scholarly journals Effect of obstructive sleep apnea and CPAP therapy on skeletal muscle lipid content in obese and non-obese male subjects

2021 ◽  
Author(s):  
Alexander M Koenig ◽  
Ulrich Koehler ◽  
Olaf Hildebrandt ◽  
Hans Schwarzbach ◽  
Lena Hannemann ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Magnetic Resonance ◽  
Fiber Type ◽  
Subcutaneous Fat ◽  
Apnea Hypopnea Index ◽  
Resonance Spectroscopy ◽  
Vastus Lateralis Muscle ◽  
Cpap Therapy ◽  
Obstructive Sleep

Abstract Obstructive sleep apnea (OSA), independently of obesity (OBS), predisposes to insulin resistance (IR) for largely unknown reasons. Since OSA-related intermittent hypoxia triggers lipolysis, overnight increases in circulating free fatty acid (FFA) including palmitic acid (PA) may lead to ectopic intramuscular lipid accumulation potentially contributing to IR. Using 3-T-1H-magnetic-resonance-spectroscopy, we therefore compared intra- and extra-myocellular lipid (IMCL and EMCL) in vastus lateralis muscle at ~7:00 a.m. between 26 male patients with moderate-to-severe OSA (17 obese, 9 non-obese) and 23 healthy male controls (12 obese, 11 non-obese). Fiber type composition was evaluated by muscle biopsies. Moreover, we measured fasted FFA including PA, HbA1c, thigh subcutaneous fat volume (ScFAT, 1.5-T-magnetic-resonance-tomograpphy) and maximal oxygen uptake (VO2max). 14 patients were reassessed after continuous-positive-airway-pressure (CPAP) therapy. Total FFA and PA were significantly by 178% and 166% higher in OSA patients vs. controls and correlated with the apnea-hypopnea index (AHI) (r≥0.45, P<0.01). Moreover, IMCL and EMCL were 55% (P<0.05) and 40% (P<0.05) higher in OSA patients, i.e. 114% and 103% in non-obese, 24.4% and 8.4% in obese subjects (with higher control levels). Overall, PA, FFA (minus PA) and ScFAT significantly contributed to IMCL (multiple r=0.568, P=0.002). CPAP significantly decreased EMCL (-26%) and, by trend only, IMCL, total FFA and PA. Muscle fiber composition was unaffected by OSA or CPAP. Increases in IMCL and EMCL are detectable at ~7:00 a.m. in OSA patients and partly attributable to overnight FFA excesses and high ScFAT or BMI. CPAP decreases FFAs and IMCL by trend but significantly reduces EMCL.

scholarly journals Obstructive sleep apnea and CPAP therapy alter distinct transcriptional programs in subcutaneous fat tissue

SLEEP ◽  
2019 ◽  
Vol 43 (6) ◽  
Author(s):  
Sina A Gharib ◽  
Amanda L Hurley ◽  
Michael J Rosen ◽  
James C Spilsbury ◽  
Amy E Schell ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Subcutaneous Adipose Tissue ◽  
Subcutaneous Fat ◽  
Study Group ◽  
Cpap Therapy ◽  
Obstructive Sleep ◽  
Group 2 ◽  
Subcutaneous Adipose ◽  
Group 1

