Journal ArticleDOI
Obstructive sleep apnea as a risk factor for stroke and death.
H. Klar Yaggi,John Concato,Walter N. Kernan,Judith H. Lichtman,Lawrence M. Brass,Vahid Mohsenin +5 more
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The obstructive sleep apnea syndrome significantly increases the risk of stroke or death from any cause, and the increase is independent of other risk factors, including hypertension.Abstract:
background Previous studies have suggested that the obstructive sleep apnea syndrome may be an important risk factor for stroke. It has not been determined, however, whether the syndrome is independently related to the risk of stroke or death from any cause after adjustment for other risk factors, including hypertension. methods In this observational cohort study, consecutive patients underwent polysomnography, and subsequent events (strokes and deaths) were verified. The diagnosis of the obstructive sleep apnea syndrome was based on an apnea–hypopnea index of 5 or higher (five or more events per hour); patients with an apnea–hypopnea index of less than 5 served as the comparison group. Proportional-hazards analysis was used to determine the independent effect of the obstructive sleep apnea syndrome on the composite outcome of stroke or death from any cause. results Among 1022 enrolled patients, 697 (68 percent) had the obstructive sleep apnea syndrome. At baseline, the mean apnea–hypopnea index in the patients with the syndrome was 35, as compared with a mean apnea–hypopnea index of 2 in the comparison group. In an unadjusted analysis, the obstructive sleep apnea syndrome was associated with stroke or death from any cause (hazard ratio, 2.24; 95 percent confidence interval, 1.30 to 3.86; P=0.004). After adjustment for age, sex, race, smoking status, alcohol-consumption status, body-mass index, and the presence or absence of diabetes mellitus, hyperlipidemia, atrial fibrillation, and hypertension, the obstructive sleep apnea syndrome retained a statistically significant association with stroke or death (hazard ratio, 1.97; 95 percent confidence interval, 1.12 to 3.48; P=0.01). In a trend analysis, increased severity of sleep apnea at baseline was associated with an increased risk of the development of the composite end point (P=0.005). conclusions The obstructive sleep apnea syndrome significantly increases the risk of stroke or death from any cause, and the increase is independent of other risk factors, including hypertension.read more
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Obesity, ethnicity, and sleep-disordered breathing: medical and health policy implications.
TL;DR: The implications of the obesity trend on the prevalence of obstructive sleep apnea and health, highlights ethnic differences, reviews the resultant economic implications, and suggests public health and health policy initiatives that may be beneficial in stemming the obesity scourge are discussed.
Journal ArticleDOI
High risk of obstructive sleep apnea is a risk factor of death censored graft loss in kidney transplant recipients: An observational cohort study
Andras Szentkiralyi,Maria E. Czira,Miklos Z. Molnar,Miklos Z. Molnar,Csaba P. Kovesdy,Csaba P. Kovesdy,Adam Remport,Lilla Szeifert,Eszter P. Vamos,János Juhász,Csilla Zita Turányi,Istvan Mucsi,Istvan Mucsi,Marta Novak,Marta Novak +14 more
TL;DR: High risk of OSA is an independent predictor of graft loss among female kidney transplant patients and HRO at baseline was not independently associated with all-cause mortality in the sample.
Journal ArticleDOI
Cerebrovascular Reactivity in Young Subjects with Sleep Apnea
John Buterbaugh,Charles Wynstra,Natalie Provencio,Daniel Combs,Michael Gilbert,Sairam Parthasarathy,Sairam Parthasarathy +6 more
TL;DR: In patients with obstructive sleep apnea, diminished change in brainstem activity during swallowing and reduced cerebrovascular reactivity may contribute to the etiopathogenesis and adverse cerebroVascular consequences, respectively.
Journal ArticleDOI
Effects of a mandibular advancement device on the upper airway morphology: a cephalometric analysis.
Michiel H. J. Doff,Aarnoud Hoekema,G. J. Pruim,van der Johannes Hoeven,L.G.M. de Bont,Boudewijn Stegenga +5 more
TL;DR: The increase of the posterior airway space at the level of the second vertebra and the uvular tip were the best predictors for relative improvement of the apnoea-hypopnoeas index, but the predictive value for treatment response of these cephalometric upper airway changes should be interpreted with caution.
Journal ArticleDOI
Obstructive sleep apnea syndrome and chronic kidney disease: a new cardiorenal risk factor.
TL;DR: The evidences supporting the complex inter-relations between sleep apnea and development and progression of chronic kidney disease are summarized.
References
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TL;DR: The prevalence of undiagnosed sleep-disordered breathing is high among men and is much higher than previously suspected among women, and is associated with daytime hypersomnolence.
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Prospective study of the association between sleep-disordered breathing and hypertension.
TL;DR: A dose-response association between sleep-disordered breathing at base line and the presence of hypertension four years later was found that was independent of known confounding factors and suggest that sleep- disordered breathing is likely to be a risk factor for hypertension and consequent cardiovascular morbidity in the general population.
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Mortality by cause for eight regions of the world: Global Burden of Disease Study
TL;DR: The Global Burden of Disease Study (GBD) used various data sources and made corrections for miscoding of important diseases (eg, ischaemic heart disease) to estimate worldwide and regional cause-of-death patterns in 1990, and the estimates by cause provide a foundation for a more informed debate on public-health priorities.