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Liu L, Wang W, Gao N, Jia T, Guo L, Geng L, Ma Y. Risk factors of disturbed sleep phases to posterior circulation cerebral infarctions: A single-center retrospective study. Medicine (Baltimore) 2023; 102:e35479. [PMID: 37832098 PMCID: PMC10578694 DOI: 10.1097/md.0000000000035479] [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: 03/22/2023] [Accepted: 09/13/2023] [Indexed: 10/15/2023] Open
Abstract
Posterior circulation stroke differs from anterior circulation stroke in terms of etiological, clinical, and prognostic properties. Sleep architecture is impaired in patients with acute stroke, which may correlate with disease severity and outcome, and the correlation between the location of cerebral infarction (CI) and sleep phase disturbance remains unknown. This study aimed to assess the correlation between disturbed sleep phases in CI and posterior circulation cerebral infarction (PCCI). We retrospectively enrolled 192 patients with first-onset acute CI, who were assigned to the anterior circulation cerebral infarction (n = 101) and PCCI (n = 91) groups. The polysomnograms in both groups were analyzed by phase. The proportions of sleep phases were significantly different between the 2 groups (P < .05). The awake (W) and non-rapid eye movement 3 (N3) phases were independently associated with PCCI in multivariate analysis. The W phase may be a risk factor for PCCI (odds ratio = 1.60, 95% CI 1.30-1.97), while the N3 phase may be a protective factor for PCCI (odds ratio = 0.498, 95% CI 0.353-0.703). This study demonstrated that CI causes different degrees of sleep phase disturbances, and the percentages of W and N3 phase disturbances were independent factors associated with PCCI. The former was a risk factor, whereas the latter was a protective factor. This study demonstrated the correlation between cerebral infarction and sleep phase disturbances from a new perspective and suggested that cerebral infarcts may alter the structure of sleep.
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Affiliation(s)
- Lu Liu
- Department of Neurology, Baoding No.1 Central Hospital, Baoding, Hebei, China
| | - Weiping Wang
- Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Nan Gao
- Department of Cardiology, Baoding No.1 Central Hospital, Baoding, Hebei, China
| | - Tongle Jia
- Department of Neurology, Baoding No.1 Central Hospital, Baoding, Hebei, China
| | - Li Guo
- Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Liying Geng
- Department of Neurology, Baoding No.1 Central Hospital, Baoding, Hebei, China
| | - Yaning Ma
- Department of Neurology, Baoding No.1 Central Hospital, Baoding, Hebei, China
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Qanash S, Mufti H, Alhejaili F, Al-Husayni F, Bukhari G, Bazhair S, Alansari G, Aldeibani A, Balkhi D, Alhjrsy Y, Albadani S, Alamoudi M, Wali S. The prevalence of rapid eye movement-related obstructive sleep apnea in a sample of Saudi population. Ann Thorac Med 2023; 18:90-97. [PMID: 37323370 PMCID: PMC10263078 DOI: 10.4103/atm.atm_388_22] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 11/30/2022] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND This study aimed to estimate the prevalence of rapid eye movement-related obstructive sleep apnea (REMrOSA) using common definitions. METHODS This was a retrospective cohort study that used three sets of criteria to identify patients with REMrOSA. These criteria were defined as strict, intermediate, and lenient depending on the apnea-hypopnea index (AHI), AHI during REM sleep/(AHI during non-REM sleep [NREM-AHI]), NREM-AHI and REM duration. RESULTS The study included 609 patients with OSA and full sleep study. The prevalence of REMrOSA was 26%, 33%, and 52% using the strict, intermediate, and lenient criteria, respectively. There were no differences in the patients' general and demographic characteristics between the different groups of the three definitions. REMrOSA patients were more likely to be younger females than non-REMrOSA (NREMrOSA) patients. Comorbidities were more frequent in the REMrOSA group compared to NREMrOSA when using strict and intermediate definitions. In contrast, AHI, mean O2 saturation, and time spent <90% O2 saturation were significantly worse during NREMrOSA compared to REMrOSA, regardless of the criteria used. Our study reported higher AHI, lower mean oxygen saturation, lower minimum oxygen saturation, and longer time of desaturation during REMrOSA when lenient definition was used compared to when strict and intermediate definitions were used. CONCLUSIONS REMrOSA is a common condition with a prevalence ranging between 26% and 52% depending on what definition is applied. Although OSA tends to be more severe with lenient definition, however, the clinical and polysomnographic features were similar among REMrOSA groups regardless of the definition used.
