES) study, consisting of N=1,007 working-age adults. Parasomnia symptoms were assessed with, “I have been told that I walk, talk, eat or act strange or violent while sleeping.” Responses were categorized as Never (1/year or less), Sometimes (&amp;lt;1/week), or Often (&amp;gt;=1/week). Sleep health variables included sleep duration, categorized as very short (&amp;lt;=4h), short (5-6h), normal (7-8h, reference group) or long (&amp;gt;=9h), Insomnia Severity Index, Epworth Sleepiness Scale, Fatigue Severity Scale, Brief Index of Sleep Control, frequency of loud snoring, and frequency of sleep medication use. Mental health variables included PHQ9 depression score, GAD7 anxiety score, Perceived Stress Scale, and self-reported survival of severe physical/emotional trauma (None, Possible, Definite). Covariates included age, sex, race/ethnicity, education, income, employment, and body mass index. Results Parasomnia symptoms were reported sometimes by 24% and often by 7% of the sample. The following sleep-related variables were associated with more movement-related symptoms sometimes: very short sleep (RRR=2.26), higher ISI (RRR=1.08), ESS (RRR=1.09), and FSS (RRR=1.05), and frequent snoring (RRR=2.84). The following were associated with more symptoms often: very short sleep (RRR-4.40), higher ISI (RRR=1.18), ESS (RRR=1.18), FSS (RRR=1.07), frequent snoring (RRR=7.38) and medication use (RRR=5.99), and less sleep control (RRR=0.43). Regarding mental health, more symptoms sometimes or often was associated with higher depression (RRR=1.11 and 1.16, respectively), anxiety (RRR=1.12 and 1.17, respectively), and stress (RRR=1.06 and 1.10, respectively) scores. Trauma survivors were more likely to report symptoms often (RRR=4.78). Conclusion Movement-related parasomnia symptoms are fairly prevalent and may impact nearly one third of community-dwelling working-age adults. Those exhibiting symptoms are more likely to experience shorter sleep duration, poor sleep quality, daytime dysfunction, and worse mental health. Screening efforts for subclinical symptoms should be increased, and further work should explore pathways linking these symptoms to health and functional outcomes. Support (If Any)

0714 Population-Level Snoring and Probable Sleep-Disordered Breathing Associated with Greater Sedentary Activity

Abstract Introduction Increased frequency of snoring can be an indicator of sleep-disordered breathing, which is associated with a myriad of comorbidities, including increased cardiovascular disease risk. Previous studies have shown that sleep-disordered breathing is associated with less physical activity, but few studies examined this at the population lavel, or relative to primary snoring. Methods This analysis used a linear regression analysis on the 2017- March 2020 data collected from the National Health and Nutrition Examination Survey (NHANES) to explore the relationship between the minutes of sedentary activity and the frequency of snoring. Participants were asked how often they snored in the last 12 months. Responses were categorized as “Never”, “Rarely-- 1-2 nights/week”, “Occasionally-- 3-4 nights/week”, or “Frequently-- &amp;gt;=5 nights/week.” Self-reported sedentary activity was measured in minutes during a typical day. A modified STOP-BANG score was created based on NHANES measures of snoring, daytime tiredness, snorting/gasping during sleep, hypertension, body mass index, age, and gender (no measure of neck circumference). Reported results were unweighted; weighted results forthcoming. Results Significant unadjusted results indicate that those who reported snoring frequently had 19.2 minutes more sedentary time ([7.98,30.4], p&amp;lt;0.0001); and those with estimated sleep apnea had 16.2 more minutes of sedentary time than those without sleep apnea ([7.19,25.2], p&amp;lt;0.001). When adjusted for sex, age, race, education level, and marital status, the estimated difference between frequent snorers and those that reported never snoring increased to 35.9 minutes of more sedentary activity ([24.4,47.3], p&amp;lt;0.0001) a day. After adjusting for covariates, those with probable sleep apnea showed 43.9 more minutes of sedentary activity compared to those without sleep apnea ([34.1,53.6], p&amp;lt;0.001). Conclusion Overall, those who snore frequently (5 or more nights a week) or have a high risk of sleep apnea show a larger number of sedentary minutes per day then those that don’t snore or have probable sleep apnea. These relationships may be bidirectional, and directionality should be addressed in future studies. Support (If Any)

