Risk Factor For Habitual Snoring Research Articles

Risk factors for habitual snoring among children aged 2-14years in Chengdu, Sichuan.

Habitual snoring (HS) is a prominent symptom of sleep-disordered breathing; thus, it isalso important to consider the associated, multidimensional risk factors for HS in children. This study was aimed to identify risk factors for HS in children. A cross-sectional survey was performed in Chengdu. Children aged 2-14years from four districts were randomly chosen to participate. Questionnaires were voluntarily completed by the children's guardians. The survey included 926 boys and 622 girls, who were an average of 6.4 ± 3.0years old. The sample included 463 habitual snorers (30.4%), 683 occasional snorers (44.8%), and 402 nonsnorers (26.4%). HS was found in 51.8% of children under 7years old and 26.6% of children aged 7years old or older. The prevalence of pregnancy complications was significantly lower in mothers who bore children with HS (p = .006). Among the HS group, 86.6% had an immediate family member who snores. Breastfeeding duration among the HS group was significantly less than among the occasional snoring and nonsnoring groups. History of symptoms of allergic rhinitis, rhinosinusitis, tonsillitis, and pneumonia/bronchitis in the past 6months was associated with HS. Likewise, maternal smoking during pregnancy, maternal exposure to secondhand smoke during pregnancy, and child exposure to secondhand smoke were also associated with HS. The prevalence of HS was higher in children under 7years old. Having a mother with more education, a family history of snoring, a shorter period of breastfeeding, upper respiratory tract inflammation, and passive smoking are important risk factors for HS. Pregnancy complications may be associated with lower prevalence of snoring in childhood.

Prevalence and evolution of snoring and the associated factors in two-year-old children

ObjectivesTo evaluate the prevalence and persistence of snoring during the first two years of life in two Finnish birth cohorts and to assess the associated factors. Study designThe study population comprised 947 children from the CHILD-SLEEP (CS) and 1393 children from the FinnBrain (FB) birth cohorts. Questionnaires were provided to both parents when the child was 24 months of age. The questionnaire consisted of parts concerning the child's sleep and environmental factors. ResultsThe combined prevalence of habitual snoring in the two birth cohorts at the age of 24 months was 2.3% (95% CI 1.5–3.1), which is markedly lower than reported previously.Children suffering from recurrent infections (CS odds ratio (OR) 3.9, 95% CI 1.2–12.5) or asthma (FB OR 4.3, 1.4–13.5) snored habitually more often. Both the mother's (CS OR 3.2, 1.2–9.0) and father's (CS OR 3.4, 1.4–8.0) snoring every night added to the risk of the child snoring. In the multivariate models, parental snoring (CS adjusted odds ratio (ORa) 2.8, 1.1–6.8), the mother's lower level of education (CS ORa 2.9, 1.2–7.5, FB ORa 2.1, 1.0–4.5), and the mother's lower monthly income (FB ORa 2.9, 1.3–6.3) associated with the child's habitual snoring. ConclusionsThe prevalence of habitual snoring in two Finnish birth cohorts is lower than reported previously. The independent risk factors for habitual snoring at the age of two years were the parents' snoring and the mother's low income and low education.

