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However, current evidence for the association of OSA with microvascular disease is conflicting.

Hypopnea was scored if the amplitude of the sum of the abdominal and thoracic inductance signals or the nasal pressure flow signal decreased by 30% or more for ≥10 s.

Apneas were classified as “obstructive” or “central” based on absence or presence of respiratory effort during the event.

Specialized software was used to link apnea and hypopnea with data from the oxygen saturation and electroencephalography signals, allowing each event to be characterized according to the degree of associated desaturation and arousal.

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Since PDSA was not an objective measure of OSA severity in the previous MESA study,21 we used rigorously collected data from polysomnography (PSG) and retinal photography in a large multi‐ethnic general population in the MESA visit 5 (2010–2012) to quantify the sex‐specific association between OSA and retinal microvascular signs.