Prevalence and Predictors of Sleep-Disordered Breathing in Men Participating in the Multicenter AIDS Cohort Study

Naresh M. Punjabi; Todd T. Brown; R. Nisha Aurora; Sanjay R. Patel; Valentina Stosor; Joshua Hyong-Jin Cho; Gypsyamber D'Souza; Joseph B. Margolick

doi:10.1016/j.chest.2022.10.030

Prevalence and Predictors of Sleep-Disordered Breathing in Men Participating in the Multicenter AIDS Cohort Study

Naresh M. Punjabi^*, Todd T. Brown, R. Nisha Aurora, Sanjay R. Patel, Valentina Stosor, Joshua Hyong-Jin Cho, Gypsyamber D'Souza, Joseph B. Margolick

^*Corresponding author for this work

Medicine, Infectious Diseases Division

Research output: Contribution to journal › Article › peer-review

7 Scopus citations

Abstract

Background: Data on the prevalence of sleep-disordered breathing (SDB) in people with HIV are limited. Moreover, whether the associations between SDB and age or BMI differ by HIV status is unknown. Research Question: Is SDB more prevalent in men with HIV than those without HIV, and do the predictors of SDB differ between the two groups? Study Design and Methods: Home polysomnography was used in the Multicenter AIDS Cohort Study to assess SDB prevalence in men with (n = 466; 92% virologically suppressed) and without (n = 370) HIV. SDB was defined using the oxygen desaturation index (ODI) and the apnea-hypopnea index (AHI), using four definitions: ≥ 5 events/h based on an ODI with a 3% (ODI₃) or 4% (ODI₄) oxygen desaturation, or an AHI with a 3% oxygen desaturation or EEG arousal (AHI_3a) or with a 4% oxygen desaturation (AHI₄). Results: SDB prevalence was similar in men with and without HIV using the ODI₃ and AHI_3a definitions. However, SDB prevalence was higher in men with than without HIV using the ODI₄ (55.9% vs 47.8%; P = .04) and the AHI₄ definitions (57.9% vs 50.4%; P = .06). Mild and moderate SDB were more common in men with than without HIV. Associations between SDB prevalence and age, race, and BMI were similar in men with and without HIV. Among men with HIV, viral load, CD4 cell count, and use of antiretroviral medications were not associated with SDB prevalence. Interpretation: SDB prevalence was high overall but greater in men with than without HIV using the ODI₄ threshold definition. Efforts to diagnose SDB are warranted in people with HIV, given that SDB is associated with daytime sleepiness and impaired quality of life.

Original language	English (US)
Pages (from-to)	687-696
Number of pages	10
Journal	CHEST
Volume	163
Issue number	3
DOIs	https://doi.org/10.1016/j.chest.2022.10.030
State	Published - Mar 2023

Funding

The authors have reported to CHEST the following: N. M. P. received research grant support from Philip-Respironics and Resmed for work unrelated to this manuscript; S. R. P. has received research funding through his institution from Bayer Pharmaceuticals, Philips Respironics, Respicardia, and Sommetrics unrelated to this work; and has served as a consultant to Bayer Pharmaceuticals, NovaResp Technologies, Philips Respironics, and Powell Mansfield, Inc. T. T. B. has served as a consultant to ViiV Healthcare , Merck , Gilead Sciences , Janssen, and Theratechnologies. None declared (N. A., V. S., J. J.-J. C., G. D., J. B. M.). Data in this manuscript were collected by the Multicenter AIDS Cohort Study (MACS), now the MACS/WIHS Combined Cohort Study (MWCCS). The contents of this publication are solely the responsibility of the authors and do not represent the official views of the National Institutes of Health (NIH). N. M. P. was supported by NIH grants HL146709, HL11716, and HL075078. MWCCS was supported by the following: Baltimore Clinical Research Site (CRS) [Grant U01-HL146201 (T. T. B. and J. B. M.)]; Data Analysis and Coordination Center [Grant U01-HL146193 (G. D., Stephen Gange, and Elizabeth Golub)]; Chicago-Northwestern CRS [Grant U01-HL146242 (Steven Wolinsky)]; Los Angeles CRS [Grant U01-HL146333 (Roger Detels and Matthew Mimiaga)]; Pittsburgh CRS (Jeremy Martinson and Charles Rinaldo). The MWCCS is funded primarily by the National Heart, Lung, and Blood Institute , with additional cofunding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development , the National Institute on Aging , National Institute of Dental and Craniofacial Research , the National Institute of Allergy and Infectious Diseases , the National Institute of Neurological Disorders and Stroke , the National Institute of Mental Health , the National Institute on Drug Abuse , the National Institute of Nursing Research , the National Cancer Institute , the National Institute on Alcohol Abuse and Alcoholism , the National Institute on Deafness and Other Communication Disorders , the National Institute of Diabetes and Digestive and Kidney Diseases, the National Institute on Minority Health and Health Disparities , and in coordination and alignment with the research priorities of the National Institutes of Health , Office of AIDS Research . MWCCS data collection also is supported by Grants UL1-TR003098 ( Johns Hopkins University Institute for Clinical and Translational Research) and UL1-TR001881 ( University of California, Los Angeles , Clinical and Translational Science Institute).

