scholarly journals Gut microbiota in obstructive sleep apnea–hypopnea syndrome: disease-related dysbiosis and metabolic comorbidities

2019 ◽  
Vol 133 (7) ◽  
pp. 905-917 ◽  
Author(s):  
Chih-Yuan Ko ◽  
Qing-Quan Liu ◽  
Huan-Zhang Su ◽  
Hua-Ping Zhang ◽  
Ji-Mim Fan ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Gut Microbiota ◽  
Area Under The Curve ◽  
Variable Regions ◽  
Microbial Dysbiosis ◽  
Obstructive Sleep ◽  
16S Rrna Pyrosequencing ◽  
Hypopnea Syndrome ◽  
Metabolic Comorbidities

Abstract Gut microbiota alterations manifest as intermittent hypoxia and fragmented sleep, thereby mimicking obstructive sleep apnea–hypopnea syndrome (OSAHS). Here, we sought to perform the first direct survey of gut microbial dysbiosis over a range of apnea–hypopnea indices (AHI) among patients with OSAHS. We obtained fecal samples from 93 patients with OSAHS [5 < AHI ≤ 15 (n=40), 15 < AHI ≤ 30 (n=23), and AHI ≥ 30 (n=30)] and 20 controls (AHI ≤ 5) and determined the microbiome composition via 16S rRNA pyrosequencing and bioinformatics analysis of variable regions 3–4. We measured fasting levels of homocysteine (HCY), interleukin-6 (IL-6), and tumor necrosis factor α (TNF-α). Results revealed gut microbial dysbiosis in several patients with varying severities of OSAHS, reliably separating them from controls with a receiver operating characteristic-area under the curve (ROC-AUC) of 0.789. Functional analysis in the microbiomes of patients revealed alterations; additionally, decreased in short-chain fatty acid (SCFA)-producing bacteria and increased pathogens, accompanied by elevated levels of IL-6. Lactobacillus levels correlated with HCY levels. Stratification analysis revealed that the Ruminococcus enterotype posed the highest risk for patients with OSAHS. Our results show that the presence of an altered microbiome is associated with HCY among OSAHS patients. These changes in the levels of SCFA affect the levels of pathogens that play a pathophysiological role in OSAHS and related metabolic comorbidities.

scholarly journals Association ofPrevotellaenterotype with polysomnographic data in obstructive sleep apnea/hypopnea syndrome patients

2018 ◽  
Author(s):  
Chih-Yuan Ko ◽  
Ji-Mim Fan ◽  
An-Ke Hu ◽  
Li-Mei Huang ◽  
Huan-Zhang Su ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Gut Microbiota ◽  
Intermittent Hypoxia ◽  
Sleep Fragmentation ◽  
Central Apnea ◽  
Variable Regions ◽  
Obstructive Sleep ◽  
Blood Cytokines ◽  
Hypopnea Syndrome

AbstractIntermittent hypoxia and sleep fragmentation are critical pathophysiological processes involved in obstructive sleep apnea/hypopnea syndrome (OSAHS). These manifestation independently affect similar brain regions and contribute to OSAHS-related comorbidities that are known to be related to the host gut alteration microbiota. We hypothesized that microbiota disruption influences the pathophysiological processes of OSAHS through a microbiota–gut–brain axis. Thus, we aim to survey enterotypes and polysomnographic data of OSAHS patients. Subjects were diagnosed by polysomnography, from whom fecal samples were obtained and analyzed for the microbiome composition by variable regions 3–4 of 16S rRNA pyrosequencing and bioinformatic analyses. We examined blood cytokines level of all subjects. Three enterotypesBacteroides(n=73),Ruminococcus(n=14), andPrevotella(n=26) were identified. Central apnea indices, mixed apnea indices, N1 sleep stage, mean apnea–hypopnea duration, and arousal indices were increased in apnea–hypopnea indices (AHI) ≥15 patients with thePrevotellaenterotype. However, for AHI<15 subjects, obstructive apnea indices and systolic blood pressure were significantly observed inRuminococcusandPrevotellaenterotypes, respectively. The present study indicates the possibility of pathophysiological interplay between enterotypes and sleep structure disruption in sleep apnea through a microbiota–gut–brain axis and offers some new insight toward the pathogenesis of OSAHS.ImportanceIntermittent hypoxia (IH) and sleep fragmentation (SF) are hallmarks of are the predominant mechanism underlying obstructive sleep apnea/hypopnea syndrome (OSAHS). Moreover, IH and SF of pathophysiological roles in the gut microbiota dysbiosis in OSAHS have been demonstrated. We hypothesized that gut microbiota disruption may cross-talk the brain function via microbiota–gut–brain axis. Indeed, we observed central apnea indices and other parameters of disturbances during sleep were significantly elevated in AHI≥15 patients with thePrevotellaenterotype. This enterotype prone to endotoxin production, driving systemic inflammation, ultimately contributes to OSAHS-linked comorbidities. Vice versa, increasing the arousal index leads to systemic inflammatory changes and accompanies metabolic dysfunction. We highlight that the possibility that the microbiota–gut–brain axis operates a bidirectional effect on the development of OSAHS pathology.

