Journal article
High night-to-night variability in obstructive sleep apnea severity is associated with prevalent cardiovascular disease
Sleep (New York, N.Y.), In Press
2026
PMID: 41885569
Abstract
Study Objectives
High night-to-night variability in obstructive sleep apnea (OSA) severity is associated with cardiovascular risk factors such as high blood pressure and pulse wave velocity, yet associations with cardiovascular events remain unknown. This study investigates the association of multi-night OSA severity and night-to-night variability with the prevalence of non-fatal major adverse cardiovascular and cerebrovascular events (MACCEs).
Materials and Methods
Multi-night data were collected from people who purchased and used an FDA-cleared under-mattress sensor to track nightly OSA severity (apnea-hypopnea index; AHI) and completed questionnaires on physician-diagnosed health conditions between 10/2022–12/2024. Mean OSA severity and variability (AHI standard deviation) were calculated over 6 months preceding questionnaire data collection. The primary outcome was a composite of non-fatal MACCEs, including myocardial infarction or heart attack, stroke, angina pectoris or coronary artery disease, and congestive heart failure. Logistic models assessed associations of OSA severity and variability with MACCE prevalence.
Results
Among 3,159 participants (19% female, aged 49 ± 13 years, BMI of 29 ± 6 kg/m2), 142 (4.5%) MACCE cases were reported. Participants with moderate–severe OSA had higher odds of MACCEs versus those without OSA (OR [95%CI]; 1.45 [0.93, 2.25]). High night-to-night OSA variability (75th vs. 25th percentile; 8.0 vs. 2.8 events/h) was associated with 34% higher odds of having a MACCE, independent of OSA severity and other confounders (1.34 [1.04, 1.72]).
Conclusions
High night-to-night variability in OSA severity is associated with higher odds of non-fatal MACCEs. These novel findings underscore the need for prospective trials to investigate the potential causal mechanisms between variability in OSA severity and incident cardiovascular events.
Details
- Title
- High night-to-night variability in obstructive sleep apnea severity is associated with prevalent cardiovascular disease
- Authors/Creators
- Bastien Lechat - Adelaide Institute for Sleep HealthLucia Pinilla - Adelaide Institute for Sleep HealthKelly Sansom - Adelaide Institute for Sleep HealthAndrew Vakulin - Adelaide Institute for Sleep HealthPierre Escourrou - Center for Research and InterdisciplinarityJean-Louis Pepin - InsermSebastien Bailly - InsermSebastien Baillieul - InsermAmy C. Reynolds - Adelaide Institute for Sleep HealthHannah Scott - Adelaide Institute for Sleep HealthJack Manners - Adelaide Institute for Sleep HealthPeter Catcheside - Adelaide Institute for Sleep HealthRobert J. Adams - Adelaide Institute for Sleep HealthDanny J. Eckert - Adelaide Institute for Sleep Health
- Publication Details
- Sleep (New York, N.Y.), In Press
- Publisher
- Oxford Univ Press
- Number of pages
- 10
- Grant note
- ANR-15-IDEX-02 / French National Research Agency; Agence Nationale de la Recherche (ANR) ANR-19-P3IA-0003 / MIAI @ Grenoble Alpes 1196261 / National Health and Medical Research Council (NHMRC) of Australia Leadership Fellowship; National Health & Medical Research Council (NHMRC) of Australia 2025886 / NHMRC of Australia Emerging Leadership Fellowship; National Health & Medical Research Council (NHMRC) of Australia Flinders Health and Medical Research Institute Sleep Health team ANR-24-CE36-3468-01 / STRATA Grenoble Alpes University Foundation
- Identifiers
- 991005884934907891
- Copyright
- ©The Author(s) 2026
- Murdoch Affiliation
- Centre for Healthy Ageing
- Language
- English
- Resource Type
- Journal article
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