Analysis of Salivary Microbiome and Its Association With Periodontitis in Patients With Obstructive Sleep Apnea

ObjectivesThis study aimed to analyze the periodontal conditions of patients with obstructive sleep apnea (OSA) in relation to the salivary microbiome.Materials and MethodsIn total, 54 male adults (27 with OSA, 27 controls) completed this cross-sectional study. All participants were monitored by overnight polysomnography (PSG) and underwent full-mouth periodontal examination. Saliva samples were then collected, and the microbial 16S ribosomal RNA gene was sequenced. The data were analyzed to determine the microbial distribution and the community structure of the two groups.ResultsDemonstrated by alpha and beta diversity, the OSA group had a lower microbial richness and a lower observed species than the controls. There was no significant difference in the microbial species diversity or evenness between the OSA and the non-OSA groups. The OSA group had fewer operational taxonomic units (OTUs), and the distribution of microbiome showed that several gram-positive bacteria had higher abundance in the OSA group. As for periodontal pathogens, the relative abundance of Prevotella was significantly increased in the OSA group. No significant difference was observed in the relative abundance of other pathogens at either the genus or species level.ConclusionsThe salivary microbial community structure was altered in patients with OSA in terms of species richness and trans-habitat diversity, along with an increase in Prevotella, a specific periodontal pathogen. These findings might explain the high prevalence of periodontitis in OSA patients.

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Evaluation of Inflammatory Markers in a Large Sample of Obstructive Sleep Apnea Patients without Comorbidities

Mediators of Inflammation ◽

10.1155/2017/4573756 ◽

2017 ◽

Vol 2017 ◽

pp. 1-13 ◽

Cited By ~ 17

Author(s):

Izolde Bouloukaki ◽

Charalampos Mermigkis ◽

Nikolaos Tzanakis ◽

Eleftherios Kallergis ◽

Violeta Moniaki ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Inflammatory Markers ◽

High Sensitivity ◽

Apnea Hypopnea Index ◽

Cross Sectional ◽

Large Sample ◽

Obstructive Sleep ◽

Significant Difference ◽

Hs Crp

Systemic inflammation is important in obstructive sleep apnea (OSA) pathophysiology and its comorbidity. We aimed to assess the levels of inflammatory biomarkers in a large sample of OSA patients and to investigate any correlation between these biomarkers with clinical and polysomnographic (PSG) parameters. This was a cross-sectional study in which 2983 patients who had undergone a polysomnography for OSA diagnosis were recruited. Patients with known comorbidities were excluded. Included patients (n=1053) were grouped according to apnea-hypopnea index (AHI) as mild, moderate, and severe. Patients with AHI < 5 served as controls. Demographics, PSG data, and levels of high-sensitivity C-reactive protein (hs-CRP), fibrinogen, erythrocyte sedimentation rate (ESR), and uric acid (UA) were measured and compared between groups. A significant difference was found between groups in hs-CRP, fibrinogen, and UA. All biomarkers were independently associated with OSA severity and gender (p<0.05). Females had increased levels of hs-CRP, fibrinogen, and ESR (p<0.001) compared to men. In contrast, UA levels were higher in men (p<0.001). Our results suggest that inflammatory markers significantly increase in patients with OSA without known comorbidities and correlate with OSA severity. These findings may have important implications regarding OSA diagnosis, monitoring, treatment, and prognosis. This trial is registered with ClinicalTrials.gov numberNCT03070769.

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The Association Between Obstructive Sleep Apnea and Periodontitis in Chinese Male Adults: A Cross-Sectional Study

10.21203/rs.3.rs-56724/v1 ◽

2020 ◽

Author(s):

Yanlong Chen ◽

Ying Duan ◽

Yan Li ◽

Xiaoxia Han ◽

He Gao ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Cross Sectional Study ◽

