Evidence map›Paper›PMID 32298733›Full record

ArticleChest2020

The Sleep Apnea-Specific Hypoxic Burden Predicts Incident Heart Failure.

Ali Azarbarzin, Scott A Sands, Luigi Taranto-Montemurro, Daniel Vena, Tamar Sofer, Sang-Wook Kim, Katie L Stone, David P White, Andrew Wellman, Susan Redline

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Chest, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 129 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
129citing papers in PubMed, 4 pooled it
11.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

129 citing papers in PubMed, 4 syntheses or guidelines pooled it, 186 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Association of alternative polysomnographic features with patient outcomes in obstructive sleep apnea: a systematic review.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2023
    Pooled it
  5. Trial
  6. Trial
  7. Trial
  8. Trial
  9. Trial
  10. Trial
  11. Combination of atomoxetine with the novel antimuscarinic aroxybutynin improves mild to moderate OSA.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2022
    Trial
  12. Trial
  13. Trial
  14. Article
  15. Observational
  16. Article
  17. Oxygen overshoot burden of central sleep apnea and its association with cardiovascular outcomes.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2026
    Article
  18. Article
  19. Article
  20. Article

69 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 4 institutions in 1 country.

Ali AzarbarzinDivision of Sleep and Circadian Disorders, Brigham and Women's Hospital and Harvard Medical School, Boston, MA. Electronic address: aazarbarzin@bwh.harvard.edu.
Scott A SandsDivision of Sleep and Circadian Disorders, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
Luigi Taranto-MontemurroDivision of Sleep and Circadian Disorders, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
Daniel VenaDivision of Sleep and Circadian Disorders, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
Tamar SoferDivision of Sleep and Circadian Disorders, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
Sang-Wook KimDivision of Sleep and Circadian Disorders, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
Katie L StoneResearch Institute, California Pacific Medical Center, San Francisco, CA.
David P WhiteDivision of Sleep and Circadian Disorders, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
Andrew WellmanDivision of Sleep and Circadian Disorders, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
Susan RedlineDivision of Sleep and Circadian Disorders, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
Circadian (United States) · USBrigham and Women's Hospital · USHarvard University · USCalifornia Pacific Medical Center · US

