404 Sleep-Disordered Breathing In Native Hawaiians/Pacific Islanders With Associated Comorbidities And Adherence To Therapy

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A160-A161
Author(s):  
Darin Ryujin ◽  
Krishna Sundar ◽  
Allyson Gilles
Keyword(s):  
Sleep Disordered Breathing ◽  
Demographic Data ◽  
Ethnic Origin ◽  
Pacific Islanders ◽  
Native Hawaiians ◽  
University Of Utah ◽  
High Prevalence ◽  
Artery Disease ◽  
Disordered Breathing

Abstract Introduction Sleep-disordered breathing in Native Hawaiians and Pacific Islanders (NHPIs), its relationship to type 2 diabetes mellitus (DM), chronic renal, and heart disease, is not well known. NHPIs comprise only 1.3% of Utah’s population, but have the highest rates of DM and deaths due to diabetic kidney disease in Utah. This study assessed the nature of sleep-disordered breathing, its association with demographic variables, and comorbidities, and adherence patterns to positive airway pressure (PAP) therapy. Methods University of Utah sleep clinics patient databases from 2014 were evaluated to identify NHPIs using first/last names. Electronic medical records were reviewed to confirm patient ethnic origin, demographic data, and comorbidities. The most recent PAP downloads were obtained. Results Of 106 NHPIs were identified, data available for 104 patients (71 males, 33 females) was analyzed. Mean age of males was 47 + 13 years and females 48±13 years. Prevalence rates of obesity were 13% (female 9%, male 15%) with BMI≥30, 33% (female 24%, male 23%) with BMI≥35, and 49% (female 58%, Male 23%) with BMI≥40). Majority of patients had severe OSA (61% males with AHI≥30; 39% females with ≥ 30), with overall mean AHI of 47±38. A high prevalence of comorbidities was noted: 61% hypertension (male 58%; female 67%), diabetes 54% (male 48%, female 67%), renal disease 20% (male 21%, female 18%), coronary artery disease 13% (male 14%, female 9%), and congestive heart failure 13% (male 15%, female 9%). Prevalence of lung disease was low 13% (male 9%, female 18%). Conclusion NHPIs evaluated for sleep-disordered breathing have high rates of obesity, severe OSA, and concerning comorbidities. PAP adherence in this group was poor compared to overall adherence for patients seen in University of Utah sleep clinics (~70%). Further research is required to assess the relationships between OSA, associated comorbidities, and disease outcomes. Addressing low rates of PAP adherence in this population may afford opportunities to improve health outcomes. Support (if any) n/a

scholarly journals Acetazolamide suppresses the prevalence of augmented breaths during exposure to hypoxia

2009 ◽  
Vol 297 (2) ◽  
pp. R370-R381 ◽  
Author(s):  
Harold J. Bell ◽  
Philippe Haouzi
Keyword(s):  
Sleep Disordered Breathing ◽  
Respiratory Rhythm ◽  
Respiratory Alkalosis ◽  
Male Rats ◽  
Breathing Cycle ◽  
Beneficial Effects ◽  
High Prevalence ◽  
Cessation Of Treatment ◽  
Unique Condition ◽  
Disordered Breathing

Augmented breaths, or “sighs,” commonly destabilize respiratory rhythm, precipitating apneas and variability in the depth and rate of breathing, which may then exacerbate sleep-disordered breathing in vulnerable individuals. We previously demonstrated that hypocapnia is a unique condition associated with a high prevalence of augmented breaths during exposure to hypoxia; the prevalence of augmented breaths during hypoxia can be returned to normal simply by the addition of CO2 to the inspired air. We hypothesized that counteracting the effect of respiratory alkalosis during hypocapnic hypoxia by blocking carbonic anhydrase would yield a similar effect. We, therefore, investigated the effect of acetazolamide on the prevalence of augmented breaths in the resting breathing cycle in five awake, adult male rats. We found a 475% increase in the prevalence of augmented breaths in animals exposed to hypocapnic hypoxia compared with room air. Acetazolamide treatment (100 mg/kg ip bid) for 3 days resulted in a rapid and potent suppression of the generation of augmented breaths during hypoxia. Within 90 min of the first dose of acetazolamide, the prevalence of augmented breaths in hypoxia fell to levels that were no greater than those observed in room air. On cessation of treatment, exposure to hypocapnic hypoxia once again caused a large increase in the prevalence of augmented breaths. These results reveal a novel means by which acetazolamide acts to stabilize breathing and may help explain the beneficial effects of the drug on breathing stability at altitude and in patients with central forms of sleep-disordered breathing.

