Risk Factor For OSA Research Articles

Multiple sclerosis treatment underutilization predicts high risk for obstructive sleep apnea in patients with multiple sclerosis

BackgroundObstructive sleep apnea (OSA) is more common in patients with multiple sclerosis (MS) than in the general population, which suggests MS may predispose patients to OSA. However, the relationships between MS treatment, disease activity, disease severity, fatigue, and OSA are unknown. ObjectivesTo evaluate the connections between OSA risk, MS fatigue, and MS severity, controlling for well-established risk factors for OSA in the general population. MethodsWe administered OSA and fatigue-related questionnaires to patients with MS and collected relevant demographic and clinical data. Then, we utilized multivariate logistic regression to examine relationships between OSA risk and MS disease severity. ResultsWe identified an inverse correlation between medication possession ratio (MPR) and high OSA risk. Statistical models also demonstrated a positive correlation between fatigue and nonwhite race with high OSA risk, controlling for male sex, younger age, and body mass index (BMI). ConclusionWe identified disease-modifying therapy (DMT) underutilization, fatigue, and nonwhite race as predictors of high OSA risk in patients with MS. These findings support aggressive treatment of MS to avoid risk of comorbid OSA and MS-induced fatigue.

Preventive medicine in OSA-A systematic review and a call to action.

The purpose of this systematic review is to evaluate the modifiable risk factors associated with OSA and analyze extant publications solely focused on prevention of the disease. Studies focused on prevention strategies for OSA and modifiable risk factors were eligible for inclusion. A detailed individual search strategy for each of the following bibliographic databases was developed: Cochrane, EMBASE, MEDLINE, PubMed and LILACS. The references cited in these articles were also crosschecked and a partial grey literature search was undertaken using Google Scholar. The methodology of selected studies was evaluated using the 14-item Quality Assessment Tool for Diagnostic Accuracy Studies. Search resulted in 720 publications examining risk factors and prevention of OSA, as well as lifestyle modifications. Of these, a thorough assessment of the abstracts and content of each of these manuscripts led to the rejection of all but four papers, the latter being included in this systematic review. In contrast, a search regarding 'Therapeutics' showed that 23,674 articles on OSA were published, clearly illustrating the imbalance between the efforts in prevention and those focused on therapeutics. Notwithstanding the importance and benefits of technological advances in medicine, consideration of the needs of people with OSA and its consequences prompts advocacy for the prevention of the disease. Thus, despite the economic interests that focus only on diagnosis and treatment, strategies preferentially aimed at overall avoidance of OSA emerge as a major priority. Thus, public and healthcare provider education, multidimensional prevention, and early diagnosis of OSA should be encouraged worldwide.

Clinical predictors of obstructive sleep apnea among residents of Sagamu local government area of Ogun State

BackgroundObstructive sleep apnea (OSA) is the most commonly diagnosed sleep-associated pulmonary disorder in the world. So many risk factors have been attributed to OSA; however, conflicting results exist on how these factors contribute to OSA.PurposeThis study hypothesized that increasing the number of risk factors for OSA, as reflected in the STOP-BANG questionnaire, increases the probability of having OSA but also increases the likelihood of having other severe diseases such as hypertension in a Nigerian population and that the severity of OSA might be dependent on specific anthropometric indices.MethodsThis study involved 110 male and female residents of Sagamu Local Government Area of Ogun State. Data was collected using a standardized instrument and the STOP-BANG questionnaire. Analysis involved descriptive statistics, parametric test of independent t-test to characterize data based on gender, and multinomial regressions to determine predictive factors of the various parameters of study on the severity of OSA.ResultsThe association of the male gender with higher risk of OSA was confirmed by this study. Diastolic blood pressure (DBP) and heart rate (HR) predicted the risk of OSA, with an increase in DBP and HR implying higher risk of OSA. Of the anthropometric tests examined in this study, body mass index (BMI), neck circumference (NC), and neck height ratio (NHtR) predicted the risk of OSA in comparing low risk and medium risk to high risk, an increase in BMI and NC implying a higher risk of OSA while an increase in NHtR implying a lower risk of OSA.

