Dyslipidemia prevalence in nonobese, nondiabetic patients with obstructive sleep apnea: does sex matter?

STUDY OBJECTIVES: Dyslipidemia in obstructive sleep apnea (OSA) has been attributed to confounding obesity and/or diabetes. This study aimed to examine lipid profiles in nondiabetic, nonobese patients with OSA and identify the possible effects of age and sex. METHODS: We retrospectively evaluated the lipid parameters of 3,050 adults who underwent polysomnography. A total of 2,168 patients were excluded due to obesity (body mass index ≥ 30 kg/m2), diabetes, alcoholism, untreated hypothyroidism, lipid-lowering drug use, missing sleep data, or treatment for suspected OSA. RESULTS: Of 882 patients (75% males, aged 46.8 ± 12.2 years) included in the study, 88.4% had OSA. Levels of total cholesterol (P = .003), low-density-lipoprotein (LDL) cholesterol (P = .005), non-high-density-lipoprotein (non-HDL) cholesterol (P = .001), and triglycerides (P = .007) were significantly higher in patients with OSA than in those without, whereas HDL-cholesterol levels did not differ. The proportion of patients with hypercholesterolemia and/or elevated non-HDL cholesterol (>  160 mg/dL) was significantly higher in OSA than in non-OSA. Correlation analyses by sex revealed stronger and more significant relationships between lipid parameters and apnea-hypopnea index in women than in men (r = .135, P .001, vs r = .080, P = .043 for total cholesterol; r = .111, P .001, vs r = .080, P = .046 for non-HDL cholesterol; r = .122, P .001, vs r = .061, P = .107 for LDL cholesterol, respectively). In regression analysis, the rate of hypercholesterolemia increased with age (P .001 for women and P = .031 for men); non-HDL- and LDL-cholesterol levels significantly increased with OSA severity (P = .035 and P = .023, respectively) and age (P = .004 and P = .001, respectively) in women. CONCLUSIONS: After excluding confounding obesity and diabetes, patients with OSA have an impaired lipid profile including total cholesterol, LDL cholesterol, non-HDL cholesterol, and triglycerides. A significant association between dyslipidemia and OSA severity was observed in women but not in men. CITATION: Basoglu OK, Tasbakan MS, Kayikcioglu M. Dyslipidemia prevalence in nonobese, nondiabetic patients with obstructive sleep apnea: does sex matter? J Clin Sleep Med. 2023;19(5):889-898. © 2023 American Academy of Sleep Medicine

Evaluation of traffic accident risk in in-city bus drivers: The use of Berlin questionnaire

OBJECTIVES: Traffic accidents associated with high mortality rate may produce serious problems especially in highways. Obstructive sleep apnea (OSA) has been associated with a high risk for traffic accidents due to excessive daytime sleepiness even in in-city drivers. In the present study, it was aimed to evaluate the rate of OSA symptoms and to identify risk factors associated with traffic accidents in in-city bus drivers. MATERIAL AND METHODS: A self-administered questionnaire including demographic and anthropometric features, sleep and work schedules, Berlin questionnaire, Epworth sleepiness score (ESS), and history of traffic accidents was used. RESULTS: The questionnaire was conducted for 1400 male bus drivers (mean age, 38.0±6.4 y, body mass index, 27.8±3.9 kg/m2). A total of 1058 (75.6%) drivers had one or more accidents while driving bus. According to the Berlin questionnaire, 176 (12.6%) drivers were found to have high OSA risk and the accident rate was 83.0% in high-risk group, whereas 74.5% of low-risk drivers had accidents (p=0.043). The drivers with a history of traffic accident were older (p=0.030), had higher ESS (p=0.019), and were more in the high-risk OSA group according to the Berlin questionnaire (p=0.015). In multivariate linear regression analysis, traffic accident was associated with only Berlin questionnaire (p=0.015). CONCLUSION: The present results support that city bus drivers with high OSA risk according to Berlin questionnaire have increased accident rates. Therefore, we suggest using Berlin questionnaire for screening sleep apnea not only in highway drivers but also in in-city bus drivers. © 2018 by Turkish Thoracic Society

