HHS Public Access Author manuscript Author Manuscript
Ann Med. Author manuscript; available in PMC 2016 March 23. Published in final edited form as: Ann Med. 2015 December ; 47(8): 687–693. doi:10.3109/07853890.2015.1107186.
Obstructive Sleep Apnea Risk and Psychological Health among Non-Hispanic Blacks in the Metabolic Syndrome Outcome (MetSO) Cohort Study Mirnova E. Ceïde1, Natasha J. Williams2, Azizi Seixas2, Samantha K. Longman-Mills3, and Girardin Jean-Louis2
Author Manuscript
1Montefiore
Medical Center, Department of Psychiatry and Behavioral Science’ Bronx, NY 10467,
USA 2Center
for Healthful Behavior Change (CHBC), Division of Health and Behavior, Department of Population Health, New York University Medical Center, New York, NY 10016, USA
3The
University of the West Indies, Mona, Jamaica
Abstract Introduction—This study assessed associations of depression and anxiety with risk of OSA among Non-Hispanic Blacks in the Metabolic Syndrome Outcome (MetSO) study.
Author Manuscript
Method—1,035 patients provided data for the analysis. ARES™ score ≥ 6 defined high OSA risk. Moderate depression was defined by a CES-D score ≥ 16. Moderate anxiety was measured by a BAI score ≥ 16. Results—The mean age was 62 ± 14 years; 70% were female. 93% were diagnosed with hypertension; 61%, diabetes; and 72%, dyslipidemia; 90% were overweight/obese; 33% had a history of heart disease and 10% had a stroke. Logistic regression analysis, adjusting for age and gender, showed that patients with depression had nearly a two-fold increased odds of being at risk for OSA (OR = 1.75, 95% CI = 1.02–2.98, p < .05). Patients with anxiety had a three-fold increased odds of being at risk for OSA (OR = 3.30, 95% CI = 2.11–5.15, p < .01). After adjusting for marital status and income, patients with anxiety had a 6% increase in OSA risk (OR=1.06, 95% CI= 1.04–1.09, p 5), positive predictive value of 0.91 and negative predictive value of 0.86.35 The questionnaire includes age, weight, height, neck circumference, report of comorbid illness such as high blood pressure, heart disease, diabetes, stroke, depression, lung disease, insomnia, sleep medication, paint medication and the Epworth Sleepiness scale. The ARES™ was used to identify OSA risk because of its accuracy in evaluating populations with a large pretest OSA probability.34
Author Manuscript
Criteria for Assessing Psychological Health
Author Manuscript
The presence of depressive and anxious symptoms was assessed to ascertain the patients’ psychological health. Depression was assessed using the Center for Epidemiological Studies-Depression (CES-D) scale, which is a 20-item questionnaire that asks individuals to rate how often over the past week they experienced symptoms associated with depression, such as restless sleep, poor appetite, and feeling lonely. Responses range from 0 to 3 for each item (0 = Rarely or None of the Time, 1 = Some or Little of the Time, 2 = Moderately or Much of the time, 3 = Most or Almost All the Time). Scores range from 0 to 60, with high scores indicating greater depressive symptoms. A CES-D score greater or equal to 16 was used to identify patients with clinically meaningful depression. The CES-D-20 has excellent internal consistency (Cronbach’s α = 0.88–0.91), excellent test-retest reliability (ICC= 0.87).36 It has demonstrated adequate validity in measuring mental health (Pearson’s r=0.75) and good sensitivity of 80.0%. Anxiety was measured with the Beck Anxiety Inventory (BAI), which is a 21-item questionnaire assessing anxiety symptoms such as “wobbliness in legs”, “scared” and “fear of losing control”.37 Accordingly, respondents are asked to rate how much each of these symptoms bothered them in the past week, on a scale ranging from 0 (not at all) to 3 (severely, I could barely stand it). Scores range from 0 to 63, with a score of 16 or higher indicating moderate to severe anxiety. The scale was validated in a sample of 160 psychiatric outpatients with various anxiety and depressive disorders, diagnosed with the Structured Clinical Interview for DSM-III.38 The BAI has a high internal consistency (Cronbach’s α = .92) and a test-retest reliability over one week of .75.37 The CES-D and BAI are both scales which identify depressive and anxiety symptoms but they are not synonymous psychiatric diagnosis.
