DEFINITELY NOT A SILENT KILLER!
Abstract: It is remarkable that such a common and well known disorder has been almost completely missed as a “not so silent killer”.
There is ‘voluminous’ evidence through studies starting back in 1970 using fluid mechanics, that snoring can predispose to stroke, and yet no one seems to know? If in doubt, ask your doctor.
Can Loud Snoring Lead to Cardiovascular Disease?
A study published in the Journal of Sleep (Vol. 31; No. 3, 2008, p. 411) assessed the self-reported prevalence of snoring in a large population of Hungarians.
The study was conducted by Dr. Andrea Dunai and colleagues at the Institute of Behavioral Sciences, Semmelweis University in Budapest, Hungary and researchers from the University of Toronto. The aim of the study was to establish whether varying kinds of snoring could be linked to cardiovascular disease and increased healthcare utilization.
12,643 Hungarians Surveyed For Snoring
Previous research has shown a correlation between snoring and increased risk of high blood pressure, ischemic heart disease and stroke. In this study, however, the researchers focused on the difference between loud snoring with breathing pauses (apnea) and quiet regular snoring.
Participants were asked if they snored, and if so, whether they snored loudly or softly. Subjects were also asked if they were being treated for cardiovascular disease, such as hypertension, acute myocardial infarction (AMI) or stroke. They were also asked if they had required hospitalization or an intervention by a healthcare professional in the last year.
The researchers collected basic socio-demographic information (gender, age, education and marital status), as well as information about the presence of diabetes, height, weight, smoking history and alcohol consumption. Interviews were carried out in the homes of 12,643 Hungarians over the age of 18 years according to age and gender from 19 counties in Hungary.
Loud Snorers Have a 67% Higher Risk of Stroke
The data showed that 37% of male respondents reported snoring loudly with breathing pauses and 23% were quiet snorers.
Among females, 21% reported loud snoring with breathing pauses and 21% were quiet snorers. Loud snoring became more prevalent with increasing Body Mass Index (BMI) and age.
More than a quarter of the participants (26%) had high blood pressure and the prevalence increased with age in both genders.
In men, the prevalence of high blood pressure was higher among loud snorers (29%) compared to those that did not report any snoring (17%).
The difference was even greater for women where 45% of loud snorers had hypertension compared with 21% of non-snorers.
The highest prevalence of AMI and stroke was found in loud snorers. Five percent of the loud snoring men and 8% of the loud snoring women had experienced a stroke.
The study found that loud snorers have a 67% higher risk of a stroke compared to non-snorers and the risk of heart attack is 34% higher.
Healthcare utilization was found to be highest among the loud snorers, where 23% required an emergency room visit or hospitalization in the previous year compared to 17% of non-snorers.
Snoring and Sleep Apnea increases with age and weight
This large survey study demonstrates that snoring is very common and that loud snoring increases the risk of high blood pressure, stroke and heart attack. Sleep disordered breathing is a spectrum of disease, ranging from soft regular snoring to notable stops in breathing (called apnea).
The severity of sleep disordered breathing increases with age and weight. This has significant implications for societies like ours in which people are living longer, more sedentary lives, and eating higher calorie diets.
So the take home is SNORING is NOT BENIGN.
Loud snoring is serious
Cardiovascular damage is already underway with the loud snorer.
If you are concerned ask your doctor, the evidence is clear – the mask and hose option (CPAP) may not be appropriate.
“Heavy snoring significantly increases the risk of carotid atherosclerosis, and the increase is independent of other risk factors, including measures of nocturnal hypoxia and obstructive sleep apnea severity. Considering the high prevalence of snoring in the community, these findings have substantial public health implications for the management of carotid atherosclerosis and the prevention of stroke.”
Dr Stephen Bray 2019