scholarly journals Impaired Glucose Metabolisms of Patients with Obstructive Sleep Apnea and Type 2 Diabetes

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Ye Zhang ◽  
Yanpeng Xing ◽  
Haibo Yuan ◽  
Xiaokun Gang ◽  
Weiying Guo ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Plasma Cortisol ◽  
Sleep Disordered Breathing ◽  
Model Assessment ◽  
Obstructive Sleep ◽  
Underlying Mechanisms ◽  
Disordered Breathing

Aims. Obstructive sleep apnea (OSA) is a very common disorder which is associated with metabolic comorbidities. The aims of this study were to analyze clinical data of patients with OSA and evaluate influence of sleep-disordered breathing on glycometabolism and its underlying mechanisms. Methods. We designed a cross-sectional study involving 53 OSA patients in The First Hospital of Jilin University from March 2015 to March 2016. They underwent a full-night polysomnography, measurement of fasting blood glucose and blood lipid profiles. Besides, we chose 20 individuals with type 2 diabetes mellitus (T2DM) as a subgroup for an in-depth study. This group additionally underwent a steamed bread meal test and measurement of HbA1c, C-reactive protein, tumor necrosis factor-α, interleukin 6, morning plasma cortisol, and growth hormone. Results. The two groups which with or without T2DM showed no significant differences in baseline characteristics. As for OSA patients with T2DM, the severe OSA group had higher homeostasis model assessment of insulin resistance (HOMA-IR) (P=0.013) than the mild-to-moderate OSA group, whereas had lower morning plasma cortisol levels (P=0.005) than the mild-to-moderate OSA group. AHI was positive correlated with HOMA-IR (r=0.523, P=0.018), yet negative correlated with morning plasma cortisol (r=−0.694, P=0.001). However, nadir SpO2 was positive correlated with morning plasma cortisol (rs=0.646, P=0.002), while negative correlated with HOMA-IR (rs=−0.489, P=0.029). Conclusions. Our study showed that sleep-disordered breathing exerted negative influence on glucose metabolisms. The impairment of hypothalamic-pituitary-adrenal axis activity may be one of the underlying mechanisms of the glycometabolic dysfunctions in OSA with T2DM patients.

scholarly journals Cardiovascular risk in Japanese-Brazilian subjects

2012 ◽  
Vol 56 (9) ◽  
pp. 608-613 ◽  
Author(s):  
Patricia Moreira Gomes ◽  
Regina Célia Garcia de Andrade ◽  
Roberta Carvalho de Figueiredo ◽  
Ana Emília Pace ◽  
Amaury Lelis Dal Fabbro ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Ankle Brachial Index ◽  
Significance Level ◽  
Exact Test ◽  
High Prevalence ◽  
Artery Disease ◽  
Student’S T ◽  
Student’S T Test

OBJECTIVE: To evaluate the prevalence of risk factors for cardiovascular disease in Japanese-Brazilian subjects. SUBJECTS AND METHODS: One hundred thirty-one residents of the Mombuca community were studied. Statistical analysis was based on the X² test, Fisher's Exact test, Student's t test, and ANOVA, at a 5% significance level. RESULTS: The average age was 56.7 years-old; 76.3% had dyslipidemia, 24.4% pre-diabetes (PDM), 10.7% type 2 diabetes mellitus (T2DM), 46.6% hypertension, 52.7% abdominal obesity, and 35.8% metabolic syndrome (MS). There were significant correlations between HOMA-IR and MS diagnosis and obesity, while HOMA-β levels were decreased in T2DM and PDM. The ankle-brachial index was positive for peripheral artery disease in 22.3% of the individuals. Electrocardiograms did not show increased evidence of myocardial ischemia. CONCLUSION: Subjects of this community are exposed to major cardiovascular risk factors, namely high prevalence of MS diagnoses and increased HOMA-IR. Arq Bras Endocrinol Metab. 2012;56(9):608-13

Sleep-disordered breathing in women: occurrence and association with coronary artery disease

1996 ◽  
Vol 101 (3) ◽  
pp. 251-256 ◽  
Author(s):  
Thomas Mooe ◽  
Terje Rabben ◽  
Urban Wiklund ◽  
Karl A. Franklin ◽  
Peter Eriksson
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Sleep Disordered Breathing ◽  
Artery Disease ◽  
Disordered Breathing

scholarly journals High prevalence of poststroke sleep-disordered breathing in Mexican Americans

