SLEEP 2011 Abstract Supplement

B. Clinical Sleep Science I. Sleep Disorders – Breathing
ic disorders. The independent contribution of snoring to these disorders,
over and above other signs and symptoms of sleep apnea, has not been
explored at the population level.
Methods: Adult(18+) data from the 2007-2008 National Health and
Nutrition Examination Survey (NHANES) were used. Cardiometabolic
measures included self-reported diagnosis of hypertension and
diabetes, systolic and diastolic BP, and blood test results: triglycerides,
cholesterol(total, HDL, LDL), C-reactive protein, fasting insulin and
glucose, impaired fasting glucose, and 2-hour Oral Glucose Tolerance
Test(OGTT). Sleep apnea predictors consisted of self-reported sleep
apnea diagnosis and frequency of: daytime sleepiness, unrestful sleep,
and snorting/gasping during sleep. Snoring frequency was measured
with: “How often do you snore?” Reponses were 0,1-2,3-4 or ≥5 nights/
week. Linear and logistic regression analyses corrected for age, gender,
race/ethnicity, education, marital status, BMI (objective), general
health, health insurance, depression, alcohol intake, current smoking,
and smoking history. The analysis comprised those who provided complete
data (N=4163 for all outcomes except for glucose(N=2008), LDL
cholesterol(N=1968), OGTT(N=1522), triglycerides(N=2012), and
insulin(N=1992)).
Results: When adjusting for other apnea predictors, but not covariates,
snoring ≥5 nights/week was a significant independent predictor of: hypertension,
diabetes, impaired glucose, systolic-BP, diastolic-BP, totalcholesterol,
HDL-cholesterol, LDL-cholesterol, OGTT, triglycerides,
insulin and glucose. Snoring 3-5 nights/week was a predictor of: hypertension,
diabetes, systolic-BP, diastolic-BP, HDL-cholesterol, OGTT,
triglycerides, insulin and glucose. Snoring 1-3 nights/week was a predictor
of: OGTT, LDL-cholesterol, and triglycerides. After adjusting for
all other apnea predictors and covariates, snoring ≥5 nights/week was
associated with increased risk of hypertension (OR=1.48;95%CI=1.12-
1.95,p21 event/hour (χ2df = 1 = 10.076, P <
0.029) had the highest risk for proteinuria (61.5%). In junior group,
HbA1c>7 (χ2df = 1 = 19.725, P < 0.001) and BMI >27.4 (χ2df = 1 =
8.79, P = 0.027) was another two discriminating factors, where the former
one dominant over the latter.
Conclusion: Our results indicate that a variety of age, AHI, HbA1c,
BMI can predict proteinuria. Furthermore, AHI the sole determinant in
senior workers, whereas HbA1c and BMI are responsible in younger
ones for proteinuria. By categorical classification algorithm analysis,
this study provides a comprehensive model for better understanding the
correlates of proteinuria.
0439
OSA AND REFLUX - RETROSPECTIVE CHART REVIEW
EXPLORING RELATIONSHIP BETWEEN OSA SEVERITY
AND ESOPHAGEAL INJURY SEVERITY
Burman D, Kristo D
Pulmonary, Allergy, Critical Care, University of Pittsburgh, Pittsburgh,
PA, USA
Introduction: Medical researchers have long suspected a relationship
between OSA and esophageal reflux. Both these conditions have a deleterious
effect on patient quality of life. However the associations still
remain controversial. There has been conflicting studies recently exploring
the relationship of OSA and reflux disease. We aimed to determine
whether there is any correlation between severity of sleep apnea based
on AHI and severity of esophageal injury based on EGD.
Methods: Retrospective chart review of 51 patients with concurrent diagnosis
of OSA and esophageal disease. OSA defined as AHI >5, esophageal
injury was characterized by EGD results and diagnosis in chart.
Various parameters like age, gender, AHI, desaturations, BMI, sleep
stages and esophageal injury were recorded in an excel sheet. Esophageal
injury was assigned numbers from 1 to 5 based on severity of injury.
Reflux was #1 and Esophageal cancer #5. Patients with major confounders
like smoking and alcohol were removed from the review. Correlation
coefficient was calculated.
Results: Data evaluation revealed a coefficient correlation of 0.421 and
had a positive linear trend. Although the correlation was slight, greater
sample size lead to a stronger correlation coefficient. It was also noted
in 2 cases that esophageal injury reversed after compliance with PAP
therapy.
Conclusion: Based on our data it can be concluded that there is a positive
linear correlation between AHI and severity of esophageal Injury.
Our data indicate as severity of OSA increases, the severity of esophageal
injury increases. Multiple patients lacking EGD data may limit the
correlation of esophageal injury with OSA. Causality cannot be established
because of the nature of the study and further investigation is warranted.
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SLEEP, Volume 34, Abstract Supplement, 2011