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Balthazar FM, Moraes WADS, Hunter JR, Prado GFD, Carvalho LBCD. Interaction between apolipoprotein E genotypes, excessive daytime sleepiness, and cognitive function in obstructive sleep apnea patients. ARQUIVOS DE NEURO-PSIQUIATRIA 2022; 80:1104-1111. [PMID: 36577409 PMCID: PMC9797275 DOI: 10.1055/s-0042-1758399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 09/14/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Some studies show an association between the apolipoprotein E ε4 allele (ApoEε4) and obstructive sleep apnea syndrome (OSAS), and other studies, an association between ApoEε4 and excessive daytime sleepiness (EDS), but there are no data in the literature on the interaction between EDS, cognitive function, and ApoEε4 in patients with OSA. OBJECTIVE To examine the cognitive function of adults with and without EDS and with and without ApoEε4. METHODS A total of 21 male and female patients aged between 33 and 79 years, underwent a clinical interview, ApoE genotyping, neuropsychological evaluation, polysomnography, and the application of the Epworth Sleepiness Scale. RESULTS Excessive daytime sleepiness was associated with lower intelligence quotient (IQ; total performance) and worse immediate visual memory, regardless of the ApoE genotype. Patients carrying the ApoEε3/ε4 genotype had a worse performance in divided attention, constructional praxis, perceptual organization, and cognitive flexibility. A combination of the ε4 allele and EDS potentiates the negative effect on cognition, except for immediate visual memory. In this case, patients had a worse performance in terms of processing speed, selective attention, and visuomotor coordination. CONCLUSIONS Excessive daytime sleepiness and the ApoEε3/ε4 genotype are associated with worse cognitive performance in OSA patients. The combination of EDS and ε4 allele potentiates cognitive impairment.
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Affiliation(s)
- Fernanda Maurer Balthazar
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Neurologia e Neurocirurgia, Setor Neuro-Sono, Disciplina de Neurologia, São Paulo SP, Brazil.
| | - Walter André dos Santos Moraes
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Neurologia e Neurocirurgia, Setor Neuro-Sono, Disciplina de Neurologia, São Paulo SP, Brazil.
| | - James Richard Hunter
- Universidade Federal de São Paulo, Departamento de Medicina, Disciplina de Infectologia, São Paulo SP, Brazil.
| | - Gilmar Fernandes do Prado
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Neurologia e Neurocirurgia, Setor Neuro-Sono, Disciplina de Neurologia, São Paulo SP, Brazil.
| | - Luciane Bizari Coin de Carvalho
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Neurologia e Neurocirurgia, Setor Neuro-Sono, Disciplina de Neurologia, São Paulo SP, Brazil.
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Mirawati DK, Sari ND, Hutabarat EAJ, Hambarsari Y, Prabaningtyas HR, Budianto P, Hafizhan M, Putra SE. Correlating excessive daytime sleepiness with body mass index, waist circumference, and lipid profile in shift workers. Saudi Med J 2022; 43:1234-1239. [PMID: 36379541 PMCID: PMC10043919 DOI: 10.15537/smj.2022.43.11.20220529] [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: 07/12/2022] [Accepted: 10/05/2022] [Indexed: 06/16/2023] Open
Abstract
OBJECTIVES To determine the correlation between excessive daytime sleepiness and body mass index, waist circumference, and lipid profile of shift workers at Dr. Moewardi General Hospital, Surakarta. METHODS This cross-sectional study was carried out at the Dr. Moewardi Hospital, Surakarta, Indonesia between October 2018 and July 2019. The participants were recruited using purposive sampling. Multiple linear regression with backward elimination was performed to identify the odds ratios between Epworth Sleepiness Scale scores, anthropometric measurements, and lipid profiles. A p-value of <0.05 indicated statistically significant correlations. RESULTS Of the 150 included participants, 127 (84.67%) were women. Statistical analyses revealed odds ratios of 2.38 (95% confidence interval [CI] 1.14-4.89, p=0.000) for daytime sleepiness severity and total cholesterol levels, and 2.45 (95% CI 1.36-4.98, p=0.020) for daytime sleepiness severity and high-density lipoprotein levels. CONCLUSION Increased total cholesterol and decreased high-density lipoprotein levels increase the risk of excessive daytime sleepiness in shift workers.
