scholarly journals Obstructive Sleep Apnea as a Risk Factor for Intracerebral Hemorrhage

Stroke ◽  
2021 ◽  
Author(s):  
Jacqueline H. Geer ◽  
Guido J. Falcone ◽  
Kevin N. Vanent ◽  
Audrey C. Leasure ◽  
Daniel Woo ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Logistic Regression ◽  
Risk Factor ◽  
Sleep Apnea ◽  
Intracerebral Hemorrhage ◽  
Odds Ratio ◽  
Berlin Questionnaire ◽  
Multivariable Logistic Regression Model ◽  
Obstructive Sleep ◽  
Increased Risk

Background and Purpose: To determine whether obstructive sleep apnea (OSA) is associated with intracerebral hemorrhage (ICH) risk, we assessed premorbid OSA exposure of patients with nontraumatic ICH and matched controls. Methods: Ethnic/Racial Variations of Intracerebral Hemorrhage is a multicenter, case-control study evaluating risk factors for ICH that recruited 3000 cases with ICH and 3000 controls. OSA status was ascertained using the Berlin Questionnaire as a surrogate for premorbid OSA. We performed logistic regression analyses to evaluate the association between OSA and ICH. Results: Two thousand and sixty-four (71%) cases and 1516 (52%) controls were classified as having OSA by the Berlin Questionnaire. Cases with OSA were significantly more likely to be male and have hypertension, heart disease, hyperlipidemia, and higher body mass index compared with those without OSA. OSA was more common among cases compared with controls (71% versus 52%, odds ratio, 2.28 [95% CI, 2.05–2.55]). In a multivariable logistic regression model, OSA was associated with increased risk for ICH (odds ratio, 1.47 [95% CI, 1.29–1.67]). Conclusions: OSA is a risk factor for ICH.

Abstract P246: Obstructive Sleep Apnea and Particulate Matter Exposure

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Mary Ann McLaughlin ◽  
Rupa L Iyengar ◽  
Jessica Janneck ◽  
Heather N Beebe ◽  
Sarah Sanghavi ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Logistic Regression ◽  
Particulate Matter ◽  
Sleep Apnea ◽  
High Risk ◽  
World Trade Center ◽  
Upper Airway ◽  
Binary Logistic Regression ◽  
Berlin Questionnaire ◽  
Obstructive Sleep

Background: Recent studies have found a high prevalence of obstructive sleep apnea (OSA) among responders of the World Trade Center (WTC) disaster. Exposure to particulate matter (PM) causing upper airway inflammation is considered a significant contributing factor in the pathogenesis of OSA. The Berlin Questionnaire (BQ) is a widely used questionnaire to screen for OSA with published sensitivity up to 86% and specificity of 87% for OSA risk. We aim to investigate whether a relationship exists between OSA risk using the BQ and exposure to PM using the Wisnevsky exposure score. Methodology: We evaluated 808 participants in the WTC-CHEST Program from January 2011 to September 2013. High risk for OSA was identified as 2 or more positive categories in the BQ. The subjects were categorized into four exposure groups: very high, high, intermediate and low (Wisnevsky exposure score). Chi-square and Binary Logistic Regression analyses were performed to determine if there was a significant relationship between OSA risk and PM exposure. Results: High risk for OSA is associated with PM exposure in the study population (p=0.002). Using a binary logistic regression adjusting for gender and age, high risk for OSA was still found to be significantly associated with PM exposure (p = 0.022). Conclusion: Prior investigations have demonstrated a link between PM exposure and pulmonary disease, digestive disorders and PTSD. These results provide strong evidence for the association of PM exposure and OSA. In fact, PM exposure in this cohort of WTC first responders is one of the most significant contributors to increased OSA risk. Assessment of both OSA risk and exposure to PM are important as both have been linked to an increase in cardiovascular risk.

