Composition of nocturnal hypoxaemic burden and its prognostic value for cardiovascular mortality in older community-dwelling men

Mathias Baumert, Sarah A. Immanuel, Katie L. Stone, Stephanie Litwack Harrison, Susan Redline, Sara Mariani, Prashanthan Sanders, R. Doug McEvoy, Dominik Linz

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Aims: To investigate the composition of nocturnal hypoxaemic burden and its prognostic value for cardiovascular (CV) mortality in community-dwelling older men. Methods and results : We analysed overnight oximetry data from polysomnograms obtained in 2840 men from the Outcomes of Sleep Disorders in Older Men (MrOS Sleep) study (ClinicalTrials.gov Identifier: NCT00070681) to determine the number of acute episodic desaturations per hour (oxygen desaturation index, ODI) and time spent below 90% oxygen saturation (T90) attributed to acute desaturations (T90desaturation) and to non-specific drifts in oxygen saturation (T90non-specific), respectively, and their relationship with CV mortality. After 8.8 ± 2.7 years follow-up, 185 men (6.5%) died from CV disease. T90 [hazard ratio (HR) 1.21, P < 0.001], but not ODI (HR 1.13, P = 0.06), was significantly associated with CV death in univariate analysis. T90 remained significant when adjusting for potential confounders (HR 1.16, P = 0.004). Men with T90 > 12 min were at an elevated risk of CV mortality (HR 1.59; P = 0.006). Approximately 20.7 (5.7-48.5) percent of the variation in T90 could be attributed to non-specific drifts in oxygen saturation. T90desaturation and T90nonspecific were individually associated with CV death but combining both variables did not improve the prediction. Conclusion: In community-dwelling older men, T90 is an independent predictor of CV mortality. T90 is not only a consequence of frank desaturations, but also reflects non-specific drifts in oxygen saturation, both contributing towards the association with CV death. Whether T90 can be used as a risk marker in the clinical setting and whether its reduction may constitute a treatment target warrants further study.

Original languageEnglish
Article numberehy838
Pages (from-to)533-541
Number of pages9
JournalEuropean Heart Journal
Volume41
Issue number4
Early online date2018
DOIs
Publication statusPublished - 21 Jan 2020

Keywords

  • Cardiovascular
  • Death
  • Hypoxaemia
  • Mortality
  • Oximetry
  • Sleep

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