{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T05:24:12Z","timestamp":1761629052307,"version":"build-2065373602"},"reference-count":18,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T00:00:00Z","timestamp":1761609600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Chagas disease (CD) remains a significant cause of morbidity and mortality in Latin America. Chronic Chagas cardiomyopathy (CCC) is the most severe clinical form. Obstructive sleep apnea (OSA), a highly prevalent sleep-related breathing disorder, is associated with adverse cardiovascular and metabolic outcomes, yet its clinical relevance in CD remains poorly understood. This study aimed to examine the association between the stages of CCC with the OSA risk and excessive daytime sleepiness (EDS) in patients with CD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross-sectional observational study included patients with chronic CD. OSA risk was assessed using the STOP-BANG questionnaire; EDS was measured by the Epworth Sleepiness Scale. CCC staging followed the 2nd Brazilian Consensus on CD. Categorical variables were compared using Pearson\u2019s chi-square test and continuous variables with ANOVA. Logistic regression models were fitted to explore associations between CCC stages with OSA risk and EDS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 133 patients (35.3% men; mean age 67.1\u202fyears) were included. Of these, 34.6% had no CCC, 49.6% were CCC stages A\/B1, and 15.8% were stages B2\/C. Of the 130 participants who completed the STOP-Bang questionnaire, 19.2% were at low risk for OSA (score \u22642), while 80.8% were at intermediate or high risk (score &amp;gt;2). EDS (Epworth Sleepiness Scale &amp;gt;10) was identified in 19.6% of participants. No significant associations were found between CCC stages with either OSA risk or EDS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Despite a high prevalence of OSA risk among patients with CD, no association was observed between CCC severity and OSA risk or EDS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2025.1652618","type":"journal-article","created":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T05:17:53Z","timestamp":1761628673000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of chronic Chagas cardiomyopathy stages with obstructive sleep apnea and excessive daytime sleepiness: a cross-sectional study"],"prefix":"10.3389","volume":"12","author":[{"given":"Luana F.","family":"Cruz","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liliane F. A.","family":"Oliveira","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabela Guimar\u00e3es","family":"Pache de Faria","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vinicius C.","family":"Viana","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruno M. F.","family":"Silva","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline P.","family":"Serrano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucia R. N. B.","family":"Paes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mauro F. F.","family":"Mediano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alejandro M.","family":"Hasslocher-Moreno","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cl\u00e1udia Maria","family":"Valete","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,28]]},"reference":[{"year":"2025","key":"ref1"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e00301-2025","DOI":"10.1590\/0037-8682-0432-2024","article-title":"Association between transmission modes and chronic Chagas disease clinical forms","volume":"58","author":"Oliveira","year":"2025","journal-title":"Rev Soc Bras Med Trop"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"e0254-2021","DOI":"10.1590\/0037-8682-0254-2021","article-title":"Indeterminate form of Chagas disease: historical, conceptual, clinical, and prognostic aspects","volume":"54","author":"Hasslocher-Moreno","year":"2021","journal-title":"Rev Soc Bras Med Trop"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"654","DOI":"10.4330\/wjc.v13.i12.654","article-title":"Chagas heart disease: an overview of diagnosis, manifestations, treatment, and care","volume":"13","author":"Saraiva","year":"2021","journal-title":"WJC"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1590\/0037-8682-0505-2016","article-title":"2nd Brazilian consensus on Chagas disease, 2015","volume":"49","author":"Dias","year":"2016","journal-title":"Rev Soc Bras Med Trop"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1311","DOI":"10.3978\/j.issn.2072-1439.2015.06.11","article-title":"Obstructive sleep apnea is a common disorder in the population -a review on the epidemiology of sleep apnea","volume":"7","author":"Franklin","year":"2015","journal-title":"J Thorac Dis"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1016\/j.smrv.2016.12.003","article-title":"Phenotypic approaches to obstructive sleep apnoea \u2013 new pathways for targeted therapy","volume":"37","author":"Eckert","year":"2018","journal-title":"Sleep Med Rev"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"zsaf138","DOI":"10.1093\/sleep\/zsaf138","article-title":"Objective, but not subjective, daytime sleepiness predicts mortality in obstructive sleep apnea","volume":"48","author":"Dai","year":"2025","journal-title":"Sleep"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"364","DOI":"10.5935\/abc.20180131","article-title":"Obstructive sleep apnea is common and associated with heart remodeling in patients with Chagas disease","volume":"111","author":"Medeiros","year":"2018","journal-title":"Arq Bras Cardiol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"266","DOI":"10.1590\/s1806-37562015000000243","article-title":"STOP-Bang questionnaire: translation to Portuguese and cross-cultural adaptation for use in Brazil","volume":"42","author":"Fonseca","year":"2016","journal-title":"J Bras Pneumol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"877","DOI":"10.1590\/S1806-37132009000900009","article-title":"Portuguese-language version of the Epworth sleepiness scale: validation for use in Brazil","volume":"35","author":"Bertolazi","year":"2009","journal-title":"J Bras Pneumol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"951","DOI":"10.5664\/jcsm.4022","article-title":"Alternative scoring models of STOP-Bang questionnaire improve specificity to detect undiagnosed obstructive sleep apnea","volume":"10","author":"Chung","year":"2014","journal-title":"J Clin Sleep Med"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1716","DOI":"10.1001\/archinte.166.16.1716","article-title":"Sleepiness and sleep in patients with both systolic heart failure and obstructive sleep apnea","volume":"166","author":"Arzt","year":"2006","journal-title":"Arch Intern Med"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"757","DOI":"10.1513\/AnnalsATS.202006-696FR","article-title":"Excessive daytime sleepiness in obstructive sleep apnea. Mechanisms and clinical management","volume":"18","author":"Lal","year":"2021","journal-title":"Ann Am Thorac Soc"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"e12778","DOI":"10.1111\/jsr.12778","article-title":"Mechanisms of reduced sleepiness symptoms in heart failure and obstructive sleep apnea","volume":"28","author":"Pak","year":"2019","journal-title":"J Sleep Res"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1513\/pats.200709-150MG","article-title":"Positive pressure therapy: a perspective on evidence-based outcomes and methods of application","volume":"5","author":"Sanders","year":"2008","journal-title":"Proc Am Thorac Soc"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1093\/sleep\/29.3.375","article-title":"Practice parameters for the use of continuous and bilevel positive airway pressure devices to treat adult patients with sleep-related breathing disorders","volume":"29","author":"Kushida","year":"2006","journal-title":"Sleep"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1598","DOI":"10.1164\/ajrccm.150.6.7952621","article-title":"Effect of continuous positive airway pressure on central sleep apnea and nocturnal PCO2 in heart failure","volume":"150","author":"Naughton","year":"1994","journal-title":"Am J Respir Crit Care Med"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1652618\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T05:17:55Z","timestamp":1761628675000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1652618\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,28]]},"references-count":18,"alternative-id":["10.3389\/fmed.2025.1652618"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2025.1652618","relation":{},"ISSN":["2296-858X"],"issn-type":[{"type":"electronic","value":"2296-858X"}],"subject":[],"published":{"date-parts":[[2025,10,28]]},"article-number":"1652618"}}