Apnea Hypopnea Index ◽

Sectional Study ◽

Cross Sectional ◽

Periodontal Tissues ◽

Obstructive Sleep ◽

Significant Difference ◽

Chinese Male

Abstract Background: Obstructive sleep apnea (OSA) is characterized by complete or partial upper airway obstruction during sleep. Periodontitis is an infectious and inflammatory disease of periodontal tissues. Recent studies suggested that both diseases could alter the host response synergistically by sharing same inflammatory pathways. The study aimed to investigate the association between OSA and periodontitis in Chinese male adults.Methods: This was a cross-sectional study of 93 male adults recruited from a dormitory compound and examined between June and September 2019. All participants were diagnosed OSA using the apnea–hypopnea index (AHI) with a portable, overnight polysomnography (PSG). Periodontal examinations were conducted the same day before PSG measuring: 1) mean probing depth (PD); 2) mean clinical attachment level (CAL); and 3) percentage of sites with bleeding on probing (BOP). An objective nasal airway resistance assessment was also practiced before PSG to reflect on the mouth breathing during sleep.Results: In all, 43.0% participants had periodontitis, 20.4% had OSA and 32.5% of those diagnosed with periodontitis were in combination with OSA. OSA was positively associated with periodontitis (odds ratio (OR) = 3.77, 95% confidence interval (CI) = 1.29 ~ 11.07). The OSA group showed a significantly higher BOP (p = 0.034) and CAL (p = 0.046), but there was no statistically significant difference of PD (p = 0.090) between the two groups. Correlation analysis showed a low but positive correlation between OSA severity and periodontitis severity classifications and periodontal parameters. Further regression analysis identified Lowest oxygen saturation (SaO2) (OR = 0.894, 95% CI = 0.842 ~ 0.949) to be significantly associated with the prevalence of periodontitis.Conclusions: A significant association was observed between OSA and periodontitis. And increasingly severe OSA might increase the severity of periodontitis. Hypoxia parameters might have a predicting effect of periodontitis, suggesting hypoxia related systematic inflammation may be the possible explanation of the association.

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Slow-wave sleep is associated with incident hypertension in patients with obstructive sleep apnea: a cross-sectional study

Journal of International Medical Research ◽

10.1177/0300060520954682 ◽

2020 ◽

Vol 48 (9) ◽

pp. 030006052095468

Author(s):

Jing Zhang ◽

Yan Zhuang ◽

Nan-sheng Wan ◽

Xin Tang ◽

Wei Zhou ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Slow Wave ◽

Slow Wave Sleep ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Incident Hypertension ◽

Obstructive Sleep ◽

Significant Difference

Objective This study aimed to examine the association between slow-wave sleep ([SWS] N3 stage) and the risk of hypertension in patients with obstructive sleep apnea (OSA) or primary snorers. Methods A retrospective cross-sectional study of 1145 participants who were evaluated for suspected OSA at our Sleep Medical Center were included. Among these participants, 1022 had OSA and 123 were primary snorers. Logistic regression modeling was performed to evaluate the association between the prevalence of hypertension and combined OSA and SWS based on polysomnographic measurements. Results Patients with OSA in the lowest SWS quartile (quartile 1, < 2.0%) showed a two-fold increased risk of hypertension after adjustment for confounding factors compared with primary snorers (odds ratio, 2.13 [95% confidence interval 1.54–2.06]). In logistic analysis stratified according to SWS quartiles, there was no significant difference in the risk of hypertension between patients with OSA and primary snorers in quartile 1. However, in the highest quartile (quartile 4), SWS was significantly associated with incident hypertension in patients with OSA rather than primary snorers. Conclusion SWS is associated with prevalent hypertension in patients with OSA. Notably, a low proportion of SWS confers a stronger association with incident hypertension than OSA.

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Postoperative monitoring of children with obstructive sleep apnea syndrome

Orvosi Hetilap ◽

10.1556/oh.2014.29879 ◽

2014 ◽

Vol 155 (18) ◽

pp. 703-707 ◽

Cited By ~ 1

Author(s):

Pálma Benedek ◽

Gabriella Kiss ◽

Eszter Csábi ◽

Gábor Katona

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Obstructive Sleep Apnea Syndrome ◽

