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Smoking and Snoring in Twins

In support of our finding that tobacco smoking is a major contributor to snoring (1), Bushnell and colleagues report a relationship between smoking and snoring in a large group of male twins. We find their report of the utmost interest, since they were able to control for inherited risk factors. Bushnell and coworkers report snoring in 26.9% of smoking subjects and 21.1% of nonsmokers. We found snoring in 24% of current smokers, 20.3% of exsmokers, and 13.7% of never-smokers. They report an odds ratio (OR) of 1.44 (95% CI, 0.98–2.13) for snoring due to smoking, while we found an OR of 2.1 (95% CI, 1.9–2.4) for smoking and 1.4 (95% CI, 1.3–1.6) for exsmoking. We classified our sample into current, ex- and never-smokers, while Bushnell and coworkers divided their sample into smokers and nonsmokers. This means that both exsmokers and never-smokers were classified as nonsmokers by Bushnell and coworkers, which could explain the higher odds ratio for smoking as a risk factor for snoring in our study. We report a dose dependency between smoking and snoring and the possibility of irreversible damage to the upper airways from smoking, since ex-smokers snored more than never-smokers. We found that smoking was related to snoring, independent of obesity, age, sex and center. Bushnell and coworkers found that smoking was related to snoring, also independent of familial/genetic factors. Taken together, these two studies show that an increase in upper airway resistance during sleep is another item to put on the already long list of the health-damaging effects of tobacco smoking.

Karl A. Franklin^a, Thórarinn Gíslason^b and Christer Janson^c

^a University Hospital, Umeå, Sweden
^b Landspitali University Hospital, Reykjavik, Iceland
^c Uppsala University, Uppsala, Sweden

FOOTNOTES

Conflict of Interest Statement: K.A.F. does not have a financial relationship with a commercial entity that has an interest in the subject of this manuscript; T.G. does not have a financial relationship with a commercial entity that has an interest in the subject of this manuscript; C.J. does not have a financial relationship with a commercial entity that has an interest in the subject of this manuscript.

REFERENCES

1. Franklin KA, Gíslason T, Omenaas E, Jõgi R, Jensen EJ, Lindberg E, Gunnbjörnsdóttir M, Nyström L, Laerum BN, Björnsson E, et al. The influence of active and passive smoking on habitual snoring. Am J Respir Crit Care Med 2004;170:799–803.[Abstract/Free Full Text]

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