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Affiliation(s)
- Diah Kurnia Mirawati
- From the Department of Neurology, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Central Java, Indonesia.
| | - Naomi Ditya Sari
- From the Department of Neurology, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Central Java, Indonesia.
| | - Ervina Arta Jayanti Hutabarat
- From the Department of Neurology, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Central Java, Indonesia.
| | - Yetty Hambarsari
- From the Department of Neurology, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Central Java, Indonesia.
| | - Hanindia Riani Prabaningtyas
- From the Department of Neurology, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Central Java, Indonesia.
| | - Pepi Budianto
- From the Department of Neurology, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Central Java, Indonesia.
| | - Muhammad Hafizhan
- From the Department of Neurology, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Central Java, Indonesia.
| | - Stefanus Erdana Putra
- From the Department of Neurology, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Central Java, Indonesia.
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Liu L, Su X, Zhao Z, Han J, Li J, Xu W, He Z, Gao Y, Chen K, Zhao L, Gao Y, Wang H, Guo J, Lin J, Li T, Fang X. Association of Metabolic Syndrome With Long-Term Cardiovascular Risks and All-Cause Mortality in Elderly Patients With Obstructive Sleep Apnea. Front Cardiovasc Med 2022; 8:813280. [PMID: 35198606 PMCID: PMC8859338 DOI: 10.3389/fcvm.2021.813280] [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: 11/11/2021] [Accepted: 12/30/2021] [Indexed: 12/11/2022] Open
Abstract
Background Evidence suggests that an increased risk of major adverse cardiac events (MACE) and all-cause mortality is associated with obstructive sleep apnea (OSA), particularly in the elderly. Metabolic syndrome (MetS) increases cardiovascular risk in the general population; however, less is known about its influence in patients with OSA. We aimed to assess whether MetS affected the risk of MACE and all-cause mortality in elderly patients with OSA. Methods From January 2015 to October 2017, 1,157 patients with OSA, aged ≥60 years, no myocardial infarction (MI), and hospitalization for unstable angina or heart failure were enrolled at baseline and were followed up prospectively. OSA is defined as an apnea-hypopnea index of ≥5 events per hour, as recorded by polysomnography. Patients were classified on the basis of the presence of MetS, according to the definition of the National Cholesterol Education Program (NCEP). Incidence rates were expressed as cumulative incidence. Cox proportional hazards analysis was used to estimate the risk of all events. The primary outcomes were MACE, which included cardiovascular death, MI, and hospitalization for unstable angina or heart failure. Secondary outcomes were all-cause mortality, components of MACE, and a composite of all events. Results MetS was present in 703 out of 1,157 (60.8%) elderly patients with OSA. During the median follow-up of 42 months, 119 (10.3%) patients experienced MACE. MetS conferred a cumulative incidence of MACE in elderly patients with OSA (log-rank, P < 0.001). In addition, there was a trend for MACE incidence risk to gradually increase in individuals with ≥3 MetS components (P = 0.045). Multivariate analysis showed that MetS was associated with an incidence risk for MACE [adjusted hazard ratio (aHR), 1.86; 95% confidence interval (CI), 1.17–2.96; P = 0.009], a composite of all events (aHR, 1.54; 95% CI, 1.03–2.32; P = 0.036), and hospitalization for unstable angina (aHR, 2.01; 95% CI, 1.04–3.90; P = 0.039). No significant differences in the risk of all-cause mortality and other components of MACE between patients with and without MetS (P > 0.05). Subgroup analysis demonstrated that males (aHR, 2.23; 95% CI, 1.28–3.91, P = 0.05), individuals aged <70 years (aHR, 2.36; 95% CI, 1.27–4.39, P = 0.006), overweight and obese individuals (aHR, 2.32; 95% CI, 1.34–4.01, P = 0.003), and those with moderate-severe OSA (aHR, 1.81;95% CI: 1.05–3.12, P = 0.032) and concomitant MetS were at a higher risk for MACE. Conclusion MetS is common in elderly patients with OSA in the absence of MI, hospitalization for unstable angina or heart failure. Further, it confers an independent, increased risk of MACE, a composite of all events, and hospitalization for unstable angina. Overweight and obese males, aged <70 years with moderate-severe OSA combined with MetS presented a significantly higher MACE risk.