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Affiliation(s)
- Sultan Qanash
- Department of Internal Medicine, National Guard Hospital, King Abdulaziz Medical City, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
- Department of Medicine, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Hani Mufti
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
- Department of Medicine, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- Department of Cardiac Sciences, Division of Cardiac Surgery, King Faisal Cardiac Center, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia
| | - Faris Alhejaili
- Department of Internal Medicine, Sleep Medicine and Research Center, Sleep Medicine Research Group, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Faisal Al-Husayni
- Department of Internal Medicine, National Guard Hospital, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Ghufran Bukhari
- Department of Internal Medicine, National Guard Hospital, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Shatha Bazhair
- Department of Respiratory, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Ghadi Alansari
- Department of Respiratory, International Medical Center, Jeddah, Saudi Arabia
| | - Alaa Aldeibani
- Department of Medicine, College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Dimah Balkhi
- Department of Respiratory, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Yara Alhjrsy
- Department of Medicine, College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Shahad Albadani
- Department of Respiratory, King Abdullah Medical City, Jeddah, Saudi Arabia
| | - Malak Alamoudi
- Department of Medicine, College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Siraj Wali
- Department of Internal Medicine, Sleep Medicine and Research Center, Sleep Medicine Research Group, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
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Sattaratpaijit N, Kulalert P, Wongpradit W. Characteristics of rapid eye movement-related obstructive sleep apnea in Thai patients. Sci Rep 2022; 12:11360. [PMID: 35790775 PMCID: PMC9256692 DOI: 10.1038/s41598-022-13382-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 05/24/2022] [Indexed: 11/18/2022] Open
Abstract
Obstructive sleep apnea (OSA) is a common sleep disorder that has been associated with cardiovascular consequences. Rapid eye movement (REM)-related obstructive sleep apnea (OSA) is a subtype of OSA which is characterized by apneas or hypopneas predominately during REM sleep. The factors associated with REM-related OSA are still unclear. We aimed to determine the prevalence and associated characteristics of REM-related OSA in Thai patients. A total of 408 patients’ charts were retrospectively reviewed. Demographic and anthropometric characteristics, comorbidities and polysomnographic data were obtained. The patients were divided into two groups: REM-related OSA and non-stage specific OSA. REM-related OSA was defined as an apnea–hypopnea index (AHI) ≥ 5 per hour, with a ratio of REM-AHI to NREM-AHI > 2, and NREM-AHI < 15 per hour. The prevalence of REM-related OSA was 21.6%. AHI and arousal index were both lower in REM-related OSA than in non-stage specific OSA. REM-related OSA was significantly associated with females (OR 2.35, 95% CI 1.25–4.42, p = 0.008), age < 60 years (OR 2.52, 95% CI 1.15–5.55, p = 0.021), and mild OSA (OR 17.46, 95% CI 9.28–32.84, p < 0.001). In conclusion, age < 60 years, female gender, and mild severity of OSA were associated with REM-related OSA.
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Affiliation(s)
- Nithita Sattaratpaijit
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Thammasat University, 99/209 Paholyotin Road, Khlong Luang, Pathum Thani, Thailand, 12120
| | - Prapasri Kulalert
- Department of Clinical Epidemiology, Faculty of Medicine, Thammasat University, 99/209 Paholyotin Road, Khlong Luang, Pathum Thani, Thailand, 12120.,Center of Excellence in Applied Epidemiology, Thammasat University, 99/209 Paholyotin Road, Khlong Luang, Pathum Thani, Thailand, 12120
| | - Wadee Wongpradit
- Department of Community Medicine and Family Medicine, Faculty of Medicine, Thammasat University, 99/209 Paholyotin Road, Khlong Luang, Pathum Thani, Thailand, 12120.
