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(Chest. 2006;130:766-773.)
© 2006 American College of Chest Physicians

Low Socioeconomic Status Is a Risk Factor for Cardiovascular Disease Among Adult Obstructive Sleep Apnea Syndrome Patients Requiring Treatment*

Ariel Tarasiuk, PhD; Sari Greenberg-Dotan, MA; Tzahit Simon, MA; Asher Tal, MD; Arie Oksenberg, PhD and Haim Reuveni, MD

* From the Sleep-Wake Disorders Unit (Drs. Tarasiuk, Tal, and Reuveni, Mrs. Greenberg-Dotan, and Mrs. Simon), Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva; and Sleep Disorders Unit (Dr. Oksenberg), Loewenstein Hospital-Rehabilitation Center, Raanana, Israel.

Correspondence to: Ariel Tarasiuk, PhD, Sleep-Wake Disorders Unit, Soroka University Medical Center, PO Box 151, Beer-Sheva, 84105 Israel; e-mail: tarasiuk{at}bgu.ac.il

Abstract

Study objective: To evaluate the possible role of low socioeconomic status (SES) as a risk factor for cardiovascular disease (CVD) among obstructive sleep apnea syndrome (OSAS) patients requiring treatment.

Design: Polysomnographic and demographic characteristics and associated morbidity were measured in 686 prospectively recruited adult OSAS patients from two regions in Israel.

Setting: Two university-affiliated sleep laboratories.

Measurements and results: The multiple logistic regression (after adjusting for gender, body mass index [BMI], and smoking) revealed that the following are independent determinants for CVD in OSAS patients requiring treatment: each decrease in income level category (odds ratio [OR], 1.4; 95% confidence interval [CI], 1.1 to 1.7), age ≥ 1 year (OR, 1.07; 95% CI, 1.04 to 1.1), hypertension (OR, 2.0; 95% CI, 1.3 to 3.1), and hyperlipidemia (OR, 3.7; 95% CI, 2.4 to 5.8); area under the receiver operating characteristic (ROC) = 81.9%. The multivariate determinants describing the low-SES OSAS patients included: minorities and immigrants combined (OR, 6.0; 95% CI, 2.9 to 12), female gender (OR, 2.4; 95% CI, 1.6 to 3.9), increased BMI (OR, 1.9; 95% CI, 1.3 to 2.9), unmarried status (OR, 1.9; 95% CI, 1.2 to 3.1), and years of education (≥ 1 year) [OR, 0.8; 95% CI, 0.7 to 0.8]; area under the ROC = 78.1%.

Conclusion: In addition to the already known traditional risk factors, low SES was found to be a novel independent risk factor for CVD among adult OSAS patients requiring treatment.

Key Words: cardiovascular disease • immigrants • low socioeconomic status • minorities • obstructive sleep apnea syndrome






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