scholarly journals Sleep Disorders and Symptoms in Blacks with Metabolic Syndrome: the Metabolic Syndrome Outcome Study (MetSO)

2018 ◽  
Vol 28 (3) ◽  
pp. 193 ◽  
Author(s):  
Natasha J. Williams ◽  
Chimene Castor ◽  
Azizi Seixas ◽  
Joseph Ravenell ◽  
Girardin Jean-Louis
Keyword(s):  
Metabolic Syndrome ◽  
Sleep Disturbance ◽  
Daytime Sleepiness ◽  
Evaluation System ◽  
Early Morning ◽  
Public Health Issue ◽  
Outcome Study ◽  
The Metabolic Syndrome ◽  
Obstructive Sleep ◽  
Falling Asleep

<p class="Pa7"><strong>Introduction: </strong>Sleep disturbance is a major public health issue and is comorbid with the cluster of conditions associated with meta­bolic syndrome (MetS). Our study explored the presence of sleep disturbance, including daytime sleepiness, the risk for obstructive sleep apnea (OSA), and insomnia symp­toms, in a cohort of adult Black men and women with MetS.</p><p class="Pa7"><strong>Methods: </strong>Patients (n=1,013) from the Met­abolic Syndrome Outcome Study (MetSO), 2009-2012, met criteria for MetS based on guidelines from the National Cholesterol Education Program’s Adult Treatment Panel and provided sociodemographic data and the Apnea Risk Evaluation System (ARES) questionnaire to assess OSA risk, sleep char­acteristics, and physician-reported diagnosis of a sleep disorder.</p><p class="Pa7"><strong>Results: </strong>Prevalence of the components of MetS included: diabetes (60%); obesity (67%); hypertension (94%); and dyslip­idemia (74%). Based on the ARES, 49% were at risk for OSA. Of all study patients, slightly more than half (53%) reported feel­ing sleepy during the day, and 10% reported an insomnia diagnosis. The most common sleep disturbance reported by 46% of the patients was early morning awakenings (EMA). This was closely followed by 42% who reported difficulty staying asleep (DSA) and 38% reporting difficulty falling asleep (DFA). Seventy percent reported short sleep (≤ 6 hours), whereas a minority (19%) reported long sleep (≥ 9 hours). Only 12% used sleep aids. Women, compared with men, reported greater daytime sleepiness, greater DFA, and greater DSA (57% vs 45%; 41% vs 32.4%; 45% vs 37%), respectively.</p><p class="Default"><strong>Conclusion: </strong>Blacks with MetS reported insomnia symptoms and insomnia disor­der, use of sleep aids, feeling sleepy during the day, and inadequate sleep durations. The presence of these sleep characteristics suggests that patients with MetS should be referred for further sleep assessment. <em></em></p><p class="Default"><em>Ethn Dis. </em>2018;28(3):193-200; doi:10.18865/ ed.28.3.193</p>

Abstract 1428: Effects of Continuous Positive Airway Pressure Treatment on Endothelial Function and Insulin Resistance in Patients with Obstructive Sleep Apnea and the Metabolic Syndrome

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Hideki Watanabe ◽  
Kunio Nakagawa ◽  
Masaaki Kakihana
Keyword(s):  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Obstructive Sleep Apnea ◽  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Early Morning ◽  
Cpap Treatment ◽  
The Metabolic Syndrome ◽  
Obstructive Sleep

Background: Obstructive sleep apnea (OSA) and the metabolic syndrome are recognized as a risk factor for cardiovascular disease. Cardiovascular events have been reported to have a peak incidence in the early hours after waking in OSA patients. This study was designed to examine the influence of OSA on endothelial function in the early morning in patients with the metabolic syndrome. Methods: The severity of sleep-disordered breathing was evaluated by polysomnography in patients with the metabolic syndrome. Ten OSA patients (an apnea-hypopnea index [AHI] >30) with the metabolic syndrome was included in this study, and we also included age-and sex-matched ten non-OSA patients (AHI <5) with the metabolic syndrome in this study. All subjects received pioglitazone for 1 month (1Mo), and then OSA patients received pioglitazone and nasal continuous positive airway pressure (CPAP) treatment for next 1 month (2Mo). Flow-mediated dilatation (FMD) and nitroglycerin-induced dilatation (NID) of brachial artery were measured by using ultrasound system. We also assessed insulin resistance by HOMA-IR. Measurements were performed in the early morning (6:00AM) and the late morning (11:00AM) at baseline, 1Mo, and 2Mo. Results: At baseline, there were not differences in FMD, and NID between the early morning and the late morning. After the treatment with pioglitazone (1Mo), FMD in the non-OSA patients was increased in the early and late morning, but FMD in the OSA patients was increased only in the late morning. After the CPAP treatment (2Mo), FMD in the OSA patients was increased in the early and late morning. HOMA-IR was improved at 1Mo in the non-OSA patients, and was improved at 2Mo in the OSA patients. Conclusion: OSA is associated with endothelial dysfunction in the early morning and insulin resistance in patients with the metabolic syndrome, and CPAP treatment is effective on the improvement of endothelial dysfunction in the early morning in OSA patients with the metabolic syndrome.

scholarly journals 1253 Multiple sleep onset REM episodes in middle age woman with excessive daytime sleepiness – Is this automatically assumed narcolepsy?

