Habitual Snoring Research Articles

Association of Snoring and Cardiovascular Symptoms - A Survey

Snoring is a loud sound that can be produced when air across the relaxed tissues of the throat. The causes of snoring include age, being overweight or out of shape, the way you are built, nasal and sinus problems, sleep posture, alcohol, smoking and medications. The present study was performed to find the association between the habit of snoring and health problems like hypertension, breathlessness, fatigue and chest pain among genders. A self-developed questionnaire to assess the snoring habits of the participants with their underlying health problems. The study was conducted on an online platform and the responses were collected. The datas were collected and analysed with the help of statistical software SPSS version 22 and chi-square test was used as a statistical analysis to find how snoring habit affects the participants based on the gender. The results revealed that male respondents who have the habit of snoring are more related to problems like breathlessness, hypertension, fatigue and chest pain compared to females. This result can be justified by the fact that females have strong hormonal support offered by estrogen that protects them from cardiovascular and respiratory disorders.

The anti-snoring bed - a pilot study

PurposeAvoiding supine position can reduce snoring in most habitual snorers. However, devices that restrict the sleeping position cause discomfort or disrupt sleep resulting in low compliance. Therefore, mechanisms, which lift the trunk of the user without disturbing sleep, have been proposed. We present the first study, which investigates whether individual interventions provided by beds with lifting mechanisms are able to stop snoring (success rate) and whether they reduce the snoring index (number of total snores divided by total time in bed) using a repeated measures design. In addition, we investigated whether the intervention is interfering with the subjective sleep quality.MethodsTwenty-two subjects were observed for four nights (adaptation, baseline, and two intervention nights). During intervention nights, the bed lifted the trunk of the user in closed-loop manner. Subjects were divided in three groups (non-snorer, snorer one, and snorer two). Non-snorers were lifted by the bed at random time points during the night. In group snorer one, a stepwise increase of the bed inclination was compared with going directly to a randomly selected angle. In group snorer two, the influence of a small inclination angle (10 ∘) and a big inclination angle (20 ∘) was compared.ResultsSnoring was stopped successfully in 22% (small angle) and 67% (big angle) of the interventions. This did not lead to a significant reduction in the snoring index. The subjective sleep quality was not reduced by the intervention.ConclusionThe anti-snoring bed is able to stop individual episodes of habitual snoring without reducing the subjective sleep quality.Trial Registrationhttps://clinicaltrials.gov, no. NCT04053738, registered 12 August 2019 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04053738.

Analysis of genetic and environmental risk factors in pediatric OSA

Objective:To investigate the genetic and family environmental risk factors of obstructive sleep apnea（OSA） in children with habitual snoring. Method:Children with habitual snoring who underwent overnight PSG were recruited. Subjects were divided into the snoring group and OSA group according to the criteria of the International Classification of Sleep Disorder（ICSD-3）. The demographic data, symptoms, signs and family environmental factors of the two groups were compared. Result:One hundred and fifty-five families were included（including children with habitual snoring and their parents）. Children were 3 to 13 years old, including 88 cases in the snoring group and 67 cases in the OSA group. Using binary logistic regression analysis, existence of apnea, higher BMI z score and mother's medical history of repeated tonsillitis and/or adenotonsillectomy in childhood were risk factors for OSA in children with habitual snoring, and the odds ratio（95%CI） was 4.081（1.835, 9.073）, 1.347（1.071, 1.694）, 3.897（1.400, 10.849） respectively. There were no significant differences in the distribution of environmental factors such as family residence, per capita household income, and parental smoking history. Conclusion:The risk factors of OSA in habitual snoring children are symptom of apnea, higher BMI z score and mother's medical history of repeated tonsillitis and/or adenotonsillectomy in childhood.

