Dataset Information

Prevalence and Risk Factors of Sleep Disordered Breathing in Fabry disease: A Prospective Cohort Study.

ABSTRACT: Excessive daytime sleepiness (EDS) is a frequently reported and not well-understood symptom in patients with Fabry disease (FD). Sleep-disordered breathing (SDB) is a possible factor. As deposition of glycosphingolipids in the upper airway muscles is likely, we hypothesized that obstructive sleep apnoea (OSA) is highly prevalent in FD and positively associated with its severity.All patients with FD who are followed in the Fabry cohort of the University Hospital Zurich (n?=?62) were asked to participate in this prospective cohort study. Eligible patients were prospectively investigated by assessing their daytime sleepiness using the Epworth Sleepiness Scale (ESS), the severity of FD using the Mainz Severity Score Index (MSSI), and by an ambulatory overnight respiratory polygraphy between November 1, 2013, and January 31, 2015. SDB was defined as an apnea/hypopnea index (AHI) of?>?5/h.Fifty-two patients (mean?±?SD age 42.8?±?14.7 years, 33% men, mean?±?SD BMI 23.4?±?3.6?kg/m) with a median (IQR) MSSI of 12 (5-19) were included. Median (IQR) ESS was 6 (2-10) and 7 patients (14%) had an ESS?>?10. Thirteen patients (25%) had SDB (78% obstructive sleep apnea, 22% central sleep apnea). In the multivariable analysis, the age was the only statistically significant predictor of SDB (OR 1.11, 95% CI 1.04-1.18, P?=?0.001). ESS was associated with depression (P?

SUBMITTER: Franzen D

PROVIDER: S-EPMC5291642 | biostudies-literature | 2015 Dec

REPOSITORIES: biostudies-literature

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Prevalence and Risk Factors of Sleep Disordered Breathing in Fabry disease: A Prospective Cohort Study.

Franzen Daniel D Gerard Nicolas N Bratton Daniel J DJ Wons Annette A Gaisl Thomas T Sievi Noriane A NA Clarenbach Christian F CF Kohler Malcolm M Krayenbühl Pierre A PA

Medicine 20151201 52

Excessive daytime sleepiness (EDS) is a frequently reported and not well-understood symptom in patients with Fabry disease (FD). Sleep-disordered breathing (SDB) is a possible factor. As deposition of glycosphingolipids in the upper airway muscles is likely, we hypothesized that obstructive sleep apnoea (OSA) is highly prevalent in FD and positively associated with its severity.All patients with FD who are followed in the Fabry cohort of the University Hospital Zurich (n = 62) were asked to part ...[more]

PMID: 26717401

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Project description:Study objectivesSleep disordered breathing (SDB) is a highly prevalent condition in high-income countries, with major consequences for cardiopulmonary health, public safety, healthcare utilization, and mortality. However, its prevalence and effect in low- and middle-income countries are less well known. We sought to determine the prevalence, risk factors, and comorbidities of SDB symptoms in four resource-limited settings.DesignCross-sectional analysis of the CRONICAS Cohort, a population-based age- and sex-stratified sample.SettingFour resource-limited settings in Peru varying in altitude, urbanization, and air pollution.ParticipantsThere were 2,682 adults aged 35 to 92 y.Measurements and resultsSelf-reported SDB symptoms (habitual snoring, observed apneas, Epworth Sleepiness Scale), sociodemographics, medical history, anthropometrics, spirometry, blood biomarkers were reported. We found a high prevalence of habitual snoring (30.2%, 95% confidence interval [CI] 28.5-32.0%), observed apneas (20.9%, 95% CI 19.4-22.5%) and excessive daytime sleepiness (18.6%, 95% CI 17.1-20.1%). SDB symptoms varied across sites; prevalence and adjusted odds for habitual snoring were greatest at sea level, whereas those for observed apneas were greatest at high altitude. In multivariable analysis, habitual snoring was associated with older age, male sex, body mass index (BMI), and higher socioeconomic status; observed apneas were associated with BMI; and excessive daytime sleepiness was associated with older age, female sex, and medium socioeconomic status. Adjusted odds of cardiovascular disease, depression, and hypertension and total chronic disease burden increased progressively with the number of SDB symptoms. A threefold increase in the odds of having an additional chronic comorbid disease (adjusted odds ratio 3.57, 95% CI 2.18-5.84) was observed in those with all three versus no SDB symptoms.ConclusionsSleep disordered breathing symptoms were highly prevalent, varied widely across four resource-limited settings in Peru, and exhibited strong independent associations with chronic diseases.

