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Ambient temperature and obstructive sleep apnea: effects on sleep, sleep apnea and morning alertness
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Pulmonary Medicine.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Pulmonary Medicine.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
2012 (English)In: Sleep, ISSN 0161-8105, E-ISSN 1550-9109, Vol. 35, no 4, 513-517 p.Article in journal (Refereed) Published
Abstract [en]

Study Objectives: The aim of the study was to investigate the effect of ambient temperature on sleep, sleep apnea, and morning alertness in patients with obstructive sleep apnea. Design: Randomized controlled trial. Setting: In-hospital investigations. Participants: Forty patients with obstructive sleep apnea naive to treatment, with an apnea-hypopnea index of 10-30. Interventions: Three different nights in room temperatures of 16 degrees C, 20 degrees C, and 24 degrees C. Measurements: Overnight polysomnography and Karolinska Sleepiness Scale. Results: The obstructive apnea-hypopnea index was 30 +/- 17 at 16 degrees C room temperature, 28 +/- 17 at 20 degrees C, and 24 +/- 18 at 24 degrees C. The obstructive apnea-hypopnea index was higher at 16 degrees C room temperature versus 24 degrees C (P = 0.001) and at 20 degrees C room temperature versus 24 degrees C (P = 0.033). Total sleep time was a mean of 30 min longer (P = 0.009), mean sleep efficiency was higher (77 +/- 11% versus 71 +/- 13% respectively, P = 0.012), and the patients were significantly more alert according to the Karolinska Sleepiness Scale (P < 0.028) in the morning at 16 degrees C room temperature versus 24 degrees C. The amount of sleep in different sleep stages was not affected by room temperature. Conclusions: Untreated patients with obstructive sleep apnea sleep longer, have better sleep efficiency, and are more alert in the morning after a night's sleep at 16 degrees C room temperature compared with 24 degrees C, but obstructive sleep apnea is more severe at 16 degrees C and 20 degrees C compared with 24 degrees C.

Place, publisher, year, edition, pages
Westchester: American Academy of Sleep Medicine , 2012. Vol. 35, no 4, 513-517 p.
Keyword [en]
Sleep apnea syndromes, sleep quality, daytime sleepiness, treatment, ambient temperature, polysomnography, sleep stages, sleep time, randomized controlled trial
National Category
Respiratory Medicine and Allergy
Research subject
Medicine
Identifiers
URN: urn:nbn:se:umu:diva-48612DOI: 10.5665/sleep.1736ISI: 000303154400012OAI: oai:DiVA.org:umu-48612DiVA: diva2:451525
Available from: 2011-10-26 Created: 2011-10-26 Last updated: 2017-12-08Bibliographically approved
In thesis
1. Obstructive sleep apnea: the relationship to cardiovascular disease, diabetes mellitus, motor vehicle driving and ambient temperature
Open this publication in new window or tab >>Obstructive sleep apnea: the relationship to cardiovascular disease, diabetes mellitus, motor vehicle driving and ambient temperature
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Obstructive sleep apnea is a common disorder, especially in men. Patients with this condition often snore and suffer from excessive daytime sleepiness. It is a treatable condition related to cardiovascular disease, road traffic accidents and obesity.

Aims: To study whether snoring and witnessed sleep apnea are related to diabetes mellitus and whether sleepy subjects who snore or report sleep apneas drive more than others. To investigate whether sleep apnea is related to stroke, mortality and myocardial infarction in patients with coronary artery disease. To study the effect of ambient temperature on sleep apnea, morning alertness and sleep quality in patients with obstructive sleep apnea.

Methods and results: Questions on snoring, sleep apnea, daytime sleepiness and yearly driving distance were included in the northern Sweden component of the WHO MONICA study. Analyzed were 7905 randomly selected men and women aged 25-79 years. Snoring and witnessed sleep apnea were related to diabetes mellitus in women, (OR 1.58, p = 0.041 and OR 3.29, p = 0.012 respectively), independent of obesity, age and smoking, but not in men. Sleepy snoring men drove a mean of 22566 km per year which was more than others who drove 17751 km per year independent of age, BMI, smoking and physical activity (p = 0.02). Sleepy men reporting sleep apnea also drove more (p = 0.01). 392 men and women with coronary artery disease referred for coronary angiography were examined with overnight sleep apnea recordings and followed for 10 years. Sleep apnea was recorded in 211 (54%) of patients at baseline. Stroke occurred in 47 (12%) patients at follow up. Sleep apnea was associated with an increased risk of stroke (HR 2.89, 95% CI 1.37 - 6.09, p = 0.005) independent of age , BMI, left ventricular function, diabetes mellitus, gender, intervention, hypertension, atrial fibrillation, a previous stroke or TIA and smoking. The risk of stroke increased with the severity of sleep apnea. 40 patients with obstructive sleep apnea were investigated with overnight polysomnography in ambient temperatures of 16°C, 20°C and 24°C in random order. Total sleep time was a mean of 30 minutes longer (p = 0.009), sleep efficiency higher (p = 0.012), patients were more alert in the morning (p = 0.028), but sleep apnea was more severe when sleeping in 16°C (p = 0.001) and 20°C (p = 0.033) vs. 24°C. The AHI was 30 ± 17 in 16ºC room temperature, 28 ± 17 in 20°C and 24 ± 18 in 24°C.

Conclusions: Snoring and witnessed sleep apneas are related to diabetes mellitus in women. Sleepy men who snore or report sleep apnea drive more than others. Sleep apnea is independently associated with the risk of stroke among patients with coronary artery disease. Subjects with obstructive sleep apnea sleep longer, are more alert in the morning after a night’s sleep, but sleep apnea is more severe when sleeping in a colder environment.

Place, publisher, year, edition, pages
Umeå: Umeå universitet, 2011. 61 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1452
Keyword
Obstructive sleep apnea. Snoring. Cardiovascular disease. Stroke. Diabetes mellitus. Traffic accidents. Ambient temperature.
National Category
Respiratory Medicine and Allergy
Research subject
Medicine
Identifiers
urn:nbn:se:umu:diva-48616 (URN)978-91-7459-291-7 (ISBN)
Public defence
2011-11-18, Sal B, Målpunkt T9, Norrlands universitetssjukhus 901 85, Umeå, 13:00 (Swedish)
Opponent
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Available from: 2011-10-28 Created: 2011-10-26 Last updated: 2011-10-28Bibliographically approved

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