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Prechaporn W, Hantrakul P, Ngamjarus C, Sukeepaisarnjaroen W, Sawanyawisuth K, Khamsai S. Pooled prevalences of obstructive sleep apnea and heart failure: a systematic review and meta-analysis. Heart Fail Rev 2024; 29:811-826. [PMID: 38722388 DOI: 10.1007/s10741-024-10399-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/19/2024] [Indexed: 06/19/2024]
Abstract
Obstructive sleep apnea (OSA) is a disease with intermittent hypoxemia during sleep. It has been shown that OSA is related to several cardiovascular diseases including heart failure. Both OSA and heart failure have a close association bidirectionally. This study aimed to estimate the pooled prevalence of OSA in patients with heart failure as well as pooled prevalence of heart failure in patients with OSA. This was a systematic review with a meta-analysis. The inclusion criteria were observational or epidemiological studies conducted in adult patients with heart failure to evaluate the prevalence of OSA and patients with OSA to evaluate the prevalence of heart failure. The outcomes of this study were prevalence of OSA in patients with heart failure and prevalence of heart failure in patients with OSA. Four databases were used for systematic searching including PubMed, Science Direct, Scopus, and CINAHL Plus. Manual searches for related studies were also conducted. Proportion meta-analyses using a random-effects model were conducted to identify pooled proportion (prevalence) of heart failure in patients with OSA and vice versa. Among 3,941 articles from the four databases met the study criteria. Thirty-three studies showed the prevalence of OSA in patients with heart failure, while thirteen studies presented the prevalence of heart failure in patients with OSA. The prevalence of OSA in patients with heart failure was 38.4% (95% CI 31.9 to 45.2; I2 of 96.1%). Using a diagnostic criterion of OSA of more than 10 events/hr had the highest prevalence of OSA in patients with heart failure at 53.4% (95% CI 42.0 to 64.5). The highest prevalence of OSA in patients with heart failure was 60.1% (95% CI 51.4 to 68.3) in a report from India. The pooled prevalence of heart failure in patients with OSA was 12.8% (95% CI 8.1 to 19.5; I2 of 94.6%). The prevalence in Romania was highest at 22.6% (95% CI 20.4 to 24.9). The pooled prevalence of OSA in patients with heart failure was higher than the pooled prevalence of heart failure in patients with OSA. The pooled prevalence rates of these associations varied among the diagnostic criteria of OSA and countries.
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Affiliation(s)
- Wisarud Prechaporn
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Phasu Hantrakul
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Chetta Ngamjarus
- Department of Epidemiology and Biostatistics, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand
| | | | | | - Sittichai Khamsai
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
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Johnson DA, Prakash-Asrani R, Lewis BD, Bliwise DL, Lewis TT. Racial/ethnic differences in the beneficial effect of social support on sleep duration. J Clin Sleep Med 2023; 19:1231-1238. [PMID: 36866616 PMCID: PMC10315597 DOI: 10.5664/jcsm.10542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 02/23/2023] [Accepted: 02/24/2023] [Indexed: 03/04/2023]
Abstract
STUDY OBJECTIVES Social support (SS) is associated with better health outcomes, including sleep health. However, the specific sources of SS that benefit sleep are unclear, and whether these associations vary by race/ethnicity or age is unknown. The aim of this study was to examine cross-sectional associations between sources of SS (number of friends, financial, church attendance, and emotional support) and self-reported short sleep duration (< 7 hours) overall and by race/ethnic groups and age among a representative sample. METHODS Using National Health and Nutrition Examination Survey (NHANES) data, logistic regression (marginal standardization) and linear regression models were fit accounting for survey design and weights to test associations between sources of SS (number of friends, financial, church attendance, emotional support) and self-reported short sleep duration (< 7 hours) overall and by race/ethnic groups (Black, Hispanic, and White) and age (< 65 vs ≥ 65 years). RESULTS Among 3,711 participants, the mean (standard error) age was 57 (0.3) years and 37% slept < 7 hours. Black adults had the highest prevalence of short sleep (55%). Overall, participants with financial support compared with those without financial support had a lower prevalence of short sleep: 23% (confidence interval [CI]: 0.68, 0.87). As the number of SS sources increased, the prevalence of short sleep duration decreased and the racial disparity in sleep duration narrowed. Associations between financial support and sleep were most pronounced among Hispanic and White adults and adults < 65 years. CONCLUSIONS In general, financial support was associated with a healthier sleep duration, particularly among those < 65 years of age. Individuals with numerous sources of SS were less likely to be short sleepers. The benefits of SS on sleep duration varied by race. Targeting specific sources of SS may help to improve sleep duration among those most at risk. CITATION Johnson DA, Prakash-Asrani R, Lewis BD, Bliwise DL, Lewis TT. Racial/ethnic differences in the beneficial effect of social support on sleep duration. J Clin Sleep Med. 2023;19(7):1231-1238.
