December 14th, 2010
08:20 AM ET
Every Christmas Eve it’s the same story: Dad has too much eggnog and too much turkey and the next thing we know, there he is in front of the fire, snoring like a freight train. We use to always have a chuckle at his expense before nudging him awake and urging him up to bed.
Well, the laughing stopped a long time ago because as a sleep physician I have learned that snoring can be a serious sign of sleep apnea and sleep apnea increases the risk of high blood pressure, heart disease, stroke, diabetes and obesity. Sleep apnea, as I think most people know, is a collapse of the upper airway during sleep that leads to frequent mini-awakenings of which the patient is rarely aware. It often causes a lowering of the oxygen levels.
We use to think that if people snored, but they tested negative for sleep apnea, then this was mostly a nuisance for the bed partner. We called this “benign” or “primary” snoring and we rarely treated it. That is all starting to change.
Now there is more than one study showing that snoring alone (without sleep apnea) increases the risk of serious disorders such as stroke and metabolic syndrome. This is important news because snoring is so common and so treatable. One large study of middle -aged men and women found that roughly 45 percent of men and 30 percent of women were habitual snorers. Occasional snoring is virtually universal.
An important study, published in the December issue of the journal SLEEP, gives new evidence for snoring as an independent risk factor for metabolic syndrome. Metabolic syndrome is a constellation of abnormalities that includes high blood pressure (130/85 mmHg or higher), increased fasting glucose level (100 mg/dl or higher), increased triglycerides (150 mg/dl or higher), decreased HDL levels (less than 40 mg/dl for men, less than 50 mg/dl for women) and increase abdominal obesity (waist circumference greater than 40 inches for men and greater than 35 inches for women. If people have more than three of these five abnormalities, then they are said to have the metabolic syndrome which then increases their risk of cardiovascular disease and type II diabetes.
There is controversy about whether this is really a “syndrome.” There is also some disagreement about how to define it, but the one I give here is from The National Cholesterol Education Program and is the most commonly used.
Regardless of whether this is really a syndrome, we know that the individual disorders have serious health consequences, so this study showing that loud, habitual snorers have nearly triple the risk of developing the metabolic syndrome is quite significant from a public health perspective.
Another interesting study, also published in SLEEP in 2008, showed that people who displayed loud snoring throughout the night during a sleep test were 10 times more likely to have carotid atherosclerosis, which means plague buildup in the carotid arteries of their neck. This is a major risk factor for stroke.
Studies such as these are changing how I advise patients who have sleep studies that are negative for sleep apnea. I now always discuss, in my report and with my patients, whether they had loud, steady snoring. If they did, I recommend treatment, usually with an oral appliance, sometimes with CPAP.
The take-home message? Snoring is not benign even in the absence of frank sleep apnea. All adults (and kids too) should be screened for snoring by their primary care doctors. Keep in mind that overindulging in egg nog and other alcoholic beverages increase the likelihood of snoring and sleep apnea. (Stay tuned for next week’s blog on how alcohol affects your sleep.) Most importantly, snoring should no longer be seen as a joking matter or as just an annoyance to the bed partner. If friends or family members snore, show you care and urge them to seek a medical evaluation. You’ll sleep better knowing that you helped improve the health of someone you love.
The information contained on this page does not and is not intended to convey medical advice. CNN is not responsible for any actions or inaction on your part based on the information that is presented here. Please consult a physician or medical professional for personal medical advice or treatment.
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