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RATIONALE: Abdominal aortic aneurysms (AAA) are associated with life-threatening complications. The likelihood that an AAA will rupture is influenced by the aneurysm diameter and its expansion rate; reasons for rapid expansion are largely unknown. OBJECTIVES: To determine the prevalence of obstructive sleep apnea (OSA) in patients with AAA, and investigate a possible association between OSA and rate of AAA expansion. METHODS: A total of 127 patients (11 females), included in an AAA surveillance program, agreed to participate and underwent a sleep study. Annual AAA expansion was determined retrospectively from available ultrasound measurements. OSA was characterized using both oxygen desaturation index (ODI) and apnea-hypopnea index (AHI). Univariate and multivariate analysis was performed to assess the effect of OSA severity on AAA expansion. MEASUREMENTS AND MAIN RESULTS: Mean age was 67.9 (SD, 6) years. Median interval between the first and last AAA measurements was 18 (range, 2-113) months. An ODI or AHI of greater than 10 was found in 40.5% and 41.5% of the patients, respectively. Patients with an ODI greater than 30 (n = 12) had a significantly faster median yearly AAA expansion rate (2.9; quartiles 2/5.7 mm/y) than patients with an ODI 0-5 (n = 47; 1.2; quartiles 0/3.1 mm/y) or 6-15 (n = 43; 1.3; quartiles 0/2.7 mm/y) (P < 0.05). In multivariate regression analysis, controlling for cardiovascular risk factors and medications, ODI greater than 30 remained an independent risk factor for AAA expansion. CONCLUSIONS: In patients with AAA, OSA is highly prevalent. Severe OSA may be a causal factor for faster AAA expansion, but this needs to be proved in a randomized controlled intervention trial.

Original publication




Journal article


Am J Respir Crit Care Med

Publication Date





668 - 674


Adult, Aged, Aorta, Abdominal, Aortic Aneurysm, Abdominal, Body Weights and Measures, Cohort Studies, Comorbidity, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prevalence, Retrospective Studies, Risk Factors, Severity of Illness Index, Sleep Apnea, Obstructive, Switzerland, Ultrasonography, United Kingdom