The influence of gender, weight, and age on OSA progression in REM and NREM sleep Público
Jones, Alan (Spring 2019)
Published
Abstract
Abstract
The influence of gender, weight, and age on OSA progression in REM and NREM sleep
By Alan Michael Jones
Background
In the United States, it is estimated that obstructive sleep apnea (OSA), which greatly increases the risk of many adverse health conditions, affects over 25 million adults with prevalence rates that have drastically increased over the last two decades, likely due to the obesity epidemic. Research has identified several explanatory variables of OSA, but studies have indicated that OSA incidence and severity is mainly determined by three variables: gender, weight and age.
Purpose
The purpose of this study is to investigate the effects and importance of gender, weight, and age on OSA levels (as measured by respiratory disturbance index (RDI) values) by using a large, community-based sample with equal amounts of men and women. This study will also investigate these variables’ impact on OSA in the whole-night, rapid eye movement (REM), and non-rapid eye movement (NREM) stages of sleep.
Sample/Design
A retrospective, secondary analysis of the Sleep Heart Health Study (SHHS) will be used. SHHS is a multi-center cohort study that was implemented in an effort to determine what the cardiovascular and other consequences were of sleep-disordered breathing. Participants were recruited from 9 existing epidemiological studies (“parent cohorts”), and two time points of data collection were performed (labeled SHHS1 and SHHS2). The total number of subjects at SHHS1 is 5804, and 4080 subjects were present at SHHS2.
Results
Overall, RDI values were significantly higher (indicating higher OSA levels) for men in all sleep
stages. Gender, body mass index (BMI), and age
were the main explanatory variables for RDI values. Overall, BMI was the main variable influencing RDI values in all sleep stages. For men and women, BMI is significantly lowerdifferent in those who, over time, stay at either a normal or mild OSA level versus those who, over time, progress to moderate or severe levels.
Conclusion
Gender age, and BMI were influential on OSA and its progression or improvement. BMI was the main variable of influence in all sleep stages, and BMI median value was significantly different lower in those who maintained a normal or mild OSA level over time compared to those with a more severe OSA level.
Table of Contents
Table of Contents
Chapter 1: Dissertation Introduction
Figure 1 Conceptual Model for the Dissertation
Chapter 2: Dissertation Manuscript 1
Manuscript Title: RDI value difference in men and women during whole-night, REM, and NREM
sleep
Table 1 Participant Age, BMI, Race/Ethnicity and Prior Diagnosis of OSA
Table 2 T-test results and descriptive statistics for RDI means
Table 3 Group statistics and p-values for RDI means
Table 4 Differences between group means for RDI means
Chapter 3: Dissertation Manuscript 2
Manuscript Title: The significance of BMI in varying OSA levels for men and women
Table 1 Participant Age, BMI, Race/Ethnicity, and Prior Diagnosis of OSA
Table 2 Men - Group number reference
Table 3 Men - Sample Distribution
Table 4 Men – Mean Baseline BMI
Table 5 Men - Median Baseline BMI
Figure 1 Men – Pairwise Comparison results
Table 6 Women - Group number reference
Table 7 Women - Sample Distribution
Table 8 Women – Mean Baseline BMI
Table 9 Women - Median Baseline BMI
Figure 2 Women – Pairwise Comparison results
Figure 3 Men – Pairwise Comparisons results narrative
Figure 4 Women – Pairwise Comparisons results narrative
Chapter 4: Dissertation Manuscript 3
Manuscript Title: Examining the significant factors contributing to RDI in whole-night, REM,
and NREM sleep
Table 1 Participant Age, BMI, Race/Ethnicity, and Prior Diagnosis of OSA
Table 2 Multiple linear regression results for Whole-Night RDIsleep
Table 3 Multiple linear regression results for REM RDIsleep
Table 4 Multiple linear regression results for NREM RDIsleep
Table 5 Multiple linear regression results for REM RDIsleep (modified with REM > 15 minutes)
Table 6 Causal mediation analysis results
Table 7 Relative Variable Importance in 3 sleep stages
Chapter 5: Dissertation Summary
Figure 1 Next Steps
About this Dissertation
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