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Affiliation(s)
- Lin Liu
- Department of Pulmonary and Critical Care Medicine of the Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Xiaofeng Su
- Medical College, Yan'an University, Yan'an, China
| | - Zhe Zhao
- Department of Pulmonary and Critical Care Medicine of the Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Jiming Han
- Medical College, Yan'an University, Yan'an, China
| | - Jianhua Li
- Cardiology Department of the Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Weihao Xu
- Cardiology Department of the Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Zijun He
- Medical College, Yan'an University, Yan'an, China
| | - Yinghui Gao
- PKU-UPenn Sleep Center, Peking University International Hospital, Beijing, China
| | - Kaibing Chen
- Sleep Center, The Affiliated Hospital of Gansu University of Chinese Medicine, Lanzhou City, China
| | - Libo Zhao
- Department of Pulmonary and Critical Care Medicine of the Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Yan Gao
- Department of General Practice, 960th Hospital of PLA, Jinan, China
| | | | - JingJing Guo
- Department of Pulmonary and Critical Care Medicine, Sleep Medicine Center, Peking University People's Hospital, Beijing, China
| | - Junling Lin
- Department of Pulmonary and Critical Care Medicine, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing, China
- *Correspondence: Xiangqun Fang
| | - Tianzhi Li
- The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
- Tianzhi Li
| | - Xiangqun Fang
- Department of Pulmonary and Critical Care Medicine of the Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
- Junling Lin
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Hamit G, Ayca O, Omer B, Nevra O, Aynur O. Association of circadian locomotor output cycles kaput rs1801260 and hypocretin receptor 1 rs2271933 polymorphisms in patients with chronic migraine and sleep disorder. NEUROL SCI NEUROPHYS 2022. [DOI: 10.4103/nsn.nsn_195_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
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[Correlation of obstructive sleep apnea with components of metabolic syndrome and implications for long-term adverse cardiovascular risk in elderly patients]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2021; 41:1592-1599. [PMID: 34916183 PMCID: PMC8685693 DOI: 10.12122/j.issn.1673-4254.2021.11.01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To investigate the relationship between obstructive sleep apnea (OSA) and components of metabolic syndrome (MetS) in the elderly and the implications for long-term risk for major adverse cardiovascular events (MACE). METHODS This multicenter prospective cohort study was conducted among 1157 consecutive patients with OSA [defined as an apnea-hypopnea index (AHI) ≥5 times/h recorded by overnight polysomnography] aged ≥60 years enrolled from January, 2015 to October, 2017. All the patients did not have a history of MACE at baseline and had complete documentations of MetS indicators. The baseline demographic data, clinical characteristics, biochemical markers, and sleep parameters were collected from all the patients, who were divided into 4 groups according to the quartile level of AHI and followed up for a median of 42 months for MACE and its component events (cardiovascular death, myocardial infarction, and hospitalization for unstable angina or heart failure). Multivariate linear regression and Cox proportional risk regression models were used to analyze the correlation of MetS components with major objective predictors of OSA, AHI and LSpO2 and the long- term risk of MACE. RESULTS AHI and LSpO2 quartiles group showed a positive dose-response relationship with MetS components [fasting blood glucose, waist circumference, systolic blood pressure, and triglycerides] and a negative dose-response relationship with high-density lipoprotein level. MACE occurred in 119 (10.3%) patients with OSA during the follow-up. Multivariate Cox regression analysis showed that a high triglycerides, a high systolic blood pressure, and an increased waist circumference were independent risk factors for MACE and its component events (P < 0.05 or 0.01); a high HDL was a protective factor against MACE and myocardial infarction (P < 0.05 or 0.01) independent of the AHI. MetS components independent of LSpO2 showed no significant correlations with the risk of MACE or its component events. CONCLUSION The major diagnostic indexes AHI and LSPO2 in elderly patients with OSA have a dose-response relationship with MetS components, and the interaction between the components of MetS and AHI can increase the risk of MACE and its component events.
