nach oben

Sleep and Breathing

Erschienen in:

12.05.2020 | Sleep Breathing Physiology and Disorders • Original Article

Association between sleep-disordered breathing and lower extremity artery disease: a meta-analysis

verfasst von: Yuhong Chen, Xiaocheng Li, Liming Zhao, Gang Wu

Erschienen in: Sleep and Breathing | Ausgabe 1/2021

Einloggen, um Zugang zu erhalten

Abstract

Objective

Previous studies suggest a relationship between sleep disordered breathing (SDB) and lower extremity artery disease (LEAD) though disagreements remain. This study was performed to assess the association between SDB and LEAD in a metaanalysis.

Methods

PubMed and Embase databases were searched for observational studies. A random-effects model incorporating between-study heterogeneity was used to pool the data.

Results

The search revealed 7 studies including 152,885 participants. Patients with SDB had higher odds of LEAD (risk ratio [RR] = 1.32, 95% confidence interval [CI] = 1.07 to 1.63, p = 0.01, I² = 66%) compared to non-SDB participants. In subgroup analyses, SDB was related to higher odds of LEAD in patients with stroke or diabetes (RR = 3.28, p < 0.001) than in a community-derived population (RR = 1.17, p = 0.08; p for subgroup difference < 0.001). Furthermore, the odds of LEAD was increased in patients with moderate (RR = 1.34, 95% CI = 1.04 to 1.73, p = 0.02) or severe SDB (RR = 1.81, 95% CI = 1.08 to 3.03, p = 0.02), but not in those with mild SDB (RR = 0.94, 95% CI = 0.69 to 1.29, p = 0.71). Differences in study design or methods for LEAD diagnosis did not appear to affect the association between SDB and LEAD.

Conclusions

Patients with SDB have higher odds of LEAD compared to non-SDB participants.

Nur mit Berechtigung zugänglich

Javaheri S, Barbe F, Campos-Rodriguez F, Dempsey JA, Khayat R, Malhotra A, Martinez-Garcia MA, Mehra R, Pack AI, Polotsky VY, Redline S, Somers VK (2017) Sleep apnea: types, mechanisms, and clinical cardiovascular consequences. J Am Coll Cardiol 69(7):841–858. https://doi.org/10.1016/j.jacc.2016.11.069CrossRefPubMedPubMedCentral

Morsy NE, Farrag NS, Zaki NFW, Badawy AY, Abdelhafez SA, El-Gilany AH, El Shafey MM, Pandi-Perumal SR, Spence DW, BaHammam AS (2019) Obstructive sleep apnea: personal, societal, public health, and legal implications. Rev Environ Health 34(2):153–169. https://doi.org/10.1515/reveh-2018-0068CrossRefPubMed

Peppard PE, Young T, Barnet JH, Palta M, Hagen EW, Hla KM (2013) Increased prevalence of sleep-disordered breathing in adults. Am J Epidemiol 177(9):1006–1014. https://doi.org/10.1093/aje/kws342CrossRefPubMedPubMedCentral

Yoshihisa A, Takeishi Y (2019) Sleep disordered breathing and cardiovascular diseases. J Atheroscler Thromb 26(4):315–327. https://doi.org/10.5551/jat.RV17032CrossRefPubMedPubMedCentral

Mehra R (2019) Sleep apnea and the heart. Cleve Clin J Med 86(9 Suppl 1):10–18. https://doi.org/10.3949/ccjm.86.s1.03CrossRefPubMed

Rivera-Perez SJ, Martinez D, Araujo GN, Goncalves SC, Lazzaretti LK, Wainstein RV, Wainstein MV, Ribeiro JP (2019) Severity of obstructive sleep apnea and extension of coronary artery disease. Sleep Breath 23(3):747–752. https://doi.org/10.1007/s11325-018-1769-5CrossRefPubMed

Qu H, Guo M, Zhang Y, Shi DZ (2018) Obstructive sleep apnea increases the risk of cardiac events after percutaneous coronary intervention: a meta-analysis of prospective cohort studies. Sleep Breath 22(1):33–40. https://doi.org/10.1007/s11325-017-1503-8CrossRefPubMed

Wang X, Ouyang Y, Wang Z, Zhao G, Liu L, Bi Y (2013) Obstructive sleep apnea and risk of cardiovascular disease and all-cause mortality: a meta-analysis of prospective cohort studies. Int J Cardiol 169(3):207–214. https://doi.org/10.1016/j.ijcard.2013.08.088CrossRefPubMed

Gerhard-Herman MD, Gornik HL, Barrett C, Barshes NR, Corriere MA, Drachman DE, Fleisher LA, Fowkes FGR, Hamburg NM, Kinlay S, Lookstein R, Misra S, Mureebe L, Olin JW, Patel RAG, Regensteiner JG, Schanzer A, Shishehbor MH, Stewart KJ, Treat-Jacobson D, Walsh ME (2017) 2016 AHA/ACC guideline on the management of patients with lower extremity peripheral artery disease: a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines. J Am Coll Cardiol 69(11):e71–e126. https://doi.org/10.1016/j.jacc.2016.11.007CrossRefPubMed

10.

