Copeptin, pro-atrial natriuretic peptide and pro-adrenomedullin as markers of hypoxic stress in patients with obstructive sleep apnea—a prospective intervention study

Abstract Study Objectives Obstructive sleep apnea (OSA) might lead to oxidative stress, inflammation and elevated circulating copeptin, proANP and proADM levels. We aimed to evaluate whether the levels of these prohormones are higher in patients with OSA and whether they might change under continuous positive airway pressure (CPAP) therapy, serving as potential proxies for the diagnosis and therapy-response in OSA. Methods A total of 310 patients with suspicion of OSA were recruited. Screening for OSA was performed using overnight pulse oximetry followed by polygraphy and a venous puncture in the morning. All patients diagnosed with OSA underwent CPAP adaptation. A venous puncture was conducted in the night before CPAP and in the following morning. At 1 and 6 months of treatment, polygraphy was performed, followed by a venous puncture in the morning. In the acquired blood, copeptin, proANP and proADM levels were measured. Results We analyzed 232 patients with OSA and 30 patients without OSA. Our results indicated that only copeptin levels differed significantly among patients with and without OSA at baseline. In OSA patients, the levels of proADM significantly changed after 1 and 6 months on CPAP therapy, when compared to baseline (p < 0.001 and p = 0.020). Additionally, proANP levels significantly decreased after 12 h on CPAP therapy, as compared to baseline levels (p < 0.001). Conclusions Copeptin is significantly associated with the presence of OSA. ProANP levels might serve as a potential proxy for the acute response to non-invasive ventilation (12 h), while proADM reflects the long-term response (1 and 6 months).

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Copeptin, Pro-atrial Natriuretic Peptide and Pro-adrenomedullin as Markers of Hypoxic Stress in Patients With Obstructive Sleep Apnea - a Prospective Intervention Study

10.21203/rs.3.rs-150708/v1 ◽

2021 ◽

Author(s):

Meropi Karakioulaki ◽

Peter Grendelmeier ◽

Werner Strobel ◽

Thomas Schmid ◽

Kathleen Jahn ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Therapy Response ◽

Cpap Therapy ◽

Non Invasive ◽

Acute Response ◽

Venous Puncture ◽

Non Invasive Ventilation ◽

Obstructive Sleep

Abstract Study Objectives: Obstructive sleep apnea (OSA) might lead to oxidative stress, inflammation and elevated circulating copeptin, proANP and proADM levels. We aimed to evaluate whether the levels of these prohormones are higher in patients with OSA and whether they might change under continuous positive airway pressure (CPAP) therapy, serving as potential proxies for the diagnosis and therapy-response in OSA. Methods: A total of 310 patients with suspicion of OSA were recruited. Screening for OSA was performed using overnight pulse oximetry followed by polygraphy and a venous puncture in the morning. All patients diagnosed with OSA underwent CPAP adaptation. A venous puncture was conducted in the night before CPAP and in the following morning. At 1 and 6 months of treatment, polygraphy was performed, followed by a venous puncture in the morning. In the acquired blood, copeptin, proANP and proADM levels were measured.Results: We analyzed 232 patients with OSA and 30 patients without OSA. Our results indicated that only copeptin levels differed significantly among patients with and without OSA at baseline. In OSA patients, the levels of proADM significantly changed after 1 and 6 months on CPAP therapy, when compared to baseline (p<0.001 and p=0.020). Additionally, proANP levels significantly decreased after 12 hours on CPAP therapy, as compared to baseline levels (p<0.001). Conclusions: Copeptin is significantly associated with the presence of OSA. ProANP levels might serve as a potential proxy for the acute response to non-invasive ventilation (12 hours), while proADM reflects the long-term response (1 and 6 months).

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Long Term Continuous Positive Airway Pressure and Non-invasive Ventilation in Obstructive Sleep Apnea in Children With Obesity and Down Syndrome

Frontiers in Pediatrics ◽

10.3389/fped.2020.00534 ◽

2020 ◽

Vol 8 ◽

Author(s):

Stijn Verhulst

Keyword(s):

Obstructive Sleep Apnea ◽

Down Syndrome ◽

Continuous Positive Airway Pressure ◽

Airway Pressure ◽

Positive Airway Pressure ◽

Invasive Ventilation ◽

Non Invasive ◽

Non Invasive Ventilation ◽

Obstructive Sleep

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Use of non invasive ventilation to treat severe hypoventilation syndrome and obstructive sleep apnea case

Sleep Medicine ◽

10.1016/j.sleep.2017.11.780 ◽

2017 ◽

Vol 40 ◽

pp. e266

Author(s):

E. Portugal Velloso ◽

L. Freitas ◽

A.C. Silva ◽

W. Sampaio

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Invasive Ventilation ◽

Non Invasive ◽

Non Invasive Ventilation ◽

Obstructive Sleep ◽

Hypoventilation Syndrome

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Upper Airway Reconstructive Surgery Long-Term Quality-of-Life Outcomes Compared with CPAP for Adult Obstructive Sleep Apnea

Otolaryngology ◽

10.1016/j.otohns.2009.03.022 ◽

2009 ◽

Vol 141 (2) ◽

pp. 257-263 ◽

Cited By ~ 41

Author(s):

Sam Robinson ◽

Michael Chia ◽

A. Simon Carney ◽

Sharad Chawla ◽

Penelope Harris ◽

...

