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A Cross-sectional Study of 3323 Men Aged 54 to 74 Years: The Copenhagen Male Study

Poul Jennum, MD; Hans Ole Hein, MD; Poul Suadicani, OD; Finn Gyntelberg, MD

Arch Neurol. 1994;51(9):937-942.

Abstract
Objective
Cognitive symptoms, headache, and sleeprelated complaints, including snoring, are commonly reported by patients with sleep apnea. Because patients with sleep apnea generally are snorers, we decided to study whether snoring per se is associated with cognitive complaints and headache.

Design
Cross-sectional epidemiologic follow-up study.

Setting
General community.

Participants
A total of 3323 men, aged 54 to 74 years, previously selected from among employees of public or private companies in the Copenhagen, Denmark, area.

Method
Participants were classified according to self-reported snoring habits and these were compared with self-reported cognitive complaints and headache. Fourteen potential confounders were included.

Results
The odds ratio (95% confidence interval) for headache was 1.5 (1.3 to 1.8, P<.0001) for self-reported snorers after adjustments for age, body mass index, and alcohol and tobacco consumption, whereas no relationships were found between snoring and memory or concentration problems in the total population. Snoring was not related to use of central nervous system medication; previous stroke; presence of parkinsonism, epilepsy, or psychiatric diseases; previous head trauma; or exposure to organic solvents. Hypersomnia was significantly associated with snoring (P<.0001), headache (P<.0001), memory problems (P<.0001), concentration problems (P<.0001), age (P<.01), body mass index (P<.001), and alcohol consumption (P<.05) and negatively correlated with smoking (P<.0001). Irrespective of the severity of hypersomnia, no association was found between snoring and memory or concentration problems. The relationship between snoring and headache was independent of severity of hypersomnia.

Conclusions
Snoring is associated with headache but not with cognitive dysfunction. Hypersomnia shows a correlation to cognitive problems. If associations are found between snoring and cognitive dysfunction, these may be related in part to the presence of hypersomnia.

Author Affiliations
From the Departments of Neurology and Clinical Neurophysiology, Hvidovre (Denmark) Hospital, University of Copenhagen (Denmark) (Dr Jennum); and the Epidemiological Research Unit, Department of Occupational Medicine, Rigshospitalet (Drs Hein and Gyntelberg and Mr Suadicani), and The Glostrup Population Studies, Department of Internal Medicine C, Glostrup Hospital (Drs Jennum and Hein) University of Copenhagen.

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