REM sleep apnoea and carotid intima thickness in men and womenA SHE-MUSTACHE Cohort Study

Abstract

<b>Background:</b> Rapid-eye-movement obstructive sleep apnoea (REM-OSA) might be particularly harmful to the cardiovascular system. <b>Aim:</b> We aimed to investigate the association between REM-OSA and signs of atherosclerosis in the form of carotid intima thickness in a community-based sample of men and women and possible sex-differences in this association. <b>Methods:</b> The association between REM-OSA and intima thickness was analysed cross-sectionally in women from the community-based “Sleep and Health in Women” (SHE) study (n=253) and age- and BMI-matched men from the “Men inUppsala; a Study of sleep, Apnoea and&nbsp;Cardiometabolic Health” (MUSTACHE) study (n=338) with adjustment for age, BMI, gender, alcohol, and smoking. All participants underwent a full-night polysomnography, a high-resolution ultrasound of the common carotid artery, anthropometric measurements, blood pressure measurements, and answered questionnaires. <b>Results:</b> There was an association between REM-OSA and thicker carotid intima that remained after adjustment for confounding (Adj. β=0.008, p=0.032). The intima was increased by 9.9% in the group with severe REM-OSA, and this association between severe REM-OSA and increased intima thickness remained after adjustment for confounders (Adj. β=0.043, p= 0.021). More women than men had severe REM-OSA; moreover, in sex stratified analyses, the association between REM-OSA and intima thickness was found in women but not in men. <b>Conclusion:</b> We conclude that severe REM-sleep apnoea is independently associated with signs of atherosclerosis. When stratified by sex, the association is seen in women but not in men.