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Studart-Pereira LM, Bianchini EMG, Assis M, Bussi MT, Corrêa CDC, Cunha TCA, Drager LF, Ieto V, Lorenzi-Filho G, de Luccas GR, Brasil EL, Sovinski SRP, Zancanella E, Pires GN. Brazilian Consensus on Sleep-Focused Speech-Language-Hearing Sciences - 2023 Brazilian Sleep Association. Sleep Sci 2023; 16:489-506. [PMID: 38370880 PMCID: PMC10869236 DOI: 10.1055/s-0043-1776109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 09/21/2023] [Indexed: 02/20/2024] Open
Abstract
Introduction This consensus aimed to develop a structured document presenting the role of sleep-focused Speech-Language-Hearing (SPH) Sciences (SPHS). The recommendations were based on the expertise of specialists and on evidence in the literature, aiming to guide the coverage of this area and the consequent improvement in the quality of the professionals' approach. Methods A Delphi method was conducted with 49 SLH pathologists (SLHP), four sleep physicians, one dentist, one physical therapist, and one methodologist. Four Delphi panel rounds were conducted in Google Forms. The items were analyzed based on the panelists' percentage of agreement; consensuses were reached when ⅔ (66.6%) of valid responses were on a same on a same answer (either "agree" or "disagree"). Results Participants voted on 102 items. The mean consensus rate was 89.9% ± 10.9%. The essential topics were the importance of professional training, the SLH diagnosis, and the SLH treatment of sleep disorders. It was verified that all fields of the SLHS are related to the area of sleep; that sleep-focused SLH pathologists (SLHP) are the responsible for assessing, indicating, and conducting specific orofacial myofunctional therapy for sleep-disordered breathing alone or in combination with other treatments; that SLHP are included in interdisciplinary teams in the area of sleep in public and private services. Discussion The Brazilian consensus on sleep-focused SLHS is a landmark in this area. This consensus described the scope of action of sleep-focused SLHP and systematized recommendations being useful as a reference for the professional practice in the area of sleep.
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Affiliation(s)
- Luciana Moraes Studart-Pereira
- Brazilian Sleep Association, São Paulo Brazil.
- Department of Speech-Language-Hearing Science, Federal University of Pernambuco, Recife Brazil.
| | | | - Márcia Assis
- Brazilian Sleep Association, São Paulo Brazil.
- Clínica do Sono de Curitiba, Hospital São Lucas, Curitibá, Brazil.
| | - Marieli Timpani Bussi
- Institute of Otorhinolaryngology & Head and Neck Surgery at UNICAMP, IOU, São Paulo Brazil.
| | | | - Thays Crosara Abrahão Cunha
- Brazilian Association of Sleep Dentistry, São Paulo Brazil.
- Núcleo de Ensino, Odontologia do Sono, São Paulo, Brazil.
| | - Luciano Ferreira Drager
- Brazilian Sleep Association, São Paulo Brazil.
- Hypertension Units, Institute of the Heart (InCor), and Course on Nephrology, University of São Paulo, São Paulo Brazil.
| | - Vanessa Ieto
- Speech-Language-Hearing Council, Brazilian Sleep Association, São Paulo Brazil.
| | | | - Gabriele Ramos de Luccas
- Department of Speech-Language Pathology and Audiology, Bauru School of Dentistry, University of São Paulo, Bauru Brazil.
| | - Evelyn Lucien Brasil
- Brazilian Sleep Association, São Paulo Brazil.
- Department of Critical Care Medicina, Hospital Israelita Albert Einstein, São Paulo Brazil.
| | | | - Edilson Zancanella
- Brazilian Association of Sleep Medicine, São Paulo Brazil.
- State University of Campinas, Campinas, São Paulo Brazil.
| | - Gabriel Natan Pires
- Departamento de Psicobiologia, Universidade Federal de São Paulo – São Paulo Brazil.
- Sleep Institute, São Paulo Brazil.
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McKay CD, Gubhaju L, Gibberd AJ, McNamara BJ, Macniven R, Joshy G, Roseby R, Williams R, Yashadhana A, Fields T, Porykali B, Azzopardi P, Banks E, Eades SJ. Health behaviours associated with healthy body composition among Aboriginal adolescents in Australia in the 'Next Generation: Youth Well-being study'. Prev Med 2023; 175:107715. [PMID: 37775084 DOI: 10.1016/j.ypmed.2023.107715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 09/21/2023] [Accepted: 09/23/2023] [Indexed: 10/01/2023]
Abstract
This study described the distribution of healthy body composition among Aboriginal adolescents in Australia aged 10-24 years and examined associations with health behaviours and self-rated health. Data were cross-sectional from the 'Next Generation: Youth Well-being study' baseline (N = 1294). We used robust Poisson regression to quantify associations of self-reported health behaviours (physical activity, screen time, sleep, consumption of vegetables, fruit, soft drinks and fast food, and tobacco smoking and alcohol) and self-rated health to healthy body mass index (BMI) and waist/height ratio (WHtR). Overall, 48% of participants had healthy BMI and 64% healthy WHtR, with healthy body composition more common among younger adolescents. Higher physical activity was associated with healthy body composition (5-7 days last week vs none; adjusted prevalence ratio (aPR) healthy BMI 1.31 [95% CI 1.05-1.64], and healthy WHtR 1.30 [1.10-1.54]), as was recommended sleep duration (vs not; aPR healthy BMI 1.56 [1.19-2.05], and healthy WHtR 1.37 [1.13-1.67]). There was a trend for higher proportion of healthy body composition with more frequent fast food consumption. Healthy body composition was also associated with higher self-rated health ('very good/excellent' vs 'poor/fair'; aPR healthy BMI 1.87 [1.45-2.42], and healthy WHtR 1.71 [1.40-2.10]). Culturally appropriate community health interventions with a focus on physical activity and sleep may hold promise for improving body composition among Aboriginal adolescents.
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Affiliation(s)
- Christopher D McKay
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.
| | - Lina Gubhaju
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Alison J Gibberd
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Bridgette J McNamara
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Rona Macniven
- School of Population Health, UNSW, Sydney, NSW, Australia
| | - Grace Joshy
- Centre for Public Health Data and Policy, National Centre for Epidemiology and Population Health, College of Health & Medicine, Australian National University, Canberra, ACT, Australia
| | - Robert Roseby
- Department of Respiratory Medicine, Monash Children's Hospital, Melbourne, VIC, Australia; Department of Paediatrics, School of Clinical Sciences, Monash University, Melbourne, VIC, Australia
| | - Robyn Williams
- Curtin Medical School, Curtin University, Perth, WA, Australia
| | - Aryati Yashadhana
- School of Population Health, UNSW, Sydney, NSW, Australia; Centre for Primary Health Care & Equity, UNSW, Sydney, NSW, Australia
| | - Ted Fields
- School of Population Health, UNSW, Sydney, NSW, Australia; Centre for Primary Health Care & Equity, UNSW, Sydney, NSW, Australia
| | - Bobby Porykali
- Guunu-maana (Heal) Aboriginal and Torres Strait Islander Health Program, The George Institute for Global Heath, Sydney, NSW, Australia
| | - Peter Azzopardi
- Murdoch Children's Research Institute, Melbourne, VIC, Australia; Telethon Kids Institute, Perth, WA, Australia
| | - Emily Banks
- Centre for Public Health Data and Policy, National Centre for Epidemiology and Population Health, College of Health & Medicine, Australian National University, Canberra, ACT, Australia
| | - Sandra J Eades
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
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Tovar Sanchez T, Mpoudi-Etame M, Kouanfack C, Delaporte E, Calmy A, Venter F, Sokhela S, Bosch B, Akpomiemie G, Tembo A, Pepperrell T, Simmons B, Casas CP, McCann K, Mirchandani M, Hill A. Risks of metabolic syndrome in the ADVANCE and NAMSAL trials. FRONTIERS IN REPRODUCTIVE HEALTH 2023; 5:1133556. [PMID: 37791109 PMCID: PMC10544962 DOI: 10.3389/frph.2023.1133556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 09/01/2023] [Indexed: 10/05/2023] Open
Abstract
Introduction The ADVANCE and NAMSAL trials evaluating antiretroviral drugs have both reported substantial levels of clinical obesity in participants. As one of the main risk factors for metabolic syndrome, growing rates of obesity may drive metabolic syndrome development. This study aims to evaluate the risk of metabolic syndrome in the ADVANCE and NAMSAL trials. Methods The number of participants with metabolic syndrome was calculated at baseline and week 192 as central obesity and any of the following two factors: raised triglycerides, reduced HDL-cholesterol, raised blood pressure and raised fasting glucose. Differences between the treatment arms were calculated using the χ2 test. Results Across all visits to week 192, treatment-emergent metabolic syndrome was 15% (TAF/FTC + DTG), 10% (TDF/FTC + DTG) and 7% (TDF/FTC/EFV) in ADVANCE. The results were significantly higher in the TAF/FTC + DTG arm compared to the TDF/FTC/EFV arm (p < 0.001), and the TDF/FTC + DTG vs. the TDF/FTC/EFV arms (p < 0.05) in all patients, and in females. In NAMSAL, the incidence of treatment-emergent metabolic syndrome at any time point was 14% (TDF/3TC + DTG) and 5% (TDF/3TC + EFV) (p < 0.001). This incidence was significantly greater in the TDF/3TC/DTG arm compared to the TDF/3TC/EFV arm in all patients (p < 0.001), and in males (p < 0.001). Conclusion In this analysis, we highlight treatment-emergent metabolic syndrome associated with dolutegravir, likely driven by obesity. Clinicians initiating or monitoring patients on INSTI-based ART must counsel for lifestyle optimisation to prevent these effects.
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Affiliation(s)
| | | | - Charles Kouanfack
- Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon
- Day Stay Hospital, Central Hospital of Yaoundé, Henri-Dunant, Yaoundé, Cameroon
- ANRS Cameroon Site, Central Hospital of Yaoundé, Henri-Dunant, Yaoundé, Cameroon
| | - Eric Delaporte
- TransVIHMI, University of Montpellier, IRD, INSERMI, Montpellier, France
| | - Alexandra Calmy
- Division of Infectious Diseases, HIV-AIDS Unit, Genva University Hospitals, Geneva, Switzerland
| | - Francois Venter
- Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Simiso Sokhela
- Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Bronwyn Bosch
- Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Godspower Akpomiemie
- Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Angela Tembo
- Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Toby Pepperrell
- School of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Bryony Simmons
- London School of Economics and Political Science, LSE Health, London, United Kingdom
| | | | - Kaitlyn McCann
- Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Manya Mirchandani
- Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Andrew Hill
- Department of Pharmacology and Therapeutics, University of Liverpool, Liverpool, United Kingdom
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Park KM, Kim J. Alterations of Limbic Structure Volumes in Patients with Obstructive Sleep Apnea. Can J Neurol Sci 2023; 50:730-737. [PMID: 36245412 DOI: 10.1017/cjn.2022.303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES We investigated the change in limbic structure volumes and intrinsic limbic network in patients with obstructive sleep apnea (OSA) compared to healthy controls. METHODS We enrolled 26 patients with OSA and 30 healthy controls. They underwent three-dimensional T1-weighted magnetic resonance imaging (MRI) on a 3 T MRI scanner. The limbic structures were analyzed volumetrically using the FreeSurfer program. We examined the intrinsic limbic network using the Brain Analysis with Graph Theory program and compared the groups' limbic structure volumes and intrinsic limbic network. RESULTS There were significant differences in specific limbic structure volumes between the groups. The volumes in the right amygdala, right hippocampus, right hypothalamus, right nucleus accumbens, left amygdala, left basal forebrain, left hippocampus, left hypothalamus, and left nucleus accumbens in patients with OSA were lower than those in healthy controls (right amygdala, 0.102 vs. 0.113%, p = 0.004; right hippocampus, 0.253 vs. 0.281%, p = 0.002; right hypothalamus, 0.028 vs. 0.032%, p = 0.002; right nucleus accumbens, 0.021 vs. 0.024%, p = 0.019; left amygdala, 0.089 vs. 0.098%, p = 0.007; left basal forebrain, 0.020 vs. 0.022%, p = 0.027; left hippocampus, 0.245 vs. 0.265%, p = 0.021; left hypothalamus, 0.028 vs. 0.031%, p = 0.016; left nucleus accumbens, 0.023 vs. 0.027%, p = 0.002). However, there were no significant differences in network measures between the groups. CONCLUSION We demonstrate that the volumes of several limbic structures in patients with OSA are significantly lower than those in healthy controls. However, there are no alterations to the intrinsic limbic network. These findings suggest that OSA is one of the risk factors for cognitive impairments.
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Affiliation(s)
- Kang Min Park
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Jinseung Kim
- Department of Family medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
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Cincotta AH. Brain Dopamine-Clock Interactions Regulate Cardiometabolic Physiology: Mechanisms of the Observed Cardioprotective Effects of Circadian-Timed Bromocriptine-QR Therapy in Type 2 Diabetes Subjects. Int J Mol Sci 2023; 24:13255. [PMID: 37686060 PMCID: PMC10487918 DOI: 10.3390/ijms241713255] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 07/19/2023] [Accepted: 07/27/2023] [Indexed: 09/10/2023] Open
Abstract
Despite enormous global efforts within clinical research and medical practice to reduce cardiovascular disease(s) (CVD), it still remains the leading cause of death worldwide. While genetic factors clearly contribute to CVD etiology, the preponderance of epidemiological data indicate that a major common denominator among diverse ethnic populations from around the world contributing to CVD is the composite of Western lifestyle cofactors, particularly Western diets (high saturated fat/simple sugar [particularly high fructose and sucrose and to a lesser extent glucose] diets), psychosocial stress, depression, and altered sleep/wake architecture. Such Western lifestyle cofactors are potent drivers for the increased risk of metabolic syndrome and its attendant downstream CVD. The central nervous system (CNS) evolved to respond to and anticipate changes in the external (and internal) environment to adapt survival mechanisms to perceived stresses (challenges to normal biological function), including the aforementioned Western lifestyle cofactors. Within the CNS of vertebrates in the wild, the biological clock circuitry surveils the environment and has evolved mechanisms for the induction of the obese, insulin-resistant state as a survival mechanism against an anticipated ensuing season of low/no food availability. The peripheral tissues utilize fat as an energy source under muscle insulin resistance, while increased hepatic insulin resistance more readily supplies glucose to the brain. This neural clock function also orchestrates the reversal of the obese, insulin-resistant condition when the low food availability season ends. The circadian neural network that produces these seasonal shifts in metabolism is also responsive to Western lifestyle stressors that drive the CNS clock into survival mode. A major component of this natural or Western lifestyle stressor-induced CNS clock neurophysiological shift potentiating the obese, insulin-resistant state is a diminution of the circadian peak of dopaminergic input activity to the pacemaker clock center, suprachiasmatic nucleus. Pharmacologically preventing this loss of circadian peak dopaminergic activity both prevents and reverses existing metabolic syndrome in a wide variety of animal models of the disorder, including high fat-fed animals. Clinically, across a variety of different study designs, circadian-timed bromocriptine-QR (quick release) (a unique formulation of micronized bromocriptine-a dopamine D2 receptor agonist) therapy of type 2 diabetes subjects improved hyperglycemia, hyperlipidemia, hypertension, immune sterile inflammation, and/or adverse cardiovascular event rate. The present review details the seminal circadian science investigations delineating important roles for CNS circadian peak dopaminergic activity in the regulation of peripheral fuel metabolism and cardiovascular biology and also summarizes the clinical study findings of bromocriptine-QR therapy on cardiometabolic outcomes in type 2 diabetes subjects.
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Mišić NŽ, Ostojić M, Cvetković S, Miodragović P, Aničić Z, Kovačić Popović A, Stefanović Đ. Wavelet Analysis of Respiratory Muscle sEMG Signals during the Physiological Breakpoint of Static Dry End-Expiratory Breath-Holding in Naive Apneists: A Pilot Study. SENSORS (BASEL, SWITZERLAND) 2023; 23:7200. [PMID: 37631736 PMCID: PMC10459781 DOI: 10.3390/s23167200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 07/18/2023] [Accepted: 07/21/2023] [Indexed: 08/27/2023]
Abstract
The wavelet spectral characteristics of three respiratory muscle signals (scalenus (SC), parasternal intercostal (IC), and rectus abdominis (RA)) and one locomotor muscle (brachioradialis (BR)) were analyzed in the time-frequency (T-F) domain during voluntary breath-holding (BH), with a focus on the physiological breakpoint that is commonly considered the first involuntary breathing movement (IBM) that signals the end of the easy-going phase of BH. The study was performed for an end-expiratory BH physiological breaking point maneuver on twelve healthy, physically active, naive breath-holders/apneists (six professional athletes; six recreational athletes, and two individuals in the post-COVID-19 period) using surface electromyography (sEMG). We observed individual effects that were dependent on muscle oxygenation and each person's fitness, which were consistent with the mechanism of motor unit (MU) recruitment and the transition of slow-twitch oxidative (type 1) to fast-twitch glycolytic (type 2) muscle fibers. Professional athletes had longer BH durations (BHDs) and strong hypercapnic responses regarding the expiratory RA muscle, which is activated abruptly at higher BHDs in a person-specific range below 250 Hz and is dependent on the BHD. This is in contrast with recreational athletes, who had strong hypoxic responses regarding inspiratory IC muscle, which is activated faster and gradually in the frequency range of 250-450 Hz (independent of the person and BHD). This pilot study preliminarily indicates that it is possible to noninvasively assess the physiological characteristics of skeletal muscles, especially oxygenation, and improve physical fitness tests by determining the T-F features of elevated myoelectric IC and RA activity during BH.
