Severe obstructive sleep apnea during REM sleep was associated with an increased 10-year cardiovascular disease risk compared to mild or no OSA (OR 1.716; 95% CI 1.213-2.427).
Cohort (n=4,152)
Does severe obstructive sleep apnea during REM sleep increase the risk of cardiovascular disease and cardiac autonomic dysfunction?
Severe obstructive sleep apnea during REM sleep is independently associated with increased 10-year cardiovascular disease risk, potentially mediated by cardiac autonomic dysfunction.
Effect estimate: OR 1.716 (95% CI 1.213-2.427)
Summary In our large‐scale study, the correlation between obstructive sleep apnea (OSA) related to rapid eye movement (REM) sleep and cardiac autonomic dysfunction was assessed by standard polysomnography (PSG). Cardiac autonomic dysfunction was evaluated by the measurement of heart rate variability (HRV). The cardiovascular disease (CVD) risk was determined using the cross‐sectional prevalence of CVD and its overall 10 year risk according to the Framingham risk score (FRS). 4152 individuals were included in the study. A higher apnea–hypopnea index during REM sleep (AHI REM ) was correlated with increased CVD risk. The adjusted odds ratios (95% CIs) for CVD prevalence and its high 10 year risk in participants having severe OSA during REM sleep (AHI REM ≥30 events/h) were 1.452 (1.012–2.084) and 1.904 (1.470–2.466) in the demographic adjusted model and 1.175 (0.810–1.704) and 1.716 (1.213–2.427) in the multivariate adjusted model, respectively, compared with the group with a AHI REM of <5 events/h. Fully adjusted multivariate linear regression models showed the independent association between AHI REM and a more elevated ratio of low‐frequency and high‐frequency (LF/HF) and LF in normalised units LF (n.u.) ( P = 0.042, P = 0.027 in all participants and P = 0.033, P = 0.029 in participants with AHI during non‐REM sleep <5 events/h, respectively). Mediation analysis demonstrated that OSA during REM sleep and CVD risk was significantly mediated by LF/HF and LF (n.u.). OSA during REM sleep may be a marker behind CVD risk because it promotes cardiac autonomic dysfunction.
Huang et al. (Tue,) conducted a cohort in Obstructive sleep apnea during rapid eye movement sleep (n=4,152). Severe OSA during REM sleep (AHI REM ≥30 events/h) vs. AHI REM <5 events/h was evaluated on High 10-year cardiovascular disease risk according to the Framingham risk score (OR 1.716, 95% CI 1.213-2.427). Severe obstructive sleep apnea during REM sleep was associated with an increased 10-year cardiovascular disease risk compared to mild or no OSA (OR 1.716; 95% CI 1.213-2.427).