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. 2022 Oct;31(5):e13599.
doi: 10.1111/jsr.13599. Epub 2022 Apr 12.

Rapid eye movement sleep apnea and carotid intima thickness in men and women: a SHE-MUSTACHE cohort study

Mirjam Ljunggren  1 , Tord Naessén  2 , Jenny Theorell-Haglöw  1 , Karl A Franklin  3 , Eva Lindberg  1
Affiliations

Rapid eye movement sleep apnea and carotid intima thickness in men and women: a SHE-MUSTACHE cohort study

Mirjam Ljunggren et al. J Sleep Res. 2022 Oct.

Abstract

Rapid eye movement (REM) obstructive sleep apnea might be particularly harmful to the cardiovascular system. We aimed to investigate the association between sleep apnea during REM sleep and signs of atherosclerotic disease in the form of carotid intima thickness in a community-based sample of men and women and possible sex differences in this association. The association between sleep apnea during REM sleep and intima thickness was analysed cross-sectionally in women from the community-based "Sleep and Health in Women" (SHE) study (n = 253) and age- and body mass index (BMI)-matched men from the "Men in Uppsala; a Study of sleep, Apnea and Cardiometabolic Health" (MUSTACHE) study (n = 338). Confounders adjusted for were age, BMI, gender, alcohol, and smoking. All participants underwent a full-night polysomnography, high-resolution ultrasonography of the common carotid artery, anthropometric measurements, blood pressure measurements, and answered questionnaires. There was an association between sleep apnea during REM sleep and thicker carotid intima that remained after adjustment for confounding (adjusted β = 0.008, p = 0.032). The intima was increased by 9.9% in the group with severe sleep apnea during REM sleep, and this association between severe sleep apnea during REM sleep and increased intima thickness remained after adjustment for confounders (adjusted β = 0.043, p = 0.021). More women than men had severe sleep apnea during REM sleep; moreover, in sex-stratified analyses, the association between sleep apnea during REM sleep and intima thickness was found in women but not in men. We conclude that severe REM sleep apnea is independently associated with signs of atherosclerosis. When stratified by sex, the association is seen in women but not in men.

Keywords: REM sleep; atherosclerosis; gender difference; sleep-disordered breathing.

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Conflict of interest statement

None of the authors has any conflict of interest relevant to the present study.

Figures

FIGURE 1
FIGURE 1
Flow chart describing the “Sleep and Health in Women” (SHE) and “Men in Uppsala; a Study of sleep, Apnea and Cardiometabolic Health” (MUSTACHE) cohorts and the final study sample
See this image and copyright information in PMC

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