Prevalence Of Obstructive Sleep Apnea Research Articles

PREVALENCE OF OBSTRUCTIVE SLEEP APNEA IN CASES OF METABOLIC SYNDROME: A CROSS-SECTIONAL STUDY

Objectives: The study aimed to find out the prevalence of obstructive sleep apnea (OSA) in individuals with metabolic syndrome (MS). Methods: This was a cross-sectional study conducted in the department of respiratory medicine of a tertiary care medical institute. Eighty patients infected with MS diagnosed on the basis of national cholesterol education program adult treatment panel III criteria were included in this study on the basis of predefined inclusion and exclusion criteria. Demographic details such as age, gender, and socioeconomic status of all the patients were noted. A thorough general and clinical examination was conducted, including the assessment of vital signs. Polysomnography was done in all cases and the diagnosis of OSA was based on polysomnography results. SSPS 21.0 was used for statistical analysis and p<0.05 was taken as statistically significant. Results: Out of 80 patients, there were 58 (72.50%) males and 22 (27.50%) females with a M: F ratio of 1: 0.37. The overall mean age of the studied cases was found to be 44.60±12.92. Mild (apnea-hypopnea index [AHI] 5–14), moderate (AHI=15–30), and severe OSA (AHI >30) was seen in 33 (41.25%), 17 (21.25%) and 9 (11.25%) patients, respectively. Overall prevalence of OSA in cases of MS was found to be 73.75% as the severity of OSA increased there was decreased in mean sleep time and the difference was found to be statistically significant (p<0.05). The most common presenting complaint was loud snoring, observed in 55 patients (93.22%). This was followed by daytime sleepiness in 47 patients (79.66%), waking up tired in 37 patients (62.71%), and disturbed sleep in 36 patients (61.02%). Conclusion: The prevalence of OSA is notably high among individuals with MS. Consequently, routine assessment for OSA should be an integral component of the management strategy for patients with MS.

Management of sleep-disordered breathing in patients with syndromic hemifacial macrosomia.

Patients with syndromic hemifacial microsomia (SHFM) are at risk of obstructive sleep apnea (OSA). The aim of the study was to describe the prevalence of OSA and its management, especially in patients with Goldenhar syndrome (GS). The respiratory polygraphies and clinical management of 15 patients, aged 2 to 23years, evaluated at a national reference center, were analyzed. Four (27%) patients had no OSA, 4 (27%) had mild OSA, and 7 (46%), of whom 5 were ≤ 2years old, had severe OSA. None of the patients had central apneas. Only one patient had alveolar hypoventilation, and another one had nocturnal hypoxemia. Two patients had severe OSA despite prior adenoidectomy or mandibular distraction osteogenesis. Median duration of follow-up was 3.5years (range 0.5-9years). None of the patients without OSA or with mild OSA at baseline respiratory polygraphy developed OSA during the follow up. Among the 7 patients with severe OSA, 3 required continuous positive airway pressure or noninvasive ventilation, and one patient required a tracheostomy. In conclusion, patients with SHFM are at high risk of severe OSA at any age, underlining the importance of systematic sleep studies to diagnose and evaluate the severity of OSA. Individualized treatment should be privileged, based on a careful examination of the entire upper airway, taking in account potential associated risk factors. All patients with SHFM should be managed by a pediatric expert multidisciplinary medical/surgical team until the end of post pubertal growth.

Obstructive Sleep Apnea as a Key Contributor to Mental Stress-Induced Myocardial Ischemia in Female Angina Patients with No Obstructive Coronary Artery Disease.

Mental stress induced myocardial ischemia (MSIMI) is regarded as the primary cause of the angina with no obstructive coronary artery disease (ANOCA). Obstructive sleep apnea (OSA) is autonomously linked to obstructive coronary heart disease, hypertension, and sudden cardiac death. Similar to the impact of psychological stress on the cardiovascular system, individuals with OSA experience periodic nocturnal hypoxia, resulting in the activation of systemic inflammation, oxidative stress, endothelial dysfunction, and sympathetic hyperactivity. The contribution of OSA to MSIMI in ANOCA patients is unclear. To explore the prevalence of OSA in ANOCA patients and the correlation between OSA and MSIMI, a prospective cohort of female ANOCA patients was recruited. We recruited female patients aged 18 to 75 years old with ANOCA and evaluated MSIMI using positron emission tomography-computed tomography. Subsequently, Level III portable monitors was performed to compare the relationship between OSA and MSIMI. There is higher REI (7.8 vs 2.6, P=0.019), ODI (4.7 vs 9.2, P=0.028) and percentage of OSA (67.74% vs 33.33%, P=0.004) in MSIMI patients. The patients diagnosed with OSA demonstrated higher myocardial perfusion imaging scores (SSS: 1.5 vs 3, P = 0.005, SDS: 1 vs 3, P = 0.007). Adjusted covariates, the risk of developing MSIMI remained 3.6 times higher in OSA patients (β=1.226, OR = 3.408 (1.200-9.681), P = 0.021). Patients with MSIMI exhibit a greater prevalence of OSA. Furthermore, the myocardial blood flow perfusion in patients with OSA is reduced during mental stress.

