A Community Study of Snoring and Sleep-disordered Breathing

Abstract

Four hundred forty-one subjects 34 to 69 yr of age were recruited from a random sample of the com­ munity. Theyanswered a questionnaire and were monitored in their homes for sleep-disordered breath­ ing (SOB). This report concerns the association between observed SOBand arterial hypertension and vascular disease. Hypertension was defined as self-report of a diagnosis of hypertension made by a physician,current treatment for hypertension, or a systolicpressure greater than 150 mm Hg or a diastolic pressure greater than 90 mm Hg.Coronary artery was defined by self-report of angina or myo­ cardial infarction or Nheartattack. There were few cases of stroke or claudication, and a category of occluslve vascular disease was defined by self-report of coronary artery or of Nblocked arter­ ies or stroke. Subjects were classified as snorers (n = 289) or nonsnorers (n = 73) by self-report of regular snoring, and as having SOB (n = 79) if more than 15 abnormal-respiratory events were recorded per hour of recording. There were significant increases in the prevalence of hypertension, coronary artery disease, and occlusive vascular from nonsnorers (26, 7, and 10%, respectively) through snorers (39, 12, and 17%) to subjects with SOB (57, 20, and 28%). The crude odds ratio for SOBversus nonsnorers was 3.8 (95% CI, 1.9 to 7.5) for hypertension, 3.5 (1.2 to 10.0) for coronary artery disease, and 3.7 (1.5 to 9.1) for occlusive vascular disease. Adjustment for age, sex, body mass index, current alcohol consumption, and smoking lowered the odds ratio to 1.5 (0.7 to 3.3) for hypertension, 1.4 (0.4 to 4.5) for coronary artery disease, and 1.5 (0.5 to 4.2) for occlusive vascular disease. We con­ cluded that the consistent reduction in odds ratios with adjustment suggests substantial confounding. Although the residual associations are clinically important, more complete and accurate adjustment for confounding might reduce the odds ratios further. Olson LG, King MT, Hensley MI, Saunders NA. A community study of snoring and sleep-disordered breathing: health outcomes. AM J RESPIRCRIT CARE MED 1995;152:717-20.