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Xie J, Li Y, Zhang Y, Vgontzas AN, Basta M, Chen B, Xu C, Tang X. Sleep duration and metabolic syndrome: An updated systematic review and meta-analysis. Sleep Med Rev 2021; 59:101451. [PMID: 33618187 DOI: 10.1016/j.smrv.2021.101451] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 08/11/2020] [Accepted: 11/22/2020] [Indexed: 02/05/2023]
Abstract
We examined the association between self-reported sleep duration and metabolic syndrome (MetS). Data were collected from 36 cross-sectional and 9 longitudinal studies with a total of 164,799 MetS subjects and 430,895 controls. Odds ratios (ORs) for prevalent MetS and risk ratios (RRs) for incident MetS were calculated through meta-analyses of adjusted data from individual studies. Short sleep duration was significantly associated with increased prevalent MetS (OR = 1.11, 95% CI = 1.05-1.18) and incident MetS (RR = 1.28, 95% CI = 1.07-1.53) in cross-sectional and longitudinal studies, respectively. Furthermore, long sleep duration was significantly associated with increased prevalent MetS in cross-sectional studies (OR = 1.14, 95% CI = 1.05-1.23), but not incident MetS (RR = 1.16, 95% CI = 0.95-1.41) in longitudinal studies. Interestingly, the association between long sleep and prevalent MetS was found in sleep duration defined by 24-h sleep (including naps) rather than nighttime sleep. Our findings suggest 1) a "U-shape" relationship between sleep duration and MetS in cross-sectional studies and 2) association between short sleep duration, but not long sleep duration with incident MetS. Future studies should shed light on the underlying mechanisms related to the association between sleep duration and MetS and examine if normalizing sleep duration reduces MetS risk in the general population.
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Affiliation(s)
- Jing Xie
- Department of Sleep Medicine, Shantou University Mental Health Center, Shantou University Medical College, Shantou, China; Sleep Medicine Center, Shantou University Medical College, Shantou, China
| | - Yun Li
- Department of Sleep Medicine, Shantou University Mental Health Center, Shantou University Medical College, Shantou, China; Sleep Medicine Center, Shantou University Medical College, Shantou, China.
| | - Yajun Zhang
- Department of Sleep Medicine, Shantou University Mental Health Center, Shantou University Medical College, Shantou, China; Sleep Medicine Center, Shantou University Medical College, Shantou, China
| | - Alexandros N Vgontzas
- Sleep Research & Treatment Center, Department of Psychiatry, Pennsylvania State University, College of Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Maria Basta
- Sleep Research & Treatment Center, Department of Psychiatry, Pennsylvania State University, College of Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Baixin Chen
- Department of Sleep Medicine, Shantou University Mental Health Center, Shantou University Medical College, Shantou, China; Sleep Medicine Center, Shantou University Medical College, Shantou, China
| | - Chongtao Xu
- Sleep Medicine Center, Shantou University Medical College, Shantou, China
| | - Xiangdong Tang
- Sleep Medicine Center, Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, China
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Determination of thresholds for minimally important difference and clinically important response on the functional outcomes of sleep questionnaire short version in adults with narcolepsy or obstructive sleep apnea. Sleep Breath 2021; 25:1707-1715. [PMID: 33394323 PMCID: PMC8376693 DOI: 10.1007/s11325-020-02270-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 11/18/2020] [Accepted: 12/08/2020] [Indexed: 10/29/2022]
Abstract
