P099 Risk of obstructive sleep apnoea in patients with rheumatic disease: a prospective cohort study

Abstract Background/Aims Sleep plays an important component in our lives and sleep abnormalities have been known to be linked with various rheumatic conditions. Obstructive sleep apnoea (OSA) could potentially affect the severity of rheumatic symptoms such as pain, fatigue and also influence the disease activity. This study aims to evaluate the risk of OSA in patients with rheumatic diseases in an Irish cohort. Methods Patients with a diagnosis of a rheumatic disease were recruited from rheumatology outpatients. These patients were asked to complete the Berlin Sleep Questionnaire (BSQ) to evaluate their level of risk for OSA. The Health Assessment Questionnaire (HAQ), Patient Global Assessment (PtGA) and the Physician Global Assessment (PhGA) were also completed. Results These patients were asked to complete the Berlin Sleep Questionnaire (BSQ) to evaluate their level of risk for OSA. The Health Assessment Questionnaire (HAQ), Patient Global Assessment (PtGA) and the Physician Global Assessment (PhGA) 111 patients were recruited. Mean age was 52 years and 22 (19.8%) were males. The most common diagnosis in our cohort was rheumatoid arthritis 54 (45.4%), followed by spondyloarthritis 12 (10.1%), psoriatic arthritis 11 (9.2%), systemic lupus erythematosus 9 (7.6%), Behçet’s disease 7 (5.9%), scleroderma 6 (5.0%) and others 20 (16.8%); with 8 patients having two diagnoses. Our cohort also completed the HAQ which demonstrated 98 (88.3%) having mild to moderate disability and 13 (11.7%) having moderate to severe disability. 39 out of 111 were noted to have a high risk for OSA based on the BSQ. In the high risk cohort, the mean PtGA score was 46.5 while PhGA score was 30.3, compared to the low risk cohort which was 36.7 for PtGA and 24.9 for PhGA. 33 (84.6%) patients in the high risk cohort had mild to moderate disability and 6 (15.4%) had moderate to severe disability as compared to 64 (88.9%) with mild to moderate disability and 8 (11.1%) with moderate to severe disability in the low risk cohort.were also completed. Conclusion This is the first prospective study in Ireland to evaluate the risk of OSA in patients with rheumatic diseases. 35.1% from our cohort were found to be at high risk for OSA and are due to undergo overnight pulse oximetry and polysomnography to objectively assess the presence or absence of OSA. The disease activity reported by both patient and physician along with the level of disability were greater in the high risk cohort. This suggests that OSA increases the likelihood of exacerbating rheumatic activities. Disclosure W. Ng: None. N. Kamarudin: None. A. Anjum: None. J. Devlin: None. A. O'Brien: None. A. Fraser: None.

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The effect of obstructive sleep apnoea on timing of acute coronary syndrome

European Heart Journal ◽

10.1093/ehjci/ehaa946.1363 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

M.H Muhmad Hamidi ◽

H Sani ◽

M.A Ibrahim ◽

K.S Ibrahim ◽

A.B Md Radzi ◽

...

Keyword(s):

Acute Coronary Syndrome ◽

High Risk ◽

Systolic Function ◽

Strong Association ◽

Multiple Logistic Regression Analysis ◽

Sleep Apnoea ◽

Neck Circumference ◽

Coronary Syndrome ◽

Obstructive Sleep ◽

Significant Difference

Abstract Background and objective Acute coronary syndrome (ACS) remains the principal cause of death in Malaysia. It is estimated about 20% of ACS occurs at nighttime during sleep between 12am to 6am. Factors associated with nocturnal ACS are unknown. Acute nocturnal pathophysiological response to obstructive sleep apnea (OSA) may increase risk of nocturnal ACS. We hypothesized that OSA risk is associated with timing of ACS onset. Methodology This study included 200 patients with ACS who underwent coronary angiogram for which the time of chest pain onset was clearly identified and divided into 2 groups; nocturnal ACS (12am-5.59am) and non-nocturnal ACS (6am–11.59pm). Two validated questionnaires, STOP-BANG and Epworth Sleepiness Scale (ESS) were self-administered by subjects to determine OSA risk. All subjects timing of ACS onset, OSA risk, demography, anthropometric measurements, comorbidities and echocardiographic characteristics were analyzed. Results Acute coronary syndrome occurs nocturnally in 19% of ACS patients. The prevalence of high risk OSA individuals among ACS patients is 43%. There is significantly higher prevalence of high risk OSA individuals in nocturnal ACS group of 95% compared to 30% of high risk OSA individuals in non-nocturnal ACS group (p=0.001). Nocturnal ACS patients was significantly younger (50.1±8.7yrs, p=0.001), had higher BMI (33.9±4.3kg/m2, p=0.005), waist circumference (106.7±10.3cm, p=0.003) and larger neck circumference (44.6±3.3cm, p=0.001) compared to non-nocturnal ACS group. These groups had similar prevalence of other comorbidities for ACS and showed no significant difference between left and right ventricular systolic function. In multiple logistic regression analysis, the most significant predictors for nocturnal ACS are OSA risk, neck circumference and age. Conclusion There is a strong association between high risk OSA individuals and nocturnal ACS onset. Patient with nocturnal ACS onset should be screened for OSA and prioritized for polysomnography. OSA prevalence according to ACS onset Funding Acknowledgement Type of funding source: None

