Related Obstructive Sleep Apnea Research Articles

Obstructive sleep apnea in relation to beat-to-beat, reading-to-reading, and day-to-day blood pressure variability.

We investigated blood pressure (BP) variability as assessed by beat-to-beat, reading-to-reading and day-to-day BP variability indices in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). In 786 hospitalized hypertensives (mean age, 53.2 years; 42.2% women), we performed 10-min beat-to-beat (n = 705), 24-h ambulatory (n = 779), and 7-day home BP (n = 445) measurements and the full overnight polysomnography. Mild, moderate and severe OSAHS were defined as an apnea-hypopnea index of 5-14, 15-29, and ≥ 30 events per hour, respectively. BP variability indices including variability independent of the mean (VIM), average real variability (ARV), and maximum-minimum difference (MMD), were compared across the OSAHS severity groups. In univariate analysis, beat-to-beat systolic VIM and MMD, reading-to-reading asleep systolic and diastolic ARV and MMD increased from patients without OSAHS, to patients with mild, moderate and severe OSAHS. This increasing trend for beat-to-beat systolic VIM and MMD remained statistically significant after adjustment for confounders (P ≤ 0.047). There was significant (P ≤ 0.039) interaction of the presence and severity of OSAHS with age and body mass index in relation to the beat-to-beat systolic VIM and MMD and with the presence of diabetes mellitus in relation to asleep systolic ARV. The association was stronger in younger (age < 50 years) and obese (body mass index ≥ 28 kg/m²) and diabetic patients. None of the day-to-day BP variability indices reached statistical significance (P ≥ 0.16). BP variability, in terms of beat-to-beat systolic VIM and MMD and asleep reading-to-reading asleep systolic ARV, were higher with the more severe OSAHS, especially in younger and obese and diabetic patients.

Sleep duration, weekend catch-up sleep, and risk of obstructive sleep apnea in relation to handgrip strength

PurposeThis cross-sectional study aimed to evaluate whether weekday sleep duration, weekend catch-up sleep, and risk of obstructive sleep apnea are individually and in combination associated with handgrip strength. MethodsData from the Korea National Health and Nutrition Examination Survey 2019, including weekday sleep duration, weekend catch-up sleep, STOP-BANG scores, relative handgrip strength (handgrip strength divided by body mass index), and confounding factors (sociodemographic factors, health behaviors, and health and nutritional status), were evaluated in 3678 Korean adults aged 40 to 80 years. Adequate (vs. inadequate) sleep parameters were defined as weekday sleep duration (6-7 vs. ≤ 5 or ≥ 8 h), weekend catch-up sleep (presence vs. absence), and risk of obstructive sleep apnea (low vs. high based on STOP-BANG scores). Sex-specific quintiles of relative handgrip strength were categorized as high (highest 5th quintile) or low (lower 1st to 4th quintiles). A complex-sample logistic regression analysis was performed. ResultsAfter adjusting for other sleep parameters and confounding variables, each adequate sleep parameter individually and collectively was associated with high relative handgrip strength (adjusted odds ratios [95% confidence interval], 1.43 [1.09, 1.89] for 6-7 h weekday sleep duration; 1.44 [1.10, 1.90] for low risk of obstructive sleep apnea; 1.72 [1.23, 2.40] for any two parameters; 1.81 [1.18, 2.79] for all parameters). The combination of adequate weekend catch-up sleep and obstructive sleep apnea risk had the highest odds ratio for high relative handgrip strength (2.36 [1.45, 3.83]). ConclusionsAdequate weekday sleep duration, weekend catch-up sleep, and low obstructive sleep apnea risk were individually and in combination associated with high handgrip strength.

Early recognition of pulmonary complications of sickle cell disease

Sickle cell disease (SCD) is an inherited hematological disorder with multiple-organ involvement. The pulmonary complications of SCD are associated with significant morbidity and mortality. This article presents an important review of acute and chronic pulmonary complications, including acute chest syndrome, pneumonia, pulmonary thromboembolism, pulmonary fat embolism, chronic sickle cell lung disease, and pulmonary hypertension, in patients with SCD. Bronchial asthma and obstructive sleep apnea in relation to SCD are discussed in this article. Early recognition of pulmonary complications leads to early therapeutic interventions and improvement of the overall treatment outcome.

