Chronic kidney disease and sleep apnea association of kidney disease with obstructive sleep apnea in a population study of men

Robert J. Adams, Sarah L. Appleton, Andrew Vakulin, Patrick J. Hanly, Stephen P. McDonald, Sean A. Martin, Carol J. Lang, Anne W. Taylor, R. Doug McEvoy, Nick A. Antic, Peter G. Catcheside, Andrew D. Vincent, Gary A. Wittert

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Study Objectives: To determine the relationship between obstructive sleep apnea (OSA) and chronic kidney disease (CKD). Previous population studies of the association are sparse, conflicting and confined largely to studies of administrative data. Methods: Cross-sectional analysis in unselected participants of the Men Androgens Inflammation Lifestyle Environment and Stress (MAILES) study, aged >40 years. Renal data were available for 812 men without a prior OSA diagnosis who underwent full in-home polysomnography (Embletta X100) in 2010-2011. CKD was defined as an estimated glomerular filtration rate (EGFR) <60 mL/min/1.73m2 or EGFR≥60 and albuminuria (albumin-creatinine ratio ≥3.0 mg/mmol). Results: CKD (10.5%, n = 85 [Stage 1-3, 9.7%; Stage 4-5, 0.7%]) of predominantly mild severity showed significant associations with OSA (apnea-hypoapnea index [AHI] ≥ 10): odds ratio (OR) = 1.9, 95% confidence interval (CI): 1.02-3.5; severe OSA (AHI ≥ 30/h): OR = 2.6, 95% CI: 1.1-6.2; and respiratory-related arousal index: ≥7.6/h, OR = 2.3, 95%CI: 1.1-4.7; but not measures of hypoxemia after adjustment for age, hypertension, diabetes, smoking, obesity, and NSAID use. There was no association of CKD with daytime sleepiness. In men with CKD, those with OSA were not significantly more likely to report symptoms (sleepiness, snoring, and apneas) or be identified with the STOP OSA screening questionnaire, compared to men without OSA. Conclusions: Predominantly mild CKD is associated with severe OSA and arousals. Further population studies examining the longitudinal relationship between CKD and OSA are warranted. Better methods are needed to identify OSA in CKD which may have few symptoms.

LanguageEnglish
JournalSleep
Volume40
Issue number1
DOIs
Publication statusPublished - 1 Jan 2017

Keywords

  • Chronic kidney disease
  • Cohort study
  • Epidemiology
  • Men
  • Obstructive sleep apnea

ASJC Scopus subject areas

  • Clinical Neurology
  • Physiology (medical)

Cite this

@article{f76357b4233e4639928cdaa86810df93,
title = "Chronic kidney disease and sleep apnea association of kidney disease with obstructive sleep apnea in a population study of men",
abstract = "Study Objectives: To determine the relationship between obstructive sleep apnea (OSA) and chronic kidney disease (CKD). Previous population studies of the association are sparse, conflicting and confined largely to studies of administrative data. Methods: Cross-sectional analysis in unselected participants of the Men Androgens Inflammation Lifestyle Environment and Stress (MAILES) study, aged >40 years. Renal data were available for 812 men without a prior OSA diagnosis who underwent full in-home polysomnography (Embletta X100) in 2010-2011. CKD was defined as an estimated glomerular filtration rate (EGFR) <60 mL/min/1.73m2 or EGFR≥60 and albuminuria (albumin-creatinine ratio ≥3.0 mg/mmol). Results: CKD (10.5{\%}, n = 85 [Stage 1-3, 9.7{\%}; Stage 4-5, 0.7{\%}]) of predominantly mild severity showed significant associations with OSA (apnea-hypoapnea index [AHI] ≥ 10): odds ratio (OR) = 1.9, 95{\%} confidence interval (CI): 1.02-3.5; severe OSA (AHI ≥ 30/h): OR = 2.6, 95{\%} CI: 1.1-6.2; and respiratory-related arousal index: ≥7.6/h, OR = 2.3, 95{\%}CI: 1.1-4.7; but not measures of hypoxemia after adjustment for age, hypertension, diabetes, smoking, obesity, and NSAID use. There was no association of CKD with daytime sleepiness. In men with CKD, those with OSA were not significantly more likely to report symptoms (sleepiness, snoring, and apneas) or be identified with the STOP OSA screening questionnaire, compared to men without OSA. Conclusions: Predominantly mild CKD is associated with severe OSA and arousals. Further population studies examining the longitudinal relationship between CKD and OSA are warranted. Better methods are needed to identify OSA in CKD which may have few symptoms.",
keywords = "Chronic kidney disease, Cohort study, Epidemiology, Men, Obstructive sleep apnea",
author = "Adams, {Robert J.} and Appleton, {Sarah L.} and Andrew Vakulin and Hanly, {Patrick J.} and McDonald, {Stephen P.} and Martin, {Sean A.} and Lang, {Carol J.} and Taylor, {Anne W.} and McEvoy, {R. Doug} and Antic, {Nick A.} and Catcheside, {Peter G.} and Vincent, {Andrew D.} and Wittert, {Gary A.}",
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Chronic kidney disease and sleep apnea association of kidney disease with obstructive sleep apnea in a population study of men. / Adams, Robert J.; Appleton, Sarah L.; Vakulin, Andrew; Hanly, Patrick J.; McDonald, Stephen P.; Martin, Sean A.; Lang, Carol J.; Taylor, Anne W.; McEvoy, R. Doug; Antic, Nick A.; Catcheside, Peter G.; Vincent, Andrew D.; Wittert, Gary A.

