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

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.

[1]  Sanjay R. Patel,et al.  Sleep Patterns and Hypertension Using Actigraphy in the Hispanic Community Health Study/Study of Latinos , 2018, Chest.

[2]  K. Reid,et al.  Actigraphic sleep measures and diet quality in the Hispanic Community Health Study/Study of Latinos Sueño ancillary study , 2017, Journal of sleep research.

[3]  Jingpu Shi,et al.  Sleep duration and risk of stroke: a dose-response meta-analysis of prospective cohort studies. , 2017, Sleep medicine.

[4]  K. Reid,et al.  Actigraphic Sleep Patterns of U.S. Hispanics: The Hispanic Community Health Study/Study of Latinos , 2017, Sleep.

[5]  Deepak L. Bhatt,et al.  Sleep Duration and Quality: Impact on Lifestyle Behaviors and Cardiometabolic Health: A Scientific Statement From the American Heart Association. , 2016, Circulation.

[6]  Jianwen Cai,et al.  Comparison of Self-Reported Sleep Duration With Actigraphy: Results From the Hispanic Community Health Study/Study of Latinos Sueño Ancillary Study. , 2016, American journal of epidemiology.

[7]  Sanjay R Patel,et al.  Disparities and genetic risk factors in obstructive sleep apnea. , 2016, Sleep medicine.

[8]  J. Veselka,et al.  Evaluation of cerebrovascular reserve in patients undergoing carotid artery stenting and its usefulness in predicting significant hemodynamic changes during temporary carotid occlusion. , 2016, Physiological research.

[9]  Michael Rueschman,et al.  Reproducibility of a Standardized Actigraphy Scoring Algorithm for Sleep in a US Hispanic/Latino Population. , 2015, Sleep.

[10]  P. J. Caballero,et al.  Cerebral hemodynamic changes at basilar artery in patients with obstructive sleep apnea syndrome. A case-control study. , 2014 .

[11]  Raanan Arens,et al.  Sleep-disordered breathing in Hispanic/Latino individuals of diverse backgrounds. The Hispanic Community Health Study/Study of Latinos. , 2014, American journal of respiratory and critical care medicine.

[12]  K. Lee,et al.  Sleep Duration and Glycemic Control in Patients with Diabetes Mellitus: Korea National Health and Nutrition Examination Survey 2007-2010 , 2013, Journal of Korean medical science.

[13]  R. Sacco,et al.  Cerebrovascular pulsatility in patients with sleep-disordered breathing , 2013, Sleep and Breathing.

[14]  AIUM Practice Guideline for the Performance of a Transcranial Doppler Ultrasound Examination for Adults and Children , 2012, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[15]  R. Westendorp,et al.  Cerebrovascular hemodynamics in Alzheimer's disease and vascular dementia: A meta-analysis of transcranial Doppler studies , 2012, Ageing Research Reviews.

[16]  David J. Durgan,et al.  Cerebrovascular Consequences of Obstructive Sleep Apnea , 2012, Journal of the American Heart Association.

[17]  A. Ramos,et al.  Sleep Disorders and Stroke , 2012, International journal of stroke : official journal of the International Stroke Society.

[18]  Pasquale Strazzullo,et al.  Sleep duration predicts cardiovascular outcomes: a systematic review and meta-analysis of prospective studies. , 2011, European heart journal.

[19]  F. Faraci Protecting against vascular disease in brain. , 2011, American journal of physiology. Heart and circulatory physiology.

[20]  Jae Ung Lee,et al.  Non-Dipper Pattern is a Determinant of the Inappropriateness of Left Ventricular Mass in Essential Hypertensive Patients , 2011, Korean circulation journal.

[21]  R. Marshall,et al.  Pumps, Aqueducts, and Drought Management: Vascular Physiology in Vascular Cognitive Impairment , 2011, Stroke.

[22]  K Rasche,et al.  Obstructive sleep apnea and type 2 diabetes , 2010, European journal of medical research.

[23]  Lloyd E Chambless,et al.  Design and implementation of the Hispanic Community Health Study/Study of Latinos. , 2010, Annals of epidemiology.

[24]  Cathy Goldstein,et al.  Obstructive sleep apnea-hypopnea and incident stroke: the sleep heart health study. , 2010, American journal of respiratory and critical care medicine.

[25]  M. Czosnyka,et al.  Cerebral autoregulation in patients with obstructive sleep apnea syndrome during wakefulness , 2009, European journal of neurology.

[26]  C. Brayne,et al.  Population studies of sporadic cerebral amyloid angiopathy and dementia: a systematic review , 2009, BMC neurology.

[27]  Joseph Schindler,et al.  Impaired cerebral autoregulation in obstructive sleep apnea. , 2008, Journal of applied physiology.

[28]  Farzaneh A. Sorond,et al.  Cerebral blood flow regulation during cognitive tasks: Effects of healthy aging , 2008, Cortex.

[29]  Ş. Demirkaya,et al.  Normal blood flow velocities of basal cerebral arteries decrease with advancing age: a transcranial Doppler sonography study. , 2008, The Tohoku journal of experimental medicine.

[30]  G. Lorenzi-Filho,et al.  Sympathetic activity, heart failure, obesity, and metabolic syndrome: is there any role for obstructive sleep apnea? , 2007, Hypertension.

[31]  Cheryl C. H. Yang,et al.  Age-related changes in cerebral hemodynamics and their correlations with cardiac autonomic functions , 2006, Neurological research.

[32]  L. Honig,et al.  Dementia with cerebrovascular disease. , 2006, Science of aging knowledge environment : SAGE KE.

[33]  J. Pépin,et al.  The severity of oxygen desaturation is predictive of carotid wall thickening and plaque occurrence. , 2005, Chest.

[34]  Paul G. Ince,et al.  Vascular pathologies and cognition in a population-based cohort of elderly people , 2004, Journal of the Neurological Sciences.

[35]  B. Göksan,et al.  Is there a link between the severity of sleep‐disordered breathing and atherosclerotic disease of the carotid arteries? , 2003, European journal of neurology.

[36]  Fabio Placidi,et al.  Carotid Artery Wall Thickness in Patients With Obstructive Sleep Apnea Syndrome , 2002, Stroke.

[37]  R. Sacco,et al.  Stroke incidence among white, black, and Hispanic residents of an urban community: the Northern Manhattan Stroke Study. , 1998, American journal of epidemiology.

[38]  I. Karacan,et al.  Cerebral blood flow in normal and abnormal sleep and dreaming , 1987, Brain and Cognition.

[39]  R. Aaslid,et al.  Noninvasive transcranial Doppler ultrasound recording of flow velocity in basal cerebral arteries. , 1982, Journal of neurosurgery.

[40]  F. Sakai,et al.  Sleep apnea, narcolepsy, and dreaming: Regional cerebral hemodynamics , 1980, Annals of neurology.