PURPOSE This study estimated thresholds for clinically important responses and minimally important differences for two indicators of improvement for the 10-item version of the functional outcomes of sleep questionnaire (FOSQ-10). METHODS Participants with excessive daytime sleepiness with narcolepsy or obstructive sleep apnea received 12 weeks of solriamfetol treatment. Participants completed the FOSQ-10 and other patient-reported outcome measures, including the single-item patient global impression of change (PGI-C) assessment. Clinicians completed the single-item clinician global impression of change (CGI-C) for each participant. Data from the two studies were analyzed separately, both without regard to treatment assignment. In total, 690 participants (47% female, mean age 48 years, 77% Caucasian, 91% from North America) were enrolled. Two clinically important changes, defined as a minimally important difference and a clinically important response, were determined using distribution and anchor-based analyses. A receiver operating characteristic analysis was used to determine the optimal FOSQ-10 change threshold. RESULTS Spearman correlations between change in FOSQ-10 scores and PGI-C and CGI-C were - 0.57 and - 0.49 for participants with narcolepsy and - 0.42 and - 0.37 for participants with obstructive sleep apnea. Receiver operating characteristic analysis suggested minimally important difference and clinically important response estimates of 1.7 and 2.5 and 1.8 and 2.2 points in narcolepsy and obstructive sleep apnea, respectively. CONCLUSIONS Minimally important difference and clinically important response estimates for the FOSQ-10 for adults with excessive daytime sleepiness in narcolepsy or obstructive sleep apnea will be helpful for interpreting changes over time and defining a clinical responder. CLINICALTRIALS. GOV IDENTIFIERS NCT02348593 (first submitted January 15, 2015) and NCT02348606 (first submitted January 15, 2015).
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Bonsignore MR, Randerath W, Schiza S, Verbraecken J, Elliott MW, Riha R, Barbe F, Bouloukaki I, Castrogiovanni A, Deleanu O, Goncalves M, Leger D, Marrone O, Penzel T, Ryan S, Smyth D, Teran-Santos J, Turino C, McNicholas WT. European Respiratory Society statement on sleep apnoea, sleepiness and driving risk. Eur Respir J 2020; 57:13993003.01272-2020. [DOI: 10.1183/13993003.01272-2020] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 08/25/2020] [Indexed: 12/22/2022]
Abstract
Obstructive sleep apnoea (OSA) is highly prevalent and is a recognised risk factor for motor vehicle accidents (MVA). Effective treatment with continuous positive airway pressure has been associated with a normalisation of this increased accident risk. Thus, many jurisdictions have introduced regulations restricting the ability of OSA patients from driving until effectively treated. However, uncertainty prevails regarding the relative importance of OSA severity determined by the apnoea–hypopnoea frequency per hour and the degree of sleepiness in determining accident risk. Furthermore, the identification of subjects at risk of OSA and/or accident risk remains elusive. The introduction of official European regulations regarding fitness to drive prompted the European Respiratory Society to establish a task force to address the topic of sleep apnoea, sleepiness and driving with a view to providing an overview to clinicians involved in treating patients with the disorder. The present report evaluates the epidemiology of MVA in patients with OSA; the mechanisms involved in this association; the role of screening questionnaires, driving simulators and other techniques to evaluate sleepiness and/or impaired vigilance; the impact of treatment on MVA risk in affected drivers; and highlights the evidence gaps regarding the identification of OSA patients at risk of MVA.
