Lung Structure and Risk of Sleep Apnea in SPIROMICS.
Academic Article
Overview
abstract
RATIONALE: SPIROMICS is a prospective cohort study that enrolled 2,981 participants with the goal of identifying new COPD subgroups and intermediate markers of disease progression. Individuals with COPD and sleep apnea (OSA) experience impaired quality of life and more frequent exacerbations. COPD severity also associates with CT-scan based emphysema and alterations in airway dimensions. OBJECTIVES: To determine whether the combination of lung function and structure influences the risk of OSA among current and former smokers. METHODS: Using two OSA risk scores, the Berlin Sleep Questionnaire (BSQ), and the DOISNORE50 (DIS), 1,767 current and former smokers were evaluated for association of lung structure and function with OSA risk. MEASUREMENTS AND MAIN RESULTS: Study cohort mean age was 63 years, BMI 28 kg/m2, and FEV1 of 74.8% predicted. The majority were male (55%), white (77%), former smokers (59%), and had COPD (63%). A high-risk OSA score was reported in 36% and 61% using DIS and BSQ respectively. There was 9% increased odds of a high-risk DIS score (OR=1.09, 95%CI:1.03-1.14) and nominally increased odds of high-risk BSQ score for every 10% decrease in FEV1% predicted (OR=1.04, 95%CI:0.998-1.09). Lung function-OSA risk associations persisted after additionally adjusting for lung structure measurements (%emphysema, %air-trapping, PRM-fSAD, mean segmental wall area, tracheal %wall area, dysanapsis) for DIS (OR=1.12, 95%CI:1.03-1.22) and BSQ (OR=1.09, 95%CI:1.01-1.18). CONCLUSIONS: Lower lung function independently associates with having high-risk for OSA in current and former smokers. Lung structural elements, especially dysanapsis, functional small airways disease, and tracheal %wall area strengthened the effects on OSA risk.