STOP-Bang as a predictor of obstructive sleep apnea-hypopnea syndrome in outpatients

Duazary ◽  
2021 ◽  
Vol 18 (4) ◽  
pp. 344-349
Author(s):  
John Carlos Pedrozo-Pupo ◽  
Jorge Armando Egurrola-Pedraza ◽  
Adalberto Campo-Arias
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Likelihood Ratio ◽  
Predictive Value ◽  
Area Under The Curve ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Obstructive Sleep ◽  
Accuracy Study ◽  
Hypopnea Syndrome

The STOP-Bang has been promoted as a valuable tool for identifying obstructive sleep apnea-hypopnea syndrome (OSAHS) in medical and surgical patients. However, its performance in Colombian samples is unknown. The objective of this study was to determine the clinimetric performance of the STOP-Bang index versus the study of polysomnography in patients from Santa Marta, Colombia. An accuracy study of diagnostic tests with a test-based approach was designed. Seven hundred sixty-two adults referred for polysomnography to evaluate OSAHS were included in the research. They were aged between 18 and 94 years old (mean=47.2, SD=13.4), 63.3% were men, and 46.5% were classified as obese. The STOP-Bang performance was compared against the best reference criterion, the hypopnea/apnea index determined by polysomnography. The diagnosis of OSAHS was confirmed in 461 (60.5%) and corroborated in 301 (39.5%). The area under the curve was 0.70 (95%CI 0.66-0.74), and the best cut-off point was 4, with a sensitivity of 79.2%, a specificity of 53.5%, the positive predictive value of 72.2%, the negative predictive value of 62.6%, positive likelihood ratio was 1.70, negative likelihood ratio was 0.39; OR=4.08 (CI95% 2.99-5.56) and Cohen's kappa of 0.33. As conclusions, performance indicators show that STOP-Bang...

scholarly journals OSAHS in adolescents: clinical presentation and differential diagnosis

2018 ◽  
Vol 21 (1) ◽  
pp. 106
Author(s):  
N. Beydon
Keyword(s):  
Obstructive Sleep Apnea ◽  
Differential Diagnosis ◽  
Sleep Apnea ◽  
Clinical Presentation ◽  
Transitional Period ◽  
Alternative Diagnosis ◽  
Obstructive Sleep ◽  
Hypopnea Syndrome

Adolescent experiment widespread changes as he/ she goes through this transitional period from childhood to adulthood. Sleep is no exception to this changeover with, as consequences, modifications of the clinical pre- sentation of subjects with Obstructive Sleep Apnea- Hypopnea Syndrome (OSAHS) and potential different alternative diagnosis.

scholarly journals Comparisons of Thyroid Hormone, Intelligence, Attention, and Quality of Life in Children with Obstructive Sleep Apnea Hypopnea Syndrome before and after Endoscopic Adenoidectomy

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Hui-Wei Feng ◽  
Tao Jiang ◽  
Hong-Ping Zhang ◽  
Zhe Wang ◽  
Hai-Ling Zhang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Thyroid Hormone ◽  
Intelligence Quotient ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
Before And After ◽  
Hypopnea Syndrome

Objective. The aim of this study was to compare the differences in thyroid hormone, intelligence, attention, and quality of life (QoL) of children with obstructive sleep apnea hypopnea syndrome (OSAHS) before and after endoscopic adenoidectomy.Method. A total of 35 OSAHS children (21 males and 14 females with a mean age of6.81±1.08years) were included in this study for analyzing the levels of thyroid hormone, intelligence, attention, and QoL. There were 22 children underwent endoscopic adenoidectomy with bilateral tonsillectomy (BT), while the other 13 children who underwent endoscopic adenoidectomy without bilateral tonsillectomy without BT.Results. Our results revealed no significant difference in serum free triiodothyronine (FT3), free thyroxine (FT4), and thyroid stimulating hormone (TSH) levels in OSAHS children before and after endoscopic adenoidectomy (allP>0.05). However, there were significant differences in full-scale intelligence quotient (FIQ) (92.45±5.88versus106.23±7.39,P<0.001), verbal intelligence quotient (VIQ) (94.17±15.01versus103.91±9.74,P=0.006), and performance intelligence quotient (PIQ) (94.12±11.04versus104.31±10.05,P=0.001), attention (98.48±8.74versus106.87±8.58,P<0.001), and total OSA-18 scores (87.62±17.15versus46.61±10.15,P<0.001) between before and after endoscopic adenoidectomy in OSAHS children.Conclusion. Our findings provided evidence that the intelligence, attention, and QoL of OSAHS children may be significantly improved after endoscopic adenoidectomy.

Endothelial Function of Patients with Morbid Obesity Submitted to Roux-en-Y Gastric Bypass With and Without Obstructive Sleep Apnea-Hypopnea Syndrome

2018 ◽  
Vol 28 (11) ◽  
pp. 3595-3603 ◽  
Author(s):  
Ana Cristina de Assunção Machado ◽  
Antonio Marcos Vargas da Silva ◽  
Luis Ulisses Signori ◽  
Glauco da Costa Alvarez ◽  
Claudio Corá Mottin
Keyword(s):  
Morbid Obesity ◽  
Obstructive Sleep Apnea ◽  
Gastric Bypass ◽  
Sleep Apnea ◽  
Endothelial Function ◽  
Obstructive Sleep ◽  
Hypopnea Syndrome
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