Sleep Data Analysis for Cardiovascular Disease Risk Factors
Explore the associations between sleep disturbances and cardiovascular disease risk factors by analyzing data from polysomnography, actigraphy, and sleep questionnaires in a large cohort. Investigate disparities by ethnicity, gender, and socioeconomic status to understand their impact on CVD disparities.
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Presentation Transcript
MESA-Sleep Aims Perform polysomnography and 7 day wrist actigraphy and supplemental sleep questionnaires (n=2200-2500) Link sleep data to MESA CVD data to quantify the associations of SDB, sleep duration, sleep fragmentation, slow wave sleep and sleep timing/rhythms with: CVD risk factors Subclinical CVD Clinical CVD Identify ethnic, gender and SES differences in the distribution of measures of sleep disturbances Evaluate whether such differences explain ethnic/race and gender differences in subclinical and clinical CVD.
Sleep Reading Center Activities 21 certified field staff (17 active) 3 certified scorers Regular reliability; AHI ICC >.97 Problem with PLMs-corrected Quality reports-reviewed monthly More intense trouble shooting as needed/re-training for new staff Weekly transmission to CC; monthly calls
Sleep Data Received 1297 PSGs and actigraph studies received PSGs: 77% PSGs very good or better 4.8% failure Actigraphs Mean days with good data: 7 +/- .5 days 3% failure Site equipment, battery, supply updates
PSG Study Quality by Site Very Good Excellent Site Total N % Fail 3-WakeForest 195 5.1% 78.5% 4-Columbia 239 4.2% 67.8% 5-Johns Hopkins 228 2.6% 80.3% 6-Minneapolis 230 2.6% 77.4% 7-Northwestern 194 3.1% 80.9% 8-UCLA 158 13.9% 75.9% Totals 1244 4.8% 76.6%
PSG Failure Causes 50 45 40 35 30 25 20 15 10 5 0 Oximetry EEG Short Multiple Other
Change in Sleep Quality (% >Very Good) Q1 2011 to 2012 100 90 80 70 60 Q1 11 50 Q1-2 12 40 30 20 10 0 WFU COL JHU UMN NU UCLA
PSG Findings and SDB In MESA 1.8% Urgent Referral (A Fib, NSVT, low oxygen) 1.8% Cheyne Stoke Respiration 43% with moderate-severe SDB (AHI>15) 10x rate of doctor diagnosed SDB in MESA 35 30 25 20 15 10 5 0 <5 5 to 15 15 to 30 >30 AHI Level
Analyses and Extensions Minority supplement funded Dennis Dean HTN analyses Arterial stiffness derived from the oximetry pleth waveform (with D Jacobs) Pollution, weather and sleep Sleep Informatics and Data Sharing Resource (R24 pending) Genetics project-rare variants (pending)
Paper Proposal Possibilities Linking sleep to: Indices of RV/Pulm HTN COPD-OSA HTN, LVM, cardiac function Stress, socioeconomic, environment HF, CSB, BNP outcomes Qol Inflammatory, metabolic and cardiac biomarkers Inter-relationship with health behaviors Genetics Etc etc etc
Plans: Initiate monthly sleep scientific calls (N Punjubi (JHU), P Lutsy (UMN), P Zee (NU)) Nominate your representative(s)
