Skip to main content
Erschienen in: Sleep and Breathing 1/2021

19.03.2020 | Sleep Breathing Physiology and Disorders • Original Article

Demographic, clinical, and biomarker predictors of apnea-hypopnea index from polysomnography in Midwestern sleep clinic patients

verfasst von: Jennifer N. Miller, Ann M. Berger, Kevin A. Kupzyk

Erschienen in: Sleep and Breathing | Ausgabe 1/2021

Einloggen, um Zugang zu erhalten

Abstract

Background

To examine if selected demographic (age, gender), clinical (diabetes, coronary artery disease, hyperlipidemia, myocardial infarction, stroke, lung disease, smoking history, alcohol intake), and biomarker [blood pressure (BP), heart rate, body mass index (BMI), neck circumference, Mallampati score] variables are predictors of apnea-hypopnea index (AHI) from polysomnography (PSG).

Methods

This cross-sectional study recruited a sample of adults (N = 170) who were being evaluated for OSA. Participants completed self-reported demographic and clinical questionnaires, and then completed PSG (n = 142). Multi-collinearity was assessed. Confounding factors, correlations, and potential interactions were explored.

Results

The final regression model was performed on 130 participants; 61 (46.9%) had an AHI ≥ 15. Systolic and diastolic BPs were highly correlated. Interactions were tested between gender and other variables (high cholesterol, BMI, neck circumference, systolic BP) and between systolic BP and other variables (high cholesterol, BMI, neck circumference, and lung disease). No interactions occurred between gender or systolic BP and other variables, meaning that the effects of the variables on AHI levels from PSG did not vary depending on gender or systolic BP. BMI, systolic BP, and absence of lung disease were predictors for AHI levels ≥ 15 from PSG.