Risk Factors for OSA Observed During Orofacial Examination: A Review

Risk Factors for OSA Observed During Orofacial Examination: A Review

Sex-based differences in obstructive sleep apnea and atrial fibrillation: Implication of atrial fibrillation burden

BackgroundObstructive sleep apnea (OSA) is a risk factor for atrial fibrillation (AF); however, it is unclear whether AF increases the risk of OSA. Furthermore, sex differences among patients with both AF and OSA remain unclear. We aimed to determine the association between an increased AF burden and OSA and investigate the differences in clinical characteristics between women and men with AF and OSA. MethodsThis was a descriptive, cross-sectional analysis from a prospective cohort study. Patients with non-valvular AF were recruited from the cardiac electrophysiology clinic of a tertiary center; they underwent a home sleep apnea test and 14-day ambulatory electrocardiography. Moderate-to-severe OSA was defined as an apnea-hypopnea index of ≥15. ResultsOf 320 patients with AF, 53.4% had moderate-to-severe OSA, and the mean body mass index (BMI) was 25.6 kg/m2. Less women (38.2%) had moderate-to-severe OSA than men (59.3%) (p < 0.001). In the multivariate analysis, age, being a man, and BMI were significantly associated with moderate-to-severe OSA. AF burden was associated with moderate-to-severe OSA only in men (odds ratio: 1.008; 95% confidence interval: 1.001–1.014). Women and men with OSA had similar BMI (p = 0.526) and OSA severity (p = 0.754), but women were older than men (70.1 ± 1.3 vs. 63.1 ± 0.9 years, p < 0.001). Women with moderate-to-severe OSA had a lower AF burden than men did (27.6 ± 7.1 vs. 49.5 ± 3.9%, p = 0.009). ConclusionsAF burden is a sex-specific risk factor for OSA and is limited to men. In contrast, women with both AF and OSA have a lower AF burden than men, despite being older and having similar OSA severity and body habitus. Thus, AF may develop later in women with OSA than in men.

Application and interpretation of machine learning models in predicting the risk of severe obstructive sleep apnea in adults

BackgroundObstructive sleep apnea (OSA) is a globally prevalent disease with a complex diagnostic method. Severe OSA is associated with multi-system dysfunction. We aimed to develop an interpretable machine learning (ML) model for predicting the risk of severe OSA and analyzing the risk factors based on clinical characteristics and questionnaires.MethodsThis was a retrospective study comprising 1656 subjects who presented and underwent polysomnography (PSG) between 2018 and 2021. A total of 23 variables were included, and after univariate analysis, 15 variables were selected for further preprocessing. Six types of classification models were used to evaluate the ability to predict severe OSA, namely logistic regression (LR), gradient boosting machine (GBM), extreme gradient boosting (XGBoost), adaptive boosting (AdaBoost), bootstrapped aggregating (Bagging), and multilayer perceptron (MLP). All models used the area under the receiver operating characteristic curve (AUC) was calculated as the performance metric. We also drew SHapley Additive exPlanations (SHAP) plots to interpret predictive results and to analyze the relative importance of risk factors. An online calculator was developed to estimate the risk of severe OSA in individuals.ResultsAmong the enrolled subjects, 61.47% (1018/1656) were diagnosed with severe OSA. Multivariate LR analysis showed that 10 of 23 variables were independent risk factors for severe OSA. The GBM model showed the best performance (AUC = 0.857, accuracy = 0.766, sensitivity = 0.798, specificity = 0.734). An online calculator was developed to estimate the risk of severe OSA based on the GBM model. Finally, waist circumference, neck circumference, the Epworth Sleepiness Scale, age, and the Berlin questionnaire were revealed by the SHAP plot as the top five critical variables contributing to the diagnosis of severe OSA. Additionally, two typical cases were analyzed to interpret the contribution of each variable to the outcome prediction in a single patient.ConclusionsWe established six risk prediction models for severe OSA using ML algorithms. Among them, the GBM model performed best. The model facilitates individualized assessment and further clinical strategies for patients with suspected severe OSA. This will help to identify patients with severe OSA as early as possible and ensure their timely treatment.Trial registrationRetrospectively registered.

