Abstract 17914: C-Reactive Protein and Sleep Apnea Symptoms in World Trade Center Responders

Abstract

Background Obstructive sleep apnea (OSA) is particularly prevalent in patients with cardiovascular disease (CVD). OSA is not an isolated sleep disturbance: the extent of its role as a causative agent in development and progression of CVD is under investigation. The hypoxemic stress that occurs during apneas leads to systemic inflammation and studies have shown correlations in the severity of OSA and the elevation of high-sensitivity C-reactive protein (CRP). We seek to characterize the association of CRP and patients at risk for OSA as assessed by the Berlin Questionnaire (BQ) and hypothesize that a positive relationship might improve diagnosis of OSA. Methods We evaluated 1,976 participants in the Law Enforcement Cardiac Screening Program, a subset of the World Trade Center Medical Monitoring and Treatment Program. Abnormal CRP is defined as CRP >/= 2 mg/L. Subjects with a positive response in 2 of the 3 categories from the Berlin Questionnaire are considered to be at high risk for OSA. We used chi-squared test and multivariate binary logistic regression in SPSS 19.0 to analyze the relationship between CRP and risk for OSA. Results Mean age is 46.77 ± 5.38 years and mean CRP is 3.26 ± 6.29. CRP >/= 2 was significantly related to high risk for OSA, p = 0.001. When adjusted for age, gender, and family history of coronary artery disease, CRP >/= 2 and risk for OSA are still significantly correlated ( p < 0.001). Conclusion CRP >/= 2 is associated with being at high risk for OSA. This association may trigger more practitioners to screen their patients with high CRP values for OSA. The presence of a positive inflammatory marker with its implications for systemic disease may encourage patients to undergo the time-consuming diagnosis of and to be adherent to the cumbersome treatment of OSA, potentially resulting in improvement of their cardiovascular health, an exciting area for further research. Funding Source: NY Fraternal Order of Police, via Office of the NY Attorney General Charity Fund.