Abstract
It is well known that the prevalence of sleep disordered breathing (SDB) is increased in patients with obesity or metabolic comorbidities. However, the way in which the prevalence of SDB increases in relation to comorbidities according to the severity of obesity remains unclear.
This cross-sectional study evaluated 7713 community participants with nocturnal oximetry ≥2 nights. SDB was assessed by the 3% oxygen desaturation index corrected for sleep duration obtained by wrist actigraphy (Acti-ODI3%). SDB severity was defined by Acti-ODI3%. Obesity was defined as body mass index ≥25 kg·/m−2.
The prevalence of SDB was 41.0% (95% CI 39.9–42.1), 46.9% (45.8–48.0), 10.1% (9.5–10.8), and 2.0% (1.7–2.3) in normal, mild, moderate, and severe SDB, respectively, with notable sex differences evident (men >post-menopausal women >pre-menopausal women). Comorbidities such as hypertension, diabetes, and metabolic syndrome were independently associated with the prevalence of moderate-to-severe SDB, and coincidence of any one of these with obesity was associated with a higher probability of moderate-to-severe SDB (OR 8.2, 95% CI 6.6–10.2; 7.8, 5.6–10.9; 6.7, 5.2–8.6, respectively). Dyslipidemia in addition to obesity was not additively associated with the prevalence of moderate to-severe SDB. The number of antihypertensive drugs was associated with SDB (p for trend <0.001). Proportion of a high cumulative percentage of sleep time with SpO2 <90% increased even among moderate-to-severe SDB with increases in obesity.
Metabolic comorbidities contribute to SDB regardless of the degree of obesity. We should recognise the extremely high prevalence of moderate-to-severe SDB in patients with obesity and metabolic comorbidities.
Footnotes
This manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.
Conflict of interest: Dr. Matsumoto has nothing to disclose.
Conflict of interest: Dr. Murase reports grants from Philips-Respironics, grants from Teijin Pharma, grants from Fukuda Denshi, grants from Fukuda Lifetec Keiji, grants from ResMed, grants from Japan Society for the Promotion of Science, outside the submitted work.
Conflict of interest: Dr. Tabara reports grants from Japan Agency for Medical Research and Development (AMED), grants from The Ministry of Education, Culture, Sports, Science & Technology in Japan, during the conduct of the study.
Conflict of interest: Dr. Minami reports personal fees from Teijin Zaitakuiryou, outside the submitted work.
Conflict of interest: Dr. Kanai has nothing to disclose.
Conflict of interest: Dr. Takeyama reports grants from Philips-Respironics, grants from ResMed, grants from Fukuda Denshi, grants from Fukuda Lifetec Keiji, grants from Teijin Pharma, outside the submitted work.
Conflict of interest: Dr. N. Takahashi reports grants from Philips-Respironics, grants from ResMed, grants from Fukuda Denshi, grants from Fukuda Lifetec Keiji, outside the submitted work.
Conflict of interest: Dr. Hamada reports grants from Teijin Pharma, outside the submitted work.
Conflict of interest: Dr. Tanizawa has nothing to disclose.
Conflict of interest: Dr. Wakamura has nothing to disclose.
Conflict of interest: Dr. Komenami has nothing to disclose.
Conflict of interest: Dr. Setoh has nothing to disclose.
Conflict of interest: Dr. Kawaguchi has nothing to disclose.
Conflict of interest: Dr. Tsutsumi has nothing to disclose.
Conflict of interest: Dr. Morita has nothing to disclose.
Conflict of interest: Dr. Y. Takahashi has nothing to disclose.
Conflict of interest: Dr. Nakayama has nothing to disclose.
Conflict of interest: Dr. Hirai has nothing to disclose.
Conflict of interest: Dr. Matsuda reports grants from Kyoto University, grants from the Ministry of Education, Culture, Sports, Science & Technology in Japan, grants from Japan Agency for Medical Research and Development (AMED), grants from The Takeda Medical Research Foundation, during the conduct of the study.
Conflict of interest: Dr. Chin reports grants from the Japanese Ministry of Education, Culture, Sports, Science and Technology, grants from the Intractable Respiratory Diseases and Pulmonary Hypertension Research Group, the Ministry of Health, Labor and Welfare, Japan, grants from the Research Foundation for Healthy Aging, grants from Health, Labour and Welfare Sciences Research Grants, Research on Region Medical, grants from the Center of Innovation Program, and the Global University Project from Japan Science and Technology Agency, Japan Agency for Medical Research and Development, during the conduct of the study; grants and personal fees from Philips-Respironics, grants and personal fees from Teijin Pharma, grants and personal fees from Fukuda Denshi, grants and personal fees from Fukuda Lifetec Keiji, grants from KYORIN Pharmaceutical Co., Ltd, grants from Nippon Boehringer Ingelheim Co., Ltd, grants and personal fees from GlaxoSmithKline, personal fees from MSD, grants and personal fees from Resmed, personal fees from Astellas Pharma, personal fees from Eisai Co., Ltd., outside the submitted work.
This is a PDF-only article. Please click on the PDF link above to read it.
- Received November 21, 2019.
- Accepted April 20, 2020.
- Copyright ©ERS 2020