Obstructive Sleep Apnea: Diagnosis and Management

As part 2 of three chapters on sleep disordered breathing, this chapter reviews obstructive sleep apnea (OSA) diagnosis and management. OSA should be considered in all patients who have loud habitual snoring, excessive daytime sleepiness, and witnessed apneas. On physical examination, craniofacial abnormalities that can lead to sleep apnea include retrognathia, micrognathia, a narrow hard palate, nasal obstruction, an overjet, and an overbite. Enlargement of the upper airway soft tissue structures (the tongue, soft palate, lateral walls, and parapharyngeal fat pads) also increases the risk of OSA. The gold standard for making the diagnosis of OSA is overnight polysomnography, but home sleep apnea tests (HSAT) are rapidly gaining acceptance, especially in patients with a high probability of OSA. The first line of therapy for OSA remains positive airway pressure (PAP), with the second line of therapy being oral appliances. Another alternative to PAP therapy is hypoglossal nerve stimulation, which has been shown to decrease the Apnea-Hypopnea index by 67.4%. This review contains 6 figures, 3 tables, and 52 references. Key Words: craniofacial abnormalities, Epworth Sleepiness Scale, home sleep apnea test, hypoglossal nerve stimulation, obstructive sleep apnea, oral appliances, oral pharyngeal crowding, polysomnography, positive airway pressure, STOP-BANG

Prevalence and correlates of obstructive sleep apnea in urban-dwelling, low-income, predominantly African-American women

Study objectivesThe current study examined the prevalence and correlates of obstructive sleep apnea in a sample of low-income, predominantly African-American women using two waves of data. MethodsParticipants were adults from two urban neighborhoods who enrolled in the PHRESH Zzz Study (N = 828; Pittsburgh Hill/Homewood Research on Neighborhoods, Sleep, and Health). A subsample who reported never receiving OSA diagnosis completed home sleep apnea testing in 2016 (n = 269, mean age 55.0 years, 79.6% female) and again in 2018 (n = 135). Correlates of OSA tested included demographic and anthropometric variables, health behavior/conditions, psychological distress and general health, smoking status, actigraphy-measured sleep, and neighborhood factors measured at baseline. Results18.0% of all 2016 participants reported receiving physician diagnoses of OSA. Among those who completed in–home assessment, 19.3% had AHI ≥15 and 33.8% had AHI ≥5 plus one or more sleep symptoms. Estimates of the prevalence of OSA in all 2016 participants were 33.8%–45.7% based on physician diagnoses and AHI results, depending on the criteria used. Age, gender, BMI, blood pressure, habitual snoring, neighborhood walkability, actigraphy-measured sleep characteristics, and smoking were concurrently associated with OSA in 2016. Changes in AHI categories from 2016 to 2018 were documented. ConclusionsLow-income African Americans, including women, are a high-risk group for OSA, but remain under-diagnosed and under-treated. The current findings show a high prevalence of OSA in African-American women and are among the first to demonstrate that both individual and neighborhood factors are implicated in OSA prevalence.

Evaluation of the relationship between malocclusions and sleep-disordered breathing in children

ABSTRACT Objective To determine the relationship between dental/skeletal malocclusions and sleep-disordered breathing (SDB) in the early diagnosis and treatment of sleep disorders in children. Methods Patients were evaluated by pedodontists to identify dental, skeletal, and functional malocclusion (n = 240; <15 years). In order to determine the sleep and daytime behavior of the patients, pediatric sleep questionnaires (PSQ) were applied. Per results of the PSQ, patients with a mean of ≥ 0.33 were defined as the high-risk group. Results A total of 25.8% children were in the high-risk group, with the most convex profile, high-angle growth direction, and mandibular retrognathy. The prevalence of habitual snoring, mouth breathing, and dry mouth was 48.4%, 64.5%, and 87.2% among all high-risk children, respectively. Conclusion Convex profile, high-angle growth direction, and retrognathic mandible were determined as risk factors for SDB. The prevalence of dry mouth, mouth breathing, and snoring was higher in the high-risk group.

