Odds Of Obstructive Sleep Apnea Research Articles

Link between Secondhand Smoke Exposure and Obstructive Sleep Apnea among Nonsmoking U.S General Adults: Finding from the National Health and Nutrition Examination Survey 2015-2020

The association between secondhand smoke exposure (SHSE) and obstructive sleep apnea (OSA) in general adults remains to be explored and therefore is investigated based on the representative National Health and Nutrition Examination Survey (NHANES) in this study. SHSE was assessed by self-reporting of passive exposure to burning cigarette in an indoor area (home, restaurant or bar, etc.), and OSA was defined by self-reporting OSA-related symptoms and frequency. A survey-weighted regression model and stratified analyses were used to estimate the association between SHSE and odds of OSA. The study involved 9,991 participants who had never smoked, representing a weighted number of 449.9 million adults ranging from 20 to 80 years old in the noninstitutionalized U. S population. There was a strong association between several kinds of SHSEs and OSA that compared with participants staying indoors without exposure to secondhand smoke (SHS), the odds of OSA was 1.2 times higher for those with SHSE at home (adjusted odds ratio AOR=1.225, 95% CI: 1.009, 1.484), 1.4 times higher for those with SHSE in car (AOR=1.404, 95% CI: 1.219, 1.616), and 1.3 times higher for those with e-cigarette SHSE (AOR=1.302, 95% CI: 1.087, 1.557). Participants with simultaneous exposure to more different SHSs were 36% (one to three kinds of SHSEs (AOR=1.368, 95% CI: 1.219, 1.534)) and 44% (above four kinds of SHSEs (AOR=1.444, 95% CI: 1.034, 2.004)) more likely to have OSA, respectively. In general, general adults with SHSE in separate indoor areas, especially those with simultaneous exposure to different SHSs, had higher OSA risk. Identifying causality and health consequences of the association requires future longitudinal studies.

Association of dual use of cigarettes with obstructive sleep apnea assessed by the STOP-Bang score.

Although previous studies have addressed the association between smoking and obstructive sleep apnea (OSA), there are few studies on the association between electronic cigarette use and OSA. Thus, we aimed to evaluate the association between the dual use of electronic and conventional cigarettes and OSA. Data from 7350 participants of the 2019-2021 Korean National Health and Nutrition Examination Survey were analyzed in this population-based study. The STOP-Bang score was calculated using eight items: snoring, tiredness, observed apnea, high blood pressure, body mass index, age, neck circumference, and sex. The main independent variable was smoking behavior. A multiple logistic regression analysis was performed. Subgroup analysis was conducted to analyze the association between smoking behavior in detail and OSA, and stratified analyses were additionally performed. Of the 7350 participants, 417 (5.7%) had a high risk of OSA, according to the STOP-Bang score. Compared to the non-smoker group, the dual user group had a 2.46-fold increase in the odds of OSA (adjusted odds ratio, AOR = 2.45; 95% CI: 1.04-5.79). Current non-smokers who were dual users in the past had increased odds of having OSA (AOR=3.61; 95% CI: 1.32-9.92). In the stratified analyses, dual cigarette use was significantly associated with OSA in females and those with a low physical activity level. Dual users and cigarette-only users had an increased probability of developing OSA. Even if they are not currently smoking or vaping, individuals who were dual users in the past were associated with a higher risk of OSA. The association between dual cigarette use and OSA was more pronounced in females and those with a low physical activity level. While intervening for obstructive sleep apnea or investigating risk factors, new smoking methods such as vaping and dual use should be considered along with conventional smoking.

Comparison of polysomnographic characteristics between low birthweight and normal birthweight children in the Northern Territory of Australia: A case-control study

To describe the sleep architecture of pediatric patients according to whether they were born low birthweight (birthweight <2500 g, LBW) or normal birthweight (birthweight >2500 g). Case control study. Pediatric sleep laboratory in the Northern Territory of Australia during a 5-year study period (2015- 2020). Pediatric patients (aged <18 years) referred to the specialist sleep service for assessment of clinically suspected sleep disorders. Sleep onset latency, rapid eye movement (REM) sleep latency, wake time after sleep onset, total sleep time, sleep efficiency, non-rapid eye movement stages N1/N2/N3, and REM sleep duration, total/spontaneous/respiratory/limb related arousal indexes, total/non-rapid eye movement/REM obstructive apnea-hypopnea index and oxygen saturation. One hundred and seventy-two pediatric patients had birthweight data available of whom 19 were LBW. LBW patients showed significantly greater sleep disruption and higher prevalence of poor sleepers (<80% efficiency). In multivariate regression models, increasing birthweight was associated with significantly greater sleep efficiency and total sleep time. After accounting for gestational age LBW was associated with increased odds of obstructive sleep apnea. Among pediatric patients LBW is associated with increased sleep disruption and reduced sleep efficiency. This is attenuated by gestational age, though both gestational age and LBW significantly influence odds of obstructive sleep apnea. This sleep health deficit may contribute to development of chronic disease in this vulnerable population, and should be monitored to provide avenues for early intervention.

