Sleep apnoea is common in severe peripheral arterial disease

Schahab, Nadjib; Sudan, Sarah; Schaefer, Christian; Tiyerili, Vedat; Steinmetz, Martin; Nickenig, Georg; Skowasch, Dirk; Pizarro, Carmen

doi:10.1371/journal.pone.0181733

Cited by 16 publications

(20 citation statements)

References 32 publications

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“…[14] Schahab et al reported OSA prevalence of 82% in a population with LEAD (n = 59), of which 35% were mild, 27% moderate, and 38% severe. [16] These differences in distribution cannot be explained by the localization of vascular lesions in tested cohorts, as data from the current study revealed no significant differences in OSA prevalence or its severity between LEAD and carotid artery disease subgroups. It is worth noting that Utriainen et al had the same scoring criteria for AHI assessment applied in the current study while Schahab et al used a more liberal criterion for hypopnea scoring, i.e., the same criterion for a reduction in airflow (≥50%) with smaller oxygen desaturation range (≥3%).…”

Section: Discussioncontrasting

confidence: 58%

Prevalence of obstructive sleep apnea in patients with peripheral arterial diseases

et al. 2019

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Background The presence of obstructive sleep apnea (OSA), a novel cardiovascular risk factor, contributes to the development of peripheral arterial diseases (PAD). There is a lack of data showing how often these diseases coexist. Aims The aim of the study was to determine the prevalence of OSA in the population of patients with PAD. Methods Patients previously qualified for the first revascularization due to PAD were included in the study. All patients underwent an overnight sleep study to detect OSA. Diagnosis of OSA was made when the apnea-hypopnea index (AHI) was ≥5 per hour. Results From 141 patients (60% men, age 69.6 ± 9.5 years), OSA was diagnosed in 68 patients (48%). OSA occurred in mild form (5 ≤ AHI < 15/h) in 39 cases (28%), in moderate form (15 ≤ AHI < 30/h) in 21 cases (15%), and in severe form (AHI ≥ 30/h) in 8 cases (6%). Patients without OSA had significantly lower body mass index (BMI; 26.9 ± 5.5 vs. 27.7 ± 5.3 kg/m 2 , p = 0.01) and lower hip circumference (97.4 ± 11.7 vs. 98.7 ± 7.4, p = 0.04). There were no differences in the distribution of other investigated cardiovascular risk factors and diseases between these groups. There were no significant differences in OSA distribution or its severity between patients with lower extremity artery disease and carotid artery disease. Conclusions The prevalence of OSA in patients with PAD is very high, affecting nearly half of the studied population.

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Section: Discussioncontrasting

confidence: 58%

Prevalence of obstructive sleep apnea in patients with peripheral arterial diseases

et al. 2019

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“…Ultimately, the review included 8 articles. [19][20][21][22][23][24][25][26] The flow diagram of the search procedure is shown in Figure 1.…”

Section: Search Resultsmentioning

confidence: 99%

“…High prevalence of SDB ranging from 70.3% to 85.4% in patients with PAD was demonstrated in 3 studies. [24][25][26] Meanwhile, 2 studies exhibited higher prevalence of SDB in participants with PAD than those without. 19,22 In 240 patients with ischemic stroke, those with PAD had higher prevalence of SDB (75%) than those without PAD (23%), 19 and the same pattern went into the study performed by Chen et al in general population (0.8% vs 0.5%, P < .001 22 ; see Table 2).…”

Section: Resultsmentioning

confidence: 99%

“…Associations between SDB and PAD. Apnea-Hypopnea Index (AHI) was found to be significantly correlated with advanced Fontaine stage (P ¼ .042) in 59 patients with PAD 24 and increased with elevating PAD severity (P ¼ .047) in 91 patients with PAD. 25 Five studies [19][20][21][22][23] showed that the positive associations between SDB and PAD remained significant after adjusting for multiple confounders, and the details were demonstrated subsequently.…”

