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. 2022 Feb;31(1):e13441.
doi: 10.1111/jsr.13441. Epub 2021 Aug 10.

Diabetes and cardiovascular diseases are associated with the worsening of intermittent hypoxaemia

Tuomas Karhu  1   2 , Sami Myllymaa  1   2 , Sami Nikkonen  1   2 , Diego R Mazzotti  3 , Antti Kulkas  1   4 , Juha Töyräs  1   5   6 , Timo Leppänen  1   2   6
Affiliations

Diabetes and cardiovascular diseases are associated with the worsening of intermittent hypoxaemia

Tuomas Karhu et al. J Sleep Res. 2022 Feb.

Abstract

Intermittent hypoxaemia is a risk factor for numerous diseases. However, the reverse pathway remains unclear. Therefore, we investigated whether pre-existing hypertension, diabetes or cardiovascular diseases are associated with the worsening of intermittent hypoxaemia. Among the included 2,535 Sleep Heart Health Study participants, hypertension (n = 1,164), diabetes (n = 170) and cardiovascular diseases (n = 265) were frequently present at baseline. All participants had undergone two polysomnographic recordings approximately 5.2 years apart. Covariate-adjusted linear regression analyses were utilized to investigate the difference in the severity of intermittent hypoxaemia at baseline between each comorbidity group and the group of participants free from all comorbidities (n = 1,264). Similarly, we investigated whether the pre-existing comorbidities are associated with the progression of intermittent hypoxaemia. Significantly higher oxygen desaturation index (β = 1.77 [95% confidence interval: 0.41-3.13], p = 0.011), desaturation severity (β = 0.07 [95% confidence interval: 0.00-0.14], p = 0.048) and desaturation duration (β = 1.50 [95% confidence interval: 0.31-2.69], p = 0.013) were observed in participants with pre-existing cardiovascular diseases at baseline. Furthermore, the increase in oxygen desaturation index (β = 3.59 [95% confidence interval: 1.78-5.39], p < 0.001), desaturation severity (β = 0.08 [95% confidence interval: 0.02-0.14], p = 0.015) and desaturation duration (β = 2.60 [95% confidence interval: 1.22-3.98], p < 0.001) during the follow-up were higher among participants with diabetes. Similarly, the increase in oxygen desaturation index (β = 2.73 [95% confidence interval: 1.15-4.32], p = 0.001) and desaturation duration (β = 1.85 [95% confidence interval: 0.62-3.08], p = 0.003) were higher among participants with cardiovascular diseases. These results suggest that patients with pre-existing diabetes or cardiovascular diseases are at increased risk for an expedited worsening of intermittent hypoxaemia. As intermittent hypoxaemia is an essential feature of sleep apnea, these patients could benefit from the screening and follow-up monitoring of sleep apnea.

Keywords: cardiovascular disease; desaturation; diabetes; hypoxaemia; progression; sleep apnea.

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Conflict of interest statement

Conflict of interest statements: None declared.

Figures

Figure 1.
Figure 1.
Flow chart of the study population and sizes of each presence and absence comorbidity groups.
See this image and copyright information in PMC

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