417 Transgender Hormone Therapy and Sleep-Disordered Breathing

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A165-A165
Author(s):  
Ronald Gavidia ◽  
Galit Levi Dunietz ◽  
Lisa Matlen ◽  
Shelley Hershner ◽  
Daphna Stroumsa ◽  
...  
Keyword(s):  
Linear Regression ◽  
Regression Models ◽  
Sleep Disordered Breathing ◽  
Hormone Replacement ◽  
Apnea Hypopnea Index ◽  
Linear Regression Models ◽  
Sleep Complaints ◽  
Human Respiration ◽  
Lower Oxygen ◽  
Disordered Breathing

Abstract Introduction Sex hormones may affect human respiration during wakefulness and sleep. Testosterone has been associated with increased obstructive respiratory events contributing to sleep-disordered breathing (SDB) in men, whereas a protective effect against SDB has been attributed to estrogen in women. These associations, primarily observed in cisgender populations, have been rarely examined in transgender individuals on hormone replacement therapy (HRT). The present study investigated associations between HRT and SDB in transgender adults. Methods A chart review of medical records from transgender patients was conducted in a large academic sleep medicine center. Individuals were included if they were at least 18 years old, had one or more sleep complaints, and SDB testing results available. Participants were then stratified by affirmed gender (transmasculine and transfeminine) and by HRT status. We used descriptive statistics procedures to examine differences between gender and HRT groups. Associations between HRT and the apnea-hypopnea index (AHI) were estimated with age-adjusted linear regression models. Results Of the 194 individuals identified, 89 satisfied the inclusion criteria. Nearly half of participants were transmasculine (52%). The mean age was 38±13 years, and mean body mass index was 34.7±9.0 Kg/m2. Approximately 60% of participants were on HRT at the time of SDB evaluation. Transmasculine people who were prescribed testosterone had a significantly increased AHI and lower oxygen nadir in comparison to transmasculine individuals not on testosterone (AHI 36.8±37.8/hour vs.15.3±16.6/hour, p=0.01; oxygen nadir 83.4±8.3% vs. 89.1±2.4%, p=0.001). In contrast, differences between transfeminine people with and without feminizing HRT (androgen blocker + estrogen) were not statistically significant (AHI 21.4±27.7/hour vs. 27.7±26.0/hour, p=0.45; oxygen nadir 86.5±6.7% vs. 84.1±7.7%, p=0.29). Linear regression models adjusted for age found an association between HRT and AHI for transmasculine (β=16.7, 95% CI 2.7, 30.8), but not for transfeminine participants (β=-2.5, 95% CI -17.9, 12.9). Conclusion These findings suggest differential associations between HRT and AHI among transgender individuals, with transmasculine on testosterone having a significant increase in AHI. Prospective studies with large sample sizes are warranted to evaluate these associations. Support (if any) Dr. Gavidia’s work was supported by an NIH/NINDS T32-NS007222 grant

Sleep characteristics and cognitive impairment in the general population

Neurology ◽  
2016 ◽  
Vol 88 (5) ◽  
pp. 463-469 ◽  
Author(s):  
José Haba-Rubio ◽  
Helena Marti-Soler ◽  
Nadia Tobback ◽  
Daniela Andries ◽  
Pedro Marques-Vidal ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
General Population ◽  
Sleep Disordered Breathing ◽  
Neuropsychological Test ◽  
Population Based ◽  
Apnea Hypopnea Index ◽  
Clinical Dementia Rating ◽  
Sleep Complaints ◽  
Confounding Variables ◽  
Disordered Breathing