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Affiliation(s)
- Nataša Ž. Mišić
- Division of Computational Bioengineering, Research & Development Institute Lola Ltd., 11030 Belgrade, Serbia; (M.O.); (S.C.)
| | - Mirko Ostojić
- Division of Computational Bioengineering, Research & Development Institute Lola Ltd., 11030 Belgrade, Serbia; (M.O.); (S.C.)
| | - Saša Cvetković
- Division of Computational Bioengineering, Research & Development Institute Lola Ltd., 11030 Belgrade, Serbia; (M.O.); (S.C.)
| | - Petar Miodragović
- Department of Physiology, Faculty of Medicine, University of Novi Sad, 21137 Novi Sad, Serbia;
| | - Zdravko Aničić
- Laboratory of Methodology and Research, Faculty of Sport and Physical Education, University of Belgrade, 11030 Belgrade, Serbia;
| | - Anita Kovačić Popović
- Department of Defectology and Clinical Psychology, Medika College for Vocational Studies in Healthcare, 11000 Belgrade, Serbia;
| | - Đorđe Stefanović
- Department for Basic Sports, Faculty of Sport and Physical Education, University of Belgrade, 11030 Belgrade, Serbia;
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Liao J, Gao X, Shi Y, Li Y, Han D. Evaluation of obstructive sleep apnea: an analysis based on aberrant genes. Sleep Breath 2023; 27:1419-1431. [PMID: 36418734 DOI: 10.1007/s11325-022-02749-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 10/26/2022] [Accepted: 11/14/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Obstructive sleep apnea (OSA) is an upstream disorder that frequently causes multisystem disorders. Much research has revealed the pathogenesis of OSA, but there is still a lack of research on the complications caused by OSA. METHODS The mRNA expression and methylation dataset based on peripheral blood mononuclear cells (PBMCs) were downloaded from the Gene Expression Omnibus (GEO) database. All differential expressed genes (DEGs) were ranked using the Robust Rank Aggregation (RRA) algorithm. A weighted gene co-expression network analysis (WGCNA) was constructed. Subsequently, we used immune infiltration, enrichment analysis, and least absolute shrinkage and selection operator (LASSO) regression analysis for apnea and hypopnea index (AHI) and hypertension and excessive daytime sleepiness (EDS) and constructed diagnostic model using random forest algorithm. RESULTS In the present study, we identified 318 DEGs in PBMCs involved in pathogenesis or continuous positive airway pressure (CPAP) therapy. Pathway enrichment identified DEGs associated with protein regulation and metabolism. Notably, through intra group analysis, we found that the immune disorder was more significant for OSA in males, non-daytime sleepy, or non-hypertensive OSA. The area under the ROC curve of model for EDS prediction is 0.889 and 0.852 for hypertension. Notably, we found that the diagnostic model had a high linear predictive value for AHI. CONCLUSIONS Our results indicate that PBMCs are a significant component of alterations in OSA and are expected to explain the mechanism of multisystem diseases caused by OSA. The present study provides new insights for symptom evaluation, classification and treatment of OSA from the molecular level.
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Affiliation(s)
- Jianhong Liao
- The Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Capital Medical University, Beijing, 100730, China
| | - Xiang Gao
- The Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Capital Medical University, Beijing, 100730, China
| | - Yunhan Shi
- The Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Capital Medical University, Beijing, 100730, China
| | - Yanru Li
- The Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
- Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Capital Medical University, Beijing, 100730, China.
| | - Demin Han
- The Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
- Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Capital Medical University, Beijing, 100730, China.
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Cabrini ML, Macedo TA, Castro E, de Barros S, Azam I, Pio-Abreu A, Silva GV, Lorenzi-Filho G, Bortolotto LA, Drager LF. Obstructive sleep apnea and hypertension-mediated organ damage in nonresistant and resistant hypertension. Hypertens Res 2023; 46:2033-2043. [PMID: 37264121 DOI: 10.1038/s41440-023-01320-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 04/12/2023] [Accepted: 05/02/2023] [Indexed: 06/03/2023]
Abstract
The potential role of obstructive sleep apnea (OSA) in hypertension-mediated organ damage (HMOD) may be influenced by the presence of resistant hypertension (RH). Herein, we enrolled patients with hypertension from a tertiary center for clinical evaluation and performed a sleep study to identify OSA (apnea-hypopnea index ≥15 events/h) and a blinded analysis of four standard HMOD parameters (left ventricular hypertrophy [LVH], increased arterial stiffness [≥10 m/s], presence of retinopathy, and nephropathy). RH was diagnosed based on uncontrolled blood pressure (BP) (≥140/90 mmHg) despite concurrent use of at least three antihypertensive drug classes or controlled BP with concurrent use of ≥4 antihypertensive drug classes at optimal doses. To avoid the white-coat effect, ambulatory BP monitoring was performed to confirm RH diagnosis. One-hundred patients were included in the analysis (mean age: 54 ± 8 years, 65% females, body mass index: 30.4 ± 4.5 kg/m²). OSA was detected in 52% of patients. Among patients with non-RH (n = 53), the presence of OSA (52.8%) was not associated with an increased frequency of HMOD. Conversely, among patients with RH, OSA (51.1%) was associated with a higher incidence of LVH (RH-OSA,61%; RH + OSA,87%; p = 0.049). Logistic regression analysis using the total sample revealed that RH (OR:7.89; 95% CI:2.18-28.52; p = 0.002), systolic BP (OR:1.04; 95% CI:1.00-1.07; p = 0.042) and OSA (OR:4.31; 95% CI:1.14-16.34; p = 0.032) were independently associated with LVH. No significant association was observed between OSA and arterial stiffness, retinopathy, or nephropathy. In conclusion, OSA is independently associated with LVH in RH, suggesting a potential role of OSA in RH prognosis.
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Affiliation(s)
- Mayara L Cabrini
- Unidade de Hipertensão, Departamento de Clinica Medica, Disciplina de Nefrologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Thiago A Macedo
- Unidade de Hipertensão, Instituto do Coração (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Emerson Castro
- Unidade de Hipertensão, Instituto do Coração (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Silvana de Barros
- Unidade de Hipertensão, Departamento de Clinica Medica, Disciplina de Nefrologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Indira Azam
- Unidade de Hipertensão, Departamento de Clinica Medica, Disciplina de Nefrologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Andrea Pio-Abreu
- Unidade de Hipertensão, Departamento de Clinica Medica, Disciplina de Nefrologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Giovanio V Silva
- Unidade de Hipertensão, Departamento de Clinica Medica, Disciplina de Nefrologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Geraldo Lorenzi-Filho
- Laboratório do Sono, Divisão de Pneumologia, Instituto do Coração (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Luiz A Bortolotto
- Unidade de Hipertensão, Instituto do Coração (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Luciano F Drager
- Unidade de Hipertensão, Departamento de Clinica Medica, Disciplina de Nefrologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
- Unidade de Hipertensão, Instituto do Coração (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
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Chang JL, Goldberg AN, Alt JA, Alzoubaidi M, Ashbrook L, Auckley D, Ayappa I, Bakhtiar H, Barrera JE, Bartley BL, Billings ME, Boon MS, Bosschieter P, Braverman I, Brodie K, Cabrera-Muffly C, Caesar R, Cahali MB, Cai Y, Cao M, Capasso R, Caples SM, Chahine LM, Chang CP, Chang KW, Chaudhary N, Cheong CSJ, Chowdhuri S, Cistulli PA, Claman D, Collen J, Coughlin KC, Creamer J, Davis EM, Dupuy-McCauley KL, Durr ML, Dutt M, Ali ME, Elkassabany NM, Epstein LJ, Fiala JA, Freedman N, Gill K, Boyd Gillespie M, Golisch L, Gooneratne N, Gottlieb DJ, Green KK, Gulati A, Gurubhagavatula I, Hayward N, Hoff PT, Hoffmann OM, Holfinger SJ, Hsia J, Huntley C, Huoh KC, Huyett P, Inala S, Ishman SL, Jella TK, Jobanputra AM, Johnson AP, Junna MR, Kado JT, Kaffenberger TM, Kapur VK, Kezirian EJ, Khan M, Kirsch DB, Kominsky A, Kryger M, Krystal AD, Kushida CA, Kuzniar TJ, Lam DJ, Lettieri CJ, Lim DC, Lin HC, Liu SY, MacKay SG, Magalang UJ, Malhotra A, Mansukhani MP, Maurer JT, May AM, Mitchell RB, Mokhlesi B, Mullins AE, Nada EM, Naik S, Nokes B, Olson MD, Pack AI, Pang EB, Pang KP, Patil SP, Van de Perck E, Piccirillo JF, Pien GW, Piper AJ, Plawecki A, Quigg M, Ravesloot MJ, Redline S, Rotenberg BW, Ryden A, Sarmiento KF, Sbeih F, Schell AE, Schmickl CN, Schotland HM, Schwab RJ, Seo J, Shah N, Shelgikar AV, Shochat I, Soose RJ, Steele TO, Stephens E, Stepnowsky C, Strohl KP, Sutherland K, Suurna MV, Thaler E, Thapa S, Vanderveken OM, de Vries N, Weaver EM, Weir ID, Wolfe LF, Tucker Woodson B, Won CH, Xu J, Yalamanchi P, Yaremchuk K, Yeghiazarians Y, Yu JL, Zeidler M, Rosen IM. International Consensus Statement on Obstructive Sleep Apnea. Int Forum Allergy Rhinol 2023; 13:1061-1482. [PMID: 36068685 PMCID: PMC10359192 DOI: 10.1002/alr.23079] [Citation(s) in RCA: 55] [Impact Index Per Article: 55.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 08/12/2022] [Accepted: 08/18/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND Evaluation and interpretation of the literature on obstructive sleep apnea (OSA) allows for consolidation and determination of the key factors important for clinical management of the adult OSA patient. Toward this goal, an international collaborative of multidisciplinary experts in sleep apnea evaluation and treatment have produced the International Consensus statement on Obstructive Sleep Apnea (ICS:OSA). METHODS Using previously defined methodology, focal topics in OSA were assigned as literature review (LR), evidence-based review (EBR), or evidence-based review with recommendations (EBR-R) formats. Each topic incorporated the available and relevant evidence which was summarized and graded on study quality. Each topic and section underwent iterative review and the ICS:OSA was created and reviewed by all authors for consensus. RESULTS The ICS:OSA addresses OSA syndrome definitions, pathophysiology, epidemiology, risk factors for disease, screening methods, diagnostic testing types, multiple treatment modalities, and effects of OSA treatment on multiple OSA-associated comorbidities. Specific focus on outcomes with positive airway pressure (PAP) and surgical treatments were evaluated. CONCLUSION This review of the literature consolidates the available knowledge and identifies the limitations of the current evidence on OSA. This effort aims to create a resource for OSA evidence-based practice and identify future research needs. Knowledge gaps and research opportunities include improving the metrics of OSA disease, determining the optimal OSA screening paradigms, developing strategies for PAP adherence and longitudinal care, enhancing selection of PAP alternatives and surgery, understanding health risk outcomes, and translating evidence into individualized approaches to therapy.
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Affiliation(s)
- Jolie L. Chang
- University of California, San Francisco, California, USA
| | | | | | | | - Liza Ashbrook
- University of California, San Francisco, California, USA
| | | | - Indu Ayappa
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | | | | | | | - Maurits S. Boon
- Sidney Kimmel Medical Center at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Pien Bosschieter
- Academic Centre for Dentistry Amsterdam, Amsterdam, The Netherlands
| | - Itzhak Braverman
- Hillel Yaffe Medical Center, Hadera Technion, Faculty of Medicine, Hadera, Israel
| | - Kara Brodie
- University of California, San Francisco, California, USA
| | | | - Ray Caesar
- Stone Oak Orthodontics, San Antonio, Texas, USA
| | | | - Yi Cai
- University of California, San Francisco, California, USA
| | | | | | | | | | | | | | | | | | - Susmita Chowdhuri
- Wayne State University and John D. Dingell VA Medical Center, Detroit, Michigan, USA
| | - Peter A. Cistulli
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - David Claman
- University of California, San Francisco, California, USA
| | - Jacob Collen
- Uniformed Services University, Bethesda, Maryland, USA
| | | | | | - Eric M. Davis
- University of Virginia, Charlottesville, Virginia, USA
| | | | | | - Mohan Dutt
- University of Michigan, Ann Arbor, Michigan, USA
| | - Mazen El Ali
- University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | | | | | | | | | - Kirat Gill
- Stanford University, Palo Alto, California, USA
| | | | - Lea Golisch
- University Hospital Mannheim, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | | | | | | | - Arushi Gulati
- University of California, San Francisco, California, USA
| | | | | | - Paul T. Hoff
- University of Michigan, Ann Arbor, Michigan, USA
| | - Oliver M.G. Hoffmann
- University Hospital Mannheim, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | | | - Jennifer Hsia
- University of Minnesota, Minneapolis, Minnesota, USA
| | - Colin Huntley
- Sidney Kimmel Medical Center at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | | | | | - Sanjana Inala
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | | | | | | | | | | | | | | | | | - Meena Khan
- Ohio State University, Columbus, Ohio, USA
| | | | - Alan Kominsky
- Cleveland Clinic Head and Neck Institute, Cleveland, Ohio, USA
| | - Meir Kryger
- Yale School of Medicine, New Haven, Connecticut, USA
| | | | | | | | - Derek J. Lam
- Oregon Health and Science University, Portland, Oregon, USA
| | | | | | | | | | | | | | - Atul Malhotra
- University of California, San Diego, California, USA
| | | | - Joachim T. Maurer
- University Hospital Mannheim, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | - Anna M. May
- Case Western Reserve University, Cleveland, Ohio, USA
| | - Ron B. Mitchell
- University of Texas, Southwestern and Children’s Medical Center Dallas, Texas, USA
| | | | | | | | | | - Brandon Nokes
- University of California, San Diego, California, USA
| | | | - Allan I. Pack
- University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | | | | | | | | | | | | | | | - Mark Quigg
- University of Virginia, Charlottesville, Virginia, USA
| | | | - Susan Redline
- Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | | | - Armand Ryden
- Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California, USA
| | | | - Firas Sbeih
- Cleveland Clinic Head and Neck Institute, Cleveland, Ohio, USA
| | | | | | | | | | - Jiyeon Seo
- University of California, Los Angeles, California, USA
| | - Neomi Shah
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | | | - Ryan J. Soose
- University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | | | - Erika Stephens
- University of California, San Francisco, California, USA
| | | | | | | | | | - Erica Thaler
- University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Sritika Thapa
- Yale School of Medicine, New Haven, Connecticut, USA
| | | | - Nico de Vries
- Academic Centre for Dentistry Amsterdam, Amsterdam, The Netherlands
| | | | - Ian D. Weir
- Yale School of Medicine, New Haven, Connecticut, USA
| | | | | | | | - Josie Xu
- University of Toronto, Ontario, Canada
| | | | | | | | | | | | - Ilene M. Rosen
- University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Gothi D, Kumar R, Anand S, Patro M, Malhotra N, Vaidya S. A study on the prevalence of RLS in OSA and the consequences of co-occurrence. Lung India 2023; 40:321-326. [PMID: 37417084 PMCID: PMC10401975 DOI: 10.4103/lungindia.lungindia_28_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 02/21/2023] [Accepted: 03/01/2023] [Indexed: 07/08/2023] Open
Abstract
Background Restless leg syndrome (RLS) is common among patients with obstructive sleep apnoea (OSA) but the prognostic importance of this is not studied. We have called OSA and RLS coexistence as ComOSAR. Materials and Methods A prospective observational study was done on patients referred for polysomnography (PSG) with the aims to evaluate 1) the prevalence of RLS in OSA and comparing it with RLS in non-OSA, 2) the prevalence of insomnia, psychiatric, metabolic and cognitive disorders in ComOSAR versus OSA alone, 3) chronic obstructive airway disease (COAD) in ComOSAR versus OSA alone. OSA, RLS and insomnia were diagnosed as per respective guidelines. They were evaluated for psychiatric disorders, metabolic disorders, cognitive disorders and COAD. Results Of 326 patients enrolled, 249 were OSA and 77 were non-OSA. 61/249 OSA patients, i.e. 24.4% had comorbid RLS, i.e. ComOSAR. RLS in non-OSA patients was similar (22/77, i.e. 28.5%); P = 0.41. ComOSAR had a significantly higher prevalence of insomnia (26% versus 10.1%; P = 0.016), psychiatric disorders (73.7% versus 48.4%; P = 0.00026) and cognitive deficits (72.1% versus 54.7%, P = 0.016) compared to OSA alone. Metabolic disorders like metabolic syndrome, diabetes mellitus, hypertension and coronary artery disease were also observed in a significantly higher number of patients with ComOSAR versus OSA alone (57% versus 34%; P = 0.0015). COAD was also seen in a significantly higher number of patients with ComOSAR compared to OSA alone (49% versus 19% respectively; P = 0.00001). Conclusion It is essential to look for RLS in patients with OSA as it leads to a significantly higher prevalence of insomnia, and cognitive, metabolic and psychiatric disorders. COAD is also more common in ComOSAR compared to OSA alone.
