CLINICAL AND CARDIOMETABOLIC RISK FACTORS AND UPPER AIRWAY CHARACTERISTICS ASSOCIATED WITH HIGH RISK OF OBSTRUCTIVE SLEEP APNEA IN ADULTS
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Keywords
obstructive sleep apnea, cardiometabolic risk, obesity, upper airway, snoring
Abstract
Obstructive sleep apnea (OSA) is linked with important clinical, cardiometabolic, anthropometric, and upper-airway abnormalities. Early identification of adults at high risk may support timely clinical evaluation and referral. This secondary observational analytical study included 343 adults classified as having high or low OSA risk. Demographic, clinical, behavioral, cardiometabolic, anthropometric, sleep-related, and upper-airway characteristics were evaluated. Continuous variables were analyzed with the independent-samples t-test, categorical associations were investigated using the chi-square test, and the relationships among continuous variables were assessed using Pearson correlation, and logistic regression was used to find factors linked to high OSA risk. 44.31% of subjects had a high OSA risk. High-risk individuals showed greater daytime sleepiness, body weight, BMI, neck circumference, and abdominal circumference. Snoring, sleepiness category, BMI category, hypertension, smoking, and marital status were significantly associated with OSA risk. Significant upper-airway associations were observed for palatopharyngeal insertion, Friedman tongue position, tongue abnormality, and palatopharyngeal gap. Strong positive correlations were found among obesity-related anthropometric measures. Logistic regression further identified snoring, obesity, high daytime sleepiness, hypertension, smoking, increased anthropometric measures, and selected upper-airway characteristics as significant individual factors related with high OSA risk. High OSA risk was closely related to symptomatic, cardiometabolic, anthropometric, and selected upper-airway characteristics. Combining routine clinical assessment with anthropometric and upper-airway evaluation may improve early identification of adults requiring further diagnostic assessment.
References
2. Balat, K., Pazarlı, A. C., Köseoğlu, H. İ., Yaşayancan, N., & Demir, O. (2021). Importance of anthropometric measurements to determine cardiometabolic diseases in obstructive sleep apnea syndrome. Turkish Thoracic Journal, 22(1), 11.
3. Cai, X., Hu, J., Wen, W., Wang, J., Wang, M., Liu, S., ... & Li, N. (2022). Associations of the cardiometabolic index with the risk of cardiovascular disease in patients with hypertension and obstructive sleep apnea: results of a longitudinal cohort study. Oxidative medicine and cellular longevity, 2022(1), 4914791.
4. Cemal, A. (2022). The role of anthropometric measurements in identifying cardiometabolic diseases in obstructive sleep apnea syndrome. Tuberk Toraks, 70(3), 287-292.
5. Ersoy, E., & Mercan, Y. (2021). Risk factors for obstructive sleep apnea and the association of obstructive sleep apnea with daytime sleepiness, obesity and comorbidity. Turkish Journal of Sleep Medicine.
6. Floras, J. S. (2018). Sleep apnea and cardiovascular disease: an enigmatic risk factor. Circulation research, 122(12), 1741-1764.
7. Gać, P., Urbanik, D., Macek, P., Martynowicz, H., Mazur, G., & Poręba, R. (2022). Coexistence of cardiovascular risk factors and obstructive sleep apnoea in polysomnography. Respiratory Physiology & Neurobiology, 295, 103782.
8. Gaines, J., Vgontzas, A. N., Fernandez-Mendoza, J., & Bixler, E. O. (2018). Obstructive sleep apnea and the metabolic syndrome: the road to clinically-meaningful phenotyping, improved prognosis, and personalized treatment. Sleep medicine reviews, 42, 211-219.
9. Geovanini, G. R., Wang, R., Weng, J., Jenny, N. S., Shea, S., Allison, M., ... & Redline, S. (2018). Association between obstructive sleep apnea and cardiovascular risk factors: variation by age, sex, and race. The Multi-Ethnic Study of Atherosclerosis. Annals of the American Thoracic Society, 15(8), 970-977.
10. Hamilton, G. S., & Joosten, S. A. (2017). Obstructive sleep apnoea and obesity. Australian family physician, 46(7), 460-463.
