Abstract 19539: Obstructive Sleep Apnea Screening Resulting in Improved CVD Risk Score

Introduction: Obstructive sleep apnea (OSA) is the most common sleep-related breathing disorder with a prevalence of 15 - 20% in the general population. OSA is related to numerous disorders and increases risk of cardiovascular disease (CVD) and CV events including myocardial infarction and cerebrovascular accidents. Behavioral modification is a quintessential component of treatment for OSA. Hypothesis: We sought to evaluate and quantify the impact of Law Enforcement Cardiac Screening (LECS) program on change in OSA risk. Methods: Patients seen in World Trade Center (WTC) LECS from 2008 - 2010 were reevaluated in WTC CHEST from 2012 - 2014. We analyzed 959 patients’ anthropometric measurements and CV risk factors against status of high risk for OSA (OSA+) defined as never met, only met criteria in LECS, only met criteria in CHEST and met criteria in both LECS and CHEST. OSA+ was defined as 2 or more positive categories on the Berlin Questionnaire (BQ). Independent t-test, ANOVA, and multivariate regression analyses were used to assess the impact of WTC LECS on OSA+ as it relates to body mass index (BMI), waist circumference, and high sensitivity CRP (hsCRP) Results: We found that those who only met high risk for OSA criteria in 2008 - 2010 (LECS only) had a significant decrease in BMI when reevaluated in 2012 - 2014 (CHEST) (41.5 kg/m2 vs. 38.4 kg/m2 respectively; p < 0.001). Patients only diagnosed in 2008 - 2010 had a significant decrease in hsCRP compared to those diagnosed in 2012 - 2014 (-1.44 vs -0.37 respectively, p = 0.040). Conclusions: Using the BQ as screening tool for OSA in a large population of asymptomatic middle aged participants allowed identification approximately 40% of the initial screening population to be at OSA+. Identifying these participants allowed us to counsel and advise patients of pertinent behavioral modifications known to improve risks for OSA. These efforts resulted in significant reduction in anthropometric measurements and improved CVD 10 year risk.