COVID-19 Pandemic and the Global Perspective of Turkish Thoracic Society

It has been more than 3 months now since the first case of COVID-19 was reported in Turkey. Globally, the number of confirmed cases and deaths reached 9,653,048 and 491,128 respectively, as reported by 216 countries by June 27, 2020. Turkey had 1,396 new cases, 194,511 total cases, and 5,065 deaths by the same date. From the first case until today, the Turkish Thoracic Society (TTS) has been very proactive in educating doctors, increasing public awareness, undertaking academic studies, and assisting with public health policies. In the present report, social, academic, and management perspectives of the pandemic are presented under appropriate subtitles. During this critical public health crisis, TTS has once again demonstrated its readiness and constructive stance by supporting public health, healthcare workers, and the environment. This review summarizes the perspective of TTS on each aspect of the COVID-19 pandemic and casts light on its contributions.C1 [Kokturk, Nurdan] Gazi Univ, Sch Med, Dept Pulm Med, Ankara, Turkey.[Itil, Bahriye Oya; Ergan, Begum; Kilinc, Oguz; Simsek, Gokcen Omeroglu; Ucan, Eyup Sabri] Dokuz Eylul Univ, Sch Med, Dept Pulm Med, Izmir, Turkey.[Altinisik, Goksel] Pamukkale Univ, Sch Med, Dept Pulm Med, Denizli, Turkey.[Adiguzel, Nalan; Karkurt, Zuhal] Univ Hlth Sci, Istanbul Sureyyapas Chest Dis Training & Res Hosp, Dept Intens Care Unit Pulm Med, Istanbul, Turkey.[Akgun, Metin] Ataturk Univ, Dept Pulm Med, Sch Med, Erzurum, Turkey.[Akyildiz, Levent] Mem Dicle Hosp, Clin Pulm Med, Diyarbakir, Turkey.[Altin, Sedat; Akyil, Fatma Tokgoz] Univ Hlth Sci, Yedikule Chest Dis & Chest Surg Training & Res Ho, Dept Pulm Med, Istanbul, Turkey.[Arikan, Huseyin] Yuzuncu Yil Univ, Dursun Odaba Med Ctr, Med Intens Care Unit, Van, Turkey.[Ates, Gungor] Sultan Hosp, Dept Pulm Med, Diyarbakir, Turkey.[Ay, Pinar] Marmara Univ, Sch Med, Dept Publ Hlth, Istanbul, Turkey.[Aykac, Nilufer] Gayrettepe Florence Nightingale Hosp, Clin Pulm Med, Istanbul, Turkey.[Babayigit, Cenk] Mustafa Kemal Univ, Sch Med, Dept Pulm Med, Antakya, Turkey.[Bostan, Pinar] Istanbul Bilgi Univ, Sch Hlth Sci, Istanbul, Turkey.[Cinel, Guzin] Ankara Yildirim Beyazit Univ, Sch Med Ankara, Dept Pediat Pulmonol, Ankara, Turkey.[Calisir, Haluk Celaleddin] Yapi Kredi Hlth & Retirement Fdn, Istanbul, Turkey.[Celik, Pinar; Gultekin, Okkes; Havlucu, Yavuz; Yorgancioglu, A. Arzu] Celal Bayar Univ, Sch Med, Dept Pulm Med, Manisa, Turkey.[Cetinkaya, Pelin Duru] Univ Hlth Sci, Adana City Training & Res Hosp, Dept Pulm Med, Adana, Turkey.[Dagli, Elif] Turkish Thorac Soc, Ankara, Turkey.[Demir, Ahmet Ugur] Hacettepe Univ, Sch Med, Dept Pulm Med, Ankara, Turkey.[Demir, Canan; Sandal, Abdulsamet] Occupat & Environm Dis Hosp, Clin Occupat Dis, Ankara, Turkey.[Dikensoy, Oner] Acibadem Univ, Sch Med, Dept Pulm Med, Istanbul, Turkey.[Edis, Ebru Cakir] Trakya Univ, Sch Med, Dept Pulm Med, Edirne, Turkey.[Elbek, Osman] Kadikoy Florence Nightingale Hosp, Clin Pulm Med, Istanbul, Turkey.[Erdinc, Munevver; Goksel, Tuncay; Gurgun, Alev; Basoglu, Ozen K.; Sayiner, Abdullah] Ege Univ, Sch Med, Dept Pulm Med, Izmir, Turkey.[Eyuboglu, A. Fusun Oner] Baskent Univ, Sch Med, Dept Pulm Med, Ankara, Turkey.[Gemicioglu, Bilun] Istanbul Univ Cerrahpasa, Cerrahpasa Sch Med, Dept Pulm Dis, Istanbul, Turkey.[Gulhan, Erkmen] Ataturk Chest Dis & Thorac Surg Training & Res Ho, Dept Thorac Surg, Ankara, Turkey.[Gurkan, Canan Gunduz; Yildiz, Tekin] Univ Hlth Sci, Sureyyapasa Chest Dis & Thorac Surg Training & Re, Dept Pulm Med, Istanbul, Turkey.[Karakurt, Sait] Marmara Univ, Sch Med, Dept Intens Care Unit Pulm Med, Istanbul, Turkey.[Kocabas, Ali] Cukurova Univ, Sch Med, Dept Pulm Med, Adana, Turkey.[Kul, Seval] Gaziantep Univ, Sch Med, Dept Biostat, Gaziantep, Turkey.[Nayci, Sibel] Mersin Univ, Sch Med, Dept Pulm Med, Mersin, Turkey.[Ozkan, Metin] Ankara Mem Hosp, Clin Pulm Med, Ankara, Turkey.[Pinarer, Ozgun] Galatasaray Univ, Sch Engn, Istanbul, Turkey.[Salturk, Cuneyt] Istanbul Yeni Yuzyil Univ, Sch Med, Dept Pulm Med, Istanbul, Turkey.[Sen, Elif] Ankara Univ, Sch Med, Dept Pulm Med, Ankara, Turkey.[Karadag, Bulent Taner] Marmara Univ, Sch Med, Dept Pediat Pulmonol, Istanbul, Turkey.[Toreyin, Zehra Nur] Hlth Sci Univ, Adana City Training & Res Hosp, Dept Occupat Dis, Ankara, Turkey.[Varol, Ayhan] Kepez State Hosp, Clin Pulm Med, Antalya, Turkey.[Yasin, Yesim] Acibadem Univ, Sch Med, Dept Publ Hlth, Istanbul, Turkey.[Bayram, Hasan] Koc Univ, Sch Med, Dept Pulm Med, Istanbul, Turkey