The Burden of Associated Comorbidities in Patients with Obstructive Sleep Apnea-Regional Differences in Two Central-Eastern European Sleep Centers.

Andras Bikov,Stefan Mihaicuta,Roxana Pleava,Martina Meszaros,Saba Bokhari,Stefan Frent,Laszlo Kunos

doi:10.3390/jcm9113583

Abstract

Background: Obstructive sleep apnea (OSA) is usually associated with cardiovascular and cerebrovascular disease, metabolic syndrome and depression. Data on relevant OSA-associated comorbidities in Central–European populations are scarce. The aim of this study was to compare the prevalence of comorbidities in two OSA cohorts from Hungary and Romania. Methods: Data from 588 (282 from Hungary, 306 from Romania) untreated patients with OSA were retrospectively analyzed. The prevalence rates of hypertension, diabetes, dyslipidemia, allergic rhinitis, asthma, chronic obstructive pulmonary disease (COPD), osteoporosis, cerebrovascular and cardiovascular disease, arrhythmia and depression were compared between the two populations following adjustment for demographics, body mass index, smoking history, comorbidities and sleep parameters. Results: The prevalence rates of hypertension, arrhythmia, cerebrovascular and cardiovascular disease, diabetes and COPD in the whole study population were directly related to the severity of OSA. We found an inverse correlation between the prevalence of osteoporosis and OSA severity (all p < 0.05). Following adjustment, the prevalence of dyslipidemia was higher in the Hungarian cohort, whilst the prevalence of asthma, cardiovascular and cerebrovascular diseases was higher in the Romanian cohort (all p < 0.05). Conclusions: There was no difference in the prevalence rate of most comorbidities in patients with OSA from the two cohorts, except for dyslipidemia, asthma, cardiovascular and cerebrovascular disease.

Highlights

Obstructive sleep apnea (OSA) is a highly prevalent disease with a reported global prevalence of 1 billion people affected worldwide and estimated prevalence exceeding 50% in some countries [1]
AHI—apnea–hypopnea index; AHINREM—apnea–hypopnea index in NREM sleep; AHI in REM (AHIREM)—apnea–hypopnea index in REM sleep; AI—arousal index; BMI—body mass index; COPD—chronic obstructive pulmonary disease; ESS—Epworth Sleepiness Scale; MinSatO2—minimal oxygen saturation; ODI—oxygen desaturation index; REM%—% of REM sleep; Sleep%—sleep efficiency; SPT—sleep period time; TST—total sleep time; TST90%—% of sleep spent with oxygen saturation under 90%. * Polysomnography has been performed for 88 Hungarian patients
We found that dyslipidemia was more common in Hungary, whilst asthma, cerebrovascular and cardiovascular diseases were more prevalent in Romania

Summary

Introduction

Obstructive sleep apnea (OSA) is a highly prevalent disease with a reported global prevalence of 1 billion people affected worldwide and estimated prevalence exceeding 50% in some countries [1]. Obstructive sleep apnea (OSA) is usually associated with cardiovascular and cerebrovascular disease, metabolic syndrome and depression. The prevalence rates of hypertension, diabetes, dyslipidemia, allergic rhinitis, asthma, chronic obstructive pulmonary disease (COPD), osteoporosis, cerebrovascular and cardiovascular disease, arrhythmia and depression were compared between the two populations following adjustment for demographics, body mass index, smoking history, comorbidities and sleep parameters. Results: The prevalence rates of hypertension, arrhythmia, cerebrovascular and cardiovascular disease, diabetes and COPD in the whole study population were directly related to the severity of OSA. Conclusions: There was no difference in the prevalence rate of most comorbidities in patients with OSA from the two cohorts, except for dyslipidemia, asthma, cardiovascular and cerebrovascular disease

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Discussion

Conclusion