Snoring, daytime sleepiness, and incident cardiovascular disease in the health, aging, and body composition study

Sleep. 2013 Nov 1;36(11):1737-45. doi: 10.5665/sleep.3140.


Objectives: To examine the association between snoring and incident cardiovascular disease (CVD).

Design settings and participants: This is a prospective study in which community dwelling older adults were evaluated at baseline, and followed up for an average of 9.9 years.

Measurements: Data on snoring, daytime sleepiness, as well as demographic and clinical characteristics of study participants was collected at baseline, and participants were followed up every six months for an average of 9.9 years. Based on snoring and sleepiness status, 4 groups of participants were created: (1) No Snoring, No Sleepiness; (2) No Snoring, Sleepiness; (3) Snoring, No Sleepiness; (4) Snoring, Sleepiness. Incident CVD was defined as a diagnosis of myocardial infarction, angina pectoris, or congestive heart failure that resulted in overnight hospitalization during the follow-up period. Cox proportional hazard was used to estimate the risk of incident cardiovascular disease during follow-up by baseline snoring and sleepiness status.

Results: A total of 2,320 participants with a mean age of 73.6 (2.9) years at baseline were included in the analysis. Fifty-two percent were women, and 58% were white. A total of 543 participants developed CVD events during the follow-up period. Participants who reported snoring associated with daytime sleepiness had significantly increased hazard ratio for CVD events (HR = 1.46 [1.03-2.08], P = 0.035) after adjusting for demographic and clinical confounding factors.

Conclusion: The results suggest that self-reported snoring and daytime sleepiness status are associated with an increased risk of future cardiovascular disease among older adults.

Keywords: Snoring; cardiovascular disease; daytime sleepiness.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, N.I.H., Intramural

MeSH terms

  • Aged
  • Angina Pectoris / epidemiology
  • Cardiovascular Diseases / epidemiology*
  • Disorders of Excessive Somnolence / epidemiology*
  • Female
  • Heart Failure / epidemiology
  • Humans
  • Incidence
  • Male
  • Myocardial Infarction / epidemiology
  • Proportional Hazards Models
  • Prospective Studies
  • Risk Factors
  • Snoring / epidemiology*