https://orcid.org/0000-0001-7637-6547
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Abstract
Purpose
The prevalence of obstructive sleep apnea (OSA) is high worldwide. This study aimed to quantify the relationship between the incidence of OSA and sleep patterns and genetic susceptibility.
Methods
A total of 355,133 white British participants enrolled in the UK Biobank between 2006 and 2010 with follow-up data until September 2021 were recruited. We evaluated sleep patterns using a customized sleep scoring method based on the low-risk sleep phenotype, defined as follows: morning chronotype, 7–8 hours of sleep per day, never/rarely experience insomnia, no snoring, no frequent daytime sleepiness, never/rarely nap, and easily getting up early. The polygenic risk score was calculated to assess genetic susceptibility to OSA. Cox proportional hazard models were used to evaluate the associations between OSA and sleep patterns and genetic susceptibility.
Results
During a mean follow-up of 12.57 years, 4618 participants were diagnosed with OSA (age: 56.83 ± 7.69 years, women: 31.3%). Compared with those with a poor sleep pattern, participants with a normal (HR: 0.42, 95% CI: 0.38–0.46), ideal (HR: 0.21, 95% CI: 0.19–0.24), or optimal (HR: 0.15, 95% CI: 0.12–0.18) sleep pattern were significantly more likely to have OSA. The genetic susceptibility of 173,239 participants was calculated, and the results showed that poor (HR: 3.67, 95% CI: 2.95–4.57) and normal (HR: 1.89, 95% CI: 1.66–2.16) sleep patterns with high genetic susceptibility can increase the risk for OSA.
Conclusion
This large-scale prospective study provides evidence suggesting that sleep patterns across seven low-risk sleep phenotypes may protect against OSA in individuals with varying degrees of genetic susceptibility.
Abbreviations
OSA, obstructive sleep apnea; GWAS, genome-wide association study; SNPs, single nucleotide polymorphisms; BMI, body mass index; ACE, Assessment Centre Environment; ICD-10, International Statistical Classification of Diseases and Related Health Problems 10th version; PRS, polygenic risk score; PRS, polygenic risk score; SAIGE, scalable and accurate implementation of generalized mixed model; SPA, saddle point approximation; PC, principal component; C+T, standard clumping + thresholding; TDI, Townsend deprivation index; MET, metabolic equivalent intensity; PAR%, population attributable risk percent; and REM, rapid eye movement.
Data Sharing Statement
All supporting data in this study were obtained from the UK Biobank (http://www.ukbiobank.ac.uk/), which is available to all researchers upon request. This study was conducted using the UK Biobank Resource (Application No. 77803). Our team welcomes potential collaborations to maximize the use of the data. The detailed data extraction protocol is available upon reasonable request from the corresponding author Guoqing Zhang ([email protected]).
Ethics Statement
UK Biobank data use was approved by the North West Multi-centre Research Ethics Committee (MREC) (REC Reference: 21/NW/0157) Ethics (ukbiobank.ac.uk). In addition, article 32 of China’s Notice on the Issuance of Ethical Review Measures for Life Science and Medical Research Involving Humans: The use of human information data or biological samples to carry out life science and medical research involving human beings, does not cause harm to human beings, does not involve personal sensitive information or commercial interests, can be exempted from ethical review, in order to reduce the unnecessary burden on researchers and promote the development of life science and medical research involving human beings. Therefore, we also provide this document for reference.
Acknowledgments
We sincerely appreciate the work of the UK Biobank collaborators. We thank Dongliang Zhu (MS) and Yungang He (PhD) for their advice in the design process of this study.
Author Contributions
All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.
Disclosure
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as potential conflicts of interest.