Objective sleep parameters were significantly associated with next-day symptoms in untreated OSA, with sex-specific effects on the sleep quality index (interaction p < 0.05).
Observational (n=86)
Are prior night's objective sleep parameters associated with next morning symptom presentation in individuals with untreated obstructive sleep apnea?
Objective sleep parameters like sleep efficiency and duration, but not traditional OSA severity surrogates like AHI, are associated with next-day symptom presentation in untreated OSA.
Abstract Introduction Obstructive sleep apnea (OSA) is a heterogeneous disease with complex pathophysiology and varying symptom presentation. Yet, most of what we know about how the disease expresses is based on the results of a single sleep study and symptom questionnaires that summarize individuals’ recent experience with OSA. Here, we leverage multi-night assessments of objective sleep parameters, including disease severity surrogates, and daytime symptom presentation in individuals with OSA. Our primary goal was to assess the association between prior night’s sleep parameters on next morning symptom presentation. We also assess whether this relationship is moderated by sex. Methods Individuals with a pre-existing and untreated OSA (apnea hypopnea index AHI≥5 events/h) were recruited from the community. Participants were invited to wear the SleepImage ring, a device that estimates a series of objective sleep parameters based on cardiopulmonary coupling for 15 consecutive nights, along with responding to semi-structured ecological momentary assessments of daytime symptoms (sleepiness, fatigue, stress, mood and sleep quality), using a scale from 0 to 100. Associations between sleep parameters and next morning symptoms were assessed using linear mixed-effects models controlled for age, body mass index categories and baseline Epworth sleepiness scale score. Models incorporating an interaction term with sex were also evaluated. Results A total of 1,513 nights from 86 participants (52.3% women; mean SD age 54.5 15.5 years; mean SD diagnostic AHI 19.0 18.3 events/h) were included. We observed significant associations between increased prior night sleep efficiency and worse next day sleepiness, fatigue, mood and sleep quality; increased sleep duration and lower stress and improved sleep quality; increased wake after sleep onset (WASO) and worse fatigue and mood; and greater mean pulse rate and worse fatigue, mood, and sleep quality. Sex-specific effects on the association between sleep quality index (SQI) and fatigue and mood were also observed (interaction p 0.05). No associations between OSA severity surrogates (AHI, time below 90% saturation, mean event duration, oxygen saturation index) and next day symptoms were observed. Conclusion Cardiopulmonary coupling estimated sleep parameters such as sleep efficiency, sleep duration (WASO) and mean pulse rate were associated with variations in next morning symptom presentations, with sex-specific effects observed on the SQI. The effect of other surrogates of OSA severity on symptoms remain unclear. This abstract is funded by: NHLBI (1R01HL170675-01; MPI: Jonna L. Morris; Diego R. Mazzotti), University of Pittsburgh School of Nursing Research Catalyst Award; Sleep and Circadian Science Sleep Image System & Sleep Research Society Foundation.
Mazzotti et al. (Fri,) conducted a observational in Obstructive sleep apnea (n=86). SleepImage ring (objective sleep parameters) was evaluated on Association between prior night's sleep parameters and next morning symptom presentation. Objective sleep parameters were significantly associated with next-day symptoms in untreated OSA, with sex-specific effects on the sleep quality index (interaction p < 0.05).