Preoperative Evaluation ◽

Sleep Apnea Syndrome ◽

Study Patient ◽

Severe Obstructive Sleep Apnea ◽

Obstructive Sleep ◽

Significant Difference ◽

Apnea Syndrome

Introduction: Treatment of pediatric obstructive sleep apnea syndrome is surgical. The incidence of postoperative respiratory complications in this population is 5–25%. Aim: The aim of the authors was to present the preoperative evaluation and monitoring procedure elaborated in Heim Pál Children Hospital, Budapest. Method: 142 patients were involved in the study. Patient history was obtained and physical examination was performed in all cases. Thereafter, polysomnography was carried out, the severity of the obstructive sleep apnea syndrome was determined, and the patients underwent tonsilloadenotomy. Results: 45 patients with mild, 50 patients with moderate and 47 patients with severe obstructive sleep apnea syndrome were diagnosed. There was no complication in patients with mild disease, while complications were observed in 6 patients in the moderate group and 24 patients in the severe group (desaturation, apnea, stridor, stop breathing) (p<0.000). In patients with severe obstructive sleep apnea syndrome, no significant difference was noted in preoperative apnoea-hypapnea index (p = 0.23) and in nadir oxygen saturation values (p = 0.73) between patients with and without complication. Conclusions: Patients with severe obstructive sleep apnea syndrome should be treated in hospital where pediatric intensive care unit is available. Orv. Hetil., 2014, 155(18), 703–707.

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Aerodynamics Analysis of the Impact of Nasal Surgery on Patients with Obstructive Sleep Apnea and Nasal Obstruction

ORL ◽

10.1159/000516243 ◽

2021 ◽

pp. 1-8

Author(s):

Lifeng Li ◽

Demin Han ◽

Hongrui Zang ◽

Nyall R. London

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Nasal Obstruction ◽

Upper Airway ◽

Apnea Hypopnea Index ◽

Nasal Surgery ◽

Subjective Sleep Quality ◽

Obstructive Sleep ◽

Significant Difference ◽

The Impact

Objective: The purpose of this study was to evaluate the effects of nasal surgery on airflow characteristics in patients with obstructive sleep apnea (OSA) by comparing the alterations of airflow characteristics within the nasal and palatopharyngeal cavities. Methods: Thirty patients with OSA and nasal obstruction who underwent nasal surgery were enrolled. A pre- and postoperative 3-dimensional model was constructed, and alterations of airflow characteristics were assessed using the method of computational fluid dynamics. The other subjective and objective clinical indices were also assessed. Results: By comparison with the preoperative value, all postoperative subjective symptoms statistically improved (p < 0.05), while the Apnea-Hypopnea Index (AHI) changed little (p = 0.492); the postoperative airflow velocity and pressure in both nasal and palatopharyngeal cavities, nasal and palatopharyngeal pressure differences, and total upper airway resistance statistically decreased (all p < 0.01). A significant difference was derived for correlation between the alteration of simulation metrics with subjective improvements (p < 0.05), except with the AHI (p > 0.05). Conclusion: Nasal surgery can decrease the total resistance of the upper airway and increase the nasal airflow volume and subjective sleep quality in patients with OSA and nasal obstruction. The altered airflow characteristics might contribute to the postoperative reduction of pharyngeal collapse in a subset of OSA patients.

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Effect of Cooling Irrigating Saline in Tongue Base Ablation in Obstructive Sleep Apnea

OTO Open ◽

10.1177/2473974x21989599 ◽

2021 ◽

Vol 5 (1) ◽

pp. 2473974X2198959

Author(s):

