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https://www.readbyqxmd.com/read/28167915/the-role-of-acute-intermittent-hypoxia-in-neutrophil-generated-superoxide-sympathovagal-balance-and-vascular-function-in-healthy-subjects
#1
Germana P L Almeida, Ivani C Trombetta, Felipe X Cepeda, Elaine Hatanaka, Rui Curi, Cristiano Mostarda, Maria C Irigoyen, José A S Barreto-Filho, Eduardo M Krieger, Fernanda M Consolim-Colombo
Introduction: Recurrent hypoxia (HPX), a hallmark of the obstructive sleep apnea (OSA), impairs autonomic balance, and increases arterial blood pressure (BP). Oxidative stress is one of the mechanisms involved in these alterations. The cumulative effect of acute intermittent HPX and the chronicity may determine whether the response crosses the threshold from having protective value to pathology. However, the impact of acute intermittent HPX-reoxygenation on markers of oxidative stress in healthy individuals remains to be fully understood...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28159487/the-use-of-pulse-transit-time-in-pediatric-sleep-studies-a-systematic-review
#2
REVIEW
Laurelle A Smith, Patrick J Dawes, Barbara C Galland
As a surrogate measure of blood pressure, pulse transit time (PTT) is commonly used in studies investigating arterial function and respiratory sleep disturbance. A systematic search of the literature was conducted with the aim of reviewing the usefulness of the technique within pediatric sleep studies. All studies that used PTT as a diagnostic tool during sleep in infants, children or adolescents were considered. The search yielded 425 articles, of which 21 full-text articles met inclusion criteria, the majority reporting on obstructive sleep apnea (OSA)...
November 30, 2016: Sleep Medicine Reviews
https://www.readbyqxmd.com/read/28157814/hypertension-in-dialysis-patients-a-consensus-document-by-the-european-renal-and-cardiovascular-medicine-eureca-m-working-group-of-the-european-renal-association-european-dialysis-and-transplant-association-era-edta-and-the-hypertension-and-the-kidney-working
#3
Pantelis A Sarafidis, Alexandre Persu, Rajiv Agarwal, Michel Burnier, Peter de Leeuw, Charles Ferro, Jean-Michel Halimi, Gunnar Heine, Michel Jadoul, Faical Jarraya, Mehmet Kanbay, Francesca Mallamaci, Patrick B Mark, Alberto Ortiz, Gianfranco Parati, Roberto Pontremoli, Patrick Rossignol, Luis Ruilope, Patricia Van der Niepen, Raymond Vanholder, Marianne C Verharr, Andrzej Wiecek, Gregoire Wuerzner, Gérard M London, Carmine Zoccali
In patients with end-stage renal disease treated with hemodialysis or peritoneal dialysis, hypertension is very common and often poorly controlled. Blood pressure (BP) recordings obtained before or after hemodialysis display a J-shaped or U-shaped association with cardiovascular events and survival, but this most likely reflects the low accuracy of these measurements and the peculiar hemodynamic setting related with dialysis treatment. Elevated BP by home or ambulatory BP monitoring is clearly associated with shorter survival...
February 2, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28157742/stroke-epidemiology-and-risk-factor-management
#4
Amy Guzik, Cheryl Bushnell
PURPOSE OF REVIEW: Death from stroke has decreased over the past decade, with stroke now the fifth leading cause of death in the United States. In addition, the incidence of new and recurrent stroke is declining, likely because of the increased use of specific prevention medications, such as statins and antihypertensives. Despite these positive trends in incidence and mortality, many strokes remain preventable. The major modifiable risk factors are hypertension, diabetes mellitus, tobacco smoking, and hyperlipidemia, as well as lifestyle factors, such as obesity, poor diet/nutrition, and physical inactivity...
February 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28153627/hematological-evaluation-in-males-with-obstructive-sleep-apnea-before-and-after-positive-airway-pressure
#5
A Feliciano, R Linhas, R Marçôa, A Cysneiros, C Martinho, R P Reis, D Penque, P Pinto, C Bárbara
Obstructive sleep apnea syndrome (OSAS) is a systemic inflammatory disease associated with cardiovascular consequences. Red blood cell distribution width (RDW), mean platelet volume (MPV), and platelet distribution width (PDW) are recognized biomarkers of cardiovascular morbidity/mortality. Limited data is available on the association between these parameters and OSAS severity and the relationship with positive airway pressure therapy (PAP). In this prospective study of male OSAS patients we analyzed hematological data in order to evaluate their value in predicting OSAS severity, the relationship with sleep parameters, and their behavior under PAP...
