scholarly journals Ventricular arrhythmias in a patient with obstructive sleep apnea syndrome and its effective non-pharmaceutical treatment

2020 ◽  
Vol 49 ◽  
Author(s):  
A. D. Palman ◽  
A. S. Akselrod
Keyword(s):  
Sleep Apnea ◽  
Cardiac Arrhythmias ◽  
Ventricular Arrhythmias ◽  
Sleep Apnea Syndrome ◽  
Cpap Therapy ◽  
Breathing Disorders ◽  
Ventricular Extrasystoles ◽  
Obstructive Sleep ◽  
Idioventricular Rhythm ◽  
Apnea Syndrome

Patients with obstructive sleep apnea syndrome (OSAS) are characterized by various cardiac arrhythmias during sleep. However, while the association between OSAS and atrial fibrillation is considered proven, the presence of a pathophysiological link between sleep apnea and ventricular arrhythmias remains a matter of debate.We present a case of a 51-year old man with arterial hypertension and type 2 diabetes who was referred for sleep assessment after being diagnosed with predominantly nocturnal cardiac arrhythmias. Overnight cardiorespiratory monitoring showed that the patient had a severe OSAS with an apnea-hypopnea index of 57 per hour and a minimal SpO2 during sleep of 73%. On the channel of electrocardiogram (ECG) frequent single monomorphic ventricular extrasystoles, eventually of the bigeminal type, and one short paroxysm of a wide-complex regular rhythm of 60 beats per minute (accelerated idioventricular rhythm) associated with prolonged apnea were identified. Continuous airway positive pressure (CPAP) therapy was started which was able to control for breathing disorders during sleep. At the follow-up 24-hours Holter ECG monitoring, the numbers of ventricular extrasystoles during sleep decreased 2-fold, without any idioventricular rhythm episodes.The clinical case clearly illustrates that in some patients with OSAS, first of all, in those with severe OSAS and comorbid cardiovascular disorders, breathing disorders during sleep can trigger ventricular arrhythmias. In such patients, CPAP therapy could both improves their quality of life and provide an indirect antiarrhythmic effect.

Cardiovascular outcomes of CPAP therapy in obstructive sleep apnea syndrome

2007 ◽  
Vol 293 (4) ◽  
pp. R1666-R1670 ◽  
Author(s):  
Walter T. McNicholas
Keyword(s):  
Cardiovascular Disease ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Cpap Therapy ◽  
Obstructive Sleep ◽  
Cardiovascular Morbidity And Mortality ◽  
Apnea Syndrome ◽  
The Impact

Considerable evidence is now available of an independent association between obstructive sleep apnea syndrome (OSAS) and cardiovascular disease. The association is particularly strong for systemic arterial hypertension, but there is growing evidence of an association with ischemic heart disease and stroke. The mechanisms underlying cardiovascular disease in patients with OSAS are still poorly understood. However, the pathogenesis is likely to be a multifactorial process involving a diverse range of mechanisms, including sympathetic overactivity, selective activation of inflammatory molecular pathways, endothelial dysfunction, abnormal coagulation, and metabolic dysregulation, the latter particularly involving insulin resistance and disordered lipid metabolism. Therapy with continuous positive airway pressure (CPAP) has been associated with significant benefits to cardiovascular morbidity and mortality, both in short-term studies addressing specific aspects of morbidity, such as hypertension, and more recently in long-term studies that have evaluated major outcomes of cardiovascular morbidity and mortality. However, there is a clear need for further studies evaluating the impact of CPAP therapy on cardiovascular outcomes. Furthermore, studies on the impact of CPAP therapy have provided useful information concerning the role of basic cell and molecular mechanisms in the pathophysiology of OSAS.

scholarly journals Hormonal status and the orexin system in obese patients with obstructive sleep apnea syndrome

