Approach the Patient With Obstructive Sleep Apnea and Obesity

The Journal of Clinical Endocrinology & Metabolism, Journal Year: 2023, Volume and Issue: 109(3), P. e1267 - e1279

Published: Sept. 27, 2023

Abstract Obstructive sleep apnea (OSA) and obesity are highly prevalent bidirectionally associated. OSA is underrecognized, however, particularly in women. By mechanisms that overlap with those of obesity, increases the risk developing, or having poor outcomes from, comorbid chronic disorders impairs quality life. Using 2 illustrative cases, we discuss relationships between type diabetes, dyslipidemia, cardiovascular disease, cognitive disturbance, mood disorders, lower urinary tract symptoms, sexual function, reproductive disorders. The differences men women, phenotypic variability OSA, highlighted. When probability high due to consistent comorbidities, both, a diagnostic study advisable. Continuous positive airway pressure mandibular advancement splints improve symptoms. Benefits for comorbidities variable depending on nightly duration use. contrast, weight loss optimization lifestyle behaviors consistently beneficial.

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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Exploring SLEEPINESS through home monitoring with ultra-long-term subcutaneous EEG and ecological momentary assessment in sleepy treatment naïve obstructive sleep apnea patients starting CPAP treatment—A study protocol article

Frontiers in Sleep, Journal Year: 2025, Volume and Issue: 3

Published: Jan. 23, 2025

Introduction Excessive daytime sleepiness (EDS) is a key symptom for patients with obstructive sleep apnea (OSA). Despite important limitations in the longitudinal monitoring of EDS, Epworth Sleepiness Scale (ESS), Maintenance Wakefulness Test, and Multiple Sleep Latency Test (MSLT) are best available objective tests to predict EDS. Limited information exists on day-to-day fluctuations symptoms from everyday life perspective OSA patients. The most feared sudden episodes that cause traffic accidents. following study protocol investigates novel possibilities ultra-long-term Electroencephalography (EEG) (ULT-EEG) home sleepy subcutaneous implant. We hypothesize high-frequency testing ULT-EEG, combination an ecological momentary assessment (EMA), can provide develop new electrophysiological propensity as alternative well-established, yet subjective, ESS. Methods This clinical exploratory experimental will include 15 treatment-naïve severe OSA, baseline ESS score above 10. subjects be implanted two-channel EEG device upon inclusion confirmative polysomnography MSLT. Subcutaneous recorded 24/7 6 weeks before during continuous positive airway pressure (CPAP) treatment. Daily assessments Karolinska Scale, Psychomotor Vigilance Task test, sleep/nap diary collected using EMA methods. Discussion combines data collection patients' natural environments ULT-EEG methods obtain metrics suitable developing preliminarily validating monitoring. aim prove concept gain insights into CPAP-related rehabilitation. Ethics dissemination All participants written informed consent participate this study. Ethical approval Region Zealand Committee 13/09/2021 (SJ939, EMN-2021-06803). conducted accordance local legislation institutional requirements comply Declaration Helsinki General Data Protection Regulation (GDPR).

Language: Английский

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Obstructive Sleep Apnea, Circadian Rhythm Disturbance, Hypertension, and Kidney Stone: An Attractive Quadrangle? [Letter]

Nature and Science of Sleep, Journal Year: 2025, Volume and Issue: Volume 17, P. 157 - 158