0314 Oral Contraceptives and Sleep Duration and Timing, Daytime Sleepiness, and Snoring in NHANES 2015-2018

Abstract Introduction Oral contraceptives have been associated with psychiatric disorders including depression and anxiety, but few studies have looked at the relationships with sleep health. Methods Data from the National Health and Nutrition Examination Survey (NHANES) 2015-2016 and 2017-2018 waves were examined. Of 6,335 females aged 44 and under, 308 had used hormonal contraceptives within 30 days of survey completion. These women also self-reported sleep and wake times and usual sleep duration on weekdays. They also reported snoring frequency, with answer choices ranging from “never” to “1-2 nights per week”, “3-4 nights/week”, or “&amp;gt;5 nights/week”. Lastly, they reported how often they felt overly sleepy during the day, with answer choices ranging from “never”, to “once/month”, “2-4 times/month”, “5-15 times a month”, or “16-30 times/month”. Linear and logistic regression analyses were adjusted for age, race/ethnicity, education, employment status, marital status, and income. Results Contraceptive users were more likely to be white, more highly educated, with higher income, employed, and never married. There were no differences by severity of depression symptoms between users and non-users according to PHQ-9 score. Contraceptive use was not associated with self-reported sleep duration in unadjusted or adjusted linear models (p=0.502 and p=0.146, respectively). Contraceptive use was also not a significant correlate of time to bed, time out of bed, time in bed, or midpoint of sleep in either unadjusted and adjusted linear models. In unadjusted logistic regression models, individuals who reported sleepiness “sometimes” or “often” were about twice as likely to be contraceptive users (OR=1.98, p=0.0023; and OR=1.87, p=0.0084, respectively). These associations were no longer significant after adjusting for covariates. In unadjusted logistic regression models, individuals with frequent snoring had 50% lower odds of contraceptive use (OR=0.50, p=0.0023), but similarly, there were no associations after adjusting for covariates. Conclusion Oral contraceptive use did not appear to be related to habitual sleep parameters, after adjusting for sociodemographic covariates in these analyses. However, further investigation must look at both objective measures and larger samples. Support (If Any)

Sleep-related Breathing Disorders in Children with Asthma: Impact on Asthma Control.

To investigate the frequency of sleep-related breathing disorder and the relationship between asthma control and sleep-related breathing disorder in children with persistent asthma. Comparative cross-sectional study. University of Health Sciences, Hamidiye Etfal Training and Research Hospital, Istanbul/Turkey, from January 2019 to June 2019. Children aged 4-11 years with persistent asthma were included. At enrollment, socio-demographic and asthmatic characteristics were investigated, and pediatric sleep questionnaire and childhood asthma control tests were administered. Out of 120 patients, 75 (62.5%) were males and 45 (37%) females. According to GINA guidelines, asthma was well controlled in 23.3% children, partially controlled in 50.8% children and uncontrolled in 25.8% children. The frequency of habitual snoring was reported as 20.8% and the frequency of sleep-related breathing disorder was 29.2%. The prevalence of sleep-related breathing disorders was significantly higher in the uncontrolled asthma group (p <0.001). Significant-independent efficacy of physician-diagnosed allergic rhinitis, habitual snoring, and low asthma control test scores was observed in predicting sleep-related breathing disorders in multivariate logistic regression model (p <0.001). Uncontrolled asthma is associated with sleep-related disordered breathing. The authors suggest that allergic rhinitis, habitual snoring, and low asthma control test scores are important risk factors for sleep-related breathing disorders in children with persistent asthma. Asthma, Asthma control test, Allergic rhinitis, Habitual snoring, Pediatric sleep questionnaire, Sleep-related breathing disorder.

Restless leg syndrome prevalence in epilepsy patients and its impact on quality of sleep.

