P1554Is self-reported sleep-disordered breathing associated with increased cardiovascular risk?
Authors: Korostovtseva L , Rotar O , Alieva A , Bochkarev M , Boyarinova M , Zvartau N , Sviryaev Y U , Konradi A , Shlyakhto E 
Published: October 2019

Abstract

Background
Sleep-disordered breathing (SDB) is associated with the increased cardiovascular (CV) morbidity and mortality. However, sleep apnea is not considered in the standard scales used for the risk stratification.

Purpose
We evaluated the association between self-reported SDB and SCORE risk (the 10-year risk of fatal CV events according to the systemic coronary risk evaluation) in the population-based sample from St Petersburg.

Methods
We selected 1555 subjects without previously known CV events (550 males, 35%; mean age 46.7±11.6 years old) out of 1600 participants of the population-based sample (from the epidemiological study ESSE-RF, St Petersburg). All subjects were interviewed (questions about lifestyle, medical history, complaints) using standard questionnaire. We assessed self-reported snore (“Do you snore?”) and sleep apnea (“Do you have sleep apneas?”). Affirmative response was considered diagnostic. Daytime sleepiness was assessed based on the answers >3 times/week to the question “How often have you been unable to refrain sleeping when required?”. The 10-year risk of fatal CV events was assessed by the SCORE high-risk charts calculator. For statistical analysis we used parametric statistics, frequency and contingency analyses (Chi-square), multiple logistic regression analysis (stepwise inclusion; the parameters not evaluated in the SCORE scale were considered, i.e. body mass index, glucose level, triglyceride, HDL-cholesterol, creatinine, C-reactive protein, self-reported insomnia).

Results
Based on the SCORE assessment the participants were divided as following: low risk (<1%) was the most predominant category (n=864, 55.6%); moderate risk (≥1% and <5%) was found in 468 (30.1%), high risk (5–10%) – in 184 (11.8%), and very high risk – in 39 (2.5%) subjects. In total, 740 (47.6%) subjects had snoring, while only 77 (5%) subjects reported sleep apneas. Neither self-reported snoring nor sleep apnea were associated with daytime sleepiness (p>0.05). High-to-very-high SCORE risk was found more often in subjects with self-reported snoring compared to non-snorers: 21.2% vs. 8.1%, respectively (Chi-square=54.3, p<0.001). At the same time no association was found between self-reported sleep apneas and cardiovascular risk. Logistic regression demonstrated an association between SCORE risk and self-reported snoring (OR=3.06 95% CI 2.25–4.16, p<0.001). Multiple regression analysis confirmed the impact of snoring in the increased SCORE risk (OR=2.16 95% CI 1.55–3.02, p<0.001) after adjustment for the other factors.

Conclusions
Our study demonstrated that in Russian population-based sample self-reported snoring (unlike self-reported sleep apnea) is associated with the increased 10-year risk of fatal CV events. The lack of association between SCORE risk and sleep apnea might be related to the subjective assessment based on the questionnaire.

Acknowledgement/Funding
The study was supported by the Grant of the President of Russian Federation for the Leading Scientific Schools of Russia (agreement No. 075-02-2018-57,