Although the Sleep Heart Health Study (SHHS) enrolled its last
participant nationwide approximately one year ago, SHHS investigators have been busy
analyzing data provided by you to learn more about sleep and breathing. The ultimate goal
of the SHHS is to determine the relationship between sleep apnea, and heart disease and
stroke. While it is still not possible to know whether sleep apnea is an independent risk
factor for these conditions, other findings related to sleep and breathing are being made
by SHHS investigators.
In a paper presented at the Association of Professional Sleep Societies Meeting in New
Orleans in June 1998, Dr. David Rappoport, a SHHS investigator from New York University
presented data from the Night to Night Variability Substudy. In this substudy, 99 SHHS
participants completed an additional sleep study within 4 months of their first study. The
purpose of this was to determine whether results would vary greatly from one night to
another. We found that the number of breathing pauses during sleep did not change
significantly from one night to another. This observation indicates that the severity of
sleep apnea can be assessed on only one night of study in a home environment.
Sleep is not constant unchanging state. There are 2 major
stages of sleep, REM (rapid eye movement) and NREM (non rapid eye movement) sleep. NREM
sleep has within it, 4 stages. In another paper presented at the same meeting, another SHHS
investigator, Dr. Susan Redline of Case Western Reserve University showed sleep stage data
from SHHS participants and demonstrated that age, sex and the number of breathing pauses
affected the quality of sleep participants exhibited. For example, increasing age was
associated with less REM and increasing NREM Stage 1 sleep. In addition, men had more NREM
Stages 1 and 2 than women. These are important findings because the SHHS has the largest
database of sleep studies anywhere in the world and it allows us to determine what the
normal distribution of sleep is during the night.
At the current time, SHHS is conducting follow-up visits on its
participants to measure blood pressure and to assess health status. Although its initial
funding from the National Institutes of Health ends in August of this year, SHHS
investigators have applied for a 5 year renewal in which we will ask you to undergo repeat
sleep studies in approximately 2-3 years. This data will allow us to better define the
natural history of sleep apnea and to assess whether there is any relationship between
changes in severity of sleep apnea and heart disease. We are optimistic about refunding
and look forward to working with you in upcoming years to learn more about sleep,
breathing, heart disease and stroke. Your cooperation and time have been greatly
appreciated.
Cognitive Substudy
Have you ever wondered about the status of your mind and thinking
abilities? The Cognitive Substudy might offer you some information about your
intellectual functioning. We are looking for SHHS participants who are between the ages of
40 and 70 to help us out in this research project.
This substudy is designed to investigate the relationship between sleep and daytime
functioning. Sleep and sleep disturbance may influence a person’s overall
intellectual function, concentration, problem-solving skills and other thinking functions,
as well as their emotional well-being.
The Cognitive Substudy is a paper-and-pencil experiment that takes about
2 ½ hours to complete. The study can be done either at your home or in our research
office at a time that is convenient for you. Participants will receive a summary of their
personal test results and monetary compensation. Most people who have already taken part
in this research project have told us that it is quite interesting.
The Cognitive Substudy has been on-going since
1997 and needs about a total of 110 Sleep Heart Health Study participants from the Tucson
area. To date we have enrolled approximately 60 people. Special thanks to those of you who
have participated in this project. In the next 5 months we will need about 50 more
volunteers to complete the study. If you are interested in participating, please contact
the coordinator of this substudy, Tracy Kuo, at 621-9666 or by e-mail
tkuo@u.arizona.edu
Current Happenings
It has been a busy year for the Sleep Heart Health Study.
Here are a few interesting things going on here in Tucson:
1. The 1998 Annual Survey is enclosed with this newsletter. Please take a few minutes
now to complete the questionnaire and return in the postage paid envelope. This information
is vitally important to the success of the Sleep Heart Health Study, as it allows us to
compare the sleep apnea score to cardiovascular and other health problems. Every answer
you give is completely confidential, and will only be used for the general purposes of
the study. Thank you in advance for your time in completing this survey.
2. Follow Up visits have been ongoing since for almost one year. This is a brief home
visit where we take your blood pressure, ask a few questions about your general health,
and annotate the medications you are currently taking. The visit is done about 18 months
after the date of your sleep study. We have completed over 600 home visits thus far, a
very exceptional number which shows the interest of our participants in this crucial part
of the study. We still must complete approximately 250 home visits. If you have not
completed the follow up visit yet, please consider doing so when called. It is a very
simple visit, and will be done at your complete convenience.
3. The Cognitive Substudy is a project which examines the potential effects of sleep
apnea on thinking and reasoning skills (please read accompanying article for details).
4. Events adjudication is the process by which we determine whether a participant has
had a cardiovascular event, such as heart attack, congestive heart failure, or stroke. By
completing a brief interview and examining health records (with permission), we use a
scientific method to record these events and compare them with the sleep study data.
Again, this information is examined by participant ID only; no names are given in
relation to the health record. Also, this data is kept strictly confidential to only
Sleep Heart Health Study investigators. The events adjudication process is ongoing.
As you may see, we have been working hard towards determining the cardiovascular
consequences of sleep apnea. Should you have any questions concerning these or other
happenings with the sleep study, please do not hesitate to call us at (520) 626-5001.
Thank you for all of your participation thus far, and please remember to take a few
moments to complete the 1998 Annual Survey.