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A477-A477
Author(s):  
Kamal Patel ◽  
Bianca J Lang
Keyword(s):  
Daytime Sleepiness ◽  
Sleep Latency ◽  
Sleep Onset ◽  
Sleep Time ◽  
Multiple Sleep Latency Test ◽  
Sleep Onset Latency ◽  
Onset Latency ◽  
Obstructive Sleep ◽  
Falling Asleep ◽  
Multiple Sleep Latency

Abstract Introduction Presence of sleep onset REM episodes often raises concerns of narcolepsy. However other conditions have shown to have presence of sleep on REM episodes which include but not limited to obstructive sleep apnea, sleep wake schedule disturbance, alcoholism, neurodegenerative disorders, depression and anxiety Report of Case Here we present a case of 30 year old female with history of asthma, patent foraman ovale, migraine headache, and anxiety who presented with daytime sleepiness, falling asleep while at work, occasional scheduled naps, non-restorative sleep, sleep paralysis, and hypnopompic hallucination. Pertinent physical exam included; mallampati score of 4/4, retrognathia, high arched hard palate, crowded posterior oropharynx. She had a score of 16 on Epworth sleepiness scale. Patient previously had multiple sleep latency test at outside facility which revealed 4/5 SOREM, with mean sleep onset latency of 11.5 minutes. She however was diagnosed with narcolepsy and tried on modafinil which she failed to tolerate. She was tried on sertraline as well which was discontinued due to lack of benefit. She had repeat multiple sleep latency test work up which revealed 2/5 SOREM, with mean sleep onset latency was 13.1 minutes. Her overnight polysomnogram prior to repeat MSLT showed SOREM with sleep onset latency of 10 minutes. Actigraphy showed consistent sleep pattern overall with sufficient sleep time but was taking hydroxyzine and herbal medication. Patient did not meet criteria for hypersomnolence disorder and sleep disordered breathing. Conclusion There is possibility her medication may have played pivotal role with her daytime symptoms. We also emphasize SOREMs can be present in other disorders such as anxiety in this case and not solely in narcolepsy

Obstructive Sleep Apnoea Impairs Heart Rate Variability in Patients with the Metabolic Syndrome

2007 ◽  
Vol 16 ◽  
pp. S84
Author(s):  
B. Weatherhead ◽  
C. Neil ◽  
M. Barnes ◽  
R. Pierce ◽  
A. Collins ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Obstructive Sleep Apnoea ◽  
Sleep Apnoea ◽  
The Metabolic Syndrome ◽  
Obstructive Sleep

scholarly journals Increased liver stiffness in patients with severe sleep apnoea and metabolic comorbidities

2018 ◽  
Vol 51 (6) ◽  
pp. 1800601 ◽  
Author(s):  
Wojciech Trzepizur ◽  
Jérôme Boursier ◽  
Marc Le Vaillant ◽  
Pierre-Henri Ducluzeau ◽  
Séverine Dubois ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Liver Disease ◽  
Liver Fibrosis ◽  
Liver Stiffness ◽  
Sleep Apnoea ◽  
Screening Tools ◽  
The Metabolic Syndrome ◽  
Obstructive Sleep ◽  
Increased Risk ◽  
Metabolic Comorbidities

The goal of this study was to assess the relationship between the severity of obstructive sleep apnoea (OSA) and liver stiffness measurement (LSM), one of the most accurate noninvasive screening tools for liver fibrosis in nonalcoholic fatty liver disease.The study included 147 patients with at least one criterion for the metabolic syndrome, assessed by polysomnography for suspected OSA. LSM was performed using transient elastography (FibroScan). Significant liver disease and advanced liver fibrosis were defined as LSM ≥7.3 and ≥9.6 kPa, respectively.23 patients were excluded because of unreliable LSM. Among 124 patients, 34 (27.4%) had mild OSA, 38 (30.6%) had moderate OSA and 52 (42.0%) had severe OSA. LSM values were 7.3– <9.6 kPa in 18 (14.5%) patients and ≥9.6 kPa in 15 (12.1%) patients. A dose–response relationship was observed between OSA severity and LSM values (p=0.004). After adjustment for age, sex, metabolic syndrome and insulin resistance, severe OSA was associated with an increased risk of LSM ≥7.3 kPa (OR 7.17, 95% CI 2.51–20.50) and LSM ≥9.6 kPa (OR 4.73, 95% CI 1.25–17.88).In patients with metabolic comorbidities, severe OSA is independently associated with increased liver stiffness, which may predispose to a higher risk of significant liver disease and poorer prognosis.