Abstract MP63: Childhood-onset Obstructive Sleep Apnea Is Associated With Increased Risk Of Adolescent Hypertension

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Julio Fernandez-Mendoza ◽  
Fan He ◽  
Susan Calhoun ◽  
Alexandros Vgontzas ◽  
Duanping Liao ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Obstructive Sleep Apnea ◽  
Risk Factor ◽  
Sleep Apnea ◽  
Apnea Hypopnea Index ◽  
Childhood Onset ◽  
Obstructive Sleep ◽  
Increased Risk ◽  
Transition To Adolescence

Introduction: Obstructive sleep apnea (OSA) is an established risk factor for hypertension in adults. However, the association of childhood OSA with an increased risk of hypertension has remained elusive. Hypothesis: Childhood-onset OSA is longitudinally associated with hypertension in adolescence. Methods: We tested this hypothesis in a population-based sample of 421 children (5-12 years) from the Penn State Child Cohort who were followed-up 6-13 years later as adolescents (12-23 years). In-lab polysomnography, to ascertain the apnea/hypopnea index (AHI), and seated blood pressure were assessed at baseline and at follow-up. The presence of hypertension at follow-up was defined based on pediatric criteria dependent upon the subject’s age (below and above 13 years). Logistic regression analyses adjusted for sex, race/ethnicity, age, body mass index percentile and systolic blood pressure percentile at baseline. Results: Childhood OSA that persisted in the transition to adolescence was associated with 2.9-fold (95%CI=1.1-7.4) higher odds of adolescent hypertension. In contrast, childhood OSA that remitted in the transition to adolescence was not associated with increased odds of adolescent hypertension (OR=0.9, 95%CI=0.3-2.6). Adolescent-onset OSA was associated with 1.7-fold (95%CI=1.1-2.9) increased odds of adolescent hypertension. Conclusions: Childhood-onset persistent OSA is a risk factor for hypertension in adolescence. Remission of childhood OSA during this transitional period, which previous research has shown to be highly determined by weight loss, does not confer a significant risk of adolescent hypertension. Early life chronic adverse sleep exposures predict cardiovascular risk in adolescence, a critical developmental period.

Abstract TP209: Time Of Stroke Onset Is Not Associated With Risk Of Obstructive Sleep Apnea In Intracerebral Hemorrhage.

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Jennifer Rose V Molano ◽  
Sebastian Koch ◽  
Carl Langefeld ◽  
Daniel Woo
Keyword(s):  
Blood Pressure ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
High Risk ◽  
Intracerebral Hemorrhage ◽  
Stroke Onset ◽  
Berlin Questionnaire ◽  
Risk Status ◽  
Nocturnal Blood Pressure ◽  
Obstructive Sleep

Objective: To test the hypothesis that risk status for obstructive sleep apnea (OSA) is associated with time of onset in intracerebral hemorrhage. Background: OSA can affect 30-70% of patients with ischemic strokes, intracerebral hemorrhage and transient ischemic attacks. In normal sleep, blood pressure and heart rate decrease due to increased parasympathetic activity. In OSA, increased sympathetic activity during sleep can lead to a absence of this blood pressure fall. This non-dipping nocturnal blood pressure pattern has been associated with a shift in the timing of sudden cardiac death, from 7am-noon in those without OSA to 12am-6am in those with OSA. Whether this diurnal shift exists in intracerebral hemorrhage cases at high risk for OSA has not been studied. Method: A nested case control study within the interviewed case cohort from the Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) study was performed. OSA risk status was categorized as “high-risk” based on a positive score in 2 out of 3 categories on the Berlin questionnaire, which ascertains snoring, daytime fatigue, body mass index and hypertension. Timing of intracerebral hemorrhage was categorized as “Nocturnal” based on a known time of stroke onset from 22:00pm to 06:00am and “Awake” based on a known time of stroke onset from 06:01am to 21:59pm. Results: Time of stroke onset was known in 434 subjects. The Berlin questionnaire categorized 54.2% of cases as high-risk for OSA. In comparison with low-risk subjects, high-risk cases tended to be younger (59.1±13.7 vs. 61.8±15.7, p=0.05), male (48% vs 58%, p=0.03), have coronary disease (6% vs 11%, p=0.09), have diabetes (27% vs 18%, p=0.02), and have dyslipidemia (43% vs 30%, p=0.006). There were no ethnic differences in the prevalence of high risk for OSA (P=0.60). Nocturnal strokes were seen in 17% of high- and low-risk OSA cases. There was no statistically significant difference in OSA status and timing of stroke (p=0.98). Conclusions: OSA risk status was not associated with timing of hemorrhagic stroke. This finding suggests that a non-dipping nocturnal blood pressure pattern is not seen in intracerebral hemorrhage cases at high-risk for OSA.