Sleep microstructure and clinical characteristics of patients with restless legs syndrome.

Restless legs syndrome (RLS) is a sleep-related movement disorder, often accompanied by sleep disruption. Obstructive sleep apnea (OSA) has a controversial prevalence among patients with RLS. We evaluated the clinical and sleep features of patients who attended our sleep clinic considering RLS and OSA. In this cross-sectional study, we obtained health records of 1,497 patients during 2015-2019 who underwent polysomnography (PSG). Baseline characteristics, sleep-related and RLS questionnaires, and sleep microstructure were assessed. Descriptive and analytical assessments were performed. RLS was assessed according to the International Restless Legs Syndrome Study Group criteria. RLS was found in 19.4% of patients, with more prevalence among women (26.9% vs 16.4%). RLS affected 19.1% of patients with OSA. Patients with RLS were significantly older with higher insomnia and depression and worse PSG results. As the respiratory disturbance index increased, the odds of RLS slightly decreased (adjusted odds ratio [95% confidence interval]: 0.80 [0.67-0.94]). The odds of OSA (respiratory disturbance index ≥ 5) was not affected by RLS. OSA in patients with RLS was significantly associated with a higher limb movement index. RLS in patients with OSA was significantly associated with higher insomnia, depression, and limb movement index (men and women), higher wake after sleep onset and percentage of N1 sleep (men), and lower sleep efficiency (men). Patients with RLS had worse PSG results, higher insomnia, and depression. Although men with OSA+/RLS+ had worsened PSG results, PSG parameters in women with OSA+/RLS+ did not differ from the OSA+/RLS- group. Patients with either OSA or RLS should be evaluated for possible comorbidities, including insomnia and depression. Notably, sex-specific characteristics need more consideration in sleep clinics. Amirifard H, Jameie M, Akbarpour S, etal. Sleep microstructure and clinical characteristics of patients with restless legs syndrome. J Clin Sleep Med. 2022;18(11):2653-2661.

0697 Improving Detection of Obstructive Sleep Apnea in Pregnant Women Using a Six-Point Screening Tool

Abstract Introduction Pregnant patients with obstructive sleep apnea (OSA) are at higher risk for adverse outcomes. There are currently no established screening tools for pregnant women. OSA in pregnancy continues to be underdiagnosed resulting in missed opportunities to prevent possible adverse outcomes. Methods A screening pilot program was implemented at our general obstetrics and maternal fetal medicine (MFM) clinic to improve diagnosis of OSA among pregnant women. Patients were screened by a nurse for snoring/apneas, BMI &amp;gt; 35, essential hypertension, glucose disorders, neck size &amp;gt; 36 cm, and symptoms of excessive daytime sleepiness. If a patient scored 3/6 or greater, a home sleep apnea test (HSAT), and in some cases an in-lab sleep study (PSG), was recommended to test for OSA after discussion of risks and benefits with an obstetrician. Results Since the initiation of the screening program, 302 women screened positive for OSA based on our 6-point screening tool. Average gestational age at the time of screening was 14.34 +/- 7.97 weeks. Of the women who scored ≥3 on the 6-point screening tool, 92 (30.46%) were referred directly to a sleep study and 31 (10.3%) received a referral to see a sleep medicine provider. A total of 78 underwent sleep testing and 58 (74.4%) were diagnosed with OSA with an apnea-hypopnea index (AHI) ≥ 5. Most patient were African American (67.9%) with an average age of 31.49 +/-5.74. The diagnosis of OSA correlated moderately well with the total score of the 6-point screening tool (p&amp;lt;.001), BMI (p=.005), essential hypertension (p=.01), glucose disorders (p=.07), and neck size (p=.039). Only a BMI of &amp;gt;35 was independently associated with a 3.7 increase in odds for OSA (95%CI=1.17, 11.76, p=.026). Conclusion A significant increase in screening for obstructive sleep apnea was achieved with implementation of the new screening protocol. Ease of use makes the six-point screening protocol a useful tool in clinic. More research is needed to test the accuracy of the six-point screening as a testing tool in this population. Additional barriers to screening and testing for OSA in pregnancy, including social and lifestyle factors should be explored in more depth. Support (If Any)

What are the Soft Tissue Risk Factors for Obstructive Sleep Apnea in Patients with Down's Syndrome?

