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Cardiovascular and somatic comorbidities and sleep measures using three hypopnea criteria in mild obstructive sleep-disordered breathing: sex, age and body mass index differences in a retrospective sleep clinic cohort.
J Clin Sleep Med. 2020 Jun 29 [Online ahead of print]JC

Abstract

STUDY OBJECTIVES

To describe sex, age and body mass index (BMI) differences in comorbidities and polysomnography (PSG) measures, categorized using three different apnea-hypopnea index (AHI) criterion, in sleep clinic patients with mild obstructive sleep-disordered breathing (SDB).

METHODS

A retrospective cohort of 305 (64% female) adult sleep clinic patients who underwent full night in-laboratory polysomnography diagnosed with mild SDB and prescribed positive airway pressure (PAP). Effects of sex, age and BMI on comorbidities and PSG measures including rates of AHI defined by ≥3% desaturations (AHI3%), with arousals (AHI3%A), by ≥4% desaturations (AHI4%) and by respiratory disturbance index (RDI) were evaluated.

RESULTS

69 (23%), 116 (38%), 258 (85%) and 267 (88%) patients had AHI4%, AHI3%, AHI3%A and RDI ≥5, respectively. 90- day PAP adherence rates were 45.9% overall and higher in women > 50 (51.2%, p=0.013)) and men (54.5%, p= 0.024) with no difference whether AHI4% or AHI3%A was <5 or ≥5. Men and women had similar rates of daytime sleepiness (43.3%), anxiety (44.9%) and hypertension (44.9%). Women were more likely to have obesity, anemia, asthma, depression, diabetes, fibromyalgia, hypothyroidism, migraine and lower rates of coronary artery disease. More patients with AHI4% <5 had depression, migraines, and anemia and more patients with AHI4% ≥5 had CHF. Women were more likely to have higher sleep maintenance and efficiency, shorter average obstructive apnea and hypopnea durations and less supine-dominant pattern. Average obstructive apnea and hypopnea duration decreased with increasing BMI and average hypopnea duration increased with age. Obstructive apnea duration and obstructive hypopnea with arousal duration decreased with increasing BMI. More women had AHI4% <5 (81.5% vs 69.1%), AHI3% <5 (68.7% v 49.1%), and AHI3%A <5 (18.5% vs 10.0%). Older age and higher BMI were associated with higher AHI.

CONCLUSIONS

Current AHI criteria do not predict comorbidities or adherence in mild sleep-disordered breathing patients. In this hypothesis generating descriptive analysis, sex, BMI and age may all be factors that should be accounted for in future research of mild SDB patients. Different sleep study measures may weigh differently into risks of cardiovascular versus somatic comorbidities.

Authors+Show Affiliations

Department of Neurology, Baystate Medical Center, University of Massachusetts Medical School -Baystate, Springfield, Massachusetts. Institute for Healthcare Delivery and Population Science and Department of Medicine, University of Massachusetts Medical School - Bayst2ate, Springfield, Massachusetts.Department of Medicine, Baystate Medical Center, University of Massachusetts Medical School -Baystate, Springfield, Massachusetts.Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.Department of Medicine, Baystate Medical Center, University of Massachusetts Medical School -Baystate, Springfield, Massachusetts.Department of Medicine, Baystate Medical Center, University of Massachusetts Medical School -Baystate, Springfield, Massachusetts.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32618562

