Australian researchers have isolated heavy snoring as an independent risk factor for carotid atherosclerosis.
“Heavy snorers should have a review of all their risk factors for vascular disease,” advises co-author John Wheatley, an associate professor of respiratory medicine at the University of Sydney.

The study of 110 adults is the first to measure snoring objectively, rather than relying on a subjective questionnaire only. Researchers found the prevalence of carotid atherosclerosis was 20% with mild snoring, 32% with moderate snoring, and 64% with heavy snoring (Sleep. 2008;31:1207-1213).

Participants, who ranged in age from 45 to 80 years, had come to a university sleep laboratory for diagnostic polysomnography. The results were used to quantify their snoring and to categorize it based on the number and frequency of snores. All subjects also underwent ultrasounds of their bilateral carotid and femoral arteries, and their overall cardiovascular risks were assessed.

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After adjusting for such factors as age, gender, smoking history, and hypertension, heavy snoring was strongly associated with carotid atherosclerosis compared with mild snoring (odds ratio [OR] 10.5) but not with femoral atherosclerosis. The authors emphasize that the robust OR resulted from the controlled nature of the study, which was designed to focus on snoring. “It does not indicate the general population risk,” they caution.

Nonetheless, “the importance of our findings is the implication that the risk of developing carotid atherosclerosis—and potentially stroke—is not confined to patients with established sleep apnea but extends to the population of heavy snorers,” they conclude.