Luciano F Drager1, Ronaldo B Santos2, Wagner A Silva2, Barbara K Parise3, Soraya Giatti4, Aline N Aielo5, Silvana P Souza2, Sofia F Furlan6, Geraldo Lorenzi-Filho7, Paulo A Lotufo5, Isabela M Bensenor5. 1. Center of Clinical and Epidemiologic Research, University of São Paulo, São Paulo, Brazil; Hypertension Unit, Heart Institute (InCor), University of São Paulo, São Paulo, Brazil; Hypertension Unit, Renal Division, University of São Paulo, São Paulo, Brazil. Electronic address: luciano.drager@incor.usp.br. 2. Center of Clinical and Epidemiologic Research, University of São Paulo, São Paulo, Brazil; Hypertension Unit, Heart Institute (InCor), University of São Paulo, São Paulo, Brazil. 3. Center of Clinical and Epidemiologic Research, University of São Paulo, São Paulo, Brazil; Hypertension Unit, Renal Division, University of São Paulo, São Paulo, Brazil. 4. Hypertension Unit, Renal Division, University of São Paulo, São Paulo, Brazil. 5. Center of Clinical and Epidemiologic Research, University of São Paulo, São Paulo, Brazil. 6. Hypertension Unit, Heart Institute (InCor), University of São Paulo, São Paulo, Brazil. 7. Sleep Laboratory, Pulmonary Division, Heart Institute (InCor), University of São Paulo, São Paulo, Brazil.
Abstract
BACKGROUND: OSA and short sleep duration (SSD) are frequently associated with daytime symptoms and cardiometabolic deregulation. However, the vast majority of studies addressing OSA have not evaluated SSD, and vice versa. Our aim was to evaluate the association of OSA, SSD, and their interactions with sleepiness and cardiometabolic risk factors in a large cohort of adults. METHODS: Consecutive subjects from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) participated in clinical evaluations, sleep questionnaires, home sleep monitoring, and actigraphy. OSA was defined as an apnea-hypopnea index ≥ 15 events/hour. SSD was defined by a mean sleep duration < 6 h. RESULTS: Data from 2,064 participants were used in the final analysis (42.8% male; mean age, 49 ± 8 years). The overall frequency of OSA and SSD were 32.9% and 27.2%, respectively. Following an adjustment for multiple confounding factors, excessive daytime sleepiness was independently associated with SSD (OR, 1.448; 95% CI, 1.172-1.790) but not with OSA (OR, 1.107; 95% CI, 0.888-1.380). The SSD interaction with OSA was not significant. Prevalent obesity (OR, 3.894; 95% CI, 3.077-4.928), hypertension (OR, 1.314; 95% CI, 1.035-1.667), and dyslipidemia (OR, 1.251; 95% CI, 1.006-1.555) were independently associated with OSA but not with SSD. Similarly, the interactions of OSA with SSD were not significant. An additional analysis using < 5 h for SSD or continuous sleep duration did not change the lack of association with the cardiometabolic risk factors. CONCLUSIONS: Objective SSD but not OSA was independently associated with daytime sleepiness. By contrast, OSA, but not SSD, was independently associated with obesity, hypertension, and dyslipidemia.
BACKGROUND: OSA and short sleep duration (SSD) are frequently associated with daytime symptoms and cardiometabolic deregulation. However, the vast majority of studies addressing OSA have not evaluated SSD, and vice versa. Our aim was to evaluate the association of OSA, SSD, and their interactions with sleepiness and cardiometabolic risk factors in a large cohort of adults. METHODS: Consecutive subjects from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) participated in clinical evaluations, sleep questionnaires, home sleep monitoring, and actigraphy. OSA was defined as an apnea-hypopnea index ≥ 15 events/hour. SSD was defined by a mean sleep duration < 6 h. RESULTS: Data from 2,064 participants were used in the final analysis (42.8% male; mean age, 49 ± 8 years). The overall frequency of OSA and SSD were 32.9% and 27.2%, respectively. Following an adjustment for multiple confounding factors, excessive daytime sleepiness was independently associated with SSD (OR, 1.448; 95% CI, 1.172-1.790) but not with OSA (OR, 1.107; 95% CI, 0.888-1.380). The SSD interaction with OSA was not significant. Prevalent obesity (OR, 3.894; 95% CI, 3.077-4.928), hypertension (OR, 1.314; 95% CI, 1.035-1.667), and dyslipidemia (OR, 1.251; 95% CI, 1.006-1.555) were independently associated with OSA but not with SSD. Similarly, the interactions of OSA with SSD were not significant. An additional analysis using < 5 h for SSD or continuous sleep duration did not change the lack of association with the cardiometabolic risk factors. CONCLUSIONS: Objective SSD but not OSA was independently associated with daytime sleepiness. By contrast, OSA, but not SSD, was independently associated with obesity, hypertension, and dyslipidemia.
Authors: Claudia C Ma; Ja Kook Gu; Ruchi Bhandari; Luenda E Charles; John M Violanti; Desta Fekedulegn; Michael E Andrew Journal: J Sleep Res Date: 2020-02-11 Impact factor: 3.981
Authors: André A F Mello; Giovanna D Angelo; Ronaldo B Santos; Isabela Bensenor; Paulo A Lotufo; Geraldo Lorenzi-Filho; Luciano F Drager; Pedro R Genta Journal: Sleep Breath Date: 2022-07-20 Impact factor: 2.655
Authors: Ronaldo B Santos; Soraya Giatti; Aline N Aielo; Wagner A Silva; Barbara K Parise; Lorenna F Cunha; Silvana P Souza; Airlane P Alencar; Paulo A Lotufo; Isabela M Bensenor; Luciano F Drager Journal: Sleep Breath Date: 2021-11-08 Impact factor: 2.655
Authors: Wagner A Silva; Bianca Almeida-Pititto; Ronaldo B Santos; Aline N Aielo; Soraya Giatti; Barbara K Parise; Silvana P Souza; Sandra F Vivolo; Paulo A Lotufo; Isabela M Bensenor; Luciano F Drager Journal: Sleep Breath Date: 2021-02-15 Impact factor: 2.816
Authors: Aline N Aielo; Ronaldo B Santos; Wagner A Silva; Barbara K Parise; Silvana P Souza; Lorenna F Cunha; Soraya Giatti; Paulo A Lotufo; Isabela M Bensenor; Luciano F Drager Journal: Sleep Sci Date: 2019 Apr-Jun
Authors: Luciano F Drager; Atul Malhotra; Yang Yan; Jean-Louis Pépin; Jeff P Armitstead; Holger Woehrle; Carlos M Nunez; Peter A Cistulli; Adam V Benjafield Journal: J Clin Sleep Med Date: 2021-04-01 Impact factor: 4.062