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A Elmasry

Publications and source records attributed to A Elmasry.

8 recordsLinked to original sources
PubMed2002

Prevalence of sleep apnoea and snoring in hypertensive men: a population based study.

BACKGROUND: Several studies have reported an association between sleep disordered breathing (SDB) and hypertension (HT) but there is still a debate as to whether this is an effect of confounders. Some researchers have found an age dependent relationship between SDB and HT with higher risk at lower ages. A case-control study was performed in hypertensive men and non-hypertensive male controls matched for age and body mass index to assess whether there is an independent association between SDB and HT. If so, we further wanted to investigate whether this effect is age dependent. METHODS: An overnight sleep study was performed in a population based, age stratified sample of 102 hypertensive men aged 43-82 years and 102 non-hypertensive controls. RESULTS: Hypertensive subjects had a significantly higher prevalence of SDB than non-hypertensive subjects (apnoea-hypopnoea index (AHI): 10.8 v 7.3; desaturation index (DI): 8.5 v 5.2; AHI >or=10: 37% v 24%, p<0.05; DI >or=10: 29% v 12%; lowest desaturation: mean (SD) 81.9 (7.3) v 84.7 (6.1), p<0.01). After adjusting for neck circumference and physical inactivity, DI >or=10 and lowest desaturation were still independent predictors of HT with adjusted odds ratios of 2.3 (95% CI 1.0 to 5.3) and 0.94 (95% CI 0.89 to 0.99), respectively. When the subjects were split into two groups according to age (<60 and >or=60 years), the influence of DI >or=10 on HT was strongest in the younger men (adjusted OR 4.3 (95% CI 1.0 to 19.3 v 2.1 (95% CI 0.7 to 6.5)) and the association between minimum oxygen saturation (SaO(2)) and HT reached statistical significance in the younger men only. CONCLUSION: SDB is more prevalent in men with HT than in controls. DI >or=10 and lowest desaturation are independent predictors of HT irrespective of confounders. The results indicate that the influence of SDB on HT is more pronounced in younger and middle aged men than in those above 60 years.

Adult↗
PubMed2002

Obstructive sleep apnoea and urine catecholamines in hypertensive males: a population-based study.

Studies addressing the relationship between obstructive sleep apnoea (OSA) and sympathoadrenal activity have been criticized for poor control of factors known to confound sympathetic function, including hypertension. The aim of this study was to investigate the relationship between OSA and urinary catecholamines in a population-based sample of hypertensive males. In 1994, 2,668 males aged 40-79 yrs answered a questionnaire regarding sleep disorders and somatic diseases. Of those who reported hypertension, an age-stratified sample of 116 was selected for monitoring of breathing during sleep and overnight urine analysis. Subjects with OSA, defined as apnoea-hypopnoea index > or = 10 x h(-1), had higher concentrations of urinary normetanephrine (182+/-57 versus 141+/-45 micromol x mol(-1) creatinine, p<0.001) and metanephrine (70+/-28 versus 61+/-28 micromol mol(-1) creatinine, p<0.05) in comparison to subjects without OSA. In a multiple regression analysis, there was an association between variables of sleep-disordered breathing and normetanephrine and metanephrine concentrations, independent of major confounding factors. The authors concluded that, in a population-based sample of hypertensive males, obstructive sleep apnoea is associated with increased urinary concentrations of extraneuronal metabolites of catecholamines independent of major confounding factors, suggesting increased sympathoadrenal activity. Elevated sympathoadrenal activity may explain the increased cardiovascular morbidity associated with obstructive sleep apnoea.

Adult↗
PubMed2001

Insomnia in men-a 10-year prospective population based study.

STUDY OBJECTIVES: to prospectively analyze changes in the prevalence of insomnia and the relationship between insomnia, aging, lifestyle, and medical disorders DESIGN: a longitudinal population survey. PARTICIPANTS: a randomly selected population sample of 2,602 men (age 30-69 years) from Uppsala in Sweden. INTERVENTION: all participants answered a questionnaire on sleep disturbances, lifestyle factors, and medical disorders in 1984 and again in 1994. MEASUREMENTS AND RESULTS: The prevalence of INSOMNIA was 10.3% in 1984 and 12.8% in 1994. No significant correlation was found between age and insomnia in any of the two time periods. Insomnia in 1994 was independently related to having insomnia in 1984 (OR=6.45), being over-weight (BMI> 27 kg/m2) (OR=1.35), physical inactivity (OR=1.42), alcohol dependence (OR=1.75), psychiatric disorders (OR=8.27) and joint/low back disorders (OR=2.95). The number of subject with reported insomnia in 1984 but not 1994 was 149. Subjects that quit smoking during the time period had an increased likeliness of remission (OR=2.70) while men who were overweight were less likely to remit (OR=0.43). CONCLUSIONS: We conclude that in men insomnia is related to lifestyle factors such as obesity, physical inactivity and alcohol dependency but not to aging. Medical disorders such as joint and low back disorders and psychiatric illnesses also increase the risk of reporting insomnia. This study demonstrates the close relationship between quality of sleep and overall health status.

Adult↗
PubMed2001

Sleep-disordered breathing and glucose metabolism in hypertensive men: a population-based study.