Effects of Passive Smoking on Snoring in Preschool Children

To examine the association between passive smoking and snoring in preschool children using parent-reported questionnaires and urine cotinine levels. This was a population-based cross-sectional survey of 2954 children aged 2-6 years in Hong Kong. Parent-reported questionnaires provided information on snoring and household smoking. One-third of children randomly chosen from the cohort provided urine samples for cotinine analysis. Increased urine cotinine was defined as urinary cotinine concentration ≥ 30 ng/mg creatinine. Using multivariate logistic regression analysis, we analyzed the association between snoring and passive smoking, controlling for potential confounders including age, sex, body mass index z-score, atopic diseases, recent upper respiratory tract infection, parental allergy, parental education, family income, and bedroom-sharing. A total of 2187 completed questionnaires were included in the final analysis, and 724 children provided urine samples for cotinine measurement. After adjustment for confounding factors, questionnaire-based household smoking (>10 cigarettes/d: OR = 2.22, 95% CI = 1.02-4.81) and increased urine cotinine (OR = 4.37, 95% CI = 1.13-16.95) were significant risk factors for habitual snoring (snoring ≥ 3 nights per week). For occasional snoring (snoring 1-2 nights per week), reported household smoking (1-10 cigarettes/d: OR = 1.41, 95% CI = 1.14-1.76; >10 cigarettes/d: OR = 1.56, 95% CI = 1.05-2.31), and increased urine cotinine (OR = 1.82, 95% CI = 1.03-3.20) were also identified as significant risk factors. A dose-effect relationship was found for snoring frequency and adjusted natural logarithms of urinary cotinine concentrations (P < .001). Environmental tobacco smoke exposure is an independent risk factor for snoring in preschool children. Parents' smoking cessation should be encouraged in management of childhood snoring.

The prevalence and correlates of habitual snoring during pregnancy

Mounting evidence implicate habitual snoring, a prominent symptom of sleep-disordered breathing, as an important risk factor for adverse pregnancy outcomes including preeclampsia and gestational diabetes. Little, however, is known about the determinants of habitual snoring among pregnant women. We sought to assess its prevalence and to identify maternal characteristics associated with habitual snoring during pregnancy. Pregnant women (N = 1,303) receiving prenatal care provided information about habitual snoring before and during pregnancy in in-person interviews completed in early pregnancy. We calculated adjusted odds ratios (aOR) and 95 % confidence intervals (95 % CI) from multivariable models designed to identify factors associated with snoring during pregnancy. Approximately 7.3 % of pregnant women reported habitual snoring during early pregnancy. The odds of habitual snoring during pregnancy was strongly related with maternal reports of habitual snoring prior to the index pregnancy (aOR = 24.32; 95 % CI, 14.30-41.51). Advanced maternal age (≥35 years) (aOR = 2.02; 95 % CI, 1.11-3.68), history of pregestational diabetes (aOR = 3.61; 95 % CI, 1.07-12.2), history of mood and anxiety disorders (aOR = 1.81; 95 % CI, 1.02-3.20), and prepregnancy overweight (25-29.9 kg/m(2)) (aOR = 2.31; 95 % CI, 1.41-3.77) and obesity (≥30 kg/m(2)) (aOR = 2.81; 95 % CI, 1.44-5.48) status were statistically significant risk factors for habitual snoring during pregnancy. In addition, maternal smoking during pregnancy (aOR = 2.70; 95 % CI, 1.17-6.26) was associated with habitual snoring during pregnancy. Identification of risk factors for habitual snoring during pregnancy has important implications for developing strategies aimed at reducing the prevalence of sleep-disordered breathing, promoting improved sleep hygiene and improved pregnancy outcomes among reproductive-age women.

Sleep Disorders in Children: The Singapore Perspective

This review article summarises the current available literature on sleep patterns and sleep problems in Singapore children. Co-sleeping is a culturally dependent practice and its prevalence in Singapore has been determined to be 73%. Co-sleeping is not associated with significant sleep problems in Singapore children. Snoring and habitual snoring occur in 28.1% and 6.0% of Singapore children, respectively. Habitual snoring in Singapore children was significantly associated with obesity, allergic rhinitis, atopic dermatitis, maternal smoking and breastfeeding. Atopy was the strongest risk factor for habitual snoring in Singapore, and the effect was cumulative. Children attending psychiatric services in Singapore may also have sleep disorders, the highest prevalence being in children with attention deficit hyperactivity disorder. The knowledge on childhood sleep disorders (including obstructive sleep apnoea) amongst the public, patients, parents and future doctors in Singapore are inadequate and there is an urgent need for increased education in this area given the importance of good sleep in children. There is also a need to change parental attitudes about sleep disorders and encourage early medical consultation.