Author Manuscript
Statistical Analysis Frequency and measures of central tendency were used to describe the sample. In preliminary analyses, Pearson and Spearman correlations were used to explore relationships between variables of interest. To determine the associations between psychological health measures and OSA risk among Non-Hispanic Blacks with metabolic syndrome, we utilized multivariate-adjusted logistic regression modeling. Covariates entered in the model were age, sex, and income. Before constructing the model, correlational analyses were performed Ann Med. Author manuscript; available in PMC 2016 March 23.
Ceïde et al.
Page 5
Author Manuscript
to assess associations between hypothesized predictors (i.e., depression and anxiety) and the dependent variable (i.e., OSA risk). Only factors showing significant correlations (p < 0.05) with the dependent measure were entered in the final regression model; this helped to reduce redundancy in the model. Effects of all factors entered in the model were simultaneously adjusted. Data was coded and analyzed using SPSS 19.0.
Results
Author Manuscript
A total of 1,035 patients with metabolic syndrome provided data for this study. The mean age of the sample was 62 ± 14 years (range: 20–97); 70% were female and 43% reported an annual income lower than $10K. Of the sample, 93% were diagnosed with hypertension; 61%, diabetes; 72%, dyslipidemia; 90% were overweight/obese; 33% had a history of heart disease and 10% had a stroke. Descriptive characteristics of cardio-metabolic parameters are presented in Table II. According to ARES™ data, 48% of the patients were at high risk for OSA. Of those who were high risk for OSA, 27% were characterized by depressed moods, based on CES-D scores, and 41% showed clinically meaningful anxiety symptoms based on BAI scores. Results show that 49.8% of women with a waist circumference greater than 35 inches, an indicator of visceral adiposity, were at risk for OSA and 50.2% of women with the same waist circumference were not at risk for OSA (see Table III).
Author Manuscript
Logistic regression analysis (Table IV), adjusting for effects of age and gender, showed that patients with moderate to severe depression had a nearly two-fold increased odds of being at risk for OSA (OR = 1.75, 95% CI = 1.02 – 2.98, p < .05). Likewise, patients with moderate to severe anxiety had a three-fold increased odds of being at risk for OSA (OR = 3.30, 95% CI = 2.11–5.15, p < .01). Also, age was positively associated with OSA risk (OR = 0.97, 95% CI = 0.95–0.98, p < .01). After adjusting for marital status and income (Table V), analysis showed that patients with anxiety had a 6% increase in OSA risk (OR=1.06, 95% CI= 1.04–1.09, pObstructive Sleep Apnea Syndrome. Depression and anxiety. 2009; 26(5):480–91. [PubMed: 18828142] 47. Rezaeitalab F, Moharrari F, Saberi S, Asadpour H, Rezaeetalab F. The correlation of anxiety and depression with obstructive sleep apnea syndrome. Journal of Respiratory Medical Sciences. 2014; 19(3):205–10. 48. Alam A, Chengappa KN, Ghinassi F. Screening for obstructive sleep apnea among individuals with severe mental illness at a primary care clinic. General hospital psychiatry. 2012; 34(6):660–4. [PubMed: 22832135] 49. Jordan AS, McSharry DG, Malhotra A. Adult obstructive sleep apnoea. Lancet. 