scholarly journals The effect of acute intermittent hypoxia on postprandial triglyceride levels in humans: a randomized crossover trial

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Renée Morin ◽  
Jean-François Mauger ◽  
Ruwan Amaratunga ◽  
Pascal Imbeault
Keyword(s):  
Intermittent Hypoxia ◽  
Crossover Trial ◽  
Blood Lipid ◽  
Healthy Individuals ◽  
Very Low Density Lipoproteins ◽  
Time Interaction ◽  
Randomized Crossover Trial ◽  
Obstructive Sleep ◽  
Postprandial Triglyceride ◽  
Blood Lipid Levels

Abstract Background Obstructive sleep apnea (OSA), a sleep disorder frequently observed in individuals living with obesity, consists of repeated involuntary breathing obstructions during sleep, leading to intermittent hypoxia (IH). In humans, acute continuous hypoxia slightly increases plasma triglycerides (TG). However, no study yet compared the postprandial TG response of individuals with or without OSA under intermittent hypoxia. Methods Using a randomized crossover design, seven individuals diagnosed with moderate OSA and eight healthy individuals without OSA were given a meal after which they were exposed for 6 h to normoxia or intermittent hypoxia (e.g., 15 hypoxic events per hour). Blood lipid levels were measured hourly during each session. Results Peak postprandial TG concentrations tended to be 22% higher under IH irrespective of group (IH × time interaction, p = 0.068). This trend toward higher total plasma TG was attributable to increased levels of denser TG-rich lipoproteins such as very low-density lipoproteins (VLDL) and chylomicrons (CM) remnants. Irrespective of group, the postprandial TG concentrations in denser TG-rich lipoproteins was 20% higher under IH (IH × time interaction, p = 0.036), although IH had virtually no impact on denser TG-rich lipoprotein concentrations in the OSA group. Conclusion Acute intermittent hypoxia tends to negatively affect postprandial TG levels in healthy individuals, which is attributable to an increase in denser TG-carrying lipoprotein levels such as VLDL and CM remnants. This altered postprandial TG response to acute intermittent hypoxia was not observed in individuals with OSA.

Glycopyrrolate does not ameliorate hypothermia associated bradycardia in healthy individuals: a randomized crossover trial

Resuscitation ◽  
2021 ◽  
Author(s):  
Jon C. Rittenberger ◽  
Alexis Weissman ◽  
Katharyn L. Flickinger ◽  
Francis X. Guyette ◽  
David Hopkins ◽  
...  
Keyword(s):  
Crossover Trial ◽  
Healthy Individuals ◽  
Randomized Crossover Trial

Randomized Trial of 2 Self-Titrated Oral Appliances for Airway Management

2020 ◽  
pp. 002203452095697
Author(s):  
E. Schneiderman ◽  
P. Schramm ◽  
J. Hui ◽  
P. D. Wilson ◽  
P. Moura ◽  
...  
Keyword(s):  
Crossover Trial ◽  
Positive Airway Pressure ◽  
Mouth Opening ◽  
Oral Appliance ◽  
Oral Appliances ◽  
Pressure Therapy ◽  
Randomized Crossover Trial ◽  
Obstructive Sleep ◽  
Respiratory Event ◽  
Test Population

The effectiveness and predictability of 2 different oral appliance (OA) designs to reduce the respiratory event index (REI) in moderate and severe obstructive sleep apnea (OSA) patients requires elucidation. The primary aim of the trial was to determine if 2 widely used midline-traction and bilateral-thrust OA designs differ in effectiveness to reduce the REI within a single test population categorized by OSA severity. Moderate and severe adult OSA patients, who were previously prescribed continuous positive airway pressure therapy (CPAP) but were dissatisfied with it ( n = 56), were studied by home-polygraphy in a randomized crossover trial using either midline-traction with restricted mouth opening (MR) or bilateral thrust with opening permitted (BP) design OAs. OAs were used nightly for 4 wk (T2) followed by a 1-wk washout period, then 4 wk (T4) using the alternate OA. REI and oxygen saturation (SaO2) were primary outcomes, while predictability and efficacy comparison of the 2 OAs were secondary outcomes. Thirty-six participants had used MR and BP OAs during both 4-wk study legs. Twenty (55.6%) MR OA-using participants, 25 (69.4%) BP OA-using participants, and 16 (44.4%) participants using both OAs had significant REI reductions. Overall baseline (T0) median REI (interquartile range) of 33.7 (20.7–54.9) was reduced to 18.0 (8.5–19.4) at T2 and to 12.5 (8.2–15.9) at T4 ( P < 0.001). Comparison of the 2 sequence groups’ (MR-BP and BP-MR) REI showed the median differences between T0 and T2 and T4 were highly significant ( P < 0.001). Regression analysis predicted about half of all users will have REIs between 8 and 16 after 2 mo. Baseline overjet measures >2.9 mm predicted greater OA advancement at T4. Mean and minimum SaO2 did not change significantly from T0 to T2 or T4. MR and BP OA designs similarly attenuated REI in moderate and severe OSA individuals who completed the 8-wk study protocol with greater REI reduction in those with severe OSA (ClinicalTrials.gov NCT03219034).

