Abstract：
BACKGROUND: The association of obstructive sleep apnea (OSA) with idiopathic intracranial hypertension (IIH) remains unclear, and few studies have used objective in-laboratory polysomnography (PSG) data. Thus, we used PSG data to examine the: 1) association between OSA, and its severity, with IIH and 2) sex differences in OSA severity in those with and without IIH.
METHODS: We retrospectively analyzed diagnostic PSG data from January 2015 to August 2023 for patients who were diagnosed with IIH by a neuro-ophthalmologist using the modified Dandy criteria. We selected three age, sex, and body mass index (BMI) matched controls for each IIH patient. We examined potential associations of IIH with OSA using regression. Sex differences were analyzed using ANOVA.
RESULTS: Of 3482 patients who underwent PSG, we analyzed 78 IIH patients (16 males) and 234 matched controls (48 males). Five (6.4 %) IIH and 39 (16.7 %) control patients had OSA, defined as AHI≥15. After adjusting for age, sex, BMI, and comorbidities, IIH was negatively associated with the presence of OSA (OR 0.29, 95%CI 0.10-0.87, p = 0.03). However, models that adjusted for acetazolamide use, with or without comorbidities, showed no significant relationship with OSA (OR 0.31, p = 0.20). Males with IIH had a significantly higher age (p = 0.020), OSA severity (p = 0.032), and arousal index (p = 0.046) compared to females with IIH.
CONCLUSIONS: IIH treated with acetazolamide was not an independent risk factor for OSA presence or severity. The presence of IIH treated with acetazolamide likely does not warrant routine screening for OSA, but related risk factors may identify appropriate patients.
METHODS: We retrospectively analyzed diagnostic PSG data from January 2015 to August 2023 for patients who were diagnosed with IIH by a neuro-ophthalmologist using the modified Dandy criteria. We selected three age, sex, and body mass index (BMI) matched controls for each IIH patient. We examined potential associations of IIH with OSA using regression. Sex differences were analyzed using ANOVA.
RESULTS: Of 3482 patients who underwent PSG, we analyzed 78 IIH patients (16 males) and 234 matched controls (48 males). Five (6.4 %) IIH and 39 (16.7 %) control patients had OSA, defined as AHI≥15. After adjusting for age, sex, BMI, and comorbidities, IIH was negatively associated with the presence of OSA (OR 0.29, 95%CI 0.10-0.87, p = 0.03). However, models that adjusted for acetazolamide use, with or without comorbidities, showed no significant relationship with OSA (OR 0.31, p = 0.20). Males with IIH had a significantly higher age (p = 0.020), OSA severity (p = 0.032), and arousal index (p = 0.046) compared to females with IIH.
CONCLUSIONS: IIH treated with acetazolamide was not an independent risk factor for OSA presence or severity. The presence of IIH treated with acetazolamide likely does not warrant routine screening for OSA, but related risk factors may identify appropriate patients.
摘要：
背景：阻塞性睡眠呼吸暂停（OSA）与特发性颅内高压（IIH）的关系尚不清楚，很少有研究使用客观的实验室多导睡眠图（PSG）数据。因此，我们使用PSG数据来检查：1)OSA之间的关联，和它的严重性，具有IIH和2）患有和不患有IIH的OSA严重程度的性别差异。
方法：我们回顾性分析了2015年1月至2023年8月神经眼科医生使用改良Dandy标准诊断为IIH的患者的PSG诊断数据。我们选择了三个年龄，性别,与每名IIH患者的体重指数（BMI）匹配的对照。我们使用回归检查了IIH与OSA的潜在关联。使用ANOVA分析性别差异。
结果：在3482名接受PSG的患者中，我们分析了78例IIH患者(16例男性)和234例匹配对照(48例男性).5例（6.4%）IIH和39例（16.7%）对照患者患有OSA，定义为AHI≥15。在调整了年龄之后,性别,BMI,和合并症，IIH与OSA的存在呈负相关（OR0.29，95CI0.10-0.87，p=0.03）。然而,针对乙酰唑胺使用进行调整的型号，有或没有合并症，与OSA无显著关系(OR0.31,p=0.20)。具有IIH的男性具有显著较高的年龄(p=0.020),OSA严重程度（p=0.032），与IIH女性相比，唤醒指数（p=0.046）。
结论：IIH治疗乙酰唑胺不是OSA存在或严重程度的独立危险因素。用乙酰唑胺处理的IIH的存在可能不保证OSA的常规筛查，但相关的危险因素可以确定合适的患者。
方法：我们回顾性分析了2015年1月至2023年8月神经眼科医生使用改良Dandy标准诊断为IIH的患者的PSG诊断数据。我们选择了三个年龄，性别,与每名IIH患者的体重指数（BMI）匹配的对照。我们使用回归检查了IIH与OSA的潜在关联。使用ANOVA分析性别差异。
结果：在3482名接受PSG的患者中，我们分析了78例IIH患者(16例男性)和234例匹配对照(48例男性).5例（6.4%）IIH和39例（16.7%）对照患者患有OSA，定义为AHI≥15。在调整了年龄之后,性别,BMI,和合并症，IIH与OSA的存在呈负相关（OR0.29，95CI0.10-0.87，p=0.03）。然而,针对乙酰唑胺使用进行调整的型号，有或没有合并症，与OSA无显著关系(OR0.31,p=0.20)。具有IIH的男性具有显著较高的年龄(p=0.020),OSA严重程度（p=0.032），与IIH女性相比，唤醒指数（p=0.046）。
结论：IIH治疗乙酰唑胺不是OSA存在或严重程度的独立危险因素。用乙酰唑胺处理的IIH的存在可能不保证OSA的常规筛查，但相关的危险因素可以确定合适的患者。