2014; 383(9918): 736–47. [PubMed: 23910433] 50. Harris Y, Gorelick PB, Samuels P, Bempong I. Why African Americans may not be participating in clinical trials. Journal of the National Medical Association. 1996; 88(10):630–4. [PubMed: 8918067] 51. Kessler RC, McGonagle KA, Swartz M, Blazer DG, Nelson CB. Sex and depression in the National Comorbidity Survey. I: Lifetime prevalence, chronicity and recurrence. Journal of affective disorders. 1993; 29(2–3):85–96. [PubMed: 8300981] 52. Chen YH, Keller JK, Kang JH, Hsieh HJ, Lin HC. Obstructive sleep apnea and the subsequent risk of depressive disorder: a population-based follow-up study. Journal of clinical sleep medicine: JCSM: official publication of the American Academy of Sleep Medicine. 2013; 9(5):417–23. [PubMed: 23674930] 53. Lehto SM, Sahlman J, Soini EJ, et al. The association between anxiety and the degree of illness in mild obstructive sleep apnoea. The clinical respiratory journal. 2013; 7(2):197–203. [PubMed: 22686135] 54. Enciso R, Clark GT. Comparing the Berlin and the ARES questionnaire to identify patients with obstructive sleep apnea in a dental setting. Sleep & breathing = Schlaf & Atmung. 2011; 15(1):83– 9. [PubMed: 20127186] 55. Boynton G, Vahabzadeh A, Hammoud S, Ruzicka DL, Chervin RD. Validation of the STOPBANG Questionnaire among Patients Referred for Suspected Obstructive Sleep Apnea. J Sleep Disord Treat Care. 2013; 2(4) 56. Kim RD, Kapur VK, Redline-Bruch J, et al. An Economic Evaluation of Home Versus LaboratoryBased Diagnosis of Obstructive Sleep Apnea. Sleep. 2015; 38(7):1027–37. [PubMed: 26118558]
Author Manuscript Ann Med. Author manuscript; available in PMC 2016 March 23.
Ceïde et al.
Page 11
Author Manuscript
Key Messages •
This study assessed associations of moderate to severe depression and anxiety with risk of OSA among Non-Hispanic Blacks with metabolic syndrome.
•
Patients with depression had nearly a two-fold increased odds of being at risk for OSA.
•
Patients with anxiety had a three-fold increased odds of being at risk for OSA.
Author Manuscript Author Manuscript Author Manuscript Ann Med. Author manuscript; available in PMC 2016 March 23.
Ceïde et al.
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Table I
Author Manuscript
Guidelines from the National Cholesterol Education Program (NCEP). NCEP ATP III Definition of the Metabolic Syndrome Characteristic
NCEP ATP III
Hypertension
BP medication or BP > 130/85 mm/Hg
Dyslipidemia
Plasma triglycerides > 150 mg/dL; HDL cholesterol < 40 mg/dL in men and < 50 mg/dL in women
Obesity
Waist circumference > 40 inches in men and > 35 inches in women
Diabetes
Fasting plasma glucose > 110 mg/dL*
Requirements for Diagnosis
Any 3 of the above disorders
Note: BP denotes blood pressure; HDL, high-density lipoprotein. *
Fasting plasma glucose was recently updated to 100 mg/dl by the American Diabetes Association.
Author Manuscript Author Manuscript Author Manuscript Ann Med. Author manuscript; available in PMC 2016 March 23.
Ceïde et al.
Page 13
Table II
Author Manuscript
Metabolic characteristics of the study participants. Variable
Mean
SD
Systolic BP (mmHg)
134.98
16.39
Diastolic BP (mmHg)
75.77
10.55
LDL Cholesterol (mg/dL)
105.6
36.88
HDL Cholesterol (mg/dL)
48.03
16.49
Triglycerides (mg/dL)
134.98
73.24
Glucose (mg/dL)
138.38
68.27
HbA1c (mmol/L)
7.93
1.63
BMI
33.8
8.56
Note: BP= Blood Pressure; LDL= Low-density lipoprotein, HDL = High-density lipoprotein; HbA1c= glycated hemoglobin; BMI= Body Mass Index in pounds.
