Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/105628
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Type: Journal article
Title: Chronic kidney disease and sleep apnea association of kidney disease with obstructive sleep apnea in a population study of men
Author: Adams, R.
Appleton, S.
Vakulin, A.
Hanly, P.
McDonald, S.
Martin, S.
Lang, C.
Taylor, A.
McEvoy, R.
Antic, N.
et al.
Citation: Sleep, 2017; 40(1):zsw015-1-zsw015-9
Publisher: Oxford University Press
Issue Date: 2017
ISSN: 0161-8105
1550-9109
Statement of
Responsibility: 
Robert J. Adams, Sarah L. Appleton, Andrew Vakulin, Patrick J. Hanly, Stephen P. McDonald, Sean A. Martin, Carol J. Lang, Anne W. Taylor, R. Doug McEvoy, Nick A. Antic, Peter G. Catcheside, Andrew D. Vincent, Gary A. Wittert
Abstract: Study Objectives: To determine the relationship between obstructive sleep apnea (OSA) and chronic kidney disease (CKD). Previous population studies of the association are sparse, conflicting and confined largely to studies of administrative data. Methods: Cross-sectional analysis in unselected participants of the Men Androgens Inflammation Lifestyle Environment and Stress (MAILES) study, aged >40 years. Renal data were available for 812 men without a prior OSA diagnosis who underwent full in-home polysomnography (Embletta X100) in 2010–2011. CKD was defined as an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73m2 or eGFR≥60 and albuminuria (albumin–creatinine ratio ≥3.0 mg/mmol). Results: CKD (10.5%, n = 85 [Stage 1–3, 9.7%; Stage 4–5, 0.7%]) of predominantly mild severity showed significant associations with OSA (apnea–hypoapnea index [AHI] ≥ 10): odds ratio (OR) = 1.9, 95% confidence interval (CI): 1.02–3.5; severe OSA (AHI ≥ 30/h): OR = 2.6, 95% CI: 1.1–6.2; and respiratory-related arousal index: ≥7.6/h, OR = 2.3, 95%CI: 1.1–4.7; but not measures of hypoxemia after adjustment for age, hypertension, diabetes, smoking, obesity, and NSAID use. There was no association of CKD with daytime sleepiness. In men with CKD, those with OSA were not significantly more likely to report symptoms (sleepiness, snoring, and apneas) or be identified with the STOP OSA screening questionnaire, compared to men without OSA. Conclusions: Predominantly mild CKD is associated with severe OSA and arousals. Further population studies examining the longitudinal relationship between CKD and OSA are warranted. Better methods are needed to identify OSA in CKD which may have few symptoms.
Keywords: Chronic kidney disease; epidemiology; obstructive sleep apnea; men; cohort study
Rights: © Sleep Research Society 2016. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.
RMID: 0030066274
DOI: 10.1093/sleep/zsw015
Grant ID: http://purl.org/au-research/grants/nhmrc/627227
Appears in Collections:Medicine publications

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