scholarly journals Obstructive sleep apnoea as a risk factor for incident metabolic syndrome: a joined Episono and HypnoLaus prospective cohorts study

2018 ◽  
Vol 52 (5) ◽  
pp. 1801150 ◽  
Author(s):  
Camila Hirotsu ◽  
Jose Haba-Rubio ◽  
Sonia M. Togeiro ◽  
Pedro Marques-Vidal ◽  
Luciano F. Drager ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Risk Factor ◽  
General Population ◽  
Obstructive Sleep Apnoea ◽  
Arterial Oxygen Saturation ◽  
Sleep Apnoea ◽  
Arterial Oxygen ◽  
Obstructive Sleep ◽  
Increased Risk

Cross-sectional studies have demonstrated that obstructive sleep apnoea (OSA) and metabolic syndrome (MetS) are often associated, but whether a temporal relationship exists is unknown. We aimed to investigate the effect of OSA on the risk of developing MetS in the general population.A prospective study was conducted combining two population-based samples: Episono (Brazil) and HypnoLaus (Switzerland). MetS was assessed according to unified criteria. Polysomnography (PSG) was performed at baseline and follow-up in Episono, and at baseline in HypnoLaus. OSA was defined according to the apnoea–hypopnoea index as mild (≥5– <15 events h−1) and moderate-to-severe (≥15 events·h−1). We included 1853 participants (mean±sd age 52±13 years, 56% female) without MetS at baseline.After mean±sd 6±1 years, 318 (17.2%) participants developed MetS. Moderate-to-severe OSA was independently associated with incident MetS (OR 2.58, 95% CI 1.61–4.11) and increased the number of MetS components from baseline to follow-up through mediation of the percentage of time with arterial oxygen saturation <90%. Subset analysis in Episono confirmed that the increase in this parameter between baseline and follow-up PSGs represented a risk factor for incident MetS (OR 1.42, 95% CI 1.04–1.95, for each 10% increase).OSA is independently associated with an increased risk of developing MetS through mediation of nocturnal hypoxaemia in the general population.

Psychosis in Sleep Apnoea

1989 ◽  
Vol 23 (4) ◽  
pp. 571-573 ◽  
Author(s):  
Sing Lee ◽  
Helen F.K. Chiu ◽  
Char-Nie Chen
Keyword(s):  
Sleep Deprivation ◽  
Obstructive Sleep Apnoea ◽  
Complete Resolution ◽  
Slow Wave Sleep ◽  
Sleep Apnoea ◽  
Arterial Oxygen ◽  
Obstructive Sleep Apnoea Syndrome ◽  
Intellectual Impairment ◽  
Obstructive Sleep

A 30-year-old man presenting with intellectual impairment and recurrent psychotic episodes was subsequently found to have suffered from a chronically untreated obstructive sleep apnoea syndrome. Polysomnography revealed sleep fragmentation, slow wave sleep deprivation and abnormal arterial oxygen desaturation. Tonsillectomy led to complete resolution of sleep apnoea and remission of psychosis at 2 years' follow-up, but his apparent intellectual impairment persisted. The limited literature on psychosis associated with sleep apnoea is briefly reviewed.

scholarly journals Obstructive Sleep Apnoea and Type 2 Diabetes

2010 ◽  
Vol 10 (1) ◽  
pp. 43 ◽  
Author(s):  
Abd A Tahrani ◽  
Asad Ali ◽  
◽  
Keyword(s):  
Type 2 Diabetes ◽  
Risk Factor ◽  
Obstructive Sleep Apnoea ◽  
Medical Condition ◽  
Diabetes Type 2 ◽  
Sleep Apnoea ◽  
Obstructive Sleep ◽  
Increased Risk ◽  
The Impact