Author Manuscript
Insulin=Fasting plasma glucose > 110 mg/dL; Dyslipidemia=Plasma triglycerides > 150 mg/dL, HDL cholesterol < 40 mg/dL in men and < 50 mg/dL in women; Elevated BP/Hypertension=BP medication or BP > 130/85 mm/Hg; Body Mass Index (kg/m2)
Author Manuscript Author Manuscript Ann Med. Author manuscript; available in PMC 2016 March 23.
Ceïde et al.
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Table III
Author Manuscript
Cross-Tab with MetS indicators, Psychological factors and OSA risk Variables
OSA risk
No OSA risk
Fisher Exact Significance (p value)
Insulin/Glucose
48.6%
51.4%
N.S.
Dyslipidemia
48.6%
51.4%
N.S.
Elevated BP/Hypertension (>130/85)
49.2%
50.8%
N.S.
Waist Circumference (Visceral adiposity) Male
42.5%
57.5%
N.S.
Waist Circumference (Visceral adiposity) Female
49.8%
50.2%
.004
Depression (CES-D)
55.1%
44.9%
N.S.
Anxiety (Moderate – Severe levels on BAI)
61.9%
38.1%
N.S.
Insulin/Glucose=Fasting plasma glucose > 110 mg/dL; Dyslipidemia=Plasma triglycerides > 150 mg/dL, HDL cholesterol < 40 mg/dL in men and < 50 mg/dL in women; Elevated BP/Hypertension=BP medication or BP > 130/85 mm/Hg; Waist Obesity=Waist circumference > 40 inches in men and > 35 inches in women; Depression= Depressive Symptoms on CES-D; Anxiety=Anxiety Symptoms on Beck Anxiety Inventory (BAI).
Author Manuscript Author Manuscript Author Manuscript Ann Med. Author manuscript; available in PMC 2016 March 23.
Ceïde et al.
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Table IV
Author Manuscript
Multivariate logistic regression analysis indicating odds ratios (ORs) for Psychological health associated with OSA risk in the MetSo; N= 1,035. Variables
OR (Odds Ratio)
95% CI
p
Gender
0.93
0.55
1.57
0.77
Age*
0.97
0.95
0.98
Ann Med. Author manuscript; available in PMC 2016 March 23. Published in final edited form as: Ann Med. 2015 December ; 47(8): 687–693. doi:10.3109/07853890.2015.1107186.
Obstructive Sleep Apnea Risk and Psychological Health among Non-Hispanic Blacks in the Metabolic Syndrome Outcome (MetSO) Cohort Study Mirnova E. Ceïde1, Natasha J. Williams2, Azizi Seixas2, Samantha K. Longman-Mills3, and Girardin Jean-Louis2
Author Manuscript
1Montefiore
Medical Center, Department of Psychiatry and Behavioral Science’ Bronx, NY 10467,
USA 2Center
for Healthful Behavior Change (CHBC), Division of Health and Behavior, Department of Population Health, New York University Medical Center, New York, NY 10016, USA
3The
University of the West Indies, Mona, Jamaica
Abstract Introduction—This study assessed associations of depression and anxiety with risk of OSA among Non-Hispanic Blacks in the Metabolic Syndrome Outcome (MetSO) study.
