CHEST
Original Research: Sleep DisordersDiabetes Mellitus Prevalence and Control in Sleep-Disordered Breathing: The European Sleep Apnea Cohort (ESADA) Study
Section snippets
Materials and Methods
The ESADA study is a pan-European, multicenter, prospective study involving 24 sleep clinics across 15 European countries and Israel. The underlying design and investigative techniques used in ESADA have been discussed in detail previously.17 Briefly, ESADA was established to investigate the role of OSA in driving cardiovascular and metabolic morbidity and mortality, with the goal of prospectively evaluating a large cohort of subjects with suspected sleep-disordered breathing. ESADA uses a
Population Characteristics
From March 2007 to July 2012, 12,636 subjects were enrolled in ESADA. A total of 6,616 of these had both a sleep study performed and a valid HbA1c level measured during the study period. Figure 1 summarizes the recruitment and evaluation process of these patients. Descriptive characteristics of the study population, stratified by OSA severity, are presented in Table 1. A total of 2,833 patients (42.8%) underwent PSG, the remainder PG. More severe OSA was associated with greater male
Discussion
In the largest study in this field to date, to our knowledge, we observed a significant relationship between OSA severity and the likelihood of a coexistent diagnosis of T2DM in a multinational population of subjects attending sleep services across Europe, alongside evidence of worse glycemic control in diabetic subjects with more severe sleep-disordered breathing. These relationships persisted despite adjustment for important confounding factors such as age, obesity, smoking history,
Acknowledgments
Author contributions: B. D. K. assumes responsibility for the content of the manuscript. B. D. K., L. G., S. R., J.-L. P., M. R. B., R. T., T. S., J. V., P. L., J. H., and W. T. M. contributed to study design, data collection, and manuscript preparation, and provided final approval for submission.
Financial/nonfinancial disclosures: The authors have reported to CHEST the following conflicts of interest: Dr Saaresranta received grants from Turku University Hospital (Governmental EVO Grant), the
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Part of this article has been published in abstract form (Kent BD, Grote L, Bonsignore MR, et al. Am J Respir Crit Care Med. 2012;185:A5379).
FUNDING/SUPPORT: The maintenance of the European Sleep Apnea (ESADA) study database is supported by unrestricted grants from ResMed and Philips Respironics (Koninklijke Philips N.V.). Drs Kent and Ryan are supported by grants from the Health Research Board, Ireland [HPF/2009/033], and Dr Grote is supported by grants from the Swedish Heart and Lung Foundation.
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