Journal Article

Cardiometabolic comorbidities in obstructive sleep apnea patients are related to disease severity, nocturnal hypoxemia, and decreased sleep quality

Bold, Ionela, Carlier, Sarah, Gruwez, Alexia, Bruyneel, Marie, Van Overstraeten, Chloé, Ben Youssef, Sidali, Andreozzi, Fabio, Bruyneel, Anne-Violette, André, Stephanie

2020

Overview

Background Obstructive sleep apnea syndrome (OSA) is currently recognized as an independent risk factor for hypertension, arrhythmia, coronary heart disease, stroke, and metabolic disorders (e.g. diabetes, dyslipidemia). In clinical practice, apnea-hypopnea index (AHI) is the marker used to classify disease severity and guide treatment. However, AHI alone does not sufficiently identify OSA patients at risk for cardiometabolic comorbidities. With this in mind, the aim of this retrospective study was to determine whether some polysomnographic parameters (e.g. apnea-hypopnea duration, sleep structure, nocturnal hypoxemia) are specifically associated with cardiometabolic comorbidities in OSA. Methods In this retrospective study, 1717 patients suffering from moderate/severe OSA were included between 2013 and 2017. Data on demographics, comorbidities, and polysomnographic characteristics were collected and analyzed to identify factors associated with cardiometabolic complications. Results The medical files of 1717 patients (68% male) were reviewed. The mean AHI was 43.1 +/− 27.7 with 57.3% of patients suffering from severe OSA, and 52% from at least one cardiovascular comorbidity (CVCo). Diabetes affected 22% of the patients and 27% exhibited dyslipidemia. Patients affected by CVCos were older, and more often women and non-smokers. These patients also had worse sleep quality, and a more marked intermittent/global nocturnal hypoxemia. With regard to diabetes, diabetics were older, more often non-smoker, non-drinker women, and were more obese. These patients also exhibited more severe OSA, especially in non-REM (NREM) sleep, worse sleep quality, and a more marked intermittent/global nocturnal hypoxemia. Dyslipidemia was more frequent in the absence of alcohol consumption, and was associated with OSA severity, decreased sleep quality, and longer AH in REM sleep. Conclusions This study identifies demographic and polysomnographic factors associated with cardiometabolic comorbidities. Patients (especially women) suffering from more severe OSA, longer sleep apneas and hypopneas, worse sleep quality, and marked intermittent/global nocturnal hypoxemia are more likely to develop cardiometabolic comorbidities. This should stimulate clinicians to obtain adequate treatment in this population.

• Publisher: BioMed Central,BioMed Central Ltd,Nature Publishing Group,BMC
• Subject: Adult / Age / Aged / Alcohol / Apnea / Arrhythmia / Body mass index / Cardiac arrhythmia / Cardiovascular comorbidities / Cardiovascular disease / Cardiovascular diseases / Cardiovascular Diseases - diagnosis / Cardiovascular Diseases - epidemiology / Cardiovascular Diseases - physiopathology / Care and treatment / Comorbidity / Complications and side effects / Coronary artery disease / Demographics / Demography / Development and progression / Diabetes / Diabetes mellitus / Dyslipidemia / Female / Females / Health risks / Heart diseases / Heart failure / Humans / Hypertension / Hypoxemia / Hypoxia - diagnosis / Hypoxia - epidemiology / Hypoxia - physiopathology / Male / Medicine / Medicine & Public Health / Metabolic Diseases - diagnosis / Metabolic Diseases - epidemiology / Metabolic Diseases - physiopathology / Metabolic disorders / Middle Aged / Nocturnal hypoxemia / NREM sleep / Observations / Obstructive sleep apnea / Patients / Pneumology/Respiratory System / Polysomnography - trends / Prospective Studies / Quality / Regression analysis / REM sleep / Retrospective Studies / Risk analysis / Risk factors / Severity of Illness Index / Sleep - physiology / Sleep apnea / Sleep Apnea, Obstructive - diagnosis / Sleep Apnea, Obstructive - epidemiology / Sleep Apnea, Obstructive - physiopathology / Sleep disorders / Sleep quality / Smoking / Stroke / Variance analysis