Abstract Obstructive sleep apnea (OSA) has been linked to dysregulated metabolic states, and treatment of sleep apnea may improve these conditions. Subcutaneous adipose tissue is a readily samplable fat depot that plays an important role in regulating metabolism. However, neither the pathophysiologic consequences of OSA nor the effects of continuous positive airway pressure (CPAP) in altering this compartment’s molecular pathways are understood. This study aimed to systematically identify subcutaneous adipose tissue transcriptional programs modulated in OSA and in response to its effective treatment with CPAP. Two subject groups were investigated: Study Group 1 was comprised of 10 OSA and 8 controls; Study Group 2 included 24 individuals with OSA studied at baseline and following CPAP. For each subject, genome-wide gene expression measurement of subcutaneous fat was performed. Differentially activated pathways elicited by OSA (Group 1) and in response to its treatment (Group 2) were determined using network and Gene Set Enrichment Analysis (GSEA). In Group 2, treatment of OSA with CPAP improved apnea-hypopnea index, daytime sleepiness, and blood pressure, but not anthropometric measures. In Group 1, GSEA revealed many up-regulated gene sets in OSA subjects, most of which were involved in immuno-inflammatory (e.g. interferon-γ signaling), transcription, and metabolic processes such as adipogenesis. Unexpectedly, CPAP therapy in Group 2 subjects was also associated with up-regulation of several immune pathways as well as cholesterol biosynthesis. Collectively, our findings demonstrate that OSA alters distinct inflammatory and metabolic programs in subcutaneous fat, but these transcriptional signatures are not reversed with short-term effective therapy.

Quantitative EEG in obstructive sleep apnea syndrome: a review of the literature

2017 ◽  
Vol 28 (3) ◽  
pp. 265-270 ◽  
Author(s):  
Szilvia Puskás ◽  
Norbert Kozák ◽  
Dóra Sulina ◽  
László Csiba ◽  
Mária Tünde Magyar
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Magnetic Resonance ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Resonance Spectroscopy ◽  
Obstructive Sleep ◽  
Apnea Syndrome ◽  
The Impact ◽  
The Brain

AbstractObstructive sleep apnea syndrome (OSAS) is characterized by the recurrent cessation (apnea) or reduction (hypopnea) of airflow due to the partial or complete upper airway collapse during sleep. Respiratory disturbances causing sleep fragmentation and repetitive nocturnal hypoxia are responsible for a variety of nocturnal and daytime complaints of sleep apnea patients, such as snoring, daytime sleepiness, fatigue, or impaired cognitive functions. Different techniques, such as magnetic resonance imaging, magnetic resonance spectroscopy, and positron emission tomography, are used to evaluate the structural and functional changes in OSAS patients. With quantitative electroencephalographic (qEEG) analysis, the possible existence of alterations in the brain electrical activity of OSAS patients can be investigated. We review the articles on qEEG results of sleep apnea patients and summarize the possible explanations of these qEEG measures. Finally, we review the impact of continuous positive airway pressure (CPAP) treatment on these alterations to assess whether CPAP use can eliminate alterations in the brain activity of OSAS patients.

scholarly journals Symptomatic response to CPAP in obstructive sleep apnea versus COPD- obstructive sleep apnea overlap syndrome: Insights from a large national registry

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0256230
Author(s):  
Dan Adler ◽  
Sébastien Bailly ◽  
Paola Marina Soccal ◽  
Jean-Paul Janssens ◽  
Marc Sapène ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
National Registry ◽  
Overlap Syndrome ◽  
Apnea Hypopnea Index ◽  
Cpap Therapy ◽  
Exertional Dyspnea ◽  
Cpap Treatment ◽  
Obstructive Sleep ◽  
Design And Methods

Background The symptomatic response to continuous positive airway pressure (CPAP) therapy in COPD-obstructive sleep apnea overlap syndrome (OVS) compared to OSA syndrome (OSA) alone has not been well studied so far. The aim of this study is to explore main differences in the clinical response to CPAP treatment in OVS compared to OSA alone. Study design and methods Using prospective data from the French National Sleep Apnea Registry, we conducted an observational study among 6320 patients with moderate-to-severe OSA, available spirometry, and at least one follow-up visit under CPAP therapy. Results CPAP efficacy measured on the residual apnea-hypopnea index and median adherence were similar between OVS and OSA patients. In both groups, the overall burden of symptoms related to sleep apnea improved with CPAP treatment. In a multivariable model adjusted for age, gender, body mass index, adherence to treatment and residual apnea-hypopnea index, OVS was associated with higher odds for persistent morning headaches (OR: 1.37 [95% CI; 1.04; 1.79]; P = 0.02), morning tiredness (OR: 1.33 [95% CI: 1.12; 1.59]; P<0.01), daytime sleepiness (OR; 1.24 [95% CI: 1.4; 1.46]: P<0.01) and exertional dyspnea (OR: 1.26 [95% CI: 1.00;1.58]; P = 0.04) when compared with OSA alone. Interpretation CPAP therapy was effective in normalizing the apnea-hypopnea index and significantly improved OSA-related symptoms, regardless of COPD status. CPAP should be offered to patients with OVS on a trial basis as a significant improvement in OSA-related symptoms can be expected, although the range of response may be less dramatic than in OSA alone.

