Major risk factors for obstructive sleep apnea monitored in the home. A cross-sectional study
Keywords:
Body mass index, Sleep apnea, obstructive, HypertensionAbstract
BACKGROUND: Obstructive sleep apnea (OSA) is characterized by recurrent pharyngeal wall collapse during sleep caused by anatomical or functional changes associated with obesity or dislocation of maxillofacial structures. OBJECTIVE: To determine the major risk factors for obstructive sleep apnea monitored in the home. DESIGN AND SETTING: Cross-sectional study conducted in a private clinic in Fortaleza (CE), Brazil. METHODS: Between 2015 and 2018, 427 patients were screened for OSA with home-based monitoring,yielding 374 positives. Information was collected on age, sex, body mass index (BMI), hy pertension, diabetes (DM), dyslipidemia, coronary artery disease (CAD), arrhythmia, peripheral artery occlusive disease (PAOD), heart failure (HF) and lung disease. The home sleep apnea test result was then compared with the clinical diagnosis. Lastly, parameters identified as significant in the univariate analysis were subjected to multivariate logistic regression. RESULTS: Male sex predominated, although not significantly. OSA was associated with hypertension, DM, dyslipidemia, age and BMI. The risk of OSA being associated with these parameters was 2.195 (hypertension), 11.14 (DM), 2.044 (dyslipidemia) and 5.71 (BMI). The association was also significant for BMI categories (normal, overweight or obese). No significant association was observed for CAD, arrhythmia, PAOD, HF or lung disease. After multivariate logistic analysis, only age and BMI (and its categories) remained significant. CONCLUSION: OSA was associated with hypertension, DM, dyslipidemia, age and BMI in univariate analyses, but only with age and BMI (and its categories) in multivariate logistic analysis.
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Destors M, Tamisier R, Galerneau LM, Lévy P, Pepin JL. Physiopathologie du syndrome d’apnées-hypopnées obstructives u sommeil et de ses conséquences cardio-métaboliques [Pathophysiology of obstructive sleep apnea syndrome and its cardiometabolic consequences]. Presse Med. 2017;46(4):395-403. PMID: 28126503; https://doi.org/10.1016/j.lpm.2016.09.008.
Javaheri S, Barbe F, Campos-Rodriguez F, et al. Sleep Apnea: Types, Mechanisms, and Clinical Cardiovascular Consequences. J Am Coll Cardiol. 2017;69(7):841-58. PMID: 28209226; https://doi.org/10.1016/j.jacc.2016.11.069.
Iannella G, Maniaci A, Magliulo G, et al. Current challenges in the diagnosis and treatment of obstructive sleep apnea syndrome in the elderly. Pol Arch Intern Med. 2020;130(7-8):649-54. PMID: 32250579; https://doi.org/10.20452/pamw.15283.
Kıvanc T, Kulaksızoglu S, Lakadamyalı H, Eyuboglu F. Importance of laboratory parameters in patients with obstructive sleep apnea and their relationship with cardiovascular diseases. J Clin Lab Anal. 2018;32(1):e22199. PMID: 28345811; https://doi.org/10.1002/jcla.22199.
İnönü Köseoğlu H, Kanbay A, Acıcan T. Uyku testi nerde yapılmalı; laboratuvarda mı, evde mi? [Where do we perform sleep test: In the laboratory or at home?]. Tuberk Toraks. 2016;64(4):299-305. PMID: 28366143; https://doi.org/10.5578/tt.28034.
Kong DL, Qin Z, Wang W, et al. Association between obstructive sleep apnea and metabolic syndrome: a meta-analysis. Clin Invest Med. 2016;39(5):e161-72. PMID: 27805899; https://doi.org/10.25011/cim.v39i5.27148.
Mok Y, Tan CW, Wong HS, et al. Obstructive sleep apnoea and Type 2 diabetes mellitus: are they connected? Singapore Med J. 2017;58(4):179-83. PMID: 28429032; https://doi.org/10.11622/smedj.2017027.
Plíhalová A, Westlake K, Polák J. Obstrukční spánková apnoe a diabetes mellitus 2. typu [Obstructive sleep apnoea and type 2 diabetes mellitus]. Vnitr Lek. 2016;62(11 Suppl 4):S79-84. PMID: 27921430.
Maniaci A, Iannella G, Cocuzza S, et al. Oxidative Stress and Inflammation Biomarker Expression in Obstructive Sleep Apnea Patients. J Clin Med. 2021;10(2):277. PMID: 33451164; https://doi.org/10.3390/jcm10020277.
Hendrikx T, Sundqvist M, Sandström H, et al. Atrial fibrillation among patients under investigation for suspected obstructive sleep apnea. PLoS One. 2017;12(2):e0171575. PMID: 28178304; https://doi.org/10.1371/journal.pone.0171575.
Bilal N, Dikmen N, Bozkus F, et al. Obstructive sleep apnea is associated with increased QT corrected interval dispersion: the effects of continuous positive airway pressure. Braz J Otorhinolaryngol. 2018;84(3):298-304. PMID: 28455120; https://doi.org/10.1016/j.bjorl.2017.03.005.
Porto F, Sakamoto YS, Salles C. Association between Obstructive Sleep Apnea and Myocardial Infarction: A Systematic Review. Arq Bras Cardiol. 2017;108(4):361-9. PMID: 28380133; https://doi.org/10.5935/abc.20170031.
Wolf J, Narkiewicz K. Optimizing the Management of Uncontrolled/Resistant Hypertension. The Importance of Sleep Apnoea Syndrome. Curr Vasc Pharmacol. 2017;16(1):44-53. PMID: 28413970; https://doi.org/10.2174/1570161115666170414115705.
Schipper MH, Jellema K, Thomassen BJW, et al. Stroke and other cardiovascular events in patients with obstructive sleep apnea and the effect of continuous positive airway pressure. J Neurol. 2017;264(6):1247-53. PMID: 28550476; https://doi.org/10.1007/s00415-017-8522-z.
Serenatna CV, English DR, Currier D, et al. Sleep apnoea in Australian men: diseases burden, co-morbidities and correlates from the Australian longitudinal study on male health. BMC Public Health. 2016;16(Suppl 3):1029. PMID: 28185594; https://doi.org/10.1186/s12889-016-3703-8.
Shirani G, Morovati SP, Shamshiri AR, et al. Prevalence of Cardiovascular Disorders in Iranian Patients Suffering from Obstructive Sleep Apnea. J Dent (Tehran). 2016;13(3):151-6. PMID: 28392811.
Steiner S, Jax T, Evers S, et al. Altered blood rheology in obstructive sleep apnea as a mediator of cardiovascular risk. Cardiology. 2005;104(2):92-6. PMID: 16015032; https://doi.org/10.1159/000086729.