Self-reported snoring is associated with nonalcoholic fatty liver disease

Although nonalcoholic fatty liver disease (NAFLD) is associated with obstructive sleep apnea syndrome (OSAS), studies on the direct relationship between NAFLD and snoring, an early symptom of OSAS, are limited. We evaluated whether snorers had higher risk of developing NAFLD. The study was performed using data of the Tongmei study (cross-sectional survey, 2,153 adults) and Kailuan study (ongoing prospective cohort, 19,587 adults). In both studies, NAFLD was diagnosed using ultrasound; snoring frequency was determined at baseline and classified as none, occasional (1 or 2 times/week), or habitual (≥3 times/week). Odds ratios (ORs) and hazard ratios (HRs) with 95% confidence intervals were estimated using logistic and Cox models, respectively. During 10 years’ follow-up in Kailuan, 4,576 individuals with new-onset NAFLD were identified at least twice. After adjusting confounders including physical activity, perceived salt intake, body mass index (BMI), and metabolic syndrome (MetS), multivariate-adjusted ORs and HRs for NAFLD comparing habitual snorers to non-snorers were 1.72 (1.25–2.37) and 1.29 (1.16–1.43), respectively. These associations were greater among lean participants (BMI < 24) and similar across other subgroups (sex, age, MetS, hypertension). Snoring was independently and positively associated with higher prevalence and incidence of NAFLD, indicating that habitual snoring is a useful predictor of NAFLD, particularly in lean individuals.

Knowledge And Awareness About Snoring Habits Among Healthy Individuals

Knowledge And Awareness About Snoring Habits Among Healthy Individuals

P0963MANAGEMENT OF SLEEP DISORDERS IN END-STAGE RENAL DISEASE, IS IT REALLY IMPORTANT?

Abstract Background and Aims Sleep apnoea (SA), either obstructive and central (OSA and CSA, respectively) associated with and excessive daytime sleepiness (EDS) are common sleep disorders among patients with end-stage renal disease (ESRD). Fluid overload characterizes end-stage kidney disease and plays an important role in the pathogenesis of OSA, CSA and EDS. In our study we assessed the prevalence of sleep apnoea and excessive daytime sleepiness in patients from a nephrology and dialysis unit from south-eastern Romania. Method 86 patients with ESRD pre-dialysis (eGFR &amp;lt; 15 ml/min/1,73 m) or on maintenance haemodialysis were monitored for an interval of 2 years. We used questionnaires to assess the prevalence of SA and EDS. All subjects underwent overnight polysomnography (PSG). Extracellular fluid volume of the total body, neck, thorax and right leg were measured using bioelectrical impedance. We also examined the association between sleep apnoea, EDS, the underlying causes of ESRD, co-morbidities, medication used, and other demographic data. Results The mean patients age was 57.5 years ± 14.9 years; 65.1% were male, and 34.9% were female. The prevalence of SA as defined by the Berlin questionnaire (BQ) was 49.5% in males and 34.8% in females, which was not a statistically significant difference (P = 0.029). Sleep apnoea was significantly associated with age, obesity, diabetes, hypertension, fluid overload and 2nd or 3rd haemodialysis shift (P-values, 0.001, &amp;lt; 0.0001, &amp;lt; 0.002, &amp;lt; 0.008, &amp;lt;0.0001, and &amp;lt; 0.005. Sleep apnoea was also significantly associated with other sleep disorders such as restless leg syndrome, insomnia, habitual snoring, and EDS (P-values, &amp;lt; 0.001, &amp;lt; 0.001, &amp;lt; 0.001, and &amp;lt; 0.001, respectively). The prevalence of EDS was 35,5%, and EDS was significantly associated with age (over 60 years old), diabetes mellitus, hypertension and obesity. 18 patients (20.9%) had refractory hypertension, that improved after CPAP administration, and 10 of these patients (over 50% with refractory HT), that refused the application of appropriate therapy of sleep disorders, suffered a major cardiovascular event during our study. Conclusion Sleep apnoea, excessive daytime sleepiness and other sleep disorders are relatively common in pre-dialysis and haemodialysis patients and are significantly associated with refractory hypertension and severe cardio-vascular events. That is why a greater attention should be given to the diagnosis and management of sleep disorders, as one of the important steps in nursing and our patients’ rehabilitation.

