Primary Aldosteronism and Obstructive Sleep Apnea: Is This A Bidirectional Relationship?

2017 ◽  
Vol 49 (12) ◽  
pp. 969-976 ◽  
Author(s):  
Aleksander Prejbisz ◽  
Sylwia Kołodziejczyk-Kruk ◽  
Jacques Lenders ◽  
Andrzej Januszewicz
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Primary Aldosteronism ◽  
Upper Airway ◽  
Endocrine Society ◽  
Obstructive Sleep ◽  
High Prevalence ◽  
Bidirectional Relationship ◽  
Causal Treatment ◽  
The Relationship

AbstractIt has been suggested that the high prevalence of obstructive sleep apnea (OSA) in resistant hypertension (RHT) may be related to the high prevalence of primary aldosteronism (PA) in patients with RHT. It has been also hypothesized that the relationship between aldosterone and OSA might be bidirectional. In patients with RHT, it has been shown that aldosterone levels correlate with severity of OSA and that blockade of aldosterone reduces the severity of OSA. It has been postulated that aldosterone worsens OSA by promoting accumulation of fluid, which shifted in the supine position to the neck, contributes to increased upper airway resistance. Also there is growing data that PA is more frequent in patients with OSA and that the treatment of PA positively influences OSA course. Also in some studies it has been shown that patients with OSA are characterized by higher aldosterone levels and higher prevalence of PA than patients without OSA and that causal treatment of OSA might decrease aldosterone levels. Moreover, the recent guideline of the Endocrine Society on management of PA recommends to screen hypertensive patients with OSA for PA.

scholarly journals Tormented Sunrises

2019 ◽  
pp. 418-434
Author(s):  
Maha Alattar
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
General Population ◽  
Sleep Disorders ◽  
Headache Disorders ◽  
Distinct Subset ◽  
Obstructive Sleep ◽  
High Prevalence ◽  
The Relationship

This chapter covers the relationship between sleep-related headaches and sleep disorders such as obstructive sleep apnea (OSA). Sleep apnea headache (SAH), a type of sleep-related headache that is classified in the International Classification of Headache Disorders, is a distinct subset of headache that is caused by OSA and occurs distinctly on awakening. Once recognized, treatment of OSA is associated with significant improvement in, and often resolution of, SAH. Given the high prevalence of headaches in the general population, sleep disorders must be considered in the evaluation of patients with headaches. A comprehensive sleep evaluation should be an integral part of the assessment of headache disorders. Sleep apnea headache and other types of headaches associated with sleep are reviewed in this chapter.

scholarly journals The relationship of obstructive sleep apnea and cardiovascular diseases from the perspective of evidence-based medicine. Part 1

2020 ◽  
Vol 19 (3) ◽  
pp. 2405
Author(s):  
М. V. Agaltsov ◽  
O. M. Drapkina
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Cardiovascular Diseases ◽  
Sleep Disorders ◽  
Developed Countries ◽  
Obstructive Sleep ◽  
Number Of Patients ◽  
High Prevalence ◽  
Relationship Of ◽  
The Relationship

The results of prospective studies, meta-analyzes and systematic reviews on the associations of obstructive sleep apnea (OSA) with various cardiovascular diseases (CVD) were analyzed. Currently, the mechanisms related to high prevalence of breathing-related sleep disorders among population of economically developed countries are clear, and an increase in the number of OSA patients has been shown. The relationship between OSA and CVD has been widely confirmed in large cohort studies. The first review part discusses the relationship of hypertension (HTN) and various heart arrhythmias (atrial fibrillation (AF), bradyarrhythmias, premature ventricular contraction, sudden death during sleep) with breathing-related sleep disorders. These groups of cardiovascular disorders currently show the most proven relationship with sleep apnea. In addition to cross-sectional studies indicating the high prevalence of OSA in patients with HTN and AF, some observational studies indicate an increase in the number of patients with HTN and paroxysmal AF with history of untreated sleep apnea. An analysis of the current issues of OSA phenotypes (in particular, REM-related OSA in hypertensive patients) as the most unfavorable cardiovascular factors is carried out.

scholarly journals The The relationship between NLRP3 rs10159239 and Vaspin rs2236242 gene variants and obstructive sleep apnea