Self-Reported Snoring, Maternal Obesity and Neck Circumference as Risk Factors for Pregnancy-Induced Hypertension and Preeclampsia

Background: Physical and hormonal changes during pregnancy alter breathing patterns of pregnant women. It is possible that occult disordered breathing during sleep may be a risk factor for the development of pregnancy-induced hypertension (PIH) and preeclampsia. Objective: Our aim was to determine the incidence of self-reported snoring in pregnant women, and to investigate the relationship of snoring, obesity and neck circumference to PIH and preeclampsia. Methods: 469 pregnant women and 208 age-matched nonpregnant women were included in the study. Both groups were asked to complete a questionnaire. Maternal complications were retrieved from the medical records. Results: Habitual snoring was reported from 1.9% of nonpregnant women, 2.5% of pregnant women prior to pregnancy and 11.9% of those same women during the third trimester of pregnancy (p < 0.001). Age, smoking during pregnancy, and weight before delivery were independent risk factors for habitual snoring in pregnancy. PIH and preeclampsia developed in 20 and 10.9% of pregnant women with habitual snoring, as compared to 11 and 5.8% of non-snoring pregnant women (p = 0.045, p = 0.125, p = 0.415), respectively. In women who developed preeclampsia, weight before pregnancy, weight before delivery and neck circumference were significantly higher in univariate analysis. Neck circumference was an independent risk factor for PIH and preeclampsia according to logistic regression analysis. Conclusion: The incidence of snoring is significantly higher in pregnant women than in nonpregnant women. Snoring may indicate a risk of PIH. Neck circumference was an independent risk factor for both PIH and preeclampsia.

Allergic Rhinitis May Be Important in Snoring Infants

We read with interest the article by Kalra et al, 1 Kalra M LeMasters G Bernstein D et al. Atopy as a risk factor for habitual snoring at age 1 year. Chest. 2006; : 942-946 Abstract Full Text Full Text PDF PubMed Scopus (38) Google Scholar who found that the prevalence of habitual snoring for 1-year-old children was 15% in a high-risk group for atopy,ie, children born to atopic parents. This prevalence was significantly higher than that reported in older children, 10.9% in 6- to 12-year-old children in Hong Kong, 2 Ng DK Kwok KL Cheung JM et al. Prevalence of sleep problems in Hong Kong primary school children: a community-based telephone survey. Chest. 2005; 128: 1315-1323 Abstract Full Text Full Text PDF PubMed Scopus (110) Google Scholar and 10 to 14% in < 6-year-olds in Europe and the United States. 3 Young T Peppard PE Gottlieb DJ Epidemiology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med. 2002; 162: 1217-1239 Crossref Scopus (3328) Google Scholar This higher prevalence is most likely due to the fact that 29% of this group of infants were atopic, and it is not surprising that Kalra et al 1 Kalra M LeMasters G Bernstein D et al. Atopy as a risk factor for habitual snoring at age 1 year. Chest. 2006; : 942-946 Abstract Full Text Full Text PDF PubMed Scopus (38) Google Scholar found that the presence of atopy increased the risk of habitual snoring (odds ratio, 2.0; 95% confidence interval, 1.2 to 3.0), a common symptom of obstructive sleep apnea syndrome (OSAS). 4 Chau KW Ng DKK Kwok CKL et al. Clinical risk factors for obstructive sleep apnea in children. Singapore Med J. 2003; 44: 570-577 PubMed Google Scholar This was similar to previous findings in Hong Kong, 2 Ng DK Kwok KL Cheung JM et al. Prevalence of sleep problems in Hong Kong primary school children: a community-based telephone survey. Chest. 2005; 128: 1315-1323 Abstract Full Text Full Text PDF PubMed Scopus (110) Google Scholar when we found allergic rhinitis to be a significant risk factor for witnessed apnea with an adjusted odds ratio of 2.19, another symptom of OSAS as well as in the United States. 5 McColley SA Carroll JL Curtis S et al. High prevalence of allergic sensitization in children with habitual snoring and obstructive apnea. Chest. 1997; 111: 170-173 Abstract Full Text Full Text PDF PubMed Scopus (172) Google Scholar It is unfortunate that Kalra et al 1 Kalra M LeMasters G Bernstein D et al. Atopy as a risk factor for habitual snoring at age 1 year. Chest. 2006; : 942-946 Abstract Full Text Full Text PDF PubMed Scopus (38) Google Scholar did not report the prevalence of nasal symptoms in their cohort, as the data would have shed light on the mechanisms that link habitual snoring and atopic status, possibly allergic rhinitis. Other important data that were not reported were the parts played by individual allergens, especially the airborne allergens vs food allergen. These data would help determine whether the inhaled route or the ingested route is important in the habitual snoring infants. In the study of Kalra et al, 1 Kalra M LeMasters G Bernstein D et al. Atopy as a risk factor for habitual snoring at age 1 year. Chest. 2006; : 942-946 Abstract Full Text Full Text PDF PubMed Scopus (38) Google Scholar the definition of positive atopic status for egg white and whole milk was wheal ≥ 3 cm than the negative control, and this would be associated with a high false-positive rate. 6 Sporik R Hill DJ Hosking CS Specificity of allergen skin testing in predicting open food challenges to milk, egg and peanut in children. Clin Exp Allergy. 2000; 30: 1495-1498 Crossref PubMed Scopus (472) Google Scholar ResponseCHESTVol. 131Issue 1PreviewWe thank Ng et al for their interest in our article.1They raise concern about lack of data on nasal symptoms and our definition for positive skin-prick test results. Using the rhinitis definition of a positive parent report to the question “In the past 12 months, has your child ever had a problem with sneezing, or a runny, or a blocked nose when he/she did not have a cold or flu?” we found a strong association between rhinitis and habitual snoring (p < 0.001) in our cohort of 681 infants. In multivariate logistic regression model with habitual snoring as the dependent variable, the adjusted odds ratio for rhinitis was 2.5 (confidence interval, 1.7 to 4.0) and atopy (defined as positive skin-prick test result to an aeroallergen or food allergen was 1.9 (confidence interval, 1.2 to 2.9). Full-Text PDF