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Romero D, Jane R. Relationship between Sleep Stages and HRV response in Obstructive Sleep Apnea Patients. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2021; 2021:5535-5538. [PMID: 34892378 DOI: 10.1109/embc46164.2021.9630148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Patients suffering from obstructive sleep apnea (OSA) usually present an increased sympathetic activity caused by the intermittent hypoxia effect on autonomic control. This study evaluated the relationship between sleep stages and the apnea duration, frequency, and type, as well as their impact on HRV markers in different groups of disease severity. The hypnogram and R-R interval signals were extracted in 81 OSA patients from night polysomnographic (PSG) recordings. The apnea-hypopnea index (AHI) defined patient classification as mild-moderate (AHI<=30, n=44) or severe (AHI>30, n=37). The normalized power in VLH, LF, and HF bands of RR series were estimated by a time-frequency approach and averaged in 1-min epochs of normal and apnea segments. The autonomic response and the impact of sleep stages were assessed in both segments to compare patient groups. Deeper sleep stages (particularly S2) concentrated the shorter and mild apnea episodes (from 10 to 40 s) compared to light (SWS) and REM sleep. Longer episodes (>50 s) although less frequent, were of similar incidence in all stages. This pattern was more pronounced for the group of severe patients. Moreover, during apnea segments, LFnu was higher (p=0.044) for the severe group, since V LFnu and HFnu presented the greatest changes when compared to normal segments. The non-REM sleep seems to better differentiate OSA patients groups, particularly through VLFnu and HFnu(p<0.001). A significant difference in both sympathetic and vagal modulation between REM and non-REM sleep was only found within the severe group. These results confirm the importance of considering sleep stages for HRV analysis to further assess OSA disease severity, beyond the traditional and clinically limited AHI values.Clinical relevance-Accounting for sleep stages during HRV analysis could better assess disease severity in OSA patients.
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Chen Q, Fu X, Wang XH, Chen J, Huang JY, Mao CJ, Zhai WQ, Li J, Liu CF. Effect of Sleep-Disordered Breathing During Rapid Eye Movement Sleep and Non-Rapid Eye Movement sleep on Acute Ischemic Stroke. J Stroke Cerebrovasc Dis 2021; 30:105913. [PMID: 34130104 DOI: 10.1016/j.jstrokecerebrovasdis.2021.105913] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 05/13/2021] [Accepted: 05/23/2021] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Sleep-disordered breathing adversely impacts stroke outcomes. We investigated whether sleep-disordered breathing during rapid eye movement sleep and non-rapid eye movement sleep differentially influenced stroke outcomes. MATERIALS AND METHODS Acute ischemic stroke patients who finished polysomnography within 14 days of stroke onset from April 2010 to August 2018 were reviewed. Patients were divided into four groups according to apnea-hypopnea index during rapid eye movement sleep and non-rapid eye movement sleep. The modified Rankin Scale was used to evaluate short-term outcome. During January and April 2019, another follow-up was performed for long-term outcomes, including stroke-specific quality-of-life scale, modified Rankin Scale, stroke recurrence and death. RESULTS Of 140 patients reviewed, 109 were finally recruited. Although patients with sleep-disordered breathing during non-rapid eye movement sleep only and with sleep-disordered breathing during both rapid eye movement sleep and non-rapid eye movement sleep had higher apnea-hypopnea indices and more disrupted sleep structures, short-term and long-term outcomes did not significantly different between four groups. In Logistic regression analysis, apnea-hypopnea index (p = 0.013, OR 1.023, 95%CI 1.005-1.042) was found independently associated with short-term outcome. Rapid eye movement sleep latency (p = 0.045, OR 0.994, 95%CI 0.987-1.000) was found independently associated with quality of life. Apnea-hypopnea indices during rapid eye movement sleep or non-rapid eye movement sleep were not significantly associated with short-term or long-term outcomes. CONCLUSIONS Apnea-hypopnea index is an independent risk factor of short-term outcome of acute ischemic stroke while sleep-disordered breathing during rapid eye movement sleep and non-rapid eye movement sleep do not affect stroke outcomes differently.
