Snoring and Progression of Coronary Artery Disease: The Stockholm Female Coronary Angiography Study

STUDY OBJECTIVES: Snoring is associated with a significant increased risk for acute myocardial infarction and stroke. However, our knowledge of mechanisms is still incomplete. The aim of the study was to investigate the influence of snoring in combination with feelings of tiredness on the 3-year progression of atherosclerosis in women with cardiovascular disease. DESIGN: Repeated quantitative coronary angiograms were carried out with an average time interval of 3.25 years. SETTING: Department of Thoracic Radiology at Karolinska Hospital, Stockholm, Sweden. PARTICIPANTS: The study sample comprised 103 women cardiac patients with repeated, valid, and comparable measurement of quantitative coronary angiograms. MEASUREMENTS AND RESULTS: Absolute luminal diameter (in mm) was measured in 10 predefined coronary segments. Mean segment diameter was calculated as the mean of all diameters measured along a given segment. The change over time was calculated by subtracting the first from the second measurement. Snoring and feelings of tiredness were measured by a short version of the Karolinska Sleep Questionnaire. We found that snoring women, after adjusting for age, waist-hip ratio, smoking, event at hospitalization, education, hypertension and alcohol intake, had a statistically significantly larger progression of atherosclerosis than did nonsnoring women (0.18 mm vs 0.07 mm change; P = .0006). CONCLUSION: Snoring contributes to the atherosclerotic process and should be taken into consideration when treating patients with cardiac disease.