Characterisation of Symptom and Polysomnographic Profiles Associated with Cardiovascular Risk in a Sleep Clinic Population with Obstructive Sleep Apnoea

IF 3 2区医学 Q2 CLINICAL NEUROLOGY Nature and Science of Sleep Pub Date : 2024-05-06 DOI:10.2147/nss.s453259

Emily Kemp, Kate Sutherland, Yu Sun Bin, Andrew SL Chan, Hasthi Dissanayake, Brendon J Yee, Kristina Kairaitis, John Robert Wheatley, Philip de Chazal, Amanda J Piper, Peter A Cistulli

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Abstract

Aim: Recent data have identified specific symptom and polysomnographic profiles associated with cardiovascular disease (CVD) in patients with obstructive sleep apnoea (OSA). Our aim was to determine whether these profiles were present at diagnosis of OSA in patients with established CVD and in those with high cardiovascular risk. Participants in the Sydney Sleep Biobank (SSB) database, aged 30– 74 years, self-reported presence of CVD (coronary artery disease, cerebrovascular disease, or heart failure). In those without established CVD, the Framingham Risk Score (FRS) estimated 10-year absolute CVD risk, categorised as “low” (< 6%), “intermediate” (6– 20%), or “high” (> 20%). Groups were compared on symptom and polysomnographic variables.
Results: 629 patients (68% male; mean age 54.3 years, SD 11.6; mean BMI 32.3 kg/m², SD 8.2) were included. CVD was reported in 12.2%. A further 14.3% had a low risk FRS, 38.8% had an intermediate risk FRS, and 34.7% had a high risk FRS. Groups differed with respect to age, sex and BMI. OSA severity increased with established CVD and increasing FRS. The symptom of waking too early was more prevalent in the higher FRS groups (p=0.004). CVD and FRS groups differed on multiple polysomnographic variables; however, none of these differences remained significant after adjusting for age, sex, and BMI.
Conclusion: Higher CVD risk was associated with waking too early in patients with OSA. Polysomnographic variations between groups were explained by demographic differences. Further work is required to explore the influence of OSA phenotypic characteristics on susceptibility to CVD.

Keywords: obstructive sleep apnoea, cardiovascular disease

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阻塞性睡眠呼吸暂停睡眠门诊人群中与心血管风险相关的症状和多导睡眠图特征描述

目的：最近的数据确定了阻塞性睡眠呼吸暂停（OSA）患者与心血管疾病（CVD）相关的特定症状和多导睡眠图特征。我们的目的是确定已确诊心血管疾病的患者和心血管疾病高危人群在确诊 OSA 时是否存在这些特征。悉尼睡眠生物库（SSB）数据库的参与者年龄在 30-74 岁之间，自述患有心血管疾病（冠心病、脑血管疾病或心力衰竭）。对于未确诊心血管疾病的患者，弗莱明汉风险评分（FRS）估算出其 10 年绝对心血管疾病风险，分为 "低"（6%）、"中"（6-20%）或 "高"（20%）。对各组的症状和多导睡眠图变量进行了比较：共纳入 629 名患者（68% 为男性；平均年龄 54.3 岁，SD 11.6；平均体重指数 32.3 kg/m2，SD 8.2）。据报告，12.2%的患者患有心血管疾病。另有 14.3% 的人具有低风险 FRS，38.8% 的人具有中等风险 FRS，34.7% 的人具有高风险 FRS。各组在年龄、性别和体重指数方面存在差异。OSA的严重程度随心血管疾病的确立和FRS的增加而增加。过早醒来的症状在 FRS 较高的组别中更为普遍（P=0.004）。心血管疾病组和急性心血管疾病组在多个多导睡眠图变量上存在差异；然而，在对年龄、性别和体重指数进行调整后，这些差异均不显著：结论：心血管疾病风险较高与 OSA 患者过早起床有关。各组之间的多导睡眠图差异可通过人口统计学差异来解释。还需要进一步研究 OSA 表型特征对心血管疾病易感性的影响。

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来源期刊

Nature and Science of Sleep Neuroscience-Behavioral Neuroscience

CiteScore

5.70

自引率

5.90%

发文量

245

审稿时长

16 weeks

期刊介绍： Nature and Science of Sleep is an international, peer-reviewed, open access journal covering all aspects of sleep science and sleep medicine, including the neurophysiology and functions of sleep, the genetics of sleep, sleep and society, biological rhythms, dreaming, sleep disorders and therapy, and strategies to optimize healthy sleep. Specific topics covered in the journal include: The functions of sleep in humans and other animals Physiological and neurophysiological changes with sleep The genetics of sleep and sleep differences The neurotransmitters, receptors and pathways involved in controlling both sleep and wakefulness Behavioral and pharmacological interventions aimed at improving sleep, and improving wakefulness Sleep changes with development and with age Sleep and reproduction (e.g., changes across the menstrual cycle, with pregnancy and menopause) The science and nature of dreams Sleep disorders Impact of sleep and sleep disorders on health, daytime function and quality of life Sleep problems secondary to clinical disorders Interaction of society with sleep (e.g., consequences of shift work, occupational health, public health) The microbiome and sleep Chronotherapy Impact of circadian rhythms on sleep, physiology, cognition and health Mechanisms controlling circadian rhythms, centrally and peripherally Impact of circadian rhythm disruptions (including night shift work, jet lag and social jet lag) on sleep, physiology, cognition and health Behavioral and pharmacological interventions aimed at reducing adverse effects of circadian-related sleep disruption Assessment of technologies and biomarkers for measuring sleep and/or circadian rhythms Epigenetic markers of sleep or circadian disruption.