OSA Is Common and Independently Associated With Hypertension and Increased Arterial Stiffness in Consecutive Perimenopausal Women

Pedrosa, Rodrigo Pinto; Barros, Isly Maria Lucena de; Drager, Luciano F.; Bittencourt, Márcio Sommer; Medeiros, Ana Kelley L.; Carvalho, Liana L.; Lustosa, Thais C.; Carvalho, Martinha Millianny Barros de; Ferreira, Moacir N.L.; Lorenzi-Filho, Geraldo; Costa, Laura Olinda Bregieiro Fernandes

doi:10.1378/chest.14-0097

Cited by 47 publications

(35 citation statements)

References 46 publications

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“…Data from the literature show that an association between OSAS and signs of arterial aging is already known: OSAS has been linked to increased aortic stiffness [10] and to PWV increase [11]. These observations are also confirmed by the improvement after OSAS treatment of both AIx [12] and PWV values [13][14][15].…”

Section: Introductionmentioning

confidence: 65%

Association between self-reported snoring and arterial stiffness: data from the Brisighella Heart Study

et al. 2015

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The correlation of both obstructive sleep apnoea syndrome (OSAS) and snoring with cardiovascular risk is well known, but its investigation is complex and not suitable for studying large cohorts of subjects. Thus, we prospectively evaluated 1476 non-pharmacologically treated subjects selected from the last survey of the Brisighella Heart Study. Snoring and sleep apnoea were investigated asking the subjects if they were aware of snoring during the night, and if this was associated with episodes of apnoea. A full set of clinical and laboratory parameters were evaluated, while augmentation index (AIx), and pulse wave velocity (PWV) were recorded with the Vicorder(®) apparatus. A logistic regression analysis identifies as main independent predictors of AIx age (OR 1.058, 95% CI 1.043-1.065, p < 0.001), Body Mass Index (OR 1.046, 95% CI 1.014-1.079, p = 0.005), and apolipoprotein B (OR 1.014, 95% CI 1.004-1.023, p = 0.001). The main independent predictors of PWV are snoring (OR 1.215, 95% CI 1.083-1.390, p < 0.001), and snoring with apnoea (OR 1.351, 95% CI 1.135-1.598, p = 0.014), age (OR 1.078, 95% CI 1.052-1.089, p < 0.001), serum uric acid [SUA] (OR 1.093, 95% CI 1.026-1.151, p < 0.001) and mean arterial pressure (OR 1.042, 95% CI 1.024-1.056, p < 0.001). In conclusion, in our cohort of overall healthy subjects, self-reported snoring and sleep apnoea are independently associated with a higher PVW, and AIx is statistically significantly higher in snorers with or without sleep apnoea than in non-snorers. Body Mass Index and apolipoprotein B are associated with AIx, while SUA and mean arterial pressure are related to PWV.

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Section: Introductionmentioning

confidence: 65%

Association between self-reported snoring and arterial stiffness: data from the Brisighella Heart Study

et al. 2015

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“…OSA is associated with a variety of cardiovascular disorders, including systemic arterial hypertension (SAH), myocardial ischemia, cardiac arrhythmia, stroke, and increased arterial stiffness 14 . In patients with OSA, the most common cardiovascular comorbidity is SAH, and the relationship between SAH and OSA was first described 30 years ago.…”

Section: Introductionmentioning

confidence: 99%

The role of physical exercise in obstructive sleep apnea

Andrade

Pedrosa

2016

J. bras. pneumol.

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Obstructive sleep apnea (OSA) is a common clinical condition, with a variable and underestimated prevalence. OSA is the main condition associated with secondary systemic arterial hypertension, as well as with atrial fibrillation, stroke, and coronary artery disease, greatly increasing cardiovascular morbidity and mortality. Treatment with continuous positive airway pressure is not tolerated by all OSA patients and is often not suitable in cases of mild OSA. Hence, alternative methods to treat OSA and its cardiovascular consequences are needed. In OSA patients, regular physical exercise has beneficial effects other than weight loss, although the mechanisms of those effects remain unclear. In this population, physiological adaptations due to physical exercise include increases in upper airway dilator muscle tone and in slow-wave sleep time; and decreases in fluid accumulation in the neck, systemic inflammatory response, and body weight. The major benefits of exercise programs for OSA patients include reducing the severity of the condition and daytime sleepiness, as well as increasing sleep efficiency and maximum oxygen consumption. There are few studies that evaluated the role of physical exercise alone for OSA treatment, and their protocols are quite diverse. However, aerobic exercise, alone or combined with resistance training, is a common point among the studies. In this review, the major studies and mechanisms involved in OSA treatment by means of physical exercise are presented. In addition to systemic clinical benefits provided by physical exercise, OSA patients involved in a regular, predominantly aerobic, exercise program have shown a reduction in disease severity and in daytime sleepiness, as well as an increase in sleep efficiency and in peak oxygen consumption, regardless of weight loss.

