1.Obstructive sleep apnea with excessive daytime sleepiness is associated with non-alcoholic fatty liver disease regardless of visceral fat.
Ji Hee YU ; Jae Hee AHN ; Hye Jin YOO ; Ji A SEO ; Sin Gon KIM ; Kyung Mook CHOI ; Sei Hyun BAIK ; Dong Seop CHOI ; Chol SHIN ; Nan Hee KIM
The Korean Journal of Internal Medicine 2015;30(6):846-855
BACKGROUND/AIMS: Obstructive sleep apnea (OSA) is associated with an increased risk of obesity and non-alcoholic fatty liver disease (NAFLD), but it remains unclear whether the risk of NAFLD is independently related to OSA regardless of visceral obesity. Thus, the aim of the present study was to examine whether OSA alone or in combination with excessive daytime sleepiness (EDS) or short sleep duration was associated with NAFLD independent of visceral fat in Korean adults. METHODS: A total of 621 participants were selected from the Korean Genome and Epidemiology Study (KoGES). The abdominal visceral fat area (VFA) and hepatic fat components of the participants were assessed using computed tomography scans and they were then categorized into four groups depending on the presence of OSA and EDS. RESULTS: The proportions of NAFLD were 21.1%, 18.5%, 32.4%, and 46.7% in participants without OSA/EDS, with only EDS, with only OSA, and with both OSA and EDS, respectively. A combination of OSA and EDS increased the odds ratio (OR) for developing NAFLD (OR, 2.75; 95% confidence interval [CI], 1.21 to 6.28) compared to those without OSA/EDS, and this association remained significant (OR, 2.38; 95% CI, 1.01 to 5.59) even after adjusting for VFA. In short sleepers (< 5 hours) with OSA, the adjusted OR for NAFLD was 2.50 (95% CI, 1.08 to 5.75) compared to those sleeping longer than 5 hours without OSA. CONCLUSIONS: In the present study, OSA was closely associated with NAFLD in Korean adults. This association was particularly strong in those with EDS or short sleep duration regardless of VFA.
*Adiposity
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Aged
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Asian Continental Ancestry Group
;
Chi-Square Distribution
;
Disorders of Excessive Somnolence/diagnosis/*epidemiology/physiopathology
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Female
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Humans
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Intra-Abdominal Fat/*physiopathology
;
Logistic Models
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Male
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Middle Aged
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Multivariate Analysis
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Non-alcoholic Fatty Liver Disease/diagnosis/*epidemiology/physiopathology
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Obesity, Abdominal/diagnosis/*epidemiology/physiopathology
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Odds Ratio
;
Republic of Korea/epidemiology
;
Risk Factors
;
*Sleep
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Sleep Apnea, Obstructive/diagnosis/*epidemiology/physiopathology
2.Obstructive sleep apnoea in Singapore: polysomnography data from a tertiary sleep disorders unit.
Li Ling LIM ; Kwang Wei THAM ; Stephanie M C FOOK-CHONG
Annals of the Academy of Medicine, Singapore 2008;37(8):629-636
INTRODUCTIONComprehensive sleep architecture and respiratory event data in local patients with suspected obstructive sleep apnoea (OSA) from overnight polysomnography (PSG), the gold standard for the evaluation of sleep-related breathing disorders, are not widely available. We present 1 year retrospective PSG data with the objective of describing PSG characteristics of patients evaluated for OSA in Singapore.
MATERIALS AND METHODSPSG data of patients evaluated for OSA in 1 year (January through December 2005) in the Sleep Laboratory of a public tertiary hospital were retrospectively reviewed.
RESULTSFive hundred and eighty-four diagnostic PSG studies were performed in patients with symptoms suggestive of sleep-disordered breathing, including snoring, excessive daytime sleepiness, unrefreshing sleep, or recurrent unexplained awakenings. There were 449 male patients (76.9%) and 135 female patients (23.1%), with a mean age of 47.5 years (SD 12.7). Men were on average younger than women, 46.1 years versus 52.0 years (P <0.0005). The mean body mass index (BMI) was 27.9 (SD 6.7), with no significant difference between genders. An association was shown between apnoea-hypopnoea index (AHI) and BMI (Pearson correlation index r = 0.362). Men had overall significantly higher AHI (16.5 vs 9), shorter mean sleep onset latency (11 vs 16.5 minutes), more light sleep (65.5% vs 58.9%), less deep sleep (17.7% vs 23%), and more respiratory event related arousals per hour of sleep (11.6 vs 5.1) (P <0.0005). Severity was classified: AHI <5 ("Normal Overall AHI") (28.3%), AHI 5-15 ("Mild") (22.3%), AHI >15-30 ("Moderate") (18.3%), AHI >30 ("Severe") (31.2%). There was no significant age difference among the 4 groups. More severe OSA patients were significantly heavier, and had more light sleep, less deep sleep, less REM sleep, more respiratory event related arousals and lower levels of oxygen desaturation.
CONCLUSIONOSA is predominant in middle-aged, overweight Singapore males and much less common in females who tend to be older. A majority of patients have moderate to severe OSA, which significantly disturbs normal sleep architecture. The relatively lower BMI compared to Caucasian OSA populations may be related to local craniofacial characteristics and/or higher percentage of body fat for BMI which has been described in Singaporeans.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Body Mass Index ; Comorbidity ; Female ; Humans ; Male ; Middle Aged ; Obesity ; epidemiology ; Polysomnography ; Retrospective Studies ; Severity of Illness Index ; Singapore ; Sleep Apnea, Obstructive ; diagnosis ; epidemiology ; physiopathology