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Affiliation(s)
- Dipti Gothi
- Department of Pulmonary and Critical Care Medicine, ESI-PGIMSR, Basaidarapur, New Delhi, India
| | - Rahul Kumar
- Department of Pulmonary and Critical Care Medicine, ESI-PGIMSR, Basaidarapur, New Delhi, India
| | - Shweta Anand
- Department of Pulmonary and Critical Care Medicine, ESI-PGIMSR, Basaidarapur, New Delhi, India
| | - Mahismita Patro
- Department of Pulmonary and Critical Care Medicine, ESI-PGIMSR, Basaidarapur, New Delhi, India
| | - Nipun Malhotra
- Department of Pulmonary and Critical Care Medicine, ESI-PGIMSR, Basaidarapur, New Delhi, India
| | - Sameer Vaidya
- Department of Pulmonary and Critical Care Medicine, Shwas Superspecialtiy Respiratory Centre, Indore, Madhya Pradesh, India
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Versace S, Pellitteri G, Sperotto R, Tartaglia S, Da Porto A, Catena C, Gigli GL, Cavarape A, Valente M. A State-of-Art Review of the Vicious Circle of Sleep Disorders, Diabetes and Neurodegeneration Involving Metabolism and Microbiota Alterations. Int J Mol Sci 2023; 24:10615. [PMID: 37445790 DOI: 10.3390/ijms241310615] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 06/15/2023] [Accepted: 06/22/2023] [Indexed: 07/15/2023] Open
Abstract
In the context of neurodegenerative disorders, cognitive decline is frequently reported in older population. Recently, numerous metabolic pathways have been implicated in neurodegeneration, including signaling disruption of insulin and other glucose-regulating hormones. In fact, Alzheimer's disease has now been considered as "type-3 diabetes". In this review, we tried to clarify the role of sleep impairment as the third major player in the complex relationship between metabolic and neurodegenerative diseases. Altered sleep may trigger or perpetuate these vicious mechanisms, leading to the development of both dementia and type 2 diabetes mellitus. Finally, we analyzed these reciprocal interactions considering the emerging role of the gut microbiota in modulating the same processes. Conditions of dysbiosis have been linked to circadian rhythm disruption, metabolic alterations, and release of neurotoxic products, all contributing to neurodegeneration. In a future prospective, gut microbiota could provide a major contribution in explaining the tangled relationship between sleep disorders, dementia and diabetes.
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Affiliation(s)
- Salvatore Versace
- Clinical Neurology, Udine University Hospital, Piazza Santa Maria della Misericordia, 15, 33100 Udine, Italy
- Department of Medicine (DAME), University of Udine, 33100 Udine, Italy
| | - Gaia Pellitteri
- Clinical Neurology, Udine University Hospital, Piazza Santa Maria della Misericordia, 15, 33100 Udine, Italy
| | - Roberto Sperotto
- Clinical Neurology, Udine University Hospital, Piazza Santa Maria della Misericordia, 15, 33100 Udine, Italy
- Department of Medicine (DAME), University of Udine, 33100 Udine, Italy
| | - Sara Tartaglia
- Clinical Neurology, Udine University Hospital, Piazza Santa Maria della Misericordia, 15, 33100 Udine, Italy
- Department of Medicine (DAME), University of Udine, 33100 Udine, Italy
| | - Andrea Da Porto
- Department of Medicine (DAME), University of Udine, 33100 Udine, Italy
- Internal Medicine, Udine University Hospital, 33100 Udine, Italy
| | - Cristiana Catena
- Department of Medicine (DAME), University of Udine, 33100 Udine, Italy
- Internal Medicine, Udine University Hospital, 33100 Udine, Italy
| | - Gian Luigi Gigli
- Department of Medicine (DAME), University of Udine, 33100 Udine, Italy
| | - Alessandro Cavarape
- Department of Medicine (DAME), University of Udine, 33100 Udine, Italy
- Internal Medicine, Udine University Hospital, 33100 Udine, Italy
| | - Mariarosaria Valente
- Clinical Neurology, Udine University Hospital, Piazza Santa Maria della Misericordia, 15, 33100 Udine, Italy
- Department of Medicine (DAME), University of Udine, 33100 Udine, Italy
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Tian Y, Li D, Mu H, Wei S, Guo D. Positive correlation between snoring and dyslipidemia in adults: results from NHANES. Lipids Health Dis 2023; 22:73. [PMID: 37328831 DOI: 10.1186/s12944-023-01839-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 05/29/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND A few studies have shown that snoring, in certain populations, is associated with dyslipidemia. However, there are currently no large-scale national studies available that explore this association. Thus, for further clarification, studies using a large sample of the general population need to be conducted. This study aimed to explore this association using the National Health and Nutrition Examination Survey (NHANES) database. METHODS A cross-sectional survey was conducted using data from the NHANES database; 2005 to 2008 and 2015 to 2018 datasets were used (weighted to be representative of United States adults aged ≥ 20 years). Information on snoring status, lipid levels, and confounding factors were included. Logistic regression of the generalized linear model was used to analyze the relationship between snoring and dyslipidemia, and hierarchical analysis, interaction analysis, and sensitivity analysis were used to explore the stability of the results. RESULTS Data from 28,687 participants were analyzed, and 67% of the participants had some degree of snoring. The fully adjusted multivariate logistic regression results demonstrated that snoring frequency was significantly positively associated with dyslipidemia (P < 0.001 for linear trend). Adjusted odds ratios (aORs) of dyslipidemia among those who snored rarely, occasionally, and frequently were 1.1 (95% confidence interval [CI], 1.02-1.18), 1.23 (95% CI, 1.10-1.38), and 1.43 (95% CI, 1.29-1.58), respectively, compared with that among those who never snored. In addition, age and snoring frequency showed a correlation (P = 0.02). Sensitivity analysis demonstrated that frequent snoring was significantly associated with lipid levels (all P ≤ 0.01 for linear trend), including increased low-density lipoprotein cholesterol (LDL-C) (β = 0.09 mmol/L; 95% CI, 0.02-0.16), triglyceride (TG) (β = 0.18 mmol/L; 95% CI, 0.10-0.26), total cholesterol (TC) (β = 0.11 mmol/L; 95% CI, 0.05-0.16), and decreased high-density lipoprotein cholesterol (HDL-C) (β=-0.04 mmol/L; 95% CI, -0.06--0.03). CONCLUSIONS A statistically significant positive association was identified between sleep snoring and dyslipidemia. It was suggested that sleep snoring interventions may reduce the risk of dyslipidemia.
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Affiliation(s)
- Ying Tian
- Clinical Research Center, Affiliated Hospital of Shandong, University of Traditional Chinese Medicine, Jinan, China
| | - Dongna Li
- Department of Cardiology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Huijuan Mu
- Drug clinical trial facility, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Sining Wei
- Prevention and treatment center, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Dong Guo
- Basic Medical School, College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China.
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63
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Li CX, Zhang YF, Zhu Z, Lu FY, Wang Y, Zhang LY, Li N, Sun XW, Li QY. Diagnosis of obstructive sleep apnea using a bio-radar contact-free system compared with an established HST device in older adults. Sleep Health 2023; 9:381-386. [PMID: 36697319 DOI: 10.1016/j.sleh.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 12/13/2022] [Accepted: 01/02/2023] [Indexed: 01/25/2023]
Abstract
GOAL AND AIMS To compare a bio-radar contact-free monitoring device in diagnosing obstructive sleep apnea (OSA) in older people with an established home sleep apnea testing system (HST). FOCUS METHOD/TECHNOLOGY A bio-radar contact-free monitoring device (OrbSense+). REFERENCE METHOD/TECHNOLOGY An established HST, Alice NightOne. SAMPLE Fifty-three out of 63 recruited subjects were included in the final analysis. Seventy-two percent were male (age 72 ± 9 years; body mass index 31.05 ± 5.56 kg/m2). DESIGN An observational, prospective study. CORE ANALYTICS Intraclass correlation coefficient (ICC), Bland-Altman analysis, and receiver operating characteristic analysis. ADDITIONAL ANALYTICS AND EXPLORATORY ANALYSES None. CORE OUTCOMES Both 45 (84.91%) were diagnosed with OSA by Alice NightOne (average respiratory event index = 21.23 events/h) and by OrbSense+ (average respiratory event index = 25.98 events/h). Respiratory event index and oxygen desaturation index obtained by Alice NightOne and OrbSense+ were highly correlated, with ICC of 0.93 and 0.88, respectively. The Bland-Altman plot comparing the means showed good agreement between the 2 diagnostic techniques. With more than 5 respiratory events per hour as the standard for OSA diagnosis, OrbSense+ had a sensitivity of 100% and a specificity of 100% in diagnosis of OSA (P < .0001). With more than 15 respiratory events per hour as the standard for OSA diagnosis, OrbSense+ was found to have a sensitivity of 100% and a specificity of 86.96% in diagnosis of OSA (P < .0001). IMPORTANT ADDITIONAL OUTCOMES None. CORE CONCLUSION The bio-radar sleep monitoring device is a reasonably accurate home sleep apnea test for use in older patients.
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Affiliation(s)
- Chuan Xiang Li
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Institute of Respiratory Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Respiratory and Critical Care Medicine, Tongren Hospital Affiliated With Wuhan University, The Third Hospital of Wuhan, Wuhan, China
| | - Yun Feng Zhang
- Department of Respiratory and Critical Care Medicine, Putuo District Liqun Hospital, Shanghai, China
| | - Zheng Zhu
- Department of Respiratory and Critical Care Medicine, Putuo District Liqun Hospital, Shanghai, China
| | - Fang Ying Lu
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Institute of Respiratory Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yi Wang
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Institute of Respiratory Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Li Yue Zhang
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Institute of Respiratory Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ning Li
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Institute of Respiratory Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xian Wen Sun
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Institute of Respiratory Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qing Yun Li
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Institute of Respiratory Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Wakabayashi I. Effects of age on polycythemia, cardiometabolic risk and their associations in middle-aged men. J Diabetes Metab Disord 2023; 22:287-295. [PMID: 37255804 PMCID: PMC10225414 DOI: 10.1007/s40200-022-01130-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 08/17/2022] [Accepted: 09/15/2022] [Indexed: 06/01/2023]
Abstract
Background Polycythemia has been reported to be associated with cardiometabolic risk factors. However, it remains to be determined whether age affects their associations. Methods The subjects were 11,261 men at ages of 30 ~ 65 years who had received annual health checkup examinations. They were divided by age into four groups of 30 ~ 39, 40 ~ 49, 50 ~ 59 and 60 ~ 65 years. Variables related to polycythemia and cardiometabolic risk and their associations were compared in the different age groups. Results The prevalences of polycythemia and metabolic syndrome tended to be lower and higher, respectively, with an increase of age. Odds ratios (ORs) of subjects with vs. subjects without polycythemia for high LDL-C/HDL-C ratio and metabolic syndrome were significantly high in the age group of 30 ~ 39 years when compared with the reference level (OR with 95% confidence interval: 3.21 [2.35 ~ 4.37] [high LDL-C/HDL-C ratio] and 3.49 [2.38 ~ 5.12] [metabolic syndrome]) and tended to be lower with an increase of age (60 ~ 65 years, OR with 95% confidence interval: 1.36 [0.63 ~ 2.93] [high LDL-C/HDL-C ratio] and 1.88 [1.16 ~ 3.03] [metabolic syndrome]). Conclusion The prevalence of polycythemia was higher and its associations with cardiometabolic risk such as high LDL-C/HDL-C ratio and metabolic syndrome were stronger in the youngest group than in the older groups. The results suggest that early detection and correction of polycythemia are more effective than its later correction for prevention of cardiovascular disease in middle-aged men.
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Affiliation(s)
- Ichiro Wakabayashi
- Department of Environmental and Preventive Medicine, School of Medicine, Hyogo Medical University, Mukogawa-cho 1-1, 663-8501 Nishinomiya, Hyogo Japan
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Fang Y, Su J, Zhang B, Zhao C, Ji L, Liang F, Wang Z, Hao J, Meng Y, Wei B, Huang Y, Dai L, Ouyang S. Autoantibodies of inflammatory cytokines as serum biomarkers in OSA patients. Clin Chim Acta 2023:117399. [PMID: 37217113 DOI: 10.1016/j.cca.2023.117399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 05/15/2023] [Accepted: 05/19/2023] [Indexed: 05/24/2023]
Abstract
As many as 90% of patients with obstructive sleep apnea (OSA) may be undiagnosed. It is necessary to explore the potential value of autoantibodies against CRP, IL-6, IL-8 and TNF-α in the diagnosis of OSA. ELISA was performed to detect the level of autoantibodies against CRP, IL-6, IL-8 and TNF-α in sera from 264 OSA patients and 231 normal controls (NCs). The expression level of autoantibodies against CRP, IL-6 and IL-8 in OSA were significantly higher than that in NC while the level of anti-TNF-α was lower in OSA than that in NC. The per SD increment of anti-CRP, anti-IL-6 and anti-IL-8 autoantibodies were significantly associated with a 430%, 100% and 31% higher risk for OSA, respectively. The AUC of anti-CRP was 0.808 (95% CI: 0.771-0.845) when comparing OSA with NC, while the AUC increased to 0.876 (95% CI: 0.846-0.906) combining four autoantibodies. For discrimination of severe OSA versus NC and non-severe OSA versus NC, the AUC for four autoantibodies combination was 0.885 (95% CI: 0.851-0.918) and 0.876 (95% CI: 0.842-0.913). This study revealed the association between autoantibodies against inflammatory factors and OSA, and the combination of autoantibodies against CRP, IL-6, IL-8 and TNF-α may function as novel biomarker for monitoring the presence of OSA.
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Affiliation(s)
- Yifei Fang
- Department of Respiratory and Sleep Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, China
| | - Jiao Su
- Department of Respiratory and Sleep Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, China
| | - Binglu Zhang
- Department of Respiratory and Sleep Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, China
| | - Chunling Zhao
- Department of Respiratory and Sleep Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, China
| | - Longtao Ji
- Henan Institute of Medical and Pharmaceutical Sciences & Henan Key Medical Laboratory of Tumor Molecular Biomarkers, Zhengzhou University, Zhengzhou 450052, Henan, China; BGI College, Zhengzhou University, Zhengzhou 450052, Henan, China
| | - Feifei Liang
- Henan Institute of Medical and Pharmaceutical Sciences & Henan Key Medical Laboratory of Tumor Molecular Biomarkers, Zhengzhou University, Zhengzhou 450052, Henan, China; BGI College, Zhengzhou University, Zhengzhou 450052, Henan, China
| | - Zhi Wang
- Henan Institute of Medical and Pharmaceutical Sciences & Henan Key Medical Laboratory of Tumor Molecular Biomarkers, Zhengzhou University, Zhengzhou 450052, Henan, China; BGI College, Zhengzhou University, Zhengzhou 450052, Henan, China
| | - Jimin Hao
- Department of Respiratory and Sleep Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, China
| | - Yang Meng
- Department of Respiratory and Sleep Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, China
| | - Beilei Wei
- Department of Respiratory and Sleep Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, China
| | - Yuyang Huang
- Department of Respiratory and Sleep Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, China
| | - Liping Dai
- Henan Institute of Medical and Pharmaceutical Sciences & Henan Key Medical Laboratory of Tumor Molecular Biomarkers, Zhengzhou University, Zhengzhou 450052, Henan, China; BGI College, Zhengzhou University, Zhengzhou 450052, Henan, China.
| | - Songyun Ouyang
- Department of Respiratory and Sleep Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, China.