Sleep characteristics and parameters of bone turnover and strength in the adult population: results from the Study of Health in Pomerania-TREND.

Poor sleep quality or sleep deprivation may be related to decreased bone mineral density. We aimed to assess whether associations of sleep characteristics and bone turnover or strength are present in adults from the general population and whether these are independent of common risk factors such as sex, age, and obesity. A total of 1037 participants from the Study of Health in Pomerania-TREND underwent laboratory-based polysomnography and quantitative ultrasound measurements at the heel. Of these participants, 804 completed standardised questionnaires to assess daytime sleepiness, insomnia, and sleep quality. Serum concentrations of two bone turnover markers, intact amino-terminal propeptide of type 1 procollagen (P1NP) and carboxy-terminal telopeptide of type 1 collagen (CTX) were measured. Cross-sectional associations of polysomnography variables (total sleep time, sleep efficiency, time spent wake after sleep onset, oxygen desaturation index, apnea-hypopnea index, and obstructive sleep apnea [OSA]), as well as sleep questionnaire scores with the bone turnover markers and the ultrasound-based stiffness index were assessed in linear regression models. In adjusted models, higher insomnia scores and lower sleep quality scores were related to a higher bone turnover in women but not in men. However, associations between polysomnography variables or questionnaire scores and the stiffness index were absent. Our study provides limited evidence for relationships between sleep characteristics and bone turnover and strength independent of common risk factors for OSA and osteoporosis. Nevertheless, women reporting poor sleep or insomnia in combination with risk factors for osteoporosis might benefit from an evaluation of bone health.

Obstructive sleep apnea in type 2 diabetes mellitus patients

Abstract Objective The study aims to identify the prevalence and risk factors for OSA in a group of Egyptian patients with type 2 diabetes. Methods 125 type 2 diabetes mellitus patients visited Mansoura University Hospital (Diabetes Mellitus Outpatient Clinic (OPC) at Specialized Medical Hospital and the Sleep Disordered Breathing Unit of the Chest Department), all of them exposed to history taking, the patients underwent anthropometric measurements (weight, height, body mass index, neck circumference), a test of their tonsillar size, Malampati score, Friedman OSA score, Epworth sleepiness scale (ESS), Berlin questionnaire, STOP BANG questionnaire, full-night polysomnography, fasting, and postprandial blood sugar. Results The study included 125 T2DM Egyptian patients with a mean age of 54.63 ± 9.47 years. Males accounted for 35.2 percent of patients, while females accounted for 64.8%. According to the study of co-morbidity, hypertension constituted 77 (61.1%), ischemic heart disease 28 (22.4%), other cardiac diseases 11 (8.8%), bronchial asthma 6 (4.8%), liver diseases 6 (4.8%), hypothyroidism 3 (2.4%), and renal diseases 3 (2.4%). A total of seven patients (5.6%) had no OSA symptoms, 87 had borderline symptoms, and 31 had positive symptoms. There were 51 (40.8%) normal patients, 12 (9.6%) borderline patients, and 62 (49.6%) sleepy patients on the Epworth scale. According to the Stop-Bang questionnaire, 121 (96.8%) patients answered positively. It was determined that 122 patients (97.6%) were at high risk based on the Berlin questionnaire. There were 17 patients (13.6%) with OSA on polysomnography, of which six were moderate (35.3%) and 11 were severe (64.7%). Among moderate and severe OSA patients, glycosylated hemoglobin levels differed significantly. Multivariate logistic regression analysis for independent predictors of OSA, chronic renal disease patients is the most common associated risk factor (OR = 14.3, CI = 1.2–67) then hypertension (OR = 5.6,CI=1.2–25.5) and heart failure (OR = 4.4). Conclusions OSA affects 13.6% patients with type 2 diabetes patients who are hypertensive are at higher risk of OSA, chronic renal failure is considered another risk factor Furthers studies are needed on a big scale of Egyptian diabetic patients to detect the prevalence of OSA

