Association between snoring and insulin levels in the US population: a cross-sectional study

Snoring may cause a number of problems such as tiredness, obesity, and even severe diseases, but the correlation between snoring and insulin secretion, which has important clinical significance, has rarely been studied. The objective of this study was to evaluate the correlation between snoring frequency and insulin secretion and discuss the potential mechanisms, thereby estimating the health condition of β-cells of individuals who snore.

The analyses used data from National Health and Nutrition Examination Survey (NHANES) from 2015 to 2018. A regression analysis was performed for snoring frequency and insulin concentration, and then multiple regression analyses excluded various factors related to insulin secretion, including age, sex, race, body mass index (BMI), factors indicating patients' nutritional condition, and symptoms possibly implying obstructive sleep apnea. Subsequently, three hierarchical multiple regression analyses were carried out respectively based on sex, race, and BMI.

After adjusting for confounding variables, snoring frequency was correlated with insulin concentration especially when snoring was at relatively high frequencies (e.g., more than 5 nights per week) (β = 1.77, 95%CI = 0.42-3.13, P = 0.010). The stratification analyses showed that high snoring frequency increased insulin secretion among women (β = 1.83, 95%CI = 0.05-3.62, P = 0.044), Hispanics (β = 3.28, 95%CI = 0.05-6.51, P = 0.047), and participants with BMI in the range > 30 kg/m² (β = 3.77, 95%CI = 0.52-7.03, P = 0.023).

Our results suggest that snoring is likely to relate to an increase in insulin when severe, especially in women, Hispanics, and people with a BMI of more than 30 kg/m².