Associations Between the Severity of Obstructive Sleep Apnea and Arterial Stiffness Estimated by Pulse Wave Velocity Assessment: A Cross-Sectional Study.

BACKGROUND AND AIMS: Obstructive sleep apnea (OSA) is a prevalent sleep disorder linked to cardiovascular diseases and is highly prevalent, especially in the elderly population. This study aimed to investigate the association between OSA severity and arterial stiffness, as measured by pulse wave velocity (PWV), in patients with moderate to severe OSA.

METHODS

This cross-sectional study included 60 adults with moderate-to-severe OSA, confirmed by polysomnography (PSG). Arterial stiffness was measured by brachial artery oscillometry. Polysomnographic parameters, including the apnea-hypopnea index (AHI), minimum oxygen saturation (SpO2), and sleep efficiency, were analyzed to determine their correlation with PWV. Correlations between PWV and PSG parameters were performed using Spearman's correlation coefficient. Additionally, multivariate regression analysis was conducted to adjust for confounders, including age, sex, BMI, hypertension, diabetes, and medication use.

RESULTS

The mean age of participants was 62.07 ± 8.83 years, with 55% being male. A significant positive correlation was found between PWV and AHI (r = 0.4724; 95% CI = 0.2438 to 0.6512; p < 0.001), indicating that arterial stiffness increases with OSA severity. Additionally, an inverse relationship was observed between PWV and minimum SpO2 (r = -0.2995; 95% CI = -0.5234 to -0.03684; p = 0.02), as well as between PWV and sleep efficiency (r = -0.2702; 95% CI = -0.4999 to -0.004971; p = 0.04). However, when adjusted for age and other potential confounders using multivariate regression, these associations between PSG parameters and arterial stiffness lost statistical significance. Age emerged as the primary independent predictor of PWV in this population.

CONCLUSION

The study confirms a significant initial association between the severity of OSA, as indicated by AHI and minimum SpO2, and arterial stiffness. The subsequent analysis highlights that the relationship between sleep parameters and PWV is primarily age-dependent, emphasizing the importance of rigorous cardiovascular risk assessment in aging OSA patients.