Keywords

HIV
prevalence
sleep apnea
sleep-disordered breathing

ASJC Scopus subject areas

Critical Care and Intensive Care Medicine
Cardiology and Cardiovascular Medicine
Pulmonary and Respiratory Medicine

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1016/j.chest.2022.10.030

Cite this

@article{e2dcdb92ebfd474e9a658664c47a37fd,

title = "Prevalence and Predictors of Sleep-Disordered Breathing in Men Participating in the Multicenter AIDS Cohort Study",

abstract = "Background: Data on the prevalence of sleep-disordered breathing (SDB) in people with HIV are limited. Moreover, whether the associations between SDB and age or BMI differ by HIV status is unknown. Research Question: Is SDB more prevalent in men with HIV than those without HIV, and do the predictors of SDB differ between the two groups? Study Design and Methods: Home polysomnography was used in the Multicenter AIDS Cohort Study to assess SDB prevalence in men with (n = 466; 92% virologically suppressed) and without (n = 370) HIV. SDB was defined using the oxygen desaturation index (ODI) and the apnea-hypopnea index (AHI), using four definitions: ≥ 5 events/h based on an ODI with a 3% (ODI3) or 4% (ODI4) oxygen desaturation, or an AHI with a 3% oxygen desaturation or EEG arousal (AHI3a) or with a 4% oxygen desaturation (AHI4). Results: SDB prevalence was similar in men with and without HIV using the ODI3 and AHI3a definitions. However, SDB prevalence was higher in men with than without HIV using the ODI4 (55.9% vs 47.8%; P = .04) and the AHI4 definitions (57.9% vs 50.4%; P = .06). Mild and moderate SDB were more common in men with than without HIV. Associations between SDB prevalence and age, race, and BMI were similar in men with and without HIV. Among men with HIV, viral load, CD4 cell count, and use of antiretroviral medications were not associated with SDB prevalence. Interpretation: SDB prevalence was high overall but greater in men with than without HIV using the ODI4 threshold definition. Efforts to diagnose SDB are warranted in people with HIV, given that SDB is associated with daytime sleepiness and impaired quality of life.",

keywords = "HIV, prevalence, sleep apnea, sleep-disordered breathing",

author = "Punjabi, {Naresh M.} and Brown, {Todd T.} and Aurora, {R. Nisha} and Patel, {Sanjay R.} and Valentina Stosor and {Hyong-Jin Cho}, Joshua and Gypsyamber D'Souza and Margolick, {Joseph B.}",

note = "Publisher Copyright: {\textcopyright} 2022 American College of Chest Physicians",

year = "2023",

month = mar,

doi = "10.1016/j.chest.2022.10.030",

language = "English (US)",

volume = "163",

pages = "687--696",

journal = "CHEST",

issn = "0012-3692",

publisher = "American College of Chest Physicians",

number = "3",

}

TY - JOUR

T1 - Prevalence and Predictors of Sleep-Disordered Breathing in Men Participating in the Multicenter AIDS Cohort Study

AU - Punjabi, Naresh M.

AU - Brown, Todd T.

AU - Aurora, R. Nisha

AU - Patel, Sanjay R.

