Skip to main content
SpringerLink
Log in

Self-reported snoring and metabolic syndrome: the Korean Multi-Rural Communities Cohort Study

  • Original Article
  • Published:
Sleep and Breathing Aims and scope Submit manuscript

Abstract

Purpose

We investigated the association between self-reported snoring and metabolic syndrome (MetS) and its components among a community-dwelling Korean population.

Methods

A total of 7,038 subjects participated in the Korean Multi-Rural Communities Cohort Study between January 2005 and February 2010 and were included in the analysis. Frequency of snoring was classified into never, rarely (<1 day/week), occasionally (1–3 days/week), and habitually (≥4 days/week).

Results

In the fully adjusted model, compared to non-snorers, the odds ratio (OR) for MetS of snorers was significantly higher in subjects with rare snoring (OR, 1.42; 95 % confidence interval (CI), 1.23–1.64), occasional snoring (OR, 1.79; 95 % CI, 1.55–2.07), and habitual snoring (OR, 2.03; 95 % CI, 1.77–2.33) than those who did not snore. The ORs for abdominal obesity were significantly higher in rare snoring subjects (OR, 1.51; 95 % CI, 1.30–1.75), occasional snoring (OR, 1.71; 95 % CI, 1.47–1.98), and habitual snoring (OR, 2.07; 95 % CI, 1.80–2.38) than in non-snorers after adjusting for covariates.

Conclusions

Snoring was significantly and linearly associated with MetS, and this association was consistently present in both sexes. Positive and graded associations were observed between snoring frequency and MetS components including high blood pressure, elevated fasting glucose levels, and abdominal obesity, independent of conventional risk factors and other MetS components.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Ayappa I, Rapoport DM (2003) The upper airway in sleep: physiology of the pharynx. Sleep Med Rev 7:9–33

    Article  PubMed  Google Scholar 

  2. Liistro G, Stănescu D, Veriter C (1991) Pattern of simulated snoring is different through mouth and nose. J Appl Physiol 70:2736–2741

    CAS  PubMed  Google Scholar 

  3. Tasali E, Ip MS (2008) Obstructive sleep apnea and metabolic syndrome: alterations in glucose metabolism and inflammation. Proc Am Thorac Soc 5:207–217

    Article  PubMed  Google Scholar 

  4. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (2001) Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 285:2486–2497

    Article  Google Scholar 

  5. Gami AS, Witt BJ, Howard DE, Erwin PJ, Gami LA, Somers VK, Montori VM (2007) Metabolic syndrome and risk of incident cardiovascular events and death: a systematic review and meta-analysis of longitudinal studies. J Am Coll Cardiol 49:403–414

    Article  CAS  PubMed  Google Scholar 

  6. Galassi A, Reynolds K, He J (2006) Metabolic syndrome and risk of cardiovascular disease: a meta-analysis. Am J Med 119:812–819

    Article  CAS  PubMed  Google Scholar 

  7. Nagayoshi M, Tanigawa T, Yamagishi K, Sakurai S, Kitamura A, Kiyama M, Okada T, Maeda K, Ohira T, Imano H, Sato S, Iso H, Investigators CIRCS (2012) Self-reported snoring frequency and incidence of cardiovascular disease: the Circulatory Risk in Communities Study (CIRCS). J Epidemiol 22:295–301

    Article  PubMed Central  PubMed  Google Scholar 

  8. Hu FB, Willett WC, Manson JE, Colditz GA, Rimm EB, Speizer FE, Hennekens CH, Stampfer MJ (2000) Snoring and risk of cardiovascular disease in females. J Am Coll Cardiol 35:308–313

    Article  CAS  PubMed  Google Scholar 

  9. Zamarrón C, Gude F, Otero Otero Y, Rodríguez-Suárez JR (1999) Snoring and myocardial infarction: a 4-year follow-up study. Respir Med 93:108–112

    Article  PubMed  Google Scholar 

  10. Peppard PE, Young T, Palta M, Skatrud J (2000) Prospective study of the association between sleep-disordered breathing and hypertension. N Engl J Med 342:1378–1384

    Article  CAS  PubMed  Google Scholar 

  11. Bixler EO, Vgontzas AN, Lin HM, Ten Have T, Leiby BE, Vela-Bueno A, Kales A (2000) Association of hypertension and sleep-disordered breathing. Arch Intern Med 160:2289–2295

    Article  CAS  PubMed  Google Scholar 

  12. Hu FB, Willett WC, Colditz GA, Ascherio A, Speizer FE, Rosner B, Hennekens CH, Stampfer MJ (1999) Prospective study of snoring and risk of hypertension in women. Am J Epidemiol 150:806–816

    Article  CAS  PubMed  Google Scholar 

  13. Al-Delaimy WK, Manson JE, Willett WC, Stampfer MJ, Hu FB (2002) Snoring as a risk factor for type II diabetes mellitus: a prospective study. Am J Epidemiol 155:387–393

    Article  PubMed  Google Scholar 

  14. Valham F, Stegmayr B, Eriksson M, Hägg E, Lindberg E, Franklin KA (2009) Snoring and witnessed sleep apnea is related to diabetes mellitus in women. Sleep Med 10:112–117

    Article  PubMed  Google Scholar 

  15. Roopa M, Deepa M, Indulekha K, Mohan V (2010) Prevalence of sleep abnormalities and their association with metabolic syndrome among Asian Indians: Chennai Urban Rural Epidemiology Study (CURES-67). J Diabetes Sci Techno 4:1524–1531

