Toward Precision Medicine: Circadian Rhythm of Blood Pressure and Chronotherapy for Hypertension - 2021 NHLBI Workshop Report

Hypertension, Journal Year: 2022, Volume and Issue: 80(3), P. 503 - 522

Published: Nov. 30, 2022

Healthy individuals exhibit blood pressure variation over a 24-hour period with higher during wakefulness and lower sleep. Loss or disruption of the circadian rhythm has been linked to adverse health outcomes, for example, cardiovascular disease, dementia, chronic kidney disease. However, current diagnostic therapeutic approaches lack sufficient attention rhythmicity pressure. Sleep patterns, hormone release, eating habits, digestion, body temperature, renal function, other important host functions as well gut microbiota rhythms, influence rhythms Potential benefits nonpharmacologic interventions such meal timing, pharmacologic chronotherapeutic interventions, bedtime administration antihypertensive medications, have recently suggested in some studies. mechanisms underlying rhythm-mediated regulation efficacy chronotherapy hypertension remain unclear. This review summarizes results National Heart, Lung, Blood Institute workshop convened on October 27 29, 2021 assess knowledge gaps research opportunities study hypertension.

Language: Английский

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The role of artificial intelligence in the treatment of obstructive sleep apnea

Journal of Otolaryngology - Head and Neck Surgery, Journal Year: 2023, Volume and Issue: 52(1)

Published: Jan. 1, 2023

The first-line and most common treatment for obstructive sleep apnea is nasal continuous positive airway pressure, which serves as a pneumatic splint to stabilize the upper effective when used with appropriate adherence. Continuous pressure compliance rates remain significantly low despite machine improvements intervention. Other options include oral appliances, myofunctional therapy, surgery. aim of this project elucidate role artificial intelligence within improving apnea.Related publications between 1999 2022 were reviewed from PubMed Embase databases utilizing search terms "artificial intelligence," "machine learning," "obstructive apnea," "treatment." Both authors independently screened results by title/abstract then full text review. 126 non-duplicate articles screened, 38 included after title abstract screen 30 inclusion criteria are outline in PICO framework involved studies focused on application guiding evaluating treatment. Non-English excluded.The OSA was categorized into following sections: Predicting outcomes various options, Improving/Evaluating treatment, Personalizing understanding underlying mechanisms OSA.Artificial has capacity improve through predicting patient currently increasing that contribute disease process physiology. Implementing AI decisions allows patients connect methods would be an individual basis.

Language: Английский

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Circadian clock disruptions link oxidative stress and systemic inflammation to metabolic syndrome in obstructive sleep apnea patients

Frontiers in Physiology, Journal Year: 2022, Volume and Issue: 13

Published: Aug. 29, 2022

Objectives: Obstructive sleep apnea (OSA) is an independent risk factor for metabolic syndrome (MetS). Recent studies have indicated that circadian clock genes were dysregulated in OSA. In addition, it clear the impairment of clocks drives progression MetS. Therefore, we hypothesized rhythm disruption links OSA with Methods: A total 118 participants, who underwent polysomnography (PSG) and diagnosed as healthy snorers (control, n = 29) or (n 89) patients based on apnea-hypopnea index (AHI), enrolled present study. General information, anthropometric data, blood biochemical indicators, gene expressions, levels oxidative inflammatory indicators collected, determined, compared all participants. Results: We found Brain muscle aryl hydrocarbon receptor nuclear translocator-like protein 1 (Bmal1) Differentiated embryo chondrocyte (Dec1) upregulated, while Period (Per1) was reduced patients. these changing trends closely associated hypoxia indicator AHI a significant impact presence MetS components, such hyperglycemia (Dec1 Per1, p < 0.05 0.001, respectively), hypertension (Bmal1 Dec1, 0.001 0.01, hyperlipidemia (Dec1, 0.01), obesity 0.05). Notably, expressions Dec1 correlated IR predicted Finally, also observed expression interrelated both biomarkers (IL-6) Conclusion: This study concluded disruptions, especially link inflammatory-related manner. Circadian can be used specific biomarker (p 0.001) therapeutic target combined Mets

Language: Английский

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Obstructive sleep apnea in a mouse model is associated with tissue-specific transcriptomic changes in circadian rhythmicity and mean 24-hour gene expression

PLoS Biology, Journal Year: 2023, Volume and Issue: 21(5), P. e3002139 - e3002139

Published: May 30, 2023

Intermittent hypoxia (IH) is a major clinical feature of obstructive sleep apnea (OSA). The mechanisms that become dysregulated after periods exposure to IH are unclear, particularly in the early stages disease. circadian clock governs wide array biological functions and intimately associated with stabilization hypoxia-inducible factors (HIFs) under hypoxic conditions. In patients, occurs during phase 24-hour sleep-wake cycle, potentially affecting their rhythms. Alterations have potential accelerate pathological processes, including other comorbid conditions can be chronic, untreated OSA. We hypothesized changes would manifest differently those organs systems known impacted by Using an model represent OSA, we evaluated rhythmicity mean expression transcriptome 6 different mouse tissues, liver, lung, kidney, muscle, heart, cerebellum, 7-day IH. found transcriptomic within cardiopulmonary tissues were more affected than tissues. Also, resulted overall increase core body temperature. Our findings demonstrate relationship between specific physiological outcomes. This study provides insight into pathophysiological

Language: Английский

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Is obstructive sleep apnea a circadian rhythm disorder?

