title: Heavy snoring as a cause of carotid artery atherosclerosis.
abstract: OBJECTIVE
  Previous studies have suggested that snoring and obstructive sleep apnea hypopnea syndrome may be important risk factors for the development of carotid atherosclerosis and stroke. However, it is not clear if snoring per se is independently related to the risk of developing carotid atherosclerotic plaque.
  
  
  METHODS
  Observational cohort study.
  
  
  METHODS
  Volunteer sample examined in a sleep laboratory.
  
  
  METHODS
  One hundred ten volunteers (snorers and nonsnorers with only mild, nonhypoxic obstructive sleep apnea hypopnea syndrome) underwent polysomnography with quantification of snoring, bilateral carotid and femoral artery ultrasound with quantification of atherosclerosis, and cardiovascular risk factor assessment. Subjects were categorized into 3 snoring groups: mild (0%-25% night snoring), moderate (> 25%-50% night snoring), and heavy (> 50% night snoring).
  
  
  METHODS
  N/A.
  
  
  RESULTS
  The prevalence of carotid atherosclerosis was 20% with mild snoring, 32% with moderate snoring, and 64% with heavy snoring (P < 0.04, X2). Logistic regression analysis was used to determine the independent effect of snoring on the prevalence of carotid and femoral atherosclerosis. After adjustment for age, sex, smoking history, and hypertension, heavy snoring was significantly associated with carotid atherosclerosis (odds ratio 10.5; 95% confidence interval 2.1-51.8; P = 0.004) but not with femoral atherosclerosis.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Ludwig Engel Centre for Respiratory Research, Westmead Hospital, Westmead, NSW, Australia. sharon_lee@wmi.usyd.edu.au
authors.forename: Sharon A
authors.initials: SA
authors.lastname: Lee
authors.forename: Terence C
authors.initials: TC
authors.lastname: Amis
authors.forename: Karen
authors.initials: K
authors.lastname: Byth
authors.forename: George
authors.initials: G
authors.lastname: Larcos
authors.forename: Kristina
authors.initials: K
authors.lastname: Kairaitis
authors.forename: Tracey D
authors.initials: TD
authors.lastname: Robinson
authors.forename: John R
authors.initials: JR
authors.lastname: Wheatley
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D017286:Polysomnography; D012307:Risk Factors; D012913:Snoring / Q000150:complications* / Q000453:epidemiology; D018615:Ultrasonography, Doppler, Color
chemical_list: D010100:Oxygen
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