{"paper_id":"34c7a797-fe4f-4286-b0c6-20c63caa242b","body_text":"Evaluating Snoring as a Cardiovascular Risk Factor: Myocardial Infarction, Stroke, and mortality in a 28-Year Study of 971 Middle-Aged Swedish Men in the Automotive industry | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Evaluating Snoring as a Cardiovascular Risk Factor: Myocardial Infarction, Stroke, and mortality in a 28-Year Study of 971 Middle-Aged Swedish Men in the Automotive industry Abdinasir Hussein, Lennart Dimberg This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8201060/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 8 You are reading this latest preprint version Abstract Background Cardiovascular disease (CVD) remains the leading cause of mortality worldwide, responsible for 32% of all deaths globally in 2019 and 29% of deaths in Sweden in 2023. Since the Framingham study began in 1942, numerous risk factors for CVD have been identified. Recently, interest has surged regarding the relationship between sleep-related breathing disorders and CVD, particularly concerning obstructive sleep-related apnea syndrome (OSAS), which is associated with an increased risk of hypertension, diabetes, myocardial infarction (MI), stroke, and dementia. However, research on snoring and the association with CVD remains inconclusive. This study aims to investigate the association between snoring and CVD, examining whether this association persists after adjusting for potential confounding factors, and to determine if snoring in men at ages 45-50 can serve as predictor of future cardiovascular outcomes. Results : In 1993, data on snoring were collected from 971 of addressed 1 000 men employed in automotive companies in Sweden who participated in a nurse-led health examination, which included completing a questionnaire and undergoing blood work at their workplace. In 2024, incidents of first-time myocardial infarctions, strokes, and deaths were identified using three national registries in Sweden. Statistical analyses were conducted to calculate odds ratios (OR) for snoring in relation to cardiovascular outcomes, perform multivariate analysis to identify potential confounders, and conduct survival analysis to assess the time to cardiovascular events. Habitual snorers exhibited higher levels of blood pressure, lipids, glucose and body mass index alongside increased rates of smoking and alcohol consumption compared to non-snorers or occasional snorers. The odds of cardiovascular mortality were 2.2 times (p=0.03) greater for snorers than for non-snorers and occasional snorers. Nevertheless, no statistical significance was observed in the multivariate analysis or the survival analyses regarding snoring. Conclusions : Habitual snorers demonstrate an increased likelihood of cardiovascular death compared to non-snorers and occasional snorers; however, the relationships between snoring and stroke, MI, and all-cause mortality remain unclear. Therefore, snoring cannot currently be classified as an independent risk factor for CVD, necessitating further investigation. Key words: snoring, myocardial infarction, stroke, mortality, cohort study, Swedish men Health sciences/Cardiology Health sciences/Diseases Health sciences/Health care Health sciences/Medical research Health sciences/Risk factors snoring myocardial infarction stroke mortality cohort study Swedish men Full Text Additional Declarations No competing interests reported. Supplementary Files Supplementsnoring.docx Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 27 Apr, 2026 Reviewers agreed at journal 09 Apr, 2026 Reviewers agreed at journal 07 Apr, 2026 Reviewers invited by journal 07 Apr, 2026 Editor assigned by journal 07 Apr, 2026 Editor invited by journal 18 Dec, 2025 Submission checks completed at journal 17 Dec, 2025 First submitted to journal 17 Dec, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {\"props\":{\"pageProps\":{\"initialData\":{\"identity\":\"rs-8201060\",\"acceptedTermsAndConditions\":true,\"allowDirectSubmit\":false,\"archivedVersions\":[],\"articleType\":\"Article\",\"associatedPublications\":[],\"authors\":[{\"id\":620418424,\"identity\":\"7fc6c266-704a-42df-8555-0904b2e7ac1e\",\"order_by\":0,\"name\":\"Abdinasir Hussein\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"University of Gothenburg\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Abdinasir\",\"middleName\":\"\",\"lastName\":\"Hussein\",\"suffix\":\"\"},{\"id\":620418427,\"identity\":\"3fdce28b-81cc-4c61-84e9-3a640f5a8a50\",\"order_by\":1,\"name\":\"Lennart Dimberg\",\"email\":\"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAsElEQVRIiWNgGAWjYBACA4bEBmYQg5+BgfEAaVokGxgYiNWSwADWYnCAaC3sya2bCyru2W0+fvjAAYYam2jCWngett2ecaY4eduZtIQDDMfSchsIapFIbLvN25aQbHYgx+AAY8NhYrX8S0g27n9DkpaGBDsDCaJtAfvlWEKCxI1nCQcSiPGLfXv6s9sFNQn2/P3JBx98qLEhrAUGEsEqE4hVDraNFMWjYBSMglEwwgAAYL1F413JErkAAAAASUVORK5CYII=\",\"orcid\":\"\",\"institution\":\"University of Gothenburg\",\"correspondingAuthor\":true,\"prefix\":\"\",\"firstName\":\"Lennart\",\"middleName\":\"\",\"lastName\":\"Dimberg\",\"suffix\":\"\"}],\"badges\":[],\"createdAt\":\"2025-11-25 