Snoring and Sleep Apnea in Women – Risk Factors, Signs and Consequences

In 2000, 7,051 women ≥ 20 years from the general population answered a questionnaire on snoring and sleep disturbances. Furthermore, 230 snoring women and 170 women regardless of snoring status were investigated with polysomnography, blood sampling and anthropometric measurements. Of these, 132 participants now underwent an ocular and endoscopic examination of their upper airways. Several findings in the upper airways characterised normal-weight women with an apnea-hypopnea index (AHI) ≥ 10. In women with BMI of > 25, no pharyngeal characteristics predicted sleep apnea. When adjusting for age, obesity, smoking, AHI and sleep parameters, several aspects of daytime sleepiness correlated to snoring independently of AHI. No symptoms correlated to AHI independently of snoring. 

Strong correlations were found between obesity and inflammatory markers. AHI and nocturnal hypoxia correlated to all markers except MPO. When adjusting for age, obesity and smoking, only IL-6 and TNFα were independently associated with nocturnal hypoxia. No independent relationship was found between systemic inflammation and AHI. In conclusion, age and obesity influence the prevalence of snoring and sleep apnea in women from the general population. Other risk factors differ according to body habitus. Daytime symptoms appear to be independently related to the snoring per se, while systemic inflammation is mainly attributed to obesity. 

Further studies, based on the large European GALEN and RHINE studies, aim to investigate how airway disease (rhinitis, rhinosinusitis, asthma and chronic bronchitis) influence quality of sleep, snoring and obstructive sleep apnea syndrome. The aim is also to study the influence of airway disease on life of quality and to find out if anatomical conditions relate to the severity of obstructive sleep apnea syndrome. 

Members of the group
Malin Svensson
Caroline Bengtsson
Eva Lindbergx
Lars Jonsson
Mats Holmström
Jenny Theorell-Haglöw
Christer Jansson