scholarly journals Features of psychosomatic status and its relationship with magnesium, blood lipid levels and complications of hypertension

2014 ◽  
Vol 21 (1) ◽  
pp. 37-41
Author(s):  
G. A. Usenko ◽  
A. G. Usenko ◽  
S. V. Mashkov ◽  
D. A. Petukhov ◽  
D. V. Vasendin
Keyword(s):  
Antihypertensive Therapy ◽  
Lipid Content ◽  
Blood Lipid ◽  
Healthy Individuals ◽  
Lipid Levels ◽  
Hypertensive Therapy ◽  
Blood Lipid Levels

In contrast to the empirical anti-hypertensive therapy, the targeted antihypertensive therapy was combined with the earlier (6 months) and more pronounced approach of the lipid content of blood and magnesium to those in healthy individuals of appropriate temperament and anxiety; lower was the proportion of people with the areterial hypertension complications.

Temporary atrial pacing is ineffective in preventing obstructive sleep apnea in patients without permanent pacemakers: A prospective, randomized, crossover trial

Heart Rhythm ◽  
2005 ◽  
Vol 2 (5) ◽  
pp. S97-S98
Author(s):  
Andrew D. Krahn ◽  
Raymond Yee ◽  
George J. Klein ◽  
Allan C. Skanes ◽  
Mark K. Erikson ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Crossover Trial ◽  
Atrial Pacing ◽  
Randomized Crossover Trial ◽  
Obstructive Sleep

scholarly journals Reduced Postprandial Serum Triglyceride After a Meal Prepared Using an Airfryer: A Randomized Crossover Trial (P08-103-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Sheng Ge ◽  
Xiaohui Feng ◽  
Haili Liu ◽  
Mian Li ◽  
Paul Higgins ◽  
...  
Keyword(s):  
Crossover Trial ◽  
Serum Triglyceride ◽  
Practical Method ◽  
Deep Fat Frying ◽  
Chicken Nuggets ◽  
Dietary Recommendations ◽  
Meal Preparation ◽  
Funding Sources ◽  
Randomized Crossover Trial ◽  
Postprandial Triglyceride

Abstract Objectives Elevated circulating non-fasting triglyceride (TG) or postprandial triglyceride (ppTG) is as an independent contributor to risk for coronary heart disease.We hypothesized that a commonly consumed fried meal (including French fries and chicken nuggets) prepared by airfrying would result in a significantly lower ppTG response than the same meal prepared using a conventional deep fat frying approach. Methods We conducted a randomized crossover trial to evaluate the effect of airfryer cooking compared to conventional deep fat frying preparation in young healthy male (n = 10) and female subjects (n = 6). A 7-day washout period was included between meal test days. All study participants were blinded to the method of meal preparation. Results The airfryer resulted in a significantly lower postprandial triglyceride response compared to deep fat frying of the same meal (P < 0.001). Glucose, insulin, and free fatty acid response differences were not found. Self-reported satiety did not differ after the meals. Furthermore, air-frying did not influence circulating inflammatory biomarkers, cholesterol, or apolipoproteins. Conclusions Air frying of common fried meals results in lower postprandial triglyceride excursions in young healthy volunteers in the absence of any effects on satiety. Air-frying represents a useful and practical method to reduce meal fat content in line with current dietary recommendations on triglyceride management and general healthy eating. Funding Sources This research was funded by Philips Research China, Philips (China) Investment Co., Ltd., Shanghai, China. Supporting Tables, Images and/or Graphs

scholarly journals Remotely controlled mandibular positioning of oral appliance therapy during polysomnography and drug-induced sleep endoscopy compared with conventional subjective titration in patients with obstructive sleep apnea: protocol for a randomized crossover trial

Trials ◽  
2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Marijke Dieltjens ◽  
Marc J. Braem ◽  
Sara Op de Beeck ◽  
Anneclaire V. M. T. Vroegop ◽  
Elahe Kazemeini ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Therapeutic Efficacy ◽  
Crossover Trial ◽  
Sleep Endoscopy ◽  
Drug Induced ◽  
Randomized Crossover Trial ◽  
Cpap Titration ◽  
Obstructive Sleep ◽  
Mandibular Protrusion