Keyword(s):

Quality Of Life ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Side Effects ◽

Upper Airway ◽

Cpap Therapy ◽

Obstructive Sleep ◽

Cpap Compliance

OBJECTIVE: To measure long-term quality-of-life (QOL) improvement following contemporary multilevel upper airway reconstruction surgery, compared with continuous positive airway pressure (CPAP) therapy. Secondary aims were to investigate factors determining clinical effectiveness and QOL impact of reported side effects. DESIGN: Cohort study. SUBJECTS AND METHODS: Consecutive, simultaneously treated adult patients with moderate-severe obstructive sleep apnea (OSA) having upper airway surgery (N = 77) or CPAP (N = 89) therapy were studied by questionnaire. Glasgow Benefit Inventory (GBI), change in snoring status and Epworth Sleepiness Scale (ESS), subjective CPAP compliance, and side effects in both groups were measured at mean ± SEM 44.12 ± 5.78 months (3.68 ± 0.48 years) after commencement of therapy. RESULTS: No significant difference was seen between surgical outcomes for GBI, snoring, or ESS and CPAP controls. Multivariate analysis showed reduction in Respiratory Disturbance Index (RDI) predicted postoperative snoring and ESS, but not GBI outcomes. Snoring control and GBI were related to CPAP compliance ( P < 0.001). CPAP side effects (reported in 26%) significantly reduced the QOL benefit of treatment, independent of compliance. Surgical complications (occurring in 44%) did not affect QOL treatment benefit. CONCLUSION: Patients with poor CPAP compliance and/or significant side effects of CPAP therapy (45% of cases in this series) should be evaluated for contemporary upper airway reconstructive surgery.

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Long-term effects of cpap therapy for suppressing carotid atherosclerosis in hypertensive patients with obstructive sleep apnea syndrome

Atherosclerosis ◽

10.1016/j.atherosclerosis.2014.05.849 ◽

2014 ◽

Vol 235 (2) ◽

pp. e282-e283

Author(s):

Y. Sawayama ◽

A. Hatashima ◽

T. Koga

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Carotid Atherosclerosis ◽

Sleep Apnea Syndrome ◽

Cpap Therapy ◽

Long Term Effects ◽

Hypertensive Patients ◽

Obstructive Sleep ◽

Apnea Syndrome

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464 Long term effects of Continuous Positive Airway Pressure on the weight of Obstructive Sleep Apnea patients in the southeast USA

SLEEP ◽

10.1093/sleep/zsab072.463 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A183-A183

Author(s):

Carmel Joseph ◽

Noel Puthenveetil ◽

Allen Joe ◽

Jaya Therattil

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Weight Change ◽

Cpap Therapy ◽

Long Term Effects ◽

Weight Changes ◽

Southeast Usa ◽

Obstructive Sleep ◽

The Impact

Abstract Introduction Obesity has been linked to exacerbating Obstructive Sleep Apnea in patients. Paradoxically however, effective CPAP therapy has been noted to lead to weight increases even while improving hypersomnia and daytime neurocognitive functioning. Prior studies have demonstrated inconsistent results regarding weight changes while on CPAP therapy. Our study aims to clarify these inconsistencies and provide specific recommendations for CPAP compliant patients to prevent weight gain. Methods 393 OSA patients were seen for multiple follow ups since initiation of CPAP therapy at a single center sleep clinic. Every visit their weight would be updated along with CPAP compliance. Data was assessed on 1 month, 6 month, and 12 month intervals. Exclusion criteria include diuretic use, diet/exercise additions, and discontinuation of CPAP therapy before the full observation window. Results Patients with long term use of their CPAP devices had an average increase of 2.68±11.29 lbs after a year. 233 participants gained weight (an average of 9.8±7.3 lbs) while 141 participants lost weight (an average of -8.5±7.2 lbs) with 19 participants showing no weight change. This weight change could be observed starting as early as one month after CPAP initiation. Conclusion CPAP therapy is most likely linked to a lasting increase in weight. Recommendations and patient education for OSA patients should be modified to include an exercise component (10,000 steps/day) and/or caloric restriction (2200 low carb diet) to offset this weight increase. Further study is needed to assess the impact such recommendations could have in long term OSA care beyond the southeast USA. Support (if any) Pulmonary Allergy & Sleep Center of Augusta

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Sex-differences in the effect of obstructive sleep apnea on patients hospitalized with pulmonary embolism and on in-hospital mortality

Scientific Reports ◽

10.1038/s41598-021-97923-y ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Javier de-Miguel-Diez ◽

Marta Lopez-Herranz ◽

Valentín Hernandez-Barrera ◽

David Jimenez ◽

Manuel Monreal ◽

...

