{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T12:33:44Z","timestamp":1789994024749,"version":"4.0.1"},"reference-count":41,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2021,6,9]],"date-time":"2021-06-09T00:00:00Z","timestamp":1623196800000},"content-version":"unspecified","delay-in-days":8,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Swedish Heart Lung Foundation","award":["20090526"],"award-info":[{"award-number":["20090526"]}]},{"name":"EU FP6 project GA2LEN8)","award":["FOOD-CT-2004-506378"],"award-info":[{"award-number":["FOOD-CT-2004-506378"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2021,5,24]]},"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Habitual snoring is associated with fatigue, headaches and low work performance. This cross-sectional study aimed to investigate if snoring is affected by environmental factors such as home dampness and exposure to air pollution.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>General population sample from four Swedish cities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>25 848 participants from the Swedish part of the epidemiological Global Asthma and Allergy and European network of excellence study carried out in 2008. The participants completed a postal questionnaire on snoring and, indoor and outdoor environmental exposure as well as potential confounders including smoking, weight, height and educational level.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the participants, 4211 (16.3%) were habitual snorers. Habitual snorers reported water damage (8.3% vs 7.0% p&lt;0.0001), floor dampness (4.6% vs 3.8% % p&lt;0.0001) and visible mould (5.2% vs 3.8% p&lt;0.0001) in their homes more often than non-snorers. Habitual snorers stated being annoyed by air pollution more often than non-snorers with habitual snorers reporting being irritated with the air in their residential area to a higher extent (sometimes 16.2% vs 13.9%, and daily 4.6% vs 3.1%) as well as annoyance from traffic fumes (somewhat 19% vs 18.5% and very 5% vs 3.6%) (p&lt;0.0001). These results remained significant after adjustment for age, body mass index, smoking history and educational level.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Snoring is more prevalent in subjects reporting home dampness and air pollution. These association should be confirmed in further research using objective measurements and a longitudinal approach.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-044911","type":"journal-article","created":{"date-parts":[[2021,6,9]],"date-time":"2021-06-09T12:19:43Z","timestamp":1623241183000},"page":"e044911","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Snoring and environmental exposure: results from the Swedish GA2LEN study"],"prefix":"10.1136","volume":"11","author":[{"given":"Daniel","family":"Silverforsen","sequence":"first","affiliation":[{"name":"Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala Universitet, Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenny","family":"Theorell-Hagl\u00f6w","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala Universitet, Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirjam","family":"Ljunggren","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala Universitet, Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roelinde","family":"Middelveld","sequence":"additional","affiliation":[{"name":"The Centre for Allergy Research and Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Environmental and Occupational Medicine, Uppsala Universitet, Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl","family":"Franklin","sequence":"additional","affiliation":[{"name":"Department of Surgery, Umea Universitet, Umea, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Norb\u00e4ck","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Environmental and Occupational Medicine, Uppsala Universitet, Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Lundb\u00e4ck","sequence":"additional","affiliation":[{"name":"Krefting Research Centre, Goteborgs Universitet, Goteborg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bertil","family":"Forsberg","sequence":"additional","affiliation":[{"name":"Public Health and Clinical Medicine, Umea Universitet, Umea, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Lindberg","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala Universitet, Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5093-6980","authenticated-orcid":false,"given":"Christer","family":"Janson","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala Universitet, Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,6,9]]},"reference":[{"key":"2025121403434541000_11.6.e044911.1","doi-asserted-by":"publisher","DOI":"10.3109\/03009734.2012.707253"},{"key":"2025121403434541000_11.6.e044911.2","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1016\/j.sleep.2017.02.028","article-title":"Frequency of snoring, rather than apnea\u2013hypopnea index, predicts both cognitive and behavioral problems in young children","volume":"34","author":"Smith","year":"2017","journal-title":"Sleep Med"},{"key":"2025121403434541000_11.6.e044911.3","doi-asserted-by":"publisher","DOI":"10.1378\/chest.08-0847"},{"key":"2025121403434541000_11.6.e044911.4","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1093\/sleep\/19.7.531","article-title":"Prevalence and correlates of snoring and observed apneas in 5,201 older adults","volume":"19","author":"Enright","year":"1996","journal-title":"Sleep"},{"key":"2025121403434541000_11.6.e044911.5","doi-asserted-by":"publisher","DOI":"10.1016\/0895-4356(88)90061-3"},{"key":"2025121403434541000_11.6.e044911.6","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1046\/j.1440-1819.2000.00726.x","article-title":"Habitual snoring in an outpatient population in Japan","volume":"54","author":"Kayukawa","year":"2000","journal-title":"Psychiatry Clin Neurosci"},{"key":"2025121403434541000_11.6.e044911.7","doi-asserted-by":"publisher","DOI":"10.1378\/chest.114.4.1048"},{"key":"2025121403434541000_11.6.e044911.8","doi-asserted-by":"publisher","DOI":"10.1378\/chest.129.4.933"},{"key":"2025121403434541000_11.6.e044911.9","doi-asserted-by":"publisher","DOI":"10.1378\/chest.93.4.678"},{"key":"2025121403434541000_11.6.e044911.10","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1111\/j.1365-2796.1995.tb01176.x","article-title":"Daytime sleepiness, snoring and gastro-oesophageal reflux amongst young adults in three European countries","volume":"237","author":"Janson","year":"1995","journal-title":"J Intern Med"},{"key":"2025121403434541000_11.6.e044911.11","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1016\/j.sleep.2015.01.016","article-title":"The impact of obesity and weight gain on development of sleep problems in a population-based sample","volume":"16","author":"Palm","year":"2015","journal-title":"Sleep Med"},{"key":"2025121403434541000_11.6.e044911.12","doi-asserted-by":"publisher","DOI":"10.15537\/smj.2015.8.11848"},{"key":"2025121403434541000_11.6.e044911.13","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200404-474OC"},{"key":"2025121403434541000_11.6.e044911.14","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.161.12.1514"},{"key":"2025121403434541000_11.6.e044911.15","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1136\/oem.2003.011379","article-title":"Insomnia is more common among subjects living in dAMP buildings","volume":"62","author":"Janson","year":"2005","journal-title":"Occup Environ Med"},{"key":"2025121403434541000_11.6.e044911.16","doi-asserted-by":"crossref","DOI":"10.1016\/j.envint.2020.105691","article-title":"Dampness and mold at home and at work and onset of insomnia symptoms, snoring and excessive daytime sleepiness","volume":"139","author":"Wang","year":"2020","journal-title":"Environ Int"},{"key":"2025121403434541000_11.6.e044911.17","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31597-5"},{"key":"2025121403434541000_11.6.e044911.18","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00113113"},{"key":"2025121403434541000_11.6.e044911.19","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1002\/ppul.24256","article-title":"Association between air pollution and sleep disordered breathing in children","volume":"54","author":"S\u00e1nchez","year":"2019","journal-title":"Pediatr Pulmonol"},{"key":"2025121403434541000_11.6.e044911.20","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.sleep.2016.08.007","article-title":"Self-Reported exposure to traffic pollution in relation to daytime sleepiness and habitual snoring: a questionnaire study in seven North-European cities","volume":"24","author":"Gislason","year":"2016","journal-title":"Sleep Med"},{"key":"2025121403434541000_11.6.e044911.21","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.02255-2014"},{"key":"2025121403434541000_11.6.e044911.22","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1111\/j.1398-9995.2005.00822.x","article-title":"Spreading excellence in allergy and asthma: the GA2 LEN (global allergy and asthma European network) project","volume":"60","author":"Van Cauwenberge","year":"2005","journal-title":"Allergy"},{"key":"2025121403434541000_11.6.e044911.23","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2011.02709.x"},{"key":"2025121403434541000_11.6.e044911.24","doi-asserted-by":"publisher","DOI":"10.1111\/all.12079"},{"key":"2025121403434541000_11.6.e044911.25","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.164.11.2102028"},{"key":"2025121403434541000_11.6.e044911.26","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1093\/sleep\/29.6.751","article-title":"What