PS-C33-2: HYPERTENSION, OBSTRUCTIVE SLEEP APNEA AND HYPERALDOSTERONISM: A BIDIRECTIONAL MENDELIAN RANDOMIZATION STUDY

Aim: The aim of this study was to investigate the causal effects between hypertension, obstructive sleep apnea and hyperaldosteronism. Methods and Results: We performed a bidirectional Mendelian randomization (MR) analysis implementing the results from a large-scale genome-wide association study for hypertension by the UK Biobank (N = 462933), obstructive sleep apnea (N = 217955) and hyperaldosteronism and (N = 211463) by the FinnGen to identify genetic instruments. The inverse variance weighted method was the main MR method used. A genetic predisposition to hypertension was significantly increased risk of OSA (OR and 95%CI, 1.49(1.159–1.939) and hyperaldosteronism (OR and 95%CI, 123.863(25.598–599.338). The significance remained consistent in MR sensitivity analyses. Genetically OSA did not show a significant association with the risk of hypertension and hyperaldosteronism, and hyperaldosteronism did not associate with hypertension and OSA. Conclusions: Our study supports that hypertension is a causal risk factor for OSA and hyperaldosteronism. However, the effect of OSA on hypertension and hyperaldosteronism, hyperaldosteronism on hypertension and OSA were not identified in this study.

P037 Differences in endotypes in people with multiple sclerosis in those with versus without OSA

Abstract Background Obstructive sleep apnoea (OSA) is as common if not more common in people with multiple sclerosis (MS) versus the general population. However, in contrast to the typical OSA risk factors in the general population, MS is far more common in women versus men, many of whom are not obese. Thus, while some people with MS likely get OSA via the same mechanisms as the general population (i.e., anatomical compromise), others may develop OSA due to specific MS-related consequences (e.g., CNS lesions that effect respiratory or upper airway neuromuscular control- i.e. via non-anatomical mechanisms). Accordingly, we investigated if the key OSA endotypes that contribute to OSA differ in people with MS in those with versus without OSA. Methods Nine people with MS with moderate-severe OSA (AHI=41±22events/h) and seven people with MS without moderate-severe OSA (AHI=9±3events/h) completed in-home level 2 sleep studies (n=11 Boston, n=5 Sydney). OSA endotypes were estimated using validated algorithms from the staged sleep study airflow signals and compared between those with versus without moderate-severe OSA. Results Respiratory control instability (loop gain) was significantly higher in people with OSA versus without (0.62±0.2 vs. 0.45±1, p=0.04). Upper airway collapsibility was also higher in OSA participants (Vpassive at the lowest decile= 53±13 vs. 74±6 %eupnea, p&amp;lt;0.01). Other OSA endotypes were not systematically different between groups. Discussion These findings suggest that while some people with MS likely get OSA via primary anatomically driven mechanisms, in others, OSA may be largely driven via non-anatomical mechanisms, potentially related to MS-specific disease consequences.

Differential effects of obstructive sleep apnea on the corneal subbasal nerve plexus and retinal nerve fiber layer.

