Coexistence of cardiovascular risk factors and obstructive sleep apnoea in polysomnography

Gać, Paweł; Urbanik, Dominika; Macek, Piotr; Martynowicz, Helena; Mazur, Grzegorz; Poręba, Rafał

doi:10.1016/j.resp.2021.103782

Cited by 10 publications

(13 citation statements)

References 37 publications

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“…Significantly higher AHI values were seen in subgroups with a higher number of cardiovascular risk factors, as well as a higher incidence and severity of obstructive sleep apnea. Among the examined cardiovascular risk factors in the aforementioned study, only obesity, hypertension, and smoking were considered independent predictors of higher AHI values [ 47 ].…”

Section: Discussionmentioning

confidence: 99%

Comorbidity Profile and Predictors of Obstructive Sleep Apnea Severity and Mortality in Non-Obese Obstructive Sleep Apnea Patients

2023

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Backgrounds and Objectives: Obstructive sleep apnea (OSA) is associated with increased morbidity and mortality. OSA is an independent risk factor for many different conditions, especially cardiovascular diseases. The purpose of this study was to ascertain the comorbidity profile of non-obese patients with newly diagnosed OSA and evaluate the risk for cardiovascular disease and mortality. The present study also aimed to establish predictors for OSA severity. Materials and Methods: This study included 138 newly diagnosed patients who underwent polysomnographic analysis. The 10-year risk for cardiovascular disease was assessed using a newly validated prediction model: Systematic Coronary Risk Evaluation (SCORE-2). In addition, the Charlson Comorbidity Index (CCI) was assessed as a widely-used example of a mortality comorbidity index. Results: The study population included 138 patients: 86 males and 52 females. Patients were stratified, according to AHI (apnea/hypopnea index), into four groups: 33 patients had mild OSA (5 ≤ AHI < 15), 33 patients had moderate OSA (15 ≤ AHI < 30), 31 patients had severe OSA (AHI ≥ 30), and 41 individuals had AHI < 5, which were a part of the control group. SCORE-2 increased in line with OSA severity and was higher in OSA groups compared to the control group (H = 29.913; DF = 3; p < 0.001). Charlson Index was significantly higher in OSA patients compared to controls (p = 0.001), with a higher prevalence of total comorbidities in the OSA group of patients. Furthermore, CCI 10-year survival score was significantly lower in the OSA group, suggesting a shorter survival of those patients with a more severe form of OSA. We also examined the prediction model for OSA severity. Conclusions: Determining the comorbidity profile and estimation of the 10-year risk score of OSA patients could be used to classify these patients into various mortality risk categories and, according to that, provide them with adequate treatment.

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Section: Discussionmentioning

confidence: 99%

Comorbidity Profile and Predictors of Obstructive Sleep Apnea Severity and Mortality in Non-Obese Obstructive Sleep Apnea Patients

2023

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“…Numerous observational studies and a few longitudinal research studies found that cardiovascular events are the most prevalent complications in OSA (Appleton et al, 2018;Duan et al, 2023;Ga c et al, 2022;Pinto et al, 2016;Testelmans et al, 2022). Impaired…”

Section: Comorbid Phenotypesmentioning

confidence: 99%

“…In this review, comorbid OSA phenotypes are referred to as OSA with existing complications. Numerous observational studies and a few longitudinal research studies found that cardiovascular events are the most prevalent complications in OSA (Appleton et al, 2018; Duan et al, 2023; Gać et al, 2022; Pinto et al, 2016; Testelmans et al, 2022). Impaired HRV is related to the risk and incidence of adverse cardiovascular outcomes.…”

Section: Obstructive Sleep Apnea Phenotypingmentioning

confidence: 99%

Obstructive sleep apnea heterogeneity and autonomic function: a role for heart rate variability in therapy selection and efficacy monitoring