    Article  Google Scholar 

  16. Leineweber C, Kecklund G, Akerstedt T, Janszky I, Orth-Gomér K (2003) Snoring and the metabolic syndrome in women. Sleep Med 4:531–536

    Article  PubMed  Google Scholar 

  17. Sabanayagam C, Zhang R, Shankar A (2012) Markers of sleep-disordered breathing and metabolic syndrome in a multiethnic sample of US adults: results from the National Health and Nutrition Examination Survey 2005–2008. Cardiol Res Pract 2012:630802

    PubMed Central  PubMed  Google Scholar 

  18. Cho N, Joo S, Kim J, Abbott RD, Kim J, Kimm K, Shin C (2006) Relation of habitual snoring with components of metabolic syndrome in Korean adults. Diabetes Res Clin Pract 71:256–263

    Article  PubMed  Google Scholar 

  19. Sun L, Pan A, Yu Z, Li H, Shi A, Yu D, Zhang G, Zong G, Liu Y, Lin X (2011) Snoring, inflammatory markers, adipokines and metabolic syndrome in apparently healthy Chinese. PLoS One 6:e27515

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  20. Lee SY, Park HS, Kim DJ, Han JH, Kim SM, Cho GJ, Kim DY, Kwon HS, Kim SR, Lee CB, Oh SJ, Park CY, Yoo HJ (2007) Appropriate waist circumference cutoff points for central obesity in Korean adults. Diabetes Res Clin Pract 75:72–80

    Article  PubMed  Google Scholar 

  21. Gislason T, Benediktsdóttir B, Björnsson JK, Kjartansson G, Kjeld M, Kristbjarnarson H (1993) Snoring, hypertension, and the sleep apnea syndrome. An epidemiologic survey of middle-aged women. Chest 103:1147–1151

    Article  CAS  PubMed  Google Scholar 

  22. Young T, Finn L, Hla KM, Morgan B, Palta M (1996) Snoring as part of a dose–response relationship between sleep-disordered breathing and blood pressure. Sleep 19:S202–S205

    CAS  PubMed  Google Scholar 

  23. Lindberg E, Janson C, Gislason T, Svärdsudd K, Hetta J, Boman G (1998) Snoring and hypertension: a 10 year follow-up. Eur Respir J 11:884–889

    Article  CAS  PubMed  Google Scholar 

  24. Elmasry A, Janson C, Lindberg E, Gislason T, Tageldin MA, Boman G (2000) The role of habitual snoring and obesity in the development of diabetes: a 10-year follow-up study in a male population. J Intern Med 248:13–20

    Article  CAS  PubMed  Google Scholar 

  25. Wall H, Smith C, Hubbard R (2012) Body mass index and obstructive sleep apnoea in the UK: a cross-sectional study of the over-50s. Prim Care Respir J 21:371–376

    Article  PubMed  Google Scholar 

  26. Fletcher EC (2003) Sympathetic over activity in the etiology of hypertension of obstructive sleep apnea. Sleep 26:15–19

    PubMed  Google Scholar 

  27. Marrone O, Riccobono L, Salvaggio A, Mirabella A, Bonanno A, Bonsignore MR (1993) Catecholamines and blood pressure in obstructive sleep apnea syndrome. Chest 103:722–727

    Article  CAS  PubMed  Google Scholar 

  28. Marshall S, Garvey WT, Traxinger RR (1991) New insights into the metabolic regulation of insulin action and insulin resistance: role of glucose and amino acids. FASEB J 5:3031–3036

    CAS  PubMed  Google Scholar 

  29. Saaresranta T, Polo O (2004) Does leptin link sleep loss and breathing disturbances with major public diseases? Ann Med 36:172–183

    Article  CAS  PubMed  Google Scholar 

  30. Gainer JL (1987) Hypoxia and atherosclerosis: re-evaluation of an old hypothesis. Atherosclerosis 68:263–266

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

This study was supported by the Korean Centers for Disease Control and Prevention (grants 2004-E71004-00, 2005-E71011-00, 2006-E71009-00, 2007-E71002-00, 2008-E71004-00, and 2009-E71006-00).

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, South Korea

    Min-Ho Shin & Sun-Seog Kweon

  2. Jeonnam Regional Cancer Center, Chonnam National University Hwasun Hospital, Hwasun, South Korea

    Sun-Seog Kweon

  3. Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul, South Korea

    Bo Youl Choi & Mi Kyung Kim

  4. Health Promotion Research Center, Department of Preventive Medicine, School of Medicine, Kyungpook National University, Daegu, South Korea

    Byung-Yeol Chun

  5. Department of Preventive Medicine, Keimyung University School of Medicine, Daegu, South Korea

    Dong Hoon Shin

  6. Department of Preventive Medicine & Institute of Wonkwang Medical Science, Wonkwang University College of Medicine, 344-2 Shinyong-dong, Iksan, Jeonbuk, 570-711, South Korea

    Young-Hoon Lee

  7. Regional Cardiocerebrovascular Center, Wonkwang University Hospital, Iksan, Jeonbuk, South Korea

    Young-Hoon Lee

Authors
  1. Min-Ho Shin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sun-Seog Kweon
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Bo Youl Choi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mi Kyung Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Byung-Yeol Chun
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Dong Hoon Shin
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Young-Hoon Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Young-Hoon Lee.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Shin, MH., Kweon, SS., Choi, B.Y. et al. Self-reported snoring and metabolic syndrome: the Korean Multi-Rural Communities Cohort Study. Sleep Breath 18, 423–430 (2014). https://doi.org/10.1007/s11325-013-0902-8

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11325-013-0902-8

Keywords

Search

Navigation