Excessive daytime sleepiness as cardiovascular risk in Croatian obese patients

    Authors

    Keywords

    excessive daytime sleepiness, cardiovascular risk, obesity, hypertension

    DOI

    https://doi.org/10.15836/ccar2019.236

    Full Text

    Introduction : Excessive daytime sleepiness (EDS) is a very common complaint, especially in obese patients and is a potentially alarming symptom related to many risk factors and comorbidities ( 1 ). In obese patients obstructive sleep apnea (OSA) is quite common. Our goal was to assess the connection between EDS and hypertension in Croatian obese patients. Patients and Methods : This cross-sectional study was carried out in a tertiary healthcare centre in an outpatient clinic for treatment of obesity. 49 participants were included. Inclusion criterion was BMI>30 kg/m 2 . Epworth Sleepiness Scale (ESS), consisting of 8 questions, every question ranged from 0-3 (overall range 0-24) was used to assess EDS. Spearman correlation coefficient, Welch t-test, chi-squared test and regression analysis were used. They were divided into 4 and 3 categories. 4 categories: 0-7, 8-9, 10-15 and 16-24. Many researches take ESS score 10 or greater as excessive daytime sleepiness, so our results were also interpreted as 3 categories: 0-7, 8-9 and 10 or greater. Results : Mean age of our participants was 50.29 ± 11.91 years. Overall mean BMI was 44.64±8.12 kg/m 2 . Results on ESS divided into 4 categories ( Figure 1 ) were statistically significant correlated to hypertension: χ 2 = 9.61; p = .02. Also, results on ESS in 3 categories ( Figure 2 ) were statistically significant correlated to hypertension: χ 2 (2) = 9.43; p = .009. Results on ESS were not significantly connected to AHI index (ESS in 4 categories: χ 2 (9)=8.43, p=.49; ESS in 3 categories: χ 2 (6)=6.45, p=.37). Furthermore, results on ESS were not correlated to sex (ESS in 4 categories χ 2 (3)=0.85, p=.84 and ESS in 3 categories: χ 2 (2)=0.56, p=.76). Scores on Epworth Sleepiness Scale divided into 4 categories depending on the presence of hypertension. Scores on Epworth Sleepiness Scale divided into 3 categories depending on the presence of hypertension. Conclusion : Our results show that the presence of hypertension alters the result on the ESS and is most visible in the so-called “borderline” area for the ESS score 8-9 in both divisions (into 3 and 4 categories), which shows a possible underestimation of the risk of the population achieving the result on the ESS <10, which is consistent with the studies of Borsini et al. ( 2 )

    Cardiologia Croatica
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    Excessive daytime sleepiness as cardiovascular risk in Croatian obese patients

    Extended Abstract
    Issue9-10
    Published
    Pages236
    PDF via DOIhttps://doi.org/10.15836/ccar2019.236
    excessive daytime sleepiness
    cardiovascular risk
    obesity
    hypertension

    Authors

    Filip Mustač*ORCIDUniversity of Zagreb School of Medicine, Zagreb, Croatia
    Martina MatovinovićORCIDUniversity Hospital Centre Zagreb, Zagreb, Croatia
    Tomislav MutakORCIDUniversity of Zagreb School of Medicine, Zagreb, Croatia
    Barbara BarunORCIDUniversity Hospital Centre Zagreb, Zagreb, Croatia
    Juraj JugORCIDUniversity of Zagreb School of Medicine, Zagreb, Croatia
    Rea LevickiORCIDCroatia
    Martina Lovrić BenčićORCIDUniversity of Zagreb School of Medicine, Zagreb, Croatia
    Ana JelakovićORCIDUniversity Hospital Centre Zagreb, Zagreb, Croatia
    Bojan JelakovićORCIDUniversity of Zagreb School of Medicine, Zagreb, Croatia

    Full Text

    Introduction : Excessive daytime sleepiness (EDS) is a very common complaint, especially in obese patients and is a potentially alarming symptom related to many risk factors and comorbidities ( 1 ). In obese patients obstructive sleep apnea (OSA) is quite common. Our goal was to assess the connection between EDS and hypertension in Croatian obese patients. Patients and Methods : This cross-sectional study was carried out in a tertiary healthcare centre in an outpatient clinic for treatment of obesity. 49 participants were included. Inclusion criterion was BMI>30 kg/m 2 . Epworth Sleepiness Scale (ESS), consisting of 8 questions, every question ranged from 0-3 (overall range 0-24) was used to assess EDS. Spearman correlation coefficient, Welch t-test, chi-squared test and regression analysis were used. They were divided into 4 and 3 categories. 4 categories: 0-7, 8-9, 10-15 and 16-24. Many researches take ESS score 10 or greater as excessive daytime sleepiness, so our results were also interpreted as 3 categories: 0-7, 8-9 and 10 or greater. Results : Mean age of our participants was 50.29 ± 11.91 years. Overall mean BMI was 44.64±8.12 kg/m 2 . Results on ESS divided into 4 categories ( Figure 1 ) were statistically significant correlated to hypertension: χ 2 = 9.61; p = .02. Also, results on ESS in 3 categories ( Figure 2 ) were statistically significant correlated to hypertension: χ 2 (2) = 9.43; p = .009. Results on ESS were not significantly connected to AHI index (ESS in 4 categories: χ 2 (9)=8.43, p=.49; ESS in 3 categories: χ 2 (6)=6.45, p=.37). Furthermore, results on ESS were not correlated to sex (ESS in 4 categories χ 2 (3)=0.85, p=.84 and ESS in 3 categories: χ 2 (2)=0.56, p=.76). Scores on Epworth Sleepiness Scale divided into 4 categories depending on the presence of hypertension. Scores on Epworth Sleepiness Scale divided into 3 categories depending on the presence of hypertension. Conclusion : Our results show that the presence of hypertension alters the result on the ESS and is most visible in the so-called “borderline” area for the ESS score 8-9 in both divisions (into 3 and 4 categories), which shows a possible underestimation of the risk of the population achieving the result on the ESS <10, which is consistent with the studies of Borsini et al. ( 2 )