MedicalResearch.com Interview with:
Matthew P Butler, PhD
Assistant Professor, Oregon Institute of Occupational Health Sciences
Assistant Professor, Department of Behavioral Neuroscience
Oregon Health & Science University
Portland, OR 97239
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Obstructive sleep apnea (OSA) is associated with heart disease and mortality, but how OSA does this is not well understood. We are therefore looking for sub-phenotypes within OSA that will help us predict who is at greatest risk.
Current diagnosis of OSA is made on the basis of the apnea-hypopnea index (AHI – the number of respiratory events per hour of sleep). But the AHI is not a very good predictor of future mortality.
We tested the hypothesis that the duration of events (how long the breathing interruptions are) would predict risk. We found that those with the shortest breathing interruptions had the highest risk of dying, after accounting for other conditions like age, gender, race, and smoking status.
MedicalResearch.com: What should readers take away from your report?
Response: Readers should take from this that there are many features in obstructive sleep apnea that aren’t captured by the standard diagnostic measure of AHI. Indeed, the length of the breathing interruption is a good predictor of mortality risk, and importantly, it predicts risk in women, unlike the AHI.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: This was a prospective study, which means we measured sleep characteristics, and then linked them to long term outcomes. This is a powerful method to reveal patterns, but the study can only point to potential mechanisms. In future research, we need to better describe the physiology of breathing interruptions to understand what it is that is different about people with short versus long breathing interruptions. We predict that this is due to a different arousal threshold, but this needs to be tested.
MedicalResearch.com: Is there anything else you would like to add?
Response: We think that this study will have future clinical relevance, because the duration of breathing interruptions can be measured from the current sleep tests that people have to diagnose obstructive sleep apnea. In the future, physicians may be able to use the duration of events to make better treatment recommendations to their patients.
Nothing to disclose.
Matthew P Butler, Jeffery T Emch, Michael Rueschman, Scott A Sands, Steven A Shea, Andrew Wellman, Susan Redline. Apnea-Hypopnea Event Duration Predicts Mortality in Men and Women in the Sleep Heart Health Study. American Journal of Respiratory and Critical Care Medicine, 2018; DOI: 10.1164/rccm.201804-0758OC
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