Sleep disordered breathing and metabolic comorbidities across sex and menopausal status in East Asians: the Nagahama Study.
Level 4 - case-series / case-control
Cross-sectional observational study without prospective follow-up or intervention.
PubMed 32409572 · doi:10.1183/13993003.02251-2019
What was done
Cross-sectional study of 7,713 community participants from the Nagahama Study in Japan evaluated with nocturnal oximetry for at least 2 nights. Sleep disordered breathing (SDB) was assessed by the 3% oxygen desaturation index corrected for sleep duration obtained by wrist actigraphy (acti-ODI3%). SDB severity was categorized by acti-ODI3%, and obesity was defined as body mass index of 25 kg/m2 or higher. The study evaluated associations between SDB and metabolic comorbidities across sex and menopausal status.
What was found
The prevalence was 41.0% (95% CI 39.9-42.1%) for normal, 46.9% (95% CI 45.8-48.0%) for mild, 10.1% (95% CI 9.5-10.8%) for moderate, and 2.0% (95% CI 1.7-2.3%) for severe SDB (males > post-menopausal females > premenopausal females). Hypertension, diabetes, and metabolic syndrome were independently associated with moderate-to-severe SDB. When coinciding with obesity, odds of moderate-to-severe SDB were: hypertension OR 8.2 (95% CI 6.6-10.2), diabetes OR 7.8 (95% CI 5.6-10.9), and metabolic syndrome OR 6.7 (95% CI 5.2-8.6). Dyslipidaemia with obesity had no additive association. Number of antihypertensive drugs was associated with SDB (p for trend < 0.001).
Why it matters
This study shows that common metabolic comorbidities strongly compound the risk of moderate-to-severe SDB in East Asian adults at lower BMI thresholds (25 kg/m2 or higher). It reinforces the need to evaluate SDB in patients with comorbid obesity and metabolic disorders.
Limits
The cross-sectional design precludes establishing causality or temporal order. Sleep disordered breathing was measured by home pulse oximetry and wrist actigraphy rather than full gold-standard polysomnography. The study was conducted in a single Japanese cohort, limiting generalizability to populations with different body habitus.
Cited by
- supports The prevalence of sleep apnea in post-menopausal women is approximately 25%.