Self-reported habitual snoring and risk of cardiovascular disease and all-cause mortality

Abstract

Objective: Inconsistent findings have reported the association between self-reported habitual snoring and risk of cardiovascular disease (CVD) and all-cause mortality. We conducted a meta-analysis to investigate whether self-reported habitual snoring was an independent predictor for CVD and all-cause mortality using prospective observational studies.

Methods: Electronic literature databases (PubMed, Medline, Embase, Cochrane Library, Wanfang database, and China National Knowledge Infrastructure) were searched for publications prior to September 2013. Only prospective studies evaluating baseline habitual snoring and subsequent risk of CVD and all-cause mortality were selected. Pooled adjust hazard risk (HR) and corresponding 95% confidence intervals (CI) were calculated for categorical risk estimates.

Results: Eight studies with 65,037 subjects were analyzed. Pooled adjust HR was 1.26 (95% CI 0.98-1.62) for CVD, 1.15 (95% CI 1.05-1.27) for coronary heart disease (CHD), and 1.26 (95% CI 1.11-1.43) for stroke comparing habitual snoring to non-snorers. Pooled adjust HR was 0.98 (95% CI 0.78-1.23) for all-cause mortality in a random effect model comparing habitual snoring to non-snorers. Habitual snoring appeared to increase greater stroke risk among men (HR 1.54; 95% CI: 1.09-2.17) than those in women (HR 1.22; 95% CI: 1.05-1.41).

Conclusions: Self-reported habitual snoring is a mild but statistically significant risk factor for stroke and CHD, but not for CVD and all-cause mortality. However, whether the risk is attributable to obstructive sleep apnea syndrome or snoring alone remains controversial.

Keywords: All-cause mortality; Cardiovascular disease; Habitual snoring; Meta-analysis; Stroke.