Longitudinal Study of Risk Factors for Habitual Snoring in a General Adult Population: The Busselton Health Study

Background The aim of this longitudinal study was to identify body size, behavioral, and respiratory risk factors for the development of habitual snoring in a general adult population. Methods The sample for this study comprised 967 adults aged 25 to 74 years who reported not snoring in the 1981 Busselton Health Survey and who also attended the 1994–1995 follow-up survey. Logistic regression was used to identify and quantify the effect of baseline and change risk factors for the development of habitual snoring. Results A total of 13% had become habitual snorers by 1994–1995. Male gender (odds ratio [OR], 3.5) and baseline body mass index (OR, 1.4 per 3.4 kg/m2) were significant predictors of habitual snoring; after accounting for these variables, no other baseline body size, behavioral, or respiratory/allergy variables were significantly related to the development of habitual snoring. However, change in body mass index over the 14-year follow-up period (OR, 1.55 per 2.3 kg/m2), development of asthma (OR, 2.8), and commencement of smoking (OR, 2.2) were additional significant independent risk factors for development of habitual snoring. Conclusions This study has confirmed male gender, obesity, and weight gain as key determinants of habitual snoring, and has indicated that development of asthma and taking up smoking also play a role. Maintaining a healthy weight and not smoking are recommended lifestyle preventive strategies to reduce the risk of sleep-disordered breathing and its sequelae. The aim of this longitudinal study was to identify body size, behavioral, and respiratory risk factors for the development of habitual snoring in a general adult population. The sample for this study comprised 967 adults aged 25 to 74 years who reported not snoring in the 1981 Busselton Health Survey and who also attended the 1994–1995 follow-up survey. Logistic regression was used to identify and quantify the effect of baseline and change risk factors for the development of habitual snoring. A total of 13% had become habitual snorers by 1994–1995. Male gender (odds ratio [OR], 3.5) and baseline body mass index (OR, 1.4 per 3.4 kg/m2) were significant predictors of habitual snoring; after accounting for these variables, no other baseline body size, behavioral, or respiratory/allergy variables were significantly related to the development of habitual snoring. However, change in body mass index over the 14-year follow-up period (OR, 1.55 per 2.3 kg/m2), development of asthma (OR, 2.8), and commencement of smoking (OR, 2.2) were additional significant independent risk factors for development of habitual snoring. This study has confirmed male gender, obesity, and weight gain as key determinants of habitual snoring, and has indicated that development of asthma and taking up smoking also play a role. Maintaining a healthy weight and not smoking are recommended lifestyle preventive strategies to reduce the risk of sleep-disordered breathing and its sequelae.