Published: Jan. 1, 2025

Between Obstructive Sleep Apnea and Kidney Stones: NHANES 2015-2018 Mendelian Randomization". 1 This study investigated the relationship between obstructive sleep apnea (OSA) kidney stone disease (KSD) explored causal link using randomization.Here, we would like to raise a little concern indicate some clinical implications of this study.First, accurate diagnosis OSA is not available from database due lack polysomnography test results, which gold standard for diagnosing OSA.Usually, frequency self-reported symptoms an alternative indicator OSA. 2 Since were obtained questionnaire, recall bias inevitable, may reduce robustness final results.The rigor benefit emphasizing that based on "self-reported symptoms" related in Title or Introduction.In addition, results about risk KSD patients "OR = 1.29; 95% CI: 1.00-1.66;p 0.05" result decreased statistical reliability critical p-value confidence interval.More covariates be considered adjusted modify example, presence chronic disease.Apart fly ointment, appreciate both population-and genetic-based evidence unraveling KSD.OSA induces disruption normal circadian clock associated with various cardiovascular metabolic complications. 3 Recently, has been proven tightly rhythm disturbance (CRD). 4Unlike previous urinary component analyses, Liu et al confirmed can promote formation, their viewpoints support CRD KSD.Currently, most widely known syndrome (MetS) (type diabetes, obesity), new concept "circadian syndrome" was proposed underline connection MetS CRD. 4 Another biological parameter, blood pressure, also regulated by clock, cause hypertension, key MetS. 5 However, hypertension still controversial opposite different cohorts. 5OSA exist bidirectional where one condition increases other, they share same pathological processes (eg, oxidative stress, excessive generation reactive oxygen species, abnormal activation renin-angiotensin-aldosterone system). 5Therefore, potential KSD.Summarily, it found OSA, are all CRD, could explain obscure KSD.We suspect "Quadrangle" formed KSD, elucidates targets prevention therapy.In conclusion, article provides valuable insights pathogenesis inspire more management.

Language: Английский

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The impact of postoperative pain interventions on circadian rhythm disruptions: mechanisms and clinical implications

Frontiers in Neuroscience, Journal Year: 2025, Volume and Issue: 19

Published: April 28, 2025

Postoperative pain is a prevalent clinical issue that significantly impacts patient recovery, making its management crucial for rehabilitation. Recent studies have shown postoperative not only affects the physiological state of patients but may also disrupt their circadian rhythms, leading to decreased sleep quality and dysfunctions. This review aims explore effects interventions on rhythm disturbances, analyze underlying mechanisms, summarize effective strategies currently used in practice. Through comprehensive analysis relevant literature, we will highlight importance during recovery process emphasize potential role regulating rhythms. Pharmacological treatments like NSAIDs melatonin efficacy rhythms improving patients. Multimodal analgesia combining pharmacological non-pharmacological methods (e.g., CBT, acupuncture) can optimize relief while minimizing side effects. However, further research needed clarify bidirectional relationship between perception translate these findings into

Language: Английский

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The dark side of apnea: altered 24-hour melatonin secretion in obstructive sleep apnea (OSAS) is disease severity dependent

Sleep And Breathing, Journal Year: 2024, Volume and Issue: 28(4), P. 1751 - 1759

Published: May 27, 2024

Abstract Purpose Melatonin aids in the synchronization of circadian rhythm to external environment. Few studies have tried elucidate relationship between melatonin and obstructive sleep apnea syndrome (OSAS). These often include few patients, do not differentiate OSAS severity and/or analyse a 24-h profile. This study set out investigate disease dependent differences salivary secretion patients compared reference population retrospective design. Methods profiles 169 were analysed (55 light, 66 moderate, 48 severe) as well 91 patients. Several aspects curve stratified according severity. Parameters included: dim light onset (DLMO), time returning below DLMO (DLMOoff), peak concentration time, total exposure. Results Significant effects corrected for confounding by age sex using linear regression. Our analysis shows that, manner, significantly lower curve, concentration, exposure smaller proportion reach DLMO. The production resistant sex. Conclusion describes clear abnormalities independent age. Future research should indicate whether oral supplementation has beneficial with attenuated endogenous production.

Language: Английский

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Are Depressive Symptoms in Obstructive Sleep Apnea Attributable to a Syndrome of Dysregulation of Rhythms and Hyperactivity (DYMERS)?

Journal of Clinical Medicine, Journal Year: 2024, Volume and Issue: 13(15), P. 4396 - 4396

Published: July 27, 2024

Background: Obstructive sleep apnea (OSA) is characterized by repeated airway obstructions during sleep, causing hypopnea, apnea, intermittent hypoxia, and fragmentation. The severity of OSA measured using the apnea–hypopnea index (AHI), with AHI ≥ 5 indicating OSA. This study aims to assess frequency type depressive disorder characteristics patients evaluate impact on quality life, also considering presence hyperactivity. Methods: A case-control referred Cagliari’s center. Controls were matched age sex from community databases. diagnoses made > 15. Depressive episodes identified BDI-SF, H-QoL (Health related Quality Life) was SF-12, focusing item 10 for hyper-energy. Results: clinical sample (n = 25) had a higher (36%) compared controls (7% 4%). Depressed worse hyper-energy scores, but additional burden depression relatively low. Conclusions: has general population. in are linked scores despite lower overall life scores. While significantly impacts less severe than other chronic diseases. These findings suggest that may be rhythm dysregulation hyperactivity (DYMERS).