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POS0574 RELATIONSHIP BETWEEN INVOLVED JOINT FOR REGION AND MODIFIED HEALTH ASSESSMENT QUESTIONNAIRE SCORE IN JAPANESE PATIENT WITH RHEUMATOID ARTHRITIS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.3644 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 521.2-521

Author(s):

I. Yoshii

Keyword(s):

Health Assessment Questionnaire ◽

Global Assessment ◽

Disease Duration ◽

Health Assessment ◽

Lower Extremities ◽

Upper Extremities ◽

Whole Body ◽

Large Joint ◽

Small Joint ◽

Assessment Questionnaire

Objectives:Rheumatoid arthritis (RA) is a chronic inflammatory disease that involves various joints in whole body. For evaluation of daily life activities (ADL), modified Health Assessment Questionnaire (mHAQ) is usually used. This index configures eight ADL functions these are separated by predominant extremities. This study aimed to evaluate how involved joint affect ADL predominantly in real world setting.Methods:A total of 24,450 times of consultation with RA patient were visited in the institute. Here, patient with RA was interviewed every another visit, and involved joint in whole body, pain score with visual analog scale (PS-VAS), and mHAQ were recorded. Involved joints were divided by four regions in accordance with joint size and part; small joint in upper extremities (US), large joint in upper extremities (UL), small joint in lower extremities (LS), and large joint in lower extremities (LL). mHAQ was also separately evaluated in accordance with predominant regions; upper extremities predominant mHAQ (mHAQ_UE), and lower extremities predominant mHAQ (mHAQ_LE). Adding to these parameters, as an index for disease activity monitoring, components of the simplified disease activity index score (SDAI) was also recorded. Relationship between mHAQ for each predominant extremities, and these parameters and sex, age, disease duration of RA, anti-cyclic citrullinated polypeptide antibodies (ACPA), rheumatoid factor (RF), and Sharp/van der Heijde score (SHS), were statistically evaluated using linear regression analysis.Results:mHAQ_UE significantly correlated with age, ACPA and RF titre, SHS, tenderness joint count (TJC), patient’s global assessment (PGA), evaluator’s global assessment (EGA), C-reactive protein (CRP), US, UL, LL, and PS-vas, whereas mHAQ-LE significantly correlated with all parameters that demonstrated significant correlation with mHAQ-UE and disease duration. mHAQ also correlated with all parameters those that demonstrated significant correlation with mHAQ-LE. Interestingly, all of mHAQ-UE, mHAQ-LE, and mHAQ did not correlated significantly with swollen joint count (SJC) and LS.Conclusion:mHAQ is influenced by various factors, however, SJC and involvement of small joint in lower extremities did not affect mHAQ.Disclosure of Interests:None declared

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High Risk Characteristics for Recurrent Cardiovascular Events among Patients with Obstructive Sleep Apnoea in the SAVE Study

EClinicalMedicine ◽

10.1016/j.eclinm.2018.09.002 ◽

2018 ◽

Vol 2-3 ◽

pp. 59-65 ◽

Cited By ~ 11

Author(s):

Weiwei Quan ◽

Danni Zheng ◽

R. Douglas McEvoy ◽

Ferran Barbe ◽

Riu Chen ◽

...

Keyword(s):

High Risk ◽

Obstructive Sleep Apnoea ◽

Cardiovascular Events ◽

Sleep Apnoea ◽

Risk Characteristics ◽

Obstructive Sleep

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The prevalence of high risk obstructive sleep apnoea among patients with type 2 diabetes in Jordan

Diabetes Research and Clinical Practice ◽

10.1016/j.diabres.2019.04.035 ◽

2019 ◽

Vol 152 ◽

pp. 16-22 ◽

Cited By ~ 3

Author(s):

Ahmad M.J. Saad ◽

Dana Hiyasat ◽

Hashem Jaddou ◽

Nathir Obeidat

Keyword(s):

Type 2 Diabetes ◽

High Risk ◽

Obstructive Sleep Apnoea ◽

Sleep Apnoea ◽

Obstructive Sleep

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Identifying patients at high risk for obstructive sleep apnoea syndrome in Nigeria: A multicentre observational study

Malawi Medical Journal ◽

10.4314/mmj.v29i2.20 ◽

2017 ◽

Vol 29 (2) ◽

pp. 183 ◽

Cited By ~ 4

Author(s):

Olufemi O. Desalu ◽

Cajetan C. Onyedum ◽

Adekunle O. Adeoti ◽

Joseph O. Fadare ◽

Emmanuel O. Sanya ◽

...