0849 Association Of Sleep Disturbance With Neck Circumference, Body Mass Index & Blood Pressure In Pregnant Japanese Women

Abstract Introduction Snoring is one of the symptoms of sleep-disordered breathing. Sleep-disordered breathing is associated with blood pressure in pregnant women. However, studies reporting this association have been conducted overseas, and there is a lack of research in the Japanese context, where women have different lifestyles and physical attributes. The aim of this study is to clarify the association of sleep disturbance with physical factors in pregnant Japanese women. Methods A cross-sectional study was conducted with 80 pregnant Japanese women. The assessments for statistical analysis included the Japanese versions of the Pittsburgh Sleep Quality Index (J-PSQI) and Epworth Sleepiness Scale (JESS), as well as snoring frequency, blood pressure, and body mass index (BMI) before and during pregnancy. Results Participants’ average gestational age was 26.23±7.56 weeks, and the J-PSQI and JESS scores were 5.5±2.6 and 9.7±4.2, respectively. The average neck circumference was 33.4±2.6cm, and BMI before and during pregnancy was 21.0±2.9cm and 23.1±3.1cm, respectively. Among the participants, 42.5% displayed habitual snoring. These women had significantly higher BMI and weight before and during pregnancy than those who did not snore habitually. Participants with lower diastolic blood pressure and pre-pregnancy weight had significantly higher JESS scores. Participants with thick necks (neck circumference≥33.4cm) had significantly higher BMI and weight before and during pregnancy, as well as lower J-PSQI scores, than those with thin necks. Conclusion In pregnant Japanese women, neck circumference and BMI before and during pregnancy were lower than among pregnant women from other countries. However, Japanese women displayed a greater tendency toward snoring during pregnancy compared to women from other countries. Snoring was associated with obesity before and during pregnancy. However, the results suggest that thinness of physique prior to pregnancy is a risk factor for sleep disturbance during pregnancy. Support

Association of Snoring with Prediabetes and Type 2 Diabetes Mellitus: The Cardiovascular and Metabolic Diseases Etiology Research Center Cohort.

BackgroundEvidence suggests that habitual snoring is an independent risk factor for poor glycemic health. We examined the associations between snoring with prediabetes and diabetes in Korean population.MethodsSelf-reported snoring characteristics were collected from 3,948 middle-aged adults without prior cardiovascular diseases. Multivariable linear regression assessed the association of snoring intensity, frequency, disruptiveness, and disrupted breathing with fasting glucose and glycosylated hemoglobin (HbA1c) level. Then, multinomial regression evaluated how increasing snoring symptoms are associated with the risk for prediabetes and diabetes, adjusting for socioeconomic and behavioral risk factors of diabetes, obesity, hypertension, and other sleep variables.ResultsHigher snoring intensity and frequency were positively associated with fasting glucose and HbA1c levels. Participants presenting the most severe snoring were at 1.84 times higher risk (95% confidence interval [CI], 1.09 to 2.29) for prediabetes and 2.24 times higher risk (95% CI, 1.84 to 2.95) for diabetes, compared to non-snorers. Such graded association was also observed amongst the most frequent snorers with higher risk for prediabetes (odds ratio [OR], 1.78; 95% CI, 1.29 to 2.22) and diabetes (OR, 2.03; 95% CI, 1.45 to 2.85). Disruptive snoring (OR, 1.60; 95% CI, 1.12 to 2.28) and near-daily disruptive breathing (OR, 2.18; 95% CI, 1.02 to 4.19) were associated with higher odds for diabetes. Such findings remained robust after additional adjustment for sleep duration, excessive daytime sleepiness, unwakefulness, and sleep-deprived driving.ConclusionSnoring is associated with impaired glucose metabolism even in otherwise metabolically healthy adults. Habitual snorers may require lifestyle modifications and pharmacological treatment to improve glycemic profile.

Approach to the snoring child.

Sleep is an important component in a child's growth and development. Snoring is common in children and often perceived as benign, but habitual snoring may be an indication of obstructive sleep apnoea (OSA). OSA can have health, developmental and cognitive consequences. The three common risk factors for paediatric OSA are tonsillar and/or adenoidal hypertrophy, obesity and allergic rhinitis. Primary care providers are well-placed to identify children at risk by screening for habitual snoring and associated OSA risk factors during routine consultations. Physician awareness of OSA symptoms/signs facilitates diagnosis, management and referral decisions. A trial of medical treatment may be considered for habitual snoring with mild symptoms/signs before referral. Overnight polysomnography is the gold standard investigation utilised by paediatric sleep specialists to diagnose OSA. Adenotonsillectomy is the first-line management for OSA with adenotonsillar hypertrophy, but residual/recurrent OSA may occur, so follow-up by primary care providers is important after surgery.