Comorbid conditions at chronic obstructive pulmonary disease: the questions under investigation and discussion

2021 ◽  
Author(s):  
O. I. Lemko ◽  
M. O. Haysak ◽  
D. V. Reshetar
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Metabolic Syndrome ◽  
Pulmonary Disease ◽  
Metabolic Disorders ◽  
Chronic Obstructive ◽  
Comorbid Conditions ◽  
Obstructive Pulmonary Disease ◽  
The Metabolic Syndrome ◽  
Obstructive Sleep

The second part of the review examines in detail the questions of diagnostics and peculiarities of the metabolic syndrome manifestations, which presents the link between most comorbid conditions at patients with chronic obstructive pulmonary disease. The metabolic syndrome is based on the insulin resistance and compensatory hyperinsulinemia, caused by both chronic low‑intensity inflammation and increased adipose tissue, often against the background of aggravated heredity at diabetes mellitus. The authors elucidate aspects of the effects of obesity, cachexia and some endocrine disorders on the disease course. The deficiency of researches on endocrine status, especially thyroid function and related metabolic disorders was emphasized. Possible pathogenetic mechanisms of osteoporosis development in this contingent of patients are considered. The need for further research of the pathogenetic role of vitamin D is discussed. Data on the role of the functional state of kidneys in the development of metabolic disorders in an organism have been presented, though kidney pathology in patients with chronic obstructive pulmonary disease is not currently considered as a comorbid condition. The contradictory literature data on the development of anemia in these patients were analysed. The authors presented data on the development of oncological processes as a systemic manifestation at COPD and performed analysis of common and mutually aggravating mechanisms of the development of these pathological conditions. Attention has been paid to the relationship between gastroesophageal reflux disease, bronchiectasis and obstructive sleep apnea with chronic obstructive pulmonary disease. The prospects of modern genetic research in chronic obstructive pulmonary disease and comorbid conditions have been determined.

scholarly journals Resistant Hypertension and Obstructive Sleep Apnea in the Primary-Care Setting

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
M. Demede ◽  
A. Pandey ◽  
F. Zizi ◽  
R. Bachmann ◽  
M. Donat ◽  
...  
Keyword(s):  
Primary Care ◽  
Metabolic Syndrome ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Resistant Hypertension ◽  
Evaluation System ◽  
Care Setting ◽  
Primary Care Setting ◽  
Obstructive Sleep ◽  
Risk Evaluation System

We ascertained the prevalence of resistant hypertension (RH) among blacks and determined whether RH patients are at greater risk for obstructive sleep apnea (OSA) than hypertensives.Method. Data emanated from Metabolic Syndrome Outcome Study (MetSO), a study investigating metabolic syndrome among blacks in the primary-care setting. Sample of 200 patients (mean age = 63 ± 13 years; female = 61%) with a diagnosis of hypertension provided subjective and clinical data. RH was defined using the JNC 7and European Society guidelines. We assessed OSA risk using the Apnea Risk Evaluation System ARES), defining high risk as a total ARES score ≥6.Results. Overall, 26% met criteria for RH and 40% were at high OSA risk. Logistic regression analysis, adjusting for effects of age, gender, and medical co morbidities, showed that patients with RH were nearly 2.5 times more likely to be at high OSA risk, relative to those with hypertension (OR = 2.46, 95% CI: 1.03–5.88,P<.05).Conclusion. Our findings show that the prevalence of RH among blacks fell within the range of RH for the general hypertensive population (3–29%). However, patients with RH were at significantly greater risk of OSA compared to patients with hypertension.

scholarly journals The Polycystic Ovary Syndrome and the Metabolic Syndrome: A Possible Chronobiotic-Cytoprotective Adjuvant Therapy

2018 ◽  
Vol 2018 ◽  
pp. 1-12 ◽  
Author(s):  
Eduardo Spinedi ◽  
Daniel P. Cardinali
Keyword(s):  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Adipose Tissue ◽  
Polycystic Ovary Syndrome ◽  
White Adipose Tissue ◽  
Polycystic Ovary ◽  
Ovary Syndrome ◽  
The Metabolic Syndrome ◽  
Obstructive Sleep ◽  
The Impact

