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Obstructive Sleep Apnea Screened by Overnight Pulse Oximetry and Higher Risk of Serious Cardiovascular Events: Prospective Cohort Study in the Primary Care

Received: 21 March 2022     Accepted: 11 April 2022     Published: 20 April 2022
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Abstract

Introduction: Obstructive sleep apnea (OSA) is a condition characterized by sleep disordered breathing which results in health impairment and other related injuries. Cardiovascular and neurocognitive morbidities and increased risk of motor vehicle accidents have been demonstrated in patients with untreated OSA. Overnight pulse oximetry is a good screening tool for OSA. There is no study to examine the prospective outcome of patients with screening positive OSA in the primary care setting. Methodology: This is a prospective cohort study involving consecutive patients whom had performed OSA screening by overnight pulse oximetry in a primary care clinic of Hong Kong from year 2011 to year 2012. One hundred and eighty consecutive OSA screening positive patients were the cohort group while 180 consecutive OSA screening negative patients were the control group. The five year incidence of serious cardiovascular complications and associated predictive factors were examined. Results: Both of cohort and control group patients were followed prospectively for 5 years. There was higher proportion of male (68.3% versus 45.0%, p<0.001) and obesity (58.3% versus 41.1%, p=0.001) patients in the cohort group. There was no statistical difference in concomitant chronic disease or difference in mean blood pressure and Epworth Sleepiness Scale (ESS) score among two groups. At five year follow up, there was no cardiovascular related mortality among two groups. The five year relative risk (RR) of screening positive OSA versus screening negative for serious cardiovascular event is 3.03 (95% CI, 1.16-7.86; p=0.018). By stratification, the relative risk for stroke is 1.69 (95% CI, 0.40-7.16; p=0.475), while for coronary artery disease (CAD) is 4.24 (95%CI, 1.18-15.29; p=0.017). Conclusion: Overnight pulse oximetry screening positive obstructive sleep apnea is the independent risk factor for coronary artery disease.

Published in Journal of Family Medicine and Health Care (Volume 8, Issue 2)
DOI 10.11648/j.jfmhc.20220802.11
Page(s) 32-36
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

Obstructive Sleep Apnea, Overnight Pulse Oximetry, Stroke, Coronary Artery Disease

References
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Cite This Article
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    Lapkin Chiang, Cheukwai Kam, Lorna Ventura Ng, Catherine Xiaorui Chen, Yimchu Li. (2022). Obstructive Sleep Apnea Screened by Overnight Pulse Oximetry and Higher Risk of Serious Cardiovascular Events: Prospective Cohort Study in the Primary Care. Journal of Family Medicine and Health Care, 8(2), 32-36. https://doi.org/10.11648/j.jfmhc.20220802.11

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    ACS Style

    Lapkin Chiang; Cheukwai Kam; Lorna Ventura Ng; Catherine Xiaorui Chen; Yimchu Li. Obstructive Sleep Apnea Screened by Overnight Pulse Oximetry and Higher Risk of Serious Cardiovascular Events: Prospective Cohort Study in the Primary Care. J. Fam. Med. Health Care 2022, 8(2), 32-36. doi: 10.11648/j.jfmhc.20220802.11

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    AMA Style

    Lapkin Chiang, Cheukwai Kam, Lorna Ventura Ng, Catherine Xiaorui Chen, Yimchu Li. Obstructive Sleep Apnea Screened by Overnight Pulse Oximetry and Higher Risk of Serious Cardiovascular Events: Prospective Cohort Study in the Primary Care. J Fam Med Health Care. 2022;8(2):32-36. doi: 10.11648/j.jfmhc.20220802.11

