Examining the relationship between obstructive sleep apnea, pulmonary abnormalities, and cardiovascular disease
Year: 2014
Type: dissertation
Study design: Observational Study
Abstract: Obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD) or Overlap syndrome has been shown to occur anywhere between 1-40% in population and clinic studies. Subjects with overlap syndrome are at increased risk of cardiovascular disease mortality than subjects with either condition alone. It has been hypothesized that hypoxic induced inflammation occurs in both conditions however research is limited as to the relationship between OSA and subclinical cardiovascular disease and the affect COPD has on this relationship. Several studies have looked at the association between OSA and COPD with conflicting results. A limitation to this research is defining COPD strictly by pulmonary function. Additionally there is inadequate research evaluating the relationship between OSA and subclinical atherosclerosis specifically examining the influence of various pulmonary abnormalities. The overall goal of the proposed research is to explore the pathway between OSA and subclinical atherosclerosis with measures of calcification from coronary and thoracic arteries and determine if these relationships are altered by pulmonary abnormalities. In addition, we evaluated the validity of self-reported OSA and the utility of Berlin sleep questionnaire in a COPD population. Multivariable regression analyses were utilized to evaluate these relationships. OSA was found to not be related to pulmonary function reduction (GOLD stages 2-4) or Emphysema however, there was a significant relationship with chronic bronchitis. In evaluating the association of OSA with calcification measures, we found a significant upward trend of prevalent OSA by increased severity of CAC (p<0.05) and there was an independent relationship between OSA and CAC independent of functional reduction and emphysema in adjusted models. Examining the differences in re-saturation time we found that subjects with OSA and Emphysema had significantly greater re-saturation time than subjects with OSA alone. When evaluating all relationships using self-reported OSA, the results were ameliorated. It was also determined that the Berlin sleep questionnaire does not accurately identify OSA in a COPD population. These are the first studies to fully examine the relationships between OSA and pulmonary abnormalities and further evaluate the influence these abnormalities have on subclinical atherosclerosis.
DOI: 10.25677/mecx-jh54
Author: Black-Shinn, Jennifer Louise
Language: English
Subfield: Physiology (medical)
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2889005174