TY - JOUR
T1 - Snoring and aortic dimension in Marfan syndrome
AU - Sowho, Mudiaga
AU - Potocki, Mariah
AU - Sgambati, Frank
AU - Neptune, Enid
N1 - Funding Information:
We acknowledge the Johns Hopkins Vascular Connective Tissue Disorders Clinic and the Marfan Foundation for their support and for providing access for participant recruitment.
Funding Information:
The Marfan Foundation and the NIH Multi-Institutional Training Program in Sleep and Genetics provided financial support in the form of fellowship sponsorship. The sponsor had no role in the design or conduct of this research.
Publisher Copyright:
© 2022, The Author(s).
PY - 2023/1
Y1 - 2023/1
N2 - Recent reports suggest that self-reported snoring, which is a feature of obstructive sleep apnea, is associated with aortic enlargement in Marfan syndrome (MFS). Objective assessment of snoring although lacking, could provide a rational for OSA screening in MFS patients. Our goal in this study was to examine the association between objective measurements of snoring with OSA and aortic size in persons with MFS. Consecutive persons with MFS who reported snoring were recruited at Johns Hopkins, completed the Epworth Sleepiness Scale (ESS) and underwent overnight polysomnography during which inspiratory sound was captured. We measured breath-by-breath peak decibel levels and snoring was defined as flow limitation with sound ≥ 40 dB(A). OSA was defined as an apnea–hypopnea-index (AHI) ≥ 15 or AHI: 5–15 and ESS > 10. Participants’ aortic data were collated to ascertain aortic root diameter. Regression models were used to determine the relationship of snoring breath% with OSA and aortic root diameter. In our cohort (M|F:13|16, Age: 37.0 ± 15.5 years, Aortic diameter; 38.9 ± 4.8 mm), a 1-unit increase in snoring breath percentage increased the odds of having OSA by 5% in both the unadjusted (OR = 1.05, p = 0.040) model, and a model adjusted for age and sex (OR = 1.05, p = 0.048). Similarly, a 10-unit increase in snoring breath percentage was associated with a 1 mm increase in contemporaneous aortic-root-diameter in both unadjusted (β = 0.09, p = 0.007), and adjusted (β = 0.08, p = 0.023) models. Objective snoring assessment could provide a means for identifying persons with MFS who need sleep studies, who may also be at risk for more severe aortic disease.
AB - Recent reports suggest that self-reported snoring, which is a feature of obstructive sleep apnea, is associated with aortic enlargement in Marfan syndrome (MFS). Objective assessment of snoring although lacking, could provide a rational for OSA screening in MFS patients. Our goal in this study was to examine the association between objective measurements of snoring with OSA and aortic size in persons with MFS. Consecutive persons with MFS who reported snoring were recruited at Johns Hopkins, completed the Epworth Sleepiness Scale (ESS) and underwent overnight polysomnography during which inspiratory sound was captured. We measured breath-by-breath peak decibel levels and snoring was defined as flow limitation with sound ≥ 40 dB(A). OSA was defined as an apnea–hypopnea-index (AHI) ≥ 15 or AHI: 5–15 and ESS > 10. Participants’ aortic data were collated to ascertain aortic root diameter. Regression models were used to determine the relationship of snoring breath% with OSA and aortic root diameter. In our cohort (M|F:13|16, Age: 37.0 ± 15.5 years, Aortic diameter; 38.9 ± 4.8 mm), a 1-unit increase in snoring breath percentage increased the odds of having OSA by 5% in both the unadjusted (OR = 1.05, p = 0.040) model, and a model adjusted for age and sex (OR = 1.05, p = 0.048). Similarly, a 10-unit increase in snoring breath percentage was associated with a 1 mm increase in contemporaneous aortic-root-diameter in both unadjusted (β = 0.09, p = 0.007), and adjusted (β = 0.08, p = 0.023) models. Objective snoring assessment could provide a means for identifying persons with MFS who need sleep studies, who may also be at risk for more severe aortic disease.
KW - Aortic diameter
KW - Marfan syndrome
KW - OSA
KW - Snoring
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U2 - 10.1007/s41105-022-00413-5
DO - 10.1007/s41105-022-00413-5
M3 - Article
C2 - 36619986
AN - SCOPUS:85135838426
SN - 1446-9235
VL - 21
SP - 33
EP - 37
JO - Sleep and Biological Rhythms
JF - Sleep and Biological Rhythms
IS - 1
ER -