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Snoring and Cardiovascular Disease Risk in Midlife Women: A Mechanistic Model of Snoring-Related Atherogenesis and Associations with C-Reactive Protein

Samuelsson, Laura B. (2015) Snoring and Cardiovascular Disease Risk in Midlife Women: A Mechanistic Model of Snoring-Related Atherogenesis and Associations with C-Reactive Protein. Master's Thesis, University of Pittsburgh. (Unpublished)

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Simple snoring is highly prevalent and should be considered a phenomenon distinct from sleep disordered breathing (SDB). Snoring is associated with cardiovascular disease (CVD) morbidity and mortality. Midlife women are at increased risk for snoring and cardiovascular disease, yet little is known about the relationships between these factors in this population. We propose and test a mechanistic model of snoring-related atherogenesis to explain these associations. This is the first study to examine the relationship in midlife women between objective and subjective snoring and C-reactive protein (CRP), a CVD biomarker, and the first study to characterize the correlates of snoring in midlife women. The full multi-ethnic sample included 300 women (52.07 ± 2.13 years, 44% African American) from the SWAN Sleep Study, ancillary to the Study of Women’s Health Across the Nation (SWAN). Objective snoring and apnea-hypopnea index (AHI) were measured in a subset of 241 participants on one night of in-home polysomnography. CRP was measured at the core SWAN visit temporally closest to the sleep study. Linear regression models examined the relationships between objectively-derived snoring index, a ratio of snore epochs to sleep epochs, and CRP in both the full sample and in postmenopausal women only. Objective and subjective snoring group differences in mean CRP were tested using ANCOVA. Frequency of objective snoring was associated with higher CRP in postmenopausal women only. Snoring was not significantly associated with CRP in the full sample. The relationship between snoring and CRP was not moderated by AHI or race. There were no group differences in CRP between objective or subjective snoring groups after adjusting for all covariates. Characterization of the sample revealed that simple snorers are distinct from women with SDB. Simple snorers also differed from absent snorers on key CVD risk factors, including higher BMI, systolic blood pressure, and number of metabolic syndrome criteria. There was little agreement between objective snoring frequency and subjective snoring self-report. These findings show that simple snoring should be considered a distinct construct from SDB and measured objectively alongside AHI in future studies. Snoring represents a unique and understudied risk factor for CVD, particularly in postmenopausal women.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Samuelsson, Laura B.lbs33@pitt.eduLBS33
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairHall, Martica H.hallmh@upmc.eduMHH1
Committee MemberMatthews, Karen Amatthewska@upmc.eduXYOO
Committee MemberKamarck, Thomas W.tkam@pitt.eduTKAM
Date: 11 June 2015
Date Type: Publication
Defense Date: 22 April 2014
Approval Date: 11 June 2015
Submission Date: 14 April 2015
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 91
Institution: University of Pittsburgh
Schools and Programs: Dietrich School of Arts and Sciences > Psychology
Degree: MS - Master of Science
Thesis Type: Master's Thesis
Refereed: Yes
Uncontrolled Keywords: snoring; cardiovascular disease; inflammation; endothelial dysfunction; midlife women
Date Deposited: 11 Jun 2015 17:59
Last Modified: 19 Dec 2016 14:41


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