In: Sleep, Vol. 40, No. 1, 01.01.2017.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Chronic kidney disease and sleep apnea association of kidney disease with obstructive sleep apnea in a population study of men

AU - Adams, Robert J.

AU - Appleton, Sarah L.

AU - Vakulin, Andrew

AU - Hanly, Patrick J.

AU - McDonald, Stephen P.

AU - Martin, Sean A.

AU - Lang, Carol J.

AU - Taylor, Anne W.

AU - McEvoy, R. Doug

AU - Antic, Nick A.

AU - Catcheside, Peter G.

AU - Vincent, Andrew D.

AU - Wittert, Gary A.

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Study Objectives: To determine the relationship between obstructive sleep apnea (OSA) and chronic kidney disease (CKD). Previous population studies of the association are sparse, conflicting and confined largely to studies of administrative data. Methods: Cross-sectional analysis in unselected participants of the Men Androgens Inflammation Lifestyle Environment and Stress (MAILES) study, aged >40 years. Renal data were available for 812 men without a prior OSA diagnosis who underwent full in-home polysomnography (Embletta X100) in 2010-2011. CKD was defined as an estimated glomerular filtration rate (EGFR) <60 mL/min/1.73m2 or EGFR≥60 and albuminuria (albumin-creatinine ratio ≥3.0 mg/mmol). Results: CKD (10.5%, n = 85 [Stage 1-3, 9.7%; Stage 4-5, 0.7%]) of predominantly mild severity showed significant associations with OSA (apnea-hypoapnea index [AHI] ≥ 10): odds ratio (OR) = 1.9, 95% confidence interval (CI): 1.02-3.5; severe OSA (AHI ≥ 30/h): OR = 2.6, 95% CI: 1.1-6.2; and respiratory-related arousal index: ≥7.6/h, OR = 2.3, 95%CI: 1.1-4.7; but not measures of hypoxemia after adjustment for age, hypertension, diabetes, smoking, obesity, and NSAID use. There was no association of CKD with daytime sleepiness. In men with CKD, those with OSA were not significantly more likely to report symptoms (sleepiness, snoring, and apneas) or be identified with the STOP OSA screening questionnaire, compared to men without OSA. Conclusions: Predominantly mild CKD is associated with severe OSA and arousals. Further population studies examining the longitudinal relationship between CKD and OSA are warranted. Better methods are needed to identify OSA in CKD which may have few symptoms.

AB - Study Objectives: To determine the relationship between obstructive sleep apnea (OSA) and chronic kidney disease (CKD). Previous population studies of the association are sparse, conflicting and confined largely to studies of administrative data. Methods: Cross-sectional analysis in unselected participants of the Men Androgens Inflammation Lifestyle Environment and Stress (MAILES) study, aged >40 years. Renal data were available for 812 men without a prior OSA diagnosis who underwent full in-home polysomnography (Embletta X100) in 2010-2011. CKD was defined as an estimated glomerular filtration rate (EGFR) <60 mL/min/1.73m2 or EGFR≥60 and albuminuria (albumin-creatinine ratio ≥3.0 mg/mmol). Results: CKD (10.5%, n = 85 [Stage 1-3, 9.7%; Stage 4-5, 0.7%]) of predominantly mild severity showed significant associations with OSA (apnea-hypoapnea index [AHI] ≥ 10): odds ratio (OR) = 1.9, 95% confidence interval (CI): 1.02-3.5; severe OSA (AHI ≥ 30/h): OR = 2.6, 95% CI: 1.1-6.2; and respiratory-related arousal index: ≥7.6/h, OR = 2.3, 95%CI: 1.1-4.7; but not measures of hypoxemia after adjustment for age, hypertension, diabetes, smoking, obesity, and NSAID use. There was no association of CKD with daytime sleepiness. In men with CKD, those with OSA were not significantly more likely to report symptoms (sleepiness, snoring, and apneas) or be identified with the STOP OSA screening questionnaire, compared to men without OSA. Conclusions: Predominantly mild CKD is associated with severe OSA and arousals. Further population studies examining the longitudinal relationship between CKD and OSA are warranted. Better methods are needed to identify OSA in CKD which may have few symptoms.

KW - Chronic kidney disease

KW - Cohort study

KW - Epidemiology

KW - Men

KW - Obstructive sleep apnea

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U2 - 10.1093/sleep/zsw015

DO - 10.1093/sleep/zsw015

M3 - Article

VL - 40

JO - Sleep

T2 - Sleep

JF - Sleep

SN - 0161-8105

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