scholarly journals The Prevalence of High Risk of Obstructive Sleep Apnea and its Association with Sociodemographic Factors among Adults in Taman Dato' Rashid Salleh, Indera Mahkota, Kuantan

2020 ◽  
Vol 18 (2) ◽  
Author(s):  
Rawahah Husna Ramli ◽  
Artika Hassan ◽  
Jamalludin Abd Rahman ◽  
Razman Mohd Rus ◽  
Hafizah Pasi ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
High Risk ◽  
Demographic Data ◽  
Adult Population ◽  
Neck Circumference ◽  
P Value ◽  
Berlin Questionnaire ◽  
Obstructive Sleep ◽  
Increased Risk

Introduction: Obstructive sleep apnea (OSA) is an insidious sleep breathing disorder, with cardinal manifestations of snoring, witnessed breathing pause during sleep and excessive daytime sleepiness. The aim of the study was to estimate the prevalence of OSA and its associated factors among adult population in Taman Dato’ Rashid Salleh, Kuantan. Materials and  method: A cross-sectional study was carried out among 157 participants who lived in Taman Dato’ Rashid Salleh from May 2018 to June 2018. Obstructive sleep apnea was quantified using the self-administered Malaynvalidated Berlin questionnaire which apart from the demographic data included three categories (10 questions) designed to elicit information regarding snoring (category 1), daytime somnolence (category 2) and the presence of obesity and/or hypertension (category 3). The respondents were considered as high risk of OSA if two or more categories were positive. Weight, height and neck circumference were measured by using Secca© weight scales, Secca© stadiometer and non-elastic plastic tape, respectively. Descriptive statistics was used to measure the prevalence, while chi-square test was used to explore the association of OSA and its background variables. Results: Out of 157 respondents, female and Malay were dominant with the 56.7% and 91.0 %, respectively. The mean age of the respondents was 36.7 (12.2) years old. The prevalence of high risk of OSA in was 18.5%. There was no association between gender, age, race, smoking and neck circumference with risk of OSA while Body Mass Index (BMI) and hypertension were significantly related to an increased risk for developing OSA (p-value < 0.001 and p=0.001, respectively).  Conclusions: Two in every 10 adults in Taman Dato’ Rashid Salleh, Kuantan were at high risk of OSA. It is recommended that appropriate health promotion should be targeted to this community to instill awareness and increase the level of understanding of the public on OSA.

Abstract TP347: Obstructive Sleep Apnea Frequency in Intracerebral Hemorrhage

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Jacqueline H Geer ◽  
Audrey C Leasure ◽  
Kevin N Vanent ◽  
Lauren H Sansing ◽  
Daniel Woo ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Ischemic Stroke ◽  
Sleep Apnea ◽  
High Risk ◽  
Intracerebral Hemorrhage ◽  
Berlin Questionnaire ◽  
Established Risk Factor ◽  
Obstructive Sleep ◽  
History Of

Introduction: Obstructive sleep apnea (OSA) is a treatable condition and well-established risk factor for ischemic stroke, but the prevalence in ICH is unknown. We aim to characterize the frequency of OSA in spontaneous intracerebral hemorrhage (ICH). Methods: The Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) study is a prospective observational study evaluating risk factors for ICH among whites, blacks, and Hispanics. OSA status was determined using two different strategies: (1) the Berlin Questionnaire, a validated screening tool to identify those with a high likelihood of OSA where “high risk” is defined as > 1 point in at least 2 of 3 categories assessing snoring, fatigue, and hypertension, and (2) self-reported history of diagnosed sleep apnea. Results: We evaluated 3000 ICH cases. Within this group, 2896 (96.5%) completed the Berlin questionnaire, with 2064 (71%) patients being high risk for OSA. Compared to patients with low risk of OSA, those at high risk were more likely to be male (61% versus 53%, p<0.001) with hypertension (93% versus 65%, p<0.001), diabetes (32% versus 20%, p<0.001), hyperlipidemia (49% versus 38%, p<0.001), and higher BMI (29.8 +/- 8.1 versus 26.8 +/- 6.5, p<0.001), and less likely to have lobar ICH location (29% versus 35%, p<0.001). Self-reported history of prior sleep apnea diagnosis was present in only 175 (9.5%) of ICH cases. Conclusions: OSA is highly prevalent and underdiagnosed in our cohort of ICH patients. Given the effective treatments available for OSA, which have been shown to improve morbidity and mortality in patients with ischemic stroke, further studies are needed to assess the role of OSA as both a determinant of both risk and outcome in ICH.