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Affiliation(s)
- Dayna A. Johnson
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Radhika Prakash-Asrani
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Billye D. Lewis
- Environmental and Health Sciences, Spelman College, Atlanta, Georgia
| | - Donald L. Bliwise
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia
| | - Tené T. Lewis
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
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Sharma S. Sleep well live well. J Clin Sleep Med 2023; 19:1173-1174. [PMID: 37154388 PMCID: PMC10315596 DOI: 10.5664/jcsm.10654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 05/04/2023] [Indexed: 05/10/2023]
Affiliation(s)
- Sunil Sharma
- West Virginia University, Morgantown, West Virginia
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Cohen SM, Howard JJ, Jin MC, Qian J, Capasso R. Racial Disparities in Surgical Treatment of Obstructive Sleep Apnea. OTO Open 2022; 6:2473974X221088870. [PMID: 35321423 PMCID: PMC8935572 DOI: 10.1177/2473974x221088870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 03/01/2022] [Indexed: 11/23/2022] Open
Abstract
Objective Determine risk factors for failure to receive surgical treatment among patients with obstructive sleep apnea. Study Design Population-based observational longitudinal cohort study. Setting Population-based database. Methods Multivariate analysis of 500,792 individuals with obstructive sleep apnea from Optum's deidentified Clinformatics Data Mart database (2004-2018). Results Black race, increased age, diabetes, atrial fibrillation, obesity, and congestive heart failure were independently associated with a decreased rate of surgery for obstructive sleep apnea. Asian race, hypertension, arrhythmias other than atrial fibrillation, pulmonary disease, and liver disease were independently associated with an increased rate of surgery for obstructive sleep apnea. Conclusion Racial disparities in health outcomes related to health care access and in economic resources have an enormous impact on public health and social equity. We found differences in rates of surgery for obstructive sleep apnea based on race. These data are consistent with others demonstrating disparities in medical treatment of sleep apnea with positive pressure and underline a need for a change in awareness and treatment in these populations.
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Affiliation(s)
- Samuel M. Cohen
- Department of Otolaryngology–Head and Neck Surgery, School of Medicine, Stanford University, Stanford, California, USA
| | - Javier J.M. Howard
- Department of Otolaryngology–Head and Neck Surgery, School of Medicine, Stanford University, Stanford, California, USA
| | - Michael C. Jin
- Department of Otolaryngology–Head and Neck Surgery, School of Medicine, Stanford University, Stanford, California, USA
| | - Jason Qian
- Department of Otolaryngology–Head and Neck Surgery, School of Medicine, Stanford University, Stanford, California, USA
| | - Robson Capasso
- Department of Otolaryngology–Head and Neck Surgery, School of Medicine, Stanford University, Stanford, California, USA
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Hansrivijit P, Puthenpura MM, Ghahramani N, Thongprayoon C, Cheungpasitporn W. Bidirectional association between chronic kidney disease and sleep apnea: a systematic review and meta-analysis. Int Urol Nephrol 2020; 53:1209-1222. [PMID: 33155087 DOI: 10.1007/s11255-020-02699-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 10/27/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Previous data have suggested a link between chronic kidney disease (CKD) and sleep apnea (SA). However, the prevalence and risk association of both disease entities are not uniformly described. METHODS Ovid MEDLINE, EMBASE, and the Cochrane Library were searched for eligible publications that included patients aged ≥ 18 years diagnosed with CKD or SA. Included studies were divided into two cohorts: (1) a cohort of CKD or end-stage kidney disease (ESKD) patients reporting the prevalence of SA or odds ratio (OR) for SA (CKD cohort) and (2) a cohort of SA patients reporting the prevalence of CKD/ESKD or OR for CKD/ESKD (SA cohort). RESULTS CKD cohort: Of 16 studies (n = 340,587), the pooled estimated prevalence of SA among CKD/ESKD patients was 47.5% (95% CI 28.8-66.9). The pooled adjusted OR for SA among CKD/ESKD patients was 1.961 (95% CI 1.702-2.260). Male sex, history of diabetes, and lower BMI were associated with increased prevalence of SA. SA cohort: Of 12 studies (n = 3,103,074), the pooled prevalence of CKD/ESKD among patients with SA was 8.2% (95% CI 4.7-13.7), whereas the pooled adjusted OR for CKD/ESKD among patients with SA was 2.088 (95% CI 1.777-2.452). Increasing age, higher BMI, male sex, white race, and history of diabetes were associated with higher prevalence of CKD/ESKD. CONCLUSION There was a bidirectional association between CKD/ESKD and SA. Interventions aiming to prevent the progression of either CKD or SA are important.