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Obstructive sleep apnea in Parkinson's disease: a study in 239 Chinese patients. Sleep Med 2020; 67:237-243. [DOI: 10.1016/j.sleep.2019.11.1251] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Revised: 03/19/2019] [Accepted: 11/20/2019] [Indexed: 11/22/2022]
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Li X, Huang H, Xu H, Shi Y, Qian Y, Zou J, Yi H, Guan J, Yin S. Excessive daytime sleepiness, metabolic syndrome, and obstructive sleep apnea: two independent large cross-sectional studies and one interventional study. Respir Res 2019; 20:276. [PMID: 31801522 PMCID: PMC6894285 DOI: 10.1186/s12931-019-1248-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 11/25/2019] [Indexed: 02/08/2023] Open
Abstract
Background Obstructive sleep apnea (OSA) and excessive daytime sleepiness (EDS) were considered to contribute to MetS. This study was performed to assess the association between MetS and EDS in two independent large-scale populations, and in subjects who underwent upper-airway surgery. Methods A total of 6312 patients without self-reported depression and 3578 suspected OSA patients were consecutively recruited, during health screening examinations and from our sleep center, respectively. A total of 57 subjects with OSA who underwent upper-airway surgery were also included. Demographic, anthropometric, biochemical, and polysomnographic data were obtained. Results In the health screening examination group, 233 (9.23%) women and 350 (10.93%) men had complaints of EDS. A total of 229 (7.04%) women and 1182 (36.88%) men met the criteria for MetS. In the OSA group, 147 (21.18%) women and 1058 (36.69%) men reported EDS. In addition, 93 (13.4%) women and 1368 (47.43%) men reported MetS. In the health screening examination group, EDS did not contribute significantly to MetS (OR = 1.125, 95% CI: 0.907–1.395; p = 0.283). In the OSA group, EDS significantly contributed to MetS (OR = 1.249, 95% CI: 1.063–1.468; p = 0.007); however, the results were not significant after adjusting for sleep variables (OR = 1.071, 95% CI: 0.905–1.268; p = 0.423). Upper-airway surgery did not affect cardio-metabolic variables in OSA patients with or without EDS. Conclusions EDS was not associated with MetS in two independent large-scale cohorts. In addition, upper-airway surgery did not affect components of MetS in OSA patients with and without EDS.
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Affiliation(s)
- Xinyi Li
- Department of Otolaryngology Head and Neck Surgery & Center of Sleep Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Yishan Road 600, Shanghai, 200233, China.,Shanghai Key Laboratory of Sleep Disordered Breathing, Yishan Road 600, Shanghai, 200233, China.,Otolaryngological Institute of Shanghai Jiao Tong University, Yishan Road 600, Shanghai, 200233, China
| | - Hengye Huang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, 225South Chongqing Road, Shanghai, 200020, China
| | - Huajun Xu
- Department of Otolaryngology Head and Neck Surgery & Center of Sleep Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Yishan Road 600, Shanghai, 200233, China. .,Shanghai Key Laboratory of Sleep Disordered Breathing, Yishan Road 600, Shanghai, 200233, China. .,Otolaryngological Institute of Shanghai Jiao Tong University, Yishan Road 600, Shanghai, 200233, China.
| | - Yue Shi
- School of Public Health, Shanghai Jiao Tong University School of Medicine, 225South Chongqing Road, Shanghai, 200020, China
| | - Yingjun Qian
- Department of Otolaryngology Head and Neck Surgery & Center of Sleep Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Yishan Road 600, Shanghai, 200233, China.,Shanghai Key Laboratory of Sleep Disordered Breathing, Yishan Road 600, Shanghai, 200233, China.,Otolaryngological Institute of Shanghai Jiao Tong University, Yishan Road 600, Shanghai, 200233, China
| | - Jianyin Zou
- Department of Otolaryngology Head and Neck Surgery & Center of Sleep Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Yishan Road 600, Shanghai, 200233, China.,Shanghai Key Laboratory of Sleep Disordered Breathing, Yishan Road 600, Shanghai, 200233, China.,Otolaryngological Institute of Shanghai Jiao Tong University, Yishan Road 600, Shanghai, 200233, China
| | - Hongliang Yi
- Department of Otolaryngology Head and Neck Surgery & Center of Sleep Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Yishan Road 600, Shanghai, 200233, China. .,Shanghai Key Laboratory of Sleep Disordered Breathing, Yishan Road 600, Shanghai, 200233, China. .,Otolaryngological Institute of Shanghai Jiao Tong University, Yishan Road 600, Shanghai, 200233, China.