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Affiliation(s)
- Qin Chen
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - Xiang Fu
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - Xian-Hui Wang
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China; Department of Neurology, Taicang Affiliated Hospital of Soochow University, The first People's Hospital of Taicang, Taicang 215400, China
| | - Jing Chen
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - Jun-Ying Huang
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - Cheng-Jie Mao
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - Wan-Qing Zhai
- Department of Neurology, Taicang Affiliated Hospital of Soochow University, The first People's Hospital of Taicang, Taicang 215400, China
| | - Jie Li
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China; Department of Neurology, Taicang Affiliated Hospital of Soochow University, The first People's Hospital of Taicang, Taicang 215400, China.
| | - Chun-Feng Liu
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China; Department of Neurology, Taicang Affiliated Hospital of Soochow University, The first People's Hospital of Taicang, Taicang 215400, China; Jiangsu Key Laboratory of Neuropsychiatric Diseases and Institute of Neuroscience, Soochow University, Suzhou 215123, China.
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6
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Gabryelska A, Białasiewicz P. Association between excessive daytime sleepiness, REM phenotype and severity of obstructive sleep apnea. Sci Rep 2020; 10:34. [PMID: 31913307 PMCID: PMC6949253 DOI: 10.1038/s41598-019-56478-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 12/12/2019] [Indexed: 01/15/2023] Open
Abstract
The aim of the study was to compare REM-dependent and REM-independent, obstructive sleep apnea syndrome (OSA) patients in relation to their daily sleepiness assessed by Epworth sleepiness scale (ESS). The study included 1863 consecutive patients, who were referred to a sleep centre with a presumed diagnosis of OSA. Following polysomnography, 292 patients fulfilled criteria for either REM-dependent OSA (REM-OSA, n = 102) or REM-independent OSA (nREM-OSA, n = 190). Both study groups were matched regarding sex and age. REM-OSA group had two times lower median apnoea-hypopnea index (AHI) compared to nREM-OSA (p < 0.001), yet day-time sleepiness measured by ESS was similar: median score 9.0 (6.0–11.0) and 8.0 (4.8–11.0), p = 0.109, respectively. Subsequent post-hoc ANCOVA analysis, with covariates (BMI, percent of total sleep time spent in REM stage, percent of total sleep time spent in the supine position), has shown statistically significant difference between study groups regarding AHI (p < 0.001) and no difference regarding ESS score (p = 0.063). Despite two times lower AHI, patients with REM-OSA present with similar day-time sleepiness as those with REM independent OSA. Daily sleepiness may be stronger associated with apneas/hypopneas occurring in REM than nREM sleep.
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Affiliation(s)
- Agata Gabryelska
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, Mazowiecka 6/8, 92-215, Lodz, Poland.
| | - Piotr Białasiewicz
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, Mazowiecka 6/8, 92-215, Lodz, Poland
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Leppänen T, Kulkas A, Oksenberg A, Duce B, Mervaala E, Töyräs J. Differences in arousal probability and duration after apnea and hypopnea events in adult obstructive sleep apnea patients. Physiol Meas 2018; 39:114004. [DOI: 10.1088/1361-6579/aae42c] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Uzer F, Toptas AB, Okur U, Bozkurt S, Dogrul E, Turhan M, Cilli A. Comparison of positional and rapid eye movement-dependent sleep apnea syndromes. Ann Thorac Med 2018; 13:42-47. [PMID: 29387255 PMCID: PMC5772107 DOI: 10.4103/atm.atm_184_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AIM We aimed to compare the clinical, epidemiological, and polysomnographic features of rapid eye movement (REM)-dependent obstructive sleep apnea syndrome (OSAS) and positional OSAS which are two separate clinical entities. METHODS Between January 2014 and December 2015, at the Akdeniz University Medical Faculty Hospital, patients who were diagnosed REM-dependent and positional OSAS with polysomnography were retrospectively studied. RESULTS In this study, 1727 patients were screened consecutively. Five hundred and eighty-four patients were included in the study. Of the patients, 24.6% (140) were diagnosed with REM-dependent OSAS and 75.4% (444) were diagnosed as positional OSAS. Female predominance was found in REM-dependent OSAS (P < 0.001). The mean total apnea-hypopnea index (AHI), non-REM AHI, and supine AHI in REM-dependent OSAS were 14.73, 9.24, and 17.73, respectively, and these values were significantly lower when compared with positional OSAS (P < 0.001). Patients diagnosed with REM-dependent OSAS had a statistically significant tendency to be overweight (P < 0.001). For REM-dependent OSAS, total pulse rate, supine pulse rate, and REM pulse rate were statistically higher than positional OSAS (P < 0.001). CONCLUSION Positional OSAS is a clinical entity that is more common than REM-dependent OSAS. OSAS severity is higher in positional OSAS than REM-dependent OSAS. REM-dependent OSAS is observed more commonly in women.
