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Duygulu G. Relationship of aberrant internal carotid artery with pharyngeal wall in obstructive sleep apnea. Sleep Breath 2023; 27:2415-2422. [PMID: 37391540 DOI: 10.1007/s11325-023-02871-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 05/26/2023] [Accepted: 06/09/2023] [Indexed: 07/02/2023]
Abstract
PURPOSE Obstructive sleep apnea (OSA) is a common clinical condition in which the upper airway partially or completely narrows or collapses during sleep. The objective of our research was to examine the relation between the abnormal internal carotid artery (ICA) and the pharyngeal wall among individuals suffering from OSA, and to compare it to a group of control subjects. METHODS In this retrospective study, the closest distances of the ICA to the pharyngeal walls and midlines were measured on CT images and compared between groups. RESULTS The closest distance of the ICA to the right pharyngeal wall was 3.8 ± 2.4 mm and the closest distance to the left pharyngeal wall was 4.1 ± 2.3 mm in patients with OSA, which was significantly less than the controls (respectively, 4.4 ± 1.6 mm and 14.4 ± 1.7 mm) (p < 0.001). The closest distances of the ICA to the right and left pharyngeal walls (p = 0.001) and to the right and left midline (p = 0.00002) were significantly lower in patients with moderate to severe OSA compared to mild patients according to apnea / hypopnea index (AHI). In the retroglossal bifurcation of the common carotid artery (CCA), the closest distances of the ICA to the right (p = 0.027) and left pharyngeal walls (p = 0.018) and to the right (p = 0.01) and left midline (p = 0.012) were significantly lower than the retroepiglottic bifurcation of the CCA. CONCLUSION We observed that the distance of the aberrant ICA to the pharyngeal wall is less in individuals with OSA than in individuals without OSA, the distance of the aberrant ICA to the pharyngeal wall decreased as the severity of AHI increased.
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Affiliation(s)
- Gokhan Duygulu
- Department of Radiology, Izmir Katip Celebi University Ataturk Research and Training Hospital, Izmir, 35360, Turkey.
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Tian Y, Li D, Mu H, Wei S, Guo D. Positive correlation between snoring and dyslipidemia in adults: results from NHANES. Lipids Health Dis 2023; 22:73. [PMID: 37328831 DOI: 10.1186/s12944-023-01839-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 05/29/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND A few studies have shown that snoring, in certain populations, is associated with dyslipidemia. However, there are currently no large-scale national studies available that explore this association. Thus, for further clarification, studies using a large sample of the general population need to be conducted. This study aimed to explore this association using the National Health and Nutrition Examination Survey (NHANES) database. METHODS A cross-sectional survey was conducted using data from the NHANES database; 2005 to 2008 and 2015 to 2018 datasets were used (weighted to be representative of United States adults aged ≥ 20 years). Information on snoring status, lipid levels, and confounding factors were included. Logistic regression of the generalized linear model was used to analyze the relationship between snoring and dyslipidemia, and hierarchical analysis, interaction analysis, and sensitivity analysis were used to explore the stability of the results. RESULTS Data from 28,687 participants were analyzed, and 67% of the participants had some degree of snoring. The fully adjusted multivariate logistic regression results demonstrated that snoring frequency was significantly positively associated with dyslipidemia (P < 0.001 for linear trend). Adjusted odds ratios (aORs) of dyslipidemia among those who snored rarely, occasionally, and frequently were 1.1 (95% confidence interval [CI], 1.02-1.18), 1.23 (95% CI, 1.10-1.38), and 1.43 (95% CI, 1.29-1.58), respectively, compared with that among those who never snored. In addition, age and snoring frequency showed a correlation (P = 0.02). Sensitivity analysis demonstrated that frequent snoring was significantly associated with lipid levels (all P ≤ 0.01 for linear trend), including increased low-density lipoprotein cholesterol (LDL-C) (β = 0.09 mmol/L; 95% CI, 0.02-0.16), triglyceride (TG) (β = 0.18 mmol/L; 95% CI, 0.10-0.26), total cholesterol (TC) (β = 0.11 mmol/L; 95% CI, 0.05-0.16), and decreased high-density lipoprotein cholesterol (HDL-C) (β=-0.04 mmol/L; 95% CI, -0.06--0.03). CONCLUSIONS A statistically significant positive association was identified between sleep snoring and dyslipidemia. It was suggested that sleep snoring interventions may reduce the risk of dyslipidemia.