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  • @article{10.11648/j.jfmhc.20220802.11,
      author = {Lapkin Chiang and Cheukwai Kam and Lorna Ventura Ng and Catherine Xiaorui Chen and Yimchu Li},
      title = {Obstructive Sleep Apnea Screened by Overnight Pulse Oximetry and Higher Risk of Serious Cardiovascular Events: Prospective Cohort Study in the Primary Care},
      journal = {Journal of Family Medicine and Health Care},
      volume = {8},
      number = {2},
      pages = {32-36},
      doi = {10.11648/j.jfmhc.20220802.11},
      url = {https://doi.org/10.11648/j.jfmhc.20220802.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jfmhc.20220802.11},
      abstract = {Introduction: Obstructive sleep apnea (OSA) is a condition characterized by sleep disordered breathing which results in health impairment and other related injuries. Cardiovascular and neurocognitive morbidities and increased risk of motor vehicle accidents have been demonstrated in patients with untreated OSA. Overnight pulse oximetry is a good screening tool for OSA. There is no study to examine the prospective outcome of patients with screening positive OSA in the primary care setting. Methodology: This is a prospective cohort study involving consecutive patients whom had performed OSA screening by overnight pulse oximetry in a primary care clinic of Hong Kong from year 2011 to year 2012. One hundred and eighty consecutive OSA screening positive patients were the cohort group while 180 consecutive OSA screening negative patients were the control group. The five year incidence of serious cardiovascular complications and associated predictive factors were examined. Results: Both of cohort and control group patients were followed prospectively for 5 years. There was higher proportion of male (68.3% versus 45.0%, p<0.001) and obesity (58.3% versus 41.1%, p=0.001) patients in the cohort group. There was no statistical difference in concomitant chronic disease or difference in mean blood pressure and Epworth Sleepiness Scale (ESS) score among two groups. At five year follow up, there was no cardiovascular related mortality among two groups. The five year relative risk (RR) of screening positive OSA versus screening negative for serious cardiovascular event is 3.03 (95% CI, 1.16-7.86; p=0.018). By stratification, the relative risk for stroke is 1.69 (95% CI, 0.40-7.16; p=0.475), while for coronary artery disease (CAD) is 4.24 (95%CI, 1.18-15.29; p=0.017). Conclusion: Overnight pulse oximetry screening positive obstructive sleep apnea is the independent risk factor for coronary artery disease.},
     year = {2022}
    }
    

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  • TY  - JOUR
    T1  - Obstructive Sleep Apnea Screened by Overnight Pulse Oximetry and Higher Risk of Serious Cardiovascular Events: Prospective Cohort Study in the Primary Care
    AU  - Lapkin Chiang
    AU  - Cheukwai Kam
    AU  - Lorna Ventura Ng
    AU  - Catherine Xiaorui Chen
    AU  - Yimchu Li
    Y1  - 2022/04/20
    PY  - 2022
    N1  - https://doi.org/10.11648/j.jfmhc.20220802.11
    DO  - 10.11648/j.jfmhc.20220802.11
    T2  - Journal of Family Medicine and Health Care
    JF  - Journal of Family Medicine and Health Care
    JO  - Journal of Family Medicine and Health Care
    SP  - 32
    EP  - 36
    PB  - Science Publishing Group
    SN  - 2469-8342
    UR  - https://doi.org/10.11648/j.jfmhc.20220802.11
    AB  - Introduction: Obstructive sleep apnea (OSA) is a condition characterized by sleep disordered breathing which results in health impairment and other related injuries. Cardiovascular and neurocognitive morbidities and increased risk of motor vehicle accidents have been demonstrated in patients with untreated OSA. Overnight pulse oximetry is a good screening tool for OSA. There is no study to examine the prospective outcome of patients with screening positive OSA in the primary care setting. Methodology: This is a prospective cohort study involving consecutive patients whom had performed OSA screening by overnight pulse oximetry in a primary care clinic of Hong Kong from year 2011 to year 2012. One hundred and eighty consecutive OSA screening positive patients were the cohort group while 180 consecutive OSA screening negative patients were the control group. The five year incidence of serious cardiovascular complications and associated predictive factors were examined. Results: Both of cohort and control group patients were followed prospectively for 5 years. There was higher proportion of male (68.3% versus 45.0%, p<0.001) and obesity (58.3% versus 41.1%, p=0.001) patients in the cohort group. There was no statistical difference in concomitant chronic disease or difference in mean blood pressure and Epworth Sleepiness Scale (ESS) score among two groups. At five year follow up, there was no cardiovascular related mortality among two groups. The five year relative risk (RR) of screening positive OSA versus screening negative for serious cardiovascular event is 3.03 (95% CI, 1.16-7.86; p=0.018). By stratification, the relative risk for stroke is 1.69 (95% CI, 0.40-7.16; p=0.475), while for coronary artery disease (CAD) is 4.24 (95%CI, 1.18-15.29; p=0.017). Conclusion: Overnight pulse oximetry screening positive obstructive sleep apnea is the independent risk factor for coronary artery disease.
    VL  - 8
    IS  - 2
    ER  - 

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Author Information
  • Department of Family Medicine and General Outpatient Clinics, Kowloon Central Cluster, Hospital Authority, Hong Kong

  • Department of Family Medicine and General Outpatient Clinics, Kowloon Central Cluster, Hospital Authority, Hong Kong

  • Department of Family Medicine and General Outpatient Clinics, Kowloon Central Cluster, Hospital Authority, Hong Kong

  • Department of Family Medicine and General Outpatient Clinics, Kowloon Central Cluster, Hospital Authority, Hong Kong

  • Department of Family Medicine and General Outpatient Clinics, Kowloon Central Cluster, Hospital Authority, Hong Kong

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