AU - Stosor, Valentina

AU - Hyong-Jin Cho, Joshua

AU - D'Souza, Gypsyamber

AU - Margolick, Joseph B.

PY - 2023/3

Y1 - 2023/3

N2 - Background: Data on the prevalence of sleep-disordered breathing (SDB) in people with HIV are limited. Moreover, whether the associations between SDB and age or BMI differ by HIV status is unknown. Research Question: Is SDB more prevalent in men with HIV than those without HIV, and do the predictors of SDB differ between the two groups? Study Design and Methods: Home polysomnography was used in the Multicenter AIDS Cohort Study to assess SDB prevalence in men with (n = 466; 92% virologically suppressed) and without (n = 370) HIV. SDB was defined using the oxygen desaturation index (ODI) and the apnea-hypopnea index (AHI), using four definitions: ≥ 5 events/h based on an ODI with a 3% (ODI3) or 4% (ODI4) oxygen desaturation, or an AHI with a 3% oxygen desaturation or EEG arousal (AHI3a) or with a 4% oxygen desaturation (AHI4). Results: SDB prevalence was similar in men with and without HIV using the ODI3 and AHI3a definitions. However, SDB prevalence was higher in men with than without HIV using the ODI4 (55.9% vs 47.8%; P = .04) and the AHI4 definitions (57.9% vs 50.4%; P = .06). Mild and moderate SDB were more common in men with than without HIV. Associations between SDB prevalence and age, race, and BMI were similar in men with and without HIV. Among men with HIV, viral load, CD4 cell count, and use of antiretroviral medications were not associated with SDB prevalence. Interpretation: SDB prevalence was high overall but greater in men with than without HIV using the ODI4 threshold definition. Efforts to diagnose SDB are warranted in people with HIV, given that SDB is associated with daytime sleepiness and impaired quality of life.

AB - Background: Data on the prevalence of sleep-disordered breathing (SDB) in people with HIV are limited. Moreover, whether the associations between SDB and age or BMI differ by HIV status is unknown. Research Question: Is SDB more prevalent in men with HIV than those without HIV, and do the predictors of SDB differ between the two groups? Study Design and Methods: Home polysomnography was used in the Multicenter AIDS Cohort Study to assess SDB prevalence in men with (n = 466; 92% virologically suppressed) and without (n = 370) HIV. SDB was defined using the oxygen desaturation index (ODI) and the apnea-hypopnea index (AHI), using four definitions: ≥ 5 events/h based on an ODI with a 3% (ODI3) or 4% (ODI4) oxygen desaturation, or an AHI with a 3% oxygen desaturation or EEG arousal (AHI3a) or with a 4% oxygen desaturation (AHI4). Results: SDB prevalence was similar in men with and without HIV using the ODI3 and AHI3a definitions. However, SDB prevalence was higher in men with than without HIV using the ODI4 (55.9% vs 47.8%; P = .04) and the AHI4 definitions (57.9% vs 50.4%; P = .06). Mild and moderate SDB were more common in men with than without HIV. Associations between SDB prevalence and age, race, and BMI were similar in men with and without HIV. Among men with HIV, viral load, CD4 cell count, and use of antiretroviral medications were not associated with SDB prevalence. Interpretation: SDB prevalence was high overall but greater in men with than without HIV using the ODI4 threshold definition. Efforts to diagnose SDB are warranted in people with HIV, given that SDB is associated with daytime sleepiness and impaired quality of life.

KW - HIV

KW - prevalence

KW - sleep apnea

KW - sleep-disordered breathing

UR - http://www.scopus.com/inward/record.url?scp=85147671358&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85147671358&partnerID=8YFLogxK

U2 - 10.1016/j.chest.2022.10.030

DO - 10.1016/j.chest.2022.10.030

M3 - Article

C2 - 36343689

AN - SCOPUS:85147671358

SN - 0012-3692

VL - 163

SP - 687

EP - 696

JO - CHEST

JF - CHEST

IS - 3

ER -

Prevalence and Predictors of Sleep-Disordered Breathing in Men Participating in the Multicenter AIDS Cohort Study

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

Access to Document

Other files and links

Fingerprint

Cite this