Prevalence, Severity, and Treatment of Obstructive Sleep Apnea in Children with Down Syndrome in Qatar.

Patients with Down syndrome (DS) are at risk for sleep disorder breathing (SDB) due to their abnormal craniofacial anatomy, hypotonia, and propensity for obesity. The prevalence and severity of SDB in this population vary between different cohorts due to the multifactorial nature of these patients and the different diagnostic criteria used. We aim to report the prevalence and severity of SDB in the DS population in Qatar. This study is a retrospective review of all patients with genetically confirmed DS who completed a diagnostic polysomnography (PSG) study at Sidra Medicine in Doha, Qatar, which is the only pediatric sleep center in the country, between September 2019 and July 2022. Clinical and PSG data were collected from the patients' electronic medical records. Central and obstructive events were scored according to the American Academy of Sleep Medicine (AASM) criteria. Obstructive sleep apnea (OSA) diagnosis was made based on apnea-hypopnea index (AHI) and defined as AHI>1.5 events/hour.OSA was considered mild if AHI was ≥ 1.5 but < 5, moderate if AHI was ≥ 5 but < 10, and severe if AHI was ≥ 10 events/hour. Diagnosis with central apnea was considered if the central apnea index was > 5 events/hour. Hypoventilation was considered present if end-tidal/transcutaneous carbon dioxide gas was more than 50 mmHg for more than 25% of total sleep time.Multiple regression analysis was performed to evaluate predictors of high AHI and rapid eye movement (REM)-AHI. A total of 80 patients (49 males and 31 females) were included. Median (range) age was 7.3 years (0.9, 21). The mean (range) BMI z-score was 1.7 (-1.3, 4.3). Sixty-five patients were diagnosed with OSA, with a prevalence rate of 81%. OSA was mild in 25 (38.5%) patients, moderate in 15 (23.1%) patients, and severe in 25 (38.5%) patients. Only one patient was diagnosed with central apnea and five patients (6.9%) with alveolar hypoventilation. Multiple regression analysis showed BMI (P = 0.007) and snoring/apnea symptoms (P=0.023) to be predictive of high AHI. No correlation was found between the same variables and REM-AHI. Treatments used for OSA included anti-inflammatory medications in 37 (46%) patients, tonsillectomy/adenoidectomy in 13 (16.5%) patients, and positive airway pressure support in 10 (15%) patients. Our patient population with DS had a high prevalence of OSA comparable to other reported cohorts. High BMI and symptoms of snoring are predictive of OSA.

Prevalence of Obstructive Sleep Apnoea in patients with primary nasal and nasopharyngeal pathologies.

The aim of this study was to study the prevalence of obstructive sleep apnea syndrome in patients with nasal and nasopharyngeal pathologies. A total of 60 consenting patients between the age of 14 to 60 years with primary nasal and nasopharyngeal pathologies were taken up for the study. These patients underwent history taking, detailed clinical examination including BMI, diagnostic nasal endoscopy and overnight polysomnography. The polysomnography results of people with different pathologies were compared and analysed. Based on the analysis it was arrived that isolated pathologies like septal deviation, nasal polypi and adenoid hypertrophy provided a statistically significant association with occurrence and severity of OSA. Also, that patients with combined pathologies were more proportionately affected by OSA than those with isolated pathologies. Nasal and nasopharyngeal pathologies have significant association with obstructive sleep apnea syndrome and all patients with these pathologies need to undergo polysomnography along with other routine investigations.

