Ricardo L M Duarte1,2, Flavio J Magalhães-da-Silveira1, David Gozal3. 1. SleepLab-Laboratório de Estudo dos Distúrbios do Sono, Centro Médico BarraShopping, Rio de Janeiro, Brazil. 2. Instituto de Doenças do Tórax, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil. 3. Department of Child Health, University of Missouri School of Medicine, Columbia, Missouri.
Abstract
STUDY OBJECTIVES: To assess whether nocturnal symptoms of insomnia influence the prevalence of obstructive sleep apnea (OSA) in a clinical referral cohort. METHODS: Insomnia was defined by the presence of 1 or more of the following complaints: difficulty initiating sleep, difficulty maintaining sleep, and/or early morning awakenings. OSA severity was based on an apnea-hypopnea index: ≥ 5.0 events/h (any OSA), ≥ 15.0 events/h (moderate/severe OSA), and ≥ 30 events/h (severe OSA). Multivariate logistic regression analysis was used to evaluate predictive factors for OSA diagnosis and severity. RESULTS: Overall, 12,021 outpatients referred for polysomnography were grouped into 2 cohorts: without insomnia (58.2%) and with insomnia (41.8%). Individuals without insomnia had a higher prevalence of OSA than those with insomnia (P < .001, for all OSA severity levels). The presence of insomnia was negatively associated with diagnosis of any OSA (adjusted odds ratio: 0.852; 95% confidence interval: 0.769-0.944), moderate/severe OSA (adjusted odds ratio: 0.819; 95% confidence interval: 0.751-0.892), and severe OSA (adjusted odds ratio: 0.816; 95% confidence interval: 0.746-0.892). Moreover, the number of nocturnal symptoms of insomnia was associated with a lower likelihood of OSA, even when adjusted for other confounders such as sex, age, body mass index, neck circumference, excessive daytime sleepiness, hypertension, and type 2 diabetes mellitus. CONCLUSIONS: In this present study that included a large sample of consecutive outpatients, there was an inverse relationship between the number of nocturnal symptoms of insomnia and OSA diagnosis. CITATION: Duarte RLM, Magalhães-da-Silveira FJ, Gozal D. Influence of nocturnal insomnia symptoms on obstructive sleep apnea diagnosis in a clinical referral cohort. J Clin Sleep Med. 2022;18(5):1271-1278.
STUDY OBJECTIVES: To assess whether nocturnal symptoms of insomnia influence the prevalence of obstructive sleep apnea (OSA) in a clinical referral cohort. METHODS: Insomnia was defined by the presence of 1 or more of the following complaints: difficulty initiating sleep, difficulty maintaining sleep, and/or early morning awakenings. OSA severity was based on an apnea-hypopnea index: ≥ 5.0 events/h (any OSA), ≥ 15.0 events/h (moderate/severe OSA), and ≥ 30 events/h (severe OSA). Multivariate logistic regression analysis was used to evaluate predictive factors for OSA diagnosis and severity. RESULTS: Overall, 12,021 outpatients referred for polysomnography were grouped into 2 cohorts: without insomnia (58.2%) and with insomnia (41.8%). Individuals without insomnia had a higher prevalence of OSA than those with insomnia (P < .001, for all OSA severity levels). The presence of insomnia was negatively associated with diagnosis of any OSA (adjusted odds ratio: 0.852; 95% confidence interval: 0.769-0.944), moderate/severe OSA (adjusted odds ratio: 0.819; 95% confidence interval: 0.751-0.892), and severe OSA (adjusted odds ratio: 0.816; 95% confidence interval: 0.746-0.892). Moreover, the number of nocturnal symptoms of insomnia was associated with a lower likelihood of OSA, even when adjusted for other confounders such as sex, age, body mass index, neck circumference, excessive daytime sleepiness, hypertension, and type 2 diabetes mellitus. CONCLUSIONS: In this present study that included a large sample of consecutive outpatients, there was an inverse relationship between the number of nocturnal symptoms of insomnia and OSA diagnosis. CITATION: Duarte RLM, Magalhães-da-Silveira FJ, Gozal D. Influence of nocturnal insomnia symptoms on obstructive sleep apnea diagnosis in a clinical referral cohort. J Clin Sleep Med. 2022;18(5):1271-1278.
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