Objective:To assess the association between sleep structure and cognitive impairment in the general population.Methods:Data stemmed from 580 participants aged >65 years of the population-based CoLaus/PsyCoLaus study (Lausanne, Switzerland) who underwent complete sleep evaluation (HypnoLaus). Evaluations included demographic characteristics, personal and treatment history, sleep complaints and habits (using validated questionnaires), and a complete polysomnography at home. Cognitive function was evaluated using a comprehensive neuropsychological test battery and a questionnaire on the participant's everyday activities. Participants with cognitive impairment (global Clinical Dementia Rating [CDR] scale score > 0) were compared with participants with no cognitive impairment (global CDR score = 0).Results:The 291 participants with a CDR score > 0 (72.5 ± 4.6 years), compared to the 289 controls with CDR = 0 (72.1 ± 4.6 years), had significantly more light (stage N1) and less deep (stage N3) and REM sleep, as well as lower sleep efficiency, higher intrasleep wake, and higher sleepiness scores (all p < 0.05). Sleep-disordered breathing was more severe in participants with cognitive impairment with an apnea/hypopnea index (AHI) of 18.0 (7.8–35.5)/h (p50 [p25–p75]) (vs 12.9 [7.2–24.5]/h, p < 0.001), and higher oxygen desaturation index (ODI). In the multivariate analysis after adjustments for confounding variables, the AHI and the ODI ≥4% and ≥6% were independently associated with cognitive impairment.Conclusions:Participants aged >65 years with cognitive impairment have higher sleepiness scores and a more disrupted sleep. This seems to be related to the occurrence of sleep-disordered breathing and the associated intermittent hypoxia.

scholarly journals Enhanced CaMKII-Dependent Late I Na Induces Atrial Proarrhythmic Activity in Patients With Sleep-Disordered Breathing

2020 ◽  
Vol 126 (5) ◽  
pp. 603-615 ◽  
Author(s):  
Simon Lebek ◽  
Konstantin Pichler ◽  
Kathrin Reuthner ◽  
Maximillian Trum ◽  
Maria Tafelmeier ◽  
...  
Keyword(s):  
Sleep Disordered Breathing ◽  
Artery Bypass ◽  
Right Atrial ◽  
Apnea Hypopnea Index ◽  
Na Channel ◽  
Linear Regression Models ◽  
Inhibitory Peptide ◽  
Clinical Trial Registration ◽  
Cross Sectional ◽  
Disordered Breathing

Rationale: Sleep-disordered breathing (SDB) is frequently associated with atrial arrhythmias. Increased CaMKII (Ca/calmodulin-dependent protein kinase II) activity has been previously implicated in atrial arrhythmogenesis. Objective: We hypothesized that CaMKII-dependent dysregulation of Na current (I Na ) may contribute to atrial proarrhythmic activity in patients with SDB. Methods and Results: We prospectively enrolled 113 patients undergoing elective coronary artery bypass grafting for cross-sectional study and collected right atrial appendage biopsies. The presence of SDB (defined as apnea-hypopnea index ≥15/h) was assessed with a portable SDB monitor the night before surgery. Compared with 56 patients without SDB, patients with SDB (57) showed a significantly increased level of activated CaMKII. Patch clamp was used to measure I Na . There was a significantly enhanced late I Na , but reduced peak I Na due to enhanced steady-state inactivation in atrial myocytes of patients with SDB consistent with significantly increased CaMKII-dependent cardiac Na channel phosphorylation (Na V 1.5, at serine 571, Western blotting). These gating changes could be fully reversed by acute CaMKII inhibition (AIP [autocamtide-2 related inhibitory peptide]). As a consequence, we observed significantly more cellular afterdepolarizations and more severe premature atrial contractions in atrial trabeculae of patients with SDB, which could be blocked by either AIP or KN93 (N-[2-[[[(E)-3-(4-chlorophenyl)prop-2-enyl]-methylamino]methyl]phenyl]-N-(2-hydroxyethyl)-4-methoxybenzenesulfonamide). In multivariable linear regression models incorporating age, sex, body mass index, existing atrial fibrillation, existing heart failure, diabetes mellitus, and creatinine levels, apnea-hypopnea index was independently associated with increased CaMKII activity, enhanced late I Na and correlated with premature atrial contraction severity. Conclusions: In atrial myocardium of patients with SDB, increased CaMKII-dependent phosphorylation of Na V 1.5 results in dysregulation of I Na with proarrhythmic activity that was independent from preexisting comorbidities. Inhibition of CaMKII may be useful for prevention or treatment of arrhythmias in SDB. Clinical Trial Registration: URL: http://www.clinicaltrials.gov . Unique identifier: NCT02877745. Visual Overview: An online visual overview is available for this article.