Pediatric sleep-disordered breathing in the orthodontic population: Prevalence of positive risk and associations

Pediatric sleep-disordered breathing (SDB) describes a spectrum of disease ranging from snoring to upper airway resistance syndrome and obstructive sleep apnea (OSA). Anatomical features assessed during orthodontic exams are often associated with symptoms of SDB in children. Hence, we need to determine the prevalence of positive risk for SDB in the pediatric orthodontic population compared with a general pediatric population and understand comorbidities associated with SDB risk among orthodontic patients. Responses from Pediatric Sleep Questionnaires were collected from 390 patients between the ages of 5 and 16years, seeking orthodontic treatment. Prevalence of overall SDB risk, habitual snoring, and sleepiness were determined in the orthodontic population and compared with those previously reported by identical methods in the general pediatric population. Additional health history information was used to assess comorbidities associated with SDB risk in 130 of the patients. At 10.8%, the prevalence of positive SDB risk was found to be significantly higher in the general pediatric orthodontic population than in a healthy pediatric population (5%). The prevalence of snoring and sleepiness in the orthodontic population was 13.3% and 17.9%, respectively. Among the comorbidities, nocturnal enuresis (13.6%), overweight (18.2%), and attention deficit hyperactivity disorder (31.8%) had a higher prevalence in orthodontic patients with higher SDB risk (P<0.05). There is a higher pediatric SDB risk prevalence in the orthodontic population compared with a healthy pediatric population. Orthodontic practitioners should make SDB screening a routine part of their clinical practice.

Associations between symptoms of sleep-disordered breathing and maternal sleep patterns with late stillbirth: Findings from an individual participant data meta-analysis.

Sleep-disordered breathing (SDB) affects up to one third of women during late pregnancy and is associated with adverse pregnancy outcomes, including hypertension, diabetes, impaired fetal growth, and preterm birth. However, it is unclear if SDB is associated with late stillbirth (≥28 weeks' gestation). The aim of this study was to investigate the relationship between self-reported symptoms of SDB and late stillbirth. Data were obtained from five case-control studies (cases 851, controls 2257) from New Zealand (2 studies), Australia, the United Kingdom, and an international study. This was a secondary analysis of an individual participant data meta-analysis that investigated maternal going-to-sleep position and late stillbirth, with a one-stage approach stratified by study and site. Inclusion criteria: singleton, non-anomalous pregnancy, ≥28 weeks' gestation. Sleep data ('any' snoring, habitual snoring ≥3 nights per week, the Berlin Questionnaire [BQ], sleep quality, sleep duration, restless sleep, daytime sleepiness, and daytime naps) were collected by self-report for the month before stillbirth. Multivariable analysis adjusted for known major risk factors for stillbirth, including maternal age, body mass index (BMI kg/m2), ethnicity, parity, education, marital status, pre-existing hypertension and diabetes, smoking, recreational drug use, baby birthweight centile, fetal movement, supine going-to-sleep position, getting up to use the toilet, measures of SDB and maternal sleep patterns significant in univariable analysis (habitual snoring, the BQ, sleep duration, restless sleep, and daytime naps). Registration number: PROSPERO, CRD42017047703. In the last month, a positive BQ (adjusted odds ratio [aOR] 1.44, 95% confidence interval [CI] 1.02-2.04), sleep duration >9 hours (aOR 1.82, 95% CI 1.14-2.90), daily daytime naps (aOR 1.52, 95% CI 1.02-2.28) and restless sleep greater than average (aOR 0.62, 95% CI 0.44-0.88) were independently related to the odds of late stillbirth. 'Any' snoring, habitual snoring, sleep quality, daytime sleepiness, and a positive BQ excluding the BMI criterion, were not associated. A positive BQ, long sleep duration >9 hours, and daily daytime naps last month were associated with increased odds of late stillbirth, while sleep that is more restless than average was associated with reduced odds. Pregnant women may be reassured that the commonly reported restless sleep of late pregnancy may be physiological and associated with a reduced risk of late stillbirth.

