Association between Self-Reported Habitual Snoring and Diabetes Mellitus: A Systemic Review and Meta-Analysis

Abstract

Aim. Several studies have reported an association between self-reported habitual snoring and diabetes mellitus (DM); however, the results are inconsistent. Methods. Electronic databases including PubMed and EMBASE were searched. Odds ratios (ORs) and 95% confidence intervals (CIs) were used to assess the strength of the association between snoring and DM using a random-effects model. Heterogeneity, subgroup, and sensitivity analyses were also evaluated. Begg's, Egger's tests and funnel plots were used to evaluate publication bias. Results. A total of eight studies (six cross sectional and two prospective cohort studies) pooling 101,246 participants were included. Of the six cross sectional studies, the summary OR and 95% CI of DM in individuals that snore compared with nonsnorers were 1.37 (95% CI: 1.20–1.57, p < 0.001). There was no heterogeneity across the included studies (I 2 = 2.9%, p = 0.408). When stratified by gender, the pooled OR (95% CI) was 1.59 (1.20–2.11) in females (n = 12298), and 0.89 (0.65–1.22) in males (n = 4276). Of the two prospective studies, the pooled RR was 1.65 (95% CI, 1.30–2.08). Conclusions. Self-reported habitual snoring is statistically associated with DM in females, but not in males. This meta-analysis indicates a need to paying attention to the effect of snoring on the occurrence of DM in females.

A Population-Based Study of the Bidirectional Association Between Obstructive Sleep Apnea and Type 2 Diabetes in Three Prospective U.S. Cohorts

“…The stronger association for a phenotype that includes EDS is also consistent with the hypothesis that EDS is a marker of the persistent proinflammatory condition associated with visceral obesity and OSA (27). By contrast, simple snoring without clinical diagnosis of OSA, although to a lesser extent, was also significantly associated with 25% higher risk of diabetes in all three cohorts, consistent with several existing studies that have identified snoring (regardless of OSA) as a risk factor for diabetes (33,34). These results suggest a potential dose-response association between OSA severity and diabetes risk and provide additional evidence on a biological gradient corroborating a causal relationship.…”

Association Between Self-Reported Snoring and Metabolic Syndrome: A Systematic Review and Meta-Analysis

“…In view of such a situation, Xiong et al ( 12 ) retrieved studies on a relationship between snoring and diabetes to perform a meta-analysis. However, their study identified the relationship between snoring frequency and risk of diabetes in the highest vs. the lowest categories of snoring frequency.…”

“…Such a practice cannot make full use of the information of the included studies and may have generally exaggerated the associations between snoring and diabetes. Furthermore, Xiong et al ( 12 ) summarized only one of MetS' components; thus, a comprehensive review of the relationship, especially one showing a dose–response trend, between snoring and MetS and each of its components is still necessary.…”

Association of sleep duration and incidence of diabetes modified by tea consumption: a report from the Shanghai men's health study

“…95% CI: 1.01–1.49) among snorers with sleep duration ≥9 hours per day, but this association was not found among non-snorers. A recent study of 6522 participants aged ≥20 years from the National Health and Nutrition Examination Survey 2005–2008 reported that snoring was associated with diabetes risk with OR of 1.44 (95% CI: 1.16–1.79), an association that was also found in a meta-analysis [45–46]. The mechanisms underlying this association have not been elucidated completely.…”