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Affiliation(s)
- Fatih Uzer
- Department of Respiratory Medicine, Kastamonu State Hospital, Kastamonu, Turkey
| | - Asli Bostancı Toptas
- Department of Otolaryngology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Ummuhan Okur
- Department of Sleep Laboratory, Akdeniz University School of Medicine, Antalya, Turkey
| | - Selen Bozkurt
- Department of Biostatistics and Medicine Informatics, Akdeniz University School of Medicine, Antalya, Turkey
| | - Ebru Dogrul
- Department of Sleep Laboratory, Akdeniz University School of Medicine, Antalya, Turkey
| | - Murat Turhan
- Department of Otolaryngology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Aykut Cilli
- Department of Respiratory Medicine, Akdeniz University School of Medicine, Antalya, Turkey
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Kurosawa H, Saisho Y, Fukunaga K, Haraguchi M, Yamasawa W, Kurihara I, Betsuyaku T, Itoh H. Association between severity of obstructive sleep apnea and glycated hemoglobin level in Japanese individuals with and without diabetes. Endocr J 2018; 65:121-127. [PMID: 28931780 DOI: 10.1507/endocrj.ej17-0356] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim of this study was to examine the association between the severity of obstructive sleep apnea (OSA) and dysglycemia in Japanese individuals with and without type 2 diabetes (T2DM). We enrolled 115 individuals diagnosed with OSA with an apnea hypopnea-index (AHI) ≥ 20 in whom continuous positive airway pressure (CPAP) therapy was introduced (N = 115, 44 with T2DM, age 62 ± 11 years, BMI 27.0 ± 4.4 kg/m2 and AHI median 36.1; interquartile range 27.2-48.1). During admission, the severity of OSA was evaluated by polysomnography, and its association with glycated hemoglobin (HbA1c) level was examined. Continuous glucose monitoring (CGM) was also conducted during the admission in 94 individuals. Apnea-hypopnea index (AHI), non-rapid eye movement (REM) AHI, minimum peripheral capillary oxygen saturation (SpO2) and percentage of sleep time (%TST) with SpO2 < 90% were significantly associated with HbA1c level in total and non-diabetic individuals (all p < 0.05) but not in those with T2DM, the majority of whom were treated with anti-diabetic medications. The associations of the non-REM AHI and %TST with SpO2 < 90% with HbA1c level remained significant after adjustment for age, sex and BMI in non-diabetic and T2DM subjects treated with dietary therapy only. Mean glucose level, but not SD or coefficient of variation of glucose, assessed by CGM was significantly associated with AHI and non-REM AHI in non-diabetic subjects after adjustment for age, sex and BMI. In conclusion, the severity of OSA was associated with increased HbA1c level independently of BMI in Japanese individuals, especially in those without diabetes.