Pediatric Adenotonsillectomy Trial for Snoring (PATS): protocol for a randomised controlled trial to evaluate the effect of adenotonsillectomy in treating mild obstructive sleep-disordered breathing

IntroductionMild obstructive sleep-disordered breathing (oSDB), characterised by habitual snoring without frequent apnoeas and hypopnoeas on polysomnography, is prevalent in children and commonly treated with adenotonsillectomy (AT). However, the absence of...

Palatal Sensory Function Worsens in Untreated Snorers but not in CPAP-Treated Patients With Sleep Apnea, Indicating Vibration-Induced Nervous Lesions

Signs of both motor and sensory nervous lesions have previously been shown in the upper airway of patients with OSA and habitual snorers. Snoring per se may damage all upper airway neurons over time, thereby causing progression to manifest sleep apnea. To test this hypothesis, nonsnoring subjects, untreated snorers, and CPAP-treated patients underwent repeated sensory testing of the soft palate in a prospective long-term study. Cold detection threshold (CDT) testing at the soft palate and lip with a thermode and nocturnal respiratory recordings were performed in 2008 to 2009 with retesting 6 to 7 years later. In 25 untreated snorers, palatal CDT worsened from a median (25th-75th percentile range) 4.2°C (3.2-5.9) to 11.0°C (7.0-17.4) (P< .001). The apnea-hypopnea index increased from a median 7.0 to 14.0 events/h (P< .05). There was no significant correlation between changes in CDT and the apnea-hypopnea index. In 21 nonsnoring control subjects, palatal CDT increased from a median 3.2°C to 5.6°C (P< .005). In 19 CPAP-treated patients, palatal CDT did not significantly change; eight patients had improved values. CDTs worsened significantly more in the snorers group than in the control subjects (P< .05) and the CPAP-treated patients (P< .001). There was no significant difference between control subjects and CPAP-treated patients. CDT worsened considerably over time in untreated snorers, significantly more than in nonsnoring control subjects and CPAP-treated patients. Untreated snorers therefore risk developing poor sensitivity in the upper airway. In contrast, efficient treatment of OSA seems to protect the sensory innervation, as the CPAP-treated group maintained their sensitivity to cold and, in some cases, the sensitivity even improved.

Habitual snoring, adiposity measures and risk of type 2 diabetes in 0.5 million Chinese adults: a 10-year cohort

ObjectivesThe present study aimed to examine whether habitual snoring was independently associated with risk of type 2 diabetes among Chinese adults, and to assess the role that adiposity measures play...

Endothelial dysfunction in children with obstructive sleep apnea syndrome

Objective: To evaluate the endothelial function in obstructive sleep apnea syndrome(OSAS) children and to identify related factors of endothelial dysfunction. Methods: This was a cross-sectional study. Children with habitual snoring (snoring ≥3 nights per week) admitted to the ward of otolaryngology, head and neck surgery, Beijing Children's Hospital were recruited to this study between 1(st) June 2015 and 1(st) March 2016. All children aged 3 to 11 years and of them 245 were boys and 110 were girls. All subjects underwent an overnight polysomnography (PSG), as well as endothelial function testing. All subjects were grouped into primary snoring (PS) and OSAS group according to the obstructive apnea hypopnea index (OAHI). T test or Wilcoxon test were used to compare the differences in PSG results between the two groups, and univariate and multivariate correlation analyses were used to explore the relevant factors affecting the endothelial function. Results: A total of 355 subjects were enrolled and 248 had OSAS, and 107 had PS. There were no significant differences in age, gender and body mass index (BMI) Z-score between the two groups (all P>0.05). OSAS group had higher OAHI, oxgen desaturation index and respiratory related arousal index (5.2 (2.2, 13.2) vs. 0.4 (0.1, 0.7), 4.1 (2.0, 13.1) vs. 0.5 (0.1, 1.0), 2.5 (1.0, 4.8) vs. 0.4 (0.1, 0.9), Z=-14.957, -11.790, -10.378, all P<0.01), and lower minimum oxygen saturation and reactive hyperemia index (RHI) than those of PS (0.89 (0.85, 0.92) vs. 0.94 (0.91, 0.95), 1.2±0.2 vs. 1.1±0.1, Z=-9.337, t=5.354, P<0.01). Univariate regression analysis showed that RHI was linearly correlated with age (parameter estimate=0.017, P<0.01), gender (parameter estimate=0.065, P<0.01), OAHI (parameter estimate=-0.023, P<0.01), oxygen desaturation index (parameter estimate=-0.019, P<0.01), respiratory related arousal index (parameter estimate=-0.031, P<0.01), and oxygen saturation nadir (parameter estimate=0.067, P=0.045). The relationship between BMI Z-score and RHI was quadratic. Multivariate regression analysis showed that age (parameter estimate=0.015, P<0.01), BMI Z-score (parameter estimate=0.040, P<0.01), BMI Z-score quadratic form (parameter estimate=-0.010, P<0.01), respiratory related arousal index (parameter estimate=-0.020, P<0.01) were independently correlated with RHI. Conclusions: Children with OSAS have significant endothelial dysfunction compared with PS. Frequent arousals due to obstructive respiratory events during sleep may be a candidate risk factor for endothelial dysfunction in children with OSAS.