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Affiliation(s)
- Ying Tian
- Clinical Research Center, Affiliated Hospital of Shandong, University of Traditional Chinese Medicine, Jinan, China
| | - Dongna Li
- Department of Cardiology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Huijuan Mu
- Drug clinical trial facility, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Sining Wei
- Prevention and treatment center, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Dong Guo
- Basic Medical School, College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China.
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Carotid Ultrasound Screening Programs in Rural Communities: A Systematic Review. J Pers Med 2021; 11:jpm11090897. [PMID: 34575673 PMCID: PMC8465856 DOI: 10.3390/jpm11090897] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 09/01/2021] [Accepted: 09/02/2021] [Indexed: 01/04/2023] Open
Abstract
Carotid atherosclerosis assessments inform about stroke and cardiovascular risk. It is known that stroke and cardiovascular disease (CVD) prevalence is higher in rural communities than in urban communities. We aimed to conduct a systematic review of rural carotid ultrasound screening programs to define carotid atherosclerosis using traditional and emerging imaging biomarkers, prevalence, and risk factors. We searched Ovid/MEDLINE, Ovid/EMBASE, SCOPUS and CINAHL from inception to 3 April 2020 for rural population studies that utilized carotid ultrasound screening for adults ≥40 years of age and free of known cerebrovascular disease. Studies were included if participants received a bilateral ultrasound scanning of the carotid arteries and reported at least one marker of carotid atherosclerosis pathology. A random effect meta-analyses calculated the estimated prevalence of carotid plaque. In total, 22/3461 articles that met all of the inclusion criteria were included. Studies reported increased intima media thickness (IMT), carotid plaque presence and carotid artery stenosis. There were no studies reporting on novel imaging markers, such as carotid stiffness, carotid plaque morphology or neovascularization. The overall random effect pooled prevalence of carotid plaque was 34.1% (95% CI, 33.6–35.0); the prevalence of increased IMT was 11.2–41.5%, and the prevalence of carotid artery stenosis was 0.4–16.0%. There is an absence of data necessary to understand the carotid atherosclerosis prevalence across global rural populations. Represented studies have focused on East Asian countries where a high burden of rural carotid artery disease has been reported. There is no rural evidence to guide the use of novel ultrasound carotid biomarkers such as stiffness or neovascularization.
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Dai N, Shi Q, Hua Y, Guo Y, Bian Z, Li L, Chen Z, Wu M, Lu Y. Snoring frequency and risk of type 2 diabetes mellitus: a prospective cohort study. BMJ Open 2021; 11:e042469. [PMID: 33986040 PMCID: PMC8126309 DOI: 10.1136/bmjopen-2020-042469] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE To evaluate the association between snoring frequency and type 2 diabetes mellitus (T2DM) according to age and gender in Chinese population. DESIGN A cohort study was performed in Suzhou site of the China Kadoorie Biobank. Residents who didn't suffer from T2DM at baseline survey (2004-2008) and in half a year after baseline were enrolled in this study and followed cause-specific morbidity until 31 December 2013. All participants were requested to complete a detailed questionnaire and undergo anthropometric measurements. Cox regression models were used to estimate HRs and 95% CIs for the snoring and T2DM association. SETTING Wuzhong district, Suzhou, China. PARTICIPANTS A total of 49 453 participants (men: 41.8%; mean age: 51.14±10.28 years) were enrolled in this study. OUTCOME MEASURES T2DM cases were defined as International Classification of Diseases 10th Revision code of E11 and were identified through disease registries and health insurance databases. RESULTS During a media of 7.18 years follow-up, 1120 T2DM cases were identified. Higher T2DM incidence was observed in participants with frequent and occasional snoring compared with those without (4.80 and 2.87 vs 2.39 per 1000 person-years). The multivariable-adjusted model found snoring was independently associated with T2DM (HR 1.28, 95% CI 1.20 to 1.38), both in men (HR 1.25, 95% CI 1.10 to 1.41) and women (HR 1.28, 95% CI 1.17 to 1.39). Moreover, a significant multiplicative interaction effect between snoring and age was detected on T2DM risk (p=0.015). CONCLUSIONS Snoring was independently associated with an increased risk of T2DM in Chinese population, both in men and women. Meanwhile, there was an interaction effect between snoring and age on T2DM risk.
