Cristiane Maria Cassol1, Denis Martinez2, Fernando Augusto Boeira Sabino da Silva3, Marcia Kraide Fischer4, Maria do Carmo Sfreddo Lenz5, Ângelo José Gonçalves Bós6. 1. Graduate Program in Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil. Electronic address: cristianecassol@gmail.com. 2. Graduate Program in Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; Graduate Program in Medical Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; Cardiology Division, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil; Sleep Clinic, Porto Alegre, Brazil. 3. Institute of Mathematics, Department of Statistics, UFRGS, Porto Alegre, Brazil. 4. Graduate Program in Medical Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil. 5. Sleep Clinic, Porto Alegre, Brazil. 6. Institute of Geriatrics and Gerontology, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil.
Abstract
BACKGROUND: The severity of obstructive sleep apnea increases by influence of conditions that are more frequent in winter. The hypothesis that the apnea-hypopnea index (AHI) of different patients undergoing polysomnography may be seasonally affected was tested. METHODS: The retrospectively analyzed database included 7,523 patients of both sexes who underwent in-laboratory baseline polysomnography to investigate any complaint of disordered sleep, during 1 decade, between January 2000 and December 2009. Data on climate and air pollution were obtained from official organizations. AHI was the main outcome variable. Cosinor analysis, a statistical method for the investigation of time series, was used to detect seasonality. RESULTS: The cosinor analysis confirmed the existence of a circannual pattern of AHI, with acrophase in winter and nadir during the summer. The seasonality is significant even after adjusting for sex, age, BMI, neck circumference, and relative air humidity. Median (25-75 interquartile range) AHI in the 6 months with colder weather was 17.8 (6.5-40.6/h), and in the warmer weather was 15.0 (5.7-33.2/h). The AHI correlated inversely with ambient temperature and directly with atmospheric pressure, relative air humidity, and carbon monoxide levels. Correlations with precipitation, particulate air matter < 10 μm, sulfur dioxide, and ozone were nonsignificant. CONCLUSIONS: More sleep-disordered breathing events were recorded in winter than in other seasons. Cosinor analysis uncovered a significant seasonal pattern in the AHI of different patients undergoing polysomnography, independent of sex, age, BMI, neck circumference, and relative air humidity. This finding suggests that obstructive sleep apnea severity may be associated with other seasonal epidemiologic phenomena.
BACKGROUND: The severity of obstructive sleep apnea increases by influence of conditions that are more frequent in winter. The hypothesis that the apnea-hypopnea index (AHI) of different patients undergoing polysomnography may be seasonally affected was tested. METHODS: The retrospectively analyzed database included 7,523 patients of both sexes who underwent in-laboratory baseline polysomnography to investigate any complaint of disordered sleep, during 1 decade, between January 2000 and December 2009. Data on climate and air pollution were obtained from official organizations. AHI was the main outcome variable. Cosinor analysis, a statistical method for the investigation of time series, was used to detect seasonality. RESULTS: The cosinor analysis confirmed the existence of a circannual pattern of AHI, with acrophase in winter and nadir during the summer. The seasonality is significant even after adjusting for sex, age, BMI, neck circumference, and relative air humidity. Median (25-75 interquartile range) AHI in the 6 months with colder weather was 17.8 (6.5-40.6/h), and in the warmer weather was 15.0 (5.7-33.2/h). The AHI correlated inversely with ambient temperature and directly with atmospheric pressure, relative air humidity, and carbon monoxide levels. Correlations with precipitation, particulate air matter < 10 μm, sulfur dioxide, and ozone were nonsignificant. CONCLUSIONS: More sleep-disordered breathing events were recorded in winter than in other seasons. Cosinor analysis uncovered a significant seasonal pattern in the AHI of different patients undergoing polysomnography, independent of sex, age, BMI, neck circumference, and relative air humidity. This finding suggests that obstructive sleep apnea severity may be associated with other seasonal epidemiologic phenomena.
Authors: Jone Vencloviene; Ruta Marija Babarskiene; Paulius Dobozinskas; Audrius Dedele; Kristina Lopatiene; Nijole Ragaisyte Journal: Environ Sci Pollut Res Int Date: 2017-05-10 Impact factor: 4.223
Authors: Roberto P da Silva; Denis Martinez; Martina M Pedroso; Camila G Righi; Emerson F Martins; Leticia M T Silva; Maria do Carmo S Lenz; Cintia Z Fiori Journal: J Clin Sleep Med Date: 2017-02-15 Impact factor: 4.062