Snoring and nocturnal reflux: association with lung function decline and respiratory symptoms

Emilsson, Össur Ingi; Hägg, Shadi Amid; Lindberg, Eva; Franklin, Karl; Torén, Kjell; Benediktsdóttir, Bryndís; Aspelund, Thor; Gómez Real, Francisco; Leynaert, Bénédicte; Demoly, Pascal; Sigsgaard, Torben; Perret, Jennifer L.; Malinovschi, Andrei; Jarvis, Deborah; García Aymerich, Judith; Gislason, Thorarinn; Janson, Christer

doi:http://dx.doi.org/10.1183/23120541.00010-2019

Snoring and nocturnal reflux: association with lung function decline and respiratory symptoms

Citation

Emilsson ÖI, Hägg SA, Lindberg E, Franklin KA, Toren K, Benediktsdottir B, Aspelund T, Gómez Real F, Leynaert B, Demoly P, Sigsgaard T, Perret J, Malinovschi A, Jarvis D, Garcia-Aymerich J, Gislason T, Janson C. Snoring and nocturnal reflux: association with lung function decline and respiratory symptoms. ERJ Open Res. 2019 May 28;5(2):00010-2019. DOI: 10.1183/23120541.00010-2019

Abstract

Introduction: The study aim was to examine the association of snoring and nocturnal gastro-oesophageal reflux (nGOR) with respiratory symptoms and lung function, and if snoring and/or nGOR associated with a steeper decline in lung function. Methods: Data from the third visit of the European Community Respiratory Health Survey (ECRHS) was used for cross-sectional analysis. Pre- and post-bronchodilator spirometry was performed, and information on sleep, nGOR and respiratory symptoms was collected (n=5715). Habitual snoring and nGOR were assessed by questionnaire reports. Pre-bronchodilator spirometry from ECRHS I, II and III (20 years follow-up) were used to analyse lung function changes by multivariate regression analysis. Results: Snoring and nGOR were independently associated with a higher prevalence of wheeze, chest tightness, breathlessness, cough and phlegm. The prevalence of any respiratory symptom was 79% in subjects with both snoring and nGOR versus 56% in those with neither (p<0.001). Subjects with both snoring and nGOR had more frequent exacerbations (adjusted prevalence 32% versus 19% among "no snoring, no nGOR", p=0.003). Snoring but not nGOR was associated with a steeper decline in forced expiratory volume in 1 s over 10 years after adjusting for confounding factors (change in % predicted -5.53, versus -4.58 among "no snoring", p=0.04) and forced vital capacity (change in % predicted -1.94, versus -0.99 among "no snoring", p=0.03). Conclusions: Adults reporting both habitual snoring and nGOR had more respiratory symptoms and more frequent exacerbations of these symptoms. Habitual snoring was associated with a steeper decline in lung function over time.