OBJECTIVES: Diabetes mellitus and obstructive sleep apnoea (OSA) are two prevalent medical problems. Both are strongly associated with obesity and hypertension. The aim of this study was to investigate whether the association between OSA and diabetes is entirely dependent on obesity in hypertensive men. DESIGN: A population-based study. SETTING: The municipality of Uppsala, Sweden. Subjects and methods. In 1994, 2668 men aged 40-79 years answered a questionnaire regarding snoring, sleep disturbances and somatic diseases. An age-stratified sample of 116 hypertensive men was selected for a whole-night sleep study. Twenty-five of them had diabetes, defined as reporting regular medical controls for diabetes or having a fasting blood glucose > or =6.1 mmol L(-1). RESULTS: The prevalence of severe OSA, defined as apnoea-hypopnoea index (AHI) > or =20 h(-1) was significantly higher in diabetic patients than in normoglycaemic subjects (36 vs. 14.5%, P < 0.05). The sample was divided into four groups based on the presence or absence of severe OSA and the presence or absence of central obesity, defined as waist-to-hip ratio (WHR) > or =1.0. In a logistic regression model with the non-OSA, WHR <1.0 as the reference group, the adjusted odds ratio (95% confidence interval) for diabetes was 11.8 (2.0-69.8) in the OSA, WHR > or =1.0 group, whilst it was 3.6 (0.9-14.8) in the non-OSA, WHR > or =1.0 group and 5.7 (0.3-112) in the OSA, WHR <1.0 group. In a linear regression model, after adjustment for WHR, there was a significant relationship between variables of sleep-disordered breathing and fasting insulin, glucose and haemoglobin A1c. CONCLUSIONS: We conclude that, in hypertensive men, although obesity is the main risk factor for diabetes, coexistent severe OSA may add to this risk. Sleep breathing disorders, independent of central obesity, may influence plasma insulin and glycaemia.

Adult↗
PubMed2000

The role of habitual snoring and obesity in the development of diabetes: a 10-year follow-up study in a male population.

OBJECTIVES: There are many similarities between diabetes (mainly type 2) and sleep breathing disturbances regarding risk factors, anthropometric criteria and consequences of morbidity and mortality. The aim of this study was to investigate whether the association between habitual snoring and diabetes is entirely dependent on obesity. DESIGN: A population-based prospective study. SETTING: The municipality of Uppsala, Sweden. SUBJECTS AND METHODS: In 1984 and in 1994, 2668 men aged 30-69 years at baseline answered questionnaires concerning sleep breathing disturbances and somatic diseases. RESULTS: Of those with habitual snoring in 1984, 5.4% reported that they had developed diabetes during the 10-year period compared with 2.4% of those without habitual snoring (P < 0.001). Amongst obese snorers, 13.5% developed diabetes compared with 8.6% of obese non-snorers (P = 0.17). In a multiple logistic regression model, the odds ratio (95% confidence interval) for development of diabetes was higher in obese snorers [7.0 (2.9-16.9)] than in obese non-snorers [5.1 (2.7-9.5)] after adjustment for age, weight gain, smoking, alcohol dependence and physical inactivity. CONCLUSIONS: We conclude that, in males aged 30-69 years, habitual snoring is associated with an increased incidence of diabetes within 10 years. Although obesity is the main risk factor for developing diabetes, coexistent habitual snoring may add to this hazard.

Adult↗
PubMed2000

Reported snoring--does validity differ by age?

Snoring is a major sign of obstructive sleep apnoea syndrome. Despite the frequent number of studies based on subjective reports of snoring, self-reported snoring has hardly been validated at all. In some previous epidemiological studies, a significant association between snoring and cardiovascular morbidity and mortality was found only below the age of 50-60 y. This study was performed to investigate whether this is due to a decrease in the validity of reported snoring with increasing age. In a population-based study, 2668 men aged 40-79 y answered a questionnaire including questions on snoring. Those who reported loud and disturbing snoring often or very often were regarded as habitual snorers. Without taking account of reported snoring, an age-stratified sample of these men was selected and their snoring was measured using a microphone for 1 night. Significant snoring was defined as recorded snoring sounds for >/= 10% of the night. The participants were divided into younger (age 40-59, mean +/- SD: 51.8 +/- 4.6 y, n=132) and older (age 60-79, 67.7 +/- 5.4 y, n=99) age groups. When analysing the validity of reported snoring, no significant differences were found between the younger and older age groups in terms of specificity [younger: 82% (95% CI 74-90%), older: 88% (81-95%)] or sensitivity [younger: 40% (26-54%), older: 35% (17-53%)]. These data indicate that, in men aged 40-79 y, the validity of reported snoring is similar in different age groups. The lack of an association between reported snoring and cardiovascular disease at higher ages can, therefore, not be explained by a decrease in the validity of reported snoring.

Age Factors↗
PubMed1999

Evolution of sleep apnea syndrome in sleepy snorers: a population-based prospective study.

This study followed a small number of men previously studied polysomnographically 10 yr earlier to investigate the relationship between the development of sleep-disordered breathing and age, weight gain, and smoking. In 1984, 3,201 men answered a questionnaire including questions about snoring and excessive daytime sleepiness (EDS). Of those reporting symptoms related to obstructive sleep apnea syndrome (OSAS), a random sample of 61 men was investigated using whole-night polysomnography in 1985. Ten years later, 38 men participated in the present follow-up, which included a structured interview and polysomnography. During the 10-yr period, nine men had been treated for OSAS. Of the 29 untreated subjects, the number of men with OSAS, defined as an apnea-hypopnea index (AHI) of >/= 5/h, increased from four in 1985 to 13 in 1995 (p < 0.01). In this small sample, no significant associations were found between DeltaAHI (i.e., AHI 1995 - AHI 1985) and age, weight gain, or smoking. We conclude that, among this small group of individuals who were selected for original polysomnographic study and follow-up because they were thought to have symptoms of sleep apnea, sleep-disordered breathing became significantly worse over time.

Adult↗