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Affiliation(s)
- Ningbin Dai
- Suzhou Center for Disease Control and Prevention, Suzhou, China
| | - Qianwen Shi
- Suzhou Center for Disease Control and Prevention, Suzhou, China
| | - Yujie Hua
- Suzhou Center for Disease Control and Prevention, Suzhou, China
| | - Yu Guo
- Chinese Academy of Medical Sciences, Beijing, China
| | - Zheng Bian
- Chinese Academy of Medical Sciences, Beijing, China
| | - Liming Li
- School of Public Health, Peking University, Beijing, China
| | - Zhengming Chen
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Ming Wu
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Yan Lu
- Suzhou Center for Disease Control and Prevention, Suzhou, China
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Taylor C, Kline CE, Rice TB, Duan C, Newman AB, Barinas-Mitchell E. Snoring severity is associated with carotid vascular remodeling in young adults with overweight and obesity. Sleep Health 2021; 7:161-167. [PMID: 33402252 DOI: 10.1016/j.sleh.2020.12.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 12/11/2020] [Accepted: 12/15/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND Snoring is often used as a surrogate measure for obstructive sleep apnea (OSA), a sleep disorder associated with cardiovascular disease (CVD) risk. Whether snoring is linked to CVD independent of OSA remains unclear. We aimed to explore the snoring and subclinical CVD association in adults with and without OSA. METHODS We conducted a cross-sectional study in 122 overweight/obese participants (24% male; mean age 40.1 years) attending the 24-month follow-up visit of a lifestyle intervention. Using home-based objective measures of sleep-disordered breathing, we stratified participants into 3 snoring/OSA categories using the snoring index (SI), a measure of snoring vibration, and oxygen desaturation index (ODI): (1) OSA (ODI ≥ 5), (2) non-OSA heavy snorer (ODI <5, above-median SI), and (3) non-OSA low snorer (ODI <5, below-median SI). Vascular measures including pulse wave velocity ([PWV]; carotid-femoral [cf], femoral-ankle [fa], brachial-ankle [ba]), carotid intima-media thickness (IMT), and carotid interadventitial diameter (IAD) were compared across snoring/OSA categories. Linear regressions assessed the association between snoring and subclinical CVD independent of traditional CVD risk factors. RESULTS Compared to non-OSA low snorers, common carotid IMT and IAD were higher in non-OSA heavy snorers, and faPWV, IMT, and IAD were higher among those with OSA. The difference between non-OSA heavy snorers and low snorers persisted after adjusting for age, race, sex, blood pressure, body mass index, lipids, and insulin resistance (P < .05 for IMT and IAD). CONCLUSIONS In overweight/obese young to middle-aged adults, objectively measured snoring was related to vascular remodeling in those without OSA. Snoring may contribute to CVD risk but warrants further examination in larger prospective cohorts.