Polycystic ovary syndrome is a highly frequent reproductive-endocrine disorder affecting up to 8–10% of women worldwide at reproductive age. Although its etiology is not fully understood, evidence suggests that insulin resistance, with or without compensatory hyperinsulinemia, and hyperandrogenism are very common features of the polycystic ovary syndrome phenotype. Dysfunctional white adipose tissue has been identified as a major contributing factor for insulin resistance in polycystic ovary syndrome. Environmental (e.g., chronodisruption) and genetic/epigenetic factors may also play relevant roles in syndrome development. Overweight and/or obesity are very common in women with polycystic ovary syndrome, thus suggesting that some polycystic ovary syndrome and metabolic syndrome female phenotypes share common characteristics. Sleep disturbances have been reported to double in women with PCOS and obstructive sleep apnea is a common feature in polycystic ovary syndrome patients. Maturation of the luteinizing hormone-releasing hormone secretion pattern in girls in puberty is closely related to changes in the sleep-wake cycle and could have relevance in the pathogenesis of polycystic ovary syndrome. This review article focuses on two main issues in the polycystic ovary syndrome-metabolic syndrome phenotype development: (a) the impact of androgen excess on white adipose tissue function and (b) the possible efficacy of adjuvant melatonin therapy to improve the chronobiologic profile in polycystic ovary syndrome-metabolic syndrome individuals. Genetic variants in melatonin receptor have been linked to increased risk of developing polycystic ovary syndrome, to impairments in insulin secretion, and to increased fasting glucose levels. Melatonin therapy may protect against several metabolic syndrome comorbidities in polycystic ovary syndrome and could be applied from the initial phases of patients’ treatment.

scholarly journals Sleeping Beauty or the Beast? – The Metabolic Syndrome from an Obstructive Sleep Apnoea Perspective

2010 ◽  
Vol 9 (1) ◽  
pp. 12 ◽  
Author(s):  
Lise Tarnow ◽  
Brigitte Klinkenbijl ◽  
Holger Woehrle ◽  
◽  
◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Obstructive Sleep Apnoea ◽  
Reduce Blood Pressure ◽  
Sleep Apnoea ◽  
Sleeping Beauty ◽  
The Metabolic Syndrome ◽  
Home Based ◽  
Obstructive Sleep

Obstructive sleep apnoea (OSA) is a significant health issue. Patients with cardiovascular disease as well as patients with diabetes have a high prevalence of OSA, and the prevalence of coronary heart disease, heart failure, stroke and diabetes is increased in patients with obstructive sleep apnoea. Physiological responses to OSA include sympathetic activation, neurohumoral changes and inflammation, all of which are precursors for cardiovascular disease and diabetes. International guidelines are starting to recognise the importance of OSA for patients with cardiovascular conditions such as heart failure and hypertension. Diagnosis is important, and home-based sleep testing devices can facilitate this process. Treating OSA with continuous positive airway pressure (CPAP) has been shown to reduce blood pressure (BP) in patients with hypertension, but more research is needed to determine which components of the metabolic syndrome respond best to the addition of CPAP therapy.

Sleep-disordered breathing, type 2 diabetes and the metabolic syndrome

2014 ◽  
Vol 11 (4) ◽  
pp. 257-275 ◽  
Author(s):  
Ian W Seetho ◽  
John PH Wilding
Keyword(s):  
Type 2 Diabetes ◽  
Metabolic Syndrome ◽  
Sleep Disordered Breathing ◽  
Sleep Apnoea ◽  
The Metabolic Syndrome ◽  
Sleep Homeostasis ◽  
Obstructive Sleep ◽  
Underlying Mechanisms ◽  
Disordered Breathing

Sleep-disordered breathing (SDB) encompasses a spectrum of conditions that can lead to altered sleep homeostasis. In particular, obstructive sleep apnoea (OSA) is the most common form of SDB and is associated with adverse cardiometabolic manifestations including hypertension, metabolic syndrome and type 2 diabetes, ultimately increasing the risk of cardiovascular disease. The pathophysiological basis of these associations may relate to repeated intermittent hypoxia and fragmented sleep episodes that characterize OSA which drive further mechanisms with adverse metabolic and cardiovascular consequences. The associations of OSA with type 2 diabetes and the metabolic syndrome have been described in studies ranging from epidemiological and observational studies to controlled trials investigating the effects of OSA therapy with continuous positive airway pressure (CPAP). In recent years, there have been rising prevalence rates of diabetes and obesity worldwide. Given the established links between SDB (in particular OSA) with both conditions, understanding the potential influence of OSA on the components of the metabolic syndrome and diabetes and the underlying mechanisms by which such interactions may contribute to metabolic dysregulation are important in order to effectively and holistically manage patients with SDB, type 2 diabetes or the metabolic syndrome. In this article, we review the literature describing the associations, the possible underlying pathophysiological mechanisms linking these conditions and the effects of interventions including CPAP treatment and weight loss.

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