Obstructive sleep apnea as a risk factor for cerebral white matter change in a middle-aged and older general population

Hyun Kim, Chang Ho Yun, Robert Joseph Thomas, Seung Hoon Lee, Hyung Suk Seo, Eo Rin Cho, Seung Ku Lee, Dae Wui Yoon, Sooyeon Suh, Chol Shin

Research output: Contribution to journalArticle

85 Citations (Scopus)

Abstract

Study Objective: Obstructive sleep apnea (OSA) contributes to the development of systemic hypertension, and hypertension strongly predicts the development of white matter change (WMC). Thus, it is plausible that OSA mediates WMC. The goal of the current study is to determine whether a contextual relationship exists between OSA and cerebral WMC. Design: Crosssectional analyses conducted in a population-based study. Setting: Korean community-based sample from the Korean Genome and Epidemiology Study (KoGES) who attended examinations in 2011 at a medical center. Participants: There were 503 individuals (mean ± SD, age 59.63 ± 7.48 y) who were free of previously diagnosed cardiovascular and neurologic diseases. Measurements and Results: Participants underwent 1-night polysomnography and were classified as no OSA (obstructive apnea-hypopnea index [AHI] < 5, n = 289), mild OSA (AHI 5-15, n = 161), and moderate to severe OSA (AHI ≥ 15, n = 53). WMC was identified with brain magnetic resonance imaging (MRI) and was found in 199 individuals (39.56%). Multivariate logistic regression analyses adjusted for covariates revealed that moderate to severe OSA was significantly associated with the presence of WMC (odds ratio [OR] 2.08, 95%, confidence interval [CI] 1.05-4.13) compared with no OSA. Additional adjustment of hypertension to the model did not alter the significance of the association (OR 2.03, 95% CI 1.02-4.05). Conclusions: Moderate to severe OSA is an independent risk factor for WMC in middle-aged and older individuals. Thus, early recognition and treatment of OSA could reduce the risk of stroke and vascular dementia.

Original languageEnglish
Pages (from-to)709-715
Number of pages7
JournalSleep
Volume36
Issue number5
DOIs
Publication statusPublished - 2013 May 1

Fingerprint

Obstructive Sleep Apnea
Population
Apnea
Hypertension
Odds Ratio
White Matter
Confidence Intervals
Social Adjustment
Vascular Dementia
Polysomnography
Nervous System Diseases
Epidemiology
Cardiovascular Diseases
Logistic Models
Stroke
Regression Analysis
Magnetic Resonance Imaging
Genome
Brain

Keywords

  • General population
  • Obstructive sleep apnea
  • Stroke
  • White matter change

ASJC Scopus subject areas

  • Physiology (medical)
  • Clinical Neurology

Cite this

Obstructive sleep apnea as a risk factor for cerebral white matter change in a middle-aged and older general population. / Kim, Hyun; Yun, Chang Ho; Thomas, Robert Joseph; Lee, Seung Hoon; Seo, Hyung Suk; Cho, Eo Rin; Lee, Seung Ku; Yoon, Dae Wui; Suh, Sooyeon; Shin, Chol.

In: Sleep, Vol. 36, No. 5, 01.05.2013, p. 709-715.

Research output: Contribution to journalArticle

Kim, Hyun ; Yun, Chang Ho ; Thomas, Robert Joseph ; Lee, Seung Hoon ; Seo, Hyung Suk ; Cho, Eo Rin ; Lee, Seung Ku ; Yoon, Dae Wui ; Suh, Sooyeon ; Shin, Chol. / Obstructive sleep apnea as a risk factor for cerebral white matter change in a middle-aged and older general population. In: Sleep. 2013 ; Vol. 36, No. 5. pp. 709-715.
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abstract = "Study Objective: Obstructive sleep apnea (OSA) contributes to the development of systemic hypertension, and hypertension strongly predicts the development of white matter change (WMC). Thus, it is plausible that OSA mediates WMC. The goal of the current study is to determine whether a contextual relationship exists between OSA and cerebral WMC. Design: Crosssectional analyses conducted in a population-based study. Setting: Korean community-based sample from the Korean Genome and Epidemiology Study (KoGES) who attended examinations in 2011 at a medical center. Participants: There were 503 individuals (mean ± SD, age 59.63 ± 7.48 y) who were free of previously diagnosed cardiovascular and neurologic diseases. Measurements and Results: Participants underwent 1-night polysomnography and were classified as no OSA (obstructive apnea-hypopnea index [AHI] < 5, n = 289), mild OSA (AHI 5-15, n = 161), and moderate to severe OSA (AHI ≥ 15, n = 53). WMC was identified with brain magnetic resonance imaging (MRI) and was found in 199 individuals (39.56{\%}). Multivariate logistic regression analyses adjusted for covariates revealed that moderate to severe OSA was significantly associated with the presence of WMC (odds ratio [OR] 2.08, 95{\%}, confidence interval [CI] 1.05-4.13) compared with no OSA. Additional adjustment of hypertension to the model did not alter the significance of the association (OR 2.03, 95{\%} CI 1.02-4.05). Conclusions: Moderate to severe OSA is an independent risk factor for WMC in middle-aged and older individuals. Thus, early recognition and treatment of OSA could reduce the risk of stroke and vascular dementia.",
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AU - Cho, Eo Rin

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