are the important risk factors for daytime sleepiness and fatigue in women?","volume":"29","author":"Theorell-Hagl\u00f6w","year":"2006","journal-title":"Sleep"},{"key":"2025121403434541000_11.6.e044911.27","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.98.11040884"},{"key":"2025121403434541000_11.6.e044911.28","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2006.10.015"},{"key":"2025121403434541000_11.6.e044911.29","doi-asserted-by":"publisher","DOI":"10.1136\/thx.53.8.631"},{"key":"2025121403434541000_11.6.e044911.30","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1183\/09031936.94.07050845","article-title":"Excessive daytime sleepiness and fatigue in nonapnoeic snorers: improvement after UPPP","volume":"7","author":"Janson","year":"1994","journal-title":"Eur Respir J"},{"key":"2025121403434541000_11.6.e044911.31","doi-asserted-by":"crossref","first-page":"1383","DOI":"10.1111\/cea.12976","article-title":"Patient-Reported signs of dampness at home may be a risk factor for chronic rhinosinusitis: a cross-sectional study","volume":"47","author":"Ahlroth Pind","year":"2017","journal-title":"Clin Exp Allergy"},{"key":"2025121403434541000_11.6.e044911.32","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1111\/j.1752-699X.2008.00122.x","article-title":"Indoor environment in three North European cities in relationship to atopy and respiratory symptoms","volume":"3","author":"Gunnbj\u00f6rnsd\u00f3ttir","year":"2009","journal-title":"Clin Respir J"},{"key":"2025121403434541000_11.6.e044911.33","doi-asserted-by":"crossref","DOI":"10.1183\/13993003.01921-2018","article-title":"Dampness, mould, onset and remission of adult respiratory symptoms, asthma and rhinitis","volume":"53","author":"Wang","year":"2019","journal-title":"Eur Respir J"},{"key":"2025121403434541000_11.6.e044911.34","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1111\/ina.12517","article-title":"Dampness and mold in homes across China: associations with rhinitis, ocular, throat and dermal symptoms, headache and fatigue among adults","volume":"29","author":"Zhang","year":"2019","journal-title":"Indoor Air"},{"key":"2025121403434541000_11.6.e044911.35","doi-asserted-by":"crossref","DOI":"10.1007\/s11916-014-0468-6","article-title":"Sleep and chronic daily headache","volume":"19","author":"Stark","year":"2015","journal-title":"Curr Pain Headache Rep"},{"key":"2025121403434541000_11.6.e044911.36","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1080\/08958378.2018.1530316","article-title":"The toxicology of air pollution predicts its epidemiology","volume":"30","author":"Ghio","year":"2018","journal-title":"Inhal Toxicol"},{"key":"2025121403434541000_11.6.e044911.37","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwr380"},{"key":"2025121403434541000_11.6.e044911.38","doi-asserted-by":"publisher","DOI":"10.1007\/s004200050398"},{"key":"2025121403434541000_11.6.e044911.39","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1016\/j.atmosenv.2017.08.015","article-title":"Indicators of residential traffic exposure: Modelled NOX, traffic proximity, and self-reported exposure in RHINE III","volume":"167","author":"Carlsen","year":"2017","journal-title":"Atmos Environ"},{"key":"2025121403434541000_11.6.e044911.40","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1093\/sleep\/13.3.245","article-title":"Comparison of self- and spouse reports of snoring and other symptoms associated with sleep apnea syndrome","volume":"13","author":"Wiggins","year":"1990","journal-title":"Sleep"},{"key":"2025121403434541000_11.6.e044911.41","doi-asserted-by":"crossref","first-page":"1651","DOI":"10.1016\/j.rmed.2013.08.040","article-title":"Asthma and physical activity e A population based study results from the Swedish GA2LEN survey","volume":"107","author":"Jerning","year":"2013","journal-title":"Respir Med"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2020-044911","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T11:43:54Z","timestamp":1765712634000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2020-044911"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6]]},"references-count":41,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2021,6,9]]},"published-print":{"date-parts":[[2021,6]]}},"alternative-id":["10.1136\/bmjopen-2020-044911"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2020-044911","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6]]}}}