Researchers from Peking University in China have identified a link between snoring and an increased risk of stroke, with findings published in The Lancet. The study examined a large Asian cohort to explore whether snoring is causally related to stroke and its subtypes using robust statistical methods.
The investigation included 82,339 adults of Asian origin, aged 30 to 79. Data were sourced from the Chinese Biobank, a repository of biological samples, and incorporated a comprehensive set of health-related measurements. To assess causality, the team applied Mendelian randomization (MR) analyses, a method that uses genetic variants as proxies to estimate the effect of a modifiable exposure on disease outcomes. The goal was to determine if snoring directly influences the risk of total stroke as well as its main subtypes: hemorrhagic and ischemic stroke. MRI imaging played a role in identifying brain changes associated with stroke risk in the context of snoring and other factors.
Participants’ height and weight were recorded as part of the study, and during a baseline health survey, individuals reported whether they snored. The project then entered a long observation phase, following volunteers for more than a decade to capture stroke incidence and related events. This extended follow-up was crucial for examining long-term associations and understanding the potential cumulative impact of snoring on cerebrovascular health.
Over the course of the study, 19,623 participants experienced a stroke. Of these events, 11,483 were ischemic strokes, and 5,710 were hemorrhagic strokes. The MR analysis revealed a positive association between snoring and the risk of all stroke types studied, supporting the interpretation that snoring itself may contribute to cerebrovascular risk beyond other known factors. These results align with broader evidence linking sleep-disordered breathing to cardiovascular and brain health, underscoring the potential importance of addressing snoring in stroke prevention strategies.
Several mechanisms were discussed to explain how snoring might elevate stroke risk. Intermittent breathing pauses during sleep can reduce oxygen delivery to tissues, triggering intermittent hypoxia that harms the endothelium, the inner lining of blood vessels. This endothelial dysfunction is driven in part by oxidative stress and inflammatory processes, which contribute to atherosclerosis and vascular instability. Recurrent vibration and mechanical stress from snoring may also influence the carotid arteries, potentially affecting arterial walls and increasing the likelihood of vascular injury. Together, these pathways offer plausible biological routes by which snoring could raise stroke risk over time.
In terms of prevention, the researchers noted that mitigating snoring could be an important component of reducing stroke risk, potentially complementing other measures like weight management and control of cardiovascular risk factors. While weight reduction remains beneficial for overall health, the study emphasizes that addressing sleep-disordered breathing might provide additional protective effects against stroke for certain individuals, especially those with genetic predispositions or existing risk factors.
Overall, the findings contribute to a growing body of evidence on how sleep-related breathing patterns influence brain and heart health. They highlight the value of large, well-characterized biobank data and rigorous causal inference methods in clarifying the links between modifiable behaviors and serious health outcomes. Clinicians may use this information to refine risk assessments and to discuss potential treatment options for patients who snore or exhibit sleep-disordered breathing patterns. Ongoing research will help identify which interventions are most effective in lowering stroke risk and how best to tailor recommendations to individual risk profiles.