With the growing prevalence of obesity, the burden of type 2 diabetes is increasing. Obstructive sleep apnoea (OSA) is a very common medical condition that is associated with increased risk of cardiovascular disease and mortality. Obesity is a common risk factor for OSA and type 2 diabetes and hence it is not surprising that OSA and type 2 diabetes are interlinked. OSA has been shown to be an independent risk factor for the development of incident pre-diabetes/type 2 diabetes. OSA is also associated with worse glycaemic control and vascular disease in patients with type 2 diabetes. However, evidence for the benefits of OSA treatment in patients with type 2 diabetes is still lacking. The aim of this article is to provide an overview of OSA, the relationships between OSA and dysglycaemia and the impact of OSA in patients with type 2 diabetes, highlighting recent advances in the field.

scholarly journals Mortality and morbidity in obstructive sleep apnoea–hypopnoea syndrome: results from a 30-year prospective cohort study

2020 ◽  
Vol 6 (3) ◽  
pp. 00057-2020 ◽  
Author(s):  
Sophie Dodds ◽  
Linda J. Williams ◽  
Amber Roguski ◽  
Marjorie Vennelle ◽  
Neil J. Douglas ◽  
...  
Keyword(s):  
Cohort Study ◽  
General Population ◽  
Prospective Cohort Study ◽  
Obstructive Sleep Apnoea ◽  
Prospective Cohort ◽  
Sleep Apnoea ◽  
Mortality And Morbidity ◽  
Obstructive Sleep

BackgroundObstructive sleep apnoea–hypopnoea syndrome (OSAHS) carries substantial negative health consequences. This study examines factors affecting mortality and morbidity according to continuous positive airway pressure (CPAP) use and predictors affecting CPAP adherence in a longitudinal cohort of OSAHS patients.Materials and methodsThis prospective, cohort study comprised 4502 patients who were diagnosed with OSAHS at a tertiary sleep disorders centre between 1982 and 2003. Of these, 1174 patients completed follow-up in 2012. Data collected included anthropometric, sleep and demographic characteristics, including comorbidities, ongoing medications and CPAP adherence. Patients were followed up for an average of 14.8±3.7 years.ResultsImputation analysis showed that long-term CPAP users (>5 years) were 5.63 times more likely to be alive at study end than non-CPAP users (95% CI: 4.83–6.58, p<0.001) and 1.74-times more likely than short-term CPAP users (≤5 years) (95% CI: 1.49–2.02, p<0.001). Females had a significantly higher mortality rate during the follow-up period (26.8% versus 19.6%, p<0.001). Respiratory mortality was more common in patients with OSAHS, in particular those who did not use CPAP, compared to the general population (17.2% versus 12.2%, p=0.002 respectively), whereas deaths from cancer were less common compared to the general population (16.2% versus 25.6%, p<0.001). Compared to CPAP users, non-CPAP-users had a significantly increased incidence of type II diabetes mellitus (DMII) (27.9% versus 18.7%, p=0.003), ischaemic heart disease (IHD) (25.5% versus 12.7%, p<0.001) and myocardial infarction (MI) (14.7% versus 4.2%, p<0.001) at long-term follow-up.ConclusionsLong-term CPAP use in men and women with OSAHS reduces mortality and decreases the incidence of DMII and cardiovascular disease.

scholarly journals Obstructive sleep apnoea treatment and blood pressure: which phenotypes predict a response? A systematic review and meta-analysis

2020 ◽  
Vol 55 (5) ◽  
pp. 1901945 ◽  
Author(s):  
Martino F. Pengo ◽  
Davide Soranna ◽  
Alice Giontella ◽  
Elisa Perger ◽  
Paola Mattaliano ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Obstructive Sleep Apnoea ◽  
Meta Analysis ◽  
Arterial Oxygen Saturation ◽  
Sleep Apnoea ◽  
Mandibular Advancement ◽  
Arterial Oxygen ◽  
Obstructive Sleep ◽  
Randomised Controlled