scholarly journals Case report of new-onset obstructive sleep apnea after carbon monoxide poisoning

2021 ◽  
Vol 49 (2) ◽  
pp. 030006052199222
Author(s):  
Xiaorong Yang ◽  
Min Xie ◽  
Lu Tan ◽  
Taomei Li ◽  
Xiangdong Tang
Keyword(s):  
Carbon Monoxide ◽  
Obstructive Sleep Apnea ◽  
Case Report ◽  
Sleep Apnea ◽  
Carbon Monoxide Poisoning ◽  
Apnea Hypopnea Index ◽  
Cpap Therapy ◽  
Laboratory Findings ◽  
First Case ◽  
Obstructive Sleep

Obstructive sleep apnea (OSA) is characterized by repetitive intermittent oxygen desaturation during sleep. Carbon monoxide poisoning (COP) is the second most common cause of death among non-medicinal poisonings, and oxygen therapy is the current standard of treatment for COP. We herein report a case of a 50-year-old woman diagnosed with severe OSA associated with COP. Both the OSA and COP gradually resolved by automatic continuous positive airway pressure (CPAP) therapy. New OSA symptoms appeared following the development of delayed encephalopathy after acute COP (DEACMP) 3 weeks later. Severe OSA was diagnosed 76 days after COP with an apnea–hypopnea index of 66 events/hour, and CPAP therapy was immediately administered. The patient’s DEACMP symptoms and OSA both improved with CPAP therapy (her apnea–hypopnea index decreased to 32.4 and 16.5 events/hour at 161 and 204 days after COP, respectively). To our knowledge, this is the first case report of OSA caused by COP based on the occurrence and disappearance of OSA symptoms and laboratory findings associated with the emergence and improvement of DEACMP.

scholarly journals Magnetic Resonance Spectroscopy and Neurocognitive Dysfunction in Obstructive Sleep Apnea before and after CPAP Treatment

SLEEP ◽  
2012 ◽  
Vol 35 (1) ◽  
pp. 41-48 ◽  
Author(s):  
Fergal J. O'Donoghue ◽  
R. Mark Wellard ◽  
Peter D. Rochford ◽  
Andrew Dawson ◽  
Maree Barnes ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Magnetic Resonance ◽  
Magnetic Resonance Spectroscopy ◽  
Resonance Spectroscopy ◽  
Neurocognitive Dysfunction ◽  
Cpap Treatment ◽  
Obstructive Sleep ◽  
Before And After

Obstructive Sleep apnea Therapy

2008 ◽  
Vol 87 (9) ◽  
pp. 882-887 ◽  
Author(s):  
A. Hoekema ◽  
B. Stegenga ◽  
P.J. Wijkstra ◽  
J.H. van der Hoeven ◽  
A.F. Meinesz ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Confidence Interval ◽  
Severe Disease ◽  
Lower Boundary ◽  
Oral Appliance ◽  
Apnea Hypopnea Index ◽  
Cpap Therapy ◽  
Oral Appliance Therapy ◽  
Obstructive Sleep