11. Hoyos, C. M., Drager, L. F., & Patel, S. R. (2017). OSA and cardiometabolic risk: What's the bottom line?. Respirology, 22(3), 420-429.
12. Ioannidou, D., Kalamaras, G., Kotoulas, S. C., & Pataka, A. (2021). Smoking and obstructive sleep apnea: Is there an association between these cardiometabolic risk factors?—Gender analysis. Medicina, 57(11), 1137.
13. Peker, Y., Celik, Y., Arbatli, S., Isik, S. R., Balcan, B., Karataş, F., ... & Çağlayan, B. (2021). Effect of high-risk obstructive sleep apnea on clinical outcomes in adults with coronavirus disease 2019: a multicenter, prospective, observational clinical trial. Annals of the American Thoracic Society, 18(9), 1548-1559.
14. Peracaula, M., Torres, D., Poyatos, P., Luque, N., Rojas, E., Obrador, A., ... & Tura-Ceide, O. (2022). Endothelial dysfunction and cardiovascular risk in obstructive sleep apnea: a review article. Life, 12(4), 537.
15. Stelmach-Mardas, M., Mardas, M., Iqbal, K., Kostrzewska, M., & Piorunek, T. (2017). Dietary and cardio-metabolic risk factors in patients with Obstructive Sleep Apnea: cross-sectional study. PeerJ, 5, e3259.
16. Su, X., Li, J. H., Gao, Y., Chen, K., Gao, Y., Guo, J. J., ... & Liu, L. (2021). Impact of obstructive sleep apnea complicated with type 2 diabetes on long-term cardiovascular risks and all-cause mortality in elderly patients. BMC geriatrics, 21(1), 508.
17. Tawaranurak, K., Leelasawatsuk, P., & Chaiyarukjirakun, V. (2019). Prevalence, risk factors and clinical manifestation of patients suspected as having obstructive sleep apnea in Songklanagarind hospital sleep center. Journal of Health Science and Medical Research, 37(4), 305-312.
18. Thompson, C., Legault, J., Moullec, G., Baltzan, M., Cross, N., Dang-Vu, T. T., ... & Gosselin, N. (2022). A portrait of obstructive sleep apnea risk factors in 27,210 middle-aged and older adults in the Canadian Longitudinal Study on Aging. Scientific Reports, 12(1), 5127.
19. Tietjens, J. R., Claman, D., Kezirian, E. J., De Marco, T., Mirzayan, A., Sadroonri, B., ... & Yeghiazarians, Y. (2019). Obstructive sleep apnea in cardiovascular disease: a review of the literature and proposed multidisciplinary clinical management strategy. Journal of the American Heart Association, 8(1), e010440.
20. Wu, C. J., Kao, T. W., Chang, Y. W., & Chen, W. L. (2018). Examining the association between obstructive sleep apnea and cardiometabolic risk factors in the elderly. Sleep and Biological Rhythms, 16(2), 231-237.
21. Yeghiazarians, Y., Jneid, H., Tietjens, J. R., Redline, S., Brown, D. L., El-Sherif, N., ... & Somers, V. K. (2021). Obstructive sleep apnea and cardiovascular disease: a scientific statement from the American Heart Association. Circulation, 144(3), e56-e67.
22. Zhang, L., Zhang, X., Li, Y. M., Xiang, B. Y., Han, T., Wang, Y., & Wang, C. (2021). Association of craniofacial and upper airway morphology with cardiovascular risk in adults with OSA. Nature and Science of Sleep, 1689-1700.
23. Zhao, X., Li, X., Xu, H., Qian, Y., Fang, F., Yi, H., ... & Yin, S. K. (2019). Relationships between cardiometabolic disorders and obstructive sleep apnea: implications for cardiovascular disease risk. The Journal of Clinical Hypertension, 21(2), 280-290.
24. Zhou, X., Lu, Q., Li, S., Pu, Z., Gao, F., & Zhou, B. (2020). Risk factors associated with the severity of obstructive sleep apnea syndrome among adults. Scientific reports, 10(1), 13508.
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