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Affiliation(s)
- Christy Taylor
- School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Christopher E Kline
- Department of Health and Human Development, University of Pittsburgh, Pittsburgh Pennsylvania, USA
| | - Thomas B Rice
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Chunzhe Duan
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Anne B Newman
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Emma Barinas-Mitchell
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
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Vishnu A, Choo J, Kadota A, Barinas-Mitchell EJM, Fujiyoshi A, Long DL, Hisamatsu T, Ahuja V, Nakamura Y, Evans RW, Miura K, Masaki KH, Shin C, Ueshima H, Sekikawa A. Comparison of carotid plaque burden among healthy middle-aged men living in the US, Japan, and South Korea. Int J Cardiol 2019; 266:245-249. [PMID: 29887456 DOI: 10.1016/j.ijcard.2018.03.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Revised: 12/22/2017] [Accepted: 03/03/2018] [Indexed: 01/07/2023]
Abstract
BACKGROUND Carotid plaque has emerged as a marker of coronary heart disease (CHD) risk. Comparison of carotid plaque burden between different race/ethnic groups may provide a relative estimate of their future CHD risk. METHODS We conducted a population-based study among apparently healthy middle-aged men aged 40-49 years (ERA JUMP study (n = 924)) and recruited 310 Whites in Pittsburgh, US, 313 Japanese in Otsu, Japan, and 301 Koreans in Ansan, South Korea. The number of carotid plaque and CHD risk factors was assessed using a standardized protocol across all centers. The burden of carotid plaque was compared between race/ethnic groups after adjustment for age and BMI, and after multivariable adjustment for other CHD risk factors using marginalized zero-inflated Poisson regression models. Cross-sectional associations of risk factors with plaque were examined. RESULTS Whites (22.8%) had more than four-fold higher prevalence (p < 0.01) of carotid plaque than Japanese men (4.8%) while the prevalence among Koreans was 10.6%. These differences remained significant after adjustment for age, BMI as well as other risk factors - incidence density ratio (95% confidence interval) for plaque was 0.13 (0.07, 0.24) for Japanese and 0.32 (0.18, 0.58) for Koreans as compared to Whites. Age, hypertension and diabetes were the only risk factors significantly associated with presence of carotid plaque in the overall population. CONCLUSION Whites have significantly higher carotid plaque burden than men in Japan and Korea. Lower carotid plaque burden among Japanese and Koreans is independent of traditional CVD risk factors.
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Affiliation(s)
- Abhishek Vishnu
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States; The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Department of Biostatistics, School of Public Health, West Virginia University, Morgantown, WV, United States.
| | - Jina Choo
- College of Nursing, Korea University, Seoul, South Korea
| | - Aya Kadota
- Department of School Nursing and Health Education, Osaka Kyoiku University, Kashiwara, Osaka, Japan
| | - Emma J M Barinas-Mitchell
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Akira Fujiyoshi
- Department of Health Science, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Dorothy Leann Long
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Takashi Hisamatsu
- Department of Health Science, Shiga University of Medical Science, Otsu, Shiga, Japan; Department of Environmental Medicine and Public Health, Faculty of Medicine, Shimane University, Izumo, Japan
| | - Vasudha Ahuja
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Yasuyuki Nakamura
- The First Department of Internal Medicine, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Rhobert W Evans
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Katsuyuki Miura
- Department of Health Science, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Kamal H Masaki
- Department of Geriatric Medicine, University of Hawaii, Honolulu, HI, United States
| | - Chol Shin
- Division of Pulmonary Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea
| | - Hirotsugu Ueshima
- Department of Health Science, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Akira Sekikawa
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
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Xi J, Wang Z, Talaat K, Glide-Hurst C, Dong H. Numerical study of dynamic glottis and tidal breathing on respiratory sounds in a human upper airway model. Sleep Breath 2017; 22:463-479. [PMID: 29101633 DOI: 10.1007/s11325-017-1588-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 09/30/2017] [Accepted: 10/24/2017] [Indexed: 11/24/2022]
Abstract
BACKGROUND Human snores are caused by vibrating anatomical structures in the upper airway. The glottis is a highly variable structure and a critical organ regulating inhaled flows. However, the effects of the glottis motion on airflow and breathing sound are not well understood, while static glottises have been implemented in most previous in silico studies. The objective of this study is to develop a computational acoustic model of human airways with a dynamic glottis and quantify the effects of glottis motion and tidal breathing on airflow and sound generation. METHODS Large eddy simulation and FW-H models were adopted to compute airflows and respiratory sounds in an image-based mouth-lung model. User-defined functions were developed that governed the glottis kinematics. Varying breathing scenarios (static vs. dynamic glottis; constant vs. sinusoidal inhalations) were simulated to understand the effects of glottis motion and inhalation pattern on sound generation. Pressure distributions were measured in airway casts with different glottal openings for model validation purpose. RESULTS Significant flow fluctuations were predicted in the upper airways at peak inhalation rates or during glottal constriction. The inhalation speed through the glottis was the predominating factor in the sound generation while the transient effects were less important. For all frequencies considered (20-2500 Hz), the static glottis substantially underestimated the intensity of the generated sounds, which was most pronounced in the range of 100-500 Hz. Adopting an equivalent steady flow rather than a tidal breathing further underestimated the sound intensity. An increase of 25 dB in average was observed for the life condition (sine-dynamic) compared to the idealized condition (constant-rigid) for the broadband frequencies, with the largest increase of approximately 40 dB at the frequency around 250 Hz. CONCLUSION Results show that a severely narrowing glottis during inhalation, as well as flow fluctuations in the downstream trachea, can generate audible sound levels.
