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Diabetes Metab J : Diabetes & Metabolism Journal



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Association of Snoring with Prediabetes and Type 2 Diabetes Mellitus: The Cardiovascular and Metabolic Diseases Etiology Research Center Cohort
So Mi Jemma Cho, Hokyou Lee, Jee-Seon Shim, Hyeon Chang Kim
Diabetes Metab J. 2020;44(5):687-698.   Published online April 16, 2020
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   

Evidence suggests that habitual snoring is an independent risk factor for poor glycemic health. We examined the associations between snoring with prediabetes and diabetes in Korean population.


Self-reported snoring characteristics were collected from 3,948 middle-aged adults without prior cardiovascular diseases. Multivariable linear regression assessed the association of snoring intensity, frequency, disruptiveness, and disrupted breathing with fasting glucose and glycosylated hemoglobin (HbA1c) level. Then, multinomial regression evaluated how increasing snoring symptoms are associated with the risk for prediabetes and diabetes, adjusting for socioeconomic and behavioral risk factors of diabetes, obesity, hypertension, and other sleep variables.


Higher snoring intensity and frequency were positively associated with fasting glucose and HbA1c levels. Participants presenting the most severe snoring were at 1.84 times higher risk (95% confidence interval [CI], 1.09 to 2.29) for prediabetes and 2.24 times higher risk (95% CI, 1.84 to 2.95) for diabetes, compared to non-snorers. Such graded association was also observed amongst the most frequent snorers with higher risk for prediabetes (odds ratio [OR], 1.78; 95% CI, 1.29 to 2.22) and diabetes (OR, 2.03; 95% CI, 1.45 to 2.85). Disruptive snoring (OR, 1.60; 95% CI, 1.12 to 2.28) and near-daily disruptive breathing (OR, 2.18; 95% CI, 1.02 to 4.19) were associated with higher odds for diabetes. Such findings remained robust after additional adjustment for sleep duration, excessive daytime sleepiness, unwakefulness, and sleep-deprived driving.


Snoring is associated with impaired glucose metabolism even in otherwise metabolically healthy adults. Habitual snorers may require lifestyle modifications and pharmacological treatment to improve glycemic profile.


Citations to this article as recorded by  
  • Does seasonality affect snoring? A study based on international data from the past decade
    Ping Wang, Cai Chen, Xingwei Wang, Ningling Zhang, Danyang Lv, Wei Li, Fulai Peng, Xiuli Wang
    Sleep and Breathing.2023; 27(4): 1297.     CrossRef
  • Association Between Snoring and Diabetes Among Pre- and Postmenopausal Women
    Yun Yuan, Fan Zhang, Jingfu Qiu, Liling Chen, Meng Xiao, Wenge Tang, Qinwen Luo, Xianbin Ding, Xiaojun Tang
    International Journal of General Medicine.2022; Volume 15: 2491.     CrossRef
  • Elevated fasting insulin results in snoring: A view emerged from causal evaluation of glycemic traits and snoring
    Minhan Yi, Quanming Fei, Kun Liu, Wangcheng Zhao, Ziliang Chen, Yuan Zhang
    European Journal of Clinical Investigation.2022;[Epub]     CrossRef
  • Sleeping Duration, Napping and Snoring in Association with Diabetes Control among Patients with Diabetes in Qatar
    Hiba Bawadi, Asma Al Sada, Noof Al Mansoori, Sharifa Al Mannai, Aya Hamdan, Zumin Shi, Abdelhamid Kerkadi
    International Journal of Environmental Research and Public Health.2021; 18(8): 4017.     CrossRef
  • Changes in creatinine‐to‐cystatin C ratio over 4 years, risk of diabetes, and cardiometabolic control: The China Health and Retirement Longitudinal Study
    Shanhu Qiu, Xue Cai, Yang Yuan, Bo Xie, Zilin Sun, Tongzhi Wu
    Journal of Diabetes.2021; 13(12): 1025.     CrossRef
  • Association Between Self-Reported Snoring and Metabolic Syndrome: A Systematic Review and Meta-Analysis
    Jinsha Ma, Huifang Zhang, Hui Wang, Qian Gao, Heli Sun, Simin He, Lingxian Meng, Tong Wang
    Frontiers in Neurology.2020;[Epub]     CrossRef
  • Early Development of Bidirectional Associations between Sleep Disturbance and Diabetes
    Yongin Cho
    Diabetes & Metabolism Journal.2020; 44(5): 668.     CrossRef

Diabetes Metab J : Diabetes & Metabolism Journal