Undiagnosed Risk of Obstructive Sleep Apnea in Obese Individuals in a Primary Health Care Context

Ribeiro, Jaime Pimenta; Araújo, A de; Vieira, Cláudia; Vasconcelos, Filipe; Pinto, Pedro; Seixas, Benedita; Cêrca, Bruno; Borges, Isabel

doi:10.20344/amp.12319

Cited by 7 publications

(3 citation statements)

References 24 publications

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“…The 6% prevalence of OSA in EMPA-REG OUTCOME is lower than expected on the basis of a study population with a mean age of 63 years and mean BMI of 30.6 kg/m 2 (21). This may be because OSA is systematically underdiagnosed since it is notoriously difficult to diagnose and classify (22) and often not prioritized during busy clinic visits (23)(24)(25), leading to low reporting in trials (26). Nevertheless, as reported by others ( 27), we found in individuals with type 2 diabetes a consistently higher cardiometabolic burden associated with baseline OSA (e.g., higher BMI, higher utilization of insulin and antihypertensive medication, more prevalent CVD, and higher event rates for CV and heart failure outcomes).…”

Section: Discussionmentioning

confidence: 99%

The Impact of Empagliflozin on Obstructive Sleep Apnea and Cardiovascular and Renal Outcomes: An Exploratory Analysis of the EMPA-REG OUTCOME Trial

et al. 2020

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OBJECTIVE To explore the effects of empagliflozin on the incidence of obstructive sleep apnea (OSA) and its effects on metabolic, cardiovascular (CV), and renal outcomes among participants with or without OSA in the EMPA-REG OUTCOME trial. RESEARCH DESIGN AND METHODS Participants with diabetes and CV disease were randomized to empagliflozin (10 and 25 mg) or placebo daily in addition to standard of care. OSA was assessed by investigator report using Medical Dictionary for Regulatory Activities version 18.0, and CV outcomes were independently adjudicated. Analyses were performed using multivariable-adjusted Cox regression models. RESULTS OSA was reported in 391 of 7,020 (5.6%) participants at baseline. Those with OSA were more likely to be male (83% vs. 71%) and to have moderate to severe obesity (BMI ≥35 kg/m2; 55% vs. 18%). Over a median of 3.1 years, empagliflozin had similar placebo-adjusted reductions in HbA1c, waist circumference, and systolic blood pressure, regardless of OSA status, but a larger effect on weight (adjusted mean ± SE difference at week 52: OSA vs. no OSA −2.9 ± 0.5 vs. −1.9 ± 0.1 kg). Incidence of 3-point major adverse CV events, CV death, heart failure hospitalization, and incident or worsening nephropathy in the placebo group was 1.2- to 2.0-fold higher for those with baseline OSA compared with those without. Empagliflozin significantly reduced the risk for outcomes regardless of OSA status (P-interaction all >0.05). Fifty patients reported a new diagnosis of OSA through 7 days after medication discontinuation, and this occurred less often with empagliflozin treatment (hazard ratio 0.48 [95% CI 0.27, 0.83]). CONCLUSIONS In EMPA-REG OUTCOME, participants with OSA had greater comorbidity and higher frequency of CV and renal events. Empagliflozin had favorable effects on risk factors and CV and renal outcomes regardless of preexisting OSA and may also reduce the risk for new-onset OSA.

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Section: Discussionmentioning

confidence: 99%

The Impact of Empagliflozin on Obstructive Sleep Apnea and Cardiovascular and Renal Outcomes: An Exploratory Analysis of the EMPA-REG OUTCOME Trial

et al. 2020

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“…However, because of the lack of awareness by the public and healthcare professionals, the vast majority of sleep apnea remains undiagnosed and untreated (8,17). While obesity may be a component that contributes to sleep apnea, it is noteworthy that not all cases of sleep apnea are induced by obesity.…”

Section: Introductionmentioning

confidence: 99%

Body Mass Index and Its Association with Daytime Sleepiness and Risk of Sleep Apnea Among Adults in International Islamic University Malaysia (IIUM) KuantanBody Mass Index and Its Association with Daytime Sleepiness and Risk of Sleep Apnea Among Adults in International Islamic University Malaysia (IIUM) Kuantan