Citation

Johnson, Karin Gardner, et al. "Cardiovascular and Somatic Comorbidities and Sleep Measures Using Three Hypopnea Criteria in Mild Obstructive Sleep-disordered Breathing: Sex, Age and Body Mass Index Differences in a Retrospective Sleep Clinic Cohort." Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine, 2020.
Johnson KG, Johnson DC, Thomas RJ, et al. Cardiovascular and somatic comorbidities and sleep measures using three hypopnea criteria in mild obstructive sleep-disordered breathing: sex, age and body mass index differences in a retrospective sleep clinic cohort. J Clin Sleep Med. 2020.
Johnson, K. G., Johnson, D. C., Thomas, R. J., Rastegar, V., & Visintainer, P. (2020). Cardiovascular and somatic comorbidities and sleep measures using three hypopnea criteria in mild obstructive sleep-disordered breathing: sex, age and body mass index differences in a retrospective sleep clinic cohort. Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine.
Johnson KG, et al. Cardiovascular and Somatic Comorbidities and Sleep Measures Using Three Hypopnea Criteria in Mild Obstructive Sleep-disordered Breathing: Sex, Age and Body Mass Index Differences in a Retrospective Sleep Clinic Cohort. J Clin Sleep Med. 2020 Jun 29; PubMed PMID: 32618562.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cardiovascular and somatic comorbidities and sleep measures using three hypopnea criteria in mild obstructive sleep-disordered breathing: sex, age and body mass index differences in a retrospective sleep clinic cohort. AU - Johnson,Karin Gardner, AU - Johnson,Douglas Clark, AU - Thomas,Robert Joseph, AU - Rastegar,Vida, AU - Visintainer,Paul, Y1 - 2020/06/29/ PY - 2020/7/4/entrez KW - comorbidity KW - hypopnea KW - mild KW - obstructive sleep apnea KW - sex KW - sleep-disordered breathing JF - Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine JO - J Clin Sleep Med N2 - STUDY OBJECTIVES: To describe sex, age and body mass index (BMI) differences in comorbidities and polysomnography (PSG) measures, categorized using three different apnea-hypopnea index (AHI) criterion, in sleep clinic patients with mild obstructive sleep-disordered breathing (SDB). METHODS: A retrospective cohort of 305 (64% female) adult sleep clinic patients who underwent full night in-laboratory polysomnography diagnosed with mild SDB and prescribed positive airway pressure (PAP). Effects of sex, age and BMI on comorbidities and PSG measures including rates of AHI defined by ≥3% desaturations (AHI3%), with arousals (AHI3%A), by ≥4% desaturations (AHI4%) and by respiratory disturbance index (RDI) were evaluated. RESULTS: 69 (23%), 116 (38%), 258 (85%) and 267 (88%) patients had AHI4%, AHI3%, AHI3%A and RDI ≥5, respectively. 90- day PAP adherence rates were 45.9% overall and higher in women > 50 (51.2%, p=0.013)) and men (54.5%, p= 0.024) with no difference whether AHI4% or AHI3%A was <5 or ≥5. Men and women had similar rates of daytime sleepiness (43.3%), anxiety (44.9%) and hypertension (44.9%). Women were more likely to have obesity, anemia, asthma, depression, diabetes, fibromyalgia, hypothyroidism, migraine and lower rates of coronary artery disease. More patients with AHI4% <5 had depression, migraines, and anemia and more patients with AHI4% ≥5 had CHF. Women were more likely to have higher sleep maintenance and efficiency, shorter average obstructive apnea and hypopnea durations and less supine-dominant pattern. Average obstructive apnea and hypopnea duration decreased with increasing BMI and average hypopnea duration increased with age. Obstructive apnea duration and obstructive hypopnea with arousal duration decreased with increasing BMI. More women had AHI4% <5 (81.5% vs 69.1%), AHI3% <5 (68.7% v 49.1%), and AHI3%A <5 (18.5% vs 10.0%). Older age and higher BMI were associated with higher AHI. CONCLUSIONS: Current AHI criteria do not predict comorbidities or adherence in mild sleep-disordered breathing patients. In this hypothesis generating descriptive analysis, sex, BMI and age may all be factors that should be accounted for in future research of mild SDB patients. Different sleep study measures may weigh differently into risks of cardiovascular versus somatic comorbidities. SN - 1550-9397 UR - https://www.unboundmedicine.com/medline/citation/32618562/Cardiovascular_and_somatic_comorbidities_and_sleep_measures_using_three_hypopnea_criteria_in_mild_obstructive_sleep-disordered_breathing:_sex,_age_and_body_mass_index_differences_in_a_retrospective_sleep_clinic_cohort DB - PRIME DP - Unbound Medicine ER -
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