Research Article: Prevalence of several somatic diseases depends on the presence and severity of obstructive sleep apnea

Date Published: February 23, 2018

Publisher: Public Library of Science

Author(s): Ragnhild L. Tveit, Sverre Lehmann, Bjørn Bjorvatn, Manlio Milanese.

http://doi.org/10.1371/journal.pone.0192671

Abstract

The objective was to investigate the prevalence of heart attack, angina pectoris, stroke, hypertension, diabetes mellitus, chronic obstructive pulmonary disease, asthma and obesity in relation to the presence and severity of obstructive sleep apnea.

The sample consisted of 1887 patients, with mean age of 48.6 years (range 16–83 years), referred to a university hospital on suspicion of obstructive sleep apnea. The patients filled out a questionnaire asking whether they were previously diagnosed with the comorbidities in interest. Obstructive sleep apnea was diagnosed and categorized based on a standard respiratory polygraphic sleep study using a type 3 portable monitor. The patients’ weight, height and blood pressure were measured during the consultations.

In total, 37.9% were categorized as not having obstructive sleep apnea (Apnea-hypopnea index <5), 29.6% mild obstructive sleep apnea (Apnea-hypopnea index 5–14.9), 17.3% moderate obstructive sleep apnea (Apnea-hypopnea index 15–29.9), and 15.2% severe obstructive sleep apnea (Apnea-hypopnea index ≥30). The prevalence of heart attack, angina pectoris, hypertension, measured systolic blood pressure ≥140 mmHg, measured diastolic blood pressure ≥90 mmHg, diabetes mellitus and obesity (body mass index≥30) were higher with greater obstructive sleep apnea severity. Logistic and linear regression analyses showed that these comorbidities were positively associated with obstructive sleep apnea severity. This was not the case for stroke, chronic obstructive pulmonary disease and asthma. After adjustment for sex, age, alcohol and smoking in the logistic regression analyses, hypertension, measured systolic blood pressure ≥140 mmHg, measured diastolic blood pressure ≥90 mmHg and obesity remained positively associated with obstructive sleep apnea severity. A higher prevalence of heart attack, angina pectoris, hypertension, diabetes mellitus, and obesity was seen with greater obstructive sleep apnea severity. Obesity and hypertension, conditions easy to clinically assess, appear as the most central comorbidities with greater obstructive sleep apnea severity.

Partial Text

Obstructive sleep apnea (OSA) is a common, but often under-diagnosed disorder [1, 2]. The prevalence of OSA in the adult Norwegian population has been estimated to be 16% for apnea-hypopnea index (AHI) ≥5 and 8% for AHI≥15 [3]. OSA affects male individuals more commonly than female individuals [2, 4].

The total sample consisted of 1929 patients referred to Haukeland University Hospital on suspicion of obstructive sleep apnea during the period of 2011 to 2014. Due to no objective registrations, 42 individuals were excluded, thus the final sample included 1887 patients. The mean age was 48.6 years (range 16–83 years) and 70.6% were men.

Among the patients referred on suspicion of OSA 37.9% had a normal AHI (<5), yielding a prevalence rate of OSA of 62.1%. Out of the referred patients 29.6% had mild OSA, 17.3% had moderate OSA, and 15.2% had severe OSA (Table 1). Among patients referred on suspicion of OSA there was a higher prevalence of heart attack, angina pectoris, hypertension, diabetes mellitus, and obesity with greater OSA severity. This was also the case for measured systolic blood pressure ≥140 mmHg and diastolic blood pressure ≥90 mmHg. However, there was no significant association between OSA severity and stroke, COPD and asthma.   Source: http://doi.org/10.1371/journal.pone.0192671