Funding

HARVARD CLINICAL AND TRANSLATIONAL SCIENCE CENTER (UL1)UL1RR025758 · NCRR · HARVARD MEDICAL SCHOOL · PI NADLER, LEE MARSHALL · 2008 to 2011
$91.4M
Oregon Clinical and Translational Research InstituteUL1TR000128 · NCATS · OREGON HEALTH & SCIENCE UNIVERSITY · PI ELLISON, DAVID H · 2012 to 2015
$28.7M
Wakefulness and Forebrain Activation by Orexin NeuronsP01HL095491 · NHLBI · BETH ISRAEL DEACONESS MEDICAL CENTER · PI WELLMAN, DAVID ANDREW · 2010 to 2019
$25.1M
OSTEOPOROTIC FRACTURES IN MENU01AG018197 · NIA · UNIVERSITY OF CALIFORNIA SAN FRANCISCO · PI CUMMINGS, STEVEN RON · 1999 to 2011
$12.7M
Outcomes of Sleep Disorders in Older MenR01HL071194 · NHLBI · UNIVERSITY OF CALIFORNIA SAN FRANCISCO · PI STONE, KATIE L · 2003 to 2013
$12.2M
Validation of a Phenotype Model to Predict Response to Alternative OSA TreatmentsR01HL102321 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI WELLMAN, DAVID ANDREW · 2011 to 2025
$7.3M
Phenotypic and Molecular Signatures for Sleep Apnea and Related MorbiditiesR35HL135818 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI REDLINE, SUSAN S. · 2017 to 2023
$7.2M
Osteoporotic Fractures in Men: MrOS Renewal-PortlandU01AR045647 · NIAMS · OREGON HEALTH & SCIENCE UNIVERSITY · PI ORWOLL, ERIC S. · 1999 to 2011
$6.7M
Osteporotic Fractures in Men (MrOS)- Admin CenterU01AG027810 · NIA · OREGON HEALTH & SCIENCE UNIVERSITY · PI ORWOLL, ERIC S. · 2006 to 2017
$5.1M
Osteoporotic Fractures in Men - Renewal: PittsburghU01AR045654 · NIAMS · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI CAULEY, JANE ANN · 1999 to 2011
$5.1M
Determination of the site of pharyngeal collapse in Obstructive Sleep Apnea patients from snoring soundsR01HL128658 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI WELLMAN, DAVID ANDREW · 2016 to 2025
$4.3M
OSTEOPOROTIC FRACTURES IN MENU01AR045614 · NIAMS · UNIVERSITY OF MINNESOTA TWIN CITIES · PI ENSRUD, KRISTINE · 1999 to 2011
$4.0M
NCATS NIH HHS UL1 TR000128NCRR NIH HHS UL1 RR025758NHLBI NIH HHS P01 HL095491NHLBI NIH HHS R01 HL070837NHLBI NIH HHS R01 HL070838NHLBI NIH HHS R01 HL070839NHLBI NIH HHS R01 HL070841NHLBI NIH HHS R01 HL070842NHLBI NIH HHS R01 HL070847NHLBI NIH HHS R01 HL070848NHLBI NIH HHS R01 HL071194NHLBI NIH HHS R01 HL102321NHLBI NIH HHS R01 HL128658NHLBI NIH HHS R35 HL135818NHLBI NIH HHS U01 HL053916NHLBI NIH HHS U01 HL053931NHLBI NIH HHS U01 HL053934NHLBI NIH HHS U01 HL053937NHLBI NIH HHS U01 HL053938NHLBI NIH HHS U01 HL053941NHLBI NIH HHS U01 HL063429NHLBI NIH HHS U01 HL063463NIAMS NIH HHS U01 AR045580NIAMS NIH HHS U01 AR045583NIAMS NIH HHS U01 AR045614NIAMS NIH HHS U01 AR045632NIAMS NIH HHS U01 AR045647NIAMS NIH HHS U01 AR045654NIA NIH HHS U01 AG018197NIA NIH HHS U01 AG027810
6 · The paper itself

Abstract

backgroundHeart failure (HF) is a leading cause of morbidity and mortality and although it is linked to sleep apnea, which physiological stressors most strongly associate with incident disease is unclear. We tested whether sleep apnea-specific hypoxic burden (SASHB) predicts incident HF in two independent cohort studies. RESEARCH QUESTION: In comparison with apnea-hypopnea index (AHI), how does sleep apnea-specific hypoxic burden predict incident HF? STUDY DESIGN AND

methodsThe samples were derived from two cohort studies: The Sleep Heart Health Study (SHHS), which included 4,881 middle-aged and older adults (54.4% women), age 63.6 ± 11.1 years; and the Outcomes of Sleep Disorders in Older Men (MrOS), which included 2,653 men, age 76.2 ± 5.4 years. We computed SASHB as the sleep apnea-specific area under the desaturation curve from pre-event baseline. We used Cox models for incident HF to estimate the adjusted hazard ratios (HRs) for natural log-transformed SASHB and AHI adjusting for multiple confounders.

resultsThe SASHB predicted incident HF in men in both cohorts, whereas AHI did not. Men in SHHS and MrOS had adjusted HRs (per 1SD increase in SASHB) of 1.18 (95% CI, 1.02-1.37) and 1.22 (95% CI, 1.02-1.45), respectively. Associations with SASHB were observed in men with both low and high AHI levels. Associations were not significant in women.

interpretationIn men, the hypoxic burden of sleep apnea was associated with incident HF after accounting for demographic factors, smoking, and co-morbidities. The findings Suggest that quantification of an easily measured index of sleep apnea-related hypoxias may be useful for identifying individuals at risk for heart disease, while also suggesting targets for intervention.

Indexed as

AdultAgedFemaleHeart FailureHumansHypoxiaIncidenceMaleMiddle AgedPredictive Value of TestsProspective StudiesRisk AssessmentRisk FactorsSleep Apnea SyndromesUnited Statesapnea-hypopnea indexheart failurepolysomnographysleep apneasleep apnea-specific hypoxic burden

Identifiers

PMID32298733
PMCPMC7417383
OpenAlexW3015409819

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.