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Affiliation(s)
- Jinxiang Xi
- Department of Mechanical and Biomedical Engineering, California Baptist University, 432 Magnolia Ave, Riverside, CA, 92504, USA.
| | - Zhaoxuan Wang
- Department of Mechanical and Industrial Engineering, University of Toronto, Toronto, ON, Canada
| | - Khaled Talaat
- Department of Mechanical and Biomedical Engineering, California Baptist University, 432 Magnolia Ave, Riverside, CA, 92504, USA
| | - Carri Glide-Hurst
- Department of Radiation Oncology, Henry Ford Health System, Detroit, MI, USA
| | - Haibo Dong
- Department of Mechanical and Aerospace Engineering, University of Virginia, Charlottesville, VA, USA
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Lee YH, Kweon SS, Choi JS, Nam HS, Park KS, Choi SW, Oh SH, Kim SA, Shin MH. A Gender-Specific Association between Self-Reported Snoring and Hemoglobin A1c Levels in a General Population without Type 2 Diabetes Mellitus. Yonsei Med J 2017; 58:1152-1159. [PMID: 29047239 PMCID: PMC5653480 DOI: 10.3349/ymj.2017.58.6.1152] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 08/03/2017] [Accepted: 08/08/2017] [Indexed: 01/26/2023] Open
Abstract
PURPOSE We explored whether a gender difference was evident in terms of the associations of snoring with hemoglobin A1c (HbA1c) and homeostatic model assessment-insulin resistance (HOMA-IR) levels in a healthy population without type 2 diabetes mellitus (DM). MATERIALS AND METHODS We analyzed 2706 males and 4080 females who participated in the baseline survey of the Namwon Study. In terms of self-reported snoring frequency, participants were classified as non-snorers or occasional (1-3 days/week), frequent (4-6 days/week), or constant (7 days/week) snorers. Participants with DM, defined as a fasting blood glucose level ≥126 mg/dL and/or use of insulin or hypoglycemic medication, were excluded from the analysis. RESULTS In females, the fully adjusted mean (95% confidence interval) HbA1c levels in non-snorers and in occasional, frequent, and constant snorers were 5.53% (5.47-5.59%), 5.53% (5.47-5.59%), 5.57% (5.49-5.64%), and 5.57% (5.51-5.64%), respectively, reflecting a dose-response relationship (p trend=0.004). Compared with female non-snorers, the risk of an elevated HbA1c level (top quintile, ≥5.9%) in constant snorers remained significant (odds ratio 1.30, 95% confidence interval 1.02-1.66) after full adjustment. In addition, in females, a significant linear trend in HbA1c level odds ratio by increased snoring frequency was apparent (p trend=0.019 in model 3). In contrast, no significant association between snoring frequency and HbA1c level was identified in males. No significant association between snoring frequency and HOMA-IR was detected in either gender. CONCLUSION We discovered a gender-specific association between snoring and HbA1c level in a healthy, community-dwelling population free of DM.