Keyword(s):

High Risk ◽

Observational Study ◽

Obstructive Sleep Apnoea ◽

Sleep Apnoea ◽

Obstructive Sleep Apnoea Syndrome ◽

Sleep Apnoea Syndrome ◽

Obstructive Sleep

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Effectiveness of a 12-week physical exercise programme on blood pressure in adults with true resistant hypertension and high risk of obstructive sleep apnoea: a study protocol for a pre-post test non randomised clinical trial

International Journal of Clinical Trials ◽

10.18203/2349-3259.ijct20201717 ◽

2020 ◽

Vol 7 (2) ◽

pp. 112

Author(s):

Suranga Dassanayake ◽

Gerard Wilkins ◽

Gisela Sole ◽

Margot Skinner

Keyword(s):

Physical Activity ◽

Blood Pressure ◽

High Risk ◽

Obstructive Sleep Apnoea ◽

Resistant Hypertension ◽

Randomised Clinical Trial ◽

Exercise Programme ◽

Primary Outcome Measure ◽

Sleep Apnoea ◽

Obstructive Sleep

Background: Resistant hypertension, a special phenotype of hypertension, is associated with increased cardiovascular risk. Exercise and physical activity are recommended as non-pharmacological interventions to manage blood pressure in hypertension. Little is known about the effectiveness of exercise in resistant hypertension. A bidirectional relationship has been identified between resistant hypertension and obstructive sleep apnoea but the literature pertaining to the benefit of exercise for populations with both conditions, is minimal. This study aims to identify the effectiveness of exercise in reducing blood pressure in a cohort of adults with resistant hypertension and high risk of obstructive sleep apnoea.Methods: Dunedin based adults with resistant hypertension and high risk of obstructive sleep apnoea will be recruited from the community and health centres to participate in the study. Consenting volunteers (no. of fourteen) will participate in a 12-week exercise programme including aerobic and strength training. The primary outcome measure will be 24h ambulatory blood pressure while the secondary outcomes will be anthropometrics, activity parameters, sleep parameters, cardiac structure and function, and quality of life. The measurements at the end of the 12-week exercise programme will be compared with baseline to determine the effectiveness of exercise in reducing blood pressure in the cohort with resistant hypertension and risk of obstructive sleep apnoea.Conclusions: Exercise and physical activity are recommended to manage hypertension. Therefore, it is anticipated that the exercise programme will have a positive effect on the blood pressure of the participants. The findings have potential to change the direction of research in the area by filling the knowledge gaps.Trial Registration: The Ministry of Health, New Zealand (Ethics Ref: 18/CEN/257), Trial registry: ACTRN12618001881224p).

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O021 Preferred attributes of care pathways for obstructive sleep apnoea from the perspective of diagnosed patients and high-risk individuals: a discrete choice experiment

SLEEP Advances ◽

10.1093/sleepadvances/zpab014.020 ◽

2021 ◽

Vol 2 (Supplement_1) ◽

pp. A10-A10

Author(s):

A Natsky ◽

A Vakulin ◽

C Chai Coetzer ◽

R Adams ◽

R McEvoy ◽

...

Keyword(s):

High Risk ◽

Discrete Choice ◽

Obstructive Sleep Apnoea ◽

Choice Experiment ◽

Sleep Apnoea ◽

Care Pathways ◽

Sleep Study ◽

Obstructive Sleep ◽

Ongoing Care

Abstract Background The current health care system is challenged with a large and rising demand for obstructive sleep apnoea (OSA) services. A paradigm shift in OSA management is required to incorporate the preferences of diagnosed patients and individuals at high-risk of OSA. This study aimed to provide empirical evidence of the values and preferences of individuals diagnosed with OSA and high-risk populations regarding distinct OSA care pathway features. Methods A discrete choice experiment (DCE) was undertaken in two groups: those with a formal diagnosis of OSA (n=421) and those undiagnosed but at high-risk of having OSA (n=1033). The DCE approach used mixed logit regression models to determine preferences relating to eight salient features of OSA management pathway, i.e. initial assessment, setting and diagnosis costs, waiting times, results interpretation, treatment options, provider of ongoing care and frequency of follow up visits. Results The findings indicate that all eight attributes investigated were statistically significant factors for respondents. Generally, both groups preferred low diagnostic costs, fewer follow-up visits, minimum waiting time for sleep study results, and sleep specialists to recommend treatment and as ongoing care providers. Management of OSA in primary care was acceptable to both groups and was the most preferred option by the high-risk group for sleep study testing and ongoing care provision. Discussion The DCE results offer a promising approach for systematic incorporation of patient and high-risk groups preferences into the future design and delivery of care pathways for OSA management.

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