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Mortality in Obstructive Sleep Apnea: Association with Impaired Wakefulness.

J. Steven Poceta1, Daniel I. Loube, Erin L. Kellgren

  • 1Division of Sleep Disorders, Scripps clinic and Research Foundation, La Jolla, California.

Sleep & Breathing = Schlaf & Atmung
|March 19, 2002
PubMed
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Impaired wakefulness in obstructive sleep apnea (OSA) patients, indicated by shorter Maintenance of Wakefulness Test (MWT) sleep latency, is linked to increased long-term mortality, predominantly from cardiovascular disease.

Area of Science:

  • Sleep Medicine
  • Cardiovascular Health
  • Mortality Studies

Background:

  • Obstructive sleep apnea (OSA) causes sleep fragmentation.
  • Shortened sleep latency on the Maintenance of Wakefulness Test (MWT) is a known consequence of OSA.
  • The association between impaired wakefulness and mortality in OSA patients remains unclear.

Purpose of the Study:

  • To investigate the relationship between impaired wakefulness and long-term mortality in obstructive sleep apnea (OSA) patients.
  • To evaluate survival rates in OSA patients over an average of 7.5 years post-diagnosis.

Main Methods:

  • A cohort of 322 obstructive sleep apnea (OSA) patients underwent polysomnography and the Maintenance of Wakefulness Test (MWT).
  • Survival data were collected for 142 patients over a mean follow-up of 7.5 years.

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  • Demographic and sleep study data were compared between patients who were alive and deceased.

    • Main Results:

    • Twenty-two out of 142 evaluable patients died, primarily from cardiovascular disease.
    • Deceased patients exhibited significantly shorter MWT mean sleep latency, even after age adjustment (21 +/- 10 min vs. 28 +/- 11 min, p < 0.005).
    • A MWT mean sleep latency below 20 minutes was associated with a significant decrease in survival.

    Conclusions:

    • Impairment of wakefulness, as measured by MWT sleep latency, is significantly associated with long-term mortality in obstructive sleep apnea (OSA) patients.
    • This association was specific to wakefulness impairment and not observed with other OSA severity measures.
    • Cardiovascular disease was the predominant cause of death in this OSA cohort.