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J Sleep Res. 2017 Apr;26(2):147-150. doi: 10.1111/jsr.12471. Epub 2016 Dec 6.

Objective snoring time and carotid intima-media thickness in non-apneic female snorers.

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University of Pennsylvania School of Nursing, Philadelphia, PA, USA.
Center for Sleep and Circadian Neurobiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Division of Sleep Medicine, Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Division of Cardiology, University of Pennsylvania, Philadelphia, PA, USA.
Institute of Human Genomic Study, College of Medicine, Korean University Ansan Hospital, Ansan, Korea.
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Korea University, Ansan, Korea.


Controversy persists about whether snoring can affect atherosclerotic changes in adjacent vessels, independently of obstructive sleep apnea and other cardiovascular risk factors. This study examined the independent association between snoring and carotid artery intima-media thickness (IMT) in non-apneic snorers and non-snorers. We studied 180 non-apneic snorers and non-snorers participating in a full-night home-based sleep study. Snoring sound was measured objectively by a microphone. Based on snoring time across the night, participants were classified as non-snorers (snoring time: 0%), mild snorers (1-25%) and moderate to heavy snorers (≥25%). We measured IMT on both common carotid arteries. The three groups were matched by age, body mass index, cholesterol, blood pressure and glucose levels, using weights from generalized boosted-propensity score models. Mean carotid IMT increased with increased snoring time across the night in women: non-snorers (0.707 mm), mild (0.718 mm) and moderate to heavy snorers (0.774 mm), but not in men. Snoring during at least one-fourth of a night's sleep is associated independently with subclinical changes in carotid IMT in women only.


atherosclerosis; carotid atherosclerosis; sleep apnea; sleep-related breathing disorders

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