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Volume 15 No. 01
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Accepted Papers





Scientific Investigations

Cerebral Hemodynamics in Sleep Apnea and Actigraphy-Determined Sleep Duration in a Sample of the Hispanic Community Health Study/Study of Latinos

Dixon Yang, MD1; Tatjana Rundek, MD, PhD1; Sanjay R. Patel, MD, MS2; Digna Cabral, BS1; Susan Redline, MD, MPH3; Fernando D. Testai, MD, PhD4; Jianwen Cai, PhD5; Douglas M. Wallace, MD1; Phyllis C. Zee, MD, PhD6; Alberto R. Ramos, MD, MS1
1Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida; 2Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania; 3Departments of Medicine, Brigham and Women's Hospital and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts; 4Department of Neurology and Rehabilitation, University of Illinois at Chicago Medical Center, Chicago, Illinois; 5Collaborative Studies Coordinating Center, University of North Carolina at Chapel Hill, North Carolina; 6Department of Neurology and Center for Circadian and Sleep Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois

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.

Citation:

Yang D, Rundek T, Patel SR, Cabral D, Redline S, Testai FD, Cai J, Wallace DM, Zee PC, Ramos AR. Cerebral hemodynamics in sleep apnea and actigraphy-determined sleep duration in a sample of the Hispanic Community Health Study/Study of Latinos. J Clin Sleep Med. 2019;15(1):15–21.


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