| | - Jian Guan
- Department of Otolaryngology Head and Neck Surgery & Center of Sleep Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Yishan Road 600, Shanghai, 200233, China.,Shanghai Key Laboratory of Sleep Disordered Breathing, Yishan Road 600, Shanghai, 200233, China.,Otolaryngological Institute of Shanghai Jiao Tong University, Yishan Road 600, Shanghai, 200233, China
| | - Shankai Yin
- Department of Otolaryngology Head and Neck Surgery & Center of Sleep Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Yishan Road 600, Shanghai, 200233, China.,Shanghai Key Laboratory of Sleep Disordered Breathing, Yishan Road 600, Shanghai, 200233, China.,Otolaryngological Institute of Shanghai Jiao Tong University, Yishan Road 600, Shanghai, 200233, China
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Residual excessive daytime sleepiness in patients with obstructive sleep apnea treated with positive airway pressure therapy. Sleep Breath 2019; 24:143-150. [DOI: 10.1007/s11325-019-01830-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 03/11/2019] [Accepted: 03/21/2019] [Indexed: 02/02/2023]
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12
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Zou J, Song F, Xu H, Fu Y, Xia Y, Qian Y, Zou J, Liu S, Fang F, Meng L, Yi H, Guan J, Zhu H, Chen B, Yin S. The Relationship between Simple Snoring and Metabolic Syndrome: A Cross-Sectional Study. J Diabetes Res 2019; 2019:9578391. [PMID: 31093507 PMCID: PMC6481037 DOI: 10.1155/2019/9578391] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 01/15/2019] [Accepted: 02/07/2019] [Indexed: 01/22/2023] Open
Abstract
PURPOSE This cross-sectional study was performed to assess the relationship between simple snoring and metabolic syndrome (MetS). METHODS A total of 5635 participants including 300 healthy volunteers without snoring allegedly were initially included from 2007 to 2016. Polysomnographic variables, anthropometric measurements, and biochemical indicators were collected. The polynomial linear trend test was used to assess the linear trend across snoring intensity for metabolic score, and logistic regression was used to evaluate the odds ratios (ORs) for MetS after controlling for age, sex, obesity, smoking status, and alcohol consumption. RESULTS The final study population consisted of 866 participants. Simple snorers showed more severe metabolic disorders and higher prevalence of MetS than nonsnorers. A significant linear trend was observed between snoring intensity and metabolic score. Simple snoring was significantly associated with increased odds for MetS among all participants (OR = 2.328, 95% CI: 1.340-4.045) and female participants (OR = 2.382, 95% CI: 1.136-4.994) after multivariable adjustment. With regard to MetS components, simple snoring was significantly associated with increased odds for hypertension (OR = 1.730, 95% CI: 1.130-2.650), abdominal obesity (OR = 1.810, 95% CI: 1.063-3.083), and hyper-triglycerides (TG) (OR = 1.814, 95% CI: 1.097-2.998) among all participants, with hypertension (OR = 3.493, 95% CI: 1.748-6.979) among males and with abdominal obesity (OR = 2.306, 95% CI: 1.245-4.270) and hyper-TG (OR = 2.803, 95% CI: 1.146-6.856) among females after multivariable adjustment. CONCLUSIONS After excluding the influence of repeated apnea and hypoxia, simple snoring was still significantly associated with MetS, especially in women. Furthermore, the associations were more obvious for hypertension among males and for abdominal obesity and hyper-TG among females. In addition to OSA, simple snoring also should be valued.
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Affiliation(s)
- Juanjuan Zou
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai 200233, China
| | - Fan Song
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai 200233, China
| | - Huajun Xu
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai 200233, China
| | - Yiqun Fu
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai 200233, China
| | - Yunyan Xia
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai 200233, China
| | - Yingjun Qian
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai 200233, China
| | - Jianyin Zou
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai 200233, China
| | - Suru Liu
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai 200233, China
| | - Fang Fang
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai 200233, China
| | - Lili Meng
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai 200233, China
| | - Hongliang Yi
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai 200233, China
| | - Jian Guan
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai 200233, China
| | - Huaming Zhu
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai 200233, China
| | - Bin Chen
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai 200233, China
| | - Shankai Yin
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai 200233, China
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