Sleep-related intermittent hypoxia is associated with decreased psychomotor vigilance in Japanese community residents

Abstract

Background: Sleep disordered breathing (SDB) is associated with decreased psychomotor vigilance (hereafter "vigilance") in clinical settings, but this association has yet to be confirmed in the general population. The aim of this study is to determine the associations between SDB and vigilance in a large sample of community-based participants.

Methods: The study sample consisted of 1508 community-dwelling Japanese persons (age: 30-79 years, women: 62.7%, mean body mass index [BMI]: 23.1 kg/m²). Vigilance was measured by the psychomotor vigilance task (PVT), and SDB was measured by overnight pulse oximetry. We investigated odds ratios for "high mean reaction time (RT)" and "high number of lapses," which we defined as the 75th percentile of each value, across categories of oximetry values (three percent oxygen desaturation index [ODI], 4% ODI, average oxygen saturation, minimum oxygen saturation).

Results: Multivariable-adjusted odds ratios of high mean RT and high number of lapses in severe SDB (3% ODI ≥ 30.0 events/h) were 3.0 (95% confidence interval: 1.0-8.9; P for trend = 0.03) and 3.3 (95% confidence interval: 1.2-9.2, P for trend = 0.03), respectively, compared to participants without SDB. Similar associations were observed between PVT metrics and four percent ODI. No significant associations between average oxygen saturation and PVT metrics were observed. Minimum oxygen saturation was significantly associated with the trend of high number of lapses (P for trend = 0.007), but not with high mean RT.

Conclusions: The present study provides evidence that the intermittent hypoxia in SDB is significantly associated with the deterioration of PVT outcome metrics.

Keywords: Cross-sectional study; Epidemiology; Psychomotor vigilance task; Sleep apnea; Sleep disordered breathing; Vigilance.