Prevalence of the Risk of Obstructive Sleep Apnea in Relation to Obese and Overweight Collegiate Students

INTRODUCTION: Obstructive sleep apnea is described as monotonous collapse and reopening of upperairway during sleep which affect the ventilation. This Obstructive sleep apnea is common among obese andoverweight individuals. OBJECTIVE: The objective of the study was to determine prevalence of the riskof obstructive sleep apnea in relation to obese and overweight collegiate students.METHODOLOGY: It is a non- experimental study with sample size of 100 which include obese andoverweight. 50 subjects with obese and 50 subjects with overweight are included and assessed for risk ofsleep apnea. OUTCOME MEASURES: Berlin Questionnaire RESULTS: Percentage of low risk wasabout 56, whereas the high risk Obstructive sleep apnea was 44% among overweight. Percentage of highrisk was 52 and low risk 48. CONCLUSION: This study concluded that the prevalence of Obstructive sleepapnea had a higher risk among obese when compare to the overweight individuals.

Global Risk Factor Evaluation of Obstructive Sleep Apnea in Relation to Research Activity and Socioeconomic Factors.

Obstructive Sleep Apnea is emerging as a global health epidemic, particularly due to the obesity pandemic. However, comprehensive prevalence data are still lacking and global OSA research has not yet been structurally evaluated. Using the latest comprehensive age/gender-specific BMI and obesity data, a global landscape estimating the risk/burden of OSA was created. Results were presented in relation to an in-depth analysis of OSA research and countries’ socioeconomic/scientific background. While the USA, Canada, and Japan are the highest publishing countries on OSA, Iceland, Greece, and Israel appeared at the forefront when relating the scientific output to socioeconomic parameters. Conversely, China, India, and Russia showed relatively low performances in these relations. Analysis of the estimated population at risk (EPR) of OSA showed the USA, China, India, and Brazil as the leading countries. Although the EPR and OSA research correlated strongly, major regional discrepancies between the estimated demand and actual research performances were identified, mainly in, but not limited to, developing nations. Our study highlights regional challenges/imbalances in the global activity on OSA and allows targeted measures to mitigate the burden of undiagnosed/untreated OSA. Furthermore, the inclusion of disadvantaged countries in international collaborations could stimulate local research efforts and provide valuable insights into the regional epidemiology of OSA.

Cephalometric Indicator of Obstructive Sleep Apnea in Relation to Severity and Sites of Obstruction in Non-Obese Male Patients

Cephalometric Indicator of Obstructive Sleep Apnea in Relation to Severity and Sites of Obstruction in Non-Obese Male Patients

Global Risk Factor Evaluation of Obstructive Sleep Apnoea in Relation to Research Activity and Socio-Economic Factors

Background: Obstructive Sleep Apnoea (OSA) is emerging as global health epidemic and is facing a rising prevalence especially due to the obesity pandemic. However, comprehensive global prevalence data is still lacking, and global OSA research in terms of activity, quality, and socio-economic characters has not yet been elucidated. Methods: Using the NewQIS platform, bibliometric techniques were combined with socio-economic benchmarks, a global health estimate report (GATHER statement), and density-equalizing-mapping-projections (DEMP). Findings: OSA publications increased exponentially since 1990/91. The USA was identified as leading country and at the centre of the international OSA research arena. Generally, the countries’ OSA research performance correlated with their overall biomedical output and economic strength with the exception of China, India, and Russia. Countries of the Middle East appeared with the highest risk of OSA (objective multivariable apnoea risk index) while exhibiting only a very limited OSA performance. Analysis of the countries’ estimated population at risk of OSA (middleaged obese males) revealed a discrepancy between the countries’ estimated burden of disease and OSA research activity (awareness). Interpretations: Although observing a strong increase in the OSA activity over the years, a lack of awareness predominantly in developing countries was identified. Furthermore, our study presents discrepancies between the countries’ estimated OSA burden and OSA research performance not limited to low resource nations. Given the socioeconomic strain of OSA, strong efforts are needed to raise awareness, initiate prevention programs to reduce risk factors (obesity), and increase the availability of diagnostic tools and treatment, especially in developing countries. Funding Statement: None. Declaration of Interests: Dr. Groneberg has nothing to disclose. Doris Klingelhoefer has nothing to disclose. Rebekka K. Seeger-Zybok has nothing to disclose. Ethics Approval Statement: Not applicable.

