Dados do Trabalho

Título

Assessing low arousal threshold in obstructive sleep apnea: insights from a general population study.

Introdução

Obstructive sleep apnea (OSA) results from a combination of anatomical and non-anatomical endotypes. Among the non-anatomical factors, a low arousal threshold (LAT) can make it challenging for individuals to tolerate and adhere to certain treatments.

Objetivo

The aim of this study was to determine the prevalence of the LAT endotype among the participants in the 4th edition of the Sao Paulo Epidemiological Sleep Study (EPISONO), and analyze the sociodemographic characteristics associated with LAT.

Métodos

We used the algorithm proposed by Edwards et al. (2014) to identify LAT that is based on polysomnographic (PSG) parameters, namely the apnea-hypopnea index (AHI), peripheral oxygen saturation (SpO₂) and the percentage of hypopneas.
Questionnaires on quality of life, fatigue, daytime sleepiness, and insomnia were also applied to assess gender-related differences between male and female non-OSA, LAT and high arousal threshold (HAT) participants.

Resultados

The groups differed significantly in terms of age and body mass index; however, there were no significant differences between ethnicities and for most of the assessed symptoms. A higher frequency of symptoms was observed in women, especially in those belonging to the LAT (OSA) group compared to men in the same group. Clinically significant insomnia was also more prevalent in females. In respect of the LAT (OSA) participants, no differences were observed between participants with and without clinically significant insomnia in the OSA group.

Conclusões

The characterization of the LAT endotype, and the higher frequency of symptoms in OSA women highlight the importance of valuing polysomnographic findings and the symptoms reported by women during clinical assessment. LAT showed no relationship with worsening arousability among participants with co-morbid insomnia and sleep apnea (COMISA) compared to those with OSA-only in this study.

Palavras -chave

sleep; obstructive sleep apnea; endotypes; low arousal threshold.