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Sleep-disordered breathing and cardiovascular disease: cross-sectional results of the Sleep Heart Health Study.

TitleSleep-disordered breathing and cardiovascular disease: cross-sectional results of the Sleep Heart Health Study.
Publication TypeJournal Article
Year of Publication2001
AuthorsShahar, E, Whitney, CW, Redline, S, Lee, ET, Newman, AB, Nieto, FJ, O'Connor, GT, Boland, LL, Schwartz, JE, Samet, JM
JournalAm J Respir Crit Care Med
Volume163
Issue1
Pagination19-25
Date Published2001 Jan
ISSN1073-449X
KeywordsAged, Cardiovascular Diseases, Cohort Studies, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Sleep Apnea Syndromes
Abstract<p>Disordered breathing during sleep is associated with acute, unfavorable effects on cardiovascular physiology, but few studies have examined its postulated association with cardiovascular disease (CVD). We examined the cross-sectional association between sleep- disordered breathing and self-reported CVD in 6,424 free-living individuals who underwent overnight, unattended polysomnography at home. Sleep-disordered breathing was quantified by the apnea-hypopnea index (AHI)-the average number of apneas and hypopneas per hour of sleep. Mild to moderate disordered breathing during sleep was highly prevalent in the sample (median AHI: 4.4; interquartile range: 1.3 to 11.0). A total of 1,023 participants (16%) reported at least one manifestation of CVD (myocardial infarction, angina, coronary revascularization procedure, heart failure, or stroke). The multivariable-adjusted relative odds (95% CI) of prevalent CVD for the second, third, and fourth quartiles of the AHI (versus the first) were 0.98 (0.77-1.24), 1.28 (1.02-1.61), and 1.42 (1.13-1.78), respectively. Sleep-disordered breathing was associated more strongly with self-reported heart failure and stroke than with self-reported coronary heart disease: the relative odds (95% CI) of heart failure, stroke, and coronary heart disease (upper versus lower AHI quartile) were 2.38 (1.22-4.62), 1.58 (1.02- 2.46), and 1.27 (0.99-1.62), respectively. These findings are compatible with modest to moderate effects of sleep-disordered breathing on heterogeneous manifestations of CVD within a range of AHI values that are considered normal or only mildly elevated.</p>
DOI10.1164/ajrccm.163.1.2001008
Alternate JournalAm J Respir Crit Care Med
PubMed ID11208620
Grant ListUO1HL53940 / HL / NHLBI NIH HHS / United States
P01 HL047540 / HL / NHLBI NIH HHS / United States
UO1HL53941 / HL / NHLBI NIH HHS / United States
UO1HL53931 / HL / NHLBI NIH HHS / United States
UO1HL53916 / HL / NHLBI NIH HHS / United States
UO1HL53938 / HL / NHLBI NIH HHS / United States
UO1HL53937 / HL / NHLBI NIH HHS / United States
UO1HL53934 / HL / NHLBI NIH HHS / United States