scholarly journals Is there an association between altered baroreceptor sensitivity and obstructive sleep apnoea in the healthy elderly?

2016 ◽  
Vol 2 (3) ◽  
pp. 00072-2016 ◽  
Author(s):  
Emilia Sforza ◽  
Magali Saint Martin ◽  
Jean Claude Barthélémy ◽  
Frédéric Roche
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Diastolic Pressure ◽  
Sleep Apnoea ◽  
Elderly Subjects ◽  
Healthy Elderly ◽  
Obstructive Sleep ◽  
Baroreceptor Reflex Sensitivity ◽  
Respiratory Polygraphy ◽  
Mild Impairment ◽  
Healthy Elderly Subjects

Obstructive sleep apnoea (OSA) is associated with a rise in cardiovascular risk in which increased sympathetic activity and depressed baroreceptor reflex sensitivity (BRS) have been proposed. We examined this association in a sample of healthy elderly subjects with unrecognised OSA.801 healthy elderly (aged ≥65 years) subjects undergoing clinical, respiratory polygraphy and vascular assessment were examined. According to the apnoea–hypopnoea index (AHI), the subjects were stratified into no OSA, mild–moderate OSA and severe OSA cases.OSA was present in 62% of the sample, 62% being mild–moderate and 38% severe. No differences were found for BRS value according to sex and OSA severity. 54% of the group had normal BRS value, 36% mild impairment and 10% severe dysfunction. BRS was negatively associated with body mass index (p=0.006), 24-h systolic (p=0.001) and diastolic pressure (p=0.001), and oxygen desaturation index (ODI) (p=0.03). Regression analyses revealed that subjects with lower BRS were those with hypertension (OR 0.41, 95% CI 0.24–0.81; p=0.002) and overweight (OR 0.42, 95% CI 0.25–0.81; p=0.008), without the effect of AHI and ODI.In the healthy elderly, the presence of a severe BRS dysfunction affects a small amount of severe cases without effect on snorers and mild OSA. Hypertension and obesity seem to play a great role in BRS impairment.

scholarly journals Self-reported sleepiness and not the apnoea hypopnoea index is the best predictor of sleepiness-related accidents in obstructive sleep apnoea

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
P. Philip ◽  
S. Bailly ◽  
M. Benmerad ◽  
J. A. Micoulaud-Franchi ◽  
Y. Grillet ◽  
...  
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Traffic Accidents ◽  
Sleep Apnoea ◽  
Near Miss ◽  
Cross Sectional ◽  
Periodic Leg Movements ◽  
Obstructive Sleep ◽  
History Of ◽  
Respiratory Polygraphy ◽  
Sectional Analysis

Abstract To evaluate the value of apnoea + hypopnoea index versus self-reported sleepiness at the wheel in anticipating the risk of sleepiness-related accidents in patients referred for obstructive sleep apnoea. A cross-sectional analysis of the French national obstructive sleep apnoea registry. 58,815 subjects referred for a suspicion of obstructive sleep apnoea were investigated by specific items addressing sleepiness at the wheel and sleepiness-related accidents. Apnoea + hypopnoea index was evaluated with a respiratory polygraphy or full polysomnography. Subjects had a median age of 55.6 years [45.3; 64.6], 65% were men, with a median apnoea + hypopnoea index of 22 [8; 39] events/h. Median Epworth sleepiness scale score was 9 [6; 13], 35% of the patients reported sleepiness at the wheel (n = 20,310), 8% (n = 4,588) reported a near-miss accident and 2% (n = 1,313) reported a sleepiness-related accident. Patients reporting sleepiness at the wheel whatever their obstructive sleep apnoea status and severity exhibited a tenfold higher risk of sleepiness-related accidents. In multivariate analysis, other predictors for sleepiness-related accidents were: male gender, ESS, history of previous near-miss accidents, restless leg syndrome/periodic leg movements, complaints of memory dysfunction and nocturnal sweating. Sleep apnoea per se was not an independent contributor. Self-reported sleepiness at the wheel is a better predictor of sleepiness-related traffic accidents than apnoea + hypopnoea index.

scholarly journals Challenges in Diagnosing and Treating Obstructive Sleep Apnoea in Children

2018 ◽  
Vol 4 (1) ◽  
pp. 23
Author(s):  
Refika Ersu ◽  
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Treatment Options ◽  
Combined Treatment ◽  
Sleep Apnoea ◽  
Treatment Modalities ◽  
Obstructive Sleep ◽  
Respiratory Polygraphy ◽  
Weight Loss Interventions ◽  
Multiple Health ◽  
Prompt Diagnosis

Prompt diagnosis and treatment of obstructive sleep apnoea in children is essential to prevent multiple health consequences, but distinctive symptoms are scarce. While overnight polysomnography is the standard diagnostic tool, it is not widely available. Nocturnal oximetry, respiratory polygraphy and standardised questionnaires are useful alternatives. Treatment options include positive airway pressure, weight loss interventions and anti-inflammatory treatment with nasal corticosteroids and/or oral montelukast. Combined treatment modalities may improve outcomes.

scholarly journals Obstructive Sleep Apnea is Associated with Preserved Bone Mineral Density in Healthy Elderly Subjects

