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Sleep and Breathing

, Volume 23, Issue 1, pp 87–94 | Cite as

Arousal index as a marker of carotid artery atherosclerosis in patients with obstructive sleep apnea syndrome

  • Mayumi SuzukiEmail author
  • Ken Shimamoto
  • Haruki Sekiguchi
  • Takamitsu Harada
  • Natsumi Satoya
  • Yuji Inoue
  • Kazuhiro Yamaguchi
  • Masatoshi Kawana
Sleep Breathing Physiology and Disorders • Original Article
  • 127 Downloads

Abstract

Purpose

It was shown in a previous cohort study that men with internal carotid artery (ICA) plaque, defined as focal wall thickness of ≥ 1.5 mm, had a threefold higher risk of stroke than those without plaque. We examined the relationship between arousal indices and sleep stages in patients with obstructive sleep apnea syndrome (OSAS) and carotid atherosclerosis.

Methods

Carotid atherosclerosis severity was evaluated using the maximal carotid wall intima-media thickness of the ICA (ICA-maxIMT) and plaque in 83 patients with OSAS.

Results

The ICA-maxIMT values were positively correlated with the apnea hypopnea index (AHI) (ρ = 0.294, P = 0.007), arousal index (ρ = 0.289, P = 0.008), oxygen desaturation index (ρ = 0.298, P = 0.006), percentage of visually scored total sleep time spent in nocturnal oxygen saturation < 90% (SpO2 < 90%) (ρ = 0.246, P = 0.025), and the percentage of visually scored total sleep time spent in non-REM sleep stage 1 (ρ = 0.326, P = 0.003) and were negatively correlated with the percentage of visually scored total sleep time spent in non-REM sleep stages 2 and 3. Arousal index, diabetes mellitus, and age were found to be independent predictors of ICA plaque presence (OR 1.052, P = 0.003; OR 8.705, P = 0.026; OR 1.064, P = 0.023, respectively).

Conclusions

Several PSG variables that are indicative of sleep fragmentation, sleep disordered breathing, and poor sleep quality correlated with the occurrence of atherosclerosis, but total arousal index was the only independent predictive factor.

Keywords

Arousal index Sleep stage IMT Carotid atherosclerosis Obstructive sleep apnea syndrome 

Notes

Acknowledgements

We would like to thank Ms. Akiko Sato, the polysomnographer, for recording and analyzing the PSG data.

Compliance with ethical standards

Ethical approval

The study was approved by the ethical committee of Tokyo Women’s Medical University, and written informed consent was obtained from all participants. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Mayumi Suzuki
    • 1
    Email author
  • Ken Shimamoto
    • 2
  • Haruki Sekiguchi
    • 1
  • Takamitsu Harada
    • 3
  • Natsumi Satoya
    • 3
  • Yuji Inoue
    • 3
  • Kazuhiro Yamaguchi
    • 1
  • Masatoshi Kawana
    • 2
  1. 1.Division of Comprehensive Sleep MedicineTokyo Women’s Medical University HospitalTokyoJapan
  2. 2.Department of General MedicineTokyo Women’s Medical UniversityTokyoJapan
  3. 3.Central Clinical LaboratoriesTokyo Women’s Medical UniversityTokyoJapan

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