Influence of lung function and sleep-disordered breathing on all-cause mortality: A community-based study

Nirupama Putcha, Ciprian Crainiceanu, Gina Norato, Jonathan Samet, Stuart F Quan, Daniel J. Gottlieb, Susan Redline, Naresh M. Punjabi

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Rationale: Whether sleep-disordered breathing (SDB) severity and diminished lung function act synergistically to heighten the risk of adverse health outcomes remains a topic of significant debate. Objectives: The current study sought to determine whether the association between lower lung function and mortality would be stronger in those with increasing severity of SDB in a communitybased cohort of middle-aged and older adults. Methods: Full montage home sleep testing and spirometry data were analyzed on 6,173 participants of the Sleep Heart Health Study. Proportional hazards models were used to calculate risk for all-cause mortality, with FEV1 and apnea-hypopnea index (AHI) as the primary exposure indicators along with several potential confounders. Measurements and Main Results: All-cause mortality rate was 26.9 per 1,000 person-years in those withSDB(AHI≥5 events/h) and 18.2 per 1,000 person-years in those without (AHI<5 events/h). For every 200-ml decrease in FEV1, all-cause mortality increased by 11.0% in those without SDB (hazard ratio, 1.11; 95% confidence interval, 1.08-1.13). In contrast, for every 200-ml decrease in FEV1, all-cause mortality increased by only 6.0% in participants with SDB (hazard ratio, 1.06;95% confidence interval, 1.04-1.09). Additionally, the incremental influence of lung function on all-cause mortality was less with increasing severity of SDB (P value for interaction between AHI and FEV1, 0.004). Conclusions: Lung function was associated with risk for all-cause mortality. The incremental contribution of lung function to mortality diminishes with increasing severity of SDB.

Original languageEnglish (US)
Pages (from-to)1007-1014
Number of pages8
JournalAmerican Journal of Respiratory and Critical Care Medicine
Volume194
Issue number8
DOIs
StatePublished - Oct 15 2016

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Sleep Apnea Syndromes
Lung
Mortality
Apnea
Sleep
Confidence Intervals
Spirometry
Health
Proportional Hazards Models

Keywords

  • Impaired lung function
  • Mortality
  • Sleep apnea

ASJC Scopus subject areas

  • Medicine(all)
  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

Cite this

Influence of lung function and sleep-disordered breathing on all-cause mortality : A community-based study. / Putcha, Nirupama; Crainiceanu, Ciprian; Norato, Gina; Samet, Jonathan; Quan, Stuart F; Gottlieb, Daniel J.; Redline, Susan; Punjabi, Naresh M.

In: American Journal of Respiratory and Critical Care Medicine, Vol. 194, No. 8, 15.10.2016, p. 1007-1014.

Research output: Contribution to journalArticle

Putcha, Nirupama ; Crainiceanu, Ciprian ; Norato, Gina ; Samet, Jonathan ; Quan, Stuart F ; Gottlieb, Daniel J. ; Redline, Susan ; Punjabi, Naresh M. / Influence of lung function and sleep-disordered breathing on all-cause mortality : A community-based study. In: American Journal of Respiratory and Critical Care Medicine. 2016 ; Vol. 194, No. 8. pp. 1007-1014.
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AU - Samet, Jonathan

AU - Quan, Stuart F

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AB - Rationale: Whether sleep-disordered breathing (SDB) severity and diminished lung function act synergistically to heighten the risk of adverse health outcomes remains a topic of significant debate. Objectives: The current study sought to determine whether the association between lower lung function and mortality would be stronger in those with increasing severity of SDB in a communitybased cohort of middle-aged and older adults. Methods: Full montage home sleep testing and spirometry data were analyzed on 6,173 participants of the Sleep Heart Health Study. Proportional hazards models were used to calculate risk for all-cause mortality, with FEV1 and apnea-hypopnea index (AHI) as the primary exposure indicators along with several potential confounders. Measurements and Main Results: All-cause mortality rate was 26.9 per 1,000 person-years in those withSDB(AHI≥5 events/h) and 18.2 per 1,000 person-years in those without (AHI<5 events/h). For every 200-ml decrease in FEV1, all-cause mortality increased by 11.0% in those without SDB (hazard ratio, 1.11; 95% confidence interval, 1.08-1.13). In contrast, for every 200-ml decrease in FEV1, all-cause mortality increased by only 6.0% in participants with SDB (hazard ratio, 1.06;95% confidence interval, 1.04-1.09). Additionally, the incremental influence of lung function on all-cause mortality was less with increasing severity of SDB (P value for interaction between AHI and FEV1, 0.004). Conclusions: Lung function was associated with risk for all-cause mortality. The incremental contribution of lung function to mortality diminishes with increasing severity of SDB.

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KW - Mortality

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