Author Manuscript
Method—1,035 patients provided data for the analysis. ARES™ score ≥ 6 defined high OSA risk. Moderate depression was defined by a CES-D score ≥ 16. Moderate anxiety was measured by a BAI score ≥ 16. Results—The mean age was 62 ± 14 years; 70% were female. 93% were diagnosed with hypertension; 61%, diabetes; and 72%, dyslipidemia; 90% were overweight/obese; 33% had a history of heart disease and 10% had a stroke. Logistic regression analysis, adjusting for age and gender, showed that patients with depression had nearly a two-fold increased odds of being at risk for OSA (OR = 1.75, 95% CI = 1.02–2.98, p < .05). Patients with anxiety had a three-fold increased odds of being at risk for OSA (OR = 3.30, 95% CI = 2.11–5.15, p < .01). After adjusting for marital status and income, patients with anxiety had a 6% increase in OSA risk (OR=1.06, 95% CI= 1.04–1.09, p 5), positive predictive value of 0.91 and negative predictive value of 0.86.35 The questionnaire includes age, weight, height, neck circumference, report of comorbid illness such as high blood pressure, heart disease, diabetes, stroke, depression, lung disease, insomnia, sleep medication, paint medication and the Epworth Sleepiness scale. The ARES™ was used to identify OSA risk because of its accuracy in evaluating populations with a large pretest OSA probability.34
Author Manuscript
Criteria for Assessing Psychological Health
Author Manuscript
The presence of depressive and anxious symptoms was assessed to ascertain the patients’ psychological health. Depression was assessed using the Center for Epidemiological Studies-Depression (CES-D) scale, which is a 20-item questionnaire that asks individuals to rate how often over the past week they experienced symptoms associated with depression, such as restless sleep, poor appetite, and feeling lonely. Responses range from 0 to 3 for each item (0 = Rarely or None of the Time, 1 = Some or Little of the Time, 2 = Moderately or Much of the time, 3 = Most or Almost All the Time). Scores range from 0 to 60, with high scores indicating greater depressive symptoms. A CES-D score greater or equal to 16 was used to identify patients with clinically meaningful depression. The CES-D-20 has excellent internal consistency (Cronbach’s α = 0.88–0.91), excellent test-retest reliability (ICC= 0.87).36 It has demonstrated adequate validity in measuring mental health (Pearson’s r=0.75) and good sensitivity of 80.0%. Anxiety was measured with the Beck Anxiety Inventory (BAI), which is a 21-item questionnaire assessing anxiety symptoms such as “wobbliness in legs”, “scared” and “fear of losing control”.37 Accordingly, respondents are asked to rate how much each of these symptoms bothered them in the past week, on a scale ranging from 0 (not at all) to 3 (severely, I could barely stand it). Scores range from 0 to 63, with a score of 16 or higher indicating moderate to severe anxiety. The scale was validated in a sample of 160 psychiatric outpatients with various anxiety and depressive disorders, diagnosed with the Structured Clinical Interview for DSM-III.38 The BAI has a high internal consistency (Cronbach’s α = .92) and a test-retest reliability over one week of .75.37 The CES-D and BAI are both scales which identify depressive and anxiety symptoms but they are not synonymous psychiatric diagnosis.
Author Manuscript
Statistical Analysis Frequency and measures of central tendency were used to describe the sample. In preliminary analyses, Pearson and Spearman correlations were used to explore relationships between variables of interest. To determine the associations between psychological health measures and OSA risk among Non-Hispanic Blacks with metabolic syndrome, we utilized multivariate-adjusted logistic regression modeling. Covariates entered in the model were age, sex, and income. Before constructing the model, correlational analyses were performed Ann Med. Author manuscript; available in PMC 2016 March 23.
Ceïde et al.
Page 5
Author Manuscript
to assess associations between hypothesized predictors (i.e., depression and anxiety) and the dependent variable (i.e., OSA risk). Only factors showing significant correlations (p < 0.05) with the dependent measure were entered in the final regression model; this helped to reduce redundancy in the model. Effects of all factors entered in the model were simultaneously adjusted. Data was coded and analyzed using SPSS 19.0.
Results
Author Manuscript
A total of 1,035 patients with metabolic syndrome provided data for this study. The mean age of the sample was 62 ± 14 years (range: 20–97); 70% were female and 43% reported an annual income lower than $10K. Of the sample, 93% were diagnosed with hypertension; 61%, diabetes; 72%, dyslipidemia; 90% were overweight/obese; 33% had a history of heart disease and 10% had a stroke. Descriptive characteristics of cardio-metabolic parameters are presented in Table II. According to ARES™ data, 48% of the patients were at high risk for OSA. Of those who were high risk for OSA, 27% were characterized by depressed moods, based on CES-D scores, and 41% showed clinically meaningful anxiety symptoms based on BAI scores. Results show that 49.8% of women with a waist circumference greater than 35 inches, an indicator of visceral adiposity, were at risk for OSA and 50.2% of women with the same waist circumference were not at risk for OSA (see Table III).