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Affiliation(s)
- Panupong Hansrivijit
- Department of Internal Medicine, University of Pittsburgh Medical Center Pinnacle, 504 S. Front St, Suite 3C, Harrisburg, PA, 17104, USA.
| | - Max M Puthenpura
- Drexel University College of Medicine, Philadelphia, PA, 19129, USA
| | - Nasrollah Ghahramani
- Division of Nephrology, Department of Medicine, Penn State University College of Medicine, Hershey, PA, 17033, USA
| | - Charat Thongprayoon
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, 55905, USA
| | - Wisit Cheungpasitporn
- Division of Nephrology, University of Mississippi Medical Center, Jackson, MS, 39216, USA
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Wang X, Yue Z, Liu Z, Han J, Li J, Zhao Y, Wang F, Tang M, Zhao G. Continuous positive airway pressure effectively ameliorates arrhythmias in patients with obstructive sleep apnea-hypopnea via counteracting the inflammation. Am J Otolaryngol 2020; 41:102655. [PMID: 32799042 DOI: 10.1016/j.amjoto.2020.102655] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 08/02/2020] [Indexed: 11/26/2022]
Abstract
INTRODUCTION This work is aimed at evaluating the therapeutic effect of continuous positive airway pressure (CPAP) in treatment of patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) combined with arrhythmias as well as clarifying the possible mechanism underpinning such an intervention. METHODS Through exclusions, a total of 108 OSAHS patients combined with arrhythmias were enrolled from June 2017 to June 2019 with full clinical information in this work. A computerized permuted block design with varying block stratification and size according to age, sex, AHI and type of arrhythmia was used to randomize 108 patients to CPAP versus sham CPAP for a period of 12-week. All were subjected to unchanged pharmacological anti-arrhythmia therapy combined with CPAP. Before and after CPAP treatment, the improvement of various arrhythmias was compared between the CPAP group and the sham-CPAP group. The levels of CRP, IL-6 and TNF-ɑ were measured simultaneously. RESULTS During follow-up, the mean (±SD) CPAP pressure used in the CPAP group was 12.3 (±3.1) cm H2O. The use of CPAP and sham CPAP was on average of 5.2 ± 0.56 and 5.1 ± 0.63 h/night, respectively. After 12 weeks of CPAP therapy, the AHI was significantly decreased and the lowest blood oxygen saturation was notably elevated in the CPAP group compared to the sham-CPAP group, P < 0.05. The CPAP therapy, compared with the sham-CPAP group, significantly reduced the incidence of all types of arrhythmia in patients with OSAHS. The level of the c-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) was significantly lower in the CPAP group than in the sham-CPAP group (P < 0.05). Pearson correlation analysis showed that the reduction in the incidence of total arrhythmias was positively correlated with the decrease of CRP, IL-6 and TNF-ɑ levels, respectively. CONCLUSION Findings from this work suggest that proper use of CPAP significantly benefits to OSAHS patients combined with arrhythmias, possibly via counteracting the inflammation.
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Kaewkes C, Sawanyawisuth K, Sawunyavisuth B. Are symptoms of obstructive sleep apnoea related to good continuous positive airway pressure compliance? ERJ Open Res 2020; 6:00169-2019. [PMID: 33015148 PMCID: PMC7520172 DOI: 10.1183/23120541.00169-2019] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 03/25/2020] [Indexed: 11/05/2022] Open
Abstract
Obstructive sleep apnoea (OSA) is a common disease that can be treated with continuous positive airway pressure (CPAP). CPAP tolerance may be associated with its compliance. Even though there are several predictors for good CPAP compliance, there are limited data available on the correlation between CPAP compliance and OSA symptoms. This study aimed to evaluate this correlation. We conducted a cross-sectional study and enrolled adult patients diagnosed with OSA through polysomnography who had experience using a CPAP machine. A self-report questionnaire was used to evaluate CPAP compliance and study variables. Predictors of CPAP compliance were analysed using stepwise multivariate logistic regression analysis. There were 68 patients with OSA who completed the questionnaire during the study period. Of those, 14 (20.59%) exhibited good CPAP compliance. Only fatigue as a symptom was an independent factor associated with good CPAP compliance, with an adjusted odds ratio of 5.380 (95% CI 1.274–22.719). In conclusion, fatigue was the only symptom associated with good CPAP compliance in patients with OSA. Fatigue improves CPAP compliance in OSA patientshttps://bit.ly/2R635zR
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Affiliation(s)
- Chaiwat Kaewkes
- Dept of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.,These authors contributed equally
| | - Kittisak Sawanyawisuth
- Dept of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.,These authors contributed equally
| | - Bundit Sawunyavisuth
- Dept of Marketing, Faculty of Business Administration and Accountancy, Khon Kaen University, Khon Kaen, Thailand
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Bates ML, Haack KKV. Everyone must be able to breathe: a plan to support diversity and inclusion in respiratory physiology. Am J Physiol Lung Cell Mol Physiol 2020; 319:L159-L162. [PMID: 32551863 PMCID: PMC7524454 DOI: 10.1152/ajplung.00269.2020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Affiliation(s)
- Melissa L Bates
- Department of Health and Human Physiology, University of Iowa, Iowa City, Iowa.,Department of Internal Medicine, University of Iowa, Iowa City, Iowa.,Stead Family Department of Pediatrics, Holden Comprehensive Cancer Center, University of Iowa, Iowa City, Iowa
| | - Karla K V Haack
- Department of Ecology, Evolution, and Organismal Biology, Kennesaw State University, Kennesaw, Georgia
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