Conclusions

BMI and systolic BP were significant predictors of OSA in this study. The absence of lung disease as a significant predictor was unique and may be due to the small number of participants who self-reported lung disease. To our knowledge, this is the first study to report this combination of variables to predict AHI levels ≥ 15 from PSG.
Literatur
1.
Zurück zum Zitat Peppard PE, Young T, Barnet JH, Palta M, Hagen EW, Hla KM (2013) Increased prevalence of sleep-disordered breathing in adults. Am J Epidemiol 177:1006–1014 CrossRef Peppard PE, Young T, Barnet JH, Palta M, Hagen EW, Hla KM (2013) Increased prevalence of sleep-disordered breathing in adults. Am J Epidemiol 177:1006–1014 CrossRef
2.
Zurück zum Zitat Berry RB, Brooks R, Gamaldo CE, Harding SM, Lloyd RM, Marcus CL, Vaughn BV (2014) For the American Academy of Sleep Medicine The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications. Darien, IL: American Academy of Sleep Medicine; 2014. Version 2.0.3. American Academy of Sleep Medicine: Darien, IL, USA Berry RB, Brooks R, Gamaldo CE, Harding SM, Lloyd RM, Marcus CL, Vaughn BV (2014) For the American Academy of Sleep Medicine The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications. Darien, IL: American Academy of Sleep Medicine; 2014. Version 2.0.3. American Academy of Sleep Medicine: Darien, IL, USA
3.
Zurück zum Zitat Stanley J, Palmisano J, Hoshal S, Binns L, O’Brien L (2018) Age and gender related differences in patient awareness of conditions associated with untreated obstructive sleep apnea. J Sleep Disord Ther 7:2167–0277.1000284 Stanley J, Palmisano J, Hoshal S, Binns L, O’Brien L (2018) Age and gender related differences in patient awareness of conditions associated with untreated obstructive sleep apnea. J Sleep Disord Ther 7:2167–0277.1000284
4.
Zurück zum Zitat Feng Y, Keenan B, Wang S, Leinwand S, Pack A, Schwab R (2017) New insights into obstructive sleep apnea pathogenesis: dynamic upper airway characteristics during awake respiration in obese subjects with and without obstructive sleep apnea. Am J Respir Crit Care Med 195 Feng Y, Keenan B, Wang S, Leinwand S, Pack A, Schwab R (2017) New insights into obstructive sleep apnea pathogenesis: dynamic upper airway characteristics during awake respiration in obese subjects with and without obstructive sleep apnea. Am J Respir Crit Care Med 195
5.
Zurück zum Zitat Torres G, Sánchez-de-la-Torre M, Martínez-Alonso M, Gómez S, Sacristán O, Cabau J, Barbé F (2015) Use of ambulatory blood pressure monitoring for the screening of obstructive sleep apnea. J Clin Hypertens 17:802–809 CrossRef Torres G, Sánchez-de-la-Torre M, Martínez-Alonso M, Gómez S, Sacristán O, Cabau J, Barbé F (2015) Use of ambulatory blood pressure monitoring for the screening of obstructive sleep apnea. J Clin Hypertens 17:802–809 CrossRef
6.
Zurück zum Zitat Kasai T, Yumino D, Redolfi S, Su M, Ruttanaumpawan P, Mak S, Newton GE, Floras JS, Bradley TD (2015) Overnight effects of obstructive sleep apnea and its treatment on stroke volume in patients with heart failure. Can J Cardiol 31:832–838 CrossRef Kasai T, Yumino D, Redolfi S, Su M, Ruttanaumpawan P, Mak S, Newton GE, Floras JS, Bradley TD (2015) Overnight effects of obstructive sleep apnea and its treatment on stroke volume in patients with heart failure. Can J Cardiol 31:832–838 CrossRef
7.
Zurück zum Zitat Lipford MC, Flemming KD, Calvin AD, Mandrekar J, Brown RD Jr, Somers VK, Caples SM (2015) Associations between cardioembolic stroke and obstructive sleep apnea. Sleep 38:1699–1705 CrossRef Lipford MC, Flemming KD, Calvin AD, Mandrekar J, Brown RD Jr, Somers VK, Caples SM (2015) Associations between cardioembolic stroke and obstructive sleep apnea. Sleep 38:1699–1705 CrossRef
8.
Zurück zum Zitat Gagnon K, Baril A, Montplaisir J, Carrier J, De Beaumont L, D'Aragon C, Chami S, Pelleieux S, Poirier J, Gauthier S (2019) Disconnection between self-reported and objective cognitive impairment in obstructive sleep apnea. J Clin Sleep Med 15:409–415 CrossRef Gagnon K, Baril A, Montplaisir J, Carrier J, De Beaumont L, D'Aragon C, Chami S, Pelleieux S, Poirier J, Gauthier S (2019) Disconnection between self-reported and objective cognitive impairment in obstructive sleep apnea. J Clin Sleep Med 15:409–415 CrossRef
9.
Zurück zum Zitat Iftikhar IH, Hoyos CM, Phillips CL, Magalang UJ (2015) Meta-analyses of the association of sleep apnea with insulin resistance, and the effects of CPAP on HOMA-IR, adiponectin, and visceral adipose fat. J Clin Sleep Med 11:475–485 CrossRef Iftikhar IH, Hoyos CM, Phillips CL, Magalang UJ (2015) Meta-analyses of the association of sleep apnea with insulin resistance, and the effects of CPAP on HOMA-IR, adiponectin, and visceral adipose fat. J Clin Sleep Med 11:475–485 CrossRef
10.
