The European Sleep Apnoea Database (ESADA): report from 22 European sleep laboratories

Hedner, Jan; Grote, Ludger; Bonsignore, Maria R.; McNicholas, Walter T.; Lavie, Peretz; Parati, Gianfranco; Śliwiński, Paweł; Barbé, Ferrán; Backer, W. De; Escourrou, P.; Fietze, Ingo; Kvamme, John Arthur; Lombardi, Carolina; Marrone, Oreste; Masa, Juan F.; Montserrat, Josep M.; Penzel, Thomas; Pretl, Martin; Riha, Renata L.; Rodenstein, Daniel; Saaresranta, Tarja; Schulz, Richard; Tkáčová, Ružena; Varoneckas, Giedrius; Vitols, A.; Vrints, H.; Zieliński, J

doi:10.1183/09031936.00046710

Cited by 121 publications

(98 citation statements)

References 17 publications

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“…The details of ESADA are described in a separate report, which provides extensive details regarding the study population and the investigative techniques employed [21].…”

Section: Methodsmentioning

confidence: 99%

“…The present data are derived from a large, well-characterised, prospective cohort of patients with clinical features of OSAS [21]. Participating centres were formally evaluated, and agreed to ensure consistent standards of patient recruitment and data acquisition.…”

Section: Study Strengths and Limitationsmentioning

confidence: 99%

“…Mandatory variables for each subject are reported elsewhere [21]. Current analyses include age, sex, height, weight, neck circumference, waist/hip ratio, smoking history, alcohol intake, details of comorbidities (based on established diagnosis) and antihypertensive medication use.…”

Section: Demographic Characteristics and Prevalent Hypertensionmentioning

confidence: 99%

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Nocturnal intermittent hypoxia predicts prevalent hypertension in the European Sleep Apnoea Database cohort study

et al. 2014

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Systemic hypertension is associated with obstructive sleep apnoea syndrome (OSAS) but the pathophysiological mechanisms are incompletely understood. A collaborative European network of 24 sleep centres established a European Sleep Apnoea Database to evaluate cardiovascular morbidity associated with OSAS.11 911 adults referred with suspected OSAS between March 2007 and September 2013 underwent overnight sleep studies, either cardiorespiratory polygraphy or polysomnography. We compared the predictive value of the apnoea-hypopnoea index (AHI) and 4% oxygen desaturation index (ODI) for prevalent hypertension, adjusting for relevant covariates including age, smoking, obesity, dyslipidaemia and diabetes.Among patients (70% male, mean¡SD age 52¡12 years), 78% had AHI .5 events?h -1 and 41% systemic hypertension. Both AHI and ODI independently related to prevalent hypertension after adjustment for relevant covariates (p,0.0001 for linear trend across quartiles (Q) of severity for both variables). However, in multiple regression analysis with both ODI and AHI in the model, ODI was, whereas AHI was not, independently associated with prevalent hypertension: odds ratios (95% CI) for Q4 versus Q1 regarding ODI were 2.01 (1.61-2.51) and regarding AHI were 0.92 (0.74-1.15) (p,0.0001 and p50.3054, respectively).This cross sectional study suggests that chronic intermittent hypoxia plays an important role in OSASrelated hypertension. @ERSpublications These findings indicate that ODI is superior to AHI in the prediction of hypertension in patients with OSAS http://ow.ly/xFn6RSupport statement: The authors also acknowledge the financial support of Philips Respironics PLC and ResMed PLC, which each provided unrestricted grants to support overall maintenance of the European Sleep Apnoea Database (ESADA) Project. These companies had no input into the design or implementation of the ESADA Project and played no role in the design or completion of the present study. Nonfinancial support was provided by the European Sleep Research Society and the European Respiratory Society (ERS) in terms of logistics for communication, meetings and data presentations for the ESADA collaborators. The ERS also funded a Task Force to support the evaluation of associations between obstructive sleep apnoea syndrome and hypertension.