2017 ◽  
Vol 33 ◽  
pp. 97-102 ◽  
Author(s):  
Lynda D. Lisabeth ◽  
Brisa N. Sánchez ◽  
Ronald D. Chervin ◽  
Lewis B. Morgenstern ◽  
Darin B. Zahuranec ◽  
...  
Keyword(s):  
Mexican Americans ◽  
Sleep Disordered Breathing ◽  
High Prevalence ◽  
Disordered Breathing

Sleep-Disordered Breathing and Myocardial Ischemia in Patients With Coronary Artery Disease

CHEST Journal ◽  
2000 ◽  
Vol 117 (6) ◽  
pp. 1597-1602 ◽  
Author(s):  
Thomas Mooe ◽  
Karl A. Franklin ◽  
Urban Wiklund ◽  
Terje Rabben ◽  
Karin Holmström
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Myocardial Ischemia ◽  
Sleep Disordered Breathing ◽  
Artery Disease ◽  
Disordered Breathing

scholarly journals The Relationship Between Adiponectin Serum Level and Coronary Artery Disease in Type 2 Diabetic Patients

2021 ◽  
Author(s):  
Zahra Mazloum Khorasani ◽  
Saeed Choobkar ◽  
Ramin Khameneh Bagheri ◽  
Mina AkbariRad ◽  
Abdollah Firoozi
Keyword(s):  
Type 2 Diabetes ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Serum Level ◽  
Demographic Data ◽  
Diabetic Patients ◽  
Type 2 Diabetics ◽  
Increased Risk ◽  
Artery Disease

Adiponectin is an adipocytokine that has a higher serum level in healthy people. In type 2 diabetes, insulin resistance, hypertension, MI, and dyslipidemia, the serum level of adiponectin is lower than 4 µg/mL. Adiponectin is proved to have a protective role against atherosclerotic changes where its low serum levels in type 2 diabetes can lead to the progression of atherosclerotic lesions. In this study, we aimed to survey the possible effects of adiponectin in the development of coronary artery disease in type 2 diabetics. Thirty diabetic cases with coronary artery disease, 30 diabetic cases without known coronary artery disease, and a group of 30 healthy volunteers, all of them were between 18-65-year-old, were entered ourstudy. We gathered demographic data by performing a physical examination followed by filling a checklist and a set of laboratory tests. All the groups were sex and age-matched (P=0.284 and P=0.163 respectively). CAD group had the lowest HBA1C (P<0.001). Both LDL and HDL were also lower in the CAD group (P<0.001). Adiponectin was also lower in the CAD group when compared to other groups (P<0.008) or when compared with only normal diabetics (P<0.002). We found a correlation between adiponectin and HDL (r=0.348, P=0.008), suggesting each unit of reduction in serum level of adiponectin could increase the chance of coronary artery disease by 38% in diabetics. In this study, we showed that the lower serum level of adiponectin is correlated with an increased risk of coronary artery disease in type 2 diabetics.

Sleep-disordered breathing, type 2 diabetes and the metabolic syndrome

2014 ◽  
Vol 11 (4) ◽  
pp. 257-275 ◽  
Author(s):  
Ian W Seetho ◽  
John PH Wilding
Keyword(s):  
Type 2 Diabetes ◽  
Metabolic Syndrome ◽  
Sleep Disordered Breathing ◽  
Sleep Apnoea ◽  
The Metabolic Syndrome ◽  
Sleep Homeostasis ◽  
Obstructive Sleep ◽  
Underlying Mechanisms ◽  
Disordered Breathing

Sleep-disordered breathing (SDB) encompasses a spectrum of conditions that can lead to altered sleep homeostasis. In particular, obstructive sleep apnoea (OSA) is the most common form of SDB and is associated with adverse cardiometabolic manifestations including hypertension, metabolic syndrome and type 2 diabetes, ultimately increasing the risk of cardiovascular disease. The pathophysiological basis of these associations may relate to repeated intermittent hypoxia and fragmented sleep episodes that characterize OSA which drive further mechanisms with adverse metabolic and cardiovascular consequences. The associations of OSA with type 2 diabetes and the metabolic syndrome have been described in studies ranging from epidemiological and observational studies to controlled trials investigating the effects of OSA therapy with continuous positive airway pressure (CPAP). In recent years, there have been rising prevalence rates of diabetes and obesity worldwide. Given the established links between SDB (in particular OSA) with both conditions, understanding the potential influence of OSA on the components of the metabolic syndrome and diabetes and the underlying mechanisms by which such interactions may contribute to metabolic dysregulation are important in order to effectively and holistically manage patients with SDB, type 2 diabetes or the metabolic syndrome. In this article, we review the literature describing the associations, the possible underlying pathophysiological mechanisms linking these conditions and the effects of interventions including CPAP treatment and weight loss.

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