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Affiliation(s)
- Young Hoon Lee
- Department of Preventive Medicine & Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Korea
- Regional Cardiocerebrovascular Center, Wonkwang University Hospital, Iksan, Korea
| | - Sun Seog Kweon
- Department of Preventive Medicine, Chonnam National University Medical School, Hwasun, Korea
- Jeonnam Regional Cancer Center, Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Jin Su Choi
- Department of Preventive Medicine, Chonnam National University Medical School, Hwasun, Korea
| | - Hae Sung Nam
- Department of Preventive Medicine, Chungnam National University College of Medicine, Daejeon, Korea
| | - Kyeong Soo Park
- Department of Preventive Medicine, Seonam University College of Medicine, Namwon, Korea
| | - Seong Woo Choi
- Department of Preventive Medicine, Chosun University Medical School, Gwangju, Korea
| | - Su Hyun Oh
- Department of Preventive Medicine, Chonnam National University Medical School, Hwasun, Korea
| | - Sun A Kim
- Department of Preventive Medicine, Chonnam National University Medical School, Hwasun, Korea
| | - Min Ho Shin
- Department of Preventive Medicine, Chonnam National University Medical School, Hwasun, Korea
- Center for Creative Biomedical Scientists, Chonnam National University, Gwangju, Korea.
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Scheffler P, Pang KP, Rotenberg BW. Should patients with primary snoring be screened for carotid artery stenosis? Laryngoscope 2017; 127:2687-2688. [PMID: 28699303 DOI: 10.1002/lary.26755] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2017] [Indexed: 11/09/2022]
Affiliation(s)
- Patrick Scheffler
- Department of Otolaryngology- Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Kenny P Pang
- Department of Otolaryngology, Asia Sleep Centre, Singapore
| | - Brian W Rotenberg
- Department of Otolaryngology-Head and Neck Surgery, University of Western Ontario, London, Ontario, Canada
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Ahn YB, Shin MS, Han DH, Sukhbaatar M, Kim MS, Shin HS, Kim HD. Periodontitis is associated with the risk of subclinical atherosclerosis and peripheral arterial disease in Korean adults. Atherosclerosis 2016; 251:311-318. [DOI: 10.1016/j.atherosclerosis.2016.07.898] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 07/06/2016] [Accepted: 07/12/2016] [Indexed: 10/21/2022]
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The Frequency and Energy of Snoring Sounds Are Associated with Common Carotid Artery Intima-Media Thickness in Obstructive Sleep Apnea Patients. Sci Rep 2016; 6:30559. [PMID: 27469245 PMCID: PMC4965750 DOI: 10.1038/srep30559] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 06/30/2016] [Indexed: 12/28/2022] Open
Abstract
Obstructive sleep apnea (OSA) is a known risk factor for atherosclerosis. We investigated the association of common carotid artery intima-media thickness (CCA-IMT) with snoring sounds in OSA patients. A total of 30 newly diagnosed OSA patients with no history of cardiovascular diseases were prospectively enrolled for measuring mean CCA-IMT with B-mode ultrasonography, body mass index, metabolic syndrome, 10-year cardiovascular disease risk score, high-sensitivity C-reactive protein, and homocysteine. Good-quality signals of full-night snoring sounds in an ordinary sleep condition obtained from 15 participants were further acoustically analyzed (Included group). All variables of interest were not significantly different (all p > 0.05) between the included and non-included groups except for diastolic blood pressure (p = 0.037). In the included group, CCA-IMT was significantly correlated with snoring sound energies of 0–20 Hz (r = 0.608, p = 0.036) and 652–1500 Hz (r = 0.632, p = 0.027) and was not significantly associated with that of 20–652 Hz (r = 0.366, p = 0.242) after adjustment for age and sex. Our findings suggest that underlying snoring sounds may cause carotid wall thickening and support the large-scale evaluation of snoring sound characters as markers of surveillance and for risk stratification at diagnosis.