Prevalence of obstructive sleep apnea in whole spectrum chronic kidney disease patients: A systematic review and meta-analysis

BackgroundObstructive sleep apnea (OSA) is a common sleep disorder among chronic kidney disease (CKD) patients, associated with considerable morbidity. Various studies from around the globe have reported different prevalence rates. ObjectiveThis systematic review and meta-analysis aimed to determine the prevalence of OSA and quantify the relationship between OSA and mortality risk in patients with CKD. MethodsFour databases were systematically searched, and additional references to relevant articles were manually searched. The prevalence of OSA and the mortality risk based on random-effects models were assessed using percentages and hazard ratio (HR) with a 95 % confidence interval (95 % CI). In addition, the heterogeneity between studies was assessed using I2 statistics. ResultsA total of 44 literature (47 studies with 223,967 participants) met the eligibility criteria for the meta-analysis. The results showed that the prevalence of OSA in CKD patients was reported to be 39.3 % (95 % CI, 32.3–46.7). Among study participants in different age groups, the highest prevalence of OSA was found in CKD respondents aged 60 years or older, at 47.1 % (95 % CI 34.4–60.3). Of the eight literature (10 cohorts) that provided survival data, the pooled estimates indicated a 26.5 % (HR: 1.265; 95 % CI 1.021–1.568) higher mortality risk in subjects with OSA than CKD patients without OSA. ConclusionsThis systematic review and meta-analysis found that more than 1/3 of CKD patients have comorbid OSA, which increases the risk of early death in CKD patients. These results should help policymakers to provide adequate healthcare for this population. Prospero registration idCRD42023465497.

#1910 Echocardiographic findings in patients with advanced diabetic kidney disease and obstructive sleep apnea

Abstract Background and Aims Obstructive sleep apnea (OSA) is associated with accelerated development of cardiovascular disease. The prevalence of OSA is increased in both type 2 diabetes (DM2) and in chronic kidney disease, and is very high in patients with diabetic kidney disease. However, the contribution of OSA to alterations in cardiac structure and function in diabetic kidney disease remains unknown. We therefore compared cardiac structure and function in diabetic kidney disease patients with or without OSA. Method In a cross-sectional study, 120 patients with DM2, a urine albumin-creatinine ratio (UACR) &amp;gt; 30 mg/g and an estimated glomerular filtration rate (eGFR) &amp;lt; 60 ml/min/1.73 m2 were tested for OSA. OSA severity was quantified by the apnea-hypopnea-index (AHI). Patients without OSA (AHI &amp;lt; 5 events/hour) were compared to patients with moderate (AHI 15-29 events/hour) or severe OSA (AHI ≥30 events/hour). Transthoracic echocardiography was conducted in all patients to evaluate cardiac structure and function. Linear regression analyses were used to assess the associations between OSA and echocardiographic parameters. Results AHI-data were available for 114 patients; 43 had no OSA, 33 had mild OSA and 38 had moderate-severe OSA. A total of 74 patients (73% men), 39 with no OSA and 35 with moderate-severe OSA, had complete data for both echocardiography and OSA. Their mean age was 71.5 ± 9.4 years, mean eGFR was 32.2 ± 12.3 mL/min/1.73 m2 and the median UACR of 533 (192–1707) mg/g. Age, smoking status, diabetes duration, eGFR, blood pressure, antihypertensive medicine, chronic obstructive pulmonary disease and atrial fibrillation were not significantly different between patients with and without OSA. Patients with moderate-severe OSA had significantly larger left atrial volume index (LAVI) (39.0 ± 19.6 vs. 28.1 ± 10.5 mL/m2, P = 0.0035), left ventricular mass index (LVMI) (49.2 ± 12.0 vs. 41.8 ± 9.7, g/m2, P = 0.0043), and right ventricular diameter (34.3 ± 5.8 vs. 28.4 ± 4.4 mm, P &amp;lt; 0.0001) compared to those without OSA (Fig. 1). Global longitudinal strain (GLS) was significantly reduced in OSA patients (−14.9 ± 3.1 vs. −16.6 ± 2.8, P = 0.0196), while no difference was observed in LV ejection fraction (54.4 ± 8.1 vs. 56.5 ± 6.2, p = 0.21). The association between OSA and LAVI, LVMI, right ventricular diameter and GLS remained significant after adjustment for age, sex, eGFR and mean arterial pressure. Conclusion Moderate-severe OSA is independently associated with alterations in cardiac structure and function in patients with diabetic kidney disease and reduced renal function. OSA could be an independent contributor to the development of heart failure in patients with diabetic kidney disease.