Fowkes FG, Aboyans V, Fowkes FJ, McDermott MM, Sampson UK, Criqui MH (2017) Peripheral artery disease: epidemiology and global perspectives. Nat Rev Cardiol 14(3):156–170. https://doi.org/10.1038/nrcardio.2016.179CrossRefPubMed

11.

Kithcart AP, Beckman JA (2018) ACC/AHA versus ESC guidelines for diagnosis and management of peripheral artery disease: JACC guideline comparison. J Am Coll Cardiol 72(22):2789–2801. https://doi.org/10.1016/j.jacc.2018.09.041CrossRefPubMed

12.

Ismaeel A, Brumberg RS, Kirk JS, Papoutsi E, Farmer PJ, Bohannon WT, Smith RS, Eidson JL, Sawicki I, Koutakis P (2018) Oxidative stress and arterial dysfunction in peripheral artery disease. Antioxidants (Basel) 7(10). https://doi.org/10.3390/antiox7100145

13.

Baltzis D, Bakker JP, Patel SR, Veves A (2016) Obstructive sleep apnea and vascular diseases. Compr Physiol 6(3):1519–1528. https://doi.org/10.1002/cphy.c150029CrossRefPubMed

14.

Lavie L (2015) Oxidative stress in obstructive sleep apnea and intermittent hypoxia—revisited—the bad ugly and good: implications to the heart and brain. Sleep Med Rev 20:27–45. https://doi.org/10.1016/j.smrv.2014.07.003CrossRefPubMed

15.

Nachtmann A, Stang A, Wang YM, Wondzinski E, Thilmann AF (2003) Association of obstructive sleep apnea and stenotic artery disease in ischemic stroke patients. Atherosclerosis 169(2):301–307. https://doi.org/10.1016/s0021-9150(03)00195-3CrossRefPubMed

16.

Chen JC, Koo M, Hwang JH (2015) Risks of peripheral arterial occlusive disease in patients with obstructive sleep apnoea: a population-based case-control study. Clin Otolaryngol 40(5):437–442. https://doi.org/10.1111/coa.12393CrossRefPubMed

17.

Shah N, Allison M, Teng Y, Wassertheil-Smoller S, Sotres-Alvarez D, Ramos AR, Zee PC, Criqui MH, Yaggi HK, Gallo LC, Redline S, Kaplan RC (2015) Sleep apnea is independently associated with peripheral arterial disease in the Hispanic Community Health Study/Study of Latinos. Arterioscler Thromb Vasc Biol 35(3):710–715. https://doi.org/10.1161/ATVBAHA.114.304625CrossRefPubMedPubMedCentral

18.

Nagayoshi M, Lutsey PL, Benkeser D, Wassel CL, Folsom AR, Shahar E, Iso H, Allison MA, Criqui MH, Redline S (2016) Association of sleep apnea and sleep duration with peripheral artery disease: the Multi-Ethnic Study of Atherosclerosis (MESA). Atherosclerosis 251:467–475. https://doi.org/10.1016/j.atherosclerosis.2016.06.040CrossRefPubMedPubMedCentral

19.

Stadler S, Jalili S, Schreib A, Jung B, Zeman F, Boger CA, Heid IM, Arzt M (2018) Association of sleep-disordered breathing with severe chronic vascular disease in patients with type 2 diabetes. Sleep Med 48:53–60. https://doi.org/10.1016/j.sleep.2018.05.001CrossRefPubMed

20.

Wu KL, Kuo CY, Tsai YC, Hung JY, Sheu CC, Yang CJ, Hsu CY, Wu MN, Tsai MJ (2019) CHADS₂, CHA₂DS₂ASc, and new ABCD scores predict the risk of peripheral arterial disease in patients with sleep apnea. J Clin Med 8(2). https://doi.org/10.3390/jcm8020188

21.

Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, Moher D, Becker BJ, Sipe TA, Thacker SB (2000) Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis of Observational Studies in Epidemiology (MOOSE) group. JAMA 283(15):2008–2012CrossRefPubMed

22.

Higgins J, Green S (2011) Cochrane handbook for systematic reviews of interventions version 5.1.0. The Cochrane Collaboration. www.cochranehandbook.org. Accessed 30 Oct 2019

23.

Mohammadieh A, Sutherland K, Cistulli PA (2017) Sleep disordered breathing: management update. Intern Med J 47(11):1241–1247. https://doi.org/10.1111/imj.13606CrossRefPubMed

24.

