Associations between common sleep disturbances and cardiovascular risk in patients with obstructive sleep apnea: A large-scale cross-sectional study

Xiaoman Zhang; Weijun Huang; Huajun Xu; Xinyi Li; Fan Wang; Kejia Wu; Chenyang Li; Yupu Liu; Jianyin Zou; Huaming Zhu; Hongliang Yi; Jian Guan; Di Qian; Shankai Yin

doi:10.3389/fcvm.2022.1034785

Associations between common sleep disturbances and cardiovascular risk in patients with obstructive sleep apnea: A large-scale cross-sectional study

Front Cardiovasc Med. 2022 Oct 31:9:1034785. doi: 10.3389/fcvm.2022.1034785. eCollection 2022.

Authors

Xiaoman Zhang¹, Weijun Huang¹, Huajun Xu¹, Xinyi Li¹, Fan Wang¹, Kejia Wu¹, Chenyang Li¹, Yupu Liu¹, Jianyin Zou¹, Huaming Zhu¹, Hongliang Yi¹, Jian Guan¹, Di Qian², Shankai Yin¹

Affiliations

¹ Department of Otolaryngology Head and Neck Surgery and Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, China.
² Department of Otolaryngology, People's Hospital of Longhua, Shenzhen, China.

Abstract

Objectives: Studies have shown that obstructive sleep apnea (OSA) is inextricably linked with cardiovascular diseases (CVD). However, the roles of certain common sleep disturbances, such as low slow-wave sleep, excessive daytime sleepiness and short sleep duration, in the pathogenesis and progression of CVD in patients with OSA have not been determined. Therefore, we conducted a large cross-sectional study to explore the effect of low slow-wave sleep, excessive daytime sleepiness and short sleep duration on the risk of CVD in patients with OSA.

Methods: Subjects were consecutively enrolled to participate in the sleep center of Shanghai Jiao Tong University Affiliated Sixth People's Hospital. All OSA patients were diagnosed by standard polysomnography, while controls were all simple snorers. A total of 4,475 participants were strictly recruited. The Framingham Risk Score were employed to assess the 10-year risk of CVD, and logistic regression was used to measure the association between sleep disturbances and the moderate-to-high CVD risk.

Results: In the whole cohort, OSA, excessive daytime sleepiness, and low slow-wave sleep were all risk factors for the moderate-to-high 10-year CVD risk (odds ratio [OR] = 3.012, 95% confidence interval [CI] 2.418-3.751; OR = 1.407, 95% CI: 1.228-1.613, and OR = 0.973,95% CI: 0.967-0.980), but sleep duration did not contribute significantly to that risk. Whether in patients with OSA and controls, low SWS (<12.8%) could increase the risk of CVD. Subjective excessive daytime sleepiness would significantly increase the risk of CVD only in patients with severe OSA.

Conclusion: It is important to pay more attention to the impact of sleep on cardiovascular health. Patients with sleep disturbances should adopt a healthy lifestyle and undergo regular follow-up of cardiovascular indicators to prevent cardiovascular complications.

Trial registration: [http://www.chictr.org.cn/showproj.aspx?proj=43057], identifier [ChiCTr1900025714].

Keywords: cardiovascular disease; excessive daytime sleepiness; obstructive sleep apnea; sleep duration; slow-wave sleep.