#1384 Obstructive sleep apnea and fluid management in the hemodialysis: are clinicians putting existing scientific evidence into practice?

Abstract Background and Aims Obstructive Sleep Apnea (OSA) prevalence was found to be higher in an intermittent hemodialysis (iHD) population of the French-speaking Switzerland than in the general population of the same geographical area. The high prevalence of OSA in iHD patients was linked to fluid overload. Interdialytic fluid management targeting a low dry weight showed to reduce OSA's severity, offering a novel therapeutic option in this population. The aims of this study were: 1) to assess the prevalence of confirmed OSA in an end-stage renal disease (ESRD) population undergoing iHD in the Italian-speaking area of Switzerland; 2) to assess the awareness of the treating nephrologists about the OSA's diagnosis of their patients; and 3) to evaluate whether nephrologists integrate the current knowledge in their fluid management strategy of iHD patients with OSA. Method We performed a multicenter, cross-sectional study between July 2022 and July 2023, screening all patients attending the four iHD units of the Ente Ospedaliero Cantonale (EOC), the public hospital network of Canton Ticino (Switzerland), and including those with confirmed OSA. For these patients, we collected anthropometric parameters, iHD protocol characteristics and fluid status from electronic patient dossiers. Fluid overload was measured by multifrequency bioelectrical impedance (Body Composition Monitor®, BCM®; Fresenius Medical Care). Nephrologists of the four iHD units were asked to identify patients with known OSA diagnosis, without consulting the medical dossiers, and were interviewed about their specific iHD strategy in patients with OSA. We compared the fluid management of patients identified as “OSA positive” and those with OSA diagnosis, but misclassified as “OSA negative” by the treating nephrologist. Results Out of 193 patients treated by iHD in the four HD units, 45 patients had a confirmed diagnosis of OSA and were included in this study. Mean age was 76.0 ± 7.5 y, 82.2% were men, mean BMI was 29.1 ± 4.5 kg/m2. They were treated 3 times per week, in mean for 3.76 ± 0.37 hours; 22 were treated by hemodialysis and 23 by hemodiafiltration. The 23% prevalence of diagnosed OSA observed in the study population was significantly lower than the 56% prevalence found in the French Switzerland iHD cohort (p &amp;lt; 0.001). Out of the 45 patients with diagnosed OSA, only 27 (60.0%) were correctly identified by the treating nephrologist. We found no difference in the dry weight target defined by the treating nephrologist between the patients correctly identified as “OSA positive” and those misclassified as “OSA negative”, both being close to the dry weight calculated with BCM® (mean difference 0.7 ± 2.3 vs 0.3 ± 1.4 kg; p = 0.564). The pre-dialysis fluid overload of the whole population was 2.4 ± 1.7 kg, being higher in the “OSA positive” group (2.9 ± 2.0 kg) than in the “OSA negative” group (1.8 ± 0.7 kg; p = 0.0172). However, we found no difference in post-dialysis achievement of dry weight between the groups (residual overweight 0.2 ± 1.0 and 0.1 ± 0.7 kg respectively; p = 0.672). In the interviews, only half of the nephrologists (4/8) were aware of the correlation between fluid overload and OSA, and two of them reported to integrate this knowledge in their fluid management strategy, even if not systematically. Conclusion Nephrologists' attention to sleep apnea in iHD patients seems to be low, despite its high prevalence in this population and scientific evidence supporting that targeting fluid overload is an effective option to improve OSA severity. However, nephrologists tried to achieve the dry weight very strictly in all patients, independently of OSA. More intensive training of nephrologists to the clinical and diagnostic peculiarities of OSA in patients with ESKD is required, in order to improve OSA diagnosis and targeted therapeutic care.

Obstructive Sleep Apnea and Pulmonary Hypertension: A Chicken-and-Egg Relationship.

