O043 Cardiovascular outcomes are worse in co-morbid respiratory disease & OSA

Introduction Respiratory disease and obstructive sleep apnoea (OSA) are individually associated with increased risk of cardiovascular disease (CVD) and all-cause mortality. People with co-morbid respiratory disease and OSA (co-ROSA) may be at increased cardiovascular risk due to worse night-time hypoxemia which may be exacerbated by disrupted sleep. However, there is a lack of data assessing cardiovascular risk and sleep in co-ROSA. Methods We used an international consumer sample of 321 307 nights of sleep data (Withings Sleep Analysers and Scan Watches) from 2573 people with self-reported doctor diagnosis of respiratory disease (asthma, chronic obstructive pulmonary disease, emphysema) and/or OSA. The odds of self-reported CVD (heart attack, stroke, coronary heart disease, congestive heart failure) and sleep metrics were compared in co-ROSA, respiratory disease or OSA using logistic regression and ANCOVA, respectively (controlled for age, sex, BMI). Results Participants were middle-aged (53.2 ± 13.7yrs, mean ± SD), predominantly male (73.2%), with high BMI (31.1 ± 6.5kg/m2), and normal sleep duration (7.2 ± 1.2hrs). Co-ROSA was associated with 53% increased odds of CVD compared to respiratory disease 95%CI [30, 92], p=.02, but not OSA, OR 66%, 95%CI [42, 105], p=.08. People with co-ROSA had shorter sleep duration, higher variability (rmssd of sleep duration), and poorer sleep efficiency compared to respiratory disease, but there were no differences between co-ROSA and OSA. Discussion CVD is more prevalent in co-ROSA than respiratory disease alone. Overall sleep quality was also poorer in co-ROSA, which could further contribute to CVD risk. Thus, OSA diagnosis should be prioritised in people with respiratory disease to better identify CVD risk.