Prevalence and related risk factors of obstructive sleep apnea in postmenopausal women

2019 ◽  
Vol 64 ◽  
pp. S333
Author(s):  
M. Salmani Nodoushan ◽  
A. Bahrami-Ahmad ◽  
S. arshi
Keyword(s):  
Risk Factors ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Postmenopausal Women ◽  
Related Risk ◽  
Obstructive Sleep

Abstract MP031: Prospective Association of Obstructive Sleep Apnea Risk Factors with Heart Failure with Preserved Ejection Fraction and Not Heart Failure with Reduced Ejection Fraction in Postmenopausal Women

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Patrick Koo ◽  
Umama Gorsi ◽  
Mary Roberts ◽  
Charles Eaton
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Ejection Fraction ◽  
Postmenopausal Women ◽  
Summary Score ◽  
Sleep Fragmentation ◽  
Berlin Questionnaire ◽  
Obstructive Sleep

Background: The relationship between obstructive sleep apnea (OSA) and heart failure (HF) has been under-researched especially in postmenopausal women. We therefore evaluated relationship between OSA risk factors and HFpEF and HFrEF in post-menopausal women. Methods: We performed a prospective analysis of a subset of participants who had adjudicated heart failure outcomes (n=42,362) in the Women Health Initiative Observational, Clinical Trial, and Extension Studies (1998-Present). The cohort was followed over an average of 13.4 years. Inverse probability weighting was employed to account for potential selection bias. Cox proportional hazards regression was used to examine the association between OSA risk factors and time to first hospitalized HF. Type of heart failure was determined using the ejection fraction (EF) obtained from 2D echocardiography. EF of ≥45% was categorized as HFpEF, and EF of < 45% was categorized as HFrEF. Models were adjusted for age, race/ethnicity, education, income, marital status, systolic blood pressure, waist-to-hip ratio, diabetes, coronary heart disease, atrial fibrillation, use of hormone replacement therapy, use of sleep medications, modified Charlson comorbidity index, smoking, alcohol consumption, physical activity, and hysterectomy. We also created an OSA summary score (obesity, snoring, poor sleep quality, sleep fragmentation, daytime sleepiness, and hypertension) based on the Berlin questionnaire, which reliably predicts OSA, to examine its relationship with HF. Results: Of the 42,362 women, 1,054 (2.49%) had preserved EF, and 631 (1.49%) had reduced EF. Four of the 6 risk factors (obesity (HR=1.51, 95% CI 1.29-1.76), snoring (HR=1.23, 95% CI 1.04-1.45), sleep fragmentation (HR=1.15, 95% CI 1.01-1.31), and hypertension (HR=1.46, 95% CI 1.31-1.62)) were associated HFpEF after adjusting for confounders. Each additional OSA risk factor in an OSA summary score compared to no risk factors significantly increased the risk of HFpEF in a dose-response fashion (HR=1.36, 1.61, 2.01, 1.97, 2.02, and 2.74 for scores of 1-6, respectively; P trend <0.001) and not HFrEF (P trend =0.26). Only hypertension was associated with HFrEF (HR=1.39, 95% CI 1.22-1.60). Conclusion: Having more OSA risk factors increases the risk of HFpEF but not HFrEF in postmenopausal women. Early recognition and management of OSA risk factors may play an important role in reducing risk of HFpEF in this population.

Obstructive Sleep Apnea: Epidemiology, Causes, and Consequences

2020 ◽  
Author(s):  
Diane C Lim ◽  
Richard J Schwab
Keyword(s):  
Risk Factors ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Cushing Syndrome ◽  
Upper Airway ◽  
Fat Distribution ◽  
Epidemiologic Studies ◽  
Obstructive Sleep ◽  
Upper Airway Muscles ◽  
Underlying Diseases