The treatment for obstructive sleep apnoea (OSA) with continuous positive airway pressure (CPAP) or mandibular advancement devices (MADs) is associated with blood pressure (BP) reduction; however, the overall effect is modest. The aim of this systematic review and meta-analysis of randomised controlled trials (RCTs) comparing the effect of such treatments on BP was to identify subgroups of patients who respond best to treatment.The article search was performed in three different databases with specific search terms and selection criteria. From 2289 articles, we included 68 RCTs that compared CPAP or MADs with either passive or active treatment. When all the studies were pooled together, CPAP and MADs were associated with a mean BP reduction of −2.09 (95% CI −2.78– −1.40) mmHg for systolic BP and −1.92 (95% CI −2.40– −1.43) mmHg for diastolic BP and −1.27 (95% CI −2.34– −0.20) mmHg for systolic BP and −1.11 (95% CI −1.82– −0.41) mmHg for diastolic BP, respectively. The subgroups of patients who showed a greater response were those aged <60 years (systolic BP −2.93 mmHg), with uncontrolled BP at baseline (systolic BP −4.14 mmHg) and with severe oxygen desaturations (minimum arterial oxygen saturation measured by pulse oximetry <77%) at baseline (24-h systolic BP −7.57 mmHg).Although this meta-analysis shows that the expected reduction of BP by CPAP/MADs is modest, it identifies specific characteristics that may predict a pronounced benefit from CPAP in terms of BP control. These findings should be interpreted with caution; however, they are particularly important in identifying potential phenotypes associated with BP reduction in patients treated for OSA.

scholarly journals Pre-operative screening for obstructive sleep apnoea

2017 ◽  
Vol 26 (143) ◽  
pp. 160012 ◽  
Author(s):  
Johan Verbraecken ◽  
Jan Hedner ◽  
Thomas Penzel
Keyword(s):  
Risk Factor ◽  
Cardiovascular Risk ◽  
General Population ◽  
Obstructive Sleep Apnoea ◽  
Cardiovascular Risk Factor ◽  
Sleep Disordered Breathing ◽  
Sleep Apnoea ◽  
Surgical Interventions ◽  
Medical Interventions ◽  
Obstructive Sleep

Sleep disordered breathing, especially obstructive sleep apnoea (OSA), has a high and increasing prevalence. Depending on the apnoea and hypopnoea scoring criteria used, and depending on the sex and age of the subjects investigated, prevalence varies between 3% and 49% of the general population. These varying prevalences need to be reflected when considering screening for OSA. OSA is a cardiovascular risk factor and patients are at risk when undergoing medical interventions such as surgery. Screening for OSA before anaesthesia and surgical interventions is increasingly considered. Therefore, methods for screening and the rationale for screening for OSA are reviewed in this study.

scholarly journals Nocturnal cerebral hypoxia in obstructive sleep apnoea: a randomised controlled trial

2018 ◽  
Vol 51 (5) ◽  
pp. 1800032 ◽  
Author(s):  
Esther I. Schwarz ◽  
Michael Furian ◽  
Christian Schlatzer ◽  
John R. Stradling ◽  
Malcolm Kohler ◽  
...  
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Near Infrared ◽  
Controlled Trial ◽  
Arterial Oxygen Saturation ◽  
Sleep Apnoea ◽  
Arterial Oxygen ◽  
Cerebral Hypoxia ◽  
Cerebral Damage ◽  
Obstructive Sleep ◽  
Randomised Controlled

