Increased fragility fracture risk in Korean women who snore: a 10-year population-based prospective cohort study

BACKGROUND Snoring is frequently associated with obstructive sleep apnea (OSA). Previous studies have shown that bone mineral density was significantly lower in patients with OSA than in controls; however, these studies did not focus on fractures. Fragility fractures can lead to long-term disabilities and a decrease in quality of life. The present study aimed to investigate the association between snoring and fragility fractures. METHODS This study included 2969 men and 3220 women aged 40 years and older from the Ansung and Ansan cohort studies in Korea. During a 10-year follow-up period, 129 and 273 fracture cases were reported in men and women, respectively. RESULTS Severe snoring (6-7 nights per week or sleep disturbance by snoring in the next room) was a statistically significant risk factor for fracture (p = 0.006, hazard ratio 1.68, 95% confidence interval 1.16-2.43) after adjusting for covariates related to fragility fracture in women. However, both snoring and severe snoring groups did not show significant associations with the fracture risk in men. CONCLUSIONS Thus, information on the frequency of snoring in women may improve the accuracy of fragility fracture risk prediction, which can help in deciding whether intervention or treatment is necessary.