Snoring and environmental exposure: results from the Swedish GA2LEN study

Objective Habitual snoring is associated with fatigue, headaches and low work performance. This cross-sectional study aimed to investigate if snoring is affected by environmental factors such as home dampness and exposure to air pollution. Setting General population sample from four Swedish cities. Participants 25 848 participants from the Swedish part of the epidemiological Global Asthma and Allergy and European network of excellence study carried out in 2008. The participants completed a postal questionnaire on snoring and, indoor and outdoor environmental exposure as well as potential confounders including smoking, weight, height and educational level. Results Of the participants, 4211 (16.3%) were habitual snorers. Habitual snorers reported water damage (8.3% vs 7.0% p<0.0001), floor dampness (4.6% vs 3.8% % p<0.0001) and visible mould (5.2% vs 3.8% p<0.0001) in their homes more often than non-snorers. Habitual snorers stated being annoyed by air pollution more often than non-snorers with habitual snorers reporting being irritated with the air in their residential area to a higher extent (sometimes 16.2% vs 13.9%, and daily 4.6% vs 3.1%) as well as annoyance from traffic fumes (somewhat 19% vs 18.5% and very 5% vs 3.6%) (p<0.0001). These results remained significant after adjustment for age, body mass index, smoking history and educational level. Conclusion Snoring is more prevalent in subjects reporting home dampness and air pollution. These association should be confirmed in further research using objective measurements and a longitudinal approach.

[1]  T. Gislason,et al.  Dampness and mold at home and at work and onset of insomnia symptoms, snoring and excessive daytime sleepiness. , 2020, Environment international.

[2]  T. Gislason,et al.  Dampness, mould, onset and remission of adult respiratory symptoms, asthma and rhinitis , 2019, European Respiratory Journal.

[3]  D. Norbäck,et al.  Dampness and mold in homes across China: Associations with rhinitis, ocular, throat and dermal symptoms, headache and fatigue among adults , 2018, Indoor air.

[4]  A. Ghio,et al.  The toxicology of air pollution predicts its epidemiology , 2018, Inhalation toxicology.

[5]  D. Gozal,et al.  Association between air pollution and sleep disordered breathing in children , 2017, Pediatric pulmonology.

[6]  C. Janson,et al.  Patient‐reported signs of dampness at home may be a risk factor for chronic rhinosinusitis: A cross‐sectional study , 2017, Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology.

[7]  T. Gislason,et al.  Indicators of residential traffic exposure: Modelled NOX, traffic proximity, and self-reported exposure in RHINE III , 2017 .

[8]  L. Kheirandish-Gozal,et al.  Frequency of snoring, rather than apnea-hypopnea index, predicts both cognitive and behavioral problems in young children. , 2017, Sleep medicine.

[9]  W. Guan,et al.  Impact of air pollution on the burden of chronic respiratory diseases in China: time for urgent action , 2016, The Lancet.

[10]  T. Gislason,et al.  Self-reported exposure to traffic pollution in relation to daytime sleepiness and habitual snoring: a questionnaire study in seven North-European cities. , 2016, Sleep medicine.

[11]  S. Wali,et al.  Prevalence and predictors of habitual snoring in a sample of Saudi middle-aged adults , 2015, Saudi medical journal.

[12]  S. Moebus,et al.  Association of short-term ozone and temperature with sleep disordered breathing , 2015, European Respiratory Journal.

[13]  C. Janson,et al.  The impact of obesity and weight gain on development of sleep problems in a population-based sample. , 2015, Sleep medicine.

[14]  C. Janson,et al.  Asthma and physical activity--a population based study results from the Swedish GA(2)LEN survey. , 2013, Respiratory medicine.

[15]  L. Kheirandish-Gozal,et al.  Neighbourhood air quality and snoring in school-aged children , 2013, European Respiratory Journal.

[16]  C. Janson,et al.  Asthma symptoms and nasal congestion as independent risk factors for insomnia in a general population: results from the GA 2 LEN survey , 2013, Allergy.

