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Introduction: Snoring is often used as a surrogate measure for obstructive sleep apnea (OSA), a sleep disorder associated with elevated cardiovascular disease (CVD) risk. Although the literature supports a link between snoring and CVD, it is not clear if this association is independent of OSA. The objective of our study was to explore the association between snoring and subclinical CVD in adults with and without OSA. We hypothesized that snorers would have a greater burden of subclinical CVD, including thicker carotid intima media thickness (CIMT) and higher pulse wave velocity (PWV). Methods: Cross-sectional analyses were conducted using 24-month follow up data from the Slow Adverse Vascular Effects (SAVE) study, a randomized controlled trial evaluating the effects of weight loss, increased physical activity, and reduced dietary sodium intake on vascular health. The original population included 349 men and women aged 20-45 years and BMI 25-40 kg/m 2 . Participants (n=122) with objective measures of sleep-disordered breathing from a home-based sleep assessment (ResMed ApneaLink) were grouped into three categories using the snoring index (SI) and oxygen desaturation index (ODI). SI is defined as the number of vibratory snoring events per hour of recording time . ODI is the number of oxyhemoglobin desaturations of ≥ 4% per hour of recording . The snoring categories were: OSA (ODI≥5; n=41), heavy snoring (ODI Results: Participants were on average 40.1 ± 5.9 years old (BMI of 31.6 ± 4.4 kg/m 2 ; 76.2% women and 82% white). Across snoring severity categories, most CVD risk factors worsened including age, blood pressure, BMI, lipids, and fasting glucose (ANOVA; all p ± 0.06 vs. 0.63 ± 0.07; mm), respectively. Following covariate adjustment, differences in carotid inter-adventitial diameter and IMT persisted between normal and heavy snoring categories (p Conclusion: Our findings suggest that, in overweight and obese adults, objectively measured snoring is related to indices of local vascular remodeling and aging, even in those without OSA. Snoring severity may be associated with CVD risk.

Introduction: Lifestyle interventions, with physical activity (PA) as a key component, are important to reducing cardiometabolic disease risk. In our work in both efficacy and effectiveness clinical trials, we have shown that season has a significant impact on subjectively determined moderate-vigorous (MV) PA levels, both at baseline and during the intervention. However, the effect of season in these lifestyle interventions has not yet been examined utilizing objective measurements of PA so that time spent in all PA intensities and sedentary behavior(SB) can be quantified. Hypothesis: Our hypothesis is that PA would increase and SB would decrease due to the intervention but that season would have an additional effect on both. Methods: We enrolled 150 overweight/obese adults (51.1±10.2 y; 79% Caucasian; 91% female) in a 12-month lifestyle intervention for weight loss that provided regular feedback to participants on diet and PA goal achievement. Six cohorts were recruited from 2012-2014. The PA goal was to achieve and maintain 150 minutes/week of MVPA. ActiGraph GT3x accelerometers, worn on the waist, were used to assess average daily step counts and time spent in PA and SB. Accelerometer recordings with 10 hours/day of wear time on ≥4 days were considered a valid assessment of typical PA and SB. Changes in activity variables at 6 months and 12 months were examined using linear mixed models. We also examined the season (winter, spring, summer, or autumn) when the intervention was implemented and if this affected changes in PA and SB. Results: Baseline accelerometer data were valid for 149 participants. Mean (SD) baseline values were 6132 (1873) steps counts/day, 11 (11) MVPA min/day, 245 (64) light intensity (L)PA min/day, 635 (85) SB min/day. Season was significantly related to step counts, LPA, MVPA, and SB with significantly lower PA and higher SB in the winter (p0.05). When adjusted (for monitor wear time/day and season) mean (SD) increases in step counts from baseline were 1128 (208) and 742(209) steps/day at 6 and 12 months, respectively (both p Conclusions: Relevant improvements in steps counts and MVPA were recorded at 6 and 12 months. This was true even after controlling for the effect of differences in the season of implementation. When considering the effect of lifestyle interventions on activity, future studies should consider the effect of seasonal changes on PA levels.