Association between self-reported snoring and hypertension: a systematic review and meta-analysis

Effects of modified oropharyngeal exercises on individuals with simple snoring: An online randomized controlled trial

BACKGROUND

Individuals who suffer from simple snoring rarely go to a doctor due to a lack of medical knowledge, but simple snoring can reduce the individual's quality of life and may cause social problems to the bed partner/family members.

OBJECTIVES

The aims of the present study are to explore the effects of online modified oropharyngeal exercises on the individuals with simple snoring and to provide a rehabilitation method for individuals with simple snoring.

METHODS

This study is a double-blinded, two-arm, randomized controlled trial. Participants were enrolled and randomly assigned to the intervention group (n = 33) or the control group (n = 33). The participants in the control group received health education on snoring, while the participants in the intervention group received the modified oropharyngeal exercise besides health education on snoring. The intervention duration was 4 weeks. The primary outcomes included snoring index, snoring loudness, and snoring quantity. The secondary outcomes included self-reported snoring, sleep quality, daytime sleepiness, anxiety symptoms, depression symptoms, and quality of life. All outcomes were measured at baseline, 4 weeks, and 8 weeks.

RESULTS

Generalized estimating equations (GEE) analyses showed significant differences between the intervention group and the control group on snoring index, loudness, and quantity (p < .001). Moreover, modified oropharyngeal exercise had effects on sleep quality, daytime sleepiness, anxiety symptoms, depression symptoms, and quality of life in individuals with simple snoring (p < .001). Self-reported snoring also improved at 8 weeks.

CONCLUSION

The modified oropharyngeal exercises were effective in improving simple snoring. It could also improve sleep quality, daytime sleepiness, anxiety symptoms, depression symptoms, and quality of life.

Snoring is associated with hypertension and diabetes mellitus among adults in north Sudan: a cross-sectional study

BACKGROUND

Different levels of association between snoring, hypertension, and diabetes mellitus (DM) are reported. There are few published studies on this topic in African countries, and no investigation was conducted in Sudan. This study aimed to assess the prevalence and factors associated with snoring and the association between snoring, hypertension, and type 2 DM (T2DM) in northern Sudan.

METHODS

A community-based cross-sectional study using a multistage sampling technique was conducted in four villages in the River Nile state of northern Sudan from July to September 2021. Sociodemographic characteristics were collected using a questionnaire. Body mass index (BMI) was measured using standard methods, and a multivariate analysis was conducted using the Statistical Package for the Social Sciences® (SPSS®) for Windows, version 22.0.

RESULTS

Of the 384 adults, 193 (50.3%) were males and 191 (49.7%) were females. Of the adults, 38 (9.9%) were underweight, 121 (31.5%) had average weight, 113 (29.4%) were overweight, and 112 (29.2%) were obese. One hundred and six (27.6%) adults were snorers. Multivariate analysis showed that increasing age (adjusted odds ratio [AOR] = 1.02, 95% confidence interval [CI] = 1.01‒1.04), increasing BMI (AOR = 1.04, 95 CI = 1.01‒1.08), obesity (AOR = 2.0, 95% CI = 1.10‒3.69), and alcohol consumption (AOR = 2.32, 95% CI = 1.14‒4.74) were positively associated with snoring. Of the 384 adults, 215 (56.0%) had hypertension. Multivariate analysis showed that increasing age (AOR = 1.04, 95% CI = 1.02‒1.06), increasing BMI (AOR = 1.08, 95% CI = 1.04‒1.13), female sex (AOR = 1.7, 95% CI = 1.08‒2.73), and snoring (AOR = 1.69, 95% CI = 1.02‒2.82) were positively associated with hypertension. One hundred and six (27.6%) adults had T2DM. Multivariate analysis showed that increasing age (AOR = 1.03, 95% CI = 1.01‒1.05) and snoring (AOR = 1.78, 95% CI = 1.09‒2.91) were associated with T2DM.

CONCLUSION

Around one-fourth of the adults in Northern Sudan are snorers. Snoring is more common among obese adults. Snoring is associated with increased odds of hypertension and T2DM. Adults who snore must pay close attention to their blood pressure and blood glucose levels to prevent hypertension and DM.

Lifestyle management of hypertension: International Society of Hypertension position paper endorsed by the World Hypertension League and European Society of Hypertension

Hypertension, defined as persistently elevated systolic blood pressure (SBP) >140 mmHg and/or diastolic blood pressure (DBP) at least 90 mmHg (International Society of Hypertension guidelines), affects over 1.5 billion people worldwide. Hypertension is associated with increased risk of cardiovascular disease (CVD) events (e.g. coronary heart disease, heart failure and stroke) and death. An international panel of experts convened by the International Society of Hypertension College of Experts compiled lifestyle management recommendations as first-line strategy to prevent and control hypertension in adulthood. We also recommend that lifestyle changes be continued even when blood pressure-lowering medications are prescribed. Specific recommendations based on literature evidence are summarized with advice to start these measures early in life, including maintaining a healthy body weight, increased levels of different types of physical activity, healthy eating and drinking, avoidance and cessation of smoking and alcohol use, management of stress and sleep levels. We also discuss the relevance of specific approaches including consumption of sodium, potassium, sugar, fibre, coffee, tea, intermittent fasting as well as integrated strategies to implement these recommendations using, for example, behaviour change-related technologies and digital tools.

Does seasonality affect snoring? A study based on international data from the past decade

BACKGROUND

Though snoring is often regarded as a harmless condition that coincides with sound sleep, it is a sleep disorder that can be a potential indicator of more severe conditions such as sleep apnea syndrome. In the present study, we investigated the association between seasonal variations and snoring.