Obstructive sleep apnea (OSA) is characterized by repeated episodes of upper airway obstruction during sleep, and it is closely linked to several cardiovascular issues due to intermittent hypoxia, nocturnal hypoxemia, and disrupted sleep patterns. Pulmonary hypertension (PH), identified by elevated pulmonary arterial pressure, shares a complex interplay with OSA, contributing to cardiovascular complications and morbidity. The prevalence of OSA is alarmingly high, with studies indicating rates of 20-30% in males and 10-15% in females, escalating significantly with age and obesity. OSA's impact on cardiovascular health is profound, particularly in exacerbating conditions like systemic hypertension and heart failure. The pivotal role of hypoxemia increases intrathoracic pressure, inflammation, and autonomic nervous system dysregulation in this interplay, which all contribute to PH's pathogenesis. The prevalence of PH among OSA patients varies widely, with studies reporting rates from 15% to 80%, highlighting the variability in diagnostic criteria and methodologies. Conversely, OSA prevalence among PH patients also remains high, often exceeding 25%, stressing the need for careful screening and diagnosis. Treatment strategies like continuous positive airway pressure (CPAP) therapy show promise in mitigating PH progression in OSA patients. However, this review underscores the need for further research into long-term outcomes and the efficacy of these treatments. This review provides comprehensive insights into the epidemiology, pathophysiology, and treatment of the intricate interplay between OSA and PH, calling for integrated, personalized approaches in diagnosis and management. The future landscape of OSA and PH management hinges on continued research, technological advancements, and a holistic approach to improving patient outcomes.

Obstructive Sleep Apnea and Oxygenation in Very Old Adults: A Propensity-Score Match Study

ObjectivesThe prevalence of obstructive sleep apnea (OSA) escalates with advancing age. Although the apnea-hypopnea index (AHI) is the standard measure for assessing OSA severity, it does not account for additional oximetric parameters that may influence disease progression in older adults. This study aimed to evaluate disparities in respiratory polygraphy/polysomnography parameters among patients with OSA, stratified by age and sex. DesignRetrospective propensity score-matched study. Setting and ParticipantsSleep unit of a university hospital; 11,747 participants, 210 aged 80 years or older. MethodsPropensity score matching was used to establish 4 age cohorts, with the 210 oldest adults serving as the reference group. Primary outcome variables included the total sleep time with oxygen saturation (SaO2) below 90% (T90), average SaO2, minimum SaO2, and AHI. The association between T90 and AHI, as well as the severity of OSA, was assessed across the 4 age categories. ResultsDespite comparable AHI scores, the oldest patients with OSA exhibited the highest T90 and the lowest SaO2 levels compared to younger counterparts. The proportion of patients with severe OSA and T90 in the highest quartile increased with age: 12.5% in young adults, 14.8% in adults, 21.7% in the old, and 34% in the very old participants (P < .001). old and very old patients had a greater likelihood of being in the most severe OSA category compared to the younger ones, with odds ratios (OR) 2.57 (95% CI 1.42–4.65) and 5.52 (95% CI 3.06–9.97), respectively. These patterns were more pronounced in women of advanced age, indicating a sex-specific variation in disease severity with increasing age. Conclusions and ImplicationsOld patients with OSA, particularly women, demonstrate elevated T90 and reduced SaO2 levels, irrespective of AHI, indicating a hypoxemia increased risk. The diagnostic criteria, management, and outcomes for OSA may require adaptations to address the unique needs of very old populations.

Comparison of Sleep Apnea Questionnaires and Reported Diagnosis in Neurological Disorders of Aging.

Obstructive sleep apnea (OSA) is associated with worse outcomes in stroke, Alzheimer's disease (AD) and Parkinson's disease (PD), but diagnosis is challenging in these groups. We aimed to compare the prevalence of high risk of OSA based on commonly used questionnaires and self-reported OSA diagnosis: 1. within groups with stroke, AD, PD and the general population (GP); 2. Between neurological groups and GP. Individuals with stroke, PD and AD were identified in the Canadian Longitudinal Study of Aging (CLSA) by survey. STOP, STOP-BAG, STOP-B28 and GOAL screening tools and OSA self-report were compared by the Chi-squared test. Logistic regression was used to compare high risk/self-report of OSA, in neurological conditions vs. GP, adjusted for confounders. We studied 30,097 participants with mean age of 62.3 years (SD 10.3) (stroke n = 1791; PD n = 175; AD n = 125). In all groups, a positive GOAL was the most prevalent, while positive STOP was least prevalent among questionnaires. Significant variations in high-risk OSA were observed between different questionnaires across all groups. Under 1.5% of individuals self-reported OSA. While all questionnaires suggested a higher prevalence of OSA in stroke than the GP, for PD and AD, there was heterogeneity depending on questionnaire. The wide range of prevalences of high risk of OSA resulting from commonly used screening tools underscores the importance of validating them in older adults with neurological disorders. OSA was self-reported in disproportionately small numbers across groups, suggesting that OSA is underdiagnosed in older adults or underreported by patients, which is concerning given its increasingly recognized impact on brain health.

