title: Severity of obstructive sleep apnea in patients with and without cardiovascular-related diseases.
abstract: BACKGROUND
  Previous studies have often investigated the association of obstructive sleep apnea (OSA) with cardiovascular morbidity and mortality, but the possibility of reverse causation has not been clearly defined.
  
  
  OBJECTIVE
  To examine if the presence of any of the cardiovascular-related  diseases, including hypertension, diabetes mellitus, coronary artery disease, and/or cerebrovascular disease, correlates with more severe OSA.
  
  
  METHODS
  This was a retrospective study where all patients age ≥ 18 years referred to our sleep laboratory for suspected OSA were included. The  data from the full-night baseline and split-night polysomnographic reports were reviewed. Data were then evaluated by logistic regression analysis to compare between 2 groups, the severity of OSA (respiratory disturbance index [RDI] < 15 vs RDI ≥ 15, and RDI < 5 vs RDI ≥ 5), other  polysomnographic variables and daytime sleepiness score (Epworth Sleepiness Scale [ESS] score < 10 and ≥ 10).
  
  
  RESULTS
  190 patients were analyzed. The patients with any of the cardiovascular-related diseases were noted to have more severe sleep apnea (RDI ≥ 15), with an adjusted odds  ratio of 3.24. Sleep efficiency ≥ 90% and mean oxygen saturation ≥ 95% were observed less commonly in the patients with any of the cardiovascular-related diseases (adjusted odds ratios of 0.45 and 0.36, respectively). There was no statistically significant difference in ESS score.
  
  
  CONCLUSIONS
  Patients with any of the cardiovascular-related diseases are at a higher risk of having moderate to severe OSA without significant increase in daytime sleepiness. Therefore, we suggest that patients with any of the cardiovascular-related diseases should be screened for OSA, even if they are  asymptomatic.
authors.affiliation: Excellence Center for Sleep Disorders, King Chulalongkorn Memorial Hospital/Thai Red Cross Society, Bangkok, Thailand.
authors.forename: Rosalind
authors.initials: R
authors.lastname: Simon
authors.forename: Naricha
authors.initials: N
authors.lastname: Chirakalwasan
authors.forename: Busarakum
authors.initials: B
authors.lastname: Teerapraipruk
authors.forename: Prakobkiat
authors.initials: P
authors.lastname: Hirunwiwatkul
authors.forename: Nattapong
authors.initials: N
authors.lastname: Jaimchariyatam
authors.forename: Tayard
authors.initials: T
authors.lastname: Desudchit
authors.forename: Natamon
authors.initials: N
authors.lastname: Charakorn
authors.forename: Chaisiri
authors.initials: C
authors.lastname: Wanlapakorn
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000150:complications* / Q000503:physiopathology; D006970:Disorders of Excessive Somnolence / Q000150:complications* / Q000503:physiopathology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000033:anatomy & histology; D016017:Odds Ratio; D010092:Oximetry; D017286:Polysomnography; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012890:Sleep / Q000502:physiology; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000503:physiopathology*