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Chronic Nasal Congestion at Night Is a Risk Factor for Snoring in a Population-Based Cohort Study
Terry Young, PhD;
Laurel Finn, MS;
Mari Palta, PhD
Arch Intern Med. 2001;161:1514-1519.
Background Nasal congestion at night is thought to have a role in snoring and sleep
apnea, but this hypothesis has not previously been tested in a population-based
study.
Methods Baseline and 5-year follow-up data on self-reported nocturnal nasal
congestion and snoring frequency were collected from a population-based sample
of 4916 men and women (age range, 30-60 years at baseline) enrolled in the
ongoing Wisconsin Sleep Cohort Study. In-laboratory polysomnography was performed
on a subset (n = 1032) of the study population to determine the frequency
of apnea and hypopnea episodes during sleep. Logistic regression was used
to estimate odds ratios for snoring with chronic nasal congestion at night.
Results Nocturnal nasal congestion frequency was independently associated with
snoring frequency in cross-sectional analyses. The odds ratios (adjusted for
sex, age, body habitus, and smoking) for habitual snoring with severe (always
or almost always) nasal congestion vs none was 3.0 (95% confidence interval,
2.2-4.0). This association was not explained by habitual snorers with frank
sleep apnea (ie,  5 apnea and hypopnea episodes per hour of sleep). Prospective
analyses showed that persons with chronic severe nasal congestion had a high
risk of habitual snoring according to the data from the 5-year follow-up survey:
the odds ratio for habitual snoring and reporting congestion always or almost
always at both baseline and follow-up was 4.9 (95% confidence interval, 2.8-8.8).
Conclusions Nocturnal nasal congestion is a strong independent risk factor for habitual
snoring, including snoring without frank sleep apnea. Intervention studies
are needed to determine if snoring can be reduced with treatment of nasal
congestion.
From the Departments of Preventive Medicine (Dr Young and Ms Finn)
and Biostatistics and Informatics (Dr Palta), University of Wisconsin at Madison.
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