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Frequency of sleep apnea in adults with the Marfan syndrome

Meike Rybczynski1, Dietmar Koschyk, Andreas Karmeier

  • 1Centre of Cardiology and Cardiovascular Surgery, University Hospital Eppendorf, Hamburg, Germany.

The American Journal of Cardiology
|June 12, 2010
PubMed

Insights

Sleep apnea is common in Marfan syndrome patients and linked to cardiovascular issues like reduced heart function and atrial fibrillation. This connection exists independently of typical sleep apnea risk factors.

Area of Science:

  • Cardiology
  • Sleep Medicine
  • Genetics

Background:

  • Sleep apnea contributes to cardiovascular disease in older adults.
  • The relationship between cardiovascular complications and sleep apnea in Marfan syndrome is not well understood.
  • Marfan syndrome patients may be at increased risk for sleep apnea.

Purpose of the Study:

  • To investigate the frequency of sleep apnea in adults with Marfan syndrome.
  • To explore the association between sleep apnea and cardiovascular morbidity in this population.

Main Methods:

  • Polygraphy using MiniScreen8 portable monitoring devices was performed on 68 adults with Marfan syndrome.
  • Apnea-hypopnea index (AHI) was calculated to assess sleep apnea severity.
  • Statistical analyses (Spearman, phi) were used to correlate AHI with cardiovascular parameters and risk factors.

Main Results:

  • Sleep apnea was detected in 31% of participants (mild in 21%, moderate/severe in 10%).
  • Increased AHI correlated with older age, higher body mass index, reduced left ventricular ejection fraction, elevated N-terminal pro-brain natriuretic peptide levels, enlarged descending aortic diameters, atrial fibrillation, and mitral valve surgery.
  • Associations with left ventricular ejection fraction, N-terminal pro-brain natriuretic peptide, atrial fibrillation, and mitral valve surgery remained significant after adjusting for age and BMI.

Conclusions:

  • Sleep apnea is more frequent in individuals with Marfan syndrome than previously recognized.
  • Classic risk factors do not predict sleep apnea in this cohort.
  • Both obstructive and central sleep apneas may be linked to cardiovascular disease variables in Marfan syndrome.

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