Incidence Of Sleep Apnea Syndrome Research Articles

Mortality and Cardiovascular Events in Patients With Chronic Kidney Disease and Sleep Apnea Syndrome

BackgroundThe incidence of sleep apnea syndrome (SAS) is reported to be markedly high in patients with chronic kidney disease (CKD). Therefore, it is extremely important to know whether SAS affects prognosis in patients with CKD. Further, it is imperative to understand the prognostic impact of home continuous positive airway pressure (CPAP) therapy, which is one of the most common treatments for SAS.Materials and MethodsWe used a clinical database to identify patients with CKD using diagnosis codes. We included patients with CKD aged 20 years or more, not on renal replacement therapy, with a known change in renal function for at least 1 year. The propensity score was used to compare event rates for patients with SAS and those without SAS. In addition, the prognostic impact of CPAP therapy was investigated. The primary outcome is a composite of death, initiation of renal replacement therapy, hospitalization for heart failure, ischemic heart disease, and cerebrovascular disease.ResultsFrom the database, 31,294 patients with CKD without SAS and 1,026 with SAS were found to be eligible. Of these, 419 (41%) patients with SAS and 10,713 (34%) patients without SAS (P < 0.01) reached the primary outcome. After adjustment with the propensity score, the SAS group was found to have a similarly poor prognosis (P < 0.01): the hazard ratio for the primary outcome was 1.26 (95% CI, 1.08–1.45, P < 0.01) in the group with SAS compared with the group without SAS. Conversely, in patients with SAS and using CPAP, the hazard ratio was lower and did not differ significantly (HR 0.96, 95% CI: 0.76–1.22, P = 0.76).ConclusionIn patients with CKD and SAS, the risk of death and cardiovascular disease is high. In addition, patients treated with CPAP may have improved life expectancy.

Evaluation of the influence of cardiac resynchronization therapy on sleep apnea syndrome

Many studies have shown a high prevalence of sleep apnea syndrome (SAS), whether obstructive sleep apnea (OSA) or central sleep apnea (CSA) in heart failure patients (HF). Very few data exit about HF patients with cardiac resynchronization therapy (CRT). In this study, we will determine the prevalence of SAS in this population and study the influence of CRT about SAS. A prospective open-label, single-center, non-interventional, cohort-type study was conducted at Reims University Hospital between 1st January and 31st August 2016. All patients implanted with CRT device without known SAS were included. Screening polysomnography was performed before and 6 months after implantation. Primary endpoint was the incidence of SAS and secondary endpoint was the evaluation of the impact of CRT on SAS. During the study period, 31 patients were implanted with a CRT device: 10 were already known having SAS and 5 did not give their consent. At M0, 100% of the 16 included patients were diagnosed having SAS, with 69% severe OSAS. All were treated by CPAP according to guidelines. At 6 months, after 48 h CPAP washout, no independent significant influence of CRT on the Apnea-Hypopnea Index (AHI) was demonstrated (37 ± 19 vs 60 ± 12, P = 0.0625). An improvement in HF parameters was observed (NYHA class (−1, P = 0.0195), QRS width (−26 ms, P = 0.0002) and LVEF (+9.5%, P = 0.0039)). At 6 months, the CRT response rate was high with significant NYHA class and LVEF improvement in 79 and 57% patients respectively. SAS (especially OSA) is frequent in HF patients eligible for CRT and mostly under-diagnosed. The lack of improvement of the AHI by the CRT alone and the existence of a specific treatment of the OSAS improving morbi-mortality, maintaining a very good response rate to the CRT invite to screen this population.

Poster Number: EI 58 - Relationship between Equol Production Status and Sleep Apnea Syndrome in the Elderly

Introduction: It has been reported that the prevalence of Sleep Apnea Syndrome (SAS) in elderly people (over 65) is more than 20%. Elderly patients with SAS have a predilection to develop hypertension, arrhythmia, angina pectoris, myocardial infarction, diabetes mellitus, and cognitive decline. On the other hand, it is controversial that consumption of soy isoflavones, which are predominantly derived from soybeans, reduces the risk of cardiovascular disease. Recent study reveals, equol, a metabolite of an isoflavone, differs greatly among individuals. Equol is converted from daizein by specific gut bacteria, and is more bioavailable than soy isoflavone. In this study, we sought to confirm whether equol production status is associated with incidence of SAS.

E0411 Effects of sleep apnea syndrome on myocardial ischaemia in patients with coronary heart disease during night

Objective1. To investigate the relationship between sleep apnea syndrome (SAS) and myocadial ischaemic events in patients with coronary heart disease (CHD). 2. To compare the differences of age, gender distribution,...

All-night respiration monitoring of elderly people by using a new non-restraint respiration monitoring system

We conducted all-night monitoring of elderly people who were admitted to our elderly health-care institution by using a new non-restraint respiration monitoring system. The monitoring system detects even the slightest respiratory movement of a sleeping person by means of a fiber grating optical sensor, without having any physical contact. A group of test subjects consisted of 25 dementia patients, 22 patients with cerebral apoplexy, and 18 non-dementia patients. We conducted an all-night monitoring with this system (a total of 372 times) and it was revealed that the incidence of sleep apnea syndrome in the elderly dementia patients and the elderly patients with cerebral apoplexy was extremely high compared with the incidence rate in the elderly non-dementia patients.

High incidence of sleep apnea syndrome in a male diabetic population

In order to study the possible relationship between sleep apnea syndrome (SAS) and diabetes mellitus, we first examined the prevalence of SAS among 12787 general patients (6554 males and 6233 females) who visited Katsumata Hospital at Nagoya, Japan. Among them, thirty-five males and five females were diagnosed as having SAS. The male patients were statistically analysed by the corrected Mantel-Haenszel χ-square test taking the body type into account, and it was found that the prevalence of SAS was significantly high both in a diabetic population and in a hypertensive one. Among 40 SAS patients of both sexes, 34 were given a glucose tolerance test (GTT) with oral administration of 75 g glucose. Thirteen showed a diabetic pattern, 12 a borderline pattern and only 9 had a normal pattern. All 13 diabetic patients had non-insulin-dependent type diabetes (NIDDM). The present results showed that SAS has a close relationship not only to hypertension but also to NIDDM.