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MESH Headings
- Aged
- Blood Glucose/analysis
- Body Mass Index
- Combined Modality Therapy
- Cross-Sectional Studies
- Diabetes Mellitus, Type 2/complications
- Diabetes Mellitus, Type 2/drug therapy
- Diabetes Mellitus, Type 2/ethnology
- Diabetes Mellitus, Type 2/therapy
- Diet, Diabetic
- Female
- Glycated Hemoglobin/analysis
- Healthy Lifestyle
- Humans
- Hyperglycemia/prevention & control
- Hypoglycemia/prevention & control
- Hypoglycemic Agents/therapeutic use
- Japan
- Male
- Middle Aged
- Monitoring, Ambulatory
- Overweight/complications
- Overweight/ethnology
- Polysomnography
- Severity of Illness Index
- Sleep Apnea, Obstructive/blood
- Sleep Apnea, Obstructive/complications
- Sleep Apnea, Obstructive/ethnology
- Sleep Apnea, Obstructive/physiopathology
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Affiliation(s)
- Hideaki Kurosawa
- Division of Nephrology, Endocrinology and Metabolism, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Yoshifumi Saisho
- Division of Nephrology, Endocrinology and Metabolism, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Koichi Fukunaga
- Division of Respiratory Medicine, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Mizuha Haraguchi
- Division of Respiratory Medicine, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Wakako Yamasawa
- Division of Respiratory Medicine, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Isao Kurihara
- Division of Nephrology, Endocrinology and Metabolism, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Tomoko Betsuyaku
- Division of Respiratory Medicine, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Hiroshi Itoh
- Division of Nephrology, Endocrinology and Metabolism, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
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Liu C, Chen MS, Yu H. The relationship between obstructive sleep apnea and obesity hypoventilation syndrome: a systematic review and meta-analysis. Oncotarget 2017; 8:93168-93178. [PMID: 29190986 PMCID: PMC5696252 DOI: 10.18632/oncotarget.21450] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 09/12/2017] [Indexed: 01/22/2023] Open
Abstract
Obstructive Sleep Apnea and Obesity Hypoventilation Syndrome are two similar diseases. Obstructive Sleep Apnea has been receiving more and more attention while the diagnostic rate of Obesity Hypoventilation Syndrome is not high. Few studies directly evaluated the relationship between them. We systematically analyzed the relevance of the two diseases. MEDLINE®, EMBASE® and the Cochrane Library were carried out to find studies until May 2017. Pooled mean difference and 95% confidence interval were calculated to evaluate the value of clinical and physiologic variables in the prediction of Obesity Hypoventilation Syndrome. 9 Studies (n = 2085) fulfilled the predefined selection criteria. Totally 575 patients (28%) with Obesity Hypoventilation Syndrome were diagnosed from 2085 Obstructive Sleep Apnea patients. Among clearly diagnosed Obstructive Sleep Apnea patients, higher Body Mass Index levels(mean difference:4.72 kg/m2; 95% confidence interval: 4.26 to 5.17; p < 0.00001), higher Apnea-Hypopnea Index (mean difference: 8.36; 95% confidence interval: −3.88 to −2.84; p < 0.00001), greater neck circumference (mean difference:1.01; 95% confidence interval: 0.10 to 1.92; p = 0.03) and lower percent predicted FEV1 (mean difference:−10.28; 95% confidence interval:−11.33 to −9.22; p < 0.00001)were associated with the occurrence with obesity hypoventilation syndrome. We should be highly skeptical of obesity hypoventilation syndrome in Obstructive Sleep Apnea patients with these factors as early identification and appropriate treatment can improve prognosis.
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Affiliation(s)
- Chaoling Liu
- Respiratory Department, Guangdong Provincial Hospital of Chinese Medicine & the 2nd Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
| | - Mao-Sheng Chen
- Division of Chest Pain Center, Guangdong Provincial Hospital of Chinese Medicine & the 2nd Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
| | - Hui Yu
- Respiratory Department, Guangdong Provincial Hospital of Chinese Medicine & the 2nd Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
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Fastenberg JH, Fang CH, Patel VM, Lin J, Stupak HD. The use of handheld nasal spirometry to predict the presence of obstructive sleep apnea. Sleep Breath 2017; 22:79-84. [DOI: 10.1007/s11325-017-1531-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2017] [Revised: 03/29/2017] [Accepted: 06/21/2017] [Indexed: 10/19/2022]
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Genta PR. The JBP and sleep medicine. J Bras Pneumol 2017; 42:401. [PMID: 28117466 PMCID: PMC5344085 DOI: 10.1590/s1806-37562016000600001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Pedro Rodrigues Genta
- . Laboratório do Sono, Disciplina de Pneumologia, Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil
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