Snoring is associated with obesity among middle aged Slum-dwelling women in Mysore, India.

Background:Globally, rates of obesity have trebled in the past four decades. India has more than 9.8 million men and 20 million women classified as obese. While poor diet and sedentary lifestyles are major causes, growing evidence suggests other factors like sleep-disordered-breathing may also be contributors.Methods:A cross-sectional survey was carried out between October 2017 and May 2018 among a nonprobability sample of slum-dwelling women, 40–64 years of age, in government-designated slums in Mysore, India. After the informed consent process, data were collected on sociodemographics, tobacco and alcohol consumption, diet, physical activity, sleep, quality of life, and personal and family history of diagnosed cardiometabolic disorders. Body mass index (BMI) was calculated using anthropometry. The serum was tested for HbA1c and lipid profile.Results:In this sample of slum-dwelling women, snoring was associated with obesity. Habitual snorers had more than double the odds (adjusted odds ratio [aOR] 2.05; 95% confidence interval [CI] 1.26–3.33; P < 0.004) of obesity I, and seven times the odds (aOR 7.71; CI: 3.58–16.62; P < 0.001) of being in the obesity II category compared to nonsnorers after adjustment for age, diabetes, hypertension, hypercholesterolemia, and daytime sleepiness. There was no difference in obesity status among participants reporting abnormal sleep duration, napping, daytime sleepiness, sleep apnea, insomnia, or the use of sleep medication.Conclusion:The relationship between snoring and obesity has not been well explored. This study among slum-dwelling Indian women found a significant relationship between snoring and obesity. Future research should explore the underlying mechanisms connecting snoring to BMI.

Prevalence of Sleep-disordered Breathing and its Association with Obesity among Saudi Schoolchildren

Epidemiological studies of sleep disturbances are essential to promote awareness among families and educational officials and deliver appropriate treatment at a very early timing. The aim of this population-based study was to determine the frequency of sleep-disordered breathing (SDB) symptoms and its association with obesity among schoolchildren in West Saudi Arabia. This cross-sectional study comprised 2,000 schoolchildren aged 6-12 years. Sleep-disordered breathing symptoms were assessed with Arabic version of Pediatric Sleep Questionnaire (PSQ). Overweight/obesity was evaluated using body mass index (BMI) and their association with SDB was tested using a regression analysis model. Overall, 23% of children were at high risk of SDB. Prevalence of habitual snoring was 15.9% and sleep apnea 4%. Boys were at higher risk of SDB than girls (p = 0.026), while age had no effect (p = 0.254). High-risk SDB had a strong association with sleep symptoms compared to low-risk SDB (p < 0.05). Sleep-disordered breathing increased significantly in overweight and obese children (p = 0.017 and p < 0.001, respectively). Around 23% Saudi schoolchildren are at risk of SDB. Related symptoms were strongly associated with high risk of SDB. Overweight and obesity had a strong and progressive association with SDB. The results will help in identifying children at high risk of developing SDB and plan for early intervention to avoid the progression of SDB later in life.