PurposeObstructive sleep apnea (OSA) is an established independent risk factor for peripheral neuropathy. Macro and microvascular changes have been documented in OSA, including high levels of potent vasoconstrictors. In diabetes, vasoconstriction has been identified as an underlying risk factor for corneal neuropathy. This study sought to establish a potential relationship between OSA and corneal nerve morphology and sensitivity, and to determine whether changes in corneal nerves may be reflective of OSA severity.DesignSingle center cross-sectional study.MethodsSixty-seven patients were stratified into two groups: those with OSA and healthy controls. Groups were matched for age, sex, race, smoking, and dry eye status. Outcome measures included serologies, a dilated fundus exam, dry eye testing, anthropometric parameters, corneal sensitivity, subbasal nerve plexus morphology, retinal nerve fiber layer (RNFL) thickness, and the use of questionnaires to assess symptoms of dry eye disease, risk of OSA, and continuous positive airway pressure (CPAP) compliance.ResultsNo significant differences were observed in corneal nerve morphology, sensitivity, or the number of dendritic cells. In the OSA test group, RNFL thinning was noted in the superior and inferior regions of the optic disc and peripapillary region. A greater proportion of participants in the OSA group required a subsequent evaluation for glaucoma than in the control. In those with OSA, an increase in the apnea hypopnea index was associated with an increase in optic nerve cupping.ConclusionsOSA does not exert a robust effect on corneal nerves. OSA is however, associated with thinning of the RNFL. Participants with glaucomatous optic nerve changes and risk factors for OSA should be examined as uncontrolled OSA may exacerbate glaucoma progression.

Diet as adjunctive therapy for sleep apnea risk: not only how much but also what to eat.

Diet as adjunctive therapy for sleep apnea risk: not only how much but also what to eat.

P019 Obstructive sleep apnoea endotypes in people with multiple sclerosis

Abstract Purpose Obstructive sleep apnoea (OSA) is common in people with multiple sclerosis (MS) despite a lack of typical risk factors for OSA in people with MS such as obesity and male predominance. Therefore, underlying factors other than sex and obesity may be particularly important in the pathogenesis of OSA in people with MS. Thus, the primary aim of this study was to determine the relative contributions of OSA endotypes in people with MS and compare this to matched controls with OSA only. Methods Eleven people with MS and OSA (MS-OSA group) (apnoea-hypopnoea index [AHI]&amp;gt;5events/h) and eleven controls matched for OSA severity, age and sex without MS (OSA group) were studied. Participants underwent a detailed overnight polysomnography with an epiglottic pressure catheter and genioglossus intramuscular electrodes to allow for quantification of pathophysiological contributors to OSA. This included the respiratory arousal threshold, genioglossus muscle responsiveness, respiratory loop gain and upper airway collapsibility. Results Measures of the four primary OSA endotypes were not different between the MS-OSA and OSA groups (e.g. NREM respiratory arousal threshold -27±15 vs. -23±8 cmH2O respectively, p=0.24). Within group analysis indicated higher loop gain in non-obese MS-OSA participants compared to obese MS-OSA participants (0.53±0.11 vs. 0.37±0.11, p=0.04). Conclusions Overall, OSA endotypes are similar between MS-OSA participants and matched OSA controls. However, within the MS-OSA group, non-obese participants have higher loop gain (unstable respiratory control) compared to obese participants. Thus, unstable respiratory control may play an important role in OSA pathogenesis in many people with MS.

416 The impact of Obstructive Sleep Apnea severity on age-related comorbities: a population-based study

Abstract Introduction Although age per se has been considered a risk factor for OSA, evidence suggest OSA in older adults may be less severe and OSA diagnostic criteria might be adjusted for this age group. Concurrently, it is likely the late-onset OSA is a distinct phenotype having different pathophysiological mechanisms, as well as clinical manifestations and consequences. We sought to investigate the clinical consequences of OSA severity in older adults from a representative sample of the older population living in the São Paulo city. Methods From the baseline survey including 1042 participants in 2007, 715 were reassessed in 2016 completing full in-lab PSG, health-related questionnaires, blood tests, and blood pressure measurements. Individuals &amp;gt; 60 y.o. (n=199) of both genders were included in the analysis. Participants were stratified according to OSA presence and severity in 3 groups G1 (non and mild OSA n=83); G2 (moderate OSA n=56); G3 (severe OSA n=60). General Linear Model (GLM) tests and Chi-square were carried out. Results Participants mean age was 70.02±7.31 and mean body mass index (BMI) 28.61±5.39, 40.71% of men. The only comorbidity associated with OSA severity was arterial hypertension occurring in 61.7% of G3, 46.4% of G4 and 41% of G1 (p=0.04). Severe OSA participants were more likely to use a higher (&amp;gt;2/day) number of medications (p=0.03). Finally, out of all blood tests only cortisol was significantly higher in severe OSA group (p&amp;lt;0.001) Conclusion Severe OSA in older individuals of the general population is not associated with metabolic conditions, such as diabetes, but it was associated with hypertension. Severe OSA may be a stressful condition, since it was associated with higher cortisol in this population. Support (if any) Associaçao Fundo Incentivo a Pesquisa (AFIP)

