The Determining Risk of Vascular Events by Apnea Monitoring (DREAM) study: design, rationale, and methods

Polysomnographic phenotypes and their cardiovascular implications in obstructive sleep apnoea

“…The Determining Risk of Vascular Events by Apnea Monitoring (DREAM) study consists of 2041 veterans from three Veterans Affairs Centers (West Haven, Connecticut; Cleveland, Ohio; and Indianapolis, Indiana) that underwent OSA evaluation between 2000 and 2004, with follow-up through 2012 20 . At enrolment (ie, time of polysomnography), data were collected on demographic and anthropometric characteristics, cardiovascular risk factors, medical comorbidities and other measures, as detailed previously.…”

“…At enrolment (ie, time of polysomnography), data were collected on demographic and anthropometric characteristics, cardiovascular risk factors, medical comorbidities and other measures, as detailed previously. 20 Cardiovascular risk was ascertained using the Framingham risk score (FRS; including age, sex, smoking status, presence of diabetes, antihypertensive medication, systolic blood pressure, total cholesterol and high-density lipoprotein levels) 21 and comorbidity burden by the Charlson comorbidity index (CCI). 22 Polysomnographic scoring, variable definitions, classification and continuous positive airway pressure (CPAP) treatment adherence (regular vs not regular) are described in the online supplementary file.…”

“…The primary outcome was the composite of incident ACS, TIA, stroke or death from any cause. Rationale for composite outcome selection and its adjudication are described previously 20 and in the online supplementary file.…”

The Association between Nocturnal Cardiac Arrhythmias and Sleep-Disordered Breathing: The DREAM Study

“…The rationale and methods of this parent study has been previously published. 13 In this study, 1,840 patients underwent comprehensive sleep testing for SDB at 3 VA medical centers (VA Connecticut Healthcare System, West Haven, CT; Richard L. Rhoudebush VAMC, Indianapolis, IN; Louis Stokes VAMC, Cleveland, OH) and were followed for cardiovascular outcomes. The current study is a cross-sectional analysis of the first 982 consecutive veteran patients referred for PSG, a subgroup of DREAM patients who also underwent additional detailed cardiac arrhythmia evaluation.…”

Síndrome da apneia obstrutiva do sono como risco independente de doenças cerebrovasculares

“…Os resultados deste estudo podem prover evidências adicionais para o entendimento da associação entre essas duas condições. 14 Outro objeto de análise diz respeito às alterações na substância branca cerebral, também conhecida como microangiopatia. Estas alterações referem-se a lesões na substância branca subcortical e periventricular, que aparecem com hiperintensidade nas sequências pesadas em T2 e Fluid-atennuated Inversion Recovery (FLAIR) da ressonância nuclear magnética (RNM).…”