Is There Any Relationship Between Primary Snoring and Carotid Intima–Media Thickness? A Cross-Sectional Study

<b>Background/Objectives</b>: Clinical observations linking primary snoring (PS) to early markers of vascular dysfunction suggest a possible contribution to subclinical atherosclerosis. This study aimed to evaluate carotid and femoral intima-media thickness (cIMT and fIMT) in patients with atherosclerosis with or without PS, and to identify potential determinants of increased cIMT. <b>Methods</b>: In this cross-sectional study, 140 patients with atherosclerosis enrolled. Participants were divided into two groups based on polysomnography results: patients with PS (<i>n</i> = 95) and patients without snoring (<i>n</i> = 45). Demographic data and anthropometric measurements were recorded for all patients. High-resolution B-mode ultrasound was used to measure cIMT and fIMT. Group comparisons, correlation analyses, and multiple linear regressions were performed to evaluate the relationship between IMT and anthropometric parameters. <b>Results</b>: Patients with PS had significantly higher cIMT than patients without PS (0.90 ± 0.15 mm vs. 0.65 ± 0.10 mm, <i>p</i> < 0.001, Cohen's d = -1.83), whereas fIMT did not differ between groups (<i>p</i> = 0.185). Carotid IMT was positively correlated with age, body mass index (BMI), waist circumference, and neck circumference (all <i>p</i> < 0.001). Multivariate analysis identified age, waist circumference, and neck circumference as independent predictors of increased cIMT (adjusted R² = 0.31, <i>p</i> < 0.001). Within the PS group, no significant difference was observed between cIMT and fIMT (<i>p</i> = 0.33). <b>Conclusions</b>: PS is strongly associated with increased carotid intima-media thickness in patients with atherosclerosis, independent of obstructive sleep apnea. The absence of a similar effect in the femoral artery supports the hypothesis that mechanical vibrations caused by snoring may cause local vascular damage in the carotid wall. These findings suggest that PS may represent an independent risk factor and an early marker of carotid atherosclerosis.