METHOD

Search index for snoring (SIS) data were obtained from Google Trends and Baidu Index. SIS data were collected for the USA, India, Germany, Russia, Japan, Australia, China, and Brazil from 2011 to 2020, with the periodicity of the relationship between seasonal time series data and snoring evaluated using a time series decomposition model.

RESULT

The highest average SIS growth rates from 2011 to 2020 were observed for Brazil, Japan, and Germany, with average SIS values of 94%, 68%, and 49%, respectively. The SIS of the USA, Russia, Japan, Brazil, Australia, Germany, and India increased by 22.3%, 12.4%, 11.9%, 35.4%, 12.3%, 28.0%, and 55.8%, respectively, in comparison with their SIS values in 2019, whereas for China, it decreased by 13.7%. Relative to countries in the southern hemisphere, those in the northern hemisphere showed comparable SIS trends, increasing from September to February and decreasing from March to August.

CONCLUSION

The SIS data showed cyclical changes over the study period. The search index for snoring increased during the cold season or the heating season, suggesting that snoring is associated with seasonal changes.

Sleep Problems Associate With Multimorbidity: A Systematic Review and Meta-analysis

Objectives: To summarize the evidence on the association between sleep problems and multimorbidity. Methods: Six electronic databases (PubMed, Web of Science, Embase, China National Knowledge Infrastructure, VIP, and Wan fang) were searched to identify observational studies on the association between sleep problems and multimorbidity. A random-effects model was used to estimate the pooled odds ratios (ORs) and 95% confidence intervals for multimorbidity. Results: A total of 17 observational studies of 133,575 participants were included. Sleep problems included abnormal sleep duration, insomnia, snoring, poor sleep quality, obstructive sleep apnea (OSA) and restless legs syndrome (RLS). The pooled ORs (95% CIs) for multimorbidity were 1.49 (1.24-1.80) of short sleep duration, 1.21 (1.11-1.44) of long sleep duration and 2.53 (1.85-3.46) for insomnia. The association of other sleep problems with multimorbidity was narratively summarized due to limited number of comparable studies. Conclusion: Abnormal sleep duration and insomnia are associated with higher odds of multimorbidity, while the evidence on association of snoring, poor sleep quality, obstructive sleep apnea and restless legs syndrome with multimorbidity remains inconclusive. Interventions targeting sleep problems should be delivered for better management of multimorbidity.

Lifestyle and the hypertensive disorders of pregnancy in nulliparous women in the United States: a secondary data analysis of the nuMom2b

BACKGROUND

Hypertensive disorders of pregnancy are a leading cause of maternal and fetal morbidity and mortality and a significant risk factor for future cardiovascular disease development in women. This study aimed to explore lifestyle wellness-related variables and how they impact the risk of hypertension in pregnancy.

METHODS

This is a secondary analysis of data from the prospective cohort study Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-To-Be (nuMoM2b). Data was collected through questionnaires, clinical evaluations, and medical records review at 8 academic medical centers in the United States. Four study visits were scheduled throughout the participant's pregnancy (visits one-four): 6⁰-13⁶, 16⁰-21⁶, and 22⁰-29⁶ weeks gestation and birth. A series of statistical modeling and logistical regression were performed using 15 lifestyle variables related to sleep, nutrition, resilience, illness avoidance, and physical activity were selected as predictor variables with an outcome variable of hypertension.

RESULTS

Of 9289 nulliparous participants considered for inclusion in our analyses, 1464 had any HDP during study participation, and 554 participants had complete data available for the study and were included in our final sample. Results were statistically significant at a level of p < 0.05. Of the sleep variables, snoring at visit 1 increased the risk of hypertension in pregnancy. Greater vegetable consumption reported at visit one decreased risks of hypertension in pregnancy. Physical activity reported at visit two and visit three were associated with decreased risk of hypertension. Physical activity reported at visit three combined with more hours of sleep each night, or through napping habit reported at visit one decreased hypertension risk. Increased fish oil consumption combined with more hours of sleep at visit one increased odds of hypertension in pregnancy.

CONCLUSIONS

Our results support that lifestyle wellness-related variables relating to sleep, physical activity and nutrition affect hypertension in pregnancy. The studied variables and others should be considered in future research and intervention development to reduce hypertension in pregnancy and improve maternal wellness.

Association between snoring frequency and male serum testosterone: Findings from the 2015-2016 National Health and Nutrition Examination Survey

BACKGROUND

This study aimed to assess the association between snoring frequency and male serum testosterone levels.

METHODS

We analyzed data from the 2015 to 2016 National Health and Nutrition Examination Survey. Snoring frequency was relied on self-report, and was divided into never, rarely (1-2 nights a week), occasionally (3-4 nights a week), or frequently (5 or more nights a week) groups. Multivariable analysis controlling for age, race, waist circumference, total cholesterol, diabetes, and hypertension was used to evaluate the association between snoring frequency and male serum testosterone. Furthermore, we performed the subgroup analyses stratified by age and waist circumference.

RESULTS

Our analysis included 1900 participants. In the fully adjusted model, only frequent snoring was inversely associated with male serum testosterone (β -0.053, 95% CI -0.101 to -0.006, P = 0.028); According to the subgroup analysis stratified by age, only in 40-59 years group, frequent snoring was inversely associated with male serum testosterone in the fully adjusted model (β -0.113, 95% CI -0.196 to -0.031, P = 0.007). As for the subgroup analysis stratified by waist circumference, our results showed only in the waist circumference ≥102 cm group (abdominal obesity), frequent snoring was inversely associated with male serum testosterone (β -0.133, 95% CI -0.216 to -0.05, P = 0.002).

CONCLUSIONS

Frequent snoring (5 or more nights a week) is inversely associated with male serum testosterone levels, especially in those aged 40-59 years and those with abdominal obesity.