To determine the risk factors and their respective magnitudes for developing Obstructive Sleep Apnea (OSA) in Down syndrome (DS) patients. Retrospective cohort study. The 2016 Kids' Inpatient Database (KID) was queried to identify all patients diagnosed with DS. The primary predictor variables were tonsillar hypertrophy (TH), adenoidal hypertrophy (AH), Hypertrophy of Tonsils & Adenoids (HTA), Laryngeal Stenosis (LS), Hypotonia, Glossoptosis, Congenital Laryngomalacia (CL), and Overweight & Obesity (OO). The primary outcome variable was OSA. The final sample consisted of 18,181 patients with a diagnosis of DS. Relative to patients aged 0-5, patients aged 6-10 (OR 3.5, P < 0.01), 11-5 (OR 3.4, P < 0.01), and 16 & above (OR 3.6, P < 0.01) were each independently associated with increased odds of OSA. Further, TH (OR 23.2, P < 0.01), AH (OR 20.3, P < 0.01), HTA (OR 64.2, P < 0.01), glossoptosis (OR 5.0, P < 0.01), CL (OR 4.3, P < 0.01), and OO (OR 3.7, P < 0.01) were all independent risk factors for OSA. The presence of hypertrophied tonsils and adenoids together was the strongest risk factor for OSA. DS patients aged six and above were at risk for OSA development relative to younger patients. Patients with DS should be tested for OSA, which otherwise will deteriorate their existing comorbidities.

Bidirectional Association Between Psoriasis and Obstructive Sleep Apnea: A Systematic Review and Meta-Analysis

The link between psoriasis and obstructive sleep apnea (OSA) has not been confirmed. We aimed to investigate the relationship between psoriasis and OSA. We conducted a systematic review and meta-analysis of case-control, cross-sectional, and cohort studies on the association between psoriasis and OSA. We searched MEDLINE and Embase for relevant studies on May 11, 2019. The Newcastle-Ottawa Scale was used to evaluate the risk of bias of included studies. We performed random-effects model meta-analysis to calculate pooled odds ratio (ORs) with 95% confidence intervals (CIs) for case-control and cross-sectional studies as well as pooled incidence rate ratio (IRR) with 95% CIs for cohort studies in association between psoriasis and OSA. A total of 4 case-control or cross-sectional studies and 3 cohort studies with a total of 5,840,495 subjects were included. We identified a significantly increased odds for OSA in psoriasis patients (pooled OR 2.60; 95% CI 1.07–6.32), and significantly increased risk for psoriasis in OSA patients (pooled IRR 2.52; 95% CI 1.89–3.36). In conclusion, our study identified a bidirectional association between psoriasis and OSA. Sleep quality should be inquired in patients with psoriasis. Respirologist consultation or polysomnography may be indicated for those presenting with night snoring, recurrent awaking, and excessive daytime sleepiness.

0473 Alendronate is Associated With a Significantly Higher Odds of Obstructive Sleep Apnea (OSA): Results from the US FDA Adverse Events Reporting System (FAERS)

0473 Alendronate is Associated With a Significantly Higher Odds of Obstructive Sleep Apnea (OSA): Results from the US FDA Adverse Events Reporting System (FAERS)

0917 Finasteride is Associated with a Higher Odds of Obstructive Sleep Apnea (OSA): Results from the US FDA Adverse Events Reporting System (FAERS)

0917 Finasteride is Associated with a Higher Odds of Obstructive Sleep Apnea (OSA): Results from the US FDA Adverse Events Reporting System (FAERS)

Obstructive sleep apnea in young infants with Down syndrome evaluated in a Down syndrome specialty clinic.

Children with Down syndrome (DS) experience congenital and functional medical issues that predispose them to obstructive sleep apnea (OSA). Research utilizing stringent age criteria among samples of infants with DS and OSA is limited. This study examines clinical correlates of OSA among infants with DS. A retrospective chart review was conducted of infants ≤6 months of age referred to a DS clinic at a tertiary children's hospital over five-years (n = 177). Chi-square tests and binary logistic regression models were utilized to analyze the data. Fifty-nine infants underwent polysomnography, based on clinical concerns. Of these, 95% (56/59) had studies consistent with OSA. Among infants with OSA, 71% were identified as having severe OSA (40/56). The minimum overall prevalence of OSA among the larger group of infants was 31% (56/177). Significant relationships were found between OSA and dysphagia, congenital heart disease (CHD), prematurity, gastroesophageal reflux disease (GERD), and other functional and anatomic gastrointestinal (GI) conditions. Results indicate that odds of OSA in this group are higher among infants with GI conditions in comparison to those without. Co-occurring dysphagia and CHD predicted the occurrence of OSA in 36% of cases with an overall predictive accuracy rate of 71%. Obstructive sleep apnea is relatively common in young infants with DS and often severe. Medical factors including GI conditions, dysphagia and CHD may help to identify infants who are at greater risk and may warrant evaluation. Further studies are needed to assess the impact of OSA in infants with DS.