UT Southwestern researchers have found a strong association between obstructive sleep apnea, a common condition characterized by partial or complete upper airway obstruction, and the development of a variety of heart conditions in adults of all ages. (Photo by Getty Images)
DALLAS – July 9, 2024 – Obstructive sleep apnea (OSA) is associated with an increased risk of cardiovascular disease even in adults, particularly those under age 40, researchers at UT Southwestern Medical Center have found. Journal of the American Heart Associationhas shown a strong association between OSA and the development of various heart-related diseases in adults of all age groups.
OSA is a common disorder that causes recurring episodes of partial or complete obstruction of the upper airway during sleep, leading to disrupted breathing patterns and intermittent oxygen deficiency. The most important risk factor for OSA is obesity.
Study leader Dr. Bhaskar Thakur is an assistant professor of family and community medicine, emergency medicine and physical medicine and rehabilitation in the Peter O’Donnell Jr. School of Public Health at the University of Texas Southwestern.
“Our study highlights the need for OSA screening to be implemented in primary care settings, especially among younger adults who would benefit most from early intervention,” said study leader Bhaskar Thakur, PhD, assistant professor of family and community medicine, emergency medicine and physical medicine and rehabilitation in UT Southwestern’s Peter O’Donnell Jr. School of Public Health. “Sleep quality discussions and review of OSA symptoms should be a routine part of annual health checks for all adult patients, regardless of age.”
UTSW researchers analyzed data from the National Health and Nutrition Examination Survey of 9,887 adults age 20 and older conducted between 2013 and 2018. The analysis found that people who reported symptoms of OSA, such as snoring, shortness of breath, breathing stops during sleep, and excessive daytime fatigue, had higher rates of cardiovascular disease, including angina, heart attack, and stroke, as well as associated risk factors such as high blood pressure, diabetes, high cholesterol, and metabolic syndrome (the presence of three or more conditions that increase the risk of heart disease).
Approximately 51% of study participants were suspected of having OSA. Of those, 36.2% had high blood pressure, 24.3% had diabetes, 66.1% had high cholesterol, and 48% had metabolic syndrome. Additionally, 8.6% reported having experienced a cardiovascular event or been diagnosed with heart disease.
The association between the likelihood of OSA and increased prevalence of cardiovascular disease or risk factors was even stronger in people in the 20-40 age group than in people aged 41 years or older. For example, the adjusted prevalence ratio (aPR) for hypertension in young adults with OSA was 1.45, indicating that they were 1.45 times more likely to have hypertension compared to young adults without OSA. Similarly, the aPR for diabetes was 1.33 and for metabolic syndrome was 1.25, indicating a significantly increased risk in young adults with OSA. In contrast, the aPRs for older adults with OSA were lower, 1.10 for hypertension, 1.12 for diabetes, and 1.07 for metabolic syndrome, indicating a less pronounced but still increased risk compared to older adults without OSA.
Young adults with OSA were three times more likely to experience a cardiovascular event than those without.
“The general public tends to think of sleep apnea as simply ‘bad quality sleep’ that causes fatigue, but the impact is much more serious,” said Dr Thakur. “With the rise in obesity, an increasing number of young adults are suffering from OSA, and without proper intervention, they are at increased risk of a range of diseases and conditions.”
While the exact nature of the relationship between OSA and cardiovascular disease is unknown, UTSW researchers are interested in continuing to study the association, particularly among younger adults.
“Our goal is to further explore this association and raise the level of understanding and awareness about the risks of OSA,” Dr. Thakur said.
Other UTSW School of Family and Community Medicine researchers who contributed to the study include department chair and professor F. David Schneider, MD, MSPH, assistant professor Anna Wani, MD, associate professor (also of neurology) and UTSW Sleep Medicine Fellowship Program director Safia Khan, MD, lecturer Chance Strenth, PhD, and former resident Rupini Alla, MD.
Dr. Schneider is the Perry E. Gross, MD, Professor Emeritus of Family Medicine and director of Family and Community Medicine at Texas Health Dallas.
About UT Southwestern Medical Center
UT Southwestern is one of the nation’s leading academic medical centers, integrating pioneering biomedical research with outstanding clinical care and education. The university’s faculty has won six Nobel Prizes and includes 25 members of the National Academy of Sciences, 21 members of the National Academy of Medicine, and 13 Howard Hughes Medical Institute investigators. The university’s more than 3,100 full-time faculty members are responsible for groundbreaking medical advances and are committed to rapidly translating science-based research into new clinical care. UT Southwestern physicians across more than 80 specialties provide more than 120,000 inpatient and 360,000 emergency care visits, and approximately 5 million outpatient visits annually.