Conte MS, Bradbury AW, Kolh P, White JV, Dick F, Fitridge R, Mills JL, Ricco JB, Suresh KR, Murad MH, Aboyans V, Aksoy M, Alexandrescu VA, Armstrong D, Azuma N, Belch J, Bergoeing M, Bjorck M, Chakfe N, Cheng S, Dawson J, Debus ES, Dueck A, Duval S, Eckstein HH, Ferraresi R, Gambhir R, Garguilo M, Geraghty P, Goode S, Gray B, Guo W, Gupta PC, Hinchliffe R, Jetty P, Komori K, Lavery L, Liang W, Lookstein R, Menard M, Misra S, Miyata T, Moneta G, Munoa Prado JA, Munoz A, Paolini JE, Patel M, Pomposelli F, Powell R, Robless P, Rogers L, Schanzer A, Schneider P, Taylor S, De Ceniga MV, Veller M, Vermassen F, Wang J, Wang S (2019) Global vascular guidelines on the management of chronic limb-threatening ischemia. Eur J Vasc Endovasc Surg 58(1S):S1–S109 e133. https://doi.org/10.1016/j.ejvs.2019.05.006CrossRefPubMedPubMedCentral

25.

Wells GA, Shea B, O'Connell D, Peterson J, Welch V, Losos M, Tugwell P (2010) The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp. Accessed 30 Oct 2019

26.

Higgins JP, Thompson SG (2002) Quantifying heterogeneity in a meta-analysis. Stat Med 21(11):1539–1558. https://doi.org/10.1002/sim.1186CrossRefPubMed

27.

Patsopoulos NA, Evangelou E, Ioannidis JP (2008) Sensitivity of between-study heterogeneity in meta-analysis: proposed metrics and empirical evaluation. Int J Epidemiol 37(5):1148–1157. https://doi.org/10.1093/ije/dyn065CrossRefPubMedPubMedCentral

28.

Egger M, Davey Smith G, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315(7109):629–634CrossRefPubMedPubMedCentral

29.

Joyeux-Faure M, Tamisier R, Borel JC, Millasseau S, Galerneau LM, Destors M, Bailly S, Pepin JL (2018) Contribution of obstructive sleep apnoea to arterial stiffness: a meta-analysis using individual patient data. Thorax 73(12):1146–1151. https://doi.org/10.1136/thoraxjnl-2018-211513CrossRefPubMed

30.

Gunduz C, Basoglu OK, Hedner J, Zou D, Bonsignore MR, Hein H, Staats R, Pataka A, Barbe F, Sliwinski P, Kent BD, Pepin JL, Grote L (2018) Obstructive sleep apnoea independently predicts lipid levels: data from the European Sleep Apnea Database. Respirology 23(12):1180–1189. https://doi.org/10.1111/resp.13372CrossRefPubMed

31.

Priou P, Le Vaillant M, Meslier N, Chollet S, Masson P, Humeau MP, Pigeanne T, Bizieux-Thaminy A, Goupil F, Gagnadoux F (2012) Independent association between obstructive sleep apnea severity and glycated hemoglobin in adults without diabetes. Diabetes Care 35(9):1902–1906. https://doi.org/10.2337/dc11-2538CrossRefPubMedPubMedCentral

32.

Kurosawa H, Saisho Y, Fukunaga K, Haraguchi M, Yamasawa W, Kurihara I, Betsuyaku T, Itoh H (2018) Association between severity of obstructive sleep apnea and glycated hemoglobin level in Japanese individuals with and without diabetes. Endocr J 65(1):121–127. https://doi.org/10.1507/endocrj.EJ17-0356CrossRefPubMed

33.

Lombardi C, Pengo MF, Parati G (2019) Obstructive sleep apnea syndrome and autonomic dysfunction. Auton Neurosci 221:102563. https://doi.org/10.1016/j.autneu.2019.102563CrossRefPubMed

34.

Ghadami MR (2018) Hypercoagulability and severe obstructive sleep apnea. JAMA Otolaryngol Head Neck Surg 144(2):175. https://doi.org/10.1001/jamaoto.2017.2761CrossRefPubMed

35.

Toraldo DM, De Benedetto M, Scoditti E, De Nuccio F (2016) Obstructive sleep apnea syndrome: coagulation anomalies and treatment with continuous positive airway pressure. Sleep Breath 20(2):457–465. https://doi.org/10.1007/s11325-015-1227-6CrossRefPubMed

Titel: Association between sleep-disordered breathing and lower extremity artery disease: a meta-analysis
verfasst von: Yuhong Chen
Xiaocheng Li
Liming Zhao
Gang Wu
Publikationsdatum: 12.05.2020
Verlag: Springer International Publishing
Erschienen in: Sleep and Breathing / Ausgabe 1/2021
Print ISSN: 1520-9512
Elektronische ISSN: 1522-1709
DOI: https://doi.org/10.1007/s11325-020-02096-z

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

25.04.2024 Allergien und Intoleranzreaktionen Nachrichten

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Objective

Methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 1/2021

Effect of CPAP therapy on nocturnal blood pressure fluctuations, nocturnal blood pressure, and arterial stiffness in patients with coexisting cardiovascular diseases and obstructive sleep apnea

Sex differences in subjectively reported symptoms of obstructive sleep apnea in community-dwelling adults with type 2 diabetes

Cross motor innervation of the hypoglossal nerve—a pilot study of predictors for successful opening of the soft palate

Breath variability increases in the minutes preceding obstructive sleep apneic events

Longer duration electroencephalogram arousals have a better relationship with impaired vigilance and health status in obstructive sleep apnoea