Connection between bone remodeling and inflammatory markers in obstructive sleep apnea in relation to disease severity: a preliminary study

INTRODUCTION There is growing evidence that obstructive sleep apnea (OSA) influences both bone metabolism and structure. Chitinase‑3‑like protein 1 (YKL‑40) is a novel inflammatory and remodeling marker, the levels of which were shown to increase in OSA. YKL‑40 can probably alter the bone turnover. OBJECTIVES The aim of the study was to assess a possible interplay between YKL‑40 and bone turnover markers in patients with different stages of OSA, and to evaluate the relation between bone mass, severity of OSA, and YKL‑40 levels. PATIENTS AND METHODS The study involved 72 male patients with OSA. They were divided into 3 groups according to disease severity, using the apnea-hypopnea index (AHI): group 1 (n = 18; 5≤ AHI <15), group 2 (n = 25; 15≤ AHI <30), and group 3 (n = 29; AHI ≥30). All patients underwent polysomnography and densitometry. Fasting blood samples were collected for YKL‑40, C‑terminal telopeptide of typeI collagen (CTX), procollagen type 1 N‑terminal propeptide (P1NP), and other markers. RESULTS P1NP differed between groups 1 and 2, as well as groups 1 and 3 (P = 0.02). Group 2 had higher CTX levels than group 1 (borderline significance, P = 0.05). A simple linear regression analysis showed that serum YKL‑40 levels were associated with the levels of CTX (P <0.0001, β = 0.9871) and P1NP (P <0.0001, β = 0.9780). CONCLUSIONS Our study might suggest that YKL‑40 is associated with bone turnover in OSA. We may assume that this marker influences both bone formation and destruction; thus, OSA could be characterized by preserved bone mineral density.

High Risk for Obstructive Sleep Apnea in Relation to Hypertension Among Southeast Asian Young Adults: Role of Obesity as an Effect Modifier

Obstructive sleep apnea (OSA) has been linked to hypertension among middle-aged and older adults in Western countries. Few studies have focused on young adults, especially those in Southeast Asian countries undergoing epidemiologic transitions and experiencing elevated noncommunicable disease burden. We investigated associations of high risk for OSA with hypertension among Asian young adults. A total of 2,911 college students in Thailand participated in this study. The high risk for OSA was assessed using the Berlin Questionnaire. Blood pressure (BP) and anthropometric measurements were taken by trained research staff. Elevated BP and hypertension were defined as BP ≥ 120/80 mm Hg and ≥ 140/90 mm Hg, respectively. Multivariable logistic regression models were fit to estimate odds ratios (ORs) and 95% confidence intervals (CIs) of elevated BP and hypertension. Stratified analyses were conducted to examine whether observed associations varied by weight status. High risk for OSA was significantly associated with elevated BP (OR = 2.38; 95% CI = 1.68-3.39) and hypertension (OR = 2.55; 95% CI = 1.57-4.15) after adjustment for demographic and lifestyle factors. When body mass index was further controlled for, observed associations were greatly attenuated. The associations were only evident among overweight and obese students. The high risk for OSA among overweight and obese young adults is associated with elevated BP and hypertension. Enhanced efforts directed toward screening and diagnosing OSA and weight control among young adults could be one strategy for improving cardiovascular health.

