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. 2021 Apr 1:12:574649.
doi: 10.3389/fneur.2021.574649. eCollection 2021.

Snoring Is Associated With Increased Risk of Stroke: A Cumulative Meta-Analysis

Jing Bai  1 , Bing He  1 , Nan Wang  1 , Yifei Chen  1   2 , Junxiang Liu  1 , Haoran Wang  1 , Dongliang Liu  1
Affiliations

Snoring Is Associated With Increased Risk of Stroke: A Cumulative Meta-Analysis

Jing Bai et al. Front Neurol. .

Abstract

Background: Several studies have suggested that snoring is associated with an increased risk of stroke; however, the results are inconsistent. We aim to conduct a systematic review and meta-analysis of observational studies assessing the association between snoring and the risk of stroke in adults. Methods: We searched PubMed for relevant studies. A random-effect model was adopted to summary relative risks (RRs), and forest plots from a cumulative meta-analysis method were used for a better presentation of how the pooled RRs changed as updated evidence accumulated. Results: The literature search yielded 16 articles that met our inclusion criteria, and a total of 3,598 stroke patients and 145,901 participants were finally included in our analysis. A consistent trend toward association was found after the initial discovery, and the summary analysis indicated that snoring is associated with a 46% (RR, 1.46; 95%CI, 1.29-1.63; p < 0.001) increased risk of stroke. Conclusions: Snoring is associated with a significantly increased risk for stroke, up to 46%. The importance of the current study lies in that we provide an imputes to take a more active approach against the increased risk of stroke in snorers.

Keywords: meta-analysis; public health; risk factors; snoring; stroke.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
PRISMA Flow-diagram depicting identification and selection process for the present meta-analysis.
Figure 2
Figure 2
Cumulative meta-analysis describing the association between snoring and risk of stroke. The results indicated there is a consistent association after the initial discovery.
Figure 3
Figure 3
Subgroup analyses by (A) study design (prospective or retrospective), (B) total participants (over 1,000 or not), (C) stroke type (total stroke, ischemic stroke, and hemorrhagic stroke), and (D) gender (mixed, male, and female). Significant association between snoring and stroke exists in all the subgroups.
Figure 4
Figure 4
Sensitivity analyses by omitting one study at a time.
Figure 5
Figure 5
Begger's funnel plots to evaluate publication bias. The shape of the funnel plot was obviously symmetrical.
See this image and copyright information in PMC

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