08:53:32\",\"currentVersionCode\":1,\"declarations\":\"\",\"doi\":\"10.21203/rs.3.rs-8201060/v1\",\"doiUrl\":\"https://doi.org/10.21203/rs.3.rs-8201060/v1\",\"draftVersion\":[],\"editorialEvents\":[],\"editorialNote\":\"\",\"failedWorkflow\":false,\"files\":[{\"id\":106961484,\"identity\":\"ee316be5-d967-47a8-998d-b536803c6e53\",\"added_by\":\"auto\",\"created_at\":\"2026-04-15 09:25:44\",\"extension\":\"pdf\",\"order_by\":1,\"title\":\"\",\"display\":\"\",\"copyAsset\":false,\"role\":\"manuscript-pdf\",\"size\":1011606,\"visible\":true,\"origin\":\"\",\"legend\":\"\",\"description\":\"\",\"filename\":\"Manuscript20251217.pdf\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-8201060/v1_covered_dd2a702e-f2a8-44a6-8beb-728426999663.pdf\"},{\"id\":106922542,\"identity\":\"04c1f837-4d3f-4635-a3de-5ee50f2ca944\",\"added_by\":\"auto\",\"created_at\":\"2026-04-14 20:25:06\",\"extension\":\"docx\",\"order_by\":0,\"title\":\"\",\"display\":\"\",\"copyAsset\":false,\"role\":\"supplement\",\"size\":20479,\"visible\":true,\"origin\":\"\",\"legend\":\"\",\"description\":\"\",\"filename\":\"Supplementsnoring.docx\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-8201060/v1/ec100d58f7d40608f827b87e.docx\"}],\"financialInterests\":\"No competing interests reported.\",\"formattedTitle\":\"Evaluating Snoring as a Cardiovascular Risk Factor: Myocardial Infarction, Stroke, and mortality in a 28-Year Study of 971 Middle-Aged Swedish Men in the Automotive industry\",\"fulltext\":[],\"fulltextSource\":\"\",\"fullText\":\"\",\"funders\":[],\"hasAdminPriorityOnWorkflow\":false,\"hasManuscriptDocX\":false,\"hasOptedInToPreprint\":true,\"hasPassedJournalQc\":\"\",\"hasAnyPriority\":false,\"hideJournal\":false,\"highlight\":\"\",\"institution\":\"\",\"isAcceptedByJournal\":false,\"isAuthorSuppliedPdf\":true,\"isDeskRejected\":\"\",\"isHiddenFromSearch\":false,\"isInQc\":false,\"isInWorkflow\":false,\"isPdf\":true,\"isPdfUpToDate\":true,\"isWithdrawnOrRetracted\":false,\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"scientific-reports\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":false,\"externalIdentity\":\"scirep\",\"sideBox\":\"Learn more about [Scientific Reports](http://www.nature.com/srep/)\",\"snPcode\":\"\",\"submissionUrl\":\"\",\"title\":\"Scientific Reports\",\"twitterHandle\":\"\",\"acdcEnabled\":true,\"dfaEnabled\":true,\"editorialSystem\":\"stoa\",\"reportingPortfolio\":\"Scientific Reports\",\"inReviewEnabled\":true,\"inReviewRevisionsEnabled\":true},\"keywords\":\"snoring, myocardial infarction, stroke, mortality, cohort study, Swedish men\",\"lastPublishedDoi\":\"10.21203/rs.3.rs-8201060/v1\",\"lastPublishedDoiUrl\":\"https://doi.org/10.21203/rs.3.rs-8201060/v1\",\"license\":{\"name\":\"CC BY 4.0\",\"url\":\"https://creativecommons.org/licenses/by/4.0/\"},\"manuscriptAbstract\":\"\\u003cp\\u003e\\u003cstrong\\u003eBackground\\u003c/strong\\u003e Cardiovascular disease (CVD) remains the leading cause of mortality worldwide, responsible for 32% of all deaths globally in 2019 and 29% of deaths in Sweden in 2023. Since the Framingham study began in 1942, numerous risk factors for CVD have been identified. Recently, interest has surged regarding the relationship between sleep-related breathing disorders and CVD, particularly concerning obstructive sleep-related apnea syndrome (OSAS), which is associated with an increased risk of hypertension, diabetes, myocardial infarction (MI), stroke, and dementia. However, research on snoring and the association with CVD remains inconclusive. This study aims to investigate the association between snoring and CVD, examining whether this association persists after adjusting for potential confounding factors, and to determine if snoring in men at ages 45-50 can serve as predictor of future cardiovascular outcomes.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eResults\\u003c/strong\\u003e: In 1993, data on snoring were collected from 971 of addressed 1 000 men employed in automotive companies in Sweden who participated in a nurse-led health examination, which included completing a questionnaire and undergoing blood work at their workplace. In 2024, incidents of first-time myocardial infarctions, strokes, and deaths were identified using three national registries in Sweden. Statistical analyses were conducted to calculate odds ratios (OR) for snoring in relation to cardiovascular outcomes, perform multivariate analysis to identify potential confounders, and conduct survival analysis to assess the time to cardiovascular events.\\u003c/p\\u003e\\n\\u003cp\\u003eHabitual snorers exhibited higher levels of blood pressure, lipids, glucose and body mass index alongside increased rates of smoking and alcohol consumption compared to non-snorers or occasional snorers. The odds of cardiovascular mortality were 2.2 times (p=0.03) greater for snorers than for \\u0026nbsp;non-snorers and occasional snorers. Nevertheless, no statistical significance was observed in the multivariate analysis or the survival analyses regarding snoring.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eConclusions\\u003c/strong\\u003e: Habitual snorers demonstrate an increased likelihood of cardiovascular death compared to non-snorers and occasional snorers; however, the relationships between snoring and stroke, MI, and all-cause mortality remain unclear. 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