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Association of Snoring With Chronic Bronchitis
Inkyung Baik, PhD;
Jehyeong Kim, MD;
Robert D. Abbott, PhD;
Soonjae Joo, PhD;
Kihwan Jung, MD;
Sungyong Lee, MD;
Jaejeong Shim, MD;
Kwangho In, MD;
Kyungho Kang, MD;
Sehwa Yoo, MD;
Chol Shin, MD, PhD
Arch Intern Med. 2008;168(2):167-173.
Background Snoring is more prevalent in patients with chronic bronchitis than in persons without it. Few studies have examined the effect of snoring on chronic bronchitis. We prospectively investigated the association between snoring and the incidence of chronic bronchitis.
Methods The baseline study was conducted from June 25, 2001, to January 29, 2003. Members of the study cohort consisted of 5015 male and female Korean citizens aged 40 to 69 years at baseline who participated in a comprehensive health examination and on-site interviews at Korea University Ansan Hospital. Of these, 4270 participants (52% men and 48% women) entered the analysis for the first 2-year follow-up from April 17, 2003, to February 20, 2005, and those who met the same inclusion criteria remained in the analysis for a second 2-year follow-up period from February 21, 2005, to November 17, 2006. We collected information on snoring at baseline and identified incident cases of chronic bronchitis during a 4-year follow-up period. On the baseline questionnaire, we excluded participants who reported the presence of cough and sputum production on most days for at least 3 months a year.
Results During 4 years of follow-up, we documented 314 cases of new-onset chronic bronchitis (27.1 cases per 1000 person-years). After taking into account age, smoking, and other risk factors for chronic bronchitis, the multivariate relative risks of chronic bronchitis were 1.25 (95% confidence interval [CI], 0.95-1.64) for persons snoring 5 times per week or less and 1.68 (95% CI, 1.17-2.42) for those snoring 6 to 7 times per week compared with never snorers (P for trend = .049). The analyses stratified by risk factors, including smoking, occupation, and body mass index, showed a stronger association among never smokers, house workers, and overweight persons. In analysis for the joint effect of smoking and snoring, the relative risks of chronic bronchitis were 1.39 (95% CI, 1.01-1.90) for nonsmoking and snoring, 2.31 (95% CI, 1.38-3.87) for smoking and never snoring, and 2.86 (95% CI, 1.91-4.27) for smoking and snoring compared with nonsmoking and never snoring.
Conclusions This prospective study observed that snoring is associated with chronic bronchitis. Our findings provide support for the hypothesis that snoring influences the development of chronic bronchitis.
Author Affiliations: Institute of Human Genomic Study (Drs Baik, Joo, and Shin) and Department of Internal Medicine (Drs Kim, Jung, and Shin), Korea University Ansan Hospital, Ansan, Republic of Korea (South Korea); College of Medicine, Korea University (Drs Baik, Kim, Jung, Lee, Shim, In, Kang, Yoo, and Shin), Department of Internal Medicine, Korea University Guro Hospital (Drs Lee, Shim, and Kang), and Department of Internal Medicine, Korea University Anam Hospital (Drs In and Yoo), Seoul, Republic of Korea (South Korea); Department of Health Science, Shiga University of Medical Science, Otsu, Japan (Dr Abbott); and Division of Biostatistics and Epidemiology, University of Virginia School of Medicine, Charlottesville (Dr Abbott).
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