scholarly journals The Impact of Obstructive Sleep Apnoea and Nasal Continuous Positive Airway Pressure on Circulating Ischaemia-Modified Albumin Concentrations

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Firat Uygur ◽  
Hakan Tanriverdi ◽  
Murat Can ◽  
Tacettin Ornek ◽  
Fatma Erboy ◽  
...  

The aim of the present study was to evaluate the impact of obstructive sleep apnoea syndrome (OSAS) and the effects of nasal continuous positive airway pressure (CPAP) on circulating ischaemia-modified albumin (IMA) concentrations. The study included 97 newly diagnosed OSAS patients and 30 nonapnoeic controls. Blood samples were obtained in the morning after polysomnography. After 3 months of CPAP treatment, 31 patients with moderate-severe OSAS were reassessed for serum IMA concentrations. Significantly higher serum IMA concentrations were measured in the OSAS group than in the control group [0.518±0.091absorbance units (ABSU),0.415±0.068ABSU,P<0.001]. Serum IMA concentrations correlated significantly with the apnoea-hypopnoea index, mean SaO2, desaturation index, and C-reactive protein concentrations. Multiple logistic regression analyses showed that OSAS increased the serum IMA concentration independent of age, sex, body mass index, smoking habit, and cardiovascular disease. After 3 months of treatment with CPAP, OSAS patients had significantly lower serum IMA concentrations (0.555±0.062ABSU to0.431±0.063ABSU,P<0.001). The results showed that OSAS is associated with elevated concentrations of IMA, which can be reversed by effective CPAP treatment.

2014 ◽  
Vol 6 (3) ◽  
pp. 221 ◽  
Author(s):  
Jessie Bakker ◽  
Karyn O’Keeffe ◽  
Alister Neill ◽  
Angela Campbell

INTRODUCTION: Continuous positive airway pressure (CPAP) is an effective treatment of obstructive sleep apnoea (OSA), but can be limited by poor adherence. In New Zealand (NZ), ethnicity has been shown to be a predictor of CPAP adherence. This study aimed to explore Maori, Pacific and NZ European patients’ experience of CPAP treatment. METHODS: Patients identifying as Maori, Pacific, or NZ European ethnicity referred for CPAP treatment for OSA attended separate, 1.5-hour group discussions facilitated by a health care worker of the same ethnic group, using an interview template. Thematic analysis was applied to the discussion transcripts independently by two investigators, following published guidelines. FINDINGS: Five Maori, five Pacific, and eight NZ Europeans participated (mean age 47, range 30–71 years, mean ± standard deviation CPAP adherence 6.32 ±1.25 hours/night). Patients in all three groups reported that they had little knowledge of OSA or CPAP prior to treatment initiation. All groups identified barriers to treatment (both at the CPAP initiation phase and long term), reported feelings of being ‘overwhelmed’ with information during the initial CPAP education session, and discussed the importance of successful role models. Family and friends were generally reported as being supportive of CPAP therapy. CONCLUSION: The three groups all reported similar initial CPAP experiences, highlighting access barriers to publicly funded assessment and treatment pathways, and sleep health knowledge as key issues. Educational resources to improve access, enable self-management, and increase community awareness of OSA would help overcome some of the issues identified in this study. KEYWORDS: Continuous positive airway pressure; obstructive sleep apnea; ethnic groups; focus groups


2021 ◽  
pp. 2003687
Author(s):  
Macy Mei-Sze Lui ◽  
Hung-Fat Tse ◽  
David Chi-Leung Lam ◽  
Kui-Kai Lau ◽  
Carmen Wing-Sze Chan ◽  
...  

RationaleThe impact of treatment for obstructive sleep apnoea (OSA) on reduction of cardiovascular risk is unclear. This study aimed to examine the effect of continuous positive airway pressure (CPAP) on ambulatory blood pressure (BP) and subclinical myocardial injury in subjects with OSA and hypertension.MethodsSubjects with hypertension requiring at least three anti-hypertensive medications and moderate-severe OSA were enrolled. Eligible subjects were randomized (1:1) to receive either CPAP treatment or control (no CPAP) for eight weeks. Changes in ambulatory BP and serum biomarkers were compared. Stratified analysis according to circadian BP pattern was performed.Main resultsNinety two subjects (75% men; age, 51±8 years; apnoea-hypopnoea index 40±8 events·h−1, taking average of 3.4 anti-hypertensive drugs [range 3–6]) were randomised. The group on CPAP treatment, compared to the control group, demonstrated significant reduction in 24-h systolic BP (−4.4 mmHg, 95% CI −8.7 to −0.1, p=0.046), 24-h diastolic BP (−2.9 mmHg, 95% CI −5.5 to −0.2, p=0.032), daytime systolic BP (−5.4 mmHg, −9.7 to −1.0, p=0.016) and daytime diastolic BP (−3.4 mmHg, 95% CI −6.1 to −0.8, p=0.012). CPAP treatment was associated with significant BP lowering only in non-dippers, but not in dippers. Serum troponin I (mean difference −1.74 pg·mL−1, 95% CI −2.97 to −0.5, p=0.006) and brain natriuretic peptide (−9.1 pg·mL−1, 95% CI −17.6 to −0.6, p=0.036) were significantly reduced in CPAP compared to control group.ConclusionIn a cohort with OSA and multiple cardiovascular risk factors including difficult-to-control hypertension, short-term CPAP treatment improved ambulatory BP and alleviated subclinical myocardial injury and strain.


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