Severity of Obstructive Sleep Apnea in Patients With and Without Cardiovascular-Related Diseases

Simon, Rosalind; Chirakalwasan, Naricha; Teerapraipruk, Busarakum; Hirunwiwatkul, Prakobkiat; Jaimchariyatam, Nattapong; Desudchit, Tayard; Charakorn, Natamon; Wanlapakorn, Chaisiri

doi:10.4187/respcare.01660

Cited by 8 publications

(7 citation statements)

References 14 publications

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“…A number of studies examined the association between sleep efficiency and arterial blood pressure, often reporting conflicting results [ 19 , 20 ]. Good sleep efficiency, defined as sleep efficiency >90%, was less frequently observed among OSAS patients with cardiovascular disease (OR 0.45 (0.22–0.91)) [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

“…In a study [ 22 ] that compared systolic arterial pressure and heart rate, nocturnal dipping between subjects with low and high sleep efficiency demonstrated that the group with low sleep efficiency presented a blunted dip of nocturnal systolic arterial pressure (10 ± 1 versus 14 ± 1%, p =0.04) and heart rate (12 ± 3 versus 21 ± 3%, p =0.03) compared with the high sleep efficiency group. Additionally, the low sleep efficiency group had higher mean nocturnal heart rate (63 ± 2 versus 55 ± 2 beats/min, p =0.02) [ 21 ]. In women, poor sleep quality has been associated with resistance to hypertensive treatment [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

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Cardiovascular Risk Assessment in a Cohort of Newly Diagnosed Patients with Obstructive Sleep Apnea Syndrome

Archontogeorgis

Voulgaris

Nena

et al. 2018

Cardiology Research and Practice

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Objectives Obstructive sleep apnea syndrome (OSAS) is associated with increased cardiovascular morbidity and mortality. The aim of this study was to assess whether the 10-year risk for cardiovascular disease in newly diagnosed patients with OSAS is increased. Materials and Methods Recently diagnosed, with polysomnography, consecutive OSAS patients were included. The Systematic Coronary Risk Evaluation (SCORE) and the Framingham Risk Score (FRS) were used to estimate the 10-year risk for cardiovascular disease. Results Totally, 393 individuals (73.3% males), scheduled to undergo a polysomnographic study with symptoms indicative of OSAS, were enrolled. According to apnea-hypopnea index (AHI), subjects were divided in four groups: mild OSAS (AHI 5–14.9/h) was diagnosed in 91 patients (23.2%), moderate OSAS (AHI 15–29.9/h) in 58 patients (14.8%), severe OSAS (AHI > 30/h) in 167 patients (42.5%), while 77 individuals (19.6%) had an AHI < 5/h and served as controls. Increased severity of OSAS was associated with increased SCORE (p < 0.001) and FRS values (p < 0.001). More specifically, a significant correlation was observed both between AHI and SCORE (r=0.251, p < 0.001) and AHI and FRS values (r=0.291, p < 0.001). Furthermore, a negative correlation was observed between FRS values and sleep efficiency (r=−0.224, p=0.006). Conclusions The 10-year risk for cardiovascular morbidity and mortality seems to increase with severity of OSAS. Physicians should bear this finding in mind, in order to seek for and consecutively eliminate risk factors for cardiovascular disease and to prevent future cardiovascular events in OSAS patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Cardiovascular Risk Assessment in a Cohort of Newly Diagnosed Patients with Obstructive Sleep Apnea Syndrome

Archontogeorgis

Voulgaris

Nena

et al. 2018

Cardiology Research and Practice

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“…Simon et al . [ 30 ] in a cohort of 190 subjects tried to see whether any of the cardiovascular diseases correlated with the severity of OSA. They found that patients with any risk factor were noticed to have more severe OSA with an odds ratio 3.24.…”

Section: Discussionmentioning

confidence: 99%

Clinical and polysomnographic predictors of severe obstructive sleep apnea in the South Indian population

