Weather-Associated Variations of Device-Detected Severe Sleep Apnea in Cardiac Pacemaker Patients

Area of Science:

• Cardiology
• Sleep Medicine
• Environmental Health

Background:

• Continuous thoracic impedance monitoring via electronic device sensors enables long-term sleep apnea monitoring.
• The ACaSA trial prospectively observed 233 pacemaker patients to assess sleep apnea burden.
• Device-detected sleep apnea (DDSA) is defined by a respiratory disturbance index (RDI) ≥ 20 events/hour.

Purpose of the Study:

• To investigate the association between local meteorological data and the subsequent night's sleep apnea burden (RDI).
• To determine if ambient temperature, humidity, precipitation, or air pressure changes influence DDSA.
• To identify independent weather-related predictors of severe DDSA.

Main Methods:

• Continuous thoracic impedance measurements were used to monitor DDSA in 210 patients over 74,031 patient-nights.
• Local meteorological data (max diurnal temperature, humidity, precipitation, air pressure change) were collected and linked to patient residences.
• A generalized linear mixed-effects model was employed to estimate associations between weather conditions and RDI.

Main Results:

• Ambient maximum diurnal temperature was independently associated with the presence of DDSA.
• Following days with a maximum temperature of 30°C, the odds of severe DDSA increased by 1.34 compared to days with 10°C (p < 0.001).
• Higher relative humidity (90% vs. 65%) also increased the odds of severe DDSA (OR 1.19, p = 0.007).

Conclusions:

• Ambient maximum diurnal temperature and relative humidity are associated with an increased likelihood of severe sleep apnea the following night.
• These findings highlight a potential environmental influence on sleep apnea severity.
• Further investigation is warranted, particularly considering the implications of ongoing global climate change.