scholarly journals Stress in obstructive sleep apnea

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jasmine L. Wong ◽  
Fernando Martinez ◽  
Andrea P. Aguila ◽  
Amrita Pal ◽  
Ravi S. Aysola ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Depressive Symptoms ◽  
Sleep Apnea ◽  
Perceived Stress ◽  
Stress Reduction ◽  
Psychological Symptoms ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
General Anxiety Disorder ◽  
Obstructive Sleep

AbstractPeople with obstructive sleep apnea (OSA) often have psychological symptoms including depression and anxiety, which are commonly treated with anti-depression or anti-anxiety interventions. Psychological stress is a related symptom with different intervention targets that may also improve mental state, but this symptom is not well characterized in OSA. We therefore aimed to describe stress in relation to other psychological symptoms. We performed a prospective cross-sectional study of 103 people, 44 untreated OSA (mean ± s.d. age: 51.2 ± 13.9 years, female/male 13/31) and 57 healthy control participants (age: 46.3 ± 13.8 years, female/male 34/23). We measured stress (Perceived Stress Scale; PSS), excessive daytime sleepiness (Epworth Sleepiness Scale; ESS), depressive symptoms (Patient Health Questionnaire; PHQ-9), and anxiety symptoms (General Anxiety Disorder; GAD-7). We compared group means with independent samples t-tests and calculated correlations between variables. Mean symptom levels were higher in OSA than control, including PSS (mean ± s.d.: OSA = 15.3 ± 6.9, control = 11.4 ± 5.5; P = 0.002), GAD-7 (OSA = 4.8 ± 5.0, control = 2.1 ± 3.9; P = 0.02), PHQ-9 (OSA = 6.9 ± 6.1, control = 2.6 ± 3.8; P = 0.003) and ESS (OSA = 8.1 ± 5.3, control = 5.0 ± 3.3; P = 0.03). Similar OSA-vs-control differences appeared in males, but females only showed significant differences in PHQ-9 and ESS, not PSS or GAD-7. PSS correlated strongly with GAD-7 and PHQ-9 across groups (R = 0.62–0.89), and moderately with ESS. Perceived stress is high in OSA, and closely related to anxiety and depressive symptoms. The findings support testing stress reduction in OSA.

428 Baroreflex sensitivity during handgrip in obstructive sleep apnea with and without CPAP

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A169-A170
Author(s):  
Amrita Pal ◽  
Fernando Martinez ◽  
Ravi Aysola ◽  
Ronald Harper ◽  
Luke Henderson ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Baroreflex Sensitivity ◽  
Muscle Sympathetic Nerve Activity ◽  
Cross Sectional Study ◽  
Autonomic Regulation ◽  
Cross Sectional ◽  
Obstructive Sleep ◽  
Healthy Control ◽  
Significant Measure

Abstract Introduction Obstructive sleep apnea (OSA) disrupts multiple aspect of autonomic regulation; it is unclear whether intervention with continuous positive airway pressure (CPAP) can correct such disruptions. One key index of autonomic regulation is baroreflex sensitivity (BRS), an index that indicates heart rate (HR) changes to blood pressure (BP) alterations, and which is a significant measure for evaluating long-term cardiovascular changes induced by OSA. BRS can be assessed from BP and HR changes during an autonomic challenge task such as handgrip (HG). In a cross-sectional study, we assessed BRS during HG in untreated OSA (OSA_un) and CPAP treated OSA (CPAP), together with healthy control (CON) participants to determine if CPAP can recover BRS. Methods We collected ECG and continuous beat-by-beat BP from 95 people: 32 newly-diagnosed OSA_un (51.5±13.9years; AHI 21.0±15.3events/hour; 20male); 31 CPAP (49.4±14.0years; 22.4±14.1events/hour in initial diagnosis; 23male); and 32 CON (44.1±13.8years; 10male). We acquired data over 7 mins, during which people performed three 30s HGs (60 s baseline, 90 s recovery, 80% maximum strength). We calculated BRS over the 7 min period using sequence analysis in AcqKnowledge 5.0 BRS, followed by group comparisons using ANOVA. We also analyzed BP, HR and their variabilities: BPV and HRV (sympathetic-vagal). Results Mean arterial BP increases during HG were similar in all groups, although baseline mean arterial BP was higher in OSA_unc and CPAP, relative to CON (p < 0.05; OSA_un:mean±std, 90±11mmHg; CPAP: 88±10mmHg; CON 82±13mmHg). BRS was lower in OSA_un and CPAP, relative to CON (p < 0.05; OSA_un: 13.1±7.6 ms/mmHg; CPAP: 13.7±9.0 ms/mmHg; control 18.3±11.9 ms/mmHg). Other cardiovascular measures of BPV, HR and HRV in addition to BP showed significant increases in response to HG, but these changes were similar in all 3 groups. Conclusion BRS during HG was reduced in both OSA_un and CPAP compared to CON, while HG evoked similar overall changes in BP and HR in all three groups. Although CPAP reduces sympathetic tone measured as Muscle Sympathetic Nerve Activity (MSNA), BRS appears to be unaffected by the intervention. Irreversible changes in the baroreflex network may occur with OSA that are not altered with CPAP usage. Support (if any) NR-017435, HL135562

