Snoring and nocturnal reflux: association with lung function decline and respiratory symptoms

Emilsson, Össur Ingi; Hägg, Shadi Amid; Lindberg, Eva; Franklin, Karl A.; Benediktsdóttir, Bryndís; Aspelund, Thor; Real, Francisco Gómez; Leynaert, Bénédicte; Demoly, Pascal; Sigsgaard, Torben; Perret, Jennifer L; Malinovschi, Andreï; Jarvis, Déborah; Garcia‐Aymerich, Judith; Gíslason, Þórarinn; Janson, Christer

doi:10.1183/23120541.00010-2019

Cited by 8 publications

(5 citation statements)

References 29 publications

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“…We have recently described that snoring is associated with a significant decline in lung function [9], and this study further validates that finding by also looking at reported nocturnal choking and apnoeas, other common OSA symptoms. We even found a negative linear relationship between the OSA symptom score and the decline in lung function, further supporting the relevance of this finding.…”

Section: Lung Function Declinesupporting

confidence: 86%

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Association between lung function decline and obstructive sleep apnoea: the ALEC study

et al. 2020

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Purpose To study changes in lung function among individuals with a risk of obstructive sleep apnoea (OSA), and if asthma affected this relationship. Methods We used data from the European Community Respiratory Health Survey II and III, a multicentre general population study. Participants answered questionnaires and performed spirometry at baseline and 10-year follow-up (n = 4,329 attended both visits). Subjects with high risk for OSA were identified from the multivariable apnoea prediction (MAP) index, calculated from BMI, age, gender, and OSA symptoms at follow-up. Asthma was defined as having doctor's diagnosed asthma at follow-up. Primary outcomes were changes in forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) from baseline to follow-up. Results Among 5108 participants at follow-up, 991 (19%) had a high risk of OSA based on the MAP index. Participants with high OSA risk more often had wheeze, cough, chest tightness, and breathlessness at follow-up than those with low OSA risk. Lung function declined more rapidly in subjects with high OSA risk (low vs high OSA risk [mean ± SD]: FEV1 = − 41.3 ± 24.3 The ALEC study is funded by the European Union's Horizon 2020 Research and Innovation programme under grant agreement no. 633212. This paper has not been published elsewhere and is not under consideration by another journal.

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Section: Lung Function Declinesupporting

confidence: 86%

“…Habitual snoring has recently been described to be associated with a decline in lung function, indicating that OSA may play a role in lung function decline [9]. However, even though snoring and OSA are linked, not all habitual snorers have OSA [5].…”

Section: Introductionmentioning

confidence: 99%

Association between lung function decline and obstructive sleep apnoea: the ALEC study

et al. 2020

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“…Regarding nGER, our previous studies have found an association between nGER and respiratory symptoms, especially among snorers and found persistent nGER to be a risk factor for developing respiratory symptoms 1 6 29. There are different theories on how nGER may cause respiratory symptoms, and different mechanisms may associate with different respiratory symptoms 8.…”

Section: Discussionmentioning

confidence: 99%

Nocturnal gastro-oesophageal reflux and respiratory symptoms are increased in sleep apnoea: comparison with the general population

Emilsson,

Aspelund,

Janson

et al. 2024

BMJ Open Resp Res

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AimTo assess respiratory symptoms and nocturnal gastro-oesophageal reflux (nGER) among untreated obstructive sleep apnoea (OSA) patients, compared with the general population. Also, if nGER associates differently with respiratory symptoms among OSA patients.Methods2 study cohorts were included: 822 newly diagnosed subjects with moderate–severe OSA and 738 Icelandic general population study participants. All participants answered the same questionnaires. Those reporting nGER symptoms at least once per week were defined as ‘with nGER’; those without nGER symptoms and without nGER medication were defined as ‘no nGER’; and other participants were defined as having ‘possible nGER’. Propensity score-based weights were used to minimise confounding and selection bias and facilitate causal interpretations.ResultsThe prevalence of nGER among OSA patients was 14.1%, compared with 5.8% in the general population. This increased prevalence in OSA was not explained by differences in age, gender, body mass index, smoking, hypertension and diabetes (adjusted OR (95% CI)=3.79 (2.24 to 6.43)). OSA patients ‘with nGER’ and with ‘possible nGER’ reported more wheezing (44% and 44% vs 25%, respectively) and productive cough (47% and 42% vs 29%, respectively), compared with OSA patients with ‘no nGER’. The same pattern was seen in the general population, although with a generally lower prevalence. The effect of nGER on respiratory symptoms was similar between the two cohorts.ConclusionnGER was more often reported among untreated moderate–severe OSA patients than in the general population. Participants with nGER had more wheezing and productive cough, both among untreated OSA patients and in the general population.

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“…Several studies have found a relationship between various sleep disorders and respiratory symptoms ( 22 , 23 ). More respiratory symptoms were also present in people with habitual snoring ( 24 ). Bjornsdottir found that people with short sleep times reported more respiratory symptoms; not only that, they found that long sleep duration was associated with morning cough and dyspnea after activity ( 25 ).…”

Section: Discussionmentioning

confidence: 99%

The association between sleep duration, respiratory symptoms, asthma, and COPD in adults

Ruan¹,

Li²,

Cheng

et al. 2023

Front. Med.

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IntroductionThe association between sleep duration and cough, wheezing, and dyspnea was unclear. This research aimed to test this relationship.MethodsResearch data were obtained from people who participated in the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2012. We used weighted logistic regression analysis and fitted curves to explore the association between sleep and respiratory symptoms. In addition, we investigated the association between sleep duration, chronic obstructive pulmonary disease (COPD), and asthma. The stratified analysis is used to analyze inflection points and specific populations.ResultsThe 14,742 subjects are weighted to reflect the 45,678,491 population across the United States. Weighted logistic regression and fitted curves show a U-shaped relationship between sleep duration and cough and dyspnea. This U-shaped relationship remained in people without COPD and asthma. The stratified analysis confirmed that sleep duration before 7.5 h was negatively associated with cough (HR 0.80, 95% CI 0.73–0.87) and dyspnea (HR 0.82, 95% CI 0.77–0.88). In contrast, it was positively associated with cough and (HR 1.30, 95% CI 1.14–1.48) dyspnea (HR 1.12, 95% CI 1.00–1.26) when sleep duration was >7.5 h. In addition, short sleep duration is associated with wheezing, asthma, and COPD.ConclusionBoth long and short sleep duration are associated with cough and dyspnea. And short sleep duration is also an independent risk factor for wheezing, asthma, and COPD. This finding provides new insights into the management of respiratory symptoms and diseases.

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Snoring and nocturnal reflux: association with lung function decline and respiratory symptoms

Cited by 8 publications

References 29 publications

Association between lung function decline and obstructive sleep apnoea: the ALEC study

Association between lung function decline and obstructive sleep apnoea: the ALEC study

Nocturnal gastro-oesophageal reflux and respiratory symptoms are increased in sleep apnoea: comparison with the general population

The association between sleep duration, respiratory symptoms, asthma, and COPD in adults

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