Cerebral hemodynamics in sleep apnea and actigraphy-determined sleep duration in a sample of the Hispanic Community Health Study/Study of Latinos

Dixon Yang, Tatjana Rundek, Sanjay R. Patel, Digna Cabral, Susan Redline, Fernando D. Testai, Jianwen Cai, Douglas Wallace, Phyllis C. Zee, Alberto Ramos

Research output: Contribution to journalArticle

Abstract

Study Objectives: We sought to evaluate cerebral hemodynamics in obstructive sleep apnea (OSA) and actigraphy-defined short sleep duration using transcranial Doppler ultrasound (TCD) blood flow velocity in a subsample of Hispanics/Latinos without stroke and cardiovascular disease. Methods: The sample consisted of consecutive participants at the Miami site of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) with overnight home sleep testing and 7 days of wrist actigraphy in the Sueño sleep ancillary study. Ninety-five participants had sleep data and TCD determined cerebral hemodynamics. We evaluated the association between OSA (apnea-hypopnea index [AHI] ≥ 5 events/h) and short sleep duration (< 6.8 hours; sample median) with cerebral blood flow velocities (CBFV) and pulsatility index (PI) for the middle cerebral (MCA) and basilar arteries (BA). Results: Median age was 48 years (range 20–64) with 71% females. Twenty-eight percent of the sample had OSA (AHI ≥ 5 events/h) with median AHI of 10.0 (range 5.0–51.7) events/h. In unadjusted analyses, participants with OSA had lower median CBFV in the BA (30.5 cm/s [interquartile range:10.2] versus 39.4 cm/s [13.3] P < .05), but not the MCA, whereas short sleepers had higher median vascular resistance in the MCA (PI = 0.92 [0.18] versus 0.86 [0.14] P < .05) and BA (PI = 1.0 [0.17] versus 0.93 [0.24] P < .05). After full adjustment, OSA was associated with decreased CBFV (β [SE] = −5.1 [2.5] P < .05) in the BA. Short sleep was associated with increased PI (β [SE] = 0.05 [0.02] P < .05) in the MCA. Conclusions: In this sample of Hispanic/Latinos, OSA was associated with decreased daytime blood flow velocity in the BA, whereas actigraphy-defined short sleep duration was associated with increased cerebrovascular pulsatility in the MCA.

Original languageEnglish (US)
Pages (from-to)15-21
Number of pages7
JournalJournal of Clinical Sleep Medicine
Volume15
Issue number1
DOIs
StatePublished - Jan 15 2019

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Actigraphy
Sleep Apnea Syndromes
Hispanic Americans
Obstructive Sleep Apnea
Basilar Artery
Blood Flow Velocity
Sleep
Hemodynamics
Cerebrovascular Circulation
Health
Apnea
Doppler Ultrasonography
Social Adjustment
Middle Cerebral Artery
Wrist
Vascular Resistance
Cardiovascular Diseases
Stroke

Keywords

  • Cerebral hemodynamics
  • Hispanic/Latinos
  • Sleep apnea
  • Sleep duration
  • Stroke risk

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Neurology
  • Clinical Neurology

Cite this

Cerebral hemodynamics in sleep apnea and actigraphy-determined sleep duration in a sample of the Hispanic Community Health Study/Study of Latinos. / Yang, Dixon; Rundek, Tatjana; Patel, Sanjay R.; Cabral, Digna; Redline, Susan; Testai, Fernando D.; Cai, Jianwen; Wallace, Douglas; Zee, Phyllis C.; Ramos, Alberto.

In: Journal of Clinical Sleep Medicine, Vol. 15, No. 1, 15.01.2019, p. 15-21.

