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Sleep and sleep-disordered breathing in adults with predominantly mild obstructive airway disease.

TitleSleep and sleep-disordered breathing in adults with predominantly mild obstructive airway disease.
Publication TypeJournal Article
Year of Publication2003
AuthorsSanders, MH, Newman, AB, Haggerty, CL, Redline, S, Lebowitz, M, Samet, J, O'Connor, GT, Punjabi, NM, Shahar, E
Corporate/Institutional AuthorsSleep Heart Health Study,
JournalAm J Respir Crit Care Med
Volume167
Issue1
Pagination7-14
Date Published2003 Jan 01
ISSN1073-449X
KeywordsAged, Cohort Studies, Female, Forced Expiratory Volume, Humans, Male, Middle Aged, Oxyhemoglobins, Polysomnography, Prospective Studies, Pulmonary Disease, Chronic Obstructive, Sleep, Sleep Apnea, Obstructive, Spirometry, Vital Capacity
Abstract<p>Neither the association between obstructive airways disease (OAD) and sleep apnea-hypopnea (SAH) nor the sleep consequences of each disorder alone and together have been characterized in an adult community setting. Our primary aims were (1) to determine if there is an association between OAD and SAH and (2) identify predictors of oxyhemoglobin desaturation during sleep in persons having OAD with and without SAH. Polysomnography and spirometry results from 5,954 participants in the Sleep Heart Health Study were analyzed. OAD was defined by a FEV1/FVC value less than 70%. Assessment of SAH prevalence in OAD was performed using thresholds of respiratory disturbance index (RDI) greater than 10 and greater than 15. A total of 1,132 participants had OAD that was predominantly mild (FEV1/FVC 63.81 +/- 6.56%, mean +/- SD). SAH was not more prevalent in participants with OAD than in those without OAD (22.32 versus 28.86%, with and without OAD, respectively, at RDI threshold values greater than 10; and 13.97 versus 18.63%, with and without OAD, respectively, at RDI threshold value greater than 15). In the absence of SAH, the adjusted odds ratio for sleep desaturation (> 5% total sleep time with saturation < 90%) was greater than 1.9 when FEV1/FVC was less than 65%. Participants with both OAD and SAH had greater sleep perturbation and desaturation than those with one disorder. Generally mild OAD alone was associated with minimally altered sleep quality. We conclude that (1) there is no association between generally mild OAD and SAH; (2) exclusive of SAH and after adjusting for demographic factors and awake oxyhemoglobin saturation, an FEV1/FVC value less than 65% is associated with increased risk of sleep desaturation; (3) desaturation is greater in persons with both OAD and SAH compared with each of these alone; and (4) individuals with generally mild OAD and without SAH in the community have minimally perturbed sleep.</p>
DOI10.1164/rccm.2203046
Alternate JournalAm J Respir Crit Care Med
PubMed ID12502472
Grant ListU01-HL63429 / HL / NHLBI NIH HHS / United States
U01HL53916 / HL / NHLBI NIH HHS / United States
U01HL53931 / HL / NHLBI NIH HHS / United States
U01HL53934 / HL / NHLBI NIH HHS / United States
U01HL53937 / HL / NHLBI NIH HHS / United States
U01HL53938 / HL / NHLBI NIH HHS / United States
U01HL53940 / HL / NHLBI NIH HHS / United States
U01HL53941 / HL / NHLBI NIH HHS / United States