A cross-section Study of Sleep Apnea Prevalence in the General Population age 71 years and its association with cardiovascular disease

Abstract

Abstract Background: There is a lack of knowledge regarding obstructive sleep apnea (OSA) prevalence in older men from the general population. The aim of this cross-sectional study was to determine the prevalence of OSA in 71-year old men derived from the general population in Gothenburg, Sweden. Moreover, to study if OSA, is associated with cardiovascular diseases and if it is more common than other cardiovascular risk factors in this population. Material and Methods: This study is based on men who participated in the re-examination, in 2014, of participants from the “The study of men born in 1943”. All participants answered questionnaires on health status, quality of life. They were than examined at Sahlgrenska University Hospital/Östra in Gothenburg, Sweden, in addition sleep-apnea screening and thumb- EKG was performed in the participants’ homes. Results: A total 536 participants were included in our database, 412 of those underwent sleepapnea screening and were eligible for this study. 121 had obstructive sleep apnea (OSA), with AHI (apnea-hypopnea index) ≥ 15/h, and 191 did not. Thus, OSA (AHI ≥ 15) is common in the old general population. Moreover, it is the second most common risk factor for CVDs after hypertension in this population. The prevalence of OSA was 29.4% in this study. BMI showed significance with OSA (AHI ≥ 15). We found that sleep-disordered breathing is associated with prevalence of hypertension in older men; however after adjustment for BMI the association was no-longer significant. In the subgroup of patients with severe OSA (AHI ≥30) an association could be found between severe OSA and atrial fibrillation even after adjustment for BMI, OR 2.43 (1.02-5.76) Conclusions: Obstructive sleep apnea (OSA) is common in the old general population. There is a more than two fold risk increase for having atrial fibrillation among those that had sever OSA. Longitudinal studies on older general population is warranted to establish whether OSA is a risk factor for development of atrial fibrillation as well as other cardiovascular disease for all individuals and not only for those in certain disease cohorts or for those with day-time sleepiness.