INCREASED MORTALITY AMONG SLEEPY SNORERS - A PROSPECTIVE POPULATION-BASED STUDY

Background-The long term health consequences of snoring and sleep apno ea syndrome are still uncertain. This study was conducted to assess th e mortality risk associated with snoring and excessive daytime sleepin ess (EDS), the two main symptoms of sleep apnoea syndrome, in men. Met hods-In 1984 a sample of 3100 men aged 30-69 responded to a postal que stionnaire including questions about snoring, EDS, and the prevalence of various diseases (response rate 77.1%). Mortality data for the peri od 1985-1995 were collected for the complete sample. Results-During th e 10 year follow up period 213 men died, 88 of cardiovascular diseases . Compared with subjects with no snoring or EDS in 1984, men with isol ated snoring or EDS displayed no significantly increased mortality. Th e combination of snoring and EDS was associated with a significant inc rease in mortality. However, the relative rates decreased with increas ing age, and in men aged 60 and above no effect on mortality was found . Men below the age of 60 with both snoring and EDS had an age adjuste d total death rate which was 2.7 times higher than men with no snoring or EDS (95% CI 1.6 to 4.5). The corresponding age adjusted hazard rat io for cardiovascular mortality was 2.9 (95% CI 1.3 to 6.7) for subjec ts with both snoring and EDS. Further adjustment for body mass index a nd reported hypertension, cardiac disease, and diabetes reduced the re lative mortality risk associated with the combination of snoring and E DS to 2.2 (95% CI 1.3 to 3.8) and the relative risk of cardiovascular mortality to 2.0 (95% CI 0.8 to 4.7). Conclusion-Snoring without EDS d oes not appear to carry an increased risk of mortality. The combinatio n of snoring and EDS appears to be associated with an increased mortal ity rate, but the effects seems to be age dependent. The increased mor tality is partly explained by an association between ''snoring and EDS '' and cardiovascular disease.