This study aimed to determine the frequency of restless leg syndrome (RLS) and other sleep-related movement disorders and their effects on sleep quality in epilepsy patients. One hundred and twenty-seven epilepsy patients were compared with 115 age-and gender-matched healthy controls. RLS was determined from the clinical characteristics of the patients according to the International RLS Study Group's (IRLSSG) diagnostic criteria. Sleep bruxism was diagnosed based on the International Classification of Sleep Disorders, Third Edition (ICSD-3) criteria. Subjective sleep quality was evaluated with the Pittsburgh Sleep Quality Index (PSQI). Poor sleep quality was more common in the epilepsy group than in the control group (42.5% versus 26.1%; p = 0.007). The epilepsy group had significantly higher PSQI total scores than the control group (p = 0.003). The frequency of RLS was higher in epileptic patients than in the control group (13.4% versus 5.2%; p = 0.024). There were no significant differences between the patient group and the control group regarding limb movement and bruxism frequency during sleep. The PSQI scores were high in epilepsy patients with RLS compared to those without RLS (p = 0.009). The frequency of habitual snoring, bruxism, and repetitive leg movement in sleep was also high in epilepsy patients with RLS compared to those without RLS (p < 0.05). The prevalence of poor sleep quality and RLS in epilepsy patients is higher than in healthy controls. Our results also show the negative impact of RLS on sleep quality in epilepsy patients. Further confirmatory studies using objective sleep tests are needed to identify the mechanisms underlying the current findings.

Snoring and napping independently increased the serum uric acid levels and hyperuricemia risk: The Henan Rural Cohort Study

Background and aimsEvidence on the association of snoring, daily sleep duration (daytime napping and night sleep duration) with hyperuricemia (HUA) was limited, especially in the resources-poor areas. This study aimed to investigate the independent effect of snoring frequency and daily sleep duration on HUA prevalence in rural Chinese adults. Methods and results29,643 participants aged 18–79 years were included in the final cross-sectional analysis from the Henan Rural Cohort Study. Multivariate logistic regression and linear regression models with HUA and serum uric acid (SUA) levels as dependent variables were conducted, respectively. Of the 29,643 included adults, 3498 suffered from HUA. Compared to never snoring, the adjusted odds ratio (OR) and 95% confidence interval (CI) of HUA for rare snoring, occasional snoring, and habitual snoring were 1.35 (1.17, 1.56), 1.30 (1.14, 1.47), and 1.59 (1.47, 1.73), respectively (P for trend <0.001). Compared with no napping, participants who had daytime napping of 61–90 and > 91 min were associated with a 29% and 30% increase in the prevalence of HUA, respectively (P for trend <0.001). But in night sleep duration groups, no significant associations were observed. The positive associations between snoring and HUA were attenuated in people aged ≥65 and people with type 2 diabetes mellitus (both P for interaction <0.05). ConclusionHabitual snoring or longer daytime napping was independently associated with increased HUA prevalence and SUA levels in rural Chinese adults, which indicates the significance of early intervention and treatment of snoring and longer daytime napping to prevent hyperuricemia.

Association Between Snoring and Diabetes Among Pre- and Postmenopausal Women.

PurposeTo examine the relationship between diabetes and snoring frequency and determine the effect of menopause and postmenopausal years on this relationship.MethodsWe included 12,218 premenopausal and postmenopausal women from part of the baseline of the China Multi-Ethnic Cohort study (CMEC) in Chongqing province. Face-to-face questionnaires, physical examination, and biological samples were used to collect data. Logistic regression and subgroup analysis were used to explore the relationship between snoring and diabetes in women with various menopausal statuses.ResultsThe risk of diabetes increased with the snoring frequency, with adjusted odds ratios of 1.23 (95% CI:1.05–1.43) and 1.47 (95% CI:1.25–1.73) for sometimes snoring and frequent snoring, compared to non-snoring. In premenopausal and postmenopausal women, frequent snoring increased the odds of diabetes by 58% (95% CI: 7–132%) and 43% (95% CI: 20–72%), respectively, compared to non-snoring. Only in women who were ≥10 years postmenopausal had a statistical association between frequent snoring and diabetes, with a 54% (95% CI: 23–92%) increased odds of diabetes, compared to women who did not snore.ConclusionSnoring frequency is positively associated with diabetes. Women who snore frequently before and for at least ten years after menopause are at higher risk of developing diabetes. Frequent snorers and long-term postmenopausal women should monitor blood glucose levels to aid in the early detection and treatment of diabetes.