Keyword(s):

Pulmonary Embolism ◽

Obstructive Sleep Apnea ◽

Sex Differences ◽

Sleep Apnea ◽

Hospital Mortality ◽

Hospital Admissions ◽

Non Invasive ◽

Non Invasive Ventilation ◽

Obstructive Sleep ◽

Discharge Database

AbstractWe determined sex differences in the prevalence of obstructive sleep apnea (OSA) among patients hospitalized with pulmonary embolism (PE) in Spain (2016–2018). We also compared outcomes according to the presence of OSA, and identified variables associated with in-hospital-mortality (IHM) after PE using the Spanish National Hospital Discharge Database. We identified 46,794 hospital admissions for PE; of these, 5.47% had OSA. OSA was more prevalent among men than women (7.57% vs. 3.65%, p < 0.001), as in the general population. Propensity score matching did not reveal differences in concomitant conditions or procedures between patients with and without OSA, except for the use of non-invasive ventilation, which was more frequent in patients with OSA. IHM was similar in patients with and without OSA (3.58% vs. 4.31% for men and 4.39% vs. 4.93% for women; p > 0.05). Older age, cancer, atrial fibrillation, non-septic shock, and need for mechanical ventilation increased IHM in men and women with OSA hospitalized with PE. The logistic regression model showed no sex differences in IHM among patients with OSA.

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For Individuals with Obstructive Sleep Apnea, Institution of CPAP therapy is Associated with an Amelioration of Symptoms of Depression which is Sustained Long Term

Journal of Clinical Sleep Medicine ◽

10.5664/jcsm.26975 ◽

2007 ◽

Vol 03 (06) ◽

pp. 631-635 ◽

Cited By ~ 28

Author(s):

Daniel J. Schwartz ◽

Gillian Karatinos

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Cpap Therapy ◽

Symptoms Of Depression ◽

Obstructive Sleep

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Factors of vascular endothelial dysfunction and thrombogenic risk in patients with chronic obstructive pulmonary disease in combination with obstructive sleep apnea after an exacerbation

Russian Pulmonology ◽

10.18093/0869-0189-2021-31-3-329-337 ◽

2021 ◽

Vol 31 (3) ◽

pp. 329-337

Author(s):

I. Ya. Tseymakh ◽

Y. N. Shoykhet

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Pulmonary Disease ◽

Comparison Group ◽

Chronic Obstructive ◽

Cpap Therapy ◽

Obstructive Pulmonary Disease ◽

Obstructive Sleep

Obstructive sleep apnea (OSA) is a common disease. The incidence is higher in patients with chronic obstructive pulmonary disease with moderate to severe bronchial obstruction or hypoxemia. OSA is associated with increased risks of fatal outcomes of acute cardiovascular diseases in such patients. Objective. To assess the effect of long-term non-invasive ventilation of the lungs in the spontaneous breathing mode with positive airway pressure (CPAP) on the indicators of systemic inflammation, insulin resistance, and thrombogenic risk together with clinical outcomes during the rehabilitation period after an exacerbation in patients with concomitant chronic obstructive pulmonary disease and obstructive sleep apnea who do not need long-term oxygen therapy. Methods. The effects of long-term CPAP therapy as a part of complex treatment were analyzed in an openlabel, prospective, comparative six-week study that enrolled 65 patients with concomitant chronic obstructive pulmonary disease and obstructive sleep apnea. The main group included 26 people who received CPAP therapy as a part of complex treatment. The comparison group included 39 people who did not use non-invasive ventilation of the lungs. The patients’ age was 55.5 ± 2.1 years in the main group and 57.1 ± 1.5 years in the comparison group (p > 0.1). Men prevailed in both groups – 92.3% in the main group and 100.0% in the comparison group (p > 0.1). Results. The clinical efficacy of CPAP therapy was confirmed by an improvement in the quality of life of patients on the SF-36 questionnaire, a decrease in the degree of daytime sleepiness on the Epworth scale (Johns, 1991). CPAP-therapy was associated with a drop in the serum levels of tumor necrosis factor α and the blood level of endothelin 1, a more pronounced decrease in the levels of C-reactive protein, interleukin 8, C-peptide, vascular endothelial growth factor, homocysteine versus the comparison group. Conclusion. The use of CPAP-therapy in patients with concomitant chronic obstructive pulmonary disease and obstructive sleep apnea who do not need long-term oxygen therapy during the rehabilitation period after an exacerbation is associated with a decrease in systemic inflammation, vascular endothelial dysfunction, and hyperhomocysteinemia.

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