OSA AS A RISK FACTOR FOR CEREBRAL WHITE MATTER CHANGE
Obstructive Sleep Apnea as a Risk Factor for Cerebral White Matter Change in a Middle-Aged and Older General Population
Hyun Kim, MSc1,2; Chang-Ho Yun, MD, PhD3; Robert Joseph Thomas, MD, MMSc4; Seung Hoon Lee, MD, PhD5; Hyung Suk Seo, MD, PhD6; Eo Rin Cho, PhD1; Seung Ku Lee, PhD1; Dae Wui Yoon, MSc1,2; Sooyeon Suh, PhD, CBSM1,7; Chol Shin, MD, PhD, FCCP1,2,8
1Institute of Human Genomic Study, School of Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea; 2Brain Korea 21 Program in Biomedical Science, School of Medicine, Korea University, Anam, Republic of Korea; 3Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea; 4Division of Pulmonary, Critical Care and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA; 5Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea; 6Department of Radiology, School of Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea; 7Stanford University, Department of Psychiatry; 8Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea
Obstructive sleep apnea (OSA) contributes to the development of systemic hypertension, and hypertension strongly predicts the development of white matter change (WMC). Thus, it is plausible that OSA mediates WMC. The goal of the current study is to determine whether a contextual relationship exists between OSA and cerebral WMC.
Cross-sectional analyses conducted in a population-based study.
Korean community-based sample from the Korean Genome and Epidemiology Study (KoGES) who attended examinations in 2011 at a medical center.
There were 503 individuals (mean ± SD, age 59.63 ± 7.48 y) who were free of previously diagnosed cardiovascular and neurologic diseases.
Measurements and Results:
Participants underwent 1-night polysomnography and were classified as no OSA (obstructive apnea-hypopnea index [AHI] < 5, n = 289), mild OSA (AHI 5-15, n = 161), and moderate to severe OSA (AHI ≥ 15, n = 53). WMC was identified with brain magnetic resonance imaging (MRI) and was found in 199 individuals (39.56%). Multivariate logistic regression analyses adjusted for covariates revealed that moderate to severe OSA was significantly associated with the presence of WMC (odds ratio [OR] 2.08, 95%, confidence interval [CI] 1.05-4.13) compared with no OSA. Additional adjustment of hypertension to the model did not alter the significance of the association (OR 2.03, 95% CI 1.02-4.05).
Moderate to severe OSA is an independent risk factor for WMC in middle-aged and older individuals. Thus, early recognition and treatment of OSA could reduce the risk of stroke and vascular dementia.
Kim H; Yun CH; Thomas RJ; Lee SH; Seo HS; Cho ER; Lee SK; Yoon DW; Suh S; Shin C. Obstructive sleep apnea as a risk factor for cerebral white matter change in a middle-aged and older general population. SLEEP 2013;36(5):709-715.