2015 ◽  
Vol 12 (2) ◽  
pp. 24-30
Author(s):  
Natalya Viktorovna Strueva ◽  
Galina Afanas'evna Melnichenko ◽  
Mikhail Gur'evich Poluektov ◽  
Larisa Viktorovna Savel'eva ◽  
Gulinara Viktorovna Katsya ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Obese Patients ◽  
Hormone Metabolism ◽  
Sleep Related Breathing Disorders ◽  
Breathing Disorders ◽  
Obstructive Sleep ◽  
Apnea Syndrome

The aim of research was to estimate the influence of hormone metabolism and sleep apnea on patients with obesity. 76 patients (37 males and 39 females) with obesity were included in this study. After night polysomnography all patients were divided in two groups comparableby age, sex ratio and BMI. The first group consisted of 41 patients with obstructive sleep apnea syndrome (OSAS), the second (controls) – 35 patients without breath disorders during sleep. OSAS is accompanied by the increase in urinary cortisol during the night, high levels ofbasal insulin, disturbances of hepatic production of IGF-1, dysfunction of the pituitary-gonadal axis. Our results show that sleep-related breathing disorders render markedly and negatively affect on hormonal parameters of patients with obesity. As a reliable difference of basalsecretion of orexin A in obese patients with and without OSAS was not revealed (42,0 [14; 99,5] vs. 18,0 [14,5; 124,5] pg/ml; р=0,9), we were not able to show the existence that the existence of OSAS is followed by any special changes of activity of the orexin system.

scholarly journals Effect of nasal CPAP therapy for obstructive sleep apnea syndrome.

1989 ◽  
Vol 40 (5) ◽  
pp. 416-421 ◽  
Author(s):  
Takayuki Yoshizawa ◽  
Keiji Kurashina ◽  
Iwao Sasaki ◽  
Kenzo Otsuka ◽  
Tsuneto Akashiba ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Cpap Therapy ◽  
Nasal Cpap ◽  
Obstructive Sleep ◽  
Apnea Syndrome

scholarly journals Effect of CPAP-therapy on bronchial and nasal inflammation in patients affected by obstructive sleep apnea syndrome

2011 ◽  
Vol 49 (2) ◽  
pp. 232-237
Author(s):  
D. Lacedonia ◽  
F.G. Salerno ◽  
G.E. Carpagnano ◽  
R. Sabato ◽  
A. Depalo ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Induced Sputum ◽  
Cpap Therapy ◽  
Cpap Treatment ◽  
Obstructive Sleep ◽  
Apnea Syndrome ◽  
Nasal Inflammation

BACKGROUND: Obstructive sleep apnea syndrome (OSAS) has been shown to be associated to upper and lower airways inflammation. Continuous positive airway pressure (CPAP) is the elective treatment of OSAS. The aim of the present study was to assess the effect of CPAP-therapy on airway and nasal inflammation. METHODS: In 13 non-smoking subjects affected by untreated OSAS and in 11 non-smoking normal volunteers, airway inflammation was detected by analyses of the induced sputum. In the OSAS group measurements were repeated after 1, 10 and 60 days of the appropriate CPAP treatment. In addition, in 12 subjects of the OSAS group, nasal inflammation was detected by the analysis of induced nasal secretions at baseline, and after 1, 10 and 60 days of CPAP treatment. RESULTS: OSAS patients, compared to normal controls, showed at baseline a higher percentage of neutrophils and a lower percentage of macrophages in the induced sputum. One, 10 and 60 days of appropriate CPAP-therapy did not change the cellular profile of the induced sputum. In addition, in the OSAS patients, the high neutrophilic nasal inflammation present under baseline conditions was not significantly modified by CPAP-therapy. Finally, no patients developed airway hyper-responsiveness after CPAP therapy. CONCLUSIONS: In OSAS subjects, the appropriate CPAP-therapy, while correcting the oxygen desaturation, does not modify the bronchial and nasal inflammatory profile.

Sign in / Sign up

Export Citation Format

Share Document