Atopy as a Risk Factor for Habitual Snoring at Age 1 Year

To determine the prevalence of habitual snoring (HS) in 1-year-old children, and to assess the relationship between HS and atopic status in these children. Cross-sectional evaluation of a birth cohort selected from the population. Ohio and Kentucky River Valley communities. Children participating in the Cincinnati Childhood Allergy and Air Pollution Study (CCAAPS) were recruited for this study. At age 1 year, the children were evaluated for atopic status and exposure to environmental tobacco smoke (ETS). Parents were asked to complete a questionnaire pertaining to their snoring frequency and that of their child. Children with HS (snoring three or more times per week) were compared to those who either did not snore or snored less than three times per week. Data were available on 681 of the 700 children participating in CCAAPS study. Of these 681 children (377 boys and 304 girls), 542 were white (80%), 118 were African American (17%), and 21 were biracial or Asian (3%). The mean age (+/- SD) of our cohort at the time of assessment for snoring was 13.7 +/- 2.6 months. Of the 681 children, 105 snored habitually (15%). There was a significant association between HS and the following: (1) positive atopic status (p = 0.005); (2) African-American race (p < 0.01); and (3) a history of snoring in the father (p < 0.01) or in the mother (p < 0.01). There was, however, no association between HS and ETS. We found a 15% prevalence of HS in 1-year-old children born to atopic parents and a significant association with positive atopic status.

PREVALENCE OF SNORING AMONG YOUNG ADULT FEMALES WITH ATOPY

PURPOSE: Snoring is the primary symptom of sleep-disordered breathing and is associated with cardiovascular and metabolic morbidity(Young T,AJRCM 2002). The prevalence of habitual snoring, in a large cohort of 30-60 year old adults, has been reported to be 19% in males and 9% in females(Jennum P, J Sleep Res 1992). However, the effect of atopy on gender predisposition of snoring is not known(Young T,AJRCM 2002). The objective of this study was thus to determine the prevalence of snoring in a community based cohort of young adult females with atopy, and to identify risk factors for habitual snoring in this group.

Correlates of habitual snoring and witnessed apnoeas in Busselton, Western Australia

Objective: The aim of this study was to identify potential body size, behavioural and respiratory risk factors for habitual snoring and witnessed apnoeas in a general population.Methods: Correlates of these conditions were studied in a sample of 3,577 adults aged 25–74 years who participated in a comprehensive health survey in Busselton, Western Australia, during 1994/95. Logistic regression was used to assess associations after age and gender adjustment and also in multivariate models.Results: The prevalence of both conditions was higher in men and rose with age. After controlling for age, gender and body mass index no additional body size variable remained significantly associated with witnessed apnoeas, whereas both waist‐hip ratio and neck‐height ratio remained significantly associated with habitual snoring. Among behavioural variables, smoking showed the strongest association, and among respiratory symptoms, asthma for habitual snoring and bronchitis for witnessed apnoeas had significant independent associations.Conclusions and Implications: This study has confirmed obesity and smoking as key determinants of habitual snoring and witnessed apnoeas. It has also shown that a number of measures of obesity are independently related to habitual snoring and that asthma and bronchitis may also play a role, independently of obesity.

