The impact of early diagnosis and treatment of obstructive sleep apnoea in bariatric surgery patients

OSA (obstructive sleep apnoea) stimulates sympathetic nervous activity and elevates resting HR (heart rate) and BP (blood pressure). In the present study in a cohort of 309 untreated OSA patients, the resting HR and BP during the daytime were correlated with AHI (apnoea/hypopnea index) and compared with patients with R389R (n=162), R389G (n=125) and G389G (n=22) genotypes of the β1-adrenoreceptor R389G polymorphism. We analysed the impact of the genotype on the decline of HR and BP in a subgroup of 148 patients (R389R, n=86; R389G, n=54; G389G, n=8) during a 6-month follow-up period under CPAP (continuous positive airway pressure) therapy during which cardiovascular medication remained unchanged. In untreated OSA patients, we found an independent relationship between AHI and resting HR (β=0.096, P<0.001), systolic BP (β=0.09, P=0.021) and diastolic BP (β=0.059, P=0.016). The resting HR/BP, however, did not differ among carriers with the R389R, R389G and G389G genotypes. CPAP therapy significantly reduced HR [−2.5 (−1.1 to −4.0) beats/min; values are mean difference (95% confidence intervals)] and diastolic BP [−3.2 (−1.5 to −5.0) mmHg]. The decline in HR was more significantly pronounced in the R389R group compared with the Gly389 carriers [−4.1 (−2.3 to −5.9) beats/min (P<0.001) compared with −0.2 (2.1 to −2.6) beats/min (P=0.854) respectively; Student's t test between groups, P=0.008]. Diastolic BP was decreased significantly (P<0.001) only in Gly389 carriers (R389G or G389G) compared with R389R carriers [−5.0 (−2.3 to −7.6) mmHg compared with −2.0 (0.4 to −4.3) mmHg respectively]. ANOVA revealed a significant difference (P=0.023) in HR reduction between the three genotypes [−4.1 (±8.4) beats/min for R389R, −0.5 (±9.3) beats/min for R389G and +1.9 (±7.2) beats/min for G389G]. In conclusion, although the R389G polymorphism of the β1-adrenoceptor gene did not influence resting HR or BP in untreated OSA patients, it may modify the beneficial effects of CPAP therapy on these parameters.

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Relationship between the severity of obstructive sleep apnoea (OSA), low-grade-inflammation (LGI) and Heme Oxygenase 1 (HO1) in morbidly obese (MO) patients, before and after bariatric surgery (BS)

Endocrine Abstracts ◽

10.1530/endoabs.41.ep797 ◽

2016 ◽

Author(s):

Raquel Tirado ◽

Masdeu Maria Jose ◽

Laura Vigil ◽

Pere Rebassa ◽

Alexis Luna ◽

...

Keyword(s):

Bariatric Surgery ◽

Heme Oxygenase ◽

Obstructive Sleep Apnoea ◽

Sleep Apnoea ◽

Heme Oxygenase 1 ◽

Morbidly Obese ◽

Low Grade ◽

Obstructive Sleep ◽

Before And After ◽

Low Grade Inflammation

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Obstructive sleep apnoea and schizophrenia: a primer for psychiatrists

Acta Neuropsychiatrica ◽

10.1111/j.1601-5215.2011.00589.x ◽

2011 ◽

Vol 23 (5) ◽

pp. 201-209 ◽

Cited By ~ 3

Author(s):

Abdulkader Alam ◽

Kadiamada Nanaiah Roy Chengappa

Keyword(s):

Obstructive Sleep Apnoea ◽

Daytime Sleepiness ◽

Treatment Options ◽

Clinical Manifestations ◽

Sleep Apnoea ◽

Diagnosis And Treatment ◽

Adverse Health Outcomes ◽

Ovid Medline ◽

Obstructive Sleep ◽

Osa Treatment

Alam A, Chengappa KNR. Obstructive sleep apnoea and schizophrenia: a primer for psychiatristsObjective:The main objective of this review is to improve psychiatric clinician awareness of obstructive sleep apnoea (OSA) and its potential consequences in patients with schizophrenia. This article will also discuss the diagnosis and treatment options for OSA while considering the significant role psychiatrists can play in facilitating the diagnosis and treatment of OSA.Data sources:Ovid, Medline and PsychInfo databases were searched for articles between 1960 and 2010. Search terms used wereSleep apnoeaorapnoeaandschizophreniaorpsychosis. The number of articles retrieved was 38. Articles were carefully reviewed for any data pertinent to OSA in patients with schizophrenia.Conclusions:OSA is a common disorder that is frequently unrecognised. As a chronic breathing condition, OSA is associated with adverse health outcomes and high mortality. OSA may co-occur with schizophrenia or evolve over time, especially with weight gain. The diagnosis should be considered whenever a patient presents with risk factors or clinical manifestations that are highly suggestive of OSA. Those who report snoring, daytime sleepiness and are obese or have a large neck circumference should be considered for an OSA diagnosis. Appropriate diagnosis and treatment of OSA can reduce daytime sleepiness, improve cardiovascular and other medical conditions, as well as reduce mortality. Psychiatrists can play very important role in suspecting OSA in their patients and making the initial referral. Furthermore, behavioural management, especially promoting weight loss and smoking cessation, are effective components of OSA treatment that psychiatrists are positioned to facilitate with their patients.

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