2021 ◽  
Vol 126 (1) ◽  
Author(s):  
Buğra Kerget ◽  
Ferhan Kerget ◽  
Çiğdem Yüce Kahraman ◽  
Alperen Aksakal ◽  
Ömer Araz
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Upper Airway ◽  
Control Group ◽  
Nucleotide Polymorphisms ◽  
Single Nucleotide ◽  
Obstructive Sleep ◽  
And Control ◽  
The Relationship ◽  
Increased Susceptibility

Background: In obstructive sleep apnea (OSA), recurrent upper airway obstruction and apnea/hypopnea episodes result in endothelial dysfunction, which leads to the release of many proinflammatory cytokines and reactive oxygen species (ROS). ROS induces NLRP3, a protein involved in the synthesis of interleukin (IL)-1 and IL-18; vaspin is a serine protease inhibitor that has an important role in suppressing the activation of NLRP3 inflammasome. In this study, we aimed to investigate the effect of NLRP3 rs10159239 (rs9239) and vaspin rs2236242 (rs6242) single nucleotide polymorphisms (SNPs) on OSA development. Methods: This study included 220 individuals who underwent polysomnography (118 patients with OSA and 102 healthy controls). NLRP3 rs9239 and vaspin rs6242 mutation frequencies were analyzed. Results: The NLRP3 rs9239 SNP genotype analysis revealed no statistically significant differences between the OSA and control groups. In the vaspin gene analysis, the rs6242 AA genotype was significantly more frequent in the OSA group compared with the control group, while the AT genotype was more frequent in controls (P = 0.004, P = 0.02). Comparison of rs6242 allele levels showed that the A allele was significantly more frequent in OSA patients than in controls (P = 0.03). The AA genotype was significantly more frequent in patients with severe OSA than in patients with mild or moderate OSA and the control group (P = 0.001 for all). Serum vaspin levels were significantly lower in carriers of the AA genotype than those with AT and TT genotypes (P = 0.001). Conclusion: The vaspin rs6242 SNP AA genotype increased susceptibility to OSA, while the AT genotype appeared to be protective. The lower plasma vaspin levels in OSA compared with the control group and in patients with the AA genotype suggest that vaspin may be a protective biomarker for OSA.

scholarly journals Contribution of male sex, age, and obesity to mechanical instability of the upper airway during sleep

2008 ◽  
Vol 104 (6) ◽  
pp. 1618-1624 ◽  
Author(s):  
Jason P. Kirkness ◽  
Alan R. Schwartz ◽  
Hartmut Schneider ◽  
Naresh M. Punjabi ◽  
Joseph J. Maly ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Body Mass ◽  
Upper Airway ◽  
Obstructive Sleep ◽  
Airway Mechanics ◽  
Male Sex ◽  
The Relationship

Male sex, obesity, and age are risk factors for obstructive sleep apnea, although the mechanisms by which these factors increase sleep apnea susceptibility are not entirely understood. This study examined the interrelationships between sleep apnea risk factors, upper airway mechanics, and sleep apnea susceptibility. In 164 (86 men, 78 women) participants with and without sleep apnea, upper airway pressure-flow relationships were characterized to determine their mechanical properties [pharyngeal critical pressure under hypotonic conditions (passive Pcrit)] during non-rapid eye movement sleep. In multiple linear regression analyses, the effects of body mass index and age on passive Pcrit were determined in each sex. A subset of men and women matched by body mass index, age, and disease severity was used to determine the sex effect on passive Pcrit. The passive Pcrit was 1.9 cmH2O [95% confidence interval (CI): 0.1–3.6 cmH2O] lower in women than men after matching for body mass index, age, and disease severity. The relationship between passive Pcrit and sleep apnea status and severity was examined. Sleep apnea was largely absent in those individuals with a passive Pcrit less than −5 cmH2O and increased markedly in severity when passive Pcrit rose above −5 cmH2O. Passive Pcrit had a predictive power of 0.73 (95% CI: 0.65–0.82) in predicting sleep apnea status. Upper airway mechanics are differentially controlled by sex, obesity, and age, and partly mediate the relationship between these sleep apnea risk factors and obstructive sleep apnea.

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