title: Snoring and obstructive sleep apnea among former World Trade Center rescue workers and volunteers.
abstract: BACKGROUND
  Snoring is a common symptom among workers with adverse health effects from their World Trade Center (WTC) occupational exposures. Rhinitis and upper airway disease are highly prevalent among these workers. Rhinitis has been associated with snoring and, in some studies, with obstructive sleep apnea (OSA). We examined the association of WTC exposure and findings on nocturnal polysomnogram, as well as known predictors of OSA in this patient population.
  
  
  METHODS
  One hundred participants with snoring underwent a polysomnogram to exclude OSA. Comorbidities had been previously evaluated and treated. The apnea-hypopnea index (AHI) defined and categorized the severity of OSA. Age, sex, body mass index (BMI), and WTC exposure variables were examined in bivariate and multiple regression analyses.
  
  
  RESULTS
  Our study sample had a similar prevalence of five major disease categories, as we previously reported. OSA was diagnosed in 62% of the patients and was not associated with any of those disease categories. A trend toward increasing AHI with increasing WTC exposure duration failed to reach the statistical significance (P = 0.14) in multiple regression analysis. An elevated AHI was associated with BMI (P = 0.003) and male sex (P < 0.001).
  
  
  CONCLUSIONS
  OSA was associated with BMI and male sex but not with occupational WTC exposure indicators in this patient population.
authors.affiliation: Department of Preventive Medicine, Mount Sinai School of Medicine, New York, NY, USA. Rafael.delaHoz@mssm.edu
authors.forename: Rafael E
authors.initials: RE
authors.lastname: de la Hoz
authors.forename: Rashmi N
authors.initials: RN
authors.lastname: Aurora
authors.forename: Paul
authors.initials: P
authors.lastname: Landsbergis
authors.forename: Laura A
authors.initials: LA
authors.lastname: Bienenfeld
authors.forename: Aboaba A
authors.initials: AA
authors.lastname: Afilaka
authors.forename: Robin
authors.initials: R
authors.lastname: Herbert
mesh_terms: D000328:Adult; D015992:Body Mass Index; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D009765:Obesity / Q000150:complications; D016273:Occupational Exposure / Q000009:adverse effects; D017286:Polysomnography; D015995:Prevalence; D018635:Rescue Work; D012307:Risk Factors; D047851:September 11 Terrorist Attacks; D012737:Sex Factors; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology* / Q000209:etiology*; D012913:Snoring / Q000453:epidemiology* / Q000209:etiology