SLEEP ◽  
2013 ◽  
Vol 36 (10) ◽  
pp. 1509-1515 ◽  
Author(s):  
◽  
Emilia Sforza ◽  
Thierry Thomas ◽  
Jean-Claude Barthélémy ◽  
Philippe Collet ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Bone Mineral ◽  
Elderly Subjects ◽  
Mineral Density ◽  
Healthy Elderly ◽  
Obstructive Sleep ◽  
Healthy Elderly Subjects

A 7-year follow-up study of obstructive sleep apnoea in healthy elderly: The PROOF cohort study

Respirology ◽  
2017 ◽  
Vol 22 (5) ◽  
pp. 1007-1014 ◽  
Author(s):  
Emilia Sforza ◽  
David Hupin ◽  
Vincent Pichot ◽  
Jean Claude Barthélémy ◽  
Frédéric Roche
Keyword(s):  
Cohort Study ◽  
Obstructive Sleep Apnoea ◽  
Sleep Apnoea ◽  
Follow Up Study ◽  
Healthy Elderly ◽  
Obstructive Sleep

scholarly journals Predictors of obstructive sleep apnoea in patients admitted for acute coronary syndrome

2017 ◽  
Vol 49 (3) ◽  
pp. 1600550 ◽  
Author(s):  
Jordi de Batlle ◽  
Cecilia Turino ◽  
Alicia Sánchez-de-la-Torre ◽  
Jorge Abad ◽  
Joaquín Duran-Cantolla ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Obstructive Sleep Apnoea ◽  
Sleep Apnoea ◽  
Killip Class ◽  
Logistic Regression Models ◽  
Coronary Syndrome ◽  
C Statistic ◽  
Obstructive Sleep ◽  
Respiratory Polygraphy ◽  
Main Determinants

Identifying undiagnosed obstructive sleep apnoea (OSA) patients in cardiovascular clinics could improve their management. Aiming to build an OSA predictive model, a broad analysis of clinical variables was performed in a cohort of acute coronary syndrome (ACS) patients.Sociodemographic, anthropometric, life-style and pharmacological variables were recorded. Clinical measures included blood pressure, electrocardiography, echocardiography, blood count, troponin levels and a metabolic panel. OSA was diagnosed using respiratory polygraphy. Logistic regression models and classification and regression trees were used to create predictive models.A total of 978 patients were included (298 subjects with apnoea–hypopnoea index (AHI) <15 events·h−1and 680 with AHI ≥15 events·h−1). Age, BMI, Epworth sleepiness scale, peak troponin levels and use of calcium antagonists were the main determinants of AHI ≥15 events·h−1(C statistic 0.71; sensitivity 94%; specificity 24%). Age, BMI, blood triglycerides, peak troponin levels and Killip class ≥II were determinants of AHI ≥30 events·h−1(C statistic of 0.67; sensitivity 31%; specificity 86%).Although a set of variables associated with OSA was identified, no model could successfully predict OSA in patients admitted for ACS. Given the high prevalence of OSA, the authors propose respiratory polygraphy as a to-be-explored strategy to identify OSA in ACS patients.

scholarly journals High D-dimer levels after stopping anticoagulants in pulmonary embolism with sleep apnoea

2015 ◽  
Vol 46 (6) ◽  
pp. 1691-1700 ◽  
Author(s):  
Angela García Suquia ◽  
Alberto Alonso-Fernández ◽  
Mónica de la Peña ◽  
David Romero ◽  
Javier Piérola ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Obstructive Sleep Apnoea ◽  
Plasminogen Activator Inhibitor ◽  
Sleep Apnoea ◽  
Plasminogen Activator Inhibitor 1 ◽  
Obstructive Sleep ◽  
Recurrent Pulmonary Embolism ◽  
Respiratory Polygraphy ◽  
Activator Inhibitor ◽  
D Dimer

Obstructive sleep apnoea is a risk factor for pulmonary embolism. Elevated D-dimer levels and other biomarkers are associated with recurrent pulmonary embolism. The objectives were to compare the frequency of elevated D-dimer levels (>500 ng·mL−1) and further coagulation biomarkers after oral anticoagulation withdrawal in pulmonary embolism patients, with and without obstructive sleep apnoea, including two control groups without pulmonary embolism.We performed home respiratory polygraphy. We also measured basic biochemical profile and haemogram, and coagulation biomarkers (D-dimer, prothrombin fragment 1+2, thrombin-antithrombin complex, plasminogen activator inhibitor 1, and soluble P-selectin).64 (74.4%) of the pulmonary embolism cases and 41 (46.11%) of the controls without pulmonary embolism had obstructive sleep apnoea. Plasmatic D-dimer was higher in PE patients with OSA than in those without obstructive sleep apnoea. D-dimer levels were significantly correlated with apnoea–hypopnoea index, and nocturnal hypoxia. There were more patients with high D-dimer after stopping anticoagulants in those with pulmonary embolism and obstructive sleep apnoea compared with PE without obstructive sleep apnoea (35.4% versus 19.0%, p=0.003). Apnoea–hypopnoea index was independently associated with high D-dimer.Pulmonary embolism patients with obstructive sleep apnoea had higher rates of elevated D-dimer levels after anticoagulation discontinuation for pulmonary embolism than in patients without obstructive sleep apnoea and, therefore, higher procoagulant state that might increase the risk of pulmonary embolism recurrence.

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