All too often, snoring is regarded as a nuisance rather than a real health problem. People who snore—and the partners who must listen to their snoring at night—usually have no problem acknowledging that snoring is disruptive and uncomfortable. But most don’t look for actual treatment for their snoring, particularly if it is not accompanied by obstructive sleep apnea, a serious sleep disorder that is characterized by interruptions to breathing during sleep.
Snoring—with or without sleep apnea—is a very real health concern. Snoring is a sign of disrupted sleep, which can lead to many health problems. And new research suggests that snoring itself may increase the risk of cardiovascular disease.
Researchers at Detroit’s Henry Ford Hospital investigated the possible effects of snoring on the cardiovascular system. They found that snoring is associated with a thickening of the inner walls of the carotid arteries. The carotid arteries are responsible for carrying blood to the brain. This thickening of the arterial wall is an early sign of carotid artery disease, a narrowing or blocking of the arteries that increases the risk of stroke. Researchers also found that people who snore were more likely to suffer from this arterial thickening than others with more widely known risk factors for cardiovascular disease, including smokers, people who are overweight, and those with high blood pressure and high cholesterol.
Researchers examined data from 913 patients who sought treatment at Henry Ford Hospital’s sleep clinic. All the participants were between the ages of 18-50, and none of them had obstructive sleep apnea. Of this group, 54 men and women completed a survey about their snoring histories. They also received ultrasounds to measure the thickness of the intima-media of the carotid artery wall. Intima-media thickness is a measurement of the two innermost layers of the carotid artery wall. Thickening of the intima-media layers is considered a sign of elevated risk for cardiovascular disease.
People who snored had greater levels of intima-media thickness than those who did not snore, according to the study results. Snoring was alone among risk factors that associated with this abnormality to the carotid arteries. Researchers found no increase in intima-media thickness among people with other standard risk factors for cardiovascular risk factors, including obesity, smoking, diabetes, high blood pressure and high cholesterol.
This study is one of the first to show evidence of an increased risk to cardiovascular health from snoring. There is abundant evidence that obstructive sleep apnea is associated with increased risk of cardiovascular disease. Obstructive sleep apnea is also associated with a growing array of other health problems, including diabetes, cancer and sexual dysfunction in both men and women. Snoring is a frequent symptom of obstructive sleep apnea—but not everyone who snores has sleep apnea. Overall, much less attention has been paid to the possible health problems of snoring when it is not accompanied by sleep apnea. The research that has been done in this area has returned conflicting evidence regarding the health risks associated with snoring.
- A limited amount of research has indicated that snoring does not pose risk to cardiovascular health. Australian researchers conducted a long-term study of nearly 400 adults and found no increased risk of cardiovascular disease or death from snoring.
- Other studies have suggested that snoring is associated with other risk factors for cardiovascular disease, but that there is no direct relationship between snoring and cardiovascular problems. Among these risk factors are obesity, smoking, and alcohol consumption.
- Still other research indicates a more direct link between snoring and cardiovascular disease. This study conducted in Hungary found increased risk of cardiovascular disorders among men and women who snore. Researchers in this study adjusted for other common risk factors, such as obesity, in order to isolate the effect of snoring on cardiovascular health.
The latest research appears to offer new evidence of a direct connection between snoring and the development of cardiovascular problems. Researchers indicate that they intend to follow this work with another study to investigate a possible association between snoring and cardiovascular events, such as heart attack and stroke.
It is important to take snoring seriously as a health problem. While we wait for science to develop a greater understanding of the ways that snoring may negatively affect health, there are things we all can do to diminish the risk of snoring:
Maintain a healthy weight. Snoring appears to be closely associated with excess weight. Keeping your weight in check through regular exercise and healthy diet is one way to prevent, reduce and even eliminate snoring.
Drink moderately. Alcohol relaxes the muscles in the throat, and makes snoring more likely. Keep your alcohol consumption moderate, and drink no closer than 3 hours before bedtime, to avoid having alcohol interfere with your sleep and increase your risk of snoring.
Don’t smoke. Smoking irritates and inflames the tissues of the upper airway, and increases the likelihood of snoring. Improving your sleep and reducing your snoring is another very good reason to quit.
Talk to your doctor. It is important to let your physician know if you snore, no matter how mild you believe your snoring to be. Your doctor can advise you on the best strategies for treatment, including mouth guards and dental devices that can help keep your airway open during sleep. Your doctor can also monitor your condition in the event it progresses to obstructive sleep apnea.
Just because snoring is common doesn’t mean it’s harmless. Protect your health and take your snoring seriously.
Michael J. Breus, PhD
The Sleep Doctor™