Abstract 18672: Association Between Sleep Disordered Breathing and Electrocardiographic Markers of Atrial Abnormalities: The MESA Study

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Younghoon Kwon ◽  
Jeffrey R Misialek ◽  
Daniel Duprez ◽  
Alvaro Alonso ◽  
David R Jacobs, Jr ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Left Atrial ◽  
Sleep Disordered Breathing ◽  
P Wave ◽  
Apnea Hypopnea Index ◽  
Linear Regression Models ◽  
Cross Sectional ◽  
Increased Risk ◽  
Electrocardiographic Markers ◽  
Disordered Breathing

Introduction: Abnormal P wave terminal force in V1 (PTFV1), an electrocardiographic marker of left atrial abnormalities, has been linked to increased risk of atrial fibrillation (AF). Examining the association between sleep disordered breathing (SDB) and PTFV1 might shed light on the potential mechanisms by which SDB increases risk of AF. Methods: A total of 1546 participants (mean age 67.2 (± 8.8) years, 53.4 % women and 63.3 % non-Whites) from the Multi-Ethnic Study of Atherosclerosis (MESA) Exam 5 Sleep ancillary were included in this analysis. PTFV1 was measured from resting standard digital ECG tracings that were automatically processed centrally. Linear and logistic regression analyses were used to examine the cross-sectional associations between measures of SDB (apnea hypopnea index [AHI], obstructive AHI [OAHI] and % time spent with oxygen saturation <90% [% SpO2 90]) and PTFV1. Results: There was a trend of higher PFTV1 values across quartiles of AHI, OAHI and % SpO2 90 (p for trend <0.01 for each). In multivariable linear regression models, the upper quartile of AHI and OAHI measures were associated with higher values of PTFV1 compared with the lower quartile (Table). A 1-SD increase of AHI and OAHI were associated with increased levels of PTFV1 (Table). When PTFV1 was considered as a binary variable (using the cut point of 4000 μV.ms to define abnormality) in logistic regression analysis, AHI and OAHI were also associated with abnormal PTFV1. Conclusion: Severity of SDB, as measured by AHI is associated with subclinical left atrial disease, as measured by PTFV1. This could partially explain the reported association between SDB and AF.

FAKTOR DETERMINAN PENYALURAN KREDIT BANK PERSERO

2018 ◽  
Vol 23 (1) ◽  
pp. 60-71
Author(s):  
Wigiyanti Masodah
Keyword(s):  
Interest Rate ◽  
Linear Regression ◽  
Interest Rates ◽  
Regression Models ◽  
Linear Regression Models ◽  
Negative Impacts ◽  
Main Activity ◽  
The Impact ◽  
The Given ◽  
Multiple Linear Regression Models

Offering credit is the main activity of a Bank. There are some considerations when a bank offers credit, that includes Interest Rates, Inflation, and NPL. This study aims to find out the impact of Variable Interest Rates, Inflation variables and NPL variables on credit disbursed. The object in this study is state-owned banks. The method of analysis in this study uses multiple linear regression models. The results of the study have shown that Interest Rates and NPL gave some negative impacts on the given credit. Meanwhile, Inflation variable does not have a significant effect on credit given. Keywords: Interest Rate, Inflation, NPL, offered Credit.

Linear Regression Models for Interval-Valued Data using Log-transformation

2020 ◽  
Author(s):  
Nykolas Mayko Maia Barbosa ◽  
João Paulo Pordeus Gomes ◽  
César Lincoln Cavalcante Mattos ◽  
Diêgo Farias Oliveira
Keyword(s):  
Linear Regression ◽  
Regression Models ◽  
Linear Regression Models ◽  
Log Transformation ◽  
Interval Valued

THE PREDICTIVE CONTENT OF DISAGGREGATED NORMAL INCOME: An Empirical Study in the JSX

2003 ◽  
Vol 5 (3) ◽  
pp. 363 ◽  
Author(s):  
Slamet Sugiri
Keyword(s):  
Linear Regression ◽  
Regression Models ◽  
Stock Exchange ◽  
Manufacturing Firms ◽  
Single Step ◽  
Model Parameters ◽  
Linear Regression Models ◽  
Operating Income ◽  
Predictive Content ◽  
Multiple Step

The main objective of this study is to examine a hypothesis that the predictive content of normal income disaggregated into operating income and nonoperating income outperforms that of aggregated normal income in predicting future cash flow. To test the hypothesis, linear regression models are developed. The model parameters are estimated based on fifty-five manufacturing firms listed in the Jakarta Stock Exchange (JSX) up to the end of 1997.This study finds that empirical evidence supports the hypothesis. This evidence supports arguments that, in reporting income from continuing operations, multiple-step approach is preferred to single-step one.

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