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Kalchiem-Dekel O, Westreich R, Regev A, Novack V, Goldberg M, Maimon N. Snoring intensity and excessive daytime sleepiness in subjects without obstructive sleep apnea. Laryngoscope 2016; 126:1696-701. [DOI: 10.1002/lary.25876] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 11/10/2015] [Accepted: 12/21/2015] [Indexed: 12/15/2022]
Affiliation(s)
- Or Kalchiem-Dekel
- Institute of Pulmonology and Department of Medicine B, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev; Beer-Sheva Israel
| | - Roi Westreich
- Institute of Pulmonology and Department of Medicine B, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev; Beer-Sheva Israel
| | - Adi Regev
- Clinical Research Center, Soroka University Medical Center; Beer-Sheva Israel
| | - Victor Novack
- Clinical Research Center, Soroka University Medical Center; Beer-Sheva Israel
| | - Mordechai Goldberg
- Clinical Research Center, Soroka University Medical Center; Beer-Sheva Israel
| | - Nimrod Maimon
- Institute of Pulmonology and Department of Medicine B, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev; Beer-Sheva Israel
- Division of Respirology; Department of Medicine; University of Toronto and University Health Network; Toronto Ontario Canada
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Cicero AFG, Morbini M, Urso R, Rosticci M, Parini A, Grandi E, D'Addato S, Borghi C. Association between self-reported snoring and arterial stiffness: data from the Brisighella Heart Study. Intern Emerg Med 2016; 11:77-83. [PMID: 26415727 DOI: 10.1007/s11739-015-1310-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2015] [Accepted: 08/20/2015] [Indexed: 01/13/2023]
Abstract
The correlation of both obstructive sleep apnoea syndrome (OSAS) and snoring with cardiovascular risk is well known, but its investigation is complex and not suitable for studying large cohorts of subjects. Thus, we prospectively evaluated 1476 non-pharmacologically treated subjects selected from the last survey of the Brisighella Heart Study. Snoring and sleep apnoea were investigated asking the subjects if they were aware of snoring during the night, and if this was associated with episodes of apnoea. A full set of clinical and laboratory parameters were evaluated, while augmentation index (AIx), and pulse wave velocity (PWV) were recorded with the Vicorder(®) apparatus. A logistic regression analysis identifies as main independent predictors of AIx age (OR 1.058, 95% CI 1.043-1.065, p < 0.001), Body Mass Index (OR 1.046, 95% CI 1.014-1.079, p = 0.005), and apolipoprotein B (OR 1.014, 95% CI 1.004-1.023, p = 0.001). The main independent predictors of PWV are snoring (OR 1.215, 95% CI 1.083-1.390, p < 0.001), and snoring with apnoea (OR 1.351, 95% CI 1.135-1.598, p = 0.014), age (OR 1.078, 95% CI 1.052-1.089, p < 0.001), serum uric acid [SUA] (OR 1.093, 95% CI 1.026-1.151, p < 0.001) and mean arterial pressure (OR 1.042, 95% CI 1.024-1.056, p < 0.001). In conclusion, in our cohort of overall healthy subjects, self-reported snoring and sleep apnoea are independently associated with a higher PVW, and AIx is statistically significantly higher in snorers with or without sleep apnoea than in non-snorers. Body Mass Index and apolipoprotein B are associated with AIx, while SUA and mean arterial pressure are related to PWV.
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Affiliation(s)
- Arrigo F G Cicero
- Medical and Surgical Sciences Department, U.O. Medicina Interna Borghi, Sant'Orsola-Malpighi University Hospital, University of Bologna, Via Albertoni, 15, 40138, Bologna, Italy.