Qin,

Fietze,

Mazzotti

et al. 2023

Journal of Sleep Research

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SUMMARYObstructive sleep apnea is a highly prevalent sleep‐related breathing disorder, resulting in a disturbed breathing pattern, changes in blood gases, abnormal autonomic regulation, metabolic fluctuation, poor neurocognitive performance, and increased cardiovascular risk. With broad inter‐individual differences recognised in risk factors, clinical symptoms, gene expression, physiological characteristics, and health outcomes, various obstructive sleep apnea subtypes have been identified. Therapeutic efficacy and its impact on outcomes, particularly for cardiovascular consequences, may also vary depending on these features in obstructive sleep apnea. A number of interventions such as positive airway pressure therapies, oral appliance, surgical treatment, and pharmaceutical options are available in clinical practice. Selecting an effective obstructive sleep apnea treatment and therapy is a challenging medical decision due to obstructive sleep apnea heterogeneity and numerous treatment modalities. Thus, an objective marker for clinical evaluation is warranted to estimate the treatment response in patients with obstructive sleep apnea. Currently, while the Apnea–Hypopnea Index is used for severity assessment of obstructive sleep apnea and still considered a major guide to diagnosis and managements of obstructive sleep apnea, the Apnea–Hypopnea Index is not a robust marker of symptoms, function, or outcome improvement. Abnormal cardiac autonomic modulation can provide additional insight to better understand obstructive sleep apnea phenotyping. Heart rate variability is a reliable neurocardiac tool to assess altered autonomic function and can also provide cardiovascular information in obstructive sleep apnea. Beyond the Apnea–Hypopnea Index, this review aims to discuss the role of heart rate variability as an indicator and predictor of therapeutic efficacy to different modalities in order to optimise tailored treatment for obstructive sleep apnea.

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“…Obstructive sleep apnea (OSA), characterized by episodic upper-airway obstructions during sleep, affects nearly a billion adults aged 30-69 years globally [1] and is strongly associated with neurocognitive impairment, diminished quality of life, and an increased likelihood of hypertension, cancer, and metabolic, cardiovascular, and cerebrovascular diseases [2][3][4][5][6][7][8][9][10]. Although continuous positive airway pressure (CPAP) is the first-line treatment for OSA-a device serving to reduce upper-airway collapse during sleep [11]-CPAP adherence rates are suboptimal [12], and long-term benefits beyond reduction of apneahypopnea events per hour of sleep (i.e., the apnea-hypopnea index; AHI) and other indexes and parameters remain uncertain [13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Effect of a Weight Loss and Lifestyle Intervention on Dietary Behavior in Men with Obstructive Sleep Apnea: The INTERAPNEA Trial

et al. 2022

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This study investigated the effects of an eight-week interdisciplinary weight loss and lifestyle intervention on dietary behavior in men who were overweight/had obesity and moderate-to-severe obstructive sleep apnea (OSA). It was based on data from INTERAPNEA (ClinicalTrials.gov ID: NCT03851653); a randomized clinical trial conducted from April 2019 to April 2020. Men aged 18–65 years with moderate-to-severe OSA and a body mass index ≥25 kg/m2 were randomly assigned to a usual-care group or an eight-week interdisciplinary weight loss and lifestyle intervention combined with usual-care. Dietary behavior was assessed through the Food Behavior Checklist (FBC) and the Mediterranean Diet Adherence Screener (MEDAS). Of the 89 participants who underwent randomization, 75 completed the intervention endpoint assessment, 89 participants being therefore included in the intention-to-treat analyses, and 75 in the per-protocol approach. As compared with usual-care, the intervention group had greater improvements at intervention endpoint in dietary behavior, as measured by the FBC total score (20% increase in FBC total score, mean between-group difference, 8.7; 95% confidence interval, 5.7 to 11.7), and MEDAS total score (33% increase in MEDAS total score, mean between-group difference, 2.1; 95% CI 1.3 to 2.9). At 6 months after intervention, the intervention group also had greater improvements in both the FBC total score (15% increase) and MEDAS total score (25% increase), with mean between-group differences of 7.7 (CI 95%, 4.4 to 10.9) and 1.7 (CI 95%, 0.9 to 2.6), respectively. An eight-week interdisciplinary weight loss and lifestyle intervention resulted in meaningful and sustainable improvements in dietary behavior, including adherence to the Mediterranean diet in men who were overweight/ had obesity and CPAP-treated moderate-to-severe OSA.

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Coexistence of cardiovascular risk factors and obstructive sleep apnoea in polysomnography

Cited by 10 publications

References 37 publications

Comorbidity Profile and Predictors of Obstructive Sleep Apnea Severity and Mortality in Non-Obese Obstructive Sleep Apnea Patients

Comorbidity Profile and Predictors of Obstructive Sleep Apnea Severity and Mortality in Non-Obese Obstructive Sleep Apnea Patients

Obstructive sleep apnea heterogeneity and autonomic function: a role for heart rate variability in therapy selection and efficacy monitoring

Effect of a Weight Loss and Lifestyle Intervention on Dietary Behavior in Men with Obstructive Sleep Apnea: The INTERAPNEA Trial

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