Characterisation of Symptom and Polysomnographic Profiles Associated with Cardiovascular Risk in a Sleep Clinic Population with Obstructive Sleep Apnoea

Abstract

Emily Kemp,1 Kate Sutherland,1– 3 Yu Sun Bin,2,3 Andrew SL Chan,1– 3 Hasthi Dissanayake,2,3 Brendon J Yee,2– 5 Kristina Kairaitis,2,3,6,7 John Robert Wheatley,2,3,6,7 Philip de Chazal,2,8 Amanda J Piper,2,4 Peter A Cistulli1– 3 On behalf of the Sydney Sleep Biobank Investigators1Department of Respiratory Medicine, Royal North Shore Hospital, St Leonards, NSW, Australia; 2Charles Perkins Centre, University of Sydney, Camperdown, NSW, Australia; 3Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia; 4Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Camperdown, NSW, Australia; 5Centre for Integrated Research and Understanding of Sleep (CIRUS), Woolcock Institute of Medical Research, Glebe, NSW, Australia; 6Ludwig Engel Centre for Respiratory Research, Westmead Institute for Medical Research, Westmead, NSW, Australia; 7Department of Respiratory and Sleep Medicine, Westmead Hospital, Westmead, NSW, Australia; 8School of Biomedical Engineering, The University of Sydney, Darlington, NSW, AustraliaCorrespondence: Peter A Cistulli, Department of Respiratory and Sleep Medicine, Level 8A, Royal North Shore Hospital, St Leonards, NSW, 2065, Australia, Tel [phone], Fax [phone], Email [email protected]: Recent data have identified specific symptom and polysomnographic profiles associated with cardiovascular disease (CVD) in patients with obstructive sleep apnoea (OSA). Our aim was to determine whether these profiles were present at diagnosis of OSA in patients with established CVD and in those with high cardiovascular risk. Participants in the Sydney Sleep Biobank (SSB) database, aged 30– 74 years, self-reported presence of CVD (coronary artery disease, cerebrovascular disease, or heart failure). In those without established CVD, the Framingham Risk Score (FRS) estimated 10-year absolute CVD risk, categorised as “low” ( 20%). Groups were compared on symptom and polysomnographic variables.Results: 629 patients (68% male; mean age 54.3 years, SD 11.6; mean BMI 32.3 kg/m2, SD 8.2) were included. CVD was reported in 12.2%. A further 14.3% had a low risk FRS, 38.8% had an intermediate risk FRS, and 34.7% had a high risk FRS. Groups differed with respect to age, sex and BMI. OSA severity increased with established CVD and increasing FRS. The symptom of waking too early was more prevalent in the higher FRS groups (p=0.004). CVD and FRS groups differed on multiple polysomnographic variables; however, none of these differences remained significant after adjusting for age, sex, and BMI.Conclusion: Higher CVD risk was associated with waking too early in patients with OSA. Polysomnographic variations between groups were explained by demographic differences. Further work is required to explore the influence of OSA phenotypic characteristics on susceptibility to CVD.Keywords: obstructive sleep apnoea, cardiovascular disease

Keywords

• obstructive sleep apnoea
• cardiovascular disease