Snoring and Carotid Artery Intima-Media Thickness

Objectives/Hypothesis: A growing body of evidence indicates that primary snoring (PS) may be the initial presentation of sleep-disordered breathing and can adversely affect an individual's health. Individuals with the sole diagnosis of PS were evaluated to determine if a relationship exists between snoring and thickening of the intima media of the carotid arteries. Study Design: Cross-sectional study. Methods: Our institution's sleep center database identified patients aged 18 to 50 years who had a diagnostic sleep study with apnea-hypopnea index <5 between December 2006 and January 2012. Subjects underwent a diagnostic carotid artery duplex ultrasound measuring the intima-media thickness (IMT) of the bilateral carotid arteries at four separate points. A validated Snoring Outcomes Survey (SOS) was completed and used to categorize snorers and nonsnorers. Groups were compared using a Student t test. Results: Of 913 patients who met inclusion criteria, 54 patients completed both the carotid duplex ultrasound and SOS. There were no statistically significant differences in IMT for the groups defined by smoking or diabetes. Compared to nonsnorers, snorers were found to have a significantly greater IMT at two points along the left internal carotid artery and one point on the right side. When considering all eight points, IMT was significantly greater in snorers. Conclusions: This study shows a relationship between PS and IMT of the carotid arteries. Given the well-described relationship between increased carotid IMT and serious health conditions, nonapneic snoring may be a precursor to changes of the carotid artery intima and should be further investigated.