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Kurnool S, McCowen KC, Bernstein NA, Malhotra A. Sleep Apnea, Obesity, and Diabetes - an Intertwined Trio. Curr Diab Rep 2023:10.1007/s11892-023-01510-6. [PMID: 37148488 DOI: 10.1007/s11892-023-01510-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/18/2023] [Indexed: 05/08/2023]
Abstract
PURPOSE OF REVIEW To synthesize the existing literature regarding the complex interplay between sleep disturbance, obesity, and diabetes. The review emphasizes the three pillars of health being diet, exercise, and sleep, with the notion that if one is ignored, then the other two could suffer. RECENT FINDINGS Sleep deprivation is associated with incident obesity, perhaps mediated by dysregulation in leptin and ghrelin - hormones important in regulation of appetite. Sleep apnea is very common particularly among obese people with type 2 diabetes mellitus. Treatment of sleep apnea has clear symptomatic benefits although its impact on long-term cardiometabolic health is less clear. Sleep disturbance may be an important modifiable risk for patients at risk of cardiometabolic disease. An assessment of sleep health may be an important component of the comprehensive care of patients with obesity and diabetes mellitus.
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Affiliation(s)
- Soumya Kurnool
- UC San Diego Department of Medicine, 9500 Gilman Drive, UC San Diego, La Jolla, CA, 92037, USA
| | - Karen C McCowen
- UC San Diego Department of Medicine, 9500 Gilman Drive, UC San Diego, La Jolla, CA, 92037, USA
| | - Nicole A Bernstein
- UC San Diego Department of Medicine, 9500 Gilman Drive, UC San Diego, La Jolla, CA, 92037, USA
| | - Atul Malhotra
- UC San Diego Department of Medicine, 9500 Gilman Drive, UC San Diego, La Jolla, CA, 92037, USA.
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Basoglu OK, Tasbakan MS, Kayikcioglu M. Dyslipidemia prevalence in nonobese, nondiabetic patients with obstructive sleep apnea: does sex matter? J Clin Sleep Med 2023; 19:889-898. [PMID: 36708260 PMCID: PMC10152354 DOI: 10.5664/jcsm.10490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 12/16/2022] [Accepted: 12/16/2022] [Indexed: 01/29/2023]
Abstract
STUDY OBJECTIVES Dyslipidemia in obstructive sleep apnea (OSA) has been attributed to confounding obesity and/or diabetes. This study aimed to examine lipid profiles in nondiabetic, nonobese patients with OSA and identify the possible effects of age and sex. METHODS We retrospectively evaluated the lipid parameters of 3,050 adults who underwent polysomnography. A total of 2,168 patients were excluded due to obesity (body mass index ≥ 30 kg/m2), diabetes, alcoholism, untreated hypothyroidism, lipid-lowering drug use, missing sleep data, or treatment for suspected OSA. RESULTS Of 882 patients (75% males, aged 46.8 ± 12.2 years) included in the study, 88.4% had OSA. Levels of total cholesterol (P = .003), low-density-lipoprotein (LDL) cholesterol (P = .005), non-high-density-lipoprotein (non-HDL) cholesterol (P = .001), and triglycerides (P = .007) were significantly higher in patients with OSA than in those without, whereas HDL-cholesterol levels did not differ. The proportion of patients with hypercholesterolemia and/or elevated non-HDL cholesterol (> 160 mg/dL) was significantly higher in OSA than in non-OSA. Correlation analyses by sex revealed stronger and more significant relationships between lipid parameters and apnea-hypopnea index in women than in men (r = .135, P < .001, vs r = .080, P = .043 for total cholesterol; r = .111, P < .001, vs r = .080, P = .046 for non-HDL cholesterol; r = .122, P < .001, vs r = .061, P = .107 for LDL cholesterol, respectively). In regression analysis, the rate of hypercholesterolemia increased with age (P < .001 for women and P = .031 for men); non-HDL- and LDL-cholesterol levels significantly increased with OSA severity (P = .035 and P = .023, respectively) and age (P = .004 and P = .001, respectively) in women. CONCLUSIONS After excluding confounding obesity and diabetes, patients with OSA have an impaired lipid profile including total cholesterol, LDL cholesterol, non-HDL cholesterol, and triglycerides. A significant association between dyslipidemia and OSA severity was observed in women but not in men. CITATION Basoglu OK, Tasbakan MS, Kayikcioglu M. Dyslipidemia prevalence in nonobese, nondiabetic patients with obstructive sleep apnea: does sex matter? J Clin Sleep Med. 2023;19(5):889-898.
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Affiliation(s)
- Ozen K. Basoglu
- Department of Chest Diseases, Ege University Faculty of Medicine, Izmir, Turkey
| | | | - Meral Kayikcioglu
- Department of Cardiology, Ege University Faculty of Medicine, Izmir, Turkey
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Ytzhaik N, Zur D, Goldstein C, Almoznino G. Obstructive Sleep Apnea, Metabolic Dysfunction, and Periodontitis-Machine Learning and Statistical Analyses of the Dental, Oral, Medical Epidemiological (DOME) Big Data Study. Metabolites 2023; 13:metabo13050595. [PMID: 37233636 DOI: 10.3390/metabo13050595] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 04/12/2023] [Accepted: 04/24/2023] [Indexed: 05/27/2023] Open
Abstract
This study aimed to analyze the associations of obstructive sleep apnea (OSA) with dental parameters while controlling for socio-demographics, health-related habits, and each of the diseases comprising metabolic syndrome (MetS), its consequences, and related conditions. We analyzed data from the dental, oral, and medical epidemiological (DOME) cross-sectional records-based study that combines comprehensive socio-demographic, medical, and dental databases of a nationally representative sample of military personnel for one year. Analysis included statistical and machine learning models. The study included 132,529 subjects; of these, 318 (0.2%) were diagnosed with OSA. The following parameters maintained a statistically significant positive association with OSA in the multivariate binary logistic regression analysis (descending order from highest to lowest OR): obesity (OR = 3.104 (2.178-4.422)), male sex (OR = 2.41 (1.25-4.63)), periodontal disease (OR = 2.01 (1.38-2.91)), smoking (OR = 1.45 (1.05-1.99)), and age (OR = 1.143 (1.119-1.168)). Features importance generated by the XGBoost machine learning algorithm were age, obesity, and male sex (located on places 1-3), which are well-known risk factors of OSA, as well as periodontal disease (fourth place) and delivered dental fillings (fifth place). The Area Under Curve (AUC) of the model was 0.868 and the accuracy was 0.92. Altogether, the findings supported the main hypothesis of the study, which was that OSA is linked to dental morbidity, in particular to periodontitis. The findings highlight the need for dental evaluation as part of the workup of OSA patients and emphasizes the need for dental and general medical authorities to collaborate by exchanging knowledge about dental and systemic morbidities and their associations. The study also highlights the necessity for a comprehensive holistic risk management strategy that takes systemic and dental diseases into account.
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Affiliation(s)
- Noya Ytzhaik
- In Partial Fulfillment DMD Thesis, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel
| | - Dorit Zur
- Medical Information Department, General Surgeon Headquarter, Medical Corps, 02149, Israel Defense Forces, Tel-Hashomer, Israel
| | - Chen Goldstein
- Faculty of Dental Medicine, Hebrew University of Jerusalem, Israel; Big Biomedical Data Research Laboratory; Dean's Office, Hadassah Medical Center, Jerusalem 91120, Israel
| | - Galit Almoznino
- Faculty of Dental Medicine, Hebrew University of Jerusalem, Israel; Big Biomedical Data Research Laboratory; Dean's Office, Hadassah Medical Center, Jerusalem 91120, Israel
- Faculty of Dental Medicine, Hebrew University of Jerusalem, Israel; Department of Endodontics, Hadassah Medical Center, Jerusalem 91120, Israel
- Faculty of Dental Medicine, Hebrew University of Jerusalem, Israel; Department of Oral Medicine, Sedation & Maxillofacial Imaging, Hadassah Medical Center, Jerusalem 91120, Israel
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Bergmann M, Wanschitz J, Stefani A, Heidbreder A, Brandauer E, Cesari M, Löscher WN, Högl B. A prospective case-control study of excessive fragmentary myoclonus in the upper and lower extremities: Clinical characteristics and electrophysiological correlates. Sleep Med 2023; 106:84-89. [PMID: 37075530 DOI: 10.1016/j.sleep.2023.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 03/19/2023] [Accepted: 04/04/2023] [Indexed: 04/21/2023]
Abstract
BACKGROUND Excessive fragmentary myoclonus (EFM) is an incidental finding in video-polysomnography (VPSG) and listed among "Sleep Related Movement Disorders - Isolated symptoms and normal variants" in the ICSD-3. We aimed to prospectively evaluate EFM in the upper and lower extremities in a large sleep laboratory cohort and to investigate clinical characteristics and peripheral nerve pathology in patients with and without EFM. METHODS Two-hundred consecutive sleep laboratory patients with EFM according to ICSD-3 criteria were included and matched to 100 patients without EFM for age, sex and presence or absence of sleep-related breathing disorder. Patients additionally underwent peripheral neurophysiological work-up. RESULTS In 31/200 (15.5%) patients EFM was present not only in the lower extremities, but also in the upper extremities. Patients with EFM had less REM sleep (%/SPT; median (IQR); 13.8 (9.1-18.2) vs. 17.1 (10.1-20.5); p = 0.008) and the PLMS-Index was higher in patients with EFM than in those without (16.2 vs. 8.8/h; p = 0.009). Polyneuropathy (PNP) and nerve root lesions L5 and S1 were more frequent in patients with than in those without EFM (31.5% vs. 21% and 5% vs. 0%; p = 0.003). CONCLUSIONS In this large cohort we systematically investigated upper and lower extremities with surface electromyography during sleep and show that EFM is much more frequent in the lower extremities than in the upper extremities and corroborate the association of EFM with peripheral nerve pathology and PLMS.
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Affiliation(s)
- Melanie Bergmann
- Department of Neurology, Medical University of Innsbruck, Austria.
| | - Julia Wanschitz
- Department of Neurology, Medical University of Innsbruck, Austria
| | - Ambra Stefani
- Department of Neurology, Medical University of Innsbruck, Austria
| | - Anna Heidbreder
- Department of Neurology, Medical University of Innsbruck, Austria
| | | | - Matteo Cesari
- Department of Neurology, Medical University of Innsbruck, Austria
| | | | - Birgit Högl
- Department of Neurology, Medical University of Innsbruck, Austria
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Cha H, Oh H, Han SA, Kim SY, Kim JK, Park HC, Han DH, Kim DY, Kim HJ. The clinical influence of nasal surgery on PAP compliance and optimal application among OSA subjects uncomfortable with PAP device wear. Sci Rep 2023; 13:4383. [PMID: 36928588 PMCID: PMC10020433 DOI: 10.1038/s41598-023-31588-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 03/14/2023] [Indexed: 03/17/2023] Open
Abstract
This study aimed to evaluate the alteration of PAP compliance after nasal surgery and to determine the optimal indications of nasal surgery in obstructive sleep apnea (OSA) subjects. Among OSA subjects using PAP devices, 29 subjects who underwent septoturbinoplasty due to nasal obstruction were included and their pre- and postoperative medical and PAP records were reviewed retrospectively. Postoperative autoPAP usage data was further assessed by grouping the compliance (the percentage of days with usage ≥ 4 h) data (group 1: the good compliance group; group 2: the poor compliance group). The data showed that 56% of subjects in group 1 complained of nasal obstruction as the only barrier to using a PAP device and about 89% reported experiencing the efficacy of PAP usage. Both the mean and peak average PAP pressures were significantly reduced in group 1 following nasal surgery. Group 2 had multiple subjective problems that interfered with wearing a PAP device and reported a lack of experiencing the efficacy of PAP usage. Preoperative nasal cavity volume values were smaller and absolute blood eosinophil counts were significantly lower in group 1. The current data demonstrate that nasal surgery might increase the compliance of PAP device wear in OSA subjects who complained of only nasal obstruction as a barrier to wearing PAP and who had small nasal cavity volumes combined with allergic inflammation.
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Affiliation(s)
- Hyunkyung Cha
- Department of Otorhinolaryngology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Republic of Korea
| | - Heonjeong Oh
- Department of Otorhinolaryngology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Sun A Han
- Department of Otorhinolaryngology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Republic of Korea
| | - Seo Young Kim
- Department of Otorhinolaryngology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Jeong Kyou Kim
- Department of Otorhinolaryngology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Hae Chan Park
- Department of Otorhinolaryngology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Doo Hee Han
- Department of Otorhinolaryngology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
- Sensory Organ Research Institute, Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - Dong-Young Kim
- Department of Otorhinolaryngology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
- Sensory Organ Research Institute, Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - Hyun Jik Kim
- Department of Otorhinolaryngology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
- Sensory Organ Research Institute, Seoul National University Medical Research Center, Seoul, Republic of Korea.
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O'Connor-Reina C, Alcala LR, Ignacio JM, Iriarte MTG, Llatas MC, Morente JCC, Del Rey DP, Alvarez IM, Ibarburu GH, Baptista P, Plaza G. Risk of diabetes in patients with sleep apnea: comparison of surgery versus CPAP in a long-term follow-up study. J Otolaryngol Head Neck Surg 2023; 52:16. [PMID: 36788636 PMCID: PMC9930296 DOI: 10.1186/s40463-022-00616-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 12/14/2022] [Indexed: 02/16/2023] Open
Abstract
This study aimed to obtain a comprehensive view of the risk of developing diabetes in patients with obstructive sleep apnea (OSA) and to compare this risk between patients receiving continuous positive airway pressure (CPAP) therapy versus upper airway surgery (UAS). We used local and the global-scale federated data research network TriNetX to obtain access to electronic medical records, including those for patients diagnosed with OSA, from health-care organizations (HCOs) worldwide. Using propensity score matching and the score-matched analyses of data for 5 years of follow-up, we found that patients who had undergone UAS had a lower risk of developing diabetes than those who used CPAP (risk ratio 0.415, 95% confidence interval (CI) 0.349-0.493). The risk for newly diagnosed diabetes patients showed a similar pattern (hazard ratio 0.382; 95% CI 0.317-0.459). Both therapies seem to protect against diabetes (Risk 0.081 after UAS vs. 0.195 after CPAP). Analysis of the large data sets collected from HCOs in Europe and globally lead us to conclude that, in patients with OSA, UAS can prevent the development of diabetes better than CPAP.
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Affiliation(s)
- Carlos O'Connor-Reina
- Otorhinolaryngology Department, Hospital Quironsalud Marbella, 29680, Marbella, Spain.
- Otorhinolaryngology Department, Hospital Quironsalud Campo de Gibraltar, Palmones, Spain.
| | - Laura Rodriguez Alcala
- Otorhinolaryngology Department, Hospital Quironsalud Marbella, 29680, Marbella, Spain
- Otorhinolaryngology Department, Hospital Quironsalud Campo de Gibraltar, Palmones, Spain
| | | | | | | | | | - David Perez Del Rey
- Biomedical Informatics Group, Universidad Politécnica de Madrid, Madrid, Spain
| | | | | | - Peter Baptista
- Otorhinolaryngology Department, Clínica Universitaria de Navarra, Pamplona, Spain
| | - Guillermo Plaza
- Otorhinolaryngology Department, Hospital Universitario de Fuenlabrada, Universidad Rey Juan Carlos, Madrid, Spain
- Otorhinolaryngology Department, Hospital Sanitas la Zarzuela, Madrid, Spain
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Govindagoudar MB, Lalwani LK, Singh PK, Sen J, Chaudhry D. Dynamic assessment of oropharynx with ultrasonography as a screening tool for obstructive sleep apnea. J Sleep Res 2023; 32:e13712. [PMID: 36054478 DOI: 10.1111/jsr.13712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 07/11/2022] [Accepted: 07/16/2022] [Indexed: 02/03/2023]
Abstract
Ultrasonography is an easily available and portable tool to assess the dynamic changes in the upper airway and surrounding soft tissue. This study aimed to evaluate the utility of oropharynx ultrasonography as a screening tool for obstructive sleep apnea (OSA). The study sequentially enrolled overweight individuals (body mass index >25 kg/m2 ) and subjected them to OSA screening tools (Berlin questionnaire, Epworth Sleepiness Scale and STOP-Bang scores), ultrasonography of the oropharynx followed by overnight polysomnography. A total of 30 healthy individuals were also recruited as controls. Detailed dynamic and static ultrasonography measurements of the oropharynx and surrounding tissue were done. The diagnostic ability of various ultrasonography parameters to detect OSA was determined using receiver operating characteristic curve analysis. A total of 63 subjects were enrolled, with 33 in the OSA group and 30 in non-OSA overweight group. All baseline characteristics were similar in the two groups. Except for the dynamic measurements of oropharynx (Retropalatal% change-inspiration, retropalatal% change-Muller manoeuvre, retroglossal% change-inspiration, and retroglossal% change-Muller manoeuvre) all other parameters were similar in the OSA and non-OSA overweight subjects. The area under the receiver operating characteristic curve was highest for retropalatal% change-inspiration: 0.989, followed by retropalatal% change-Muller manoeuvre: 0.988. Both were also significant predictors of OSA with odds ratios of 0.338 (p = 0.003; 95% confidence interval [CI] 0.164-0.696) and 0.346 (p = 0.018; 95% CI 0.143-0.837), respectively. Ultrasonography provides a near complete picture of the dynamic changes and collapsibility of the oropharynx and can be an effective tool in screening for OSA.
