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

André, Stephanie (Saint-Pierre University Hospital, Brussels, Belgium ; Université Libre de Bruxelles, Brussels, Belgium ; Brugmann University Hospital, Brussels, Belgium) ; Andreozzi, Fabio (Saint-Pierre University Hospital, Brussels, Belgium ; Université Libre de Bruxelles, Brussels, Belgium) ; Van Overstraeten, Chloé (Saint-Pierre University Hospital, Brussels, Belgium ; Université Libre de Bruxelles, Brussels, Belgium) ; Ben Youssef, Sidali (Saint-Pierre University Hospital, Brussels, Belgium ; Université Libre de Bruxelles, Brussels, Belgium) ; Bold, Ionela (Saint-Pierre University Hospital, Brussels, Belgium ; Université Libre de Bruxelles, Brussels, Belgium) ; Carlier, Sarah (Saint-Pierre University Hospital, Brussels, Belgium ; Université Libre de Bruxelles, Brussels, Belgium ; Brugmann University Hospital, Brussels, Belgium) ; Gruwez, Alexia (Saint-Pierre University Hospital, Brussels, Belgium ; Université Libre de Bruxelles, Brussels, Belgium ; Brugmann University Hospital, Brussels, Belgium) ; Bruyneel, Anne-Violette (Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland ; KiCarre, research department, Lentilly, France) ; Bruyneel, Marie (Saint-Pierre University Hospital, Brussels, Belgium ; Université Libre de Bruxelles, Brussels, Belgium ; Brugmann University Hospital, Brussels, Belgium)

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.


Keywords:
Article Type:
scientifique
Faculty:
Santé
School:
HEdS - Genève
Institute:
Aucun institut
Date:
2020-01
Pagination:
10 p.
Published in:
Respiratory research
Numeration (vol. no.):
2020, vol. 21, article 35
DOI:
ISSN:
1465-993X
External resources:
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 Record created 2020-06-04, last modified 2021-03-01

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