Depressive Symptoms in Comorbid Obstructive Sleep Apnea and Insomnia: An Integrative Review

2021 ◽  
pp. 019394592198965
Author(s):  
Bomin Jeon ◽  
Faith S. Luyster ◽  
Judith A. Callan ◽  
Eileen R. Chasens
Keyword(s):  
Obstructive Sleep Apnea ◽  
Depressive Symptoms ◽  
Sleep Apnea ◽  
Control Design ◽  
Case Control ◽  
Integrative Review ◽  
Study Quality ◽  
Cross Sectional ◽  
Obstructive Sleep ◽  
The Relationship

The purpose of this integrative review was to synthesize evidence concerning the relationship between comorbid obstructive sleep apnea and insomnia (OSA+I), and depressive symptoms. OSA and insomnia are common sleep disorders, recently comorbid OSA+I has been recognized as prevalent in adults. Although each sleep disorder increases the risk and severity of depressive symptoms, the effect of comorbid OSA+I on depressive symptoms remains unclear. A systematic search of PubMed, CINAHL, and PsycINFO identified 15 data-based studies. All the studies were observational with either a cross-sectional (n = 14) or a case-control design (n = 1). Study quality was assessed. Most of the studies (n = 14) indicated that comorbid OSA+I had an additive role on depressive symptoms. Insomnia appeared to have a more important role than OSA in increasing the severity of depressive symptoms in persons with comorbid OSA+I.

scholarly journals Simplifying the Screening of Obstructive Sleep Apnea With a 2-Item Model, No-Apnea: A Cross-Sectional Study

2018 ◽  
Vol 14 (07) ◽  
pp. 1097-1107 ◽  
Author(s):  
Ricardo L.M. Duarte ◽  
Marcelo F. Rabahi ◽  
Flavio J. Magalhães-da-Silveira ◽  
Tiago S. de Oliveira-e-Sá ◽  
Fernanda C.Q. Mello ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Obstructive Sleep

432 Brain Structure and Baroreflex Sensitivity Associations in Obstructive Sleep Apnea with and without CPAP

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A171-A171
Author(s):  
Amrita Pal ◽  
Fernando Martinez ◽  
Ravi Aysola ◽  
Ronald Harper ◽  
Luke Henderson ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Baroreflex Sensitivity ◽  
Muscle Sympathetic Nerve Activity ◽  
Cross Sectional Study ◽  
Autonomic Regulation ◽  
Cross Sectional ◽  
Obstructive Sleep ◽  
Healthy Control ◽  
Significant Measure

