Association of Periodic Limb Movements and Obstructive Sleep Apnea With Risk of Cardiovascular Disease and Mortality
Background Obstructive sleep apnea is a well‐established risk factor for cardiovascular disease (CVD). Recent studies have also linked periodic limb movements during sleep to CVD. We aimed to determine whether periodic limb movements during sleep and obstructive sleep apnea are independent or synerg...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2024-02-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.123.031630 |
| _version_ | 1797296252156641280 |
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| author | Andrey Zinchuk Narat Srivali Li Qin Sangchoon Jeon Ahmad Ibrahim Scott A. Sands Brian Koo Henry K. Yaggi |
| author_facet | Andrey Zinchuk Narat Srivali Li Qin Sangchoon Jeon Ahmad Ibrahim Scott A. Sands Brian Koo Henry K. Yaggi |
| author_sort | Andrey Zinchuk |
| collection | DOAJ |
| description | Background Obstructive sleep apnea is a well‐established risk factor for cardiovascular disease (CVD). Recent studies have also linked periodic limb movements during sleep to CVD. We aimed to determine whether periodic limb movements during sleep and obstructive sleep apnea are independent or synergistic factors for CVD events or death. Methods and Results We examined data from 1049 US veterans with an apnea‐hypopnea index (AHI) <30 events/hour. The primary outcome was incident CVD or death. Cox proportional hazards regression assessed the relationships between the AHI, periodic limb movement index (PLMI), and the AHI×PLMI interaction with the primary outcome. We then examined whether AHI and PLMI were associated with primary outcome after adjustment for age, sex, race and ethnicity, obesity, baseline risk of mortality, and Charlson Comorbidity Index. During a median follow‐up of 5.1 years, 237 of 1049 participants developed incident CVD or died. Unadjusted analyses showed an increased risk of the primary outcome with every 10‐event/hour increase in PLMI (hazard ratio [HR], 1.08 [95% CI, 1.05–1.13]) and AHI (HR, 1.17 [95% CI, 1.01– 1.37]). Assessment associations of AHI and PLMI and their interaction with the primary outcome revealed no significant interaction between PLMI and AHI. In fully adjusted analyses, PLMI, but not AHI, was associated with an increased risk of primary outcome: HR of 1.05 (95% CI, 1.00–1.09) per every 10 events/hour. Results were similar after adjusting with Framingham risk score. Conclusions Our study revealed periodic limb movements during sleep as a risk factor for incident CVD or death among those who had AHI <30 events/hour, without synergistic association between periodic limb movements during sleep and obstructive sleep apnea. |
| first_indexed | 2024-03-07T22:01:52Z |
| format | Article |
| id | doaj.art-1351336cd0ec430f9ab6684d62dc4ee6 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-03-07T22:01:52Z |
| publishDate | 2024-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-1351336cd0ec430f9ab6684d62dc4ee62024-02-24T04:06:35ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802024-02-0113310.1161/JAHA.123.031630Association of Periodic Limb Movements and Obstructive Sleep Apnea With Risk of Cardiovascular Disease and MortalityAndrey Zinchuk0Narat Srivali1Li Qin2Sangchoon Jeon3Ahmad Ibrahim4Scott A. Sands5Brian Koo6Henry K. Yaggi7Section of Pulmonary, Critical Care and Sleep Medicine Yale University School of Medicine New Haven CT USASection of Pulmonary, Critical Care and Sleep Medicine Yale University School of Medicine New Haven CT USADivision of Acute Care/Health Systems Yale School of Nursing, Yale University New Haven CT USABrigham and Women’s Hospital Boston MA USASection of Pulmonary, Critical Care and Sleep Medicine Yale University School of Medicine New Haven CT USAHarvard Medical School Boston MA USAClinial Epidemiology Research Center VA CT Health Care System West Haven CT USASection of Pulmonary, Critical Care and Sleep Medicine Yale University School of Medicine New Haven CT USABackground Obstructive sleep apnea is a well‐established risk factor for cardiovascular disease (CVD). Recent studies have also linked periodic limb movements during sleep to CVD. We aimed to determine whether periodic limb movements during sleep and obstructive sleep apnea are independent or synergistic factors for CVD events or death. Methods and Results We examined data from 1049 US veterans with an apnea‐hypopnea index (AHI) <30 events/hour. The primary outcome was incident CVD or death. Cox proportional hazards regression assessed the relationships between the AHI, periodic limb movement index (PLMI), and the AHI×PLMI interaction with the primary outcome. We then examined whether AHI and PLMI were associated with primary outcome after adjustment for age, sex, race and ethnicity, obesity, baseline risk of mortality, and Charlson Comorbidity Index. During a median follow‐up of 5.1 years, 237 of 1049 participants developed incident CVD or died. Unadjusted analyses showed an increased risk of the primary outcome with every 10‐event/hour increase in PLMI (hazard ratio [HR], 1.08 [95% CI, 1.05–1.13]) and AHI (HR, 1.17 [95% CI, 1.01– 1.37]). Assessment associations of AHI and PLMI and their interaction with the primary outcome revealed no significant interaction between PLMI and AHI. In fully adjusted analyses, PLMI, but not AHI, was associated with an increased risk of primary outcome: HR of 1.05 (95% CI, 1.00–1.09) per every 10 events/hour. Results were similar after adjusting with Framingham risk score. Conclusions Our study revealed periodic limb movements during sleep as a risk factor for incident CVD or death among those who had AHI <30 events/hour, without synergistic association between periodic limb movements during sleep and obstructive sleep apnea.https://www.ahajournals.org/doi/10.1161/JAHA.123.031630cardiovascular diseaseepidemiologyobstructive sleep apneaperiodic limb movements during sleep |
| spellingShingle | Andrey Zinchuk Narat Srivali Li Qin Sangchoon Jeon Ahmad Ibrahim Scott A. Sands Brian Koo Henry K. Yaggi Association of Periodic Limb Movements and Obstructive Sleep Apnea With Risk of Cardiovascular Disease and Mortality Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease cardiovascular disease epidemiology obstructive sleep apnea periodic limb movements during sleep |
| title | Association of Periodic Limb Movements and Obstructive Sleep Apnea With Risk of Cardiovascular Disease and Mortality |
| title_full | Association of Periodic Limb Movements and Obstructive Sleep Apnea With Risk of Cardiovascular Disease and Mortality |
| title_fullStr | Association of Periodic Limb Movements and Obstructive Sleep Apnea With Risk of Cardiovascular Disease and Mortality |
| title_full_unstemmed | Association of Periodic Limb Movements and Obstructive Sleep Apnea With Risk of Cardiovascular Disease and Mortality |
| title_short | Association of Periodic Limb Movements and Obstructive Sleep Apnea With Risk of Cardiovascular Disease and Mortality |
| title_sort | association of periodic limb movements and obstructive sleep apnea with risk of cardiovascular disease and mortality |
| topic | cardiovascular disease epidemiology obstructive sleep apnea periodic limb movements during sleep |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.123.031630 |
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