Author Manuscript
Logistic regression analysis (Table IV), adjusting for effects of age and gender, showed that patients with moderate to severe depression had a nearly two-fold increased odds of being at risk for OSA (OR = 1.75, 95% CI = 1.02 – 2.98, p < .05). Likewise, patients with moderate to severe anxiety had a three-fold increased odds of being at risk for OSA (OR = 3.30, 95% CI = 2.11–5.15, p < .01). Also, age was positively associated with OSA risk (OR = 0.97, 95% CI = 0.95–0.98, p < .01). After adjusting for marital status and income (Table V), analysis showed that patients with anxiety had a 6% increase in OSA risk (OR=1.06, 95% CI= 1.04–1.09, pObstructive Sleep Apnea Syndrome. Depression and anxiety. 2009; 26(5):480–91. [PubMed: 18828142] 47. Rezaeitalab F, Moharrari F, Saberi S, Asadpour H, Rezaeetalab F. The correlation of anxiety and depression with obstructive sleep apnea syndrome. Journal of Respiratory Medical Sciences. 2014; 19(3):205–10. 48. Alam A, Chengappa KN, Ghinassi F. Screening for obstructive sleep apnea among individuals with severe mental illness at a primary care clinic. General hospital psychiatry. 2012; 34(6):660–4. [PubMed: 22832135] 49. Jordan AS, McSharry DG, Malhotra A. Adult obstructive sleep apnoea. Lancet. 2014; 383(9918): 736–47. [PubMed: 23910433] 50. Harris Y, Gorelick PB, Samuels P, Bempong I. Why African Americans may not be participating in clinical trials. Journal of the National Medical Association. 1996; 88(10):630–4. [PubMed: 8918067] 51. Kessler RC, McGonagle KA, Swartz M, Blazer DG, Nelson CB. Sex and depression in the National Comorbidity Survey. I: Lifetime prevalence, chronicity and recurrence. Journal of affective disorders. 1993; 29(2–3):85–96. [PubMed: 8300981] 52. Chen YH, Keller JK, Kang JH, Hsieh HJ, Lin HC. Obstructive sleep apnea and the subsequent risk of depressive disorder: a population-based follow-up study. Journal of clinical sleep medicine: JCSM: official publication of the American Academy of Sleep Medicine. 2013; 9(5):417–23. [PubMed: 23674930] 53. Lehto SM, Sahlman J, Soini EJ, et al. The association between anxiety and the degree of illness in mild obstructive sleep apnoea. The clinical respiratory journal. 2013; 7(2):197–203. [PubMed: 22686135] 54. Enciso R, Clark GT. Comparing the Berlin and the ARES questionnaire to identify patients with obstructive sleep apnea in a dental setting. Sleep & breathing = Schlaf & Atmung. 2011; 15(1):83– 9. [PubMed: 20127186] 55. Boynton G, Vahabzadeh A, Hammoud S, Ruzicka DL, Chervin RD. Validation of the STOPBANG Questionnaire among Patients Referred for Suspected Obstructive Sleep Apnea. J Sleep Disord Treat Care. 2013; 2(4) 56. Kim RD, Kapur VK, Redline-Bruch J, et al. An Economic Evaluation of Home Versus LaboratoryBased Diagnosis of Obstructive Sleep Apnea. Sleep. 2015; 38(7):1027–37. [PubMed: 26118558]
Author Manuscript Ann Med. Author manuscript; available in PMC 2016 March 23.
Ceïde et al.
Page 11
Author Manuscript
Key Messages •
This study assessed associations of moderate to severe depression and anxiety with risk of OSA among Non-Hispanic Blacks with metabolic syndrome.
•
Patients with depression had nearly a two-fold increased odds of being at risk for OSA.
•
Patients with anxiety had a three-fold increased odds of being at risk for OSA.