Shahadan,

Mustapah,

Mohamad Ismail

2023

Int J Care Scholars

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Introduction: The prevalence of obesity keeps rising by the year, and Malaysia was revealed as the top country in Southeast Asia that has a high prevalence of obesity. Due to the rising obesity globally is feared that it may be associated with the increasing chance of having sleep apnea and excessive daytime sleepiness. Consequently, it may lead to poor work performance, unfortunate accidents, and premature death if not treated earlier. This research sought to identify the BMI values and their association with the risk of sleep apnea and daytime sleepiness among adults in IIUM Kuantan. Methods: By applying convenience sampling, 143 respondents were recruited in this cross-sectional study. The Berlin questionnaire and Epworth Sleepiness Scale were used as the research instruments to determine the risk of sleep apnea and daytime sleepiness among the respondents, respectively. Ordinal Logistic Regression and Pearson correlation were used to analyse the associations. Result: The mean (SD) BMI was 22.3 kg/m2 (4.33)- normal, and the mean score of daytime sleepiness was 9.92 (4.80)- higher than normal. Most respondents had a low risk of sleep apnea (87.4%), 5.6% showed a slightly increased risk, and 7.0% had a high risk of sleep apnea. There is a significant association between BMI and risk of sleep apnea (p<0.05), as an increase in BMI (expressed in kg/m2) is associated with an increase in the odds of having a risk of sleep apnea. There is no significant association between BMI and daytime sleepiness (p>0.05), as these variables are weakly and inversely correlated. Conclusion: This study found a significant association between BMI and risk of sleep apnea. However, we failed to confirm the association between BMI and daytime sleepiness. Due to the lack of BMI varieties, the researcher recommends focusing on overweight and obese to get a wide variation of BMI.

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“…One of the most common sleep disorders is sleep apnea syndrome, also referred to as sleep-disordered breathing (SDB). Sleep apnea is an underdiagnosed medical condition [3,4] that is characterized by repeated episodes of absence (apnea) or reduction (hypopnea) in airflow during sleep, which can be either obstructive or central in origin. These events lead to hypoxia and microarousals, producing sleep fragmentation and leading to symptoms such as excessive fatigue and daytime sleepiness.…”

Section: Introductionmentioning

confidence: 99%

Detection of Sleep-Disordered Breathing in Patients with Spinal Cord Injury Using a Smartphone

Castillo-Escario

Kumru

Ferrer-Lluis

et al. 2021

Sensors

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Patients with spinal cord injury (SCI) have an increased risk of sleep-disordered breathing (SDB), which can lead to serious comorbidities and impact patients’ recovery and quality of life. However, sleep tests are rarely performed on SCI patients, given their multiple health needs and the cost and complexity of diagnostic equipment. The objective of this study was to use a novel smartphone system as a simple non-invasive tool to monitor SDB in SCI patients. We recorded pulse oximetry, acoustic, and accelerometer data using a smartphone during overnight tests in 19 SCI patients and 19 able-bodied controls. Then, we analyzed these signals with automatic algorithms to detect desaturation, apnea, and hypopnea events and monitor sleep position. The apnea–hypopnea index (AHI) was significantly higher in SCI patients than controls (25 ± 15 vs. 9 ± 7, p < 0.001). We found that 63% of SCI patients had moderate-to-severe SDB (AHI ≥ 15) in contrast to 21% of control subjects. Most SCI patients slept predominantly in supine position, but an increased occurrence of events in supine position was only observed for eight patients. This study highlights the problem of SDB in SCI and provides simple cost-effective sleep monitoring tools to facilitate the detection, understanding, and management of SDB in SCI patients.

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Undiagnosed Risk of Obstructive Sleep Apnea in Obese Individuals in a Primary Health Care Context

Cited by 7 publications

References 24 publications

The Impact of Empagliflozin on Obstructive Sleep Apnea and Cardiovascular and Renal Outcomes: An Exploratory Analysis of the EMPA-REG OUTCOME Trial

The Impact of Empagliflozin on Obstructive Sleep Apnea and Cardiovascular and Renal Outcomes: An Exploratory Analysis of the EMPA-REG OUTCOME Trial

Detection of Sleep-Disordered Breathing in Patients with Spinal Cord Injury Using a Smartphone

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