Prevalence of Sleep Problems in Hong Kong Primary School Children

To estimate the prevalence of snoring, witnessed sleep apnea, teeth grinding, primary and secondary nocturnal enuresis, and sleep duration in Hong Kong primary school children. Cross-sectional telephone questionnaire survey in a community. A total of 3,047 6- to 12-year-old apparently healthy children. Those who agreed to the study were contacted by telephone. Survey questions were asked about the symptoms of the different sleep disorders, and the frequency of each positive symptom was noted for the preceding 1 week. Prevalence and risk factors of sleep disorders in Hong Kong primary school children. The prevalence of the following sleep symptoms was listed as follows: habitual snoring (10.9%), witnessed sleep apnea (1.5%), nocturnal enuresis (5.1%), and sleep teeth grinding (20.5%). Significant risk factors for habitual snoring included witnessed sleep apnea, mouth breathing during sleep, snoring in first-degree relatives, headache on rising, male gender, allergic rhinitis, and sleep teeth grinding. Significant risk factors for witnessed sleep apnea included habitual snoring, allergic rhinitis, tiredness on rising, and excessive daytime sleepiness. Poor academic results were associated with present of witnessed sleep apnea and absence of sleep teeth grinding. None of the sleep problem was associated with poor conduct results. The mean sleep duration was 8.79 h (SD 0.96). This study provides epidemiologic data of sleep-disordered breathing, enuresis, sleep teeth grinding, and duration of sleep in Chinese primary school children in Hong Kong.

Allergic Rhinitis as a Risk Factor for Habitual Snoring in Children

Allergic Rhinitis as a Risk Factor for Habitual Snoring in Children

Snoring in primary school children and domestic environment: A Perth school based study

BackgroundThe home is the predominant environment for exposure to many environmental irritants such as air pollutants and allergens. Exposure to common indoor irritants including volatile organic compounds, formaldehyde and nitrogen dioxide, may increase the risk of snoring for children. The aim of this study was to investigate domestic environmental factors associated with snoring in children.MethodsA school-based respiratory survey was administered during March and April of 2002. Nine hundred and ninety six children from four primary schools within the Perth metropolitan area were recruited for the study. A sub-group of 88 children aged 4–6 years were further selected from this sample for domestic air pollutant assessment.ResultsThe prevalences of infrequent snoring and habitual snoring in primary school children were 24.9% and 15.2% respectively. Passive smoking was found to be a significant risk factor for habitual snoring (odds ratio (OR) = 1.77; 95% confidence interval (CI): 1.20–2.61), while having pets at home appeared to be protective against habitual snoring (OR = 0.58; 95% CI: 0.37–0.92). Domestic pollutant assessments showed that the prevalence of snoring was significantly associated with exposure to nitrogen dioxide during winter. Relative to the low exposure category (<30 μg/m3), the adjusted ORs of snoring by children with medium (30 – 60 μg/m3) and high exposures (> 60 μg/m3) to NO2 were 2.5 (95% CI: 0.7–8.7) and 4.5 (95% CI: 1.4–14.3) respectively. The corresponding linear dose-response trend was also significant (P = 0.011).ConclusionSnoring is common in primary school children. Domestic environments may play a significant role in the increased prevalence of snoring. Exposure to nitrogen dioxide in domestic environment is associated with snoring in children.

Risk Factors and Natural History of Habitual Snoring

It has been suggested that habitual snoring (HS) has adverse health outcomes in children. We aimed to identify risk factors for HS and determine its natural history in primary school children. Cross-sectional, population-based cohort study. Twenty-seven primary schools located within the city limits of Hannover, Germany. Third-grade primary school children. Snoring frequency and potential risk factors were investigated using parental questionnaires. Unadjusted and adjusted odds ratios (ORs) for HS and their 95% confidence intervals (CIs) were calculated. One year after the initial contact, snoring status was re-evaluated in habitual snorers. In total, 1,760 children were contacted, and 1,144 parents and their children (49% were girls) agreed to participate and returned a completed questionnaire. A body mass index >/= 90th percentile (OR, 3.5; 95% CI, 1.8 to 7.1), low maternal education (OR, 2.3; 95% CI, 1.1 to 4.7), regular daytime mouth breathing (OR, 7.4; 95% CI, 3.5 to 15.6), and a higher frequency of sore throats (OR, 17.6; 95% CI, 6.4 to 48.8) were independent risk factors for HS. Parental smoking and frequent infections were significantly but not independently associated with HS. The association of low maternal education and HS was higher in boys (OR, 4.4; 95% CI, 1.5 to 13.6; vs OR, 1.2; 95% CI, 0.4 to 3.6), while that of sore throats and HS was higher in girls (OR, 52.7; 95% CI, 6.0 to 460.2; vs OR, 13.3; 95% CI, 3.0 to 58.5). At follow-up, 39 of 80 eligible habitual snorers (48.8%) still snored regularly. Children who continued to snore differed significantly in maternal education, household smoking, snoring loudness, and prior ear, nose, throat surgery from those who had ceased to snore habitually. Socioeconomic status, obesity, signs of nasal obstruction, and pharyngeal problems were independent risk factors for HS in these primary school children. The expression of HS varied considerably over time.

