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    The Association Between Obstructive Sleep Apnea Defined by 3 Percent Oxygen Desaturation or Arousal Definition and Self-Reported Cardiovascular Disease in the Sleep Heart Health Study

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    Author
    Quan, Stuart F
    Budhiraja, Rohit
    Javaheri, Sogol
    Parthasarathy, Sairem
    Berry, Richard B
    Affiliation
    Asthma and Airways Research Center
    Issue Date
    2020-10
    
    Metadata
    Show full item record
    Publisher
    Arizona Thoracic Society
    Citation
    Quan SF, Budhiraja R, Javaheri S, Parthasarathy S, Berry RB. The Association Between Obstructive Sleep Apnea Defined by 3 Percent Oxygen Desaturation or Arousal Definition and Self-Reported Cardiovascular Disease in the Sleep Heart Health Study. Southwest J Pulm Crit Care. 2020;21(4):86-103. doi: https://doi.org/10.13175/swjpcc054-20
    Journal
    Southwest Journal of Pulmonary and Critical Care
    Rights
    Copyright © The Author(s). The Southwest Journal of Pulmonary and Critical Care is an open access journal and makes no claim to the copyright of your article, data, or other work.
    Collection Information
    This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at repository@u.library.arizona.edu.
    Abstract
    Background: Studies have established that OSA defined using a hypopnea definition requiring a >4% oxygen desaturation (AHI4%) is associated with cardiovascular (CVD) or coronary heart (CHD) disease. This study determined whether OSA defined using a hypopnea definition characterized by a >3% oxygen desaturation or an arousal (AHI3%A) is associated with CVD/CHD. Methods: Data were analyzed from 6307 Sleep Heart Health Study participants who had polysomnography. Self-reported CVD included angina, heart attack, heart failure, stroke or previous coronary bypass surgery or angioplasty. Self-reported CHD included the aforementioned conditions but not stroke or heart failure. The association between OSA and CVD/CHD was examined using logistic regression models with stepwise inclusion of demographic, anthropometric, social/behavioral and co-morbid medical conditions. A parsimonious model in which diabetes and hypertension were excluded because of their potential to be on the causal pathway between OSA and CVD/CHD also was constructed. Results: For CVD, the odds ratios and 95% confidence intervals for AHI3%A >30/hour were 1.39 (1.03-1.87) and 1.45 (1.09-1.94) in the fully adjusted and parsimonious models. Results for CHD were 1.29 (0.96-1.74) and 1.36 (0.99-1.85). In participants without OSA according to more stringent AHI4% criteria but with OSA using the AHI3%A definition, similar findings were observed. Conclusion: OSA defined using an AHI3%A is associated with both CVD and CHD. Use of a more restrictive AHI4% definition will misidentify a large number of individuals with OSA who have CVD or CHD. These individuals may be denied access to therapy, potentially worsening their underlying CVD or CHD.
    Note
    Open access journal
    ISSN
    2160-6773
    EISSN
    2160-6773
    DOI
    10.13175/swjpcc054-20
    Version
    Final published version
    Additional Links
    https://www.swjpcc.com/sleep/2020/10/19/the-association-between-obstructive-sleep-apnea-defined-by-3.html
    ae974a485f413a2113503eed53cd6c53
    10.13175/swjpcc054-20
    Scopus Count
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    UA Faculty Publications

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