Increased Incidence of Cardiovascular Disease in Middle-aged Men with Obstructive Sleep Apnea

Abstract

The incidence of a cardiovascular disease (CVD) was explored in a consecutive sleep clinic cohort of 182 middle-aged men (mean age, 46.8 +/- 9.3; range, 30-69 years in 1991) with or without obstructive sleep apnea (OSA). All subjects were free of hypertension or other CVD, pulmonary disease, diabetes mellitus, psychiatric disorder, alcohol dependency, as well as malignancy at baseline. Data were collected via the Swedish Hospital Discharge Register covering a 7-year period before December 31, 1998, as well as questionnaires. Effectiveness of OSA treatment initiated during the period as well as age, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP) at baseline, and smoking habits were controlled. The incidence of at least one CVD was observed in 22 of 60 (36.7%) cases with OSA (overnight oxygen desaturations of 30 or more) compared with in 8 of 122 (6.6%) subjects without OSA (p < 0.001). In a multiple logistic regression model, significant predictors of CVD incidence were OSA at baseline (odds ratio [OR] 4.9; 95% confidence interval [CI], 1.8-13.6) and age (OR 23.4; 95% CI, 2.7-197.5) after adjustment for BMI, SBP, and DBP at baseline. In the OSA group, CVD incidence was observed in 21 of 37 (56.8%) incompletely treated cases compared with in 1 of 15 (6.7%) efficiently treated subjects (p < 0.001). In a multiple regression analysis, efficient treatment was associated with a significant risk reduction for CVD incidence (OR 0.1; 95% CI, 0.0-0.7) after adjustment for age and SBP at baseline in the OSA subjects. We conclude that the risk of developing CVD is increased in middle-aged OSA subjects independently of age, BMI, SBP, DBP, and smoking. Furthermore, efficient treatment of OSA reduces the excess CVD risk and may be considered also in relatively mild OSA without regard to daytime sleepiness.

The attitudes of general dental practitioners and medical specialists to the provision of intra–oral appliances for the management of snoring and sleep apnoea

“…1 Sleep apnoea, or more specifi cally obstructive sleep apnoea (OSA), is a more serious problem as the apnoeic episodes lead to reduced blood oxygen saturation and cardiovascular problems (particularly hypertension) in the long term. 2 OSA also causes signifi cant daytime sleepiness, with impaired daytime functioning and increased risk of road traffi c accidents. [3][4][5][6] Uncomplicated snoring occurs in approximately 40% of the adult population in the UK and approximately 10% of these snorers have OSA.…”

The Association Between Snoring, Daytime Sleepiness and Obesity in Professional Wrestlers

“…OSA is associated with daytime sleepiness, poor academic performance, stroke, hypertension and ischemic heart disease (3,4).Furthermore, not only habitual snoring combined with OSA or upper airway resistance syndrome, but also habitual snoring alone appears to be linked with impaired daytime functioning in adults (5,6). Population based cohort studies revealed age, obesity, smoking, nasal (eg, septal deviation, rhinitis) and pharyngeal (eg, hypertrophy of tonsils, otitis) problems as independent risk factors for self reported habitual snoring (7,8).Professional wrestlers have some of risk factors for snoring including male gender, high body mass index (BMI) and large neck circumference.…”

Clinical Outcomes and Cost-effectiveness of Continuous Positive Airway Pressure to Manage Obstructive Sleep Apnea in Patients With Type 2 Diabetes in the U.K.

“…Nevertheless, even just the coexistence of OSA and T2D has important clinical, public health, and economic implications. They are both independently linked to high cardiovascular morbidity and mortality (6)(7)(8), and both are potential therapeutic targets for either primary or secondary prevention of cardiovascular disease. OSA is also linked to drug-resistant hypertension (9).…”