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Associations of snoring frequency with blood pressure among the lean Japanese population: the Toon Health Study

Journal of Human Hypertension (2019) | Download Citation


To date, there are few studies in Asian populations on the association between snoring (a major clinical symptom of sleep apnea) and hypertension. This study aims to examine whether snoring frequency is associated with blood pressure and hypertension in the general Japanese population, after adjustment for major confounding factors. A cross-sectional study of 2021 middle-aged Japanese men and women enrolled in the Toon Health Study between 2009−2012 was conducted. Snoring frequency was assessed using a self-reported questionnaire, and was classified into four categories: never, ≤2 times/week, ≥3 times/week, and unknown. Multivariable regression coefficients for each snoring category were calculated for systolic and diastolic blood pressure, and their odds ratios (ORs) and 95% confidence intervals (95% CIs) for hypertension were calculated after adjusting for major confounding factors. The same analyses were also conducted after stratification by several major confounding factors. Multivariable-adjusted means of systolic and diastolic blood pressure among individuals who snored ≥3 times/week were 4.57 mmHg and 2.58 mmHg higher, respectively, than in individuals who never snored (p < 0.05). The multivariable-adjusted OR (95% CI) for hypertension in the group that snored ≥3 times/week was 1.79 (1.29–2.48), compared with the group that never snored. We also found a significant positive association between snoring frequency and hypertension not only in normal and overweight individuals, but also in lean individuals (body mass index ≤22.8 kg/m2). Higher snoring frequency was associated with higher blood pressure and hypertension among both lean and non-lean Japanese.

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This study was supported in part by Grants-in-Aid for Scientific Research from The Ministry of Education, Culture, Sports, Science and Technology of Japan (Grants-in-Aid for Research B, no 22390134 in 2010–2012 and 25293142 in 2013–2015, and Health and Labor Sciences Research Grants from the Ministry of Health, Welfare and Labor, Japan (Comprehensive Research on Life-Style Related Diseases including Cardiovascular Diseases and Diabetes Mellitus, no 201021038A in 2010–2012). The authors are grateful to the staff and participants of the Toon Health Study for their valuable contributions.

Author information


  1. Ehime University School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan

    • Ryoji Goto
  2. Department of Public Health, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan

    • Takeshi Tanigawa
    •  & Kiyohide Tomooka
  3. Laboratory of Community Health and Nutrition, Special Course of Food and Health Science, Department of Bioscience, Graduate School of Agriculture, Ehime University, 3-5-7 Tarumi, Matsuyama, Ehime, 790-8566, Japan

    • Koutatsu Maruyama
  4. Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Okayama, 700-8558, Japan

    • Eri Eguchi
  5. Department of Molecular and Genetic Medicine, Ehime University Graduate School of Medicine Shitsukawa, Toon, Ehime, 791-0295, Japan

    • Haruhiko Osawa
  6. Department of Public Health and Epidemiology, Faculty of Medicine, Oita University, Oita, Oita, 879-5593, Japan

    • Isao Saito


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The authors declare that they have no conflict of interest.

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Correspondence to Takeshi Tanigawa.

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