Ahmed Yassin Bahgat

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Controlled Trial ◽

Tongue Base ◽

Control Group ◽

University Hospitals ◽

Energy Field ◽

Obstructive Sleep ◽

Prospective Randomized Controlled Trial ◽

Significant Difference

Objective Plasma is formed by creating a high-density energy field within an electrically conductive fluid such as saline. Sometimes ablated bits of tissue get stuck between the electrodes of the wand, obstructing the suction channel. The purpose of this study is to investigate the effect of cooling the irrigating saline during ablation of the hypertrophied tongue base in patients with obstructive sleep apnea. Study Design Prospective randomized controlled trial. Setting An otorhinolaryngology department in Main University hospitals. Methods Sixty adult patients with obstructive sleep apnea and tongue base hypertrophy underwent tongue base ablation surgery. Patients were randomly divided into 2 groups of 30 patients each: cooled saline and room temperature saline. The Coblation wand used was the EVac 70 Xtra HP (Smith & Nephew). Results In this study, a significant difference in operative time (mean ± SD) was seen between groups: 21.2 ± 5.5 minutes in the cold group and 47 ± 9.5 minutes in the control group ( P = .001). The wands in the cold group did not obstruct, while all the wands in the control group were obstructed by tissue clogs with variable degrees, hence wasting more time to clean the wands’ tips. Conclusion Cooling the irrigating saline overcame the problem of wand clogs, and the wand tip did not occlude at all during the procedures, thus saving time lost in wand cleaning and demonstrating a faster and safer surgical procedure. Further studies are needed to identify the hemostatic effect of the cooled saline over the regular one.

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Inverse Cross-sectional and Longitudinal Relationships between Diabetic Retinopathy and Obstructive Sleep Apnea in Type 2 Diabetes

Ophthalmology Science ◽

10.1016/j.xops.2021.100011 ◽

2021 ◽

Vol 1 (1) ◽

pp. 100011

Author(s):

Jakob Grauslund ◽

Lonny Stokholm ◽

Anne S. Thykjær ◽

Sören Möller ◽

Caroline S. Laugesen ◽

...

Keyword(s):

Type 2 Diabetes ◽

Obstructive Sleep Apnea ◽

Diabetic Retinopathy ◽

Sleep Apnea ◽

Cross Sectional ◽

Obstructive Sleep ◽

Longitudinal Relationships

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Stress in obstructive sleep apnea

Scientific Reports ◽

10.1038/s41598-021-91996-5 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Jasmine L. Wong ◽

Fernando Martinez ◽

Andrea P. Aguila ◽

Amrita Pal ◽

Ravi S. Aysola ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Depressive Symptoms ◽

Sleep Apnea ◽

Perceived Stress ◽

Stress Reduction ◽

Psychological Symptoms ◽

Cross Sectional Study ◽

Cross Sectional ◽

General Anxiety Disorder ◽

Obstructive Sleep

AbstractPeople with obstructive sleep apnea (OSA) often have psychological symptoms including depression and anxiety, which are commonly treated with anti-depression or anti-anxiety interventions. Psychological stress is a related symptom with different intervention targets that may also improve mental state, but this symptom is not well characterized in OSA. We therefore aimed to describe stress in relation to other psychological symptoms. We performed a prospective cross-sectional study of 103 people, 44 untreated OSA (mean ± s.d. age: 51.2 ± 13.9 years, female/male 13/31) and 57 healthy control participants (age: 46.3 ± 13.8 years, female/male 34/23). We measured stress (Perceived Stress Scale; PSS), excessive daytime sleepiness (Epworth Sleepiness Scale; ESS), depressive symptoms (Patient Health Questionnaire; PHQ-9), and anxiety symptoms (General Anxiety Disorder; GAD-7). We compared group means with independent samples t-tests and calculated correlations between variables. Mean symptom levels were higher in OSA than control, including PSS (mean ± s.d.: OSA = 15.3 ± 6.9, control = 11.4 ± 5.5; P = 0.002), GAD-7 (OSA = 4.8 ± 5.0, control = 2.1 ± 3.9; P = 0.02), PHQ-9 (OSA = 6.9 ± 6.1, control = 2.6 ± 3.8; P = 0.003) and ESS (OSA = 8.1 ± 5.3, control = 5.0 ± 3.3; P = 0.03). Similar OSA-vs-control differences appeared in males, but females only showed significant differences in PHQ-9 and ESS, not PSS or GAD-7. PSS correlated strongly with GAD-7 and PHQ-9 across groups (R = 0.62–0.89), and moderately with ESS. Perceived stress is high in OSA, and closely related to anxiety and depressive symptoms. The findings support testing stress reduction in OSA.

