Adult ; Bone Density/physiology ; Cohort Studies ; Female ; Follow-Up Studies ; Fractures, Bone/diagnosis ; Fractures, Bone/epidemiology* ; Frailty/diagnosis ; Frailty/epidemiology* ; Humans ; Male ; Middle Aged ; Population Surveillance*/methods ; Prospective Studies ; Republic of Korea/epidemiology ; Risk Factors ; Sex Characteristics* ; Snoring/diagnosis ; Snoring/epidemiology* ; Surveys and Questionnaires ; Time Factors
Keywords
Cohort study ; Fracture ; Osteoporosis ; Pre-screening ; Snoring
Abstract
BACKGROUND: Snoring is frequently associated with obstructive sleep apnea (OSA). Previous studies have shown that bone mineral density was significantly lower in patients with OSA than in controls; however, these studies did not focus on fractures. Fragility fractures can lead to long-term disabilities and a decrease in quality of life. The present study aimed to investigate the association between snoring and fragility fractures.
METHODS: This study included 2969 men and 3220 women aged 40 years and older from the Ansung and Ansan cohort studies in Korea. During a 10-year follow-up period, 129 and 273 fracture cases were reported in men and women, respectively.
RESULTS: Severe snoring (6-7 nights per week or sleep disturbance by snoring in the next room) was a statistically significant risk factor for fracture (p = 0.006, hazard ratio 1.68, 95% confidence interval 1.16-2.43) after adjusting for covariates related to fragility fracture in women. However, both snoring and severe snoring groups did not show significant associations with the fracture risk in men.
CONCLUSIONS: Thus, information on the frequency of snoring in women may improve the accuracy of fragility fracture risk prediction, which can help in deciding whether intervention or treatment is necessary.