Zurück zum Zitat Davies SE, Bishopp A, Wharton S, Turner AM, Mansur AH (2019) The association between asthma and obstructive sleep apnea (OSA): a systematic review. J Asthma 56:118–129 CrossRef Davies SE, Bishopp A, Wharton S, Turner AM, Mansur AH (2019) The association between asthma and obstructive sleep apnea (OSA): a systematic review. J Asthma 56:118–129 CrossRef
12.
Zurück zum Zitat Vinnikov D, Blanc PD, Alilin A, Zutler M, Holty JC (2017) Fatigue and sleepiness determine respiratory quality of life among veterans evaluated for sleep apnea. Health Qual Life Outcomes 15:48 CrossRef Vinnikov D, Blanc PD, Alilin A, Zutler M, Holty JC (2017) Fatigue and sleepiness determine respiratory quality of life among veterans evaluated for sleep apnea. Health Qual Life Outcomes 15:48 CrossRef
13.
Zurück zum Zitat Qaseem A, Dallas P, Owens DK, Starkey M, Holty JC, Shekelle P (2014) Diagnosis of obstructive sleep apnea in adults: a clinical practice guideline from the American College of Physicians. Ann Intern Med 161:210–220 CrossRef Qaseem A, Dallas P, Owens DK, Starkey M, Holty JC, Shekelle P (2014) Diagnosis of obstructive sleep apnea in adults: a clinical practice guideline from the American College of Physicians. Ann Intern Med 161:210–220 CrossRef
14.
Zurück zum Zitat Heffner JE, Rozenfeld Y, Kai M, Stephens EA, Brown LK (2012) Prevalence of diagnosed sleep apnea among patients with type 2 diabetes in primary care. CHEST J 141:1414–1421 CrossRef Heffner JE, Rozenfeld Y, Kai M, Stephens EA, Brown LK (2012) Prevalence of diagnosed sleep apnea among patients with type 2 diabetes in primary care. CHEST J 141:1414–1421 CrossRef
15.
Zurück zum Zitat Lyons OD, Ryan CM (2015) Sleep apnea and stroke. Can J Cardiol 31:918–927 CrossRef Lyons OD, Ryan CM (2015) Sleep apnea and stroke. Can J Cardiol 31:918–927 CrossRef
16.
Zurück zum Zitat McNicholas WT (2017) COPD-OSA overlap syndrome: evolving evidence regarding epidemiology, clinical consequences, and management. Chest 152:1318–1326 CrossRef McNicholas WT (2017) COPD-OSA overlap syndrome: evolving evidence regarding epidemiology, clinical consequences, and management. Chest 152:1318–1326 CrossRef
17.
Zurück zum Zitat Kolla BP, Foroughi M, Saeidifard F, Chakravorty S, Wang Z, Mansukhani MP (2018) The impact of alcohol on breathing parameters during sleep: a systematic review and meta-analysis. Sleep Med Rev 42:59–67 CrossRef Kolla BP, Foroughi M, Saeidifard F, Chakravorty S, Wang Z, Mansukhani MP (2018) The impact of alcohol on breathing parameters during sleep: a systematic review and meta-analysis. Sleep Med Rev 42:59–67 CrossRef
18.
Zurück zum Zitat Schwab RJ, Leinwand SE, Bearn CB, Maislin G, Rao RB, Nagaraja A, Wang S, Keenan BT (2017) Digital morphometrics: a new upper airway phenotyping paradigm in OSA. Chest 152:330–342 CrossRef Schwab RJ, Leinwand SE, Bearn CB, Maislin G, Rao RB, Nagaraja A, Wang S, Keenan BT (2017) Digital morphometrics: a new upper airway phenotyping paradigm in OSA. Chest 152:330–342 CrossRef
19.
Zurück zum Zitat Walter RJ, Hagedorn SI, Lettieri CJ (2017) Impact of diagnosing and treating obstructive sleep apnea on healthcare utilization. Sleep Med 38:73–77 CrossRef Walter RJ, Hagedorn SI, Lettieri CJ (2017) Impact of diagnosing and treating obstructive sleep apnea on healthcare utilization. Sleep Med 38:73–77 CrossRef
20.
Zurück zum Zitat Scalzitti NJ, O'Connor PD, Nielsen SW, Aden JK, Brock MS, Taylor DM, Mysliwiec V, Dion GR (2018) Obstructive sleep apnea is an independent risk factor for hospital readmission. J Clin Sleep Med 14:753–758 CrossRef Scalzitti NJ, O'Connor PD, Nielsen SW, Aden JK, Brock MS, Taylor DM, Mysliwiec V, Dion GR (2018) Obstructive sleep apnea is an independent risk factor for hospital readmission. J Clin Sleep Med 14:753–758 CrossRef
21.
Zurück zum Zitat Collop N, Anderson WM, Boehlecke B, Claman D, Goldberg R, Gottlieb D, Hudgel D, Sateia M, Schwab R (2007) Clinical guidelines for the use of unattended portable monitors in the diagnosis of obstructive sleep apnea in adult patients. J Clin Sleep Med 3:737–747 CrossRef Collop N, Anderson WM, Boehlecke B, Claman D, Goldberg R, Gottlieb D, Hudgel D, Sateia M, Schwab R (2007) Clinical guidelines for the use of unattended portable monitors in the diagnosis of obstructive sleep apnea in adult patients. J Clin Sleep Med 3:737–747 CrossRef
22.
Zurück zum Zitat Hosmer DW, Lemeshow S (2000) Introduction to the logistic regression model. Applied Logistic Regression, Second Edition 1–30 Hosmer DW, Lemeshow S (2000) Introduction to the logistic regression model. Applied Logistic Regression, Second Edition 1–30
23.
