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Obstructive Sleep Apnea and Longitudinal Changes in Interstitial Lung Imaging and Lung Function: The MESA Study.

John S Kim1,2, Ali Azarbarzin3, Anna J Podolanczuk4

  • 1Department of Medicine, University of Virginia School of Medicine, Charlottesville, Virginia.

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Obstructive sleep apnea (OSA) is linked to increased lung density and faster lung function decline in older adults. This suggests OSA may contribute to early interstitial lung disease (ILD) development.

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hypoxiainterstitial lung diseasenocturnal oxygen saturationsleep apnea

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Area of Science:

  • Pulmonology
  • Sleep Medicine
  • Radiology

Background:

  • Obstructive sleep apnea (OSA) is a potential risk factor for interstitial lung disease (ILD).
  • Radiological markers of ILD may be associated with OSA.
  • Previous studies were limited by cross-sectional designs and confounding factors like body mass.

Purpose of the Study:

  • To investigate the association between OSA severity and high-attenuation areas (HAAs) on CT scans.
  • To examine the relationship between OSA severity and changes in lung function over time.
  • To assess these associations in older community-dwelling adults.

Main Methods:

  • Utilized data from the Multi-Ethnic Study of Atherosclerosis (MESA) cohort.
  • Included participants with polysomnography (apnea-hypopnea index, AHI) and serial CT scans (exams 5 and 6).
  • Employed linear mixed-effects models to analyze changes in HAAs, lung volumes, and forced vital capacity (FVC), adjusting for confounders.

Main Results:

  • Higher AHI (≥15 events/h) and hypoxic burden were associated with increased HAAs over 10 years.
  • Participants with AHI ≥15 events/h showed a more rapid decline in total lung volumes and FVC.
  • These associations persisted regardless of body habitus.

Conclusions:

  • Increased hypoxia burden from OSA is linked to greater lung density over time.
  • OSA is associated with accelerated decline in lung volumes and function.
  • Findings suggest OSA may play a role in the early pathogenesis of ILD.