Pooled prevalences of obstructive sleep apnea and heart failure: a systematic review andmeta-analysis.

Obstructive sleep apnea (OSA) is a disease with intermittent hypoxemia during sleep. It has been shown that OSA is related to several cardiovascular diseases including heart failure. Both OSA and heart failure have a close association bidirectionally. This study aimed to estimatethe pooled prevalence of OSA in patients with heart failure as well as pooled prevalence of heart failure in patients with OSA. This was a systematic review with a meta-analysis. The inclusion criteria were observational or epidemiological studies conducted in adult patients with heart failure to evaluate the prevalence of OSA and patients with OSA to evaluate the prevalence of heart failure. The outcomes of this study were prevalence of OSA in patients with heart failure and prevalence of heart failure in patients with OSA. Four databases were used for systematic searching including PubMed, Science Direct, Scopus, and CINAHL Plus. Manual searches for related studies were also conducted. Proportion meta-analyses using a random-effects model were conducted to identify pooled proportion (prevalence) of heart failure in patients with OSA and vice versa. Among 3,941 articles from the four databases met the study criteria. Thirty-three studies showed the prevalence of OSA in patients with heart failure, while thirteen studies presented the prevalence of heart failure in patients with OSA. The prevalence of OSA in patients with heart failure was 38.4% (95% CI 31.9 to 45.2; I2 of 96.1%). Using a diagnostic criterion of OSA of more than 10 events/hr had the highest prevalence of OSA in patients with heart failure at 53.4% (95% CI 42.0 to 64.5). The highest prevalence of OSA in patients with heart failure was 60.1% (95% CI 51.4 to 68.3) in a report from India. The pooled prevalence of heart failure in patients with OSA was 12.8% (95% CI 8.1 to 19.5; I2 of 94.6%). The prevalence in Romania was highest at 22.6% (95% CI 20.4 to 24.9). The pooled prevalence of OSA in patients with heart failure was higher than the pooled prevalence of heart failure in patients with OSA. The pooled prevalence rates of these associations varied among the diagnostic criteria of OSA and countries.

Association of Sleep Pattern and Genetic Susceptibility with Obstructive Sleep Apnea: A Prospective Analysis of the UK Biobank.

The prevalence of obstructive sleep apnea (OSA) is high worldwide. This study aimed to quantify the relationship between the incidence of OSA and sleep patterns and genetic susceptibility. A total of 355,133 white British participants enrolled in the UK Biobank between 2006 and 2010 with follow-up data until September 2021 were recruited. We evaluated sleep patterns using a customized sleep scoring method based on the low-risk sleep phenotype, defined as follows: morning chronotype, 7-8 hours of sleep per day, never/rarely experience insomnia, no snoring, no frequent daytime sleepiness, never/rarely nap, and easily getting up early. The polygenic risk score was calculated to assess genetic susceptibility to OSA. Cox proportional hazard models were used to evaluate the associations between OSA and sleep patterns and genetic susceptibility. During a mean follow-up of 12.57 years, 4618 participants were diagnosed with OSA (age: 56.83 ± 7.69 years, women: 31.3%). Compared with those with a poor sleep pattern, participants with a normal (HR: 0.42, 95% CI: 0.38-0.46), ideal (HR: 0.21, 95% CI: 0.19-0.24), or optimal (HR: 0.15, 95% CI: 0.12-0.18) sleep pattern were significantly more likely to have OSA. The genetic susceptibility of 173,239 participants was calculated, and the results showed that poor (HR: 3.67, 95% CI: 2.95-4.57) and normal (HR: 1.89, 95% CI: 1.66-2.16) sleep patterns with high genetic susceptibility can increase the risk for OSA. This large-scale prospective study provides evidence suggesting that sleep patterns across seven low-risk sleep phenotypes may protect against OSA in individuals with varying degrees of genetic susceptibility.