Cerebral hypoxia may promote cerebral damage in patients with obstructive sleep apnoea (OSA). We investigated whether OSA patients experience nocturnal cerebral hypoxia that is prevented by continuous positive airway pressure (CPAP).OSA patients using CPAP underwent sleep studies including pulse oximetry (arterial oxygen saturation (SpO2)) and near-infrared spectroscopy to monitor cerebral tissue oxygenation (CTO) at baseline and after 2 weeks on either subtherapeutic or therapeutic CPAP according to randomised allocation. Changes in oxygenation at end of the 2-week intervention were compared between groups.Among 21 patients (mean apnoea/hypopnoea index 50.3 events·h−1), OSA recurred in all nine patients using subtherapeutic CPAP and in none of the patients using therapeutic CPAP: mean (95% CI) between-group differences in changes of oxygen desaturation index from baseline to 2 weeks +40.7 (31.1–50.4) events·h−1 for SpO2 and +37.0 (25.3–48.7) events·h−1 for CTO (both p<0.001). Mean nocturnal SpO2 and CTO decreased more in patients using subtherapeutic versus therapeutic CPAP: −2.4 (−3.4–−1.1)% and −3.8 (−7.4–−0.1)%, respectively; both p<0.03. Severe CTO drops ≥13% associated with cerebral dysfunction in previous studies occurred in four out of nine patients using subtherapeutic CPAP, but in none out of 12 patients using therapeutic CPAP (p=0.01).In patients with OSA, CPAP withdrawal resulted in nocturnal cerebral deoxygenation, suggesting a role of cerebral hypoxia in predisposing untreated OSA patients to cerebral damage.

Obstructive Sleep Apnoea Impairs Heart Rate Variability in Patients with the Metabolic Syndrome

2007 ◽  
Vol 16 ◽  
pp. S84
Author(s):  
B. Weatherhead ◽  
C. Neil ◽  
M. Barnes ◽  
R. Pierce ◽  
A. Collins ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Obstructive Sleep Apnoea ◽  
Sleep Apnoea ◽  
The Metabolic Syndrome ◽  
Obstructive Sleep

Quality of life of children with sleep-disordered breathing treated with adenotonsillectomy

2010 ◽  
Vol 125 (2) ◽  
pp. 193-198 ◽  
Author(s):  
S M Powell ◽  
M Tremlett ◽  
D A Bosman
Keyword(s):  
Quality Of Life ◽  
Obstructive Sleep Apnoea ◽  
Sleep Disordered Breathing ◽  
Sleep Apnoea ◽  
Life Assessment ◽  
Effect Sizes ◽  
Obstructive Sleep ◽  
Disordered Breathing

AbstractObjective:To assess the quality of life of UK children with sleep-disordered breathing undergoing adenotonsillectomy, by using the Obstructive Sleep Apnoea 18 questionnaire and determining score changes and effect sizes.Design:Prospective, longitudinal study.Setting:The otolaryngology department of a university teaching hospital in Northern England.Participants:Twenty-eight children for whom adenotonsillectomy was planned as treatment for sleep-disordered breathing, and who had either a clinical history consistent with obstructive sleep apnoea or a polysomnographic diagnosis.Main outcome measure:The Obstructive Sleep Apnoea 18 questionnaire, a previously validated, disease-specific quality of life assessment tool; changes in questionnaire scores and effect sizes were assessed.Methods:The Obstructive Sleep Apnoea 18 questionnaire was administered to each child's parent pre-operatively, then again at the follow-up appointment. Questionnaire scores ranged from 1 to 7. Score changes were analysed using the paired t-test; effect sizes were calculated using 95 per cent confidence intervals.Results:Complete data were obtained for 22 children (mean age, 61 months). Ten had undergone pre-operative polysomnography. Twenty-one children underwent adenotonsillectomy (one underwent tonsillectomy). Median follow up was eight weeks (interquartile range, six to 11 weeks). Following surgery, the overall mean score improvement was 2.6 (p < 0.0001) and the mean effect size 2.4 (95 per cent confidence interval 1.9 to 2.8). There were significant improvements in each of the individual questionnaire domains, i.e. sleep disturbance (mean score change 3.9, p < 0.0001), physical suffering (2.2, p < 0.0001), emotional distress (2.0, p = 0.0001), daytime problems (1.8, p = 0.0001) and caregiver concerns (2.6, p < 0.0001).Conclusion:In these children with sleep-disordered breathing treated by adenotonsillectomy, Obstructive Sleep Apnoea 18 questionnaire results indicated significantly improved mean score changes and effect sizes across all questionnaire domains, comparing pre- and post-operative data.

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