Project description:BackgroundSleep-disordered breathing (SDB) is a common syndrome in children, related to their immune responses, cardiovascular function, and neurocognitive function. This study aimed to determine the prevalence of SDB among children in Wuxi, China, and to evaluate the protective and risk factors of SDB in children.MethodsA cross-sectional study was conducted on children attending different schools across Wuxi, China, aged 3-14?years old. Of a total of 5630 questionnaires distributed to the parents of the children, 3997 (71.0%) were deemed to be valid. The data on the general sociodemographic factors, children's allergy and sleep characteristics, and the parents' sleep characteristics were also collected. The Paediatric Sleep Questionnaire (PSQ) score was used to identify children at high risk of SDB. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by logistic regression.ResultsThe prevalence of SDB in this cohort was 13.4% (N?=?534). SDB prevalence significantly differed in children with asthma (28.2% vs. 12.8%, P?<?0.001), eczema (19.0% vs. 10.0%, P?<?0.001), urticaria (16.4% vs. 12.9%, P?<?0.01) and rhinitis (21.4% vs. 10.7%, P?<?0.001). No significant differences were found in SDB prevalence with respect to pillow material or quilt material. On multivariate logistic regression analysis, asthma (OR 1.986 (95% CI 1.312-3.007), P?<?0.01), eczema (OR 1.675 (95% CI 1.377-2.037), P?<?0.001), rhinitis (OR 1.998 (95% CI 1.635-2.441), suffered from familial sleep sickness (OR 2.416 (95% CI 1.975-2.955), P?<?0.001) and whose mothers slept for a shorter duration (6?h-8?h: OR 1.370 (95% CI 1.089-1.724), P?<?0.01; <6?h: OR 3.385(95% CI 2.098-5.461), P?<?0.001) increased the odds of having SDB. The incidence of SDB significantly decreased with children's age (6-11?years old: 0R 0.768 (95% CI 0.597-0.989), P?<?0.05; 12-14?years old: OR 0.691 (95% CI 0.530-0.901), P?<?0.01).ConclusionThe results of this study demonstrated that atopic diseases (asthma, eczema, and rhinitis) and family sleep habits were risk factors for SDB in children in Wuxi, China.

Project description:Sleep problems are common in people with multiple sclerosis (MS). Reported prevalence rates of sleep-disordered breathing (SDB) vary between 0 and 87%. Differences in recruitment procedures and study designs likely contribute to the wide variance in reported prevalence rates of SBD in MS. This can make attempts to compare SDB rates in people with MS to the general population challenging. Little is known about the pathophysiological mechanisms that contribute to SDB in people with MS or whether MS contributes to SDB disease progression. However, compared to the general obstructive sleep apnea (OSA) population, there are clear differences in the clinical phenotypes of SDB in the MS population. For instance they are typically not obese and rates of SDB are often comparable or higher to the general population, despite the high female predominance of MS. Thus, the risk factors and pathophysiological causes of SDB in people with MS are likely to be different compared to people with OSA who do not have MS. There may be important bidirectional relationships between SDB and MS. Demyelinating lesions of MS in the brain stem and spinal cord could influence breathing control and upper airway muscle activity to cause SDB. Intermittent hypoxia caused by apneas during the night can increase oxidative stress and may worsen neurodegeneration in people with MS. In addition, inflammation and changes in cytokine levels may play a key role in the relationship between SDB and MS and their shared consequences. Indeed, fatigue, neurocognitive dysfunction, and depression may worsen considerably if both disorders coexist. Recent studies indicate that treatment of SDB in people with MS with conventional first-line therapy, continuous positive airway pressure therapy, can reduce fatigue and cognitive impairment. However, if the causes of SDB differ in people with MS, so too may the optimal therapy. Thus, many questions remain concerning the relationship between these two disorders and the underlying mechanisms and shared consequences. Improved understanding of these factors has the potential to unlock new therapeutic targets.

Dataset Information

Prevalence and Risk Factors of Sleep Disordered Breathing in Fabry disease: A Prospective Cohort Study.

Publications

Prevalence and Risk Factors of Sleep Disordered Breathing in Fabry disease: A Prospective Cohort Study.

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