| | - Martino Morbini
- Medical and Surgical Sciences Department, U.O. Medicina Interna Borghi, Sant'Orsola-Malpighi University Hospital, University of Bologna, Via Albertoni, 15, 40138, Bologna, Italy
| | - Riccardo Urso
- Medical and Surgical Sciences Department, U.O. Medicina Interna Borghi, Sant'Orsola-Malpighi University Hospital, University of Bologna, Via Albertoni, 15, 40138, Bologna, Italy
| | - Martina Rosticci
- Medical and Surgical Sciences Department, U.O. Medicina Interna Borghi, Sant'Orsola-Malpighi University Hospital, University of Bologna, Via Albertoni, 15, 40138, Bologna, Italy
| | - Angelo Parini
- Medical and Surgical Sciences Department, U.O. Medicina Interna Borghi, Sant'Orsola-Malpighi University Hospital, University of Bologna, Via Albertoni, 15, 40138, Bologna, Italy
| | - Elisa Grandi
- Medical and Surgical Sciences Department, U.O. Medicina Interna Borghi, Sant'Orsola-Malpighi University Hospital, University of Bologna, Via Albertoni, 15, 40138, Bologna, Italy
| | - Sergio D'Addato
- Medical and Surgical Sciences Department, U.O. Medicina Interna Borghi, Sant'Orsola-Malpighi University Hospital, University of Bologna, Via Albertoni, 15, 40138, Bologna, Italy
| | - Claudio Borghi
- Medical and Surgical Sciences Department, U.O. Medicina Interna Borghi, Sant'Orsola-Malpighi University Hospital, University of Bologna, Via Albertoni, 15, 40138, Bologna, Italy
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Zhang N, Ye N, Chen Y, Guo X, Sun G, Sun Y. The relationship between snoring and left ventricular hypertrophy of China: a cross-sectional study. BMC Cardiovasc Disord 2016; 16:15. [PMID: 26772538 PMCID: PMC4714535 DOI: 10.1186/s12872-016-0185-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 01/07/2016] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Population-based investigations studying the association between snoring and left ventricular hypertrophy (LVH) are lacking. Therefore, our study aims to investigate whether snoring is significantly associated with LVH, and to make clear the effect of varying degrees of snoring intensity on LVH. METHODS A total of 10,139 participants were involved in this cross-sectional study. Snoring status and snoring intensity were evaluated by a structured questionnaire. LVH was defined as left ventricular mass index ≥ 51 g/m(2.7) for both men and women. RESULTS The total prevalence of LVH was 10.0%. the prevalence increased significantly in snorers according to snoring intensity, including low (10.3%), normal (13.1%), strong (14.7%) and very strong (16.7%). After adjustment for age, race, gender, educational status, physical activity, annual income, current smoking status, current drinking status, sleep duration, hypertension, body mass index, waist circumference, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglyceride, total cholesterol and fasting plasma glucose, snoring (OR, 1.371; 95% CI, 1.147-1.637, P < 0.001) was significantly associated with LVH. In addition, among the four kinds of intensity of snoring, normal (OR, 1.436; 95% CI, 1.126-1.832, P = 0.004), strong (OR, 1.462; 95% CI, 1.124-1.902, P < 0.001) and very strong (OR, 1.813; 95% CI, 1.273-2.684, P < 0.001), rather than low (OR, 1.094; 95% CI, 0.834-1.434, P = 0.518) were significantly associated with LVH. CONCLUSIONS Snoring is independently associated with LVH. What's more, with the rise in snoring intensity, snoring will exert an increasing effect on LVH.
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Affiliation(s)
- Naijin Zhang
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, 110001, Shenyang, Liaoning, China.
| | - Ning Ye
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, 110001, Shenyang, Liaoning, China.
| | - Yintao Chen
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, 110001, Shenyang, Liaoning, China.
| | - Xiaofan Guo
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, 110001, Shenyang, Liaoning, China.
| | - Guozhe Sun
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, 110001, Shenyang, Liaoning, China.
| | - Yingxian Sun
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, 110001, Shenyang, Liaoning, China.
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15
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Cho SH. Clinical Implications of Snoring. JOURNAL OF RHINOLOGY 2016. [DOI: 10.18787/jr.2016.23.2.75] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Seok Hyun Cho
- Department of Otorhinolaryngology, College of Medicine, Hanyang University, Seoul, Korea
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