Author Manuscript Author Manuscript Author Manuscript Ann Med. Author manuscript; available in PMC 2016 March 23.
Ceïde et al.
Page 12
Table I
Author Manuscript
Guidelines from the National Cholesterol Education Program (NCEP). NCEP ATP III Definition of the Metabolic Syndrome Characteristic
NCEP ATP III
Hypertension
BP medication or BP > 130/85 mm/Hg
Dyslipidemia
Plasma triglycerides > 150 mg/dL; HDL cholesterol < 40 mg/dL in men and < 50 mg/dL in women
Obesity
Waist circumference > 40 inches in men and > 35 inches in women
Diabetes
Fasting plasma glucose > 110 mg/dL*
Requirements for Diagnosis
Any 3 of the above disorders
Note: BP denotes blood pressure; HDL, high-density lipoprotein. *
Fasting plasma glucose was recently updated to 100 mg/dl by the American Diabetes Association.
Author Manuscript Author Manuscript Author Manuscript Ann Med. Author manuscript; available in PMC 2016 March 23.
Ceïde et al.
Page 13
Table II
Author Manuscript
Metabolic characteristics of the study participants. Variable
Mean
SD
Systolic BP (mmHg)
134.98
16.39
Diastolic BP (mmHg)
75.77
10.55
LDL Cholesterol (mg/dL)
105.6
36.88
HDL Cholesterol (mg/dL)
48.03
16.49
Triglycerides (mg/dL)
134.98
73.24
Glucose (mg/dL)
138.38
68.27
HbA1c (mmol/L)
7.93
1.63
BMI
33.8
8.56
Note: BP= Blood Pressure; LDL= Low-density lipoprotein, HDL = High-density lipoprotein; HbA1c= glycated hemoglobin; BMI= Body Mass Index in pounds.
Author Manuscript
Insulin=Fasting plasma glucose > 110 mg/dL; Dyslipidemia=Plasma triglycerides > 150 mg/dL, HDL cholesterol < 40 mg/dL in men and < 50 mg/dL in women; Elevated BP/Hypertension=BP medication or BP > 130/85 mm/Hg; Body Mass Index (kg/m2)
Author Manuscript Author Manuscript Ann Med. Author manuscript; available in PMC 2016 March 23.
Ceïde et al.
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Table III
Author Manuscript
Cross-Tab with MetS indicators, Psychological factors and OSA risk Variables
OSA risk
No OSA risk
Fisher Exact Significance (p value)
Insulin/Glucose
48.6%
51.4%
N.S.
Dyslipidemia
48.6%
51.4%
N.S.
Elevated BP/Hypertension (>130/85)
49.2%
50.8%
N.S.
Waist Circumference (Visceral adiposity) Male
42.5%
57.5%
N.S.
Waist Circumference (Visceral adiposity) Female
49.8%
50.2%
.004
Depression (CES-D)
55.1%
44.9%
N.S.
Anxiety (Moderate – Severe levels on BAI)
61.9%
38.1%
N.S.
Insulin/Glucose=Fasting plasma glucose > 110 mg/dL; Dyslipidemia=Plasma triglycerides > 150 mg/dL, HDL cholesterol < 40 mg/dL in men and < 50 mg/dL in women; Elevated BP/Hypertension=BP medication or BP > 130/85 mm/Hg; Waist Obesity=Waist circumference > 40 inches in men and > 35 inches in women; Depression= Depressive Symptoms on CES-D; Anxiety=Anxiety Symptoms on Beck Anxiety Inventory (BAI).
Author Manuscript Author Manuscript Author Manuscript Ann Med. Author manuscript; available in PMC 2016 March 23.
Ceïde et al.
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Table IV
Author Manuscript
Multivariate logistic regression analysis indicating odds ratios (ORs) for Psychological health associated with OSA risk in the MetSo; N= 1,035. Variables
OR (Odds Ratio)
95% CI
p
Gender
0.93
0.55
1.57
0.77
Age*
0.97
0.95
0.98
