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Smoking and Snoring in Twins

Franklin and colleagues (1) recently demonstrated a significant relationship between smoking and habitual snoring. Because both snoring (2) and factors associated with airway inflammation (3) are heritable, we decided to investigate this association in the Vietnam Era Twin (VET) Registry.

The VET Registry consists of 7,368 male–male monozygotic and dizygotic twin pairs. A health questionnaire was sent to 10,762 registry members in 1999 asking, among other things, if they smoked, snored heavily, and were ever diagnosed with obstructive sleep apnea (OSA). Twins who smoked were more likely to snore compared with co-twins who did not smoke (26.9% versus 21.1%; OR, 1.44; 95% CI, 0.98–2.13; p = 0.06). Conversely, the prevalence of OSA was similar in twins who smoked compared with co-twins who did not smoke (4.7% versus 5.5%; OR, 0.83; 95% CI, 0.42–1.65; p = 0.60). This suggests that the relationship between smoking and snoring persists even when controlling for familial/genetic factors. The lack of an association between smoking and sleep apnea suggests that although smoking contributes to airway resistance and snoring, it does not progress to clinically apparent sleep apnea. Franklin and colleagues point out that the relationship between smoking and snoring is stronger for women than for men. The VET Registry only contains male twins, and we could not examine the association in females. Nevertheless, our twin analysis supports the findings of Franklin and colleagues of an association between smoking and snoring (1).

Theodore Bushnell, Nathaniel F. Watson, E. Fischer and Jack Goldberg

University of Washington, Seattle, Washington

FOOTNOTES

Conflict of Interest Statement: T.B. does not have a financial relationship with a commercial entity that has an interest in the subject of this manuscript; N.F.W. does not have a financial relationship with a commercial entity that has an interest in the subject of this manuscript; M.E.F. does not have a financial relationship with a commercial entity that has an interest in the subject of this manuscript; J.G. 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]
2. Ferini-Strambi L, Calori G, Oldani A, Della Marca G, Zucconi M, Castronovo V, Gallus G, Smirne S. Snoring in twins. Respir Med 1995;89:337–340.[Medline]
3. Pankow JS, Folsom AR, Cushman M, Borecki IB, Hopkins PN, Eckfeldt JH, Tracy RP. Familial and genetic determinants of systemic markers of inflammation: the NHLBI family heart study. Atherosclerosis 2001;154:681–689.[CrossRef][Medline]

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