Dongru Du,1– 3,* Jianjun Luo,1,4,* Weiling Cai,1,5 Jiangyue Qin,6 Yao Yang,1,2 Xueru Hu,1,2 Xiaohua Li,1,7 Fengming Luo,1– 3 Yongchun Shen1,2 

1Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, 610064, People’s Republic of China; 2State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu, 610064, People’s Republic of China; 3Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, Sichuan University, Chengdu, 610064, People’s Republic of China; 4Department of Intensive Care Unit, The People’s Hospital of Leshan, Leshan, 614000, People’s Republic of China; 5Department of Pulmonary and Critical Care Medicine, The People’s Hospital of Luojiang, Deyang, 618599, People’s Republic of China; 6General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, 610041, People’s Republic of China; 7Department of Pulmonary and Critical Care Medicine, Sixth People’s Hospital of Chengdu, Chengdu, Sichuan, 610051, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Fengming Luo; Yongchun Shen, Email fengmingluo@outlook.com; shen_yongchun@126.com

Objective: To investigate whether self-reported symptoms of obstructive sleep apnea (OSA), including snoring, snorting/stopping breathing, and sleepiness, are associated with increased risk of kidney stones.
Methods: This cross-sectional study was conducted based on the 2015– 2020 National Health and Nutrition Examination Survey (NHANES). Self-reported symptoms of OSA and history of kidney stones were diagnosed via questionnaires. Multivariable logistic regression was used to determine the associations between self-reported symptoms of OSA and kidney stones. Subgroup analyses and interaction tests were performed to address this issue further.
Results: A total of 9,973 participants were enrolled, and the prevalence of kidney stones was 10.76%. Although no significant association was observed between frequent snoring and kidney stones after covariate adjustments (OR 1.033, 95% CI 0.726, 1.469 p = 0.850), frequent snorting/stopping breathing was associated with a greater risk of kidney stones after covariate adjustments (OR 1.655, 95% CI 1.262, 2.172, p = 0.002). Participants who often or almost always felt sleepy also had a greater risk of kidney stones after covariate adjustment (OR 1.651, 95% CI 1.222, 2.229; p = 0.004). The interaction tests suggested that marital status (p = 0.015) and smoking status (p < 0.001) significantly interacted with the association between snorting/stopping breathing and kidney stones.
Conclusion: Self-reported frequent snorting/stopping breathing and sleepiness may be associated with increased risk of kidney stones. Although these findings may emphasize prevention of kidney stones in these people, further research was still needed to verify our results.

Keywords: obstructive sleep apnea, snoring, snorting/stopping breathing, sleepiness, kidney stones, NHANES