In clinical practice, oral appliances are used primarily for obstructive sleep apnea patients who do not respond to continuous positive airway pressure (CPAP) therapy. We hypothesized that an oral appliance is not inferior to CPAP in treating obstructive sleep apnea effectively. We randomly assigned 103 individuals to oral-appliance or CPAP therapy. Polysomnography after 8–12 weeks indicated that treatment was effective for 39 of 51 persons using the oral appliance (76.5%) and for 43 of 52 persons using CPAP (82.7%). For the difference in effectiveness, a 95% two-sided confidence interval was calculated. Non-inferiority of oral-appliance therapy was considered to be established when the lower boundary of this interval exceeded −25%. The lower boundary of the confidence interval was −21.7%, indicating that oral-appliance therapy was not inferior to CPAP for effective treatment of obstructive sleep apnea. However, subgroup analysis revealed that oral-appliance therapy was less effective in individuals with severe disease (apnea-hypopnea index > 30). Since these people could be at particular cardiovascular risk, primary oral-appliance therapy appears to be supported only for those with non-severe apnea.

scholarly journals Is sleep apnea-hypopnea index relevant for impaired brain perfusion and desaturation in patients with severe obstructive sleep apnea syndromes?

2020 ◽  
Author(s):  
Zhongxing Zhang ◽  
Ming Qi ◽  
Gordana Hügli ◽  
Ramin Khatami
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Cerebral Hemodynamics ◽  
Apnea Hypopnea Index ◽  
Cpap Therapy ◽  
Hemodynamic Changes ◽  
Cerebral Hemodynamic ◽  
Respiratory Events ◽  
Cpap Titration ◽  
Obstructive Sleep

AbstractBackgroundObstructive sleep apnea syndrome (OSAS) is a common sleep disorder with the prevalence of 9-38% in the general population. Severe OSAS defined as apnea-hypopnea index (AHI) ≥ 30/h is a major risk factor for developing cerebro-cardiovascular diseases like stroke. Treatments such as continuous positive airway pressure (CPAP) therapy are recommended for those patients because untreated OSA can cause tremendous medical expenses and economic burden. Understanding the mechanisms of how repetitive sleep apneas/hypopneas induce changes in cerebral hemodynamics in severe OSAS is crucial for the understanding of disease severity, disease progression in brain damage and the treatment efficacy. However, these mechanisms and the association between AHI and the induced changes in cerebral hemodynamics in severe OSAS are essentially unknown. Using a stepwise incremental CPAP titration protocol we aim to identify the most relevant physiological factors including AHI and their quantitative contributions to cerebral hemodynamic changes before and during CPAP treatment in severe OSAS patients.Methods and findings29 newly diagnosed severe OSAS patients underwent incremental CPAP titration during polysomnography recordings: 1-h sleep without CPAP served as self-controlled baseline followed by stepwise increments of 1-cmH2O pressure per-hour starting from 5-8 cmH2O individually. Frequency-domain near-infrared spectroscopy measured the changes in blood volume (BV) and oxygen saturation (StO2) in the left forehead. The coefficients of variation of BV (CV-BV) and the decreases of StO2 (de-StO2) during more than 2000 respiratory events were predicted by various predictors including AHI using linear mixed-effect models, respectively. The best predictors were automatically selected by stepwise regression. Surprisingly, AHI was excluded from the final selected models. Longer events and apneas rather than hypopneas induce larger changes in CV-BV and stronger cerebral desaturation. Respiratory events occurring during higher baseline StO2 before their onsets, during rapid-eye-movement sleep and those associated with higher heart rate (HR) during the events trigger smaller changes in CV-BV and de-StO2. CPAP pressures attenuate the changes in CV-BV and de-StO2.ConclusionsIn severe OSAS the length and the type of respiratory event rather than widely used AHI may be better parameters to indicate the severity of cerebral vascular damage. Thus both, length and type of respiratory events should be considered as predictors of cerebro-cardiovascular events in future epidemiological studies and in clinical practice. OSAS patients with profound long apnea events need to pay special attention and quickly treated with CPAP therapy as it can restore the induced cerebral hemodynamic changes.

scholarly journals Morning pentraxin3 levels reflect obstructive sleep apnea–related acute inflammation