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Affiliation(s)
- Manjunath B Govindagoudar
- Department of Pulmonary and Critical Care Medicine, Post Graduate Institute of Medical Sciences, Rohtak, India
| | - Lokesh Kumar Lalwani
- Department of Respiratory Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, India
| | - Pawan Kumar Singh
- Department of Pulmonary and Critical Care Medicine, Post Graduate Institute of Medical Sciences, Rohtak, India
| | - Jyotsna Sen
- Department of Radiodiagnosis, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, India
| | - Dhruva Chaudhry
- Department of Pulmonary and Critical Care Medicine, Post Graduate Institute of Medical Sciences, Rohtak, India
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Peonidin-3-O-Glucoside from Purple Corncob Ameliorates Nonalcoholic Fatty Liver Disease by Regulating Mitochondrial and Lysosome Functions to Reduce Oxidative Stress and Inflammation. Nutrients 2023; 15:nu15020372. [PMID: 36678243 PMCID: PMC9866220 DOI: 10.3390/nu15020372] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 12/27/2022] [Accepted: 01/05/2023] [Indexed: 01/14/2023] Open
Abstract
A frequent chronic liver condition across the world is nonalcoholic fatty liver disease (NAFLD). Oxidative stress caused by lipid accumulation is generally considered to be the main cause of NAFLD. Anthocyanins can effectively inhibit the production of reactive oxygen species and improve oxidative stress. In this work, six major anthocyanins were separated from purple corncob by semi-preparative liquid chromatography. The effects of the 6 kinds of anthocyanins against NAFLD were investigated using a free fatty acid (FFA)-induced cell model. The results showed that peonidin 3-O-glucoside (P3G) can significantly reduce lipid accumulation in the NAFLD cell model. The treatment with P3G also inhibited oxidative stress via inhibiting the excessive production of reactive oxygen species and superoxide anion, increasing glutathione levels, and enhancing the activities of SOD, GPX, and CAT. Further studies unveiled that treatment with P3G not only alleviated inflammation but also improved the depletion of mitochondrial content and damage of the mitochondrial electron transfer chain developed concomitantly in the cell model. P3G upregulated transcription factor EB (TFEB)-mediated lysosomal function and activated the peroxisome proliferator-activated receptor alpha (PPARα)-mediated peroxisomal lipid oxidation by interacting with PPARα possibly. Overall, this study added to our understanding of the protective effects of purple corn anthocyanins against NAFLD and offered suggestions for developing functional foods containing these anthocyanins.
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Song Y, Zhu J, Dong Z, Wang C, Xiao J, Yang W. Incidence and risk factors of postoperative nausea and vomiting following laparoscopic sleeve gastrectomy and its relationship with Helicobacter pylori: A propensity score matching analysis. Front Endocrinol (Lausanne) 2023; 14:1102017. [PMID: 36909334 PMCID: PMC9992875 DOI: 10.3389/fendo.2023.1102017] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 02/10/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Postoperative nausea and vomiting (PONV) are common after laparoscopic sleeve gastrectomy (LSG), affecting patient satisfaction and postoperative recovery. The purpose of this study was to investigate the incidence and severity of PONV after LSG and the relationship between Helicobacter pylori (HP) and PONV. METHODS Patients undergoing LSG in our center from June 1, 2018, to May 31, 2022, were divided into HP-positive and HP-negative groups for retrospective analysis. The independent risk factors of PONV were determined by univariate and binary logistic regression analysis using a 1:1 propensity score matching (PSM) method. RESULTS A total of 656 patients was enrolled, and 193 pairs of HP-positive and negative groups were matched after PSM. Both groups of patients had similar clinical features and surgical procedures. PONV occurred in 232 patients (60.1%) after LSG, and the incidence of PONV in HP-positive patients was 61.10%. The incidence and severity of PONV were statistically similar in both groups (P=0.815). Multivariate analysis showed that the female sex (OR=1.644, P=0.042), postoperative pain (OR=2.203, P=0.001) and use of postoperative opioid (OR=2.229, P=0.000) were independent risk factors for PONV after LSG, whereas T2DM (OR=0.510, P=0.009) and OSAS (OR=0.545, P=0.008) independently reduced the incidence rate of PONV. There was no difference either in smoking (P=0.255) or alcohol drinking (P=0.801). HP infection did not affect PONV (P=0.678). CONCLUSIONS The incidence of PONV following LSG was relatively high. Female sex, postoperative pain and use of postoperative opioid predicted a higher incidence of PONV. Patients with T2DM and OSAS were less likely to have PONV. There was no clear association between HP infection and PONV after LSG.
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Affiliation(s)
- Yali Song
- Department of Metabolic and Bariatric Surgery, Clinical Research Institute, The First Affiliated Hospital, Jinan University, Guangzhou, China
- Institute of Obesity and Metabolic Disorders, Jinan University, Guangzhou, China
| | - Jie Zhu
- Department of Metabolic and Bariatric Surgery, Clinical Research Institute, The First Affiliated Hospital, Jinan University, Guangzhou, China
- Institute of Obesity and Metabolic Disorders, Jinan University, Guangzhou, China
| | - Zhiyong Dong
- Department of Metabolic and Bariatric Surgery, Clinical Research Institute, The First Affiliated Hospital, Jinan University, Guangzhou, China
- Institute of Obesity and Metabolic Disorders, Jinan University, Guangzhou, China
- Laboratory of Metabolic and Molecular Medicine, Guangdong-Hong Kong-Macao Joint University, Guangzhou, China
| | - Cunchuan Wang
- Department of Metabolic and Bariatric Surgery, Clinical Research Institute, The First Affiliated Hospital, Jinan University, Guangzhou, China
- Institute of Obesity and Metabolic Disorders, Jinan University, Guangzhou, China
- Laboratory of Metabolic and Molecular Medicine, Guangdong-Hong Kong-Macao Joint University, Guangzhou, China
| | - Jia Xiao
- Department of Metabolic and Bariatric Surgery, Clinical Research Institute, The First Affiliated Hospital, Jinan University, Guangzhou, China
- Institute of Obesity and Metabolic Disorders, Jinan University, Guangzhou, China
- Laboratory of Metabolic and Molecular Medicine, Guangdong-Hong Kong-Macao Joint University, Guangzhou, China
- *Correspondence: Jia Xiao, ; Wah Yang,
| | - Wah Yang
- Department of Metabolic and Bariatric Surgery, Clinical Research Institute, The First Affiliated Hospital, Jinan University, Guangzhou, China
- Institute of Obesity and Metabolic Disorders, Jinan University, Guangzhou, China
- Laboratory of Metabolic and Molecular Medicine, Guangdong-Hong Kong-Macao Joint University, Guangzhou, China
- *Correspondence: Jia Xiao, ; Wah Yang,
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Maxwell CV, Shirley R, O'Higgins AC, Rosser ML, O'Brien P, Hod M, O'Reilly SL, Medina VP, Smith GN, Hanson MA, Adam S, Ma RC, Kapur A, McIntyre HD, Jacobsson B, Poon LC, Bergman L, Regan L, Algurjia E, McAuliffe FM. Management of obesity across women's life course: FIGO Best Practice Advice. Int J Gynaecol Obstet 2023; 160 Suppl 1:35-49. [PMID: 36635081 PMCID: PMC10107516 DOI: 10.1002/ijgo.14549] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Obesity is a chronic, progressive, relapsing, and treatable multifactorial, neurobehavioral disease. According to the World Health Organization, obesity affects 15% of women and has long-term effects on women's health. The focus of care in patients with obesity should be on optimizing health outcomes rather than on weight loss. Appropriate and common language, considering cultural sensitivity and trauma-informed care, is needed to discuss obesity. Pregnancy is a time of significant physiological change. Pre-, ante-, and postpartum clinical encounters provide opportunities for health optimization for parents with obesity in terms of, but not limited to, fertility and breastfeeding. Pre-existing conditions may also be identified and managed. Beyond pregnancy, women with obesity are at an increased risk for gastrointestinal and liver diseases, impaired kidney function, obstructive sleep apnea, and venous thromboembolism. Gynecological and reproductive health of women living with obesity cannot be dismissed, with accommodations needed for preventive health screenings and consideration of increased risk for gynecologic malignancies. Mental wellness, specifically depression, should be screened and managed appropriately. Obesity is a complex condition and is increasing in prevalence with failure of public health interventions to achieve significant decrease. Future research efforts should focus on interprofessional care and discovering effective interventions for health optimization.
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Affiliation(s)
- Cynthia V Maxwell
- Maternal Fetal Medicine; Sinai Health and Women's College Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Rachelle Shirley
- Maternal Fetal Medicine, Sinai Health, University of Toronto, Toronto, Ontario, Canada
| | - Amy C O'Higgins
- Maternal Fetal Medicine, Sinai Health, University of Toronto, Toronto, Ontario, Canada
| | - Mary L Rosser
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York-Presbyterian, New York, New York, USA
| | - Patrick O'Brien
- Institute for Women's Health, University College London, London, UK
| | - Moshe Hod
- Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sharleen L O'Reilly
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland.,School of Agriculture and Food Science, University College Dublin, Dublin, Ireland
| | - Virna P Medina
- Department of Obstetrics and Gynecology, Faculty of HealthUniversidad del Valle, Clínica Imbanaco Quirón Salud, Universidad Libre, Cali, Colombia
| | - Graeme N Smith
- Department of Obstetrics and Gynecology, Kingston Health Sciences Centre, Queen's University, Kingston, Ontario, Canada
| | - Mark A Hanson
- Institute of Developmental Sciences, University Hospital Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, UK
| | - Sumaiya Adam
- Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.,Diabetes Research Centre, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Ronald C Ma
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, SAR, China.,Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Anil Kapur
- World Diabetes Foundation, Bagsvaerd, Denmark
| | - Harold David McIntyre
- Mater Health, University of Queensland, Mater Health Campus, South Brisbane, Queensland, Australia
| | - Bo Jacobsson
- Department of Obstetrics and Gynecology, Sahlgrenska University Hospital/Ostra, Gothenburg, Sweden.,Department of Genetics and Bioinformatics, Domain of Health Data and Digitalisation, Institute of Public Health, Oslo, Norway
| | - Liona C Poon
- Department of Obstetrics and Gynecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, SAR, China
| | - Lina Bergman
- Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Obstetrics and Gynecology, Stellenbosch University, Cape Town, South Africa.,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | | | - Esraa Algurjia
- The World Association of Trainees in Obstetrics & Gynecology, Paris, France.,Elwya Maternity Hospital, Baghdad, Iraq
| | - Fionnuala M McAuliffe
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
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Wang M, Flexeder C, Kilanowski A, Kress S, Herberth G, Schikowski T, Peters A, Standl M. Changes in sleep duration and sleep difficulties from adolescence to young adulthood and the risk of obesity: Bidirectional evidence in the GINIplus and LISA studies. Sleep Med 2023; 101:401-410. [PMID: 36516524 DOI: 10.1016/j.sleep.2022.11.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 11/25/2022] [Accepted: 11/29/2022] [Indexed: 12/05/2022]
Abstract
OBJECTIVE This study aimed to assess the association of changes in sleep behaviors from adolescence to young adulthood with the risk of overweight/obesity, and the reverse relationship. METHODS Data of 1978 participants was obtained from the 15- and 20-year follow-ups of the GINIplus and LISA birth cohorts. Insufficient sleep was defined as reported sleep duration <8 h for adolescents, <7 h for adults, and sleep difficulties as reported having sleeping difficulties. Logistic regression models were used to assess bidirectional associations of changes in insufficient sleep and sleep difficulties with overweight/obesity. The polygenic risk scores (PRS) for body mass index (BMI) was tested in a sub-sample (n = 918). RESULTS Compared with sufficient sleep in both adolescence and young adulthood, insufficient sleep only in young adulthood was associated with an increased risk of overweight/obesity (odds ratio = 1.85, 95%confidence interval = [1.27-2.69]). Compared with no sleep difficulties at both time-points, only persistent sleep difficulties was associated with a higher risk of overweight/obesity (2.15 [1.22-3.77]). The PRS for BMI was associated with overweight/obesity (1.41 [1.17-1.70]), but no significant gene-sleep interaction effect was observed. Reversely, only persistent overweight/obesity was associated with increased risks of insufficient sleep (1.81 [1.21-2.70]), and sleep difficulties (1.77 [1.18-2.66]), respectively. CONCLUSIONS Insufficient sleep only presented a cross-sectional association with overweight/obesity in young adulthood, while long-term sleep difficulties from adolescence to young adulthood was associated with young adult overweight/obesity. Reversely, long-term overweight/obesity from adolescence to young adulthood was associated with insufficient sleep and sleep difficulties in young adulthood.
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Affiliation(s)
- Mingming Wang
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany; Institute for Medical Information Processing, Biometry and Epidemiology, Pettenkofer School of Public Health, LMU Munich, Munich, Germany
| | - Claudia Flexeder
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany; Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, Ludwig Maximilians University of Munich, Munich, Germany
| | - Anna Kilanowski
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany; Institute for Medical Information Processing, Biometry and Epidemiology, Pettenkofer School of Public Health, LMU Munich, Munich, Germany; Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, Ludwig Maximilians University of Munich, Munich, Germany
| | - Sara Kress
- IUF - Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany; Medical Research School Düsseldorf, Heinrich Heine University, Düsseldorf, Germany
| | - Gunda Herberth
- Department of Environmental Immunology, Helmholtz Centre for Environmental Research - UFZ, Leipzig, Germany
| | - Tamara Schikowski
- IUF - Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany; Chair of Epidemiology, Ludwig-Maximilians University of Munich, Munich, Germany
| | - Marie Standl
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany.
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77
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Ukraintseva YV, Soloveva AK. [The phenomenon of awakening from sleep and underlying neurophysiological and autonomic mechanisms]. Zh Nevrol Psikhiatr Im S S Korsakova 2023; 123:21-27. [PMID: 37275994 DOI: 10.17116/jnevro202312305221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Current research has shown that sleep is not a global process evenly covering the entire brain. The heterogeneity of wakefulness levels in different parts of the brain and differences in their activation thresholds are especially pronounced during the transitions between sleep and wakefulness. During awakening, subcortical brain structures activate first, followed by sensory and motor cortical regions, whereas the associative cortex wakes up much later. Awakening, unlike falling asleep, is not a smooth process. It begins with a short-term sharp activation of the autonomic nervous system and some wake-promoting brain regions. The amplitude of this activity burst is out of proportion to obvious physiological needs and exceeds that observed in later periods of quiet wakefulness. The review discusses the similarities and differences between awakening from sleep and hibernation in hibernating rodents. Data on some clinical consequences of impaired awakening mechanisms are also provided.
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Affiliation(s)
- Yu V Ukraintseva
- Institute of Higher Nervous Activity and Neurophysiology of the Russian Academy of Science, Moscow, Russia
- Institute of Biomedical Problems of the Russian Academy of Science, Moscow, Russia
| | - A K Soloveva
- Institute of Higher Nervous Activity and Neurophysiology of the Russian Academy of Science, Moscow, Russia
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78
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Huang J, Chen L, Li X, Chen M, Lin T, Chen G. Association Between Metabolic-Associated Fatty Liver Disease and Obstructive Sleep Apnea: A Cross-Sectional Study. Nat Sci Sleep 2023; 15:49-57. [PMID: 36879664 PMCID: PMC9985450 DOI: 10.2147/nss.s398971] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 02/20/2023] [Indexed: 03/04/2023] Open
Abstract
AIM Emerging evidence has revealed that obstructive sleep apnea (OSA) is an independent risk factor for the development of a variety of adverse metabolic disease states. In this study, we evaluated the association between OSA severity and metabolic dysfunction-associated fatty liver disease (MAFLD) among Asian populations. MATERIALS AND METHODS This was a cross-sectional, single-center study. The study cohort consisted of patients undergoing polysomnography and abdominal ultrasonography. Logistic regression analysis was used to evaluate the independent risk factors of MAFLD in patients with OSA. RESULTS A total of 1065 patients (277 non-MAFLD and 788 MAFLD) were included in the study. The prevalence of MAFLD in non-OSA, mild-moderate OSA, and severe OSA patients was 58.16%, 72.41%, and 78.0%, respectively (p < 0.001). We identified significant differences in body mass index (BMI), apnea-hypopnea index (AHI), oxygen desaturation index (ODI), and lowest O2 saturation (LaSO2) between non-MAFLD and MAFLD patients (all p < 0.001). After adjusting for confounding variables, we used multivariate regression analysis to show that BMI, ODI, and triglyceride (TG) levels independently predicted the occurrence of MAFLD (odds ratio [OR] = 1.234, p < 0.001; OR = 1.022, p = 0.013; OR = 1.384, p = 0.001, respectively). Moreover, stratified analysis according to BMI indicated that TG levels were the predominant risk factor for MAFLD in a group of patients with a BMI < 23 kg/m2, while BMI, ODI, TG levels, and total cholesterol (TC) were the major risk factors for MAFLD in a group of patients with a BMI ≥ 23 kg/m2 (all p < 0.05). CONCLUSION OSA-associated chronic intermittent hypoxia was independently associated with the risk of MAFLD, especially in OSA patients with a BMI ≥ 23 kg/m2, suggesting that oxidative stress might play an important role in the pathogenesis of MAFLD in patients with OSA.
