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Prevalence of and factors associated with obstructive sleep apnea in a cohort of adults with long duration type 1 diabetes mellitus

Denic, Hristina (2014) Prevalence of and factors associated with obstructive sleep apnea in a cohort of adults with long duration type 1 diabetes mellitus. Master's Thesis, University of Pittsburgh. (Unpublished)

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Chronic health conditions like diabetes and sleep disorders have been increasing. Previous research showed that diabetes and sleep disorders are interrelated. The majority of studies examining this relationship focused on type 2 diabetes. Although a relationship between sleep disorders and type 1 diabetes (T1D) has been studied, investigations have been limited to youth and small samples. We, therefore, aimed to assess the prevalence, overall and gender-specific, and correlates, of obstructive sleep apnea (OSA) risk in an adult cohort with long-standing T1D.
A total of 170 individuals with T1D attending the 25-year follow-up of the Pittsburgh Epidemiology of Diabetes Complications study who completed an OSA screening tool, the Berlin Questionnaire (BQ), were included in this cross-sectional analysis. Those scoring positively on the BQ and/or reported a previous OSA diagnosis were classified as being at high OSA risk.
The OSA risk prevalence was 25.9% (25.0% among men, 26.6% among women). High versus low-OSA-risk individuals differed univariately with respect to markers of obesity, systolic blood pressure, estimated glucose disposal rate, lipid profile, and smoking history, although no differences were observed in hemoglobin A1c. In the final multivariable model, adjusting for sex and diabetes duration, body mass index (BMI) (directly, p=0.01), high-density lipoprotein (HDL) (inversely, p=0.03), and smoking history (directly, p=0.04) correlated with OSA risk. In gender-specific analyses, adjusting for diabetes duration, BMI (directly, p=0.007) and HDL (inversely, p=0.03) were also associated with OSA risk in women, while diastolic blood pressure (p=0.01) and smoking history (p=0.04) were positive OSA correlates in men.
Our findings suggest that the prevalence of high OSA risk in adults with long-standing T1D is comparable to that in the general population. Given that both OSA screening tools and treatment are widely available, identifying high OSA risk among individuals already burdened with a serious chronic disease is of public health importance. Indeed, modifiable risk factors were independently associated with OSA risk in this study, suggesting that the adoption of a healthier lifestyle may reduce OSA risk in T1D, improving the wellbeing and reducing the subsequent risk of further complication development. Future prospective cohorts should be conducted to explore this hypothesis.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Denic, Hristinahrd7@pitt.eduHRD7
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Thesis AdvisorCostacou, TinaCostacouT@edc.pitt.eduCOSTACOU
Committee MemberOrchard, Trevortjo@pitt.eduTJO
Committee MemberArena, Vincent C.arena@pitt.eduARENA
Date: 30 September 2014
Date Type: Publication
Defense Date: 17 July 2014
Approval Date: 30 September 2014
Submission Date: 21 July 2014
Access Restriction: 2 year -- Restrict access to University of Pittsburgh for a period of 2 years.
Number of Pages: 53
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Epidemiology
Degree: MS - Master of Science
Thesis Type: Master's Thesis
Refereed: Yes
Uncontrolled Keywords: Obstructive sleep apnea, type 1 diabetes
Date Deposited: 30 Sep 2014 12:42
Last Modified: 15 Nov 2016 14:22


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