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. 2022 Mar 24;12(1):5127.
doi: 10.1038/s41598-022-08164-6.

A portrait of obstructive sleep apnea risk factors in 27,210 middle-aged and older adults in the Canadian Longitudinal Study on Aging

Cynthia Thompson #  1 , Julie Legault #  1   2 , Gregory Moullec  1   3 , Marc Baltzan  4   5 , Nathan Cross  6   7   8 , Thien Thanh Dang-Vu  6   7   8 , Marie-Ève Martineau-Dussault  1   2 , Patrick Hanly  9 , Najib Ayas  10   11 , Dominique Lorrain  12   13 , Gillian Einstein  14 , Julie Carrier  1   2 , Nadia Gosselin  15   16
Affiliations

A portrait of obstructive sleep apnea risk factors in 27,210 middle-aged and older adults in the Canadian Longitudinal Study on Aging

Cynthia Thompson et al. Sci Rep. .

Abstract

Determining the prevalence and characteristics of individuals susceptible to present with obstructive sleep apnea (OSA) is essential for developing targeted and efficient prevention and screening strategies. We included 27,210 participants aged ≥45 years old (50.3% women) from the Canadian Longitudinal Study on Aging. Using the STOP questionnaire combined to the percentage of body fat (%BF), we estimated the prevalence of individuals at high-risk for OSA in a sex and age-specific manner, and tested the relation with comorbidities, menopause and systemic inflammation. The prevalence was 17.5%, and was lower in women (13.1%) than in men (21.9%). A high level of high-sensitivity C-reactive protein was the strongest factor associated with OSA risk and this association was 1.3-2.3 times higher in women than in men. OSA risk increased with age, cardiovascular diseases, diabetes mellitus, anxio-depressive symptoms, asthma and arthritis. In women, post-menopausal status was associated with a high OSA risk. Nearly 1 adult out of 5 older than 45 is at risk for OSA in Canada. Comorbidities, menopause and systemic inflammation, more than age, explain increased OSA prevalence. Considering this high prevalence and associations with medical and mental comorbidities, health care practitioners should incorporate systematic OSA screening in their clinical procedures.

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Conflict of interest statement

NG is supported by the Canadian Institutes of Health Research (CIHR) through a Foundation grant (#FDN154291), which funded the salary of CT, and studentships to MEMD and JL. NG, TDV, GM and JC receive salary awards from the Fonds de la recherche du Québec (FRQ). NC is supported by a fellowship from the FRQ-Santé. GE was supported by the Wilfred and Joyce Posluns Chair in Women’s Brain Health and Aging. This study was an initiative of the Canadian Sleep and Circadian Network, a network funded by the CIHR. The funding sources had no role in study design, data collection, analyses, interpretation, or writing of the manuscript. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication.

Figures

Figure 1
Figure 1
Flowchart describing the inclusion and exclusion of participants for analyses based on the surrogate STOP score.
Figure 2
Figure 2
Prevalence of participants at high-risk for OSA by age group in women (solid curve) and men (dashed curve). Error bars represent the 95% confidence interval.
Figure 3
Figure 3
Prevalence of non-menopausal (solid curve) and post-menopausal (dashed curve) women at high-risk for OSA by age. Error bars represent the 95% confidence interval.
Figure 4
Figure 4
Adjusted odds ratios for high-risk for OSA in women (black circles) and men (grey x-marks) of age, level of systemic inflammation, OSA-related comorbidities and menopausal status with a statistically significant association with risk for OSA. White squares represent the reference categories. Bars represent the 95% confidence intervals. Hypothyroidism, chronic obstructive pulmonary disease, dementia, and Parkinson’s disease were included in the models but are not shown since they were not associated with high-risk for OSA.
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