2014 ◽  
Vol 117 (10) ◽  
pp. 1141-1148 ◽  
Author(s):  
Yusuke Kobukai ◽  
Takashi Koyama ◽  
Hiroyuki Watanabe ◽  
Hiroshi Ito
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Acute Inflammation ◽  
High Sensitivity ◽  
Apnea Hypopnea Index ◽  
Cpap Therapy ◽  
Reactive Protein ◽  
Obstructive Sleep ◽  
Before And After ◽  
Hs Crp

This study investigated morning levels of pentraxin3 (PTX3) as a sensitive biomarker for acute inflammation in patients with obstructive sleep apnea (OSA). A total of 61 consecutive patients with OSA were divided into two groups: non-to-mild ( n = 20) and moderate-to-severe ( n = 41) OSA based on their apnea-hypopnea index (AHI) score. Those patients with moderate-to-severe OSA were further divided into continuous positive airway pressure (CPAP) treated ( n = 21) and non-CPAP-treated ( n = 20) groups. Morning and evening serum PTX3 and high-sensitivity (hs) C-reactive protein (CRP) levels were measured before and after 3 mo of CPAP therapy. The baseline hs-CRP and PTX3 levels were higher in patients with moderate-to-severe OSA than in those with non-to-mild OSA. Moreover, the serum PTX3 levels, but not the hs-CRP levels, were significantly higher after than before sleep in the moderate-to-severe OSA group (morning PTX3, 1.96 ± 0.52; evening PTX3, 1.71 ± 0.44 ng/ml). OSA severity as judged using the AHI was significantly correlated with serum PTX3 levels but not hs-CRP levels. The highest level of correlation was found between the AHI and morning PTX3 levels ( r = 0.563, P < 0.001). CPAP therapy reduced evening and morning serum hs-CRP and PTX3 levels in patients with moderate-to-severe OSA; however, the reduction in PTX3 levels in the morning was greater than that in the evening (morning −29.8 ± 16.7% vs. evening −12.6 ± 26.8%, P = 0.029). Improvement in the AHI score following CPAP therapy was strongly correlated with reduced morning PTX3 levels( r = 0.727, P < 0.001). Based on these results, morning PTX3 levels reflect OSA-related acute inflammation and are a useful marker for improvement in OSA following CPAP therapy.

scholarly journals Decreased serum betatrophin may correlate with the improvement of obstructive sleep apnea after Roux-en-Y Gastric Bypass surgery

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Zhiyuan Song ◽  
Kaifeng Guo ◽  
Weijun Huang ◽  
Huajun Xu ◽  
Yupu Liu ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Obstructive Sleep Apnea ◽  
Gastric Bypass ◽  
Sleep Apnea ◽  
Subcutaneous Fat ◽  
Magnetic Resonance Images ◽  
Apnea Hypopnea Index ◽  
Contributing Factors ◽  
Visceral Fat Area ◽  
Obstructive Sleep

AbstractObesity is strongly correlated with obstructive sleep apnea (OSA), and bariatric surgery can effectively treat obesity and alleviate OSA. However, the contributing factors are still unclear. We aimed to explore the relationship between betatrophin and OSA in patients undergoing Roux-en-Y gastric bypass (RYGB) surgery. Our study consisted of thirty-seven individuals with OSA and type 2 diabetes (16 males, 21 females) undergoing RYGB surgery. The polysomnography test, anthropometric results, serum betatrophin, and abdominal magnetic resonance images were evaluated both before and 1 year after RYGB surgery. Factors that may correlate with the alleviation of OSA were investigated. In our study, RYGB surgery significantly decreased apnea hypopnea index (AHI) and serum betatrophin concentration (p < 0.001). The abdominal visceral fat area, subcutaneous fat area and HOMA-IR were also significantly decreased (p < 0.001). The preoperative AHI, postoperative AHI and the change in AHI were significantly correlated with the preoperative betatrophin, postoperative betatrophin and the change in betatrophin, respectively (p < 0.05). These correlations were still significant after adjustment for other risk factors. The change in betatrophin was also independently associated with the change in minimum oxygen saturation (p < 0.001). Our data might indicate that serum betatrophin was significantly independently correlated with the improvement of OSA after bariatric surgery.

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