Research output: Contribution to journalArticle

Yang, Dixon ; Rundek, Tatjana ; Patel, Sanjay R. ; Cabral, Digna ; Redline, Susan ; Testai, Fernando D. ; Cai, Jianwen ; Wallace, Douglas ; Zee, Phyllis C. ; Ramos, Alberto. / Cerebral hemodynamics in sleep apnea and actigraphy-determined sleep duration in a sample of the Hispanic Community Health Study/Study of Latinos. In: Journal of Clinical Sleep Medicine. 2019 ; Vol. 15, No. 1. pp. 15-21.
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abstract = "Study Objectives: We sought to evaluate cerebral hemodynamics in obstructive sleep apnea (OSA) and actigraphy-defined short sleep duration using transcranial Doppler ultrasound (TCD) blood flow velocity in a subsample of Hispanics/Latinos without stroke and cardiovascular disease. Methods: The sample consisted of consecutive participants at the Miami site of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) with overnight home sleep testing and 7 days of wrist actigraphy in the Sue{\~n}o sleep ancillary study. Ninety-five participants had sleep data and TCD determined cerebral hemodynamics. We evaluated the association between OSA (apnea-hypopnea index [AHI] ≥ 5 events/h) and short sleep duration (< 6.8 hours; sample median) with cerebral blood flow velocities (CBFV) and pulsatility index (PI) for the middle cerebral (MCA) and basilar arteries (BA). Results: Median age was 48 years (range 20–64) with 71{\%} females. Twenty-eight percent of the sample had OSA (AHI ≥ 5 events/h) with median AHI of 10.0 (range 5.0–51.7) events/h. In unadjusted analyses, participants with OSA had lower median CBFV in the BA (30.5 cm/s [interquartile range:10.2] versus 39.4 cm/s [13.3] P < .05), but not the MCA, whereas short sleepers had higher median vascular resistance in the MCA (PI = 0.92 [0.18] versus 0.86 [0.14] P < .05) and BA (PI = 1.0 [0.17] versus 0.93 [0.24] P < .05). After full adjustment, OSA was associated with decreased CBFV (β [SE] = −5.1 [2.5] P < .05) in the BA. Short sleep was associated with increased PI (β [SE] = 0.05 [0.02] P < .05) in the MCA. Conclusions: In this sample of Hispanic/Latinos, OSA was associated with decreased daytime blood flow velocity in the BA, whereas actigraphy-defined short sleep duration was associated with increased cerebrovascular pulsatility in the MCA.",
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AU - Yang, Dixon

AU - Rundek, Tatjana

AU - Patel, Sanjay R.

AU - Cabral, Digna

AU - Redline, Susan

AU - Testai, Fernando D.

AU - Cai, Jianwen

AU - Wallace, Douglas

AU - Zee, Phyllis C.

AU - Ramos, Alberto

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N2 - Study Objectives: We sought to evaluate cerebral hemodynamics in obstructive sleep apnea (OSA) and actigraphy-defined short sleep duration using transcranial Doppler ultrasound (TCD) blood flow velocity in a subsample of Hispanics/Latinos without stroke and cardiovascular disease. Methods: The sample consisted of consecutive participants at the Miami site of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) with overnight home sleep testing and 7 days of wrist actigraphy in the Sueño sleep ancillary study. Ninety-five participants had sleep data and TCD determined cerebral hemodynamics. We evaluated the association between OSA (apnea-hypopnea index [AHI] ≥ 5 events/h) and short sleep duration (< 6.8 hours; sample median) with cerebral blood flow velocities (CBFV) and pulsatility index (PI) for the middle cerebral (MCA) and basilar arteries (BA). Results: Median age was 48 years (range 20–64) with 71% females. Twenty-eight percent of the sample had OSA (AHI ≥ 5 events/h) with median AHI of 10.0 (range 5.0–51.7) events/h. In unadjusted analyses, participants with OSA had lower median CBFV in the BA (30.5 cm/s [interquartile range:10.2] versus 39.4 cm/s [13.3] P < .05), but not the MCA, whereas short sleepers had higher median vascular resistance in the MCA (PI = 0.92 [0.18] versus 0.86 [0.14] P < .05) and BA (PI = 1.0 [0.17] versus 0.93 [0.24] P < .05). After full adjustment, OSA was associated with decreased CBFV (β [SE] = −5.1 [2.5] P < .05) in the BA. Short sleep was associated with increased PI (β [SE] = 0.05 [0.02] P < .05) in the MCA. Conclusions: In this sample of Hispanic/Latinos, OSA was associated with decreased daytime blood flow velocity in the BA, whereas actigraphy-defined short sleep duration was associated with increased cerebrovascular pulsatility in the MCA.

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