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“…33 Specifically, untreated obstructive sleep apnea is known to contribute to drowsy driving and automobile accidents, decrease in cognitive and work performance, hypertension, cardiovascular disease, diabetes, and depression. [34][35][36][37][38][39][40] According to previous studies by Chung et al, 17 screening for obstructive sleep apnea requires more than one question. To further emphasize that point, receiver operating curves for single questions (BRFSS#1, wake gasping, observed apneas, and total Epworth Sleepiness Scale) were all less than 0.6 and thus considered very weak predictors of an AHI > 5.…”

Section: Screening For Sleep Disordersmentioning

confidence: 99%

Validation of the Behavioral Risk Factor Surveillance System Sleep Questions

Jungquist

Mund

Aquilina

et al. 2016

Journal of Clinical Sleep Medicine

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Study Objective: Sleep problems may constitute a risk for health problems, including cardiovascular disease, depression, diabetes, poor work performance, and motor vehicle accidents. The primary purpose of this study was to assess the validity of the current Behavioral Risk Factor Surveillance System (BRFSS) sleep questions by establishing the sensitivity and specificity for detection of sleep/ wake disturbance. Methods: Repeated cross-sectional assessment of 300 community dwelling adults over the age of 18 who did not wear CPAP or oxygen during sleep. Reliability and validity testing of the BRFSS sleep questions was performed comparing to BFRSS responses to data from home sleep study, actigraphy for 14 days, Insomnia Severity Index, Epworth Sleepiness Scale, and PROMIS-57. Results: Only two of the five BRFSS sleep questions were found valid and reliable in determining total sleep time and excessive daytime sleepiness. I NTRO DUCTI O NThe Behavioral Risk Factor Surveillance System (BRFSS) is an ongoing telephone health survey system conducted by the Centers for Disease Control and Prevention (CDC) in the 50 United States as well as District of Columbia, Puerto Rico, the U.S. Virgin Islands, and Guam. The purpose of the BRFSS is to track health risk behaviors, preventive health practices, and health care access primarily related to chronic disease and injury. The use of the system started in 1984 and continues monthly. More than 350,000 adults are interviewed each year. Information from the surveys is used in research and clinical practice, and is frequently used to support public health policies and health-related legislative efforts. 1In early 2000, the CDC, in collaboration with the National Sleep Foundation, facilitated a work group charged with raising awareness about, increasing the understanding of, and reducing the impact of sleep deprivation and sleep disorders. In response to the work group's recommendations, the sleep question that was initiated in the BRFSS in 1995 was expanded upon with four optional module questions to capture sleep related symptoms. The current BRFSS sleep questions are: (1) During the past 30 days for about how many days have you felt you did not get enough rest or sleep; (2) On average, how many hours of sleep do you get in a 24-hour period? Think about the time you actually spend sleeping or napping, not just the amount of sleep you think you should get; (3) Do you snore; (4) During the past 30 days, for about how many days did you find yourself unintentionally falling asleep during the day; and (5) During the past 30 days, have you ever nodded off or fallen asleep, even just for a brief moment, while driving? The questions were implemented into the state telephone surveys around 2005, but to date, evidence of their validation is lacking. Therefore, a study was performed to assess the reliability and validity of the BRFSS sleep questions to determine their sensitivity to detect sleep disorders and insufficient sleep in adults. Establishing questions that will accurately identif...

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OSA Is Common and Independently Associated With Hypertension and Increased Arterial Stiffness in Consecutive Perimenopausal Women

Cited by 47 publications

References 46 publications

Association between self-reported snoring and arterial stiffness: data from the Brisighella Heart Study

Association between self-reported snoring and arterial stiffness: data from the Brisighella Heart Study

The role of physical exercise in obstructive sleep apnea

Validation of the Behavioral Risk Factor Surveillance System Sleep Questions

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