Excessive Sleeping in sleep apnea patients linked to CV Mortality in Hispanic population
Obstructive sleep apnea (OSA) is a common, chronic condition associated with multiple adverse outcomes, with increased prevalence concomitant with increasing obesity rates. In a study, the researchers have reported that excessive sleepiness increases the risk of incident cardiovascular mortality in the Hispanic population with moderate to severe OSA (msOSA).
The study findings were published in the CHEST Journal.
Studies have demonstrated a strong association between sleepiness-related symptoms and comorbidities with poor cardiovascular outcomes among patients with msOSA. However, the validation of these associations in the Hispanic population from South America and the ability to predict incident cardiovascular disease remains unclear. Therefore, Dr Gonzalo Labarca and his team conducted a study to explore different approaches in a cohort of patients with moderate to severe OSA from a sleep clinic based in Santiago, Chile.
Using the SantOSA cohort, the researchers reproduced four cluster analyses following a cluster analysis similar to each training dataset. The four cluster analyses were:
• Sleep Heart Health Study [SHHS],
• Icelandic Sleep Apnea Cohort [ISAC],
• Sleep Apnea Cardiovascular Endpoints [SAVE], and
• The Institute de Recherche en Sante Respiratoire des Pays de la Loire [IRSR] cohorts.
They evaluated the incidence of cardiovascular mortality using a Kaplan-Meier (log-rank) model and Cox proportional hazards models by adjusting the confounders.
Key findings of the study:
- Among 780 patients with msOSA, the researchers were able to reproduce two previous cluster analyses (SHHS and ISAC) but not with SAVE and IRSR cluster analyses.
- They identified the following subtypes for SHHS: "minimally symptomatic," "disturbed sleep," "moderate sleepiness," and "severe sleepiness."
- In ISAC, they noted three different subtypes ("minimally symptomatic," "disturbed sleep," and "excessive sleepiness") were similar to the original dataset.
- In the SantOSA cohort, they found a significant association between excessive sleepiness and incident CV mortality after 5 follow-up years using the Sleep Heart Health Study (HR= 5.47) and the Icelandic Sleep Apnea Cohort (HR = 3.23) cluster analyses.
The authors concluded, "Among patients with msOSA, a symptom-based approach can validate different OSA patient subtypes, and those with excessive sleepiness have an increased risk of incident cardiovascular mortality in the Hispanic population from South America."
For further information:
DOI: https://doi.org/10.1016/j.chest.2021.06.047