scholarly journals Tae-Eum Type as an Independent Risk Factor for Obstructive Sleep Apnea

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Seung Ku Lee ◽  
Dae Wui Yoon ◽  
Hyeryeon Yi ◽  
Si Woo Lee ◽  
Jong Yeol Kim ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Risk Factor ◽  
Sleep Apnea ◽  
Independent Risk Factor ◽  
Population Based ◽  
Apnea Hypopnea Index ◽  
Sasang Constitution ◽  
Obstructive Sleep ◽  
Increased Risk ◽  
Constitution Type

Obstructive sleep apnea (OSA) is prevalent and associated with several kinds of chronic diseases. There has been evidence that a specific type of Sasang constitution is a risk factor for metabolic and cardiovascular diseases that can be found in patients with OSA, but there are no studies that address the association between the Sasang constitution type (SCT) and OSA. The purpose of this study was to investigate the association between the SCT and OSA. A total of 652 participants were included. All participants were examined for demographic information, medical history, and completed an interviewer-administered questionnaire on life style and sleep-related variables. Biochemical analyses were performed to determine the glucose and lipid profiles. An objective recording of OSA was done with an unattended home PSG using an Embla portable device. The apnea-hypopnea index (AHI) and oxygen desaturation index (ODI) were significantly higher in the Tae-eum (TE) type as compared to the So-eum (SE) and the So-yang (SY) types. Even after adjusting for confounding variables, the TE type still had a 2.34-fold (95% CI, 1.11–4.94;P=0.0262) increased risk for OSA. This population-based cohort study found that the TE constitutional type is an independent risk factor for the development of OSA.

scholarly journals Obstructive sleep apnea, detected by the Berlin Questionnaire: an associated risk factor for coronary artery disease

2012 ◽  
Vol 28 (8) ◽  
pp. 1530-1538 ◽  
Author(s):  
Daniela Massierer ◽  
Denis Martinez ◽  
Sandra Costa Fuchs ◽  
Paulo P. Pellin ◽  
Márcio S. Garcia ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Obstructive Sleep Apnea ◽  
Risk Factor ◽  
Coronary Artery ◽  
Sleep Apnea ◽  
Population Based ◽  
Berlin Questionnaire ◽  
Obstructive Sleep ◽  
Coronary Lesions ◽  
Artery Disease

Obstructive sleep apnea (OSA), a risk factor for coronary artery disease, remains under diagnosed. We investigated if OSA identified by the Berlin Questionnaire (BQ) is associated with the risk of coronary artery disease. Cases were patients referred for elective coronariography. The cases were classified with significant coronary lesions (stenosis > 50% in an epicardial coronary) or without significant coronary lesions. Controls were selected from a population-based sample. Positive BQ results were identified in 135 (41.2%) of 328 cases, in contrast with 151 (34.4%) of 439 control subjects (p = 0.03). In a multinomial logistic analysis, the risk for OSA identified by the BQ was independently associated with coronary artery disease in cases with lesions of at least 50% (OR = 1.53; 95%CI: 1.02-2.30; p = 0.04). The risk from OSA identified by the BQ was higher in younger subjects (40-59 years) (OR = 1.76; 95%CI: 1.05-2.97; p = 0.03) and in women (OR = 3.56; 95%CI: 1.64-7.72; p = 0.001). In conclusion, OSA identified by the BQ greatly increases the risks of coronary artery disease in patients having significant coronary artery lesions indicated by anangiogram, particularly in younger individuals and in women.

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