Social determinants of sleep apnea in Canada: A cross-sectional study exploring the intersection between immigrants’ length of residence and visible minority status

This study aims to explore the intersection between immigrants' length of residence and visible minority status, examining how these factors influence the likelihood of obstructive sleep apnea (OSA) reported by a health professional. Utilizing data from the 2015–16 Canadian Community Health Survey and employing logistic regression analyses, we compare the prevalence of OSA reported by a health professional among distinct groups: white native-born, visible minority native-born, white recent immigrants, visible minority recent immigrants, white established immigrants, and visible minority established immigrants. At the unadjusted level, our findings indicate that visible minority native-born (cOR=0.57, p < 0.001) and recent immigrants (cOR=0.34, p < 0.001) are less likely to receive a sleep apnea diagnosis compared to white native-born individuals. However, when adjusting for demographic variables, particularly the age of respondents, the robustness of the significance diminishes for visible minority native-born (aOR=1.07, p > 0.05), while becoming significant for white established immigrants (aOR=0.79, p < 0.01). Despite remaining largely consistent after accounting for socioeconomic, behavioural, and health characteristics, the significance for visible minority recent immigrants (aOR=0.69, p > 0.05) and white established immigrants (aOR=0.82, p < 0.05) is substantially explained when considering BMI. Based on these findings, we discuss implications for policymakers and suggest avenues for future research.

Obstructive Sleep Apnea and Risk of Postoperative Complications after Non-Cardiac Surgery.

Obstructive sleep apnea (OSA), a common sleep disorder, poses significant challenges in perioperative management due to its complexity and multifactorial nature. With a global prevalence of approximately 22.6%, OSA often remains undiagnosed, and increases the risk of cardiac and respiratory postoperative complications. Preoperative screening has become essential in many institutions to identify patients at increased risk, and experts recommend proceeding with surgery in the absence of severe symptoms, albeit with heightened postoperative monitoring. Anesthetic and sedative agents exacerbate upper airway collapsibility and depress central respiratory activity, complicating intraoperative management, especially with neuromuscular blockade use. Additionally, OSA patients are particularly prone to opioid-induced respiratory depression, given their increased sensitivity to opioids and heightened pain perception. Thus, regional anesthesia and multimodal analgesia are strongly advocated to reduce perioperative complication risks. Postoperative care for OSA patients necessitates vigilant monitoring and tailored management strategies, such as supplemental oxygen and Positive Airway Pressure therapy, to minimize cardiorespiratory complications. Health care institutions are increasingly focusing on enhanced monitoring and resource allocation for patient safety. However, the rising prevalence of OSA, heterogeneity in disease severity, and lack of evidence for the efficacy of costly perioperative measures pose challenges. The development of effective screening and monitoring algorithms, alongside reliable risk predictors, is crucial for identifying OSA patients needing extended postoperative care. This review emphasizes a multidimensional approach in managing OSA patients throughout the perioperative period, aiming to optimize patient outcomes and minimize adverse outcomes.

Prevalence of obstructive sleep apnea in patients with chronic obstructive pulmonary disease in Vietnam.

Chronic obstructive pulmonary disease and obstructive sleep apnea are two common respiratory diseases. Chronic obstructive pulmonary disease patients co-morbid with obstructive sleep apnea are associated with increased cardiovascular adverse events, frequent acute exacerbations, and higher mortality. Only a few studies on obstructive sleep apnea among patients with chronic obstructive pulmonary disease are available in Vietnam. The study aims to determine the prevalence of obstructive sleep apnea in patients with chronic obstructive pulmonary disease in Vietnam. This is a cross-sectional study in patients with chronic obstructive pulmonary disease at multi-sites in Vietnam: the People's Hospital of Gia Dinh, Bach Mai Hospital, Phoi Viet Clinics, and Lam Dong Medical College using type 3 sleep monitoring device at sleep labs to diagnose obstructive sleep apnea in all study participants. Two hundred seventy-eight patients with chronic obstructive pulmonary disease were enrolled. Among the patients, 93.2% were male, with an average age of 66.9 ± 9.3 and a BMI of 21.9 ± 3.8kg/m2; 82.0% were symptomatic including 44.6% in group B and 37.4% in group D with average post-FEV1 of 49.8 ± 18.3% predicted values. One hundred seventeen patients (42.1%) with chronic obstructive pulmonary disease presented obstructive sleep apnea defined by AHI ≥ 15 events/h. The prevalence of obstructive sleep apnea in patients with chronic obstructive pulmonary disease in Vietnam was 42.1% for an AHI of ≥ 15 events/h.

