Dados do Trabalho

Título

Association of Obstructive Sleep Apnea, Insomnia and the combination (COMISA) with Hypertension, Diabetes and Dyslipidemia: The ELSA-Brasil study.

Introdução

Obstructive sleep apnea (OSA) and insomnia and the combination, namely COMISA (Comorbid Insomnia and Sleep Apnea) may be associated with cardiovascular risk factors and worse cardiometabolic outcomes.

Objetivo

We aimed to evaluate the associations between OSA, insomnia and COMISA with hypertension (HTN), type 2 diabetes mellitus (DM2) and dyslipidemia (DLP).

Métodos

Participants from the ELSA-Brasil underwent clinical and sleep assessments including OSA (defined by the apnea-hypopnea index ≥ 15 events per hour by a portable sleep monitor), insomnia (defined by any complaint of difficulty initiating or maintaining sleep in parallel of reporting daytime fatigue in the last 30 days) and COMISA. We stratified our sample in 4 groups: 1) control (no OSA and insomnia); 2) OSA (OSA without insomnia) 3) Insomnia (insomnia without OSA); 4) COMISA. HTN, DM2 and DLP were diagnosis using standard definitions. A multivariate analysis was used to determinate whether OSA, insomnia or COMISA were independently associated with HTN, DM2 and DLP adjusting for age, sex, self-reported race, body mass index, physical activity, and excessive drinking.

Resultados

We studied 2062 participants (age 49±8 years; 42.7% men; 26.2% HTN,15.4 % DM2, 54.4% DLP). 23% had OSA, 11.6% had insomnia and 5.2% fulfilled the COMISA diagnosis. Comparing to controls and insomnia groups, patients with OSA and COMISA were older, had higher values of adiposity parameters, and higher frequency of HTN, DM2 and DLP. Multivariate analysis revealed that OSA was independently associated with HTN (OR:1.59; 95% CI: 1.08, 2.35), in contrast, we did not observe significant associations with DM2 and DLP. There was not association among the groups Insomnia and COMISA with HTN, DM2 and DLP.

Conclusões

OSA, but not insomnia or COMISA, is independently associated with HTN in the ELSA-Brasil study.

Palavras -chave

obstructive sleep apnea; hypertension; insomnia; diabetes; dyslipidemia