Abstract Body: Objective:
Sleep-disordered breathing (SDB) and obstructive sleep apnea are associated with increased cardiovascular (CV) disease risk. Life’s Essential 8 (LE8) is the American Heart Association’s comprehensive framework evaluating CV health across 8 domains: diet, physical activity, nicotine exposure, sleep duration, body mass index (BMI), lipids, glucose, and blood pressure (BP). This study evaluates overall CV health in SDB patients using the LE8 framework.

Methods:
Patients with SDB presenting to a sleep surgery clinic from May 2024 – October 2025 were included. Demographics and LE8 components were obtained from chart review. Dietary quality was assessed via Mini-EAT questionnaire (score <61, unhealthy; 61-69, intermediate; >69, healthy). Laboratory values were within 1 year of their visit and included fasting glucose, hemoglobin A1c (HbA1c), and non-high-density lipoprotein (non-HDL) cholesterol. Use of anti-hypertensives, cholesterol-lowering medications, and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) was recorded. Composite LE8 score was calculated using modified AHA guidelines, with <50 representing poor, 50-79 intermediate, and >80 ideal CV health.

Results:
In total, 69 patients (75.4% male, 60.9% White) were included. Patients were middle-aged (55.2 ± 11.9 years), overweight (BMI 29.2 ± 5.1 kg/m2), and had intermediate dietary quality (Mini-EAT score 63.8 ± 8.0). Only 56.5% of patients met the AHA’s recommendation of ≥150 minutes of moderate or ≥75 minutes of vigorous physical activity per week. Nineteen patients (27.5%) were using GLP-1 RAs, 34 (49.3%) using anti-hypertensives, and 32 (46.4%) using cholesterol-lowering medications. On average, non-HDL cholesterol was 120.7 ± 41.7 mg/dL; fasting glucose, 100.7 ± 34.0 mg/dL; HbA1c, 5.6 ± 0.85%; systolic BP, 125.8 ± 18.6 mmHg; diastolic BP, 79.9 ± 9.7 mmHg. Nightly sleep duration averaged 6.5 ± 1.3 hours. Mean composite LE8 score was 66.2 ± 15.6, indicating intermediate CV health. Only 11 patients (15.9%) had scores in the ideal category. LE8 scores did not significantly differ by sex (p = 0.33) or age (p = 0.47). In multivariable regression analyses, Black or African American race was significantly associated with lower total LE8 scores (p = 0.002).

Conclusion:
Patients with SDB have intermediate or poor CV health as evaluated via LE8. Interventions targeting modifiable factors could improve CV health in this population susceptible to increased risk.