0523 Screening for Prevalence and Pattern of Sleepiness and Obstructive Sleep Apnea Among Nigerian Population

0523 Screening for Prevalence and Pattern of Sleepiness and Obstructive Sleep Apnea Among Nigerian Population

0866 Prevalence of Obesity in Obstructive Sleep Apnea Within a Large Community-based Cohort of Middle-aged/Older Adults

Abstract Introduction Obesity is a well-known risk factor for obstructive sleep apnea (OSA), gaining interest due to the global rise in obesity and novel obesity drugs. The rationale behind this lies in the role of obesity in the pathophysiology of OSA. However, many OSA patients are non-obese, and the association between obesity and OSA may vary by age and sex. Past population studies largely reported the prevalence of OSA according to different obesity categories. In this study, we sought to determine the prevalence of obesity across different levels of OSA severity, age, and sex. Methods The analytic sample included individuals with OSA from the Sleep Heart Health Study (SHHS). OSA severity was quantified using the apnea-hypopnea index (AHI4; apneas plus hypopneas with at least 4% oxygen desaturation per hour). Individuals were stratified by the severity of OSA (mild: 5≤AHI4&amp;lt; 15; moderate: 15≤AHI4&amp;lt; 30; severe: AHI4≥30 events/hour), body mass index (BMI), age, and sex. Results A total of 2950 of 5749 participants in SHHS had OSA (AHI4≥5 events/hour; 1729/788/433 mild/moderate/severe). Of these, 40.6% were female; mean±SD age was 65.3±10.7 years; and median [interquartile range] BMI was 28.8 [25.8; 32.3] kg/m2. For those with any OSA, 60.6% were non-obese (BMI&amp;lt; 30 kg/m2) and 39.4% were obese (BMI≥30 kg/m2). Across OSA severities, 34.1% of mild, 42.6% of moderate and 54.3% of severe OSA were obese. A greater proportion of younger adults (&amp;lt; 65 years) with OSA were obese (48.3%) than older adults (≥65 years) with OSA (30.9%). In older adults 26.7% of mild, 34.5% of moderate and 40.3%of severe OSA were obese. Finally, a greater proportion of females with OSA were obese (43.6%) than males with OSA (36.5%). Conclusion The majority of middle-aged/older adults with OSA are non-obese. The association between obesity and OSA varies by age and sex, with a higher prevalence of obesity in younger adults and in females with OSA. Additional analyses of data from the Multi-Ethnic Study of Atherosclerosis, the Osteoporotic Fractures in Men study, and the HypnoLaus study are being conducted to establish the association between OSA and obesity within other community-based samples. Support (if any) NHLBI R01HL153874, R35HL135818 and unrestricted grant support from Apnimed.

0497 Obstructive Sleep Apnea Prevalence in a Young Mixed Trauma Population with Post-traumatic Stress Disorder Symptoms

0497 Obstructive Sleep Apnea Prevalence in a Young Mixed Trauma Population with Post-traumatic Stress Disorder Symptoms

Burden of obstructive sleep apnea in patients with lung cancer and its effect on performance status.

The association between lung cancer and obstructive sleep apnea has remained a matter of debate for years. Obstructive sleep apnea is thought to increase the incidence of lung cancer due to intermittent hypoxaemia and sleep fragmentation. The aim of this study is to assess the prevalence of obstructive sleep apnea in patients with lung cancer and its effect on those patients' performance status. This is a prevalence study that was conducted at Chest Diseases Department, Alexandria Main University Hospitals. We enrolled 153 patients with lung cancer. All patients underwent cardiorespiratory monitoring using a home sleep-testing device. Performance status was assessed using Karnofsky performance status scale. The study included 120 (78.4%) males and 33 (21.6%) females newly diagnosed with lung cancer. The mean age was 59.98 ± 11.11 years. Obstructive sleep apnea (apnea-hypopnea index ≥ 5) was present in 134 (87.6%) patients. Eighty-five (63.4%) patients had mild obstructive sleep apnea, 39 (29.1%) patients had moderate obstructive sleep apnea, and 10 (7.46%) patients had severe obstructive sleep apnea. Prolonged nocturnal oxygen desaturation as demonstrated by time of oxygen saturation spent below 90% (T90%) during total sleep time > 30% was present in 25 (16.3%) patients. There was a significant difference in the median value of Karnofsky performance status scale between patients with lung cancer and associated obstructive sleep apnea and those without obstructive sleep apnea. In conclusion, obstructive sleep apnea is highly prevalent among patients with lung cancer. Performance status is worse among patients with lung cancer in the presence of obstructive sleep apnea. Screening patients with lung cancer for obstructive sleep apnea is important regardless of the presence of classical symptoms of obstructive sleep apnea.