![]() All subjects performed at least five forced expiratory manoeuvres and maximal values with ≥200 mL reproducibility were used for analysis. Forced expiratory volume in 1 s (FEV 1) and forced vital capacity (FVC) were recorded. A few centres differed in equipment but without notable heterogeneity in results. Lung function in ECRHS III was measured with the spirometer EasyOne (ndd Medical Technologies Inc., Andover, MA, USA) but in ECRHS I and II with the Biomedin Spirometer (Biomedin srl, Padua, Italy). Therefore, analysis of lung function decline was stratified by symptoms reported at the end of follow-up. Data on nGOR and snoring were only available from ECRHS III ( figure 1). Spirometry was performed on all three occasions, with reversibility testing with an inhaled β-adrenergic bronchodilator only performed in ECRHS III. In the current study, 759 (13%) participants came from the symptomatic sample. The majority of participants in the ECRHS I were randomly selected from the general population, with an additional subgroup selected based on a positive screening questionnaire on respiratory symptoms. Spirometry at ECRHS III was available from 5156 subjects. Data for this study were available for 5715 participants from 22 European centres and one centre in Melbourne, Australia. For the current study, data were used from the European Community Respiratory Health Survey (ECRHS) I, II and III, a prospective, international, population-based cohort study with three separate waves of visits over 20 years. This study is a part of the Ageing Lungs in European Cohorts (ALEC) consortium ( which is a large research collaboration that aims to improve knowledge on risk factors of lung diseases and lung function decline. The aim of the study was to examine the association of snoring and nGOR with respiratory symptoms and lung function, and to determine whether participants with snoring or nGOR had a steeper decline in lung function over a previous 20-year period. Otherwise, data on the respiratory effects of snoring and nGOR in combination are lacking. ![]() Recent data from a small, cross-sectional study found the combination of snoring and nGOR to associate synergistically with exacerbations of respiratory symptoms, with increased microaspirations of gastric contents being one plausible explanation. As snoring is even more prevalent in the general population, this makes snoring (a symptom of upper airway resistance) even more interesting in this context. ![]() There is a stronger association between nGOR and snoring than between nGOR and the apnoea–hypopnoea index. Īs nGOR and sleep disordered breathing often co-exist and are linked by an increased prevalence in obese individuals, it is of interest to study their combined effect on the respiratory tract. However, nGOR by itself is only weakly associated with changes in lung function. We have previously even found nGOR to associate with rhinosinusitis. Respiratory symptoms are also commonly associated with nGOR and having persistent nGOR induces various respiratory symptoms. Even though sleep disordered breathing induces airway inflammation and airway remodelling, it is not known if it causes changes in spirometry over time. Individuals with both sleep disordered breathing and asthma have poorer sleep quality and a lower nocturnal oxygen saturation. Snoring is associated with respiratory symptoms such as wheezing and chronic bronchitis. Asthma and sleep apnea can worsen each other and compound symptoms.Sleep disordered breathing and nocturnal gastro-oesophageal reflux (nGOR) are common and comorbid conditions, and both have inter-relationships with respiratory symptoms. Sleep apnea: Sleep apnea is a condition characterized by pauses in breathing during sleep.Epinephrine, melatonin, and thyroid hormones all have such effects. Hormones: Hormonal changes during sleep change your metabolism and your rate and depth of breathing. ![]() Inflammation plays a major role in asthma, and a slight increase can worsen your symptoms at night. This is related to a natural decline in your steroid levels.
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