Lindberg E, Janson C, Svärdsudd K, Gislason T, Hetta J, Boman G
Department of Lung Medicine, Uppsala University, Akademiska sjukhuset, Sweden.
Thorax. 1998 Aug;53(8):631-7. doi: 10.1136/thx.53.8.631.
The long term health consequences of snoring and sleep apnoea syndrome are still uncertain. This study was conducted to assess the mortality risk associated with snoring and excessive daytime sleepiness (EDS), the two main symptoms of sleep apnoea syndrome, in men.
In 1984 a sample of 3100 men aged 30-69 responded to a postal questionnaire including questions about snoring, EDS, and the prevalence of various diseases (response rate 77.1%). Mortality data for the period 1985-1995 were collected for the complete sample.
During the 10 year follow up period 213 men died, 88 of cardiovascular diseases. Compared with subjects with no snoring or EDS in 1984, men with isolated snoring or EDS displayed no significantly increased mortality. The combination of snoring and EDS was associated with a significant increase in mortality. However, the relative rates decreased with increasing age, and in men aged 60 and above no effect on mortality was found. Men below the age of 60 with both snoring and EDS had an age adjusted total death rate which was 2.7 times higher than men with no snoring or EDS (95% CI 1.6 to 4.5). The corresponding age adjusted hazard ratio for cardiovascular mortality was 2.9 (95% CI 1.3 to 6.7) for subjects with both snoring and EDS. Further adjustment for body mass index and reported hypertension, cardiac disease, and diabetes reduced the relative mortality risk associated with the combination of snoring and EDS to 2.2 (95% CI 1.3 to 3.8) and the relative risk of cardiovascular mortality to 2.0 (95% CI 0.8 to 4.7).
Snoring without EDS does not appear to carry an increased risk of mortality. The combination of snoring and EDS appears to be associated with an increased mortality rate, but the effects seems to be age dependent. The increased mortality is partly explained by an association between "snoring and EDS" and cardiovascular disease.
打鼾及睡眠呼吸暂停综合征对健康的长期影响仍不明确。本研究旨在评估打鼾和日间过度嗜睡（EDS）这两种睡眠呼吸暂停综合征的主要症状与男性死亡风险之间的关联。
1984年，对3100名年龄在30 - 69岁的男性进行了问卷调查，内容包括打鼾、EDS及各种疾病的患病率（应答率为77.1%）。收集了整个样本在1985 - 1995年期间的死亡率数据。
在10年的随访期内，有213名男性死亡，其中88人死于心血管疾病。与1984年无打鼾或EDS的受试者相比，单纯打鼾或EDS的男性死亡率没有显著增加。打鼾和EDS同时存在与死亡率显著增加相关。然而，相对死亡率随年龄增长而降低，在60岁及以上男性中未发现对死亡率有影响。60岁以下同时有打鼾和EDS的男性，其年龄调整后的总死亡率比无打鼾或EDS的男性高2.7倍（95%可信区间为1.6至4.5）。对于同时有打鼾和EDS的受试者，心血管疾病死亡的相应年龄调整风险比为2.9（95%可信区间为1.3至6.7）。进一步对体重指数以及报告的高血压、心脏病和糖尿病进行调整后，与打鼾和EDS同时存在相关的相对死亡风险降至2.2（95%可信区间为1.3至3.8），心血管疾病死亡的相对风险降至2.0（95%可信区间为0.8至4.7）。
无EDS的打鼾似乎不会增加死亡风险。打鼾和EDS同时存在似乎与死亡率增加有关，但这种影响似乎与年龄有关。死亡率增加部分可归因于“打鼾和EDS”与心血管疾病之间的关联。
