Journal ArticleDOI
Sleep-disordered breathing and cardiovascular disease: cross-sectional results of the Sleep Heart Health Study.
Eyal Shahar,Coralyn Whitney,Susan Redline,Lee Et,A.B. Newman,F. J. Nieto,George T. O'Connor,Lori L. Boland,Joseph E. Schwartz,Jonathan M. Samet +9 more
TLDR
Findings are compatible with modest to moderate effects of sleep-disordered breathing on heterogeneous manifestations of CVD within a range of AHI values that are considered normal or only mildly elevated.Abstract:
Disordered breathing during sleep is associated with acute, unfavorable effects on cardiovascular physiology, but few studies have examined its postulated association with cardiovascular disease (CVD). We examined the cross-sectional association between sleep- disordered breathing and self-reported CVD in 6,424 free-living individuals who underwent overnight, unattended polysomnography at home. Sleep-disordered breathing was quantified by the apnea-hypopnea index (AHI)-the average number of apneas and hypopneas per hour of sleep. Mild to moderate disordered breathing during sleep was highly prevalent in the sample (median AHI: 4.4; interquartile range: 1.3 to 11.0). A total of 1,023 participants (16%) reported at least one manifestation of CVD (myocardial infarction, angina, coronary revascularization procedure, heart failure, or stroke). The multivariable-adjusted relative odds (95% CI) of prevalent CVD for the second, third, and fourth quartiles of the AHI (versus the first) were 0.98 (0.77-1.24), 1.28 (1.02-1.61), and 1.42 (1.13-1.78), respectively. Sleep-disordered breathing was associated more strongly with self-reported heart failure and stroke than with self-reported coronary heart disease: the relative odds (95% CI) of heart failure, stroke, and coronary heart disease (upper versus lower AHI quartile) were 2.38 (1.22-4.62), 1.58 (1.02- 2.46), and 1.27 (0.99-1.62), respectively. These findings are compatible with modest to moderate effects of sleep-disordered breathing on heterogeneous manifestations of CVD within a range of AHI values that are considered normal or only mildly elevated.read more
Citations
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Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure
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Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study
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Epidemiology of obstructive sleep apnea: a population health perspective.
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References
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Journal ArticleDOI
The Occurrence of Sleep-Disordered Breathing among Middle-Aged Adults
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.
Journal ArticleDOI
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.
Journal ArticleDOI
Association of Sleep-Disordered Breathing, Sleep Apnea, and Hypertension in a Large Community-Based Study
F. Javier Nieto,Terry Young,Bonnie K. Lind,Eyal Shahar,Jonathan M. Samet,Susan Redline,Ralph B. D'Agostino,Anne B. Newman,Michael D. Lebowitz,Thomas G. Pickering +9 more
TL;DR: The findings from the largest cross-sectional study to date indicate that SDB is associated with systemic hypertension in middle-aged and older individuals of different sexes and ethnic backgrounds.
Journal Article
EEG arousals: Scoring rules and examples. A preliminary report from the Sleep Disorders Atlas Task Force of the American Sleep Disorder Association
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Book
Case-Control Studies: Design, Conduct, Analysis
TL;DR: Case-control studies, often called 'retrospective' studies, provide a research method for investigating factors that may prevent or cause disease.