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However, the reverse pathway remains unclear. Therefore, we investigated whether pre\u2010existing hypertension, diabetes or cardiovascular diseases are associated with the worsening of intermittent hypoxaemia. Among the included 2,535 Sleep Heart Health Study participants, hypertension (<jats:italic>n<\/jats:italic>\u00a0=\u00a01,164), diabetes (<jats:italic>n<\/jats:italic>\u00a0=\u00a0170) and cardiovascular diseases (<jats:italic>n<\/jats:italic>\u00a0=\u00a0265) were frequently present at baseline. All participants had undergone two polysomnographic recordings approximately 5.2\u00a0years apart. Covariate\u2010adjusted linear regression analyses were utilized to investigate the difference in the severity of intermittent hypoxaemia at baseline between each comorbidity group and the group of participants free from all comorbidities (<jats:italic>n<\/jats:italic>\u00a0=\u00a01,264). Similarly, we investigated whether the pre\u2010existing comorbidities are associated with the progression of intermittent hypoxaemia. Significantly higher oxygen desaturation index (\u03b2\u00a0=\u00a01.77 [95% confidence interval: 0.41\u20133.13], <jats:italic>p<\/jats:italic>\u00a0=\u00a00.011), desaturation severity (\u03b2\u00a0=\u00a00.07 [95% confidence interval: 0.00\u20130.14], <jats:italic>p<\/jats:italic>\u00a0=\u00a00.048) and desaturation duration (\u03b2\u00a0=\u00a01.50 [95% confidence interval: 0.31\u20132.69], <jats:italic>p<\/jats:italic>\u00a0=\u00a00.013) were observed in participants with pre\u2010existing cardiovascular diseases at baseline. Furthermore, the increase in oxygen desaturation index (\u03b2\u00a0=\u00a03.59 [95% confidence interval: 1.78\u20135.39], <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001), desaturation severity (\u03b2\u00a0=\u00a00.08 [95% confidence interval: 0.02\u20130.14], <jats:italic>p<\/jats:italic>\u00a0=\u00a00.015) and desaturation duration (\u03b2\u00a0=\u00a02.60 [95% confidence interval: 1.22\u20133.98], <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001) during the follow\u2010up were higher among participants with diabetes. Similarly, the increase in oxygen desaturation index (\u03b2\u00a0=\u00a02.73 [95% confidence interval: 1.15\u20134.32], <jats:italic>p<\/jats:italic>\u00a0=\u00a00.001) and desaturation duration (\u03b2\u00a0=\u00a01.85 [95% confidence interval: 0.62\u20133.08], <jats:italic>p<\/jats:italic>\u00a0=\u00a00.003) were higher among participants with cardiovascular diseases. These results suggest that patients with pre\u2010existing diabetes or cardiovascular diseases are at increased risk for an expedited worsening of intermittent hypoxaemia. As intermittent hypoxaemia is an essential feature of sleep apnea, these patients could benefit from the screening and follow\u2010up monitoring of sleep apnea.<\/jats:p>","DOI":"10.1111\/jsr.13441","type":"journal-article","created":{"date-parts":[[2021,8,10]],"date-time":"2021-08-10T22:15:22Z","timestamp":1628633722000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Diabetes and cardiovascular diseases are associated with the worsening of intermittent hypoxaemia"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9464-447X","authenticated-orcid":false,"given":"Tuomas","family":"Karhu","sequence":"first","affiliation":[{"name":"Department of Applied Physics University of Eastern Finland Kuopio Finland"},{"name":"Diagnostic Imaging Center Kuopio University Hospital Kuopio Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sami","family":"Myllymaa","sequence":"additional","affiliation":[{"name":"Department of Applied Physics University of Eastern Finland Kuopio Finland"},{"name":"Diagnostic Imaging Center Kuopio University Hospital Kuopio Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0615-4118","authenticated-orcid":false,"given":"Sami","family":"Nikkonen","sequence":"additional","affiliation":[{"name":"Department of Applied Physics University of Eastern Finland Kuopio Finland"},{"name":"Diagnostic Imaging Center Kuopio University Hospital Kuopio Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3924-9199","authenticated-orcid":false,"given":"Diego R.","family":"Mazzotti","sequence":"additional","affiliation":[{"name":"Division of Medical Informatics Department of Internal Medicine University of Kansas Medical Center Kansas City Kansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8252-3996","authenticated-orcid":false,"given":"Antti","family":"Kulkas","sequence":"additional","affiliation":[{"name":"Department of Applied Physics University of Eastern Finland Kuopio Finland"},{"name":"Department of Clinical Neurophysiology Sein\u00e4joki Central Hospital Sein\u00e4joki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8035-1606","authenticated-orcid":false,"given":"Juha","family":"T\u00f6yr\u00e4s","sequence":"additional","affiliation":[{"name":"Department of Applied Physics University of Eastern Finland Kuopio Finland"},{"name":"Science Service Center Kuopio University Hospital Kuopio Finland"},{"name":"School of Information Technology and Electrical Engineering The University of Queensland Brisbane QLD Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4017-821X","authenticated-orcid":false,"given":"Timo","family":"Lepp\u00e4nen","sequence":"additional","affiliation":[{"name":"Department of Applied Physics University of Eastern Finland Kuopio Finland"},{"name":"Diagnostic Imaging Center Kuopio University Hospital Kuopio Finland"},{"name":"School of Information Technology and Electrical Engineering The University of Queensland Brisbane QLD Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,8,10]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcad.2008.08.001"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2015.10.002"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(13)70039-0"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy624"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2020.03.053"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2019.05.015"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(19)30198-5"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00075408"},{"key":"e_1_2_10_10_1","volume-title":"The AASM manual for the scoring of sleep and associated events: Rules, terminology and technical specifications \u2010 Version 2.4","author":"Berry R. 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