Impact of Hyoid Position, Mandible Body Length and Anthropometric Measurements on Sleep Indices in Patients with Snoring in North Indian Population.

In Indian population, the estimated prevalence of OSA is 7.5% to 13.5%. Craniofacial anatomical variations and obesity are the major risk factors for OSA. Among the craniofacial anatomy, the neck circumference and abnormal craniofacial morphology play an important role in the pathogenesis of OSA. Obesity is the major risk factor for which waist and hip circumference and BMI are considered. The aim of this paper was to evaluate the impact of hyoid position, mandible body length (MBL) and anthropometric measurements on sleep indices in patients with snoring in North Indian population. In this cross-sectional study, we analyzed the position of the hyoid, mandible body length and anthropometric measurements, of 104 patients attending ENT OPD with the complaint of snoring and excessive daytime sleepiness. All subjects underwent a full overnight polysomnography. The position of the hyoid, MBL and the anthropometric measurements were compared with the sleep architecture of the subjects, and a p value < 0.05 was considered significant. A strong positive correlation is seen between the position of the hyoid, MBL and anthropometric measurements on the sleep indices in this study. Pearson 2-tailed correlation was evaluated, and upon analysis, it was found that at significance level of 0.01, obesity (BMI) is strongly correlated with overall AHI with correlation coefficient of 0.926, whereas AHI in supine position was having coefficient of 0.837 and AHI on right side and left side was almost same 0.597 and 0.575, respectively. Similarly WC is strongly correlated with AHI and RDI, having coefficient of 0.930 with both. NC and HC also showed strong positive correlation with overall AHI and RDI having correlation coefficient of 0.893, 0.926 with AHI and 0.893, 0.926 with RDI, respectively. The MBL also showed a strong positive correlation with AHI and RDI with correlation coefficient of 0.994 in both. The position of the hyoid also showed a strong positive correlation with AHI and RDI. Results indicated that significant positive correlation was found between position of the hyoid, MBL and anthropometric measurements on the sleep indices in patients with snoring in North Indian population.

Obstructive Sleep Apnea in Obese Patients: a UK Population Analysis

BackgroundObstructive sleep apnea (OSA) is an increasingly common disorder associated with increased cardiovascular disease, mortality, reduced productivity, and an increased risk of road traffic accidents. A significant proportion of patients with OSA in the UK are undiagnosed. This study aims to identify risk factors for OSA in an obese cohort.MethodA population-based study was conducted of obese patients (BMI ≥ 30 kg/m2) from the Clinical Practice Research Datalink (CPRD). A logistic regression model was used to calculate odds ratios (ORs) for developing OSA according to other clinicopathological characteristics. Multivariate analysis was conducted of individual factors that affect the propensity to develop OSA. Statistical significance was defined as p < 0.050.ResultsFrom 276,600 obese patients identified during a data extraction of the CPRD in July 2017, the prevalence of OSA was 5.4%. The following risk factors were found to be independently associated with increased likelihood of OSA: male sex (OR = 3.273; p < 0.001), BMI class II (OR = 1.640; p < 0.001), BMI class III (OR = 3.768; p < 0.001), smoking (OR = 1.179; p < 0.001), COPD (OR = 1.722; p < 0.001), GERD (OR = 1.557; p < 0.001), hypothyroidism (OR = 1.311; p < 0.001), acromegaly (OR = 3.543; p < 0.001), and benzodiazepine use (OR = 1.492; p < 0.001). Bariatric surgery was associated with reduced risk of OSA amongst this obese population (OR = 0.260; p < 0.001).ConclusionsIn obese patients, there are numerous comorbidities that are associated with increased likelihood of OSA. These factors can help prompt clinicians to identify undiagnosed OSA. Bariatric surgery appears to be protective against developing OSA.