Snoring and atopic disease: a strong association.

The prevalence and factors associated with snoring and habitual snoring in Asian children are largely unknown. Our objectives were to evaluate the prevalence and factors associated with snoring and habitual snoring in preschool and primary school children in Singapore. A self-response questionnaire on snoring was administered to parents of children aged 4-7 years in randomly selected preschools and primary schools in Singapore. The overall response rate was 91.3% (nt = 11,114). Snoring and habitual snoring were reported in 28.1% and in 6.0% of the children, respectively. On multivariate logistic regression analysis, snoring was significantly associated with male gender, race, atopy (asthma, allergic rhinitis, or atopic dermatitis), maternal atopy (allergic rhinitis or atopic dermatitis), maternal smoking, and breastfeeding. Habitual snoring was significantly associated with obesity (odds ratio (OR), 3.75; 95% confidence interval (CI), 1.67-8.42), allergic rhinitis (OR, 2.90; 95% CI, 2.06-4.08), atopic dermatitis (OR, 1.80; 95% CI, 1.28-2.54), maternal smoking (OR, 2.22; 95% CI, 1.09-4.53), and breastfeeding (OR, 1.49; 95% CI, 1.11-1.98). Atopy was the strongest risk factor for habitual snoring, and the effect was cumulative. The odds ratio of a child with all three atopic diseases (asthma, allergic rhinitis, and atopic dermatitis) to have habitual snoring was 7.45 (95% CI, 3.48-15.97). In conclusion, snoring and habitual snoring are common in Asian children. Atopy is strongly associated with snoring and habitual snoring. We suggest that children who are significantly atopic receive additional attention during screening for snoring, habitual snoring, and other features of obstructive sleep apnea syndrome.

Chronic Nasal Congestion at Night Is a Risk Factor for Snoring in a Population-Based Cohort Study

Nasal congestion at night is thought to have a role in snoring and sleep apnea, but this hypothesis has not previously been tested in a population-based study. Baseline and 5-year follow-up data on self-reported nocturnal nasal congestion and snoring frequency were collected from a population-based sample of 4916 men and women (age range, 30-60 years at baseline) enrolled in the ongoing Wisconsin Sleep Cohort Study. In-laboratory polysomnography was performed on a subset (n = 1032) of the study population to determine the frequency of apnea and hypopnea episodes during sleep. Logistic regression was used to estimate odds ratios for snoring with chronic nasal congestion at night. Nocturnal nasal congestion frequency was independently associated with snoring frequency in cross-sectional analyses. The odds ratios (adjusted for sex, age, body habitus, and smoking) for habitual snoring with severe (always or almost always) nasal congestion vs none was 3.0 (95% confidence interval, 2.2-4.0). This association was not explained by habitual snorers with frank sleep apnea (ie, >/=5 apnea and hypopnea episodes per hour of sleep). Prospective analyses showed that persons with chronic severe nasal congestion had a high risk of habitual snoring according to the data from the 5-year follow-up survey: the odds ratio for habitual snoring and reporting congestion always or almost always at both baseline and follow-up was 4.9 (95% confidence interval, 2.8-8.8). Nocturnal nasal congestion is a strong independent risk factor for habitual snoring, including snoring without frank sleep apnea. Intervention studies are needed to determine if snoring can be reduced with treatment of nasal congestion.