[17]  Liang-Yi Si,et al.  Obstructive sleep apnea syndrome (OSAS) and hypertension: Pathogenic mechanisms and possible therapeutic approaches , 2012, Upsala journal of medical sciences.

[18]  Y. Guo,et al.  The association of ambient air pollution with airway inflammation in schoolchildren. , 2012, American journal of epidemiology.

[19]  D. Jarvis,et al.  Asthma in adults and its association with chronic rhinosinusitis: The GA2LEN survey in Europe , 2012, Allergy.

[20]  D. Jarvis,et al.  Indoor environment in three North European cities in relationship to atopy and respiratory symptoms , 2009, The clinical respiratory journal.

[21]  M. Svensson,et al.  Daytime sleepiness relates to snoring independent of the apnea-hypopnea index in women from the general population. , 2008, Chest.

[22]  C. Janson,et al.  Snoring and daytime sleepiness as risk factors for hypertension and diabetes in women--a population-based study. , 2007, Respiratory medicine.

[23]  C. Janson,et al.  What are the important risk factors for daytime sleepiness and fatigue in women? , 2006, Sleep.

[24]  C. Janson,et al.  Risk factors associated with snoring in women with special emphasis on body mass index: a population-based study. , 2006, Chest.

[25]  J. Bousquet,et al.  Spreading excellence in allergy and asthma: the GA2LEN (Global Allergy and Asthma European Network) project , 2005, Allergy.

[26]  T. Gislason,et al.  Insomnia is more common among subjects living in damp buildings , 2005, Occupational and Environmental Medicine.

[27]  T. Gislason,et al.  The influence of active and passive smoking on habitual snoring. , 2004, American journal of respiratory and critical care medicine.

[28]  T. Gislason,et al.  Role of snoring and daytime sleepiness in occupational accidents. , 2001, American journal of respiratory and critical care medicine.

[29]  T. Young,et al.  Chronic nasal congestion at night is a risk factor for snoring in a population-based cohort study. , 2001, Archives of internal medicine.

[30]  N. Iwata,et al.  Habitual snoring in an outpatient population in Japan , 2000, Psychiatry and clinical neurosciences.

[31]  D Norbäck,et al.  Nasal and ocular symptoms, tear film stability and biomarkers in nasal lavage, in relation to building-dampness and building design in hospitals , 1999, International archives of occupational and environmental health.

[32]  A. Taube,et al.  A 10-year follow-up of snoring in men. , 1998, Chest.

[33]  T. Gislason,et al.  Snoring and hypertension: a 10 year follow-up. , 1998, The European respiratory journal.

[34]  P. Enright,et al.  Prevalence and correlates of snoring and observed apneas in 5,201 older adults. , 1996, Sleep.

[35]  T. Gislason,et al.  Daytime sleepiness, snoring and gastro‐oesophageal reflux amongst young adults in three European countries , 1995, Journal of internal medicine.

[36]  C. Janson,et al.  Excessive daytime sleepiness and fatigue in nonapnoeic snorers: improvement after UPPP. , 1994, The European respiratory journal.

[37]  J. Samet,et al.  Comparison of self- and spouse reports of snoring and other symptoms associated with sleep apnea syndrome. , 1990, Sleep.

[38]  S. Quan,et al.  Risk factors in a general population for snoring. Importance of cigarette smoking and obesity. , 1988, Chest.

[39]  R. Stark,et al.  Sleep and Chronic Daily Headache , 2014, Current Pain and Headache Reports.

[40]  B. Phillips.  What are the Important Risk Factors for Daytime Sleepiness and Fatigue in Women?Theorell-Haglöw J, Lindberg E, Janson C (Uppsala Univ, Sweden) Sleep 29:751-757, 2006§ , 2007 .

[41]  W. Ingwersen.  Spreading excellence. , 2005, The Journal of small animal practice.

[42]  A. Taube,et al.  Prevalence of sleep apnea syndrome among Swedish men--an epidemiological study. , 1988, Journal of clinical epidemiology.