Purpose. Nasal congestion at night is thought to have a role in snoring and sleep apnea, but this hypothesis has not previously been tested in a population-based study.
Study Population and Methods. Baseline and 5-year follow-up data on self-reported nocturnal nasal congestion and snoring frequency were collected from a population-based sample of 4916 men and women (age range: 30–60 years at baseline) enrolled in the ongoing Wisconsin Sleep Cohort Study. In-laboratory polysomnography was performed on a subset (n = 1032) of the study population to determine the frequency of apnea and hypopnea episodes during sleep. Logistic regression was used to estimate odds ratios for snoring with chronic nasal congestion at night.
Results. Nocturnal nasal congestion frequency was independently associated with snoring frequency in cross-sectional analyses. The odds ratios (adjusted for sex, age, body habitus, and smoking) for habitual snoring with severe (always or almost always) nasal congestion versus none was 3.0 (95% confidence interval: 2.2–4.0). This association was not explained by habitual snorers with frank sleep apnea (ie, ≥5 apnea and hypopnea episodes per hour of sleep). Prospective analyses showed that persons with chronic severe nasal congestion had a high risk of habitual snoring according to the data from the 5-year follow-up survey: the odds ratio for habitual snoring and reporting congestion always or almost always at both baseline and follow-up was 4.9 (95% confidence interval: 2.8–8.8).
Conclusions. Nocturnal nasal congestion is a strong independent risk factor for habitual snoring, including snoring without frank sleep apnea. Intervention studies are needed to determine if snoring can be reduced with treatment of nasal congestion.
Reviewer’s Comments. This is the first study to identify chronic nasal congestion as a risk factor for simple (ie, without hypopneas or apnea) snoring. Previously, it had been my understanding that nasal congestion was not felt to be an important single independent risk factor for snoring or other sleep-disturbed breathing (SDB) syndromes. Because simple snoring may be an early manifestation of SDB, implications for diagnosis and therapy are apparent. Nasal congestion attributable to allergic causes was not a stronger prediction of snoring than other causes of nasal congestion.
- Copyright © 2002 by the American Academy of Pediatrics