Language: Английский

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Advancements in the neurocirculatory reflex response to hypoxia

AJP Regulatory Integrative and Comparative Physiology, Journal Year: 2024, Volume and Issue: 327(1), P. R1 - R13

Published: May 13, 2024

Hypoxia is a pivotal factor in the pathophysiology of various clinical conditions, including obstructive sleep apnea, which has strong association with cardiovascular diseases like hypertension, posing significant health risks. Although precise mechanisms linking hypoxemia-associated conditions hypertension remains incompletely understood, compelling evidence suggests that hypoxia induces plasticity neurocirculatory control system. Despite variations experimental designs and severity, frequency, duration exposure, from animal human models consistently demonstrates robust effects hypoxemia triggering reflex-mediated sympathetic activation. Both acute chronic alters regulation and, some circumstances, leads to outflow elevated blood pressures persist beyond hypoxic stimulus. Dysregulation autonomic could lead adverse outcomes increase risk developing hypertension.

Language: Английский

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Self-Reported Symptoms of Obstructive Sleep Apnea are Associated with Increased Risk of Kidney Stones: A Cross-Sectional Study from NHANES 2015-2020

Nature and Science of Sleep, Journal Year: 2024, Volume and Issue: Volume 16, P. 2099 - 2110

Published: Dec. 1, 2024

To investigate whether self-reported symptoms of obstructive sleep apnea (OSA), including snoring, snorting/stopping breathing, and sleepiness, are associated with increased risk kidney stones. This cross-sectional study was conducted based on the 2015-2020 National Health Nutrition Examination Survey (NHANES). Self-reported OSA history stones were diagnosed via questionnaires. Multivariable logistic regression used to determine associations between Subgroup analyses interaction tests performed address this issue further. A total 9,973 participants enrolled, prevalence 10.76%. Although no significant association observed frequent snoring after covariate adjustments (OR 1.033, 95% CI 0.726, 1.469 p = 0.850), breathing a greater 1.655, 1.262, 2.172, 0.002). Participants who often or almost always felt sleepy also had adjustment 1.651, 1.222, 2.229; 0.004). The suggested that marital status (p 0.015) smoking < 0.001) significantly interacted sleepiness may be these findings emphasize prevention in people, further research still needed verify our results.

Language: Английский

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G protein-coupled receptor 55 activated by palmitoylethanolamide is associated with the development of nocturia associated with circadian rhythm disorders

Life Sciences, Journal Year: 2023, Volume and Issue: 332, P. 122072 - 122072

Published: Sept. 11, 2023

Bladder function is regulated by clock genes and dysregulation of circadian bladder can cause nocturia. The blood concentration palmitoylethanolamide (PEA), a fatty acid metabolite, changes with rhythm. Clock gene abnormalities demonstrate the highest PEA levels during sleep phase. GPR55 agonist that influences urination; therefore, increased phase may Herein, we investigated to evaluate relationship between nocturia evoked higher in patients rhythm disorders.Male C57BL/6 mice were used. localization was evaluated immunofluorescence staining, qRT-PCR, western blotting. Variations PEA-induced intracellular Ca2+ concentrations measured primary cultured mouse urothelial cells (UCs) using imaging. NGF PGI2 release UCs ELISA. micturition reflex pathway after administration staining.GPR55 predominant UC layer. induced from endoplasmic reticulum into cytoplasm. ELISA staining revealed released UCs, stimulated pontine center mice, nocturia.The loss regular metabolizing acids causes Binding activate downstream processes reflex, leading These findings suggest new mechanism for its potential as therapeutic target.

Language: Английский

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