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Abstract Introduction Short sleep duration and obstructive sleep apnea (OSA) are associated with increased rates of cardiovascular disease. Vascular inflammation and endothelial dysfunction are potential mechanisms for this association but can be burdensome or impractical to measure in clinical settings. Other characteristics of sleep health, such as sleep quality, insomnia symptoms, and daytime sleepiness, are infrequently studied in relation to endothelial function. The current study investigated the association between multiple dimensions of sleep health (apnea hypopnea index (AHI), insomnia symptoms, sleep quality, and daytime sleepiness) and endothelial dysfunction using peripheral arterial tonometry (PAT; EndoPAT, Itamar Medical). Methods Participants (N=43) with mild-to-moderate OSA, completed a baseline assessment including demographics, Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), and Epworth Sleepiness Scale (ESS). OSA severity was measured with AHI from one night of PSG (home or in-lab). Microvascular endothelial function was assessed using EndoPAT. The hyperemic response was measured following upper arm occlusion and the reactive hyperemia index (RHI) was calculated. Cross-sectional associations of sleep (ISI, PSQI, ESS, AHI), demographic characteristics (age, sex) and BMI with the natural log of RHI (used due to non-normality) were examined using linear regression models. Results In the study sample, mean (SD) age = 54.4 (12.6) years, 63% were female and 77% identified as Black race. Higher AHI (b = -.015. SE = .01, p =.03) and older age (b = -.01. SE = .003, p =.005) were significantly associated with lower RHI, indicating worse endothelial function. ISI, PSQI, ESS, sex, and BMI were not significantly associated with RHI (p’s.05). Conclusion This study identified an association between OSA severity (higher AHI) and greater endothelial dysfunction, using the novel non-invasive EndoPAT, and null associations with other self-reported sleep characteristics. The study was underpowered to include covariate adjustment or interaction terms, but future studies with larger samples and studies examining potential benefits of OSA treatment on endothelial function are needed. Support (if any) R01HL146059, K24HL143055, K24HL13632. EndoPAT device provided by ZOLL Itimar.
Savin et al. (Sat,) studied this question.