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428 Baroreflex sensitivity during handgrip in obstructive sleep apnea with and without CPAP

SLEEP ◽

10.1093/sleep/zsab072.427 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A169-A170

Author(s):

Amrita Pal ◽

Fernando Martinez ◽

Ravi Aysola ◽

Ronald Harper ◽

Luke Henderson ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Baroreflex Sensitivity ◽

Muscle Sympathetic Nerve Activity ◽

Cross Sectional Study ◽

Autonomic Regulation ◽

Cross Sectional ◽

Obstructive Sleep ◽

Healthy Control ◽

Significant Measure

Abstract Introduction Obstructive sleep apnea (OSA) disrupts multiple aspect of autonomic regulation; it is unclear whether intervention with continuous positive airway pressure (CPAP) can correct such disruptions. One key index of autonomic regulation is baroreflex sensitivity (BRS), an index that indicates heart rate (HR) changes to blood pressure (BP) alterations, and which is a significant measure for evaluating long-term cardiovascular changes induced by OSA. BRS can be assessed from BP and HR changes during an autonomic challenge task such as handgrip (HG). In a cross-sectional study, we assessed BRS during HG in untreated OSA (OSA_un) and CPAP treated OSA (CPAP), together with healthy control (CON) participants to determine if CPAP can recover BRS. Methods We collected ECG and continuous beat-by-beat BP from 95 people: 32 newly-diagnosed OSA_un (51.5±13.9years; AHI 21.0±15.3events/hour; 20male); 31 CPAP (49.4±14.0years; 22.4±14.1events/hour in initial diagnosis; 23male); and 32 CON (44.1±13.8years; 10male). We acquired data over 7 mins, during which people performed three 30s HGs (60 s baseline, 90 s recovery, 80% maximum strength). We calculated BRS over the 7 min period using sequence analysis in AcqKnowledge 5.0 BRS, followed by group comparisons using ANOVA. We also analyzed BP, HR and their variabilities: BPV and HRV (sympathetic-vagal). Results Mean arterial BP increases during HG were similar in all groups, although baseline mean arterial BP was higher in OSA_unc and CPAP, relative to CON (p < 0.05; OSA_un:mean±std, 90±11mmHg; CPAP: 88±10mmHg; CON 82±13mmHg). BRS was lower in OSA_un and CPAP, relative to CON (p < 0.05; OSA_un: 13.1±7.6 ms/mmHg; CPAP: 13.7±9.0 ms/mmHg; control 18.3±11.9 ms/mmHg). Other cardiovascular measures of BPV, HR and HRV in addition to BP showed significant increases in response to HG, but these changes were similar in all 3 groups. Conclusion BRS during HG was reduced in both OSA_un and CPAP compared to CON, while HG evoked similar overall changes in BP and HR in all three groups. Although CPAP reduces sympathetic tone measured as Muscle Sympathetic Nerve Activity (MSNA), BRS appears to be unaffected by the intervention. Irreversible changes in the baroreflex network may occur with OSA that are not altered with CPAP usage. Support (if any) NR-017435, HL135562

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Depressive Symptoms in Comorbid Obstructive Sleep Apnea and Insomnia: An Integrative Review

Western Journal of Nursing Research ◽

10.1177/0193945921989656 ◽

2021 ◽

pp. 019394592198965

Author(s):

Bomin Jeon ◽

Faith S. Luyster ◽

Judith A. Callan ◽

Eileen R. Chasens

Keyword(s):

Obstructive Sleep Apnea ◽

Depressive Symptoms ◽

Sleep Apnea ◽

Control Design ◽

Case Control ◽

Integrative Review ◽

Study Quality ◽

Cross Sectional ◽

Obstructive Sleep ◽

The Relationship

The purpose of this integrative review was to synthesize evidence concerning the relationship between comorbid obstructive sleep apnea and insomnia (OSA+I), and depressive symptoms. OSA and insomnia are common sleep disorders, recently comorbid OSA+I has been recognized as prevalent in adults. Although each sleep disorder increases the risk and severity of depressive symptoms, the effect of comorbid OSA+I on depressive symptoms remains unclear. A systematic search of PubMed, CINAHL, and PsycINFO identified 15 data-based studies. All the studies were observational with either a cross-sectional (n = 14) or a case-control design (n = 1). Study quality was assessed. Most of the studies (n = 14) indicated that comorbid OSA+I had an additive role on depressive symptoms. Insomnia appeared to have a more important role than OSA in increasing the severity of depressive symptoms in persons with comorbid OSA+I.

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