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Affiliation(s)
- Jiefeng Huang
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Fujian Medical University, Fujian Medical University, Fuzhou, People's Republic of China.,Institute of Respiratory Disease, Fujian Medical University, Fujian Medical University, Fuzhou, People's Republic of China.,Department of Respiratory and Critical Care Medicine, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, People's Republic of China
| | - Lida Chen
- Department of Respiratory and Critical Care Medicine, Zhangzhou Affiliated Hospital of Fujian Medical University, Xiangcheng, Zhangzhou, People's Republic of China
| | - Xiuling Li
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Fujian Medical University, Fujian Medical University, Fuzhou, People's Republic of China.,Institute of Respiratory Disease, Fujian Medical University, Fujian Medical University, Fuzhou, People's Republic of China.,Department of Respiratory and Critical Care Medicine, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, People's Republic of China
| | - Menglan Chen
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Fujian Medical University, Fujian Medical University, Fuzhou, People's Republic of China.,Institute of Respiratory Disease, Fujian Medical University, Fujian Medical University, Fuzhou, People's Republic of China.,Department of Respiratory and Critical Care Medicine, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, People's Republic of China
| | - Ting Lin
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Fujian Medical University, Fujian Medical University, Fuzhou, People's Republic of China.,Institute of Respiratory Disease, Fujian Medical University, Fujian Medical University, Fuzhou, People's Republic of China.,Department of Respiratory and Critical Care Medicine, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, People's Republic of China
| | - Gongping Chen
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Fujian Medical University, Fujian Medical University, Fuzhou, People's Republic of China.,Institute of Respiratory Disease, Fujian Medical University, Fujian Medical University, Fuzhou, People's Republic of China.,Department of Respiratory and Critical Care Medicine, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, People's Republic of China
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79
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Bidirectional Associations between Daytime Napping Duration and Metabolic Syndrome: A Nationally Representative Cohort Study. Nutrients 2022; 14:nu14245292. [PMID: 36558451 PMCID: PMC9785410 DOI: 10.3390/nu14245292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 12/07/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND We aimed to examine the bidirectional associations between daytime napping duration and metabolic syndrome (MetS). METHODS Using data from the China Health and Retirement Longitudinal Study from 2011 to 2015, modified Poisson regression models were performed to explore the longitudinal associations of baseline napping duration with the occurrence and remission of MetS. Generalized estimating equation was conducted to explore the association between baseline MetS status with subsequent changes in daytime napping duration. Cross-lagged panel analysis was performed to further verify their bidirectional relationships. RESULTS During the four-year follow-up, among 5041 participants without MetS at baseline, extended naps were significantly associated with MetS occurrence, compared with non-napping. This association was only significant in individuals with adequate night-time sleep duration or good sleep quality of the 2898 participants with MetS at baseline. Excessive napping duration may be not favorable for MetS remission especially for adequate night-time sleepers. With respect to reverse associations, baseline MetS status significantly increased the napping duration during the subsequent follow-up period. Finally, there were significant bidirectional cross-lagged associations between napping duration and MetS severity score after adjusting for all covariates. CONCLUSIONS Our study indicates bidirectional relationships exist between daytime napping duration and MetS. Interestingly, longer napping duration was detrimental to cardiometabolic health only in those with sufficient night-time sleep duration or good sleep quality.
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80
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Non-contact diagnosis of sleep breathing disorders using infrared optical gas imaging: a prospective observational study. Sci Rep 2022; 12:21052. [PMID: 36473950 PMCID: PMC9727032 DOI: 10.1038/s41598-022-25637-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 12/02/2022] [Indexed: 12/12/2022] Open
Abstract
Full-night polysomnography (PSG) is the gold standard for diagnosing obstructive sleep apnea (OSA). However, PSG requires several sensors to be attached to the patient's body, which can interfere with sleep. Moreover, non-contact devices that utilize impulse radio ultra-wideband radar have limitations as they cannot directly measure respiratory airflow. This study aimed to detect respiratory events through infrared optical gas imaging and verify its feasibility for the diagnosis of OSA. Data collection through PSG and infrared optical gas imaging was simultaneously conducted on 50 volunteers. Respiratory airflow signal was extracted from the infrared optical gas images using an automated algorithm. We compared the respiratory parameters obtained from infrared optical gas imaging with those from PSG. All respiratory events scored from the infrared optical gas imaging were strongly correlated with those identified with standard PSG sensors. Based on a receiver operating characteristic curve, infrared optical gas imaging was deemed appropriate for the diagnosis of OSA. Infrared optical gas imaging accurately detected respiratory events during sleep; therefore, it may be employed as a screening tool for OSA.
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81
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Zeljković A, Milojević A, Vladimirov S, Zdravković M, Memon L, Brajković M, Gardijan V, Gojković T, Stefanović A, Miljković-Trailović M, Spasojević-Kalimanovska V, Ninić A. Alterations of cholesterol synthesis and absorption in obstructive sleep apnea: Influence of obesity and disease severity. Nutr Metab Cardiovasc Dis 2022; 32:2848-2857. [PMID: 36323608 DOI: 10.1016/j.numecd.2022.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 09/11/2022] [Accepted: 09/12/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND AIMS Obstructive sleep apnea (OSA) is closely linked to obesity and related adverse metabolic changes, including dyslipidemia. However, it is not clear whether OSA is an independent contributing factor to dyslipidemia, or the observed association is a reflection of a concomitant presence of obesity. Additionally, dyslipidemia is usually evaluated through measurement of parameters of routine lipid status, while more precise evaluation of lipid homeostasis is rarely performed in OSA. In this study, we analyzed markers of cholesterol synthesis and absorption in patients with OSA with respect to the presence of obesity and the disease severity. METHODS AND RESULTS This study enrolled 116 OSA patients. Concentrations of non-cholesterol sterols (NCS), measured by LC-MS/MS, were used as markers of cholesterol synthesis and absorption. Apnea-hypopnea index (AHI) and oxygen saturation (SaO2) were utilized as markers of OSA severity. Serum lipid status parameters were determined by routine enzymatic methods. Markers of cholesterol synthesis were increased (P = 0.005), whilst markers of cholesterol absorption decreased (P = 0.001) in obese OSA patients. Cholesterol synthesis/absorption ratio was elevated in obese subjects (P < 0.001). Concentration of cholesterol synthesis marker lathosterol was significantly higher in subjects with severe OSA (P = 0.014) and we observed a trend of decreased cholesterol absorption in these patients. AHI was revealed as an independent determinant of lathosterol concentration (P = 0.022). CONCLUSIONS Our results suggest that the presence of obesity and severe forms of OSA is characterized by elevated endogenous cholesterol synthesis. AHI was singled out as an independent determinant of the serum level of cholesterol synthesis marker lathosterol.
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Affiliation(s)
- Aleksandra Zeljković
- Department of Medical Biochemistry, University of Belgrade - Faculty of Pharmacy, Belgrade, Serbia.
| | - Ana Milojević
- Department of Laboratory Diagnostics, University Medical Center "Bežanijska kosa", Belgrade, Serbia
| | - Sandra Vladimirov
- Department of Medical Biochemistry, University of Belgrade - Faculty of Pharmacy, Belgrade, Serbia
| | - Marija Zdravković
- Department of Cardiology, University Medical Center "Bežanijska kosa" and University of Belgrade-Faculty of Medicine, Belgrade, Serbia
| | - Lidija Memon
- Department of Laboratory Diagnostics, University Medical Center "Bežanijska kosa", Belgrade, Serbia
| | - Milica Brajković
- Department of Pulmonology, University Medical Center "Bežanijska kosa", Belgrade, Serbia
| | - Vera Gardijan
- Department of Pulmonology, University Medical Center "Bežanijska kosa", Belgrade, Serbia
| | - Tamara Gojković
- Department of Medical Biochemistry, University of Belgrade - Faculty of Pharmacy, Belgrade, Serbia
| | - Aleksandra Stefanović
- Department of Medical Biochemistry, University of Belgrade - Faculty of Pharmacy, Belgrade, Serbia
| | | | | | - Ana Ninić
- Department of Medical Biochemistry, University of Belgrade - Faculty of Pharmacy, Belgrade, Serbia
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Huang B, Huang Y, Zhai M, Zhou Q, Ji S, Liu H, Zhuang X, Zhang Y, Zhang J. Prevalence, clinical characteristics, and predictors of sleep disordered breathing in hospitalized heart failure patients. Clin Cardiol 2022; 45:1311-1318. [PMID: 36177653 DOI: 10.1002/clc.23925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 08/05/2022] [Accepted: 09/06/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Heart failure (HF) is often comorbid with sleep disordered breathing (SDB). This prospective study investigated the prevalence, clinical characteristics, and predictors of SDB in hospitalized HF patients. METHODS Sleep studies were performed on hospitalized HF patients from January 2015 to February 2019. SDB was categorized as no/mild SDB, obstructive sleep apnea (OSA), and central sleep apnea (CSA). RESULTS The study included 1069 hospitalized HF patients. The prevalence rates of OSA and CSA were 16.6% and 36.9%, respectively. Patients with OSA or CSA were more likely to be male and have a higher body mass index (BMI) and more comorbidities. Multivariate logistic regression analysis showed that male sex (odds ratio [OR] = 1.803, 95% confidence interval [CI] = 1.099-2.958), BMI (per 5 kg/m2 increase: OR = 2.270, 95% CI = 1.852-2.783), hypertension (OR = 2.719, 95% CI = 1.817-4.070), diabetes (OR = 1.477, 95% CI = 1.020-2.139), and left ventricular ejection fraction (LVEF) (per 5% increase, OR = 1.126, 95% CI = 1.053-1.204) were independent predictors of OSA. Male sex (OR = 1.699, 95% CI = 1.085-1.271), age (per 10 years, OR = 1.235, 95% CI = 1.118-1.363), heart rate (per 10 bpm, OR = 1.174, 95% CI = 1.099-2.958), LVEF (per 5% increase, OR = 0.882, 95% CI = 0.835-0.932), NT-proBNP (lnNT-proBNP, OR = 1.234, 95% CI = 1.089-1.398) and hypocapnia (OR = 1.455, 95% CI = 1.105-1.915) were independent predictors of CSA. The areas under the receiver operating characteristic curves were 0.794 (95% CI = 0.758-0.830) and 0.673 (95% CI = 0.640-0.706), respectively. CONCLUSIONS More than half of hospitalized HF patients had OSA or CSA, and CSA was the predominant type. OSA and CSA predictors differ. The clinical characteristics of HF patients can help make preliminary predictions for SDB patients.
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Affiliation(s)
- Boping Huang
- Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China
| | - Yan Huang
- Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China
| | - Mei Zhai
- Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China
| | - Qiong Zhou
- Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China
| | - Shiming Ji
- Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China
| | - Huihui Liu
- Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China
| | - Xiaofeng Zhuang
- Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China
| | - Yuhui Zhang
- Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China
| | - Jian Zhang
- Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China
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83
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A Narrative Review of Sex and Gender Differences in Sleep Disordered Breathing: Gaps and Opportunities. LIFE (BASEL, SWITZERLAND) 2022; 12:life12122003. [PMID: 36556368 PMCID: PMC9786006 DOI: 10.3390/life12122003] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 11/26/2022] [Accepted: 11/29/2022] [Indexed: 12/05/2022]
Abstract
INTRODUCTION Sleep disordered breathing (SDB) is a common condition, associated with multiple comorbidities including cardiovascular and metabolic disease. It has been previously established that SDB is more prevalent in men than women, shifting the literature's focus away from the latter population. As such, underdiagnosis, and thus undertreatment, of SDB in women exists. METHODS To establish the differences in prevalence, clinical presentation, and pathophysiology of SDB between the two sexes, a narrative review of the current literature was performed. RESULTS Rates of SDB are higher among men, likely driven by differences in symptom presentation between men and women, with women presenting with more "atypical" symptoms, and lack of sensitivity in SDB screening tools to detect SDB in women. In addition to the cardiovascular risks of SDB, women with SDB may have worse quality of life, higher prevalence of insomnia, and respiratory issues. DISCUSSION More research is needed to better define the unique pathophysiology and clinical presentation of SDB in women. In addition, an increased awareness among health care providers and the lay public of the SDB-specific sex and gender differences will serve to minimize disparities in identification and treatment of SDB in women.
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84
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Hsieh YH, Schell AE, Yeh E, Strohl MP, Curado TF, Strohl KP. Neurostimulation in the Management of Obstructive Sleep Apnea. CURRENT SLEEP MEDICINE REPORTS 2022. [DOI: 10.1007/s40675-022-00233-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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85
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Guo L, Hu Y. Clinical Observation of Low-Temperature Plasma Knife Tonsil Adenoidectomy for Pediatric Snoring and Analysis of Influencing Factors. Emerg Med Int 2022; 2022:1691583. [PMID: 36467863 PMCID: PMC9715336 DOI: 10.1155/2022/1691583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 09/28/2022] [Indexed: 09/05/2023] Open
Abstract
Objective To investigate the clinical efficacy of low-temperature plasma knife tonsil adenoidectomy for pediatric snoring and to analyze the factors influencing the efficacy. Methods 90 children with snoring who were scheduled for surgical treatment in our hospital from June 2020 to December 2021 were selected as the research objects. According to the random number table method, they were divided into control group (group C) and observation group (group O), with 45 cases in each group. The children in group C were treated with power cutting system to remove adenoids combined with conventional peeling of bilateral tonsils, while the children in group O were treated with low-temperature plasma adenoidectomy combined with bilateral tonsillectomy, and both the groups received psychological care, preoperative preparation, health guidance, postoperative posture care and close monitoring of vital signs during the perioperative period. The clinical efficacy, perioperative related indexes (including operation time, intraoperative bleeding, postoperative pain time, and hospital stay) were compared between the two groups. The apnea-hypopnea index (AHI), oxygen decrement index (ODI), longest apnea time (LAT), and lowest oxygen saturation (LSaO2) were measured before operation and 1 week after operation to evaluate the ventilatory function of the two groups. According to the curative effect, 90 children with snoring were divided into cure + significant effective group and valid + invalid group. The general data and preoperative biochemical indexes of the two groups were collected, and logistic regression model was used to analyze the related influencing factors of the curative effect. Results The total effective rate of group O (100.00%, 45 cases) was significantly higher than that of group C (91.11%, 41 cases) (P < 0.05); the operative time, intraoperative bleeding, postoperative pain time, and hospitalization time of group O were shorter/less than those of group C; the AHI, ODI, and LAT of group O at 1 week after surgery were shorter/less than those of the control group; and LSaO2 was higher than that of group C. The differences were statistically significant (P < 0.05). Univariate analysis showed that there were significant differences in age, BMI, course of disease, preoperative AHI, preoperative LsaO2, and surgical method between cure + significant effective group and valid + invalid group (P < 0.05). Multivariate analysis showed that high BMI, high preoperative AHI, and power cutting system for adenoids combined with routine peeling of the bilateral tonsils were independent risk factors for postoperative outcome in children with obstructive sleep apnea syndrome (OSAS) (P < 0.05).
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Affiliation(s)
- Li Guo
- Department of Otorhinolaryngology, Zhejiang Zhuji People Hospital, Zhuji 311800, Zhejiang, China
| | - Yirong Hu
- Department of Maternal and Children Health, Chongqing Liangjiang New Area People's Hospital, Chongqing 401121, China
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Lu D, Xu S, Dai P, Wu L, Zhang H, Zhou B. Gut microbiota in hypertensive patients with versus without obstructive sleep apnea. J Clin Hypertens (Greenwich) 2022; 24:1598-1605. [PMID: 36411588 PMCID: PMC9731600 DOI: 10.1111/jch.14598] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 10/18/2022] [Accepted: 10/25/2022] [Indexed: 11/24/2022]
Abstract
We investigated the alteration of gut microbiota and the associated metabolic risks in hypertensive patients with obstructive sleep apnea (OSA) comorbidity. Fecal and blood samples were collected from 52 hypertensive patients, who were divided into three groups: A (controls, apnea-hypopnea index[AHI] < 5, n = 15), B (mild OSA, 5 < AHI < 20, n = 17), and C (moderate-to-severe OSA, AHI > 20, n = 20). The composition of the gut microbiota was studied through 16s RNA sequencing of variable regions 3-4. Analysis of the results revealed that group C had a significant higher concentration of total cholesterol, low-density lipoprotein, and IL-1β compared with group A. The Shannon index showed that bacterial biodiversity was lower in OSA patients. At the phylum level, the ratio of Firmicutes to Bacteroidetes (F/B) was significantly higher in group C than in groups A and B. At the genus level, the relative abundance of short-chain fatty acids (SCFA)-producing bacteria (e.g., Bacteroides and Prevotella) was lower while the number of inflammation-related bacteria (e.g., Lactobacillus) was increased in patients with OSA. We found that the IL-1β level was negatively correlated with Bacteroidetes. The area under the receiver operating characteristic curve was .672 for F/B ratio in determining hypertensive patients with OSA. In patients with hypertension, OSA was associated with worse gut dysbiosis, as evidenced by decreased levels of short-chain fatty acids-producing bacteria and increased number of inflammation-related bacteria. The differences in gut microbiota discriminate hypertensive patients with OSA from those without and may result in an enhanced inflammatory response and increase the risk of metabolic diseases.