Sreedharan¹,

Agrawal²,

Rajith³

et al. 2016

Ann Indian Acad Neurol

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Background:With the emergence of lifestyle diseases in epidemic proportions, obstructive sleep apnea (OSA) is being increasingly recognized in less developed countries as well.Aim:We sought to study the demographic, clinical, and polysomnographic (PSG) predictors of OSA severity in a cohort of South Indian patients.Materials and Methods:Consecutive patients with PSG proven OSA [apnea hypopnea index (AHI) ≥5/h] were prospectively recruited. The study period was from January 2012 to December 2012. Demographic data, history of vascular risk factors, substance abuse, sleep quality, snoring, and witnessed apneas were collected using a structured pro forma. In addition, PSG variables such as AHI, sleep latency and efficiency, duration of slow wave and rapid eye movement (REM) sleep, and other parameters were collected. Correlations between AHI severity and clinical and PSG parameters were done.Results:There were 152 (119 males and 33 females) subjects with a mean age of 53.8 years and body mass index (BMI) of 29.31. Mean AHI was 36.2/h (range: 5.1-110) and 66 subjects had severe OSA. Around 12% had the presenting complaint as insomnia, mainly of sleep maintenance. Of the subjects, 35% had witnessed apneas and 67% had excessive daytime sleepiness (EDS); 40% of patients had ≥2 risk factors. PSG parameters showed short sleep onset latency with a high arousal index. Mean apnea duration was 24.92 s. We found that age >55 years, BMI >25 kg/m2, witnessed apneas, EDS, hypertension, dyslipidemia, reduced slow wave sleep duration, mean apnea duration >20 s, and desaturation index >10/h correlated well with OSA severity while the arousal index, sleep latency and efficiency, and exposure to smoking and alcohol showed no association.Conclusions:Older subjects with witnessed apneas are likely to have more severe OSA. Even though overall sleep architecture was similar between the groups, severe OSA had shorter slow wave sleep, longer apneas, and higher nocturnal hypoxemia.

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“…7 Simon et al recently suggested that cardiovascular-related disease may indicate a higher risk for sleep apnea and that elderly patients with cardiovascular disease should be screened for sleep apnea. 8 Interventions for OSA include weight loss, altered sleeping positioning, and CPAP. 9 Elderly patients who use CPAP for OSA have increased alertness; improved neurobehavioral outcomes in cognitive processing, memory, and executive function; and decreased sleep disruption.…”

Section: Introductionmentioning

confidence: 99%

Factors Affecting CPAP Acceptance in Elderly Patients With Obstructive Sleep Apnea in Taiwan

et al. 2013

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BACKGROUND: The prevalence of obstructive sleep apnea (OSA) increases with age. Treatment often includes CPAP. CPAP adherence is correlated with disease severity and symptoms. We hypothesized that CPAP acceptance rates in elderly patients with OSA would be lower than in younger patients with OSA, and examined factors associated with CPAP acceptance. METHODS: We reviewed the charts of 315 subjects with OSA (apnea-hypopnea index > 5 events/h) who were treated at our hospital from 2008 to 2011 with CPAP therapy. All underwent CPAP titration testing before CPAP prescription. Subjects were grouped by age: young (25-40 y, n ‫؍‬ 35), middle-age (41-65 y, n ‫؍‬ 169), and elderly (> 65 y, n ‫؍‬ 111). Demographic variables, excessive daytime sleepiness, overnight polysomnography study variables, CPAP acceptance, and CPAP adherence were compared. Regression analysis was performed to identify factors associated with acceptance. RESULTS: The elderly subjects had less excessive daytime sleepiness and less pronounced alterations in overnight polysomnography variables than the subjects in the other groups, but had more cardiovascular comorbidities. The CPAP acceptance rate (overall 125/315, 39.7%) was significantly lower in the elderly group, compared with the younger group (31.5% vs 60%, P ‫؍‬ .01). CPAP acceptance was associated with fewer comorbidities, higher excessive daytime sleepiness, and higher apnea-hypopnea index, but not age. CPAP adherence was not associated with age. CONCLUSIONS: CPAP acceptance is low in elderly patients in Taiwan. CPAP acceptance, instead of CPAP adherence, is the critical issue with elderly patients with OSA.

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Severity of Obstructive Sleep Apnea in Patients With and Without Cardiovascular-Related Diseases

Cited by 8 publications

References 14 publications

Cardiovascular Risk Assessment in a Cohort of Newly Diagnosed Patients with Obstructive Sleep Apnea Syndrome

Cardiovascular Risk Assessment in a Cohort of Newly Diagnosed Patients with Obstructive Sleep Apnea Syndrome

Clinical and polysomnographic predictors of severe obstructive sleep apnea in the South Indian population

Factors Affecting CPAP Acceptance in Elderly Patients With Obstructive Sleep Apnea in Taiwan

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