Surgery for obstructive sleep apnea in young children: Outcome evaluated by polysomnograhy and quality of life

PurposeHypertrophy of adenoid and tonsils is the most common risk factor for OSA in children, and adenotonsillectomy is considered the first-line treatment. The effect of surgery for OSA in children varies considerably between studies, and few studies have focused on the effect in young children under 5 years of age. Thus, the aim of this study was to: 1) evaluate the effect of surgery for OSA in young children using objective data from polysomnography and parent-reported symptoms using questionnaires, and 2) identify predictors of residual OSA following surgery. MethodsThis is a prospective cohort study of children aged 2–4 years who were referred for surgery to treat OSA. Measures collected before and after surgery included polysomnography (PSG), Pediatric Sleep Questionnaire (PSQ), OSA-18 and clinical data. Results56 children completed a preoperative and postoperative PSG. Their median age was 3.1 (IQR 2.6–3.1) years. After surgery, 63% had an obstructive apnea hypopnea index (OAHI) < 1, 82% had an OAHI < 2 and 95% had an OAHI < 5. Parent-reported OSA-18 and PSQ scores improved significantly after surgery. In logistic regression analyses, higher preoperative OAHI was the only significant clinical predictor of residual OSA after surgery. ConclusionThere was a high resolution rate after surgery for OSA in this group of young children, with significant improvements in both the OAHI measured with PSG and parent-reported symptoms. The only clinical predictor of residual OSA after surgery was higher preoperative OAHI.

Prevalence and Risk Factors for OSA among Urban and Rural Subjects in Bengaluru District, South India: A Cross-sectional Study

Prevalence and Risk Factors for OSA among Urban and Rural Subjects in Bengaluru District, South India: A Cross-sectional Study

Exercise as a treatment for sleep apnea

Citation:Lee-Iannotti JK, Parish JM. Exercise as a treatment for sleep apnea. J Clin Sleep Med. 2020;16(7):1005–1006.

Global burden of sleep-disordered breathing and its implications.

One-seventh of the world's adult population, or approximately one billion people, are estimated to have OSA. Over the past four decades, obesity, the main risk factor for OSA, has risen in striking proportion worldwide. In the past 5 years, the WHO estimates global obesity to affect almost two billion adults. A second major risk factor for OSA is advanced age. As the prevalence of the ageing population and obesity increases, the vulnerability towards having OSA increases. In addition to these traditional OSA risk factors, studies of the global population reveal select contributing features and phenotypes, including extreme phenotypes and symptom clusters that deserve further examination. Untreated OSA is associated with significant comorbidities and mortality. These represent a tremendous threat to the individual and global health. Beyond the personal toll, the economic costs of OSA are far-reaching, affecting the individual, family and society directly and indirectly, in terms of productivity and public safety. A better understanding of the pathophysiology, individual and ethnic similarities and differences is needed to better facilitate management of this chronic disease. In some countries, measures of the OSA disease burden are sparse. As the global burden of OSA and its associated comorbidities are projected to further increase, the infrastructure to diagnose and manage OSA will need to adapt. The use of novel approaches (electronic health records and artificial intelligence) to stratify risk, diagnose and affect treatment are necessary. Together, a unified multi-disciplinary, multi-organizational, global approach will be needed to manage this disease.