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“…The details of ESADA are described in a separate report, which provides extensive details regarding the study population and the investigative techniques employed [21].…”

Section: Methodsmentioning

confidence: 99%

Section: Study Strengths and Limitationsmentioning

confidence: 99%

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Nocturnal intermittent hypoxia predicts prevalent hypertension in the European Sleep Apnoea Database cohort study

et al. 2014

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“…The current study aimed to describe the prevalence of sleep-related MVA risk factors in the European Sleep Apnea Database (ESADA), a large multi-national reference cohort (Hedner et al, 2011). The RFs addressed in this descriptive analysis have been validated previously against the occurrence of actual MVA events in a large national registry collecting more than 500 000 police-reported accidents (STRADA, 2013).…”

Section: Introductionmentioning

confidence: 99%

Driving habits and risk factors for traffic accidents among sleep apnea patients – a European multi‐centre cohort study

Karimi

Hedner

Lombardi

et al. 2014

Journal of Sleep Research

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SUMMARYObstructive sleep apnea is associated with increased motor vehicle accident risk, and improved detection of patients at risk is of importance. The present study addresses potential risk factors in the European Sleep Apnea Database and includes patients with suspected obstructive sleep apnea [n = 8476, age 51.5 (12.5) years, body mass index 31.0 (6.6) kg m À2 , 82.4% driver's licence holders]. Driving distance (km year À1), driver's licence type, sleep apnea severity, sleepiness and comorbidities were assessed. Previously validated risk factors for accident history: Epworth Sleepiness Scale ≥16; habitual sleep time ≤5 h; use of hypnotics; and driving ≥15 000 km year À1 were analysed across European regions. At least one risk factor was identified in male and female drivers, 68.75 and 51.3%, respectively. The occurrence of the risk factors was similar across Europe, with only a lower rate in the eastern region (P = 0.001). The mean number of risk factors increased across classes of sleep apnea severity. Frequent driving was prevalent [14.0 (interquartile range 8.0-20.0) 9 10 3 km year À1 ] and 32.7% of drivers had severe obstructive sleep apnea [apnea-hypopnea index 50.3 (38.8-66.0) n h À1 ]. Obesity, shorter sleep time and younger age were associated with increased traffic exposure (P ≤ 0.03). In conclusion, the risk factors associated with accident history were common among European patients with suspected obstructive sleep apnea, but varied between geographical regions. There was a weak covariation between occurrence of risk factors and clinically determined apnea severity but frequent driving, a strong risk factor for accidents, was over-represented. Systematic evaluation of accident-related risk factors is important to detect sleep apnea patients at risk for motor vehicle accidents. IN TROD UCTI ONObstructive sleep apnea (OSA) leads to hypoxaemia, autonomic activation and sleep fragmentation. The condition affects at least 24% of male and 9% of female adults (Punjabi, 2008;Young et al., 1993). Daytime consequences of OSA include excessive daytime sleepiness (EDS) (Stoohs et al., 1994) and cognitive impairment (Mitler, 1993) in many, but not all, OSA patients.Risk factors (RFs) for motor vehicle accidents (MVA) include driving exposure and experience, road and weather conditions, traffic density and time of day (Horne and Reyner, 1995;Pack, 1995;Stutts et al., 2003). The linked human factors include circadian timing, time on task, cumulative sleep deficit and presence of comorbidities such as metabolic, neurological or cardiovascular disease

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“…The European Sleep Apnea Database (ESADA), started in 2007, is an ongoing clinical and prospective cohort study comprising patients with suspected OSA referred to 25 clinical sleep centers, 21 of them affiliated to universities, in 18 countries [23]. In this cohort, approximately 82% (n = 6984 of 8476)were license holders [24].…”

Section: Prediction Of Mva Risk In the European Sleep Apnea Database mentioning

confidence: 99%

Obstructive sleep apnea and driving risk: The current Turkish legislation, controversies, and future perspectives

Peker¹

2016

MMJ

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The European Sleep Apnoea Database (ESADA): report from 22 European sleep laboratories

Cited by 121 publications

References 17 publications

Nocturnal intermittent hypoxia predicts prevalent hypertension in the European Sleep Apnoea Database cohort study

Nocturnal intermittent hypoxia predicts prevalent hypertension in the European Sleep Apnoea Database cohort study

Driving habits and risk factors for traffic accidents among sleep apnea patients – a European multi‐centre cohort study

Obstructive sleep apnea and driving risk: The current Turkish legislation, controversies, and future perspectives

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