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Percentage of sleep time with increase in respiratory effort is a strong predictor of prevalent hypertension in obstructive sleep apnea patients

N Le-Dong, J Martinot, R Tamisier, J Pépin
European Respiratory Journal 2022 60: 691; DOI: 10.1183/13993003.congress-2022.691
N Le-Dong
1Sunrise, Namur, Belgium
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J Martinot
2Sleep Laboratory, CHU Université Catholique de Louvain (UCL) Namur Site Sainte-Elisabeth, Namur, Belgium
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R Tamisier
3HP2 Laboratory, Inserm U1300, University Grenoble Alpes, Grenoble, France
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J Pépin
3HP2 Laboratory, Inserm U1300, University Grenoble Alpes, Grenoble, France
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Abstract

Rationale: Increase in respiratory effort (RE) is a key feature of obstructive sleep apnea (OSA) and is participating in sympathetic overactivity and remodeling of vascular walls. We aimed to evaluate the impact of percentage of sleep time in RE (RE_dt) as a predictor of prevalent hypertension (HT) in adults with OSA.

Methods: A machine learning model was built to predict HT from clinical profiles including age, sex, BMI, conventional PSG indices and RE_dt derived from mandibular movement signals (Sunrise, Namur, Belgium).

Results: In 1126 patients referred for suspected OSA (M/F ratio = 1.2; BMI = 31.4 ± 7.6; apnea hypopnea index (AHI) = 24.6 ± 20.9), HT prevalence was 30.8%. Percentage of TST spent in RE was significantly associated with a higher likelihood of prevalent HT (OR = 17.6; 95%CI: 9.7-31.9).

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The classification rule allows for predicting HT with high accuracy (85.9%). Shapley additive explanation process was conducted to assign a score to each feature values depending on their contribution to the prediction. This analysis (Figure) revealed that RE_dt was the best predictor among sleep test driven metrics, its contribution was even better than that of ODI, AHI or RDI.

Conclusion: The percentage of sleep time spent with an increase in RE derived from mandibular movement signals appears as a new relevant metric to assess OSA impact in cardiovascular risk.

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Footnotes

Cite this article as Eur Respir J 2022; 60: Suppl. 66, 691.

This article was presented at the 2022 ERS International Congress, in session “-”.

This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).

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Percentage of sleep time with increase in respiratory effort is a strong predictor of prevalent hypertension in obstructive sleep apnea patients
N Le-Dong, J Martinot, R Tamisier, J Pépin
European Respiratory Journal Sep 2022, 60 (suppl 66) 691; DOI: 10.1183/13993003.congress-2022.691

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Percentage of sleep time with increase in respiratory effort is a strong predictor of prevalent hypertension in obstructive sleep apnea patients
N Le-Dong, J Martinot, R Tamisier, J Pépin
European Respiratory Journal Sep 2022, 60 (suppl 66) 691; DOI: 10.1183/13993003.congress-2022.691
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