As part one of the three chapters on sleep-disordered breathing, this chapter reviews obstructive sleep apnea (OSA) epidemiology, causes, and consequences. When comparing OSA prevalence between 1988 to 1994 and 2007 to 2010, we observe that OSA is rapidly on the rise, paralleling increasing rates in obesity. Global epidemiologic studies indicate that there are differences specific to ethnicity with Asians presenting with OSA at a lower body mass index than Caucasians. We have learned that structural and physiologic factors increase the risk of OSA and both can be influenced by genetics. Structural risk factors include craniofacial bony restriction, changes in fat distribution, and the size of the upper airway muscles. Physiologic risk factors include airway collapsibility, loop gain, pharyngeal muscle responsiveness, and arousal threshold. The consequences of OSA include daytime sleepiness and exacerbation of many underlying diseases. OSA has been associated with cardiovascular diseases including hypertension, coronary heart disease, stroke, atrial fibrillation, and other cardiac arrhythmias; pulmonary hypertension; metabolic disorders such as type 2 diabetes, hypothyroidism, acromegaly, Cushing syndrome, and polycystic ovarian syndrome; mild cognitive impairment or dementia; and cancer. This review contains 4 figures, 1 table and 48 references. Key Words: cardiac consequences, craniofacial bony restriction, epidemiology, fat distribution, metabolic disease, neurodegeneration, obesity, obstructive sleep apnea

Abstract P195: Lack of Association between Sleep Duration and ECG Arrhythmia Risk Measures: Chicago Area Sleep Study

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Jason Ng ◽  
Phyllis C Zee ◽  
Jeffrey J Goldberger ◽  
Kristen L Knutson ◽  
Kiang Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Duration ◽  
Low Risk ◽  
Qtc Interval ◽  
Sleep Study ◽  
Chicago Area ◽  
Obstructive Sleep ◽  
Pr Interval

Introduction Sleep duration is significantly associated with cardiovascular disease risk factors such as hypertension, diabetes, and obesity in adults at low risk for obstructive sleep apnea. Although it is known that apnea increases the risk for sudden cardiac death, it is not known whether adults with short sleep duration independent of apnea have a higher risk for cardiac arrhythmias Hypothesis We tested the hypothesis that sleep duration in adults at low risk for obstructive sleep apnea would be associated with ECG measures that are known risk factors for ventricular arrhythmias. Methods The Chicago Area Sleep Study recruited 610 participants via commercially available telephone listings. Participants were screened using in-home apnea detection equipment (ApneaLinkTM) for one night to exclude subjects with apnea/hypopnea index ≥ 15. Participants wore wrist actigraphs for 7 days to objectively determine sleep duration. A 10-minute 12-lead ECG was recorded for each subject. Standard measures of heart rate, PR interval, and QTc interval were obtained along with markers of ventricular repolarization, Tpeak to Tend interval (Tpe) and spatial QRS-T angle. Signal-averaged ECG analysis was performed to measure filtered QRS duration (fQRSd), RMS voltage of terminal 40 ms (RMS), and duration of terminal QRS signals <40μV (LAS). Participants with atrial fibrillation, >20% ectopic beats and those using antihypertensive and sleep medications were excluded from analysis. The effect of sleep duration on the ECG parameters was estimated using a multiple linear regression model adjusting for demographics (sex, age, and race) and cardiovascular risk factors (BMI, hypertension, coronary heart disease, and diabetes). Results ECGs from a total of 504 participants (200 male, 48±8 years old) were analyzed. Mean sleep duration was 7±1 hrs, heart rate was 64±9 bpm, PR interval was 165±18 ms, and QTc interval was 424±23 ms. Mean Tpe interval was 83±14 ms and spatial QRS-T angle was 29±26 deg. The signal-averaged ECG measures of fQRSd, RMS, and LAS had mean values of 78±12 ms, 58±34 μV, and 24±9 ms, respectively. In an unadjusted model, there was a borderline association between sleep duration and QTc (β=0.004 ms/hr, SE=0.0023, p=0.08). However, that association was no longer significant following adjustment with demographics and cardiovascular risk factors. No other ECG measures were associated with sleep duration. Conclusions In a population at low risk of obstructive sleep apnea, ECG-based measures of cardiovascular risks were not associated with sleep duration. Previously reported associations between short sleep and cardiovascular events may not be arrhythmic in origin.

scholarly journals Which oropharyngeal factors are significant risk factors for obstructive sleep apnea? An age-matched study and dentist perspectives

2016 ◽  
Vol Volume 8 ◽  
pp. 215-219 ◽  
Author(s):  
Kittisak Sawanyawisuth ◽  
Supanigar Ruangsri ◽  
Teekayu Plangkoon Jorns ◽  
Subin Puasiri ◽  
Thitisan Luecha ◽  
...  
Keyword(s):  
Risk Factors ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Significant Risk ◽  
Obstructive Sleep ◽  
Matched Study
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