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Affiliation(s)
- Dasheng Lu
- Department of CardiologyThe First Affiliated Hospital of Anhui Medical UniversityHefeiAnhui ProvinceChina,Department of CardiologyThe Second Affiliated Hospital of Wannan Medical CollegeWuhuAnhui ProvinceChina,Vascular Diseases Research Center of Wannan Medical CollegeWuhuChina
| | - Shaodong Xu
- Department of CardiologyThe Third Affiliated Hospital of Anhui Medical UniversityHefeiAnhui ProvinceChina
| | - Ping Dai
- Department of Sleep medicineThe Second Affiliated Hospital of Wannan Medical CollegeWuhuAnhui ProvinceChina
| | - Lijuan Wu
- Department of OtorhinolaryngologyThe First Affiliated Hospital of Wannan Medical CollegeWuhuAnhui ProvinceChina
| | - Hongxiang Zhang
- Department of CardiologyThe Second Affiliated Hospital of Wannan Medical CollegeWuhuAnhui ProvinceChina,Vascular Diseases Research Center of Wannan Medical CollegeWuhuChina
| | - Birong Zhou
- Department of CardiologyThe First Affiliated Hospital of Anhui Medical UniversityHefeiAnhui ProvinceChina
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87
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Bale BF, Doneen AL, Leimgruber PP, Vigerust DJ. The critical issue linking lipids and inflammation: Clinical utility of stopping oxidative stress. Front Cardiovasc Med 2022; 9:1042729. [PMID: 36439997 PMCID: PMC9682196 DOI: 10.3389/fcvm.2022.1042729] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 10/24/2022] [Indexed: 07/30/2023] Open
Abstract
The formation of an atheroma begins when lipoproteins become trapped in the intima. Entrapped lipoproteins become oxidized and activate the innate immune system. This immunity represents the primary association between lipids and inflammation. When the trapping continues, the link between lipids and inflammation becomes chronic and detrimental, resulting in atherosclerosis. When entrapment ceases, the association between lipids and inflammation is temporary and healthy, and the atherogenic process halts. Therefore, the link between lipids and inflammation depends upon lipoprotein retention in the intima. The entrapment is due to electrostatic forces uniting apolipoprotein B to polysaccharide chains on intimal proteoglycans. The genetic transformation of contractile smooth muscle cells in the media into migratory secretory smooth muscle cells produces the intimal proteoglycans. The protein, platelet-derived growth factor produced by activated platelets, is the primary stimulus for this genetic change. Oxidative stress is the main stimulus to activate platelets. Therefore, minimizing oxidative stress would significantly reduce the retention of lipoproteins. Less entrapment decreases the association between lipids and inflammation. More importantly, it would halt atherogenesis. This review will analyze oxidative stress as the critical link between lipids, inflammation, and the pathogenesis of atherosclerosis. Through this perspective, we will discuss stopping oxidative stress to disrupt a harmful association between lipids and inflammation. Numerous therapeutic options will be discussed to mitigate oxidative stress. This paper will add a new meaning to the Morse code distress signal SOS-stopping oxidative stress.
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Affiliation(s)
- Bradley Field Bale
- Department of Medical Education and Clinical Sciences, Washington State University College of Medicine, Spokane, WA, United States
| | - Amy Lynn Doneen
- Department of Medical Education and Clinical Sciences, Washington State University College of Medicine, Spokane, WA, United States
| | - Pierre P. Leimgruber
- Department of Medical Education and Clinical Sciences, Washington State University College of Medicine, Spokane, WA, United States
- Department of Medical Education and Clinical Sciences, University of Washington School of Medicine, Seattle, WA, United States
| | - David John Vigerust
- Department of Neurological Surgery, Vanderbilt University School of Medicine, Nashville, TN, United States
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88
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Chen J, Perera G, Shetty H, Broadbent M, Xu Y, Stewart R. Body mass index and mortality in patients with schizophrenia spectrum disorders: a cohort study in a South London catchment area. Gen Psychiatr 2022; 35:e100819. [PMID: 36447757 PMCID: PMC9639123 DOI: 10.1136/gpsych-2022-100819] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 09/30/2022] [Indexed: 11/06/2022] Open
Abstract
Background People with schizophrenia have a high premature mortality risk. Obesity is a key potential underlying risk factor that is relatively unevaluated to date. Aims In this study, we investigated the associations of routinely recorded body size with all-cause mortality and deaths from common causes in a large cohort of people with schizophrenia spectrum disorders. Methods We assembled a retrospective observational cohort using data from a large mental health service in South London. We followed all patients over the age of 18 years with a clinical diagnosis of schizophrenia spectrum disorders from the date of their first recorded body mass index (BMI) between 1 January 2007 and 31 March 2018. Results Of 11 900 patients with a BMI recording, 1566 died. The Cox proportional hazards regression models, after adjusting for sociodemographic, socioeconomic variables and comorbidities, indicated that all-cause mortality was only associated with underweight status compared with healthy weight status (hazard ratio (HR): 1.33, 95% confidence interval (CI): 1.01 to 1.76). Obesity (HR: 1.24, 95% CI: 1.01 to 1.52) and morbid obesity (HR: 1.54, 95% CI: 1.03 to 2.42) were associated with all-cause mortality in the 18-45 years age range, and obesity was associated with lower risk (HR: 0.66, 95% CI: 0.50 to 0.87) in those aged 65+ years. Cancer mortality was raised in underweight individuals (HR: 1.93, 95% CI: 1.03 to 4.10) and respiratory disease mortality raised in those with morbid obesity (HR: 2.17, 95% CI: 1.02 to 5.22). Conclusions Overall, being underweight was associated with higher mortality in this disorder group; however, this was potentially accounted for by frailty in older age groups, and obesity was a risk factor for premature mortality in younger ages. The impact of obesity on life expectancy for people with schizophrenia spectrum disorders is clear from our findings. A deeper biological understanding of the relationship between these diseases and schizophrenia will help improve clinical practice.
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Affiliation(s)
- Jianhua Chen
- Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Shanghai Clinical Research Center for Mental Health, Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Gayan Perera
- Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK
| | - Hitesh Shetty
- Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK
| | - Matthew Broadbent
- Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK
| | - Yifeng Xu
- Shanghai Clinical Research Center for Mental Health, Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Robert Stewart
- Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK
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89
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Controne I, Scoditti E, Buja A, Pacifico A, Kridin K, Fabbro MD, Garbarino S, Damiani G. Do Sleep Disorders and Western Diet Influence Psoriasis? A Scoping Review. Nutrients 2022; 14:nu14204324. [PMID: 36297008 PMCID: PMC9608488 DOI: 10.3390/nu14204324] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/11/2022] [Accepted: 10/13/2022] [Indexed: 11/07/2022] Open
Abstract
Western diet may trigger sleep disorders and vice versa, but their single and mutual effects on systemic inflammatory diseases (i.e., psoriasis) are far from being fully elucidated. At the same time, psoriatic patients display a great burden of sleep disorders and dysmetabolisms related to an unhealthy lifestyle (i.e., diet). These patients are also affected by a chronic disorder deeply modulated by environmental factors (i.e., sleep and diet) capable to influence drug-response and disease progression. Thus, we aimed to summarize the evidence in the literature that may highlight a potential link among psoriasis–diet–sleep in order to further promote a multidisciplinary approach to psoriatic patients in the scientific community.
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Affiliation(s)
- Ilaria Controne
- Clinical Dermatology, IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy
| | - Egeria Scoditti
- Institute of Clinical Physiology, National Research Council (CNR), 73100 Lecce, Italy
| | - Alessandra Buja
- Department of Cardiologic, Vascular and Thoracic Sciences, and Public Health, University of Padova, 35128 Padova, Italy
| | - Alessia Pacifico
- Clinical Dermatology Department, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
| | - Khalaf Kridin
- Lübeck Institute of Experimental Dermatology, University of Lübeck, 23562 Lübeck, Germany
| | - Massimo Del Fabbro
- Clinical Dermatology, IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy
- IRCCS Fondazione Ca’ Granda IRCCS Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Sergio Garbarino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Maternal/Child Sciences (DINOGMI), University of Genoa, 16132 Genoa, Italy
| | - Giovanni Damiani
- Clinical Dermatology, IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
- Correspondence: ; Tel.: +39-02-662141
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Distinct functional brain abnormalities in insomnia disorder and obstructive sleep apnea. Eur Arch Psychiatry Clin Neurosci 2022; 273:493-509. [PMID: 36094570 DOI: 10.1007/s00406-022-01485-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 08/29/2022] [Indexed: 11/03/2022]
Abstract
Insomnia disorder (ID) and obstructive sleep apnea (OSA) are the two most prevalent sleep disorders worldwide, but the pathological mechanism has not been fully understood. Functional neuroimaging findings indicated regional abnormal neural activities existed in both diseases, but the results were inconsistent. This meta-analysis aimed to explore concordant regional functional brain changes in ID and OSA, respectively. We conducted a coordinate-based meta-analysis (CBMA) of resting-state functional magnetic resonance imaging (rs-fMRI) studies using the anisotropic effect-size seed-based d mapping (AES-SDM) approach. Studies that applied regional homogeneity (ReHo), amplitude of low-frequency fluctuations (ALFF) or fractional ALFF (fALFF) to analyze regional spontaneous brain activities in ID or OSA were included. Meta-regressions were then applied to investigate potential associations between demographic variables and regional neural activity alterations. Significantly increased brain activities in the left superior temporal gyrus (STG.L) and right superior longitudinal fasciculus (SLF.R), as well as decreased brain activities in several right cerebral hemisphere areas were identified in ID patients. As for OSA patients, more distinct and complicated functional activation alterations were identified. Several neuroimaging alterations were functionally correlated with mean age, duration or illness severity in two patients groups revealed by meta-regressions. These functionally altered areas could be served as potential targets for non-invasive brain stimulation methods. This present meta-analysis distinguished distinct brain function changes in ID and OSA, improving our knowledge of the neuropathological mechanism of these two most common sleep disturbances, and also provided potential orientations for future clinical applications.Registration number: CRD42022301938.
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91
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Hasan R, Genta PR, Pinheiro GDL, Garcia ML, Scudeller PG, de Carvalho CRR, Lorenzi-Filho G. Validation of an overnight wireless high-resolution oximeter for the diagnosis of obstructive sleep apnea at home. Sci Rep 2022; 12:15136. [PMID: 36071120 PMCID: PMC9452585 DOI: 10.1038/s41598-022-17698-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 07/29/2022] [Indexed: 12/02/2022] Open
Abstract
Obstructive sleep apnea (OSA) is extremely common and has several consequences. However, most cases remain undiagnosed. One limitation is the lack of simple and validated methods for OSA diagnosis at home. The aim of this study was to validate a wireless high-resolution oximeter with a built-in accelerometer linked to a smartphone with automated cloud analysis (Biologix) that was compared with a home sleep test (HST, Apnea Link Air) performed on the same night. We recruited 670 patients out of a task force of 1013 patients with suspected OSA who were referred to our center for diagnosis. The final sample consisted of 478 patients (mean age: 56.7 ± 13.1 years, mean body mass index: 31.9 ± 6.3 kg/m2). To estimate the night-to-night OSA severity variability, 62 patients underwent HST for two consecutive nights. The HST-apnea–hypopnea index (AHI) and the Biologix-oxygen desaturation index (ODI) was 25.0 ± 25.0 events/h and 24.9 ± 26.5 events/h, respectively. The area under the curve—sensibility/specificity to detect at least mild (HST-AHI > 5), moderate-to-severe (HST-AHI > 15), and severe OSA (HST-AHI > 30) were (0.983)—94.7/92.8, (0.986)—94.8/93.9, and (0.990)—95.8/94.3, respectively. The limits of agreement originating from the Bland–Altman plot and the correlation between HST-AHI and Biologix-ODI were lower than the night-to-night HST-AHI variability (25.5 and 34.5 events/h, respectively, p = 0.001). We conclude that Biologix is a simple and reliable technique for OSA diagnosis at home.
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Affiliation(s)
- Rosa Hasan
- Laboratorio do Sono, LIM 63, Instituto de Psiquiatria (IPq), Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.,Laboratorio do Sono, LIM 63, Divisão de Pneumologia, Instituto do Coraçao, InCor, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo, Eneas de Carvalho Aguiar 44, 8º andar, Sao Paulo, SP, 05403-900, Brazil
| | - Pedro Rodrigues Genta
- Laboratorio do Sono, LIM 63, Divisão de Pneumologia, Instituto do Coraçao, InCor, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo, Eneas de Carvalho Aguiar 44, 8º andar, Sao Paulo, SP, 05403-900, Brazil
| | - George do Lago Pinheiro
- Laboratorio do Sono, LIM 63, Divisão de Pneumologia, Instituto do Coraçao, InCor, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo, Eneas de Carvalho Aguiar 44, 8º andar, Sao Paulo, SP, 05403-900, Brazil
| | - Michelle Louvaes Garcia
- Laboratorio do Sono, LIM 63, Divisão de Pneumologia, Instituto do Coraçao, InCor, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo, Eneas de Carvalho Aguiar 44, 8º andar, Sao Paulo, SP, 05403-900, Brazil
| | - Paula Gobi Scudeller
- Divisão de Pneumologia, Instituto do Coraçao, InCor, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | | | - Geraldo Lorenzi-Filho
- Laboratorio do Sono, LIM 63, Divisão de Pneumologia, Instituto do Coraçao, InCor, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo, Eneas de Carvalho Aguiar 44, 8º andar, Sao Paulo, SP, 05403-900, Brazil.
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Makarem N, Alcantara C, Musick S, Quesada O, Sears DD, Chen Z, Tehranifar P. Multidimensional Sleep Health Is Associated with Cardiovascular Disease Prevalence and Cardiometabolic Health in US Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191710749. [PMID: 36078471 PMCID: PMC9518578 DOI: 10.3390/ijerph191710749] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/22/2022] [Accepted: 08/23/2022] [Indexed: 06/01/2023]
Abstract
Individual sleep dimensions have been linked to cardiovascular disease (CVD) risk and cardiometabolic health (CMH), but sleep health is multifaceted. We investigated associations of a multidimensional sleep health (MDSH) score, enabling the assessment of sleep health gradients, with CVD and CMH. Participants were 4555 adults aged ≥20 years from the 2017-2018 National Health and Nutrition Examination Survey. A MDSH score, capturing poor, moderate, and ideal sleep was computed from self-reported sleep duration, sleep regularity, difficulty falling asleep, symptoms of sleep disorders, and daytime sleepiness. Survey-weighted multivariable linear and logistic models examined associations of MDSH with CVD and CMH. Ideal and moderate vs. poor MDSH were related to lower odds of hypertension (62% and 41%), obesity (73% and 56%), and central adiposity (68% and 55%), respectively; a statistically significant linear trend was observed across gradients of MDSH (p-trend < 0.001). Ideal vs. moderate/poor MDSH was associated with 32% and 40% lower odds of prevalent CVD and type 2 diabetes, respectively. More favorable MDSH was associated with lower blood pressure, BMI, waist circumference, and fasting glucose. In sex-stratified analyses, ideal vs. moderate/poor MDSH was associated with lower CVD odds and blood pressure in women only. The MDSH framework may be more than just the sum of its parts and could better capture information regarding CVD risk.
