Self-reported habitual snoring and health-related quality of life among adults attending community health centers in Shanghai, China: a cross-sectional study

Abstract

Background Habitual snoring is a common symptom in primary care but is often overlooked as a minor nuisance. Although sleep-disordered breathing has been associated with adverse health outcomes, the association between self-reported habitual snoring and health-related quality of life (HRQoL) remains insufficiently characterized among adults attending community health centers in China. This study examined the association of habitual snoring with physical and mental HRQoL in this setting. Methods We conducted a cross-sectional study among 2,312 adults recruited from community health centers in Shanghai, China. Habitual snoring was defined as self-reported snoring on at least 3 nights per week. HRQoL was assessed using the 12-item Short Form Health Survey (SF-12), from which the Physical Component Summary (PCS) and Mental Component Summary (MCS) scores were derived. PCS and MCS scores < 50 were classified as below norm and were not interpreted as diagnostic cutoffs. Multivariable logistic regression models were used to examine the associations of habitual snoring with below-norm HRQoL after adjustment for sociodemographic characteristics, health behaviors, BMI, and chronic disease. As a sensitivity analysis, PCS and MCS were additionally analyzed as continuous outcomes using multivariable linear regression models. Results Of the 2,312 participants (mean age 44.4 years; 63% female), 36.9% reported habitual snoring (≥3 nights/week). Habitual snorers had significantly lower scores on both the Physical Component Summary (PCS: 42.9 vs. 46.0, P < 0.001) and the Mental Component Summary (MCS: 49.9 vs. 50.8, P = 0.023) compared to non-snorers. After multivariable adjustment, habitual snoring was associated with higher odds of below-norm physical HRQoL (ORm = 1.590, 95% CI: 1.291–1.957) and mental HRQoL (ORm = 1.250, 95% CI: 1.047–1.493). In sensitivity analyses, habitual snoring remained significantly associated with lower PCS (β = −2.38, 95% CI: −3.00 to −1.75) and lower MCS (β = −1.21, 95% CI: −2.04 to −0.38). Conclusion Habitual snoring was common among adults attending community health centers in Shanghai and was associated with lower physical and mental HRQoL, particularly physical HRQoL. These findings support greater attention to simple symptom-based screening for snoring in community care, where it may help identify individuals who may benefit from further sleep-related evaluation and health management.