US Pharm. 2019;44(7):5.

New evidence points to the association of sleep apnea and shortened sleep time and with cardiometabolic risk factors and sleepiness. The recent research study reported in the journal CHEST offers interesting insight into the various distinctive health impacts of sleep disorders.

In this study led by Luciano F. Drager, MD, PhD, of the University of Sao Paulo, Brazil, obstructive sleep apnea (OSA) and short sleep duration (SSD) were compared with excessive daytime sleepiness, anxiety/depressive symptoms, and several cardiometabolic risk factors, such as obesity, hypertension, diabetes, and dyslipidemia. Employing a large adult sample, investigators found that SSD was independently linked with daytime sleepiness; OSA, they discovered, was not.

On the other hand, the scientists learned, OSA was independently associated with obesity, hypertension, and dyslipidemia. Neither disorder was independently associated with anxiety or depression.

“The potential impact on patient care is that our results underscore the need to advance our knowledge of OSA and SSD determination to avoid the ‘one-size-fits-all’ approach,” said Dr. Drager, “and instead tailor personalized preventive, diagnostic, prognostic, and therapeutic strategies to our patients.”

Data came from nearly 2,100 participants from the cross-sectional Brazilian Longitudinal Study of Adult Health, a long-term study of Brazilian civil servants (aged 35-74 years) that seeks to give investigators insight into the development and progression of clinical and subclinical chronic diseases.

More patients than expected suffered from sleep disorders, including almost one-third with OSA. In addition, more than one-quarter of participants had SSD, which meant that they slept on average fewer than 6 hours per night. The study reported other unanticipated findings, such as more people afflicted with inappropriate sleep durations than commonly thought.

“In this study, only one quarter of participants slept seven to eight hours on average, the most highly recommended sleep duration for middle-aged adults,” said Dr. Drager. While individuals with SSD were more likely to report excessive sleepiness during the daytime, SSD was not associated with obesity, hypertension, or dyslipidemia.

Dr. Drager suggests that in previous studies any positive associations found between SSD and cardiometabolic risk factors could have been due to nonapparent OSA. “The additional lack of association of SSD with obesity, dyslipidemia, and diabetes in our large cohort reinforces the potential need to reappraise the evidence on subjective SSD and cardiometabolic risk factors,” he said.

For another examination of the link between OSA and various diseases, including congestive heart failure, atrial fibrillation, hypertension, and type 2 diabetes, see “Obstructive Sleep Apnea: A Review” by Michele Pisano, PharmD, BCGP, CDE, et al (this issue, page 16).

To comment on this article, contact