Myofunctional assessment for obstructive sleep apnea and the association with patterns of upper airway collapse: a preliminary study.

ObjectivesTo organize an assessment instrument with questionnaires and myofunctional orofacial/oropharyngeal assessment for OSA patients and correlate it with the upper airway obstructive site detected during drug-induced sleep endoscopy (DISE).Material and Methods29 OSA patients aged 22-65 years with an indication to undergo DISE to evaluate an alternative treatment to PAP and signed the consent form. Patients over 65 years old with maxillofacial deficiency and BMI>30 were excluded. The subjects answered the Pittsburgh, Berlin (snore), and Epworth questionnaires. The myofunctional orofacial/oropharyngeal assessment comprised soft palate, palatine pillars, and uvula (structure and mobility), tonsils (size), mandible (bony bases), hard palate (depth and width), tongue (posture, volume, width, and height), floor of mouth (mylohyoid), tongue suction and sustaining (mobility), “lowering of the back of the tongue” (stimulus), which were scored by three speech-language pathologists with expertise. DISE was scored according to VOTE classification. The statistical analysis (t-test) compared groups without and with obstruction in VOTE with questionnaires and myofunctional orofacial/oropharyngeal assessment.ResultsThe following were significantly different: snoring frequency (p=0.03) with VOTE/velopharynx; intensity (p=0.02) and frequency of snoring (p=0.03) with VOTE/lateral wall of oropharynx; suction the tongue and sustain (p=0.02) with VOTE/velopharynx; hard palate depth (p=0.02) and width (p=0.05) with obstruction VOTE/epiglottis; tonsils volume (p=0.05) with VOTE/epiglottis; tongue posture (p=0.00) with obstruction VOTE/epiglottis; floor of the mouth (p=0.02) with VOTE/epiglottis.ConclusionHigher snoring frequency and intensity was observed in patients with obstruction at the velopharynx and oropharyngeal lateral wall. Obstruction at the velopharynx was associated with poor tongue ability to suck the tongue against the hard palate. Obstruction at the epiglottis had structural and functional associations, including the oropharyngeal lateral wall, affected by the palatine tonsils size, depth and width of the hard palate, tongue position, and flaccidity of the floor of mouth. Considering that this is a preliminary study, the data should be carefully verified and not generalized.

Adherence to a Healthy Sleep Pattern and Risk of Chronic Kidney Disease: The UK Biobank Study

ObjectiveTo examine the association of a healthy sleep pattern, characterized by sleep of 7 to 8 h/d, morning person, no insomnia, no frequent snoring, and no daytime sleepiness, with the risk of chronic kidney disease (CKD). MethodsWe included 392,218 European adults, aged 38 to 73 years, who were free of CKD at recruitment between March 13, 2006, and October 1, 2010, from the UK Biobank study. Data on sleep behaviors were collected through questionnaires at recruitment. Cox proportional hazards regression models were used to assess the relations between the healthy sleep score and risk of CKD. ResultsWe identified 18,842 incident CKD cases after a mean follow-up of 11.1 (SD 2.2) years. The healthy sleep score was inversely associated with the risk of CKD in a dose-dependent manner (P for trend, <.001). Compared with the participants with a poor sleep pattern (score of 0-1), the multivariate adjusted hazard ratio of CKD was 0.77 (95% CI, 0.71 to 0.84) for those with the healthiest sleep pattern (score of 5). In addition, we found that the inverse association was stronger in individuals without history of hypertension compared with individuals with hypertension at baseline (P for interaction, .003) and in those 60 years of age or younger compared with their older counterparts (P for interaction, <.001). ConclusionOur data suggest that adherence to an overall healthy sleep pattern is associated with a lower risk of CKD, especially for individuals without history of hypertension and those who are younger.