Comment on: Obstructive sleep apnoea in relation to rheumatic disease: reply

Comment on: Obstructive sleep apnoea in relation to rheumatic disease: reply

Comment on: Obstructive sleep apnoea in relation to rheumatic disease

Comment on: Obstructive sleep apnoea in relation to rheumatic disease

Obstructive sleep apnoea in relation to rheumatic disease

Sleep problems are common concerns in rheumatology patients and have been independently linked to increased pain perception and fatigue severity. Evidence supports an increased prevalence of primary sleep disorders, including sleep apnoea, in some rheumatic disease populations, particularly RA. Obstructive sleep apnoea is a significant public health concern and contributes to increased cardiovascular morbidity and mortality. Patients with obstructive sleep apnoea have also been found to have elevations in circulating acute-phase markers and pro-inflammatory cytokines. Co-existence of sleep apnoea in rheumatic disease patients may influence the severity of reported symptoms of pain and fatigue, accelerate the risk of cardiovascular events and possibly influence levels of circulating inflammatory markers and mediators. In this article we review the risk factors, prevalence and impact of sleep apnoea from a rheumatological perspective. Additionally, we recommend considering sleep apnoea screening in patients with rheumatic disease and, when appropriate, referral to a specialized sleep disorders clinic.

A Polysomnography Study of Snoring and Obstructive Sleep Apnea in Relation to Chronic Bronchitis

A Polysomnography Study of Snoring and Obstructive Sleep Apnea in Relation to Chronic Bronchitis

Leukotriene B4: early mediator of atherosclerosis in obstructive sleep apnoea?

Severity of oxygen desaturation is predictive of early atherosclerosis in obstructive sleep apnoea (OSA). Leukotriene (LT)B(4) is a lipid mediator involved in atherogenesis. In 40 non-obese OSA patients, free of a cardiovascular history, and 20 healthy volunteers, the following were evaluated: 1) LTB(4) production by polymorphonuclear leukocytes (PMNs) stimulated with A23187; and 2) the relationships between LTB(4) production and both OSA severity and infraclinical atherosclerosis markers. The effect of continuous positive airway pressure (CPAP) on LTB(4) production was also studied. An overnight sleep study was followed by first-morning blood sampling. Isolated PMNs were stimulated with A23187 in order to induce LTB(4) production, which was measured by liquid chromatography-tandem mass spectrometry. Carotid intima-media thickness (IMT) and luminal diameter were measured in subset groups of 28 OSA patients and 11 controls. LTB(4) production was increased in OSA patients compared with controls. LTB(4) levels correlated with the mean and minimal arterial oxygen saturation (S(a,O(2))). LTB(4) production correlated with luminal diameter data in patients with a mean S(a,O(2)) of < or = 94% but not with IMT. Lastly, CPAP significantly reduced LTB(4) production by 50%. Leukotriene B(4) production is increased in obstructive sleep apnoea in relation to oxygen desaturation. Leukotriene B(4) could promote early vascular remodelling in moderate-to-severe hypoxic obstructive sleep apnoea patients.

Evolution of Mild Obstructive Sleep Apnea after Different Treatments

To evaluate the prognosis of mild obstructive sleep apnea in relation to different treatment modalities. An open, retrospective, longitudinal follow-up study. Fifty adult patients diagnosed and treated for mild obstructive sleep apnea at the Department of Otorhinolaryngology at Kuopio University Hospital between 1998 and 2004 had a control polysomnography in 2005. The changes in apnea-hypopnea index (AHI) were observed in untreated (n = 28), operative (n = 11), and continuous positive airway pressure (n = 11) treatment groups at a long-term follow-up visit. The mean follow-up period was 4 (range, 1.3-9.0; SD, 1.9) years. The untreated patients had a statistically significant increase in AHI (13.3, SD 18.3) at the follow-up. Half of these patients developed a moderate or severe degree of sleep apnea, and only 11% were cured. In patients who were treated with continuous positive airway pressure, the degree of obstructive sleep apnea became worse in 64% of cases, and in 27% of patients, the AHI returned to normal (<5). The degree of obstructive sleep apnea in operated patients deteriorated only in 18%, and in 27% of the patients, the AHI returned to normal (<5). Mild obstructive sleep apnea has a natural tendency to worsen with time. Active treatment of mild obstructive sleep apnea appears, therefore, to be advisable.