Journal of Sleep Research, Journal Year: 2023, Volume and Issue: 32(4)

Published: March 15, 2023

Summary Obstructive sleep apnea is the most common sleep‐related breathing disorder worldwide and remains underdiagnosed. Its multiple associated comorbidities contribute to a decreased quality of life work performance as well an increased risk death. Standard treatment seems have limited effects on cardiovascular metabolic aspects disease, emphasising need for early diagnosis additional therapeutic approaches. Recent evidence suggests that dysregulation circadian rhythms, processes with endogenous rhythmicity are adjusted environment through various cues, involved in pathogenesis comorbidities. In patients obstructive apnea, altered gene expression patterns been demonstrated. respiratory events may promote disturbance intermittent hypoxia, subsequent inflammation disruption neural hormonal homeostasis. this review, current knowledge rhythm regulation, disorders summarised. Studies connect abnormalities critically evaluated. Furthermore, pathogenetic mechanisms underlie association, notably hypoxia signalling, presented. A bidirectional relationship between proposed. Approaching prove beneficial development new, personalised diagnostic, prognostic tools. However, further studies needed before clinical approach includes targeting system.

Language: Английский

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Designing and Developing a Vision-Based System to Investigate the Emotional Effects of News on Short Sleep at Noon: An Experimental Case Study

Sensors, Journal Year: 2023, Volume and Issue: 23(20), P. 8422 - 8422

Published: Oct. 12, 2023

Background: Sleep is a critical factor in maintaining good health, and its impact on various diseases has been recognized by scientists. Understanding sleep patterns quality crucial for investigating sleep-related disorders their potential links to health conditions. The development of non-intrusive contactless methods analyzing data essential accurate diagnosis treatment. Methods: A novel system called the visual analyzer (VSleep) was designed analyze movements generate reports based changes body position angles. utilized camera without requiring any physical contact with body. Python graphical user interface (GUI) section developed during present an Excel format. To evaluate effectiveness VSleep system, case study conducted. participants' daytime naps were recorded. also examined different types news (positive, neutral, negative) patterns. Results: successfully detected recorded angles formed bodies, providing detailed information about results revealed distinct effects category, highlighting external factors behaviors. Conclusions: demonstrated efficacy need accessories. holds great diagnosing disorders. proposed affordable, easy use, portable, mobile application can be perform experiment prepare results.

Language: Английский

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The role of the SIRT1-BMAL1 pathway in regulating oxidative stress in the early development of ischaemic stroke

Scientific Reports, Journal Year: 2024, Volume and Issue: 14(1)

Published: Jan. 20, 2024

Language: Английский

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Circadian clock dysregulation: a potential mechanism of depression in obstructive sleep apnea patients

Translational Psychiatry, Journal Year: 2024, Volume and Issue: 14(1)

Published: Oct. 7, 2024

Abstract Obstructive sleep apnea (OSA) is characterized by co-occurrence with affective disorders. Our study aims to investigate the association of circadian clock gene expressions, and presence severity depressive symptoms in OSA patients. The included 184 individuals, who underwent polysomnography (PSG) had their peripheral blood collected evening before morning after PSG. Patients were divided into two groups: (apnea-hypopnea index (AHI) > 5) control group (AHI < 5). RNA was extracted from leukocytes. Expression levels selected genes ( BMAL1 , CLOCK PER1 CRY1 NPAS2 NR1D1 ) assessed qRT-PCR. Questionnaire data (including Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS), Chronotype (CQ), Montgomery–Åsberg Depression Rating (MADRS)). expression all examined patients upregulated compared (except ). No differences observed between groups at either time point. Additionally, there a positive correlation (assessed MADRS) Finally, multivariable linear regression, ISI score B = 0.750, p 0.001), AM CQ 0.416, 0.007), 4.310, 0.042) found be predictive factors for greater depression Dysregulated linked symptom severity, suggesting disruption may underlie OSA.

Language: Английский

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Circadian Biology in Obstructive Sleep Apnea

Diagnostics, Journal Year: 2021, Volume and Issue: 11(6), P. 1082 - 1082

Published: June 13, 2021

Obstructive sleep apnea (OSA) is a complex process that can lead to the dysregulation of molecular clock, as well 24 h rhythms and wake, blood pressure, other associated biological processes. Previous work has demonstrated crosstalk between circadian clock hypoxia-responsive pathways. However, even in absence OSA, disrupted clocks exacerbate OSA-associated outcomes (e.g., cardiovascular or cognitive outcomes). As we expand our understanding biology setting this information could play significant role diagnosis treatment OSA. Here, summarize pre-existing knowledge patients with OSA examine utility biomarkers alternative clinical tools.

Language: Английский

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Melatonin mediates intestinal barrier dysfunction and systemic inflammation in moderate-severe OSA patients

Annals of Medicine, Journal Year: 2024, Volume and Issue: 56(1)

Published: July 8, 2024

Intestinal barrier dysfunction and systemic inflammation are common in obstructive sleep apnoea (OSA). We aimed to investigate the role of melatonin, an anti-inflammatory mediator, mediating relationships between OSA, intestinal inflammation.

Language: Английский

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