Zurück zum Zitat Rogers A, Ravenell J, Donat M, Sexias A, Ogedegbe C, McFarlane SI, Jean-Louis G (2015) Predictors of obstructive sleep apnea risk among Blacks with metabolic syndrome. J Obes Overweight 1:1104 PubMedPubMedCentral Rogers A, Ravenell J, Donat M, Sexias A, Ogedegbe C, McFarlane SI, Jean-Louis G (2015) Predictors of obstructive sleep apnea risk among Blacks with metabolic syndrome. J Obes Overweight 1:1104 PubMedPubMedCentral
24.
Zurück zum Zitat Kendzerska T, Gershon AS, Hawker G, Leung RS, Tomlinson G (2014) Obstructive sleep apnea and risk of cardiovascular events and all-cause mortality: a decade-long historical cohort study. PLoS Med 11:e1001599 CrossRef Kendzerska T, Gershon AS, Hawker G, Leung RS, Tomlinson G (2014) Obstructive sleep apnea and risk of cardiovascular events and all-cause mortality: a decade-long historical cohort study. PLoS Med 11:e1001599 CrossRef
25.
Zurück zum Zitat Pedrosa RP, Drager LF, Gonzaga CC, Sousa MG, de Paula LK, Amaro AC, Amodeo C, Bortolotto LA, Krieger EM, Bradley TD, Lorenzi-Filho G (2011) Obstructive sleep apnea: the most common secondary cause of hypertension associated with resistant hypertension. Hypertension 58:811–817 CrossRef Pedrosa RP, Drager LF, Gonzaga CC, Sousa MG, de Paula LK, Amaro AC, Amodeo C, Bortolotto LA, Krieger EM, Bradley TD, Lorenzi-Filho G (2011) Obstructive sleep apnea: the most common secondary cause of hypertension associated with resistant hypertension. Hypertension 58:811–817 CrossRef
26.
Zurück zum Zitat Hu X, Fan J, Chen S, Yin Y, Zrenner B (2015) The role of continuous positive airway pressure in blood pressure control for patients with obstructive sleep apnea and hypertension: a meta-analysis of randomized controlled trials. J Clin Hypertens 17:215–222 CrossRef Hu X, Fan J, Chen S, Yin Y, Zrenner B (2015) The role of continuous positive airway pressure in blood pressure control for patients with obstructive sleep apnea and hypertension: a meta-analysis of randomized controlled trials. J Clin Hypertens 17:215–222 CrossRef
27.
Zurück zum Zitat Haas DC, Foster GL, Nieto FJ, Redline S, Resnick HE, Robbins JA, Young T, Pickering TG (2005) Age-dependent associations between sleep-disordered breathing and hypertension: importance of discriminating between systolic/diastolic hypertension and isolated systolic hypertension in the Sleep Heart Health Study. Circulation 111:614–621 CrossRef Haas DC, Foster GL, Nieto FJ, Redline S, Resnick HE, Robbins JA, Young T, Pickering TG (2005) Age-dependent associations between sleep-disordered breathing and hypertension: importance of discriminating between systolic/diastolic hypertension and isolated systolic hypertension in the Sleep Heart Health Study. Circulation 111:614–621 CrossRef
28.
Zurück zum Zitat Krachman SL, Tiwari R, Vega ME, Yu D, Soler X, Jaffe F, Kim V, Swift I, D’Alonzo GE, Criner GJ (2016) Effect of emphysema severity on the apnea–hypopnea index in smokers with obstructive sleep apnea. Ann Am Thoracic Society 13:1129–1135 CrossRef Krachman SL, Tiwari R, Vega ME, Yu D, Soler X, Jaffe F, Kim V, Swift I, D’Alonzo GE, Criner GJ (2016) Effect of emphysema severity on the apnea–hypopnea index in smokers with obstructive sleep apnea. Ann Am Thoracic Society 13:1129–1135 CrossRef
29.
Zurück zum Zitat Zidan M, Daabis R, Gharraf H (2015) Overlap of obstructive sleep apnea and bronchial asthma: effect on asthma control. Egypt J Chest Dis Tuberc 64:425–430 CrossRef Zidan M, Daabis R, Gharraf H (2015) Overlap of obstructive sleep apnea and bronchial asthma: effect on asthma control. Egypt J Chest Dis Tuberc 64:425–430 CrossRef
30.
Zurück zum Zitat Greenberg-Dotan S, Reuveni H, Tal A, Oksenberg A, Cohen A, Shaya FT, Tarasiuk A, Scharf SM (2014) Increased prevalence of obstructive lung disease in patients with obstructive sleep apnea. Sleep Breath 18:69–75 CrossRef Greenberg-Dotan S, Reuveni H, Tal A, Oksenberg A, Cohen A, Shaya FT, Tarasiuk A, Scharf SM (2014) Increased prevalence of obstructive lung disease in patients with obstructive sleep apnea. Sleep Breath 18:69–75 CrossRef
Metadaten
Titel
Demographic, clinical, and biomarker predictors of apnea-hypopnea index from polysomnography in Midwestern sleep clinic patients
verfasst von
Jennifer N. Miller
Ann M. Berger
Kevin A. Kupzyk
Publikationsdatum
19.03.2020
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/s11325-020-02053-w

Weitere Artikel der Ausgabe 1/2021

Sleep and Breathing 1/2021 Zur Ausgabe

Sleep Breathing Physiology and Disorders • Original Article

Increased frequency of obstructive sleep apnea in the patients with systemic sclerosis

Sleep Breathing Physiology and Disorders • Original Article

A novel minimal-contact biomotion method for long-term respiratory rate monitoring

Sleep Breathing Physiology and Disorders • Original Article

The effect of in-lab polysomnography and home sleep polygraphy on sleep position

Update Innere Medizin

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.