Abstract Background The amount of mandibular protrusion is a key factor in optimizing the efficacy of mandibular advancement device (MAD) therapy in an individual patient diagnosed with obstructive sleep apnea. This process is called titration and is generally based on resolution of subjective symptoms like snoring and/or daytime sleepiness as a function of protrusion. An objective approach uses a remotely controlled mandibular positioner (RCMP) during a full-night polysomnography (PSG), in analogy with continuous positive airway pressure (CPAP) titration. More recently, the feasibility of RCMP use during drug-induced sleep endoscopy (DISE) titration was reported. Methods This randomized crossover trial will compare DISE-assisted titration to PSG-guided titration, as well as with the conventional subjective titration method. The primary outcome is the actual mandibular protrusive position found to be the most optimal for each tested titration procedure. Furthermore, the therapeutic efficacy will be compared among the different titration modalities using level 1 sleep studies. Discussion Currently, the optimal titration of MAD therapy is most often based on ‘trial and error’. The conventional method relies on subjective improvement in symptoms, although this may not provide the most accurate indicator for efficient titration. Therefore, relying on objective criteria in the titration process should be advantageous. In analogy with CPAP, titration of the most optimal mandibular protrusion could be performed using RCMP during an overnight titration PSG. Recently, it was shown that titration under direct visualization of upper airway patency and collapsibility is feasible using the RCMP during DISE. However, no clinical results for such a procedure are as yet available. This study is the first to compare the most optimal mandibular protrusive position according to three titration procedures, as well as to compare the therapeutic efficacy of these titration methods. Trial registration ClinicalTrials.gov, NCT03716648. Registered on 23 October 2018.

scholarly journals Remotely controlled mandibular positioning of oral appliance therapy during polysomnography and drug-induced sleep endoscopy compared with conventional subjective titration in patients with obstructive sleep apnea: protocol for a randomized crossover trial

2019 ◽  
Author(s):  
Marijke Dieltjens ◽  
Marc J. BRAEM ◽  
Sara Op de Beeck ◽  
Anneclaire V.M.T. VROEGOP ◽  
Elahe KAZEMEINI ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Therapeutic Efficacy ◽  
Crossover Trial ◽  
Sleep Endoscopy ◽  
Drug Induced ◽  
Randomized Crossover Trial ◽  
Cpap Titration ◽  
Obstructive Sleep ◽  
Mandibular Protrusion

Abstract Background The amount of mandibular protrusion is a key factor in optimizing the efficacy of mandibular advancement device (MAD) therapy in the individual patient diagnosed with obstructive sleep apnea (OSA). This process is called titration and is generally based on resolution of subjective symptoms like snoring and/or daytime sleepiness as a function of protrusion. An objective approach uses a remotely controlled mandibular positioner (RCMP) during a full-night polysomnography, in analogy with CPAP titration. More recently, the feasibility of RCMP use during drug-induced sleep endoscopy (DISE) titration was reported. Methods This randomized crossover trial will compare DISE-assisted titration with PSG-guided-titration, as well as with the conventional subjective titration method. The primary outcome is the actual mandibular protrusive position found to be the most optimal for each tested titration procedure. Furthermore, the therapeutic efficacy will be compared among the different titration modalities using level 1 sleep studies. Discussion Currently, the optimal titration of MAD therapy is most often based on ‘trial and error’. The conventional method relies on subjective improvement in symptoms, although this may not provide the most accurate indicator for efficient titration. Therefore, relying on objective criteria in the titration process should be advantageous. In analogy with CPAP, titration of the most optimal mandibular protrusion could be performed using RCMP during an overnight titration PSG. Recently, it was shown that titration under direct visualization of upper airway patency and collapsibility is feasible using the RCMP during DISE. However, no clinical results of such a procedure are available yet. This study is the first to compare the most optimal mandibular protrusive position according to three titration procedures, as well as to compare the therapeutic efficacy of these titration methods.

scholarly journals A Randomized Crossover Trial of a Pressure Relief Technology (SensAwake™) in Continuous Positive Airway Pressure to Treat Obstructive Sleep Apnea

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Richard K. Bogan ◽  
Charles Wells
Keyword(s):  
Sleep Quality ◽  
Crossover Trial ◽  
Positive Airway Pressure ◽  
Pressure Relief ◽  
Quality Outcomes ◽  
Cpap Adherence ◽  
Randomized Crossover Trial ◽  
Obstructive Sleep ◽  
Cpap Devices

Objectives/Background. Improving adherence to CPAP devices is crucial to reduce the long-term morbidity associated with OSA. SensAwake is a unique pressure relief technology that aims to promptly reduce the pressure upon sensing irregular respiration indicative of wakefulness. The purpose of this study was to compare adherence and sleep-quality outcomes in patients treated by CPAP with and without SensAwake technology.Methods. Participants with moderate-to-severe OSA were randomized to use CPAP devices with or without SensAwake (4 weeks) before crossing over.Results. Sixty-five patients completed both arms of the trial. There were no statistically significant differences in CPAP adherence with or without SensAwake over the study period (SensAwake ON272.67±17.06versus SensAwake OFF289.09±15.24;p=0.180). SensAwake reported a significantly lower system leak, 90th percentile leak, and time spent with excessive (>60 L/min) leak. Subgroup analysis suggested a trend towards improved adherence in patients with moderate-to-severe insomnia when using SensAwake.Conclusions. Using SensAwake incurred benefit in terms of reduced leaks; however, SensAwake did not improve CPAP adherence or objective sleep quality. Further studies should investigate the accuracy of observed trends towards increased adherence using SensAwake among patients with OSA and insomnia.

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