The influence of gender, weight, and age on OSA progression in REM and NREM sleep
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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 lower/different 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.
Type | Dissertation |
Acquisition | Proxy-submission |
Review Type | None: Degree-based Submission |
Format | Text-based Document |
Evidence Level | Retrospective/Secondary Analysis |
Research Approach | Quantitative Research |
Keywords | REM Sleep; Gender; Obstructive Sleep Apnea; Respiratory Disturbance Index |
Grantor | Emory University |
Advisor | Rogers, Ann E.; Bliwise, Donald L.; Hertzberg, Vicki S.; Lewis, Tene T. |
Level | PhD |
Year | 2019 |
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