Chronicity and comorbidities: Is estimated longer duration of obstructive sleep apnoea linked to higher cardiometabolic risk?

Abstract

Background and objectives: Obstructive sleep apnea (OSA) is associated with an increased risk of cardiometabolic disorders. Still, the role of OSA duration in the development and severity of these conditions remains unclear. This study aimed to evaluate the association between estimated OSA duration and cardio-metabolic comorbidities.

Materials and methods: In this cross-sectional study, 279 adults (≥35 years; body mass index ≥20 kg/m 2 ) with moderate-severe OSA diagnosed by level-1 polysomnography were included. Diagnosis of cardiometabolic disorders was based on examination, medical records, and laboratory investigations. Duration of OSA was estimated using the OSA-Onset algorithm, and comorbidity prevalence was compared across tertiles of estimated duration.

Results: In this cross-sectional exploratory analysis, the median estimated OSA duration was 18.7 years, and the median estimated age of onset was 32.3 years. Systemic hypertension was the most prevalent comorbidity (79.6%) and showed a higher prevalence across tertiles of estimated OSA duration (68.8%, 83.9%, and 86%, respectively; P = 0.007). In multivariable models, estimated OSA duration was statistically associated with hypertension (odds ratio [OR] 1.039, 95% confidence interval [CI] 1.012-1.068; P = 0.005). Sensitivity analysis excluding participants with implausible negative onset estimates yielded similar results (OR 1.036, 95% CI 1.006-1.066; P = 0.017). No statistically significant associations were observed for other cardiometabolic conditions. Given multiple comparisons and correlated outcomes, findings should be interpreted as exploratory.

Conclusion: In this cross-sectional exploratory study, longer algorithm-estimated OSA duration was statistically associated with hypertension but not with other cardiometabolic comorbidities. These findings are hypothesis-generating and require confirmation in longitudinal studies.