Section: Resultsmentioning

confidence: 99%

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Sleep-Disordered Breathing and Peripheral Arterial Disease: Current Evidence

et al. 2019

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Introduction: Sleep-disordered breathing (SDB) is associated with atherosclerosis. Peripheral arterial disease (PAD) is a manifestation of atherosclerosis in lower extremity arteries. No systematic review addressing the relationship between PAD and SDB was found. We performed this study aimed to summarize the relationship between SDB and PAD described in current clinical studies. Material and Methods: PubMed and Embase electronic databases were searched for clinical articles (published before 3 April, 2019) describing studies that evaluated the association between SDB and PAD. We showed the results involved in the association in clinical studies. Results: In total, 8 clinical studies have been included, and most of them were cross-sectional studies. Six articles demonstrated the coexistence of SDB and PAD, evidenced by high prevalence of SDB in patients with PAD and vice versa. Meanwhile, the included studies exhibited independent positive associations between SDB or sleep parameters and PAD after adjusting for multiple confounders. Conclusion: From present clinical prospective, positive association between SDB and PAD was shown. More prospective, randomized controlled studies are needed to establish the cause–effect relationships involved.

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“…Similarly, another study examined the relationship of SA and PAD in 59 individuals found that OSA is prevalent in those people. However, this relationship seems to be mediated by the presence of DM [26]. Overall, future population cohort might want to investigate in depth the relationship between OSA and PAD in the presence and absent of DM.…”

Section: Discussionmentioning

confidence: 99%

Associations between ankle-brachial index, diabetes, and sleep apnea in the Hispanic community health study/study of Latinos (HCHS/SOL) database

Alshehri

Alqahtani

Alenazi

et al. 2020

BMC Cardiovasc Disord

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Background: Sleep apnea and diabetes mellitus (DM) negatively impact cardiovascular health. One important indicator of cardiovascular health is the Ankle-Brachial Index (ABI). Either low ABI or high ABI are signs of peripheral vascular impairment. Impaired vascular health and DM, together, might provoke sleep apnea; however, information regarding these relationships is limited. Therefore, this study aimed to investigate the association between ABI, DM status, and severity of obstructive sleep apnea in people of Hispanic/Latino descent who are diverse in culture, environmental exposures, nativity, socioeconomic status, and disease burden. Methods: A cross sectional analysis from a multi-center epidemiologic study, Hispanic Community Health Study/ Study of Latinos, was utilized and included 3779 participants (mean age 55.32 ± 7.67, females 57.9%). The sample was divided into 4 groups based on the American Diabetes Association diagnostic guidelines (no DM or DM), and the ABI status (normal and abnormal). Multiple linear regression analysis was used to determine the association of the four groups and other independent variables with severity of sleep apnea measured by apnea-hypopnea index. Kruskal-Wallis H test was used for comparisons between groups for the apnea-hypopnea index. The significant level was set at 0.01. Results: There were significant differences between groups in the mean of apnea-hypopnea index (P < 0.001; no DM + normal ABI = 5.42 ± 9.66, no DM + abnormal ABI = 7.11 ± 11.63, DM + normal ABI = 10.99 ± 15.16, DM + abnormal ABI = 12.81 ± 17.80). Linear regression showed that DM and abnormal ABI were significantly associated with severe sleep apnea (β = 3.25, P = 0.001) after controlling for age, sex, BMI, income, education, alcohol use, cigarette use, hypertension or related medication, stroke and statin use.

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Sleep apnoea is common in severe peripheral arterial disease

Cited by 16 publications

References 32 publications

Prevalence of obstructive sleep apnea in patients with peripheral arterial diseases

Prevalence of obstructive sleep apnea in patients with peripheral arterial diseases

Sleep-Disordered Breathing and Peripheral Arterial Disease: Current Evidence

Associations between ankle-brachial index, diabetes, and sleep apnea in the Hispanic community health study/study of Latinos (HCHS/SOL) database

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