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Obstructive sleep apnoea treatment and fasting lipids: a comparative effectiveness study.

ABSTRACT: Obstructive sleep apnoea (OSA) is associated with cardiovascular disease. Dyslipidaemia has been implicated as a mechanism linking OSA with atherosclerosis, but no consistent associations with lipids exist for OSA or positive airway pressure treatment. We assessed the relationships between fasting lipid levels and obesity and OSA severity, and explored the impact of positive airway pressure treatment on 2-year fasting lipid level changes. Analyses included moderate-to-severe OSA patients from the Icelandic Sleep Apnoea Cohort. Fasting morning lipids were analysed in 613 untreated participants not on lipid-lowering medications at baseline. Patients were then initiated on positive airway pressure and followed for 2 years. Sub-classification using propensity score quintiles, which aimed to replicate covariate balance associated with randomised trials and, therefore, minimise selection bias and allow causal inference, was used to design the treatment group comparisons. 199 positive airway pressure adherent patients and 118 non-users were identified. At baseline, obesity was positively correlated with triglycerides and negatively correlated with total cholesterol, and low-density and high-density lipoprotein cholesterol. A small correlation was observed between the apnoea/hypopnoea index and high-density lipoprotein cholesterol. No effect of positive airway pressure adherence on 2-year fasting lipid changes was observed. Results do not support the concept of changes in fasting lipids as a primary mechanism for the increased risk of atherosclerotic cardiovascular disease in OSA.

SUBMITTER: Keenan BT

PROVIDER: S-EPMC6668707 | biostudies-literature | 2014 Aug

REPOSITORIES: biostudies-literature

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Obstructive sleep apnoea treatment and fasting lipids: a comparative effectiveness study.

Keenan Brendan T BT Maislin Greg G Sunwoo Bernie Y BY Arnardottir Erna Sif ES Jackson Nicholas N Olafsson Isleifur I Juliusson Sigurdur S Schwab Richard J RJ Gislason Thorarinn T Benediktsdottir Bryndis B Pack Allan I AI

The European respiratory journal 20140515 2

Obstructive sleep apnoea (OSA) is associated with cardiovascular disease. Dyslipidaemia has been implicated as a mechanism linking OSA with atherosclerosis, but no consistent associations with lipids exist for OSA or positive airway pressure treatment. We assessed the relationships between fasting lipid levels and obesity and OSA severity, and explored the impact of positive airway pressure treatment on 2-year fasting lipid level changes. Analyses included moderate-to-severe OSA patients from th ...[more]

PMID: 24833762

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Project description:ObjectiveTo assess the frequency of obstructive sleep apnoea among women with and without hypertensive disorders of pregnancy.DesignCohort study.SettingObstetric clinics at an academic medical centre.PopulationPregnant women with hypertensive disorders (chronic hypertension, gestational hypertension, or pre-eclampsia) and women who were normotensive.MethodsWomen completed a questionnaire about habitual snoring and underwent overnight ambulatory polysomnography.Main outcome measuresThe presence and severity of obstructive sleep apnoea.ResultsObstructive sleep apnoea was found among 21 of 51 women with hypertensive disorders (41%), but in only three of 16 women who were normotensive (19%, chi-square test, P=0.005). [Author correction added on 16 June 2014, after first online publication: Results mentioned in the abstract were amended.] Non-snoring women with hypertensive disorders typically had mild obstructive sleep apnoea, but >25% of snoring women with hypertensive disorders had moderate to severe obstructive sleep apnoea. Among women with hypertensive disorders, the mean apnoea/hypopnoea index was substantially higher in snorers than in non-snorers (19.9±34.1 versus 3.4±3.1, P=0.013), and the oxyhaemoglobin saturation nadir was significantly lower (86.4±6.6 versus 90.2±3.5, P=0.021). Among women with hypertensive disorders, after stratification by obesity, the pooled relative risk for obstructive sleep apnoea in snoring women with hypertension compared with non-snoring women with hypertension was 2.0 (95% CI 1.4-2.8).ConclusionsPregnant women with hypertension are at high risk for unrecognised obstructive sleep apnoea. Although longitudinal and intervention studies are urgently needed, given the known relationship between obstructive sleep apnoea and hypertension in the general population, it would seem pertinent that hypertensive pregnant women who snore should be tested for obstructive sleep apnoea, a condition believed to cause or promote hypertension.

Dataset Information

Obstructive sleep apnoea treatment and fasting lipids: a comparative effectiveness study.

Publications

Obstructive sleep apnoea treatment and fasting lipids: a comparative effectiveness study.

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