Abstract Introduction Obstructive sleep apnea (OSA) disrupts multiple aspects of autonomic regulation; it is unclear whether intervention with continuous positive airway pressure (CPAP) can correct such disruptions. One key index of autonomic regulation is baroreflex sensitivity (BRS), an index that indicates heart rate (HR) changes to blood pressure (BP) alterations, and which is a significant measure for evaluating long-term cardiovascular changes induced by OSA. BRS can be assessed from BP and HR changes during an autonomic challenge task such as handgrip (HG). In a cross-sectional study, we assessed BRS during HG in untreated OSA (OSA_un) and CPAP treated OSA (CPAP), together with healthy control (CON) participants to determine if CPAP can recover BRS. Methods We collected ECG and continuous beat-by-beat BP from 95 people: 32 newly-diagnosed OSA_un (51.5±13.9years; AHI 21.0±15.3events/hour; 20male); 31 CPAP (49.4±14.0years; 22.4±14.1events/hour in initial diagnosis; 23male); and 32 CON (44.1±13.8years; 10male). We acquired data over 7 mins, during which people performed three 30s HGs (60 s baseline, 90 s recovery, 80% maximum strength). We calculated BRS over the 7 min period using sequence analysis in AcqKnowledge 5.0 BRS, followed by group comparisons using ANOVA. We also analyzed BP, HR, and their variabilities: BPV and HRV (sympathetic-vagal). Results Mean arterial BP increases during HG were similar in all groups, although baseline mean arterial BP was higher in OSA_unc and CPAP, relative to CON (p < 0.05; OSA_un:mean±std, 90±11mmHg; CPAP: 88±10mmHg; CON 82±13mmHg). BRS was lower in OSA_un and CPAP, relative to CON (p < 0.05; OSA_un: 13.1±7.6 ms/mmHg; CPAP: 13.7±9.0 ms/mmHg; control 18.3±11.9 ms/mmHg). Other cardiovascular measures of BPV, HR, and HRV in addition to BP showed significant increases in response to HG, but these changes were similar in all 3 groups. Conclusion BRS during HG was reduced in both OSA_un and CPAP compared to CON, while HG evoked similar overall changes in BP and HR in all three groups. Although CPAP reduces sympathetic tone measured as Muscle Sympathetic Nerve Activity (MSNA), BRS appears to be unaffected by the intervention. Irreversible changes in the baroreflex network may occur with OSA that are not altered with CPAP usage. Support (if any) NR-017435, HL135562

Abstract TMP55: Polysomnographic and Sleep-related Variables Associated to Leukoaraiosis in Patients with Obstructive Sleep Apnea

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Kevin R Duque ◽  
Brian Villafuerte ◽  
Fiorella Adrianzen ◽  
Rodrigo Zamudio ◽  
Andrea Mendiola ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Logistic Regression ◽  
Sleep Apnea ◽  
Multinomial Logistic Regression ◽  
Sleep Time ◽  
Cross Sectional Study ◽  
Apnea Hypopnea Index ◽  
Cross Sectional ◽  
Obstructive Sleep ◽  
Medical Histories

Introduction: Obstructive sleep apnea (OSA) is a biological plausible risk factor for leukoaraiosis (LA). We tested the hypothesis that polysomnographic (PSG) and sleep-related variables are associated to LA in OSA patients. Methods: Cross-sectional study in which PSG records, medical histories and brain 1.5T MRI were collected from all consecutive patients who had attended a Sleep Medicine Center between 2009-2014. LA was graded from 0 to 9 with the ’Atherosclerosis Risk In Communities’ study scale. OSA was defined by The International Classification of Sleep Disorders, 2014, and its severity categorizing according to apnea-hypopnea index (AHI, <15 mild, 15 to <30 moderate, 30 to <45 severe and ≥45 very severe). A multinomial logistic regression was performed to describe the association between OSA severity and LA (divided into 2 groups: mild-to-moderate LA and non-to-minimal LA). The covariates for all regression models were age, gender, BMI, hypertension, ischemic stroke, myocardial infarction, diabetes and pack-year of smoking. Results: From 82 OSA patients (77% male; mean age 58±9 years, range 19-91), 54 (66%) had LA. Mild-to-moderate LA was found in 13 patients (8 mild and 5 moderate LA) and non-to-minimal LA in 69 (41 minimal and 28 non LA). Spearman’s correlation coefficient between AHI and LA grade was 0.41 (p<0.001). Furthermore, the higher OSA severity, the higher LA severity (p<0.001, for Jonckheere-Terpstra test for ordered alternatives). In the multinomial logistic regression model adjusted for cofounders, severe OSA patients had higher risk for mild or moderate LA (HR 12.8, 95% IC 1.2-141) compared to mild-to-moderate OSA patients. Additionally, self-reported habitual sleep duration from 7 to 9 hours (HR 0.36, 90% IC 0.14-0.90) and proportion of time in apnea/hypopnea over total sleep time (HR 1.04 for one unit increase, 90% IC 1.01-1.08) could be associated with the presence of LA (adjusted only for age and gender). In a multiple regression analysis with all the aforementioned variables, age (p=0.002), diabetes (p=0.003), and OSA severity (p=0.04) were predictors of the presence of LA. Conclusion: Patients with severe OSA had higher risk for mild to moderate LA when compared to patients with mild or moderate OSA.

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