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Affiliation(s)
- Nour Makarem
- Department of Epidemiology, Mailman School of Public Heath, Columbia University Irving Medical Center, New York, NY 10032, USA
| | | | - Sydney Musick
- Department of Epidemiology, Mailman School of Public Heath, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Odayme Quesada
- Women’s Heart Center, The Christ Hospital Heart and Vascular Institute, Cincinnati, OH 45219, USA
| | - Dorothy D. Sears
- College of Health Solutions, Arizona State University, Phoenix, AZ 85004, USA
- Department of Medicine, University of California San Diego, San Diego, CA 92093, USA
- Center for Circadian Biology, University of California San Diego, San Diego, CA 92093, USA
| | - Ziyu Chen
- Department of Epidemiology, Mailman School of Public Heath, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Parisa Tehranifar
- Department of Epidemiology, Mailman School of Public Heath, Columbia University Irving Medical Center, New York, NY 10032, USA
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93
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Li K, Shu Y, Liu X, Xie W, Li P, Kong L, Yu P, Zeng Y, Huang L, Long T, Zeng L, Li H, Peng D. Dynamic regional homogeneity alterations and cognitive impairment in patients with moderate and severe obstructive sleep apnea. Front Neurosci 2022; 16:940721. [PMID: 36090274 PMCID: PMC9459312 DOI: 10.3389/fnins.2022.940721] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 08/03/2022] [Indexed: 11/13/2022] Open
Abstract
Background and purposePrevious studies have found that abnormal local spontaneous brain activity in patients with obstructive sleep apnea (OSA) was associated with cognitive impairment, and dynamic functional connections can capture the time changes of functional connections during magnetic resonance imaging acquisition. The purpose of this study was to investigate the dynamic characteristics of regional brain connectivity and its relationship with cognitive function in patients with OSA and to explore whether the dynamic changes can be used to distinguish them from healthy controls (HCs).MethodsSeventy-nine moderate and severe male OSA patients without any treatment and 84 HCs with similar age and education were recruited, and clinical data and resting functional magnetic resonance imaging data were collected. The dynamic regional homogeneity (dReHo) was calculated using a sliding window technique, and a double-sample t-test was used to test the difference in the dReHo map between OSA patients and HCs. We explored the relationship between dReHo and clinical and cognitive function in OSA patients using Pearson correlation analysis. A support vector machine was used to classify the OSA patients and HCs based on abnormal dReHo.ResultCompared with HCs, OSA patients exhibited higher dReHo values in the right medial frontal gyrus and significantly lower dReHo values in the right putamen, right superior temporal gyrus, right cingulate gyrus, left insula and left precuneus. The correlation analysis showed that the abnormal dReHo values in multiple brain regions in patients with OSA were significantly correlated with nadir oxygen saturation, the oxygen depletion index, sleep period time, and Montreal cognitive assessment score. The support vector machine classification accuracy based on the dReHo difference in brain regions was 81.60%, precision was 81.01%, sensitivity was 81.01%, specificity was 82.14%, and area under the curve was 0.89.ConclusionThe results of this study suggested that there was abnormal dynamic regional spontaneous brain activity in patients with OSA, which was related to clinical and cognitive evaluation and can be used to distinguish OSA patients from HCs. The dReHo is a potential objective neuroimaging marker for patients with OSA that can further the understanding of the neuropathological mechanism of patients with OSA.
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Affiliation(s)
- Kunyao Li
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yongqiang Shu
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xiang Liu
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Wei Xie
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Panmei Li
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Linghong Kong
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Pengfei Yu
- Science and Technology Division, Big Data Research Center, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yaping Zeng
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Ling Huang
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Ting Long
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Li Zeng
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Haijun Li
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
- PET Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
- Haijun Li,
| | - Dechang Peng
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
- PET Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
- *Correspondence: Dechang Peng,
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94
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Alsaif A, Aldilaijan K, Almasoud M, Jebakumar AZ. Knowledge and attitudes about obstructive sleep apnea among otorhinolaryngology trainee residents in Saudi Arabia: A survey-based cross-sectional study. MEDEDPUBLISH 2022; 12:58. [PMID: 37637180 PMCID: PMC10448149 DOI: 10.12688/mep.19245.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023] Open
Abstract
BACKGROUND Obstructive sleep apnea is a common disorder frequently encountered in otorhinolaryngology practice. This study was conducted to assess the knowledge and attitudes toward obstructive sleep apnea among otorhinolaryngology trainees in Saudi Arabia. Methods: This was a survey-based cross-sectional study. An online questionnaire was sent in July 2020 via email and WhatsApp instant messaging to all otorhinolaryngology trainee residents in Saudi Arabia. We utilized the previously validated obstructive sleep apnea knowledge and attitudes questionnaire (OSAKA). Results: 32.4% of all email recipients completed the questionnaire and met the inclusion criteria. 66.7% were males, thirty-two participants (53.3%) were at the junior level (R2-R3), and twenty-eight (46.7%) were at the senior level (R4-R5). The mean total knowledge score was 13.98/18. Senior residents had a higher mean total knowledge score than junior residents. Senior residents had a higher mean total attitude score than junior residents. Age, gender, residency program area, and years of previous otorhinolaryngology practice showed no significant differences in terms of knowledge levels and attitudes toward obstructive sleep apnea. Exposure to obstructive sleep apnea surgery and awareness of sleep disorders other than sleep apnea were found to be associated with an increased level of confidence in identifying patients at risk of obstructive sleep apnea and in the ability to manage them. Conclusions: This study describes the current condition of obstructive sleep apnea knowledge and attitudes among otorhinolaryngology residents in Saudi Arabia. Addressing studied elements may improve training outcomes.
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Affiliation(s)
- Abdulrahman Alsaif
- Department of Otorhinolaryngolgoy, King Abdulaziz Hospital, Alahsa, 31982, Saudi Arabia
| | - Khalid Aldilaijan
- Department of Otorhinolaryngology, King Fahd Military Medical Complex, Dhahran, 31932, Saudi Arabia
| | - Mai Almasoud
- Department of Otorhinolaryngology, King Fahd Military Medical Complex, Dhahran, 31932, Saudi Arabia
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95
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Vinnikov D, Krasotski V. Healthy worker survival effect at a high-altitude mine: prospective cohort observation. Sci Rep 2022; 12:13903. [PMID: 35974144 PMCID: PMC9381584 DOI: 10.1038/s41598-022-18331-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 08/09/2022] [Indexed: 11/12/2022] Open
Abstract
Very little is known about the factors of healthy worker survival effect at high-altitude mines. We conducted this cohort observation of the new hires for a high-altitude gold mine in Kyrgyzstan with the aim to ascertain predictors of survival at work. All new hires in 2009 through 2012 for a high-altitude gold mine (3600–4500 m above sea level) were followed up to January 2022. We tested the association of demographic, physiological predictors and diagnoses at the pre-employment screening with non-survival at work in Cox proportional hazards yielding hazard ratios (HR) with their 95% confidence intervals (CI). The cumulative observation time was 5190 person-years. Blood pressure at pre-employment, lung function, the diagnoses of essential hypertension, chronic obstructive pulmonary disease (COPD) or any other analyzed physiological variables were not associated with non-survival at work. However, smoking (HR 1.55; 95% CI 1.10; 2.17) increased the likelihood of non-survival at work, independent of any diagnosis or lowland residence (HR 1.95; 95% CI 1.31; 2.90). Adjusted for covariates and all diagnoses, having chronic rheumatic fever (HR 10.95; 95% CI 2.92; 33.92), hemorrhoids (HR 1.32; 95% CI 1.01; 3.75), adhesive otitis (HR 1.74; 95% CI 1.05; 2.89) or obesity (HR 1.71; 95% CI 1.01; 2.88) were associated with non-survival at work with time. This prospective observation of new hires for a high-altitude mining operation demonstrated that selected diagnoses, smoking and lowland residence elevated the risk of early exit in prospective workers.
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Affiliation(s)
- Denis Vinnikov
- al-Farabi Kazakh National University, 71 al-Farabi avenue, Almaty, 050040, Kazakhstan. .,Peoples' Friendship University of Russia (RUDN University), Moscow, Russian Federation.
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Sultana R, Sissoho F, Kaushik VP, Raji MA. The Case for Early Use of Glucagon-like Peptide-1 Receptor Agonists in Obstructive Sleep Apnea Patients with Comorbid Diabetes and Metabolic Syndrome. Life (Basel) 2022; 12:1222. [PMID: 36013401 PMCID: PMC9410036 DOI: 10.3390/life12081222] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 07/22/2022] [Accepted: 08/09/2022] [Indexed: 06/15/2023] Open
Abstract
Patients with obstructive sleep apnea (OSA) have high rates of co-occurring type 2 diabetes, hypertension, obesity, stroke, congestive heart failure, and accelerated atherosclerotic cardiovascular diseases. These conditions frequently require multiple medications, raising the risk of polypharmacy, adverse drug-drug and drug-disease interactions, decreased quality of life, and increased healthcare cost in these patients. The current review of extant literature presents evidence supporting glucagon-like peptide-1 receptor agonists (GLP-1RA) as one pharmacologic intervention that provides a "one-stop shop" for OSA patients because of the multiple effects GLP-1RA has on comorbidities (e.g., hypertension, diabetes, obesity, metabolic syndrome, and atherosclerotic cardiovascular diseases) that commonly co-occur with OSA. Examples of glucagon-like peptide-1 receptor agonists approved by the FDA for diabetes (some of which are also approved for obesity) are liraglutide, exenatide, lixisenatide, dulaglutide, semaglutide, and albiglutide. Prescribing of GLP-1RAs to address these multiple co-occurring conditions has enormous potential to reduce polypharmacy, cost, and adverse drug events, and to improve quality of life for patients living with OSA and diabetes. We thus strongly advocate for increased and early use of GLP-1RA in OSA patients with co-occurring diabetes and other cardiometabolic conditions common in OSA.
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Affiliation(s)
- Rizwana Sultana
- Division of Pulmonary Critical Care and Sleep Medicine, Department of Internal Medicine, University of Texas Medical Branch (UTMB), Galveston, TX 77555, USA
| | - Fatoumatta Sissoho
- Division of Geriatrics & Palliative Medicine, Department of Internal Medicine, University of Texas Medical Branch (UTMB), Galveston, TX 77555, USA
| | - Vinod P. Kaushik
- Division of Geriatrics & Palliative Medicine, Department of Internal Medicine, University of Texas Medical Branch (UTMB), Galveston, TX 77555, USA
| | - Mukaila A. Raji
- Division of Geriatrics & Palliative Medicine, Department of Internal Medicine, University of Texas Medical Branch (UTMB), Galveston, TX 77555, USA
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97
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Xu L, Gao H, Wang W. Joint detection of
miR
‐149‐3p and hepcidin predicts the onset of obstructive sleep apnea syndrome in obese patients. Laryngoscope Investig Otolaryngol 2022; 7:1643-1651. [PMID: 36258850 PMCID: PMC9575112 DOI: 10.1002/lio2.813] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 03/15/2022] [Accepted: 04/26/2022] [Indexed: 11/09/2022] Open
Abstract
Background Methods Results Conclusion
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Affiliation(s)
- Lina Xu
- Department of Respiratory Medicine Weifang People's Hospital Weifang Shandong China
| | - Haipeng Gao
- Department of Respiratory Medicine Weifang People's Hospital Weifang Shandong China
| | - Weizhen Wang
- Department of Respiratory Medicine Weifang People's Hospital Weifang Shandong China
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98
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Blood pressure and childhood obstructive sleep apnea: A systematic review and meta-analysis. Sleep Med Rev 2022; 65:101663. [DOI: 10.1016/j.smrv.2022.101663] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 05/20/2022] [Accepted: 06/07/2022] [Indexed: 12/26/2022]
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99
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Xu W, Yang YM, Zhu J, Wu S, Wang J, Zhang H, Shao XH, Mo R, Tan JS, Wang JY. Clinical characteristics and thrombotic risk of atrial fibrillation with obstructive sleep apnea: results from a multi-center atrial fibrillation registry study. BMC Cardiovasc Disord 2022; 22:331. [PMID: 35879670 PMCID: PMC9310481 DOI: 10.1186/s12872-022-02773-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 07/13/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sleep apnea is a risk factor for atrial fibrillation (AF) but it is underdiagnosed. Whether obstructive sleep apnea (OSA) is correlated with thrombotic risk in AF remains unclear. The aim of the present study was to analyze the clinical characteristics and assess the thrombotic risk of AF with OSA. METHODS In the present registry study,1990 consecutive patients with AF from 20 centers were enrolled. The patients were divided into 2 groups depending on whether they presented with both AF and OSA. All the patients were followed up for 1 year to evaluate the incidences of stroke and non-central nervous system (CNS) embolism. RESULTS Of the 1990 AF patients, 70 (3.5%) and 1920 (96.5%) patients were in the OSA group and non-OSA group, respectively. The results of the multivariate logistic model analysis showed that male sex, body mass index (BMI), smoking, and major bleeding history were independent risk factors for patients with AF and OSA. The comparison of the Kaplan-Meier curves using the log-rank test revealed that AF with OSA was correlated with an increased risk of non-CNS embolism (p < 0.01). After multivariate adjustments were performed, OSA remained an independent risk factor for non-CNS embolism (HR 5.42, 95% CI 1.34-22.01, p = 0.02), but was not correlated with the risk of stroke in patients with AF. CONCLUSIONS The present study revealed that male sex, high BMI values, smoking, and major bleeding history were independent risk factors for patients with AF and OSA. Moreover, OSA was an independent risk factor for non-CNS embolism in AF. Our results indicate that non-CNS embolism requires focus in patients with AF and OSA.
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Affiliation(s)
- Wei Xu
- Emergency Center, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xicheng District, 100037, Beijing, People's Republic of China
| | - Yan-Min Yang
- Emergency Center, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xicheng District, 100037, Beijing, People's Republic of China.
| | - Jun Zhu
- Emergency Center, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xicheng District, 100037, Beijing, People's Republic of China
| | - Shuang Wu
- Emergency Center, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xicheng District, 100037, Beijing, People's Republic of China
| | - Juan Wang
- Emergency Center, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xicheng District, 100037, Beijing, People's Republic of China
| | - Han Zhang
- Emergency Center, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xicheng District, 100037, Beijing, People's Republic of China
| | - Xing-Hui Shao
- Emergency Center, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xicheng District, 100037, Beijing, People's Republic of China
| | - Ran Mo
- Emergency Center, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xicheng District, 100037, Beijing, People's Republic of China
| | - Jiang-Shan Tan
- Emergency Center, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xicheng District, 100037, Beijing, People's Republic of China
| | - Jing-Yang Wang
- Emergency Center, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xicheng District, 100037, Beijing, People's Republic of China
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100
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Duarte RLDM, Togeiro SMGP, Palombini LDO, Rizzatti FPG, Fagondes SC, Magalhães-da-Silveira FJ, Cabral MM, Genta PR, Lorenzi-Filho G, Clímaco DCS, Drager LF, Codeço VM, Viegas CADA, Rabahi MF. Brazilian Thoracic Association Consensus on Sleep-disordered Breathing. JORNAL BRASILEIRO DE PNEUMOLOGIA : PUBLICACAO OFICIAL DA SOCIEDADE BRASILEIRA DE PNEUMOLOGIA E TISILOGIA 2022; 48:e20220106. [PMID: 35830079 PMCID: PMC9262434 DOI: 10.36416/1806-3756/e20220106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 05/23/2022] [Indexed: 12/02/2022]
Abstract
Sleep is essential for the proper functioning of all individuals. Sleep-disordered breathing can occur at any age and is a common reason for medical visits. The objective of this consensus is to update knowledge about the main causes of sleep-disordered breathing in adult and pediatric populations, with an emphasis on obstructive sleep apnea. Obstructive sleep apnea is an extremely prevalent but often underdiagnosed disease. It is often accompanied by comorbidities, notably cardiovascular, metabolic, and neurocognitive disorders, which have a significant impact on quality of life and mortality rates. Therefore, to create this consensus, the Sleep-Disordered Breathing Department of the Brazilian Thoracic Association brought together 14 experts with recognized, proven experience in sleep-disordered breathing.
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Affiliation(s)
| | - Sonia Maria Guimarães Pereira Togeiro
- . Disciplina de Clínica Médica, Escola Paulista de Medicina - EPM - Universidade Federal de São Paulo - UNIFESP - São Paulo (SP) Brasil.,. Instituto do Sono, São Paulo (SP) Brasil
| | | | | | - Simone Chaves Fagondes
- . Serviço de Pneumologia, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul - UFRGS - Porto Alegre (RS) Brasil
| | | | | | - Pedro Rodrigues Genta
- . Laboratório de Investigação Médica 63 - LIM 63 (Laboratório do Sono) - Divisão de Pneumologia, Instituto do Coração - InCor - Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo - HCFMUSP - São Paulo (SP) Brasil
| | - Geraldo Lorenzi-Filho
- . Laboratório de Investigação Médica 63 - LIM 63 (Laboratório do Sono) - Divisão de Pneumologia, Instituto do Coração - InCor - Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo - HCFMUSP - São Paulo (SP) Brasil
| | | | - Luciano Ferreira Drager
- . Unidade de Hipertensão, Instituto do Coração - InCor - Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo - HCFMUSP - São Paulo (SP) Brasil
| | - Vitor Martins Codeço
- . Hospital Regional da Asa Norte, Secretaria de Estado de Saúde do Distrito Federal, Brasília (DF) Brasil
| | | | - Marcelo Fouad Rabahi
- . Faculdade de Medicina, Universidade Federal de Goiás - UFG - Goiânia (GO) Brasil
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