Snoring May Be Bigger Health Threat to Women Than Men
The hearts of women who snore appear to become damaged more quickly than those of men who "saw lumber" at night, a new study suggests.
Evaluating nearly 4,500 British adults who underwent cardiac imaging, researchers also learned that obstructive sleep apnea (OSA) may be vastly underdiagnosed among snorers.
This finding surprised study author Dr. Adrian Curta, who heads cardiac imaging at Munich University Hospital in Germany.
"A further surprise was the different manifestation of disease according to gender," Curta said. "Females show different alterations in cardiac [measures]. A possible reason for this could be that women with OSA are more vulnerable to cardiac alterations."
Loud snoring is a hallmark of obstructive sleep apnea, which affects between 3 percent and 7 percent of adults in the United States, according to the U.S. National Institutes of Health. Also characterized by brief periods where breathing stops, often followed by gasping for air, sleep apnea is becoming recognized as a contributor to serious health conditions, such as high blood pressure, heart disease and poor blood sugar metabolism.
Sleep apnea treatment depends on the cause. Treatments include surgery to open narrowed upper airways or using a CPAP (continuous positive airway pressure) machine while sleeping.
Curta and his colleagues evaluated data from the UK Biobank, which follows the health and well-being of 500,000 volunteers. The researchers looked at data from nearly 4,500 participants who underwent cardiac imaging. These study volunteers were split into three groups: 38 with obstructive sleep apnea; 1,919 who reported snoring; and 2,536 without OSA or snoring.
In both men and women, those with sleep apnea and snoring tended to have larger left ventricles of the heart, meaning the walls were enlarged and the heart was working harder to pump, Curta said.
But when the snoring group was compared to the unaffected group, a more significant difference was found in the size of the left ventricle among women compared to men. These cardiac changes in self-reported snorers suggest earlier heart impairment in women and could point to undiagnosed sleep apnea, he said.
The findings suggest the transition from snoring to obstructive sleep apnea is an evolving process linked to a potentially dangerous enlargement of the left ventricle. But the research did not prove that sleep apnea causes heart changes, only that an association exists between the two.
Curta noted that researchers are still uncertain why snoring would remodel women's hearts more quickly than men's. More research needs to be done to understand this process, he said.
"The most important clinical implication is that we need better prevention for OSA, such as a broader information program," Curta said. "Individuals with snoring should ask someone to observe them during sleep if they show periods of breathing cessation."
Those who do stop breathing while sleeping should undergo a sleep study to determine how advanced their sleep apnea is and the proper treatment, Curta said.
Dr. Tetyana Kendzerska is a sleep physician at Ottawa Hospital Sleep Center in Canada, and wasn't involved in the new research. Since obesity is a known contributor to snoring and sleep apnea, Kendzerska said losing excess weight is encouraged for those with snoring or sleep apnea.
"We know that men and women report different symptoms for OSA, and as a result, obstructive sleep apnea is seriously underreported and underdiagnosed in women," she said.
"Given that potential cardiovascular risk associated with sleep apnea may be greater in women than in men, first we need to identify women with sleep apnea [by] increasing awareness among health care professionals," Kendzerska added.
The research was to be presented Thursday at the annual meeting of the Radiological Society of North America, in Chicago. Research presented at meetings typically hasn't been peer-reviewed or published, and results are considered preliminary.
The U.S. National Institute of Neurological Disorders and Stroke has more on sleep apnea.
SOURCES: Adrian Curta, M.D., head, cardiac imaging, Munich University Hospital, Germany; Tetyana Kendzerska, M.D., Ph.D., sleep physician, Ottawa Hospital Center, assistant professor, division of respirology, University of Ottawa, and associate scientist, Ottawa Hospital Research Institute, Ottawa, Canada; Nov. 29, 2018, presentation, Radiological Society of North America annual meeting, Chicago
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