Abstract 14839: Clinical, Polysomnographic and Echocardiographic Correlates of Excessive Daytime Sleepiness

Abstract

Introduction: Excessive Daytime Sleepiness (EDS) has been associated with adverse CVD outcomes. However, the mechanisms of elevated CVD risk in persons with EDS remains uncertain. In this study, we examined polysomnographic and echocardiographic correlates of EDS in a population of adults who underwent both sleep and cardiac stress tests. Methods: We analyzed data from 264 participants who had an in-lab polysomnogram (PSG) and a cardiac stress test between 2016 and 2019. All patients completed the Epworth Sleepiness Scale (ESS) questionnaire. EDS was categorized into 3 groups no EDS (ESS<10), non-severe EDS (ESS 10-14), and severe EDS (ESS ≥15). T90%, the percentage of sleep time spent with oxygen desaturation < 90%, was categorized into severe (≥ 20%) and non-severe nocturnal hypoxemia (<20%). We assessed the relationship between EDS and CV risk factors, and EDS and echocardiographic parameters of diastolic dysfunction such as the E/e’, E/A ratio, left atrial volume index, tricuspid regurgitation jet velocity, and systolic function (ejection fraction, EF). Results: The mean age (SD) of the participants was 59 (11) years, and 59% were female. In logistic regression analysis severe EDS was associated with >3-fold odds of a history of stroke or TIA [a OR 3.2 (95%CI:1.2-8.2), P=0.017] and nearly 4 times the odds of severe nocturnal hypoxemia [aOR 3.8 (95%CI: 1.7-8.6, P=0.002] compared to those with no EDS. We found no other association between EDS and demographic or CV characteristics or PSG variables. In the subset of patients with available echocardiogram data (n=199 - 213), there was no association between EDS and EF or echocardiographic parameters of diastolic dysfunction. Conclusions: EDS is strongly associated with severe nocturnal hypoxia and a history of stroke or TIA in adults with OSA. Further studies are needed to characterize the relationship between EDS and CVD.