January 30, 2017: Revista Portuguesa de Pneumologia
https://www.readbyqxmd.com/read/28131740/adipose-tissue-is-influenced-by-hypoxia-of-obstructive-sleep-apnea-syndrome-independent-of-obesity
#6
C E Thorn, B Knight, E Pastel, L J McCulloch, B Patel, A C Shore, K Kos
AIMS: Obstructive sleep apnea syndrome (OSAS) is associated with increased cardiovascular risk and diabetes independent of obesity. We investigated whether adipose tissue dysfunction is exacerbated due to increased tissue hypoxia. METHODS: Adipose tissue (AT) oxygenation was measured with a Clarke-type electrode (pATO2) in 16 men with OSAS before and after 4 months of continuous positive airway pressure therapy (CPAP) and in BMI-matched controls. Oxygenation was simultaneously monitored in arterial blood by pulse oximetry (SaO2); mixed blood in AT microcirculation by reflectance spectroscopy (SATO2) along with blood flow...
January 25, 2017: Diabetes & Metabolism
https://www.readbyqxmd.com/read/28130342/nfat-regulation-of-cystathionine-gamma-lyase-expression-in-endothelial-cells-is-impaired-in-rats-exposed-to-intermittent-hypoxia
#7
Laura V Gonzalez Bosc, Jessica M Osmond, Wieslawa Giermakowska, Carolyn E Pace, Jennifer L Riggs, Olan Jackson-Weaver, Nancy L Kanagy
Sleep apnea is a risk factor for cardiovascular disease, and intermittent hypoxia (IH, 20 episodes/hr of 5% O2/5% CO2 for 7 hr/day) to mimic sleep apnea increases blood pressure and impairs H2S-induced vasodilation in rats. The enzyme that produces H2S, cystathionine gamma lyase (CSE), is decreased in rat mesenteric artery endothelial cells (EC) following in vivo IH exposure. In silico analysis identified putative NFAT binding sites in the CSE promoter. Therefore, we hypothesized that IH exposure reduces [Ca(2+)] activation of calcineurin/NFAT to lower CSE expression and impairs vasodilation...
January 27, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28128967/impact-of-mandibular-advancement-therapy-on-endothelial-function-in-severe-obstructive-sleep-apnea
#8
Frédéric Gagnadoux, Jean-Louis Pépin, Bruno Vielle, Vanessa Bironneau, Frédérique Chouet-Girard, Sandrine Launois, Nicole Meslier, Jean-Claude Meurice, Xuan-Lan Nguyen, Audrey Paris, Pascaline Priou, Renaud Tamisier, Wojciech Trzepizur, François Goupil, Bernard Fleury
RATIONALE: Endothelial dysfunction, a major predictor of late cardiovascular events, is linked to the severity of obstructive sleep apnea (OSA). OBJECTIVES: To determine whether treatment with mandibular advancement device, the main alternative to continuous positive airway pressure, improves endothelial function in patients with severe OSA. METHODS: In this trial, we randomized patients with severe OSA and no overt cardiovascular disease to receive 2 months of treatment with either effective mandibular advancement device or a sham device...
January 27, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28126502/-therapeutic-alternatives-to-continuous-positive-airway-pressure-for-obstructive-sleep-apnea-hypopnea-syndrome
#9
Frédéric Gagnadoux, Marie Jouvenot, Nicole Meslier, Pascaline Priou, Wocjiech Trzepizur
Oral appliance therapy (OAT) is the main therapeutic alternative to continuous positive airway pressure (CPAP). OAT has been recommended as an appropriate first-line treatment option for moderate obstructive sleep apnea-hypopnea syndrome (OSAHS) in patients without severe cardiovascular comorbidity. The lower efficacy of OAT in reducing sleep-disordered breathing could be offset by a higher compliance relative to CPAP, resulting in similar health outcomes in terms of sleepiness, neurobehavioral functioning, quality of life and blood pressure...
January 23, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28118872/model-derived-markers-of-autonomic-cardiovascular-dysfunction-in-sleep-disordered-breathing
#10
REVIEW
Michael C K Khoo, Patjanaporn Chalacheva
Evidence indicates that sleep-disordered breathing leads to elevated sympathetic tone and impaired vagal activity, promoting hypertension and cardiometabolic disease. Low-cost but accurate monitoring of autonomic function is useful for the aggressive management of sleep apnea. This article reviews the development and application of multivariate dynamic biophysical models that enable the causal dependencies among respiration, blood pressure, heart rate variability, and peripheral vascular resistance to be quantified...
December 2016: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/28118868/definition-and-importance-of-autonomic-arousal-in-patients-with-sleep-disordered-breathing
#11
REVIEW
Wibke Bartels, Dana Buck, Martin Glos, Ingo Fietze, Thomas Penzel
Autonomic arousal at the end of sleep apnea events are not well-explored. We prospectively studied 20 patients with obstructive sleep apnea (OSA) and 24 healthy volunteers for 2 nights with cardiorespiratory polysomnography and continuous noninvasive blood pressure (Portapres). Recordings were scored visually for cortical and autonomic arousal. In the OSA group, 2151 cortical arousals and in the controls 1089 cortical arousals were scored. Respiratory arousal caused most frequently an increase of highest mean arterial blood pressure in patients and controls...
December 2016: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/28118460/screening-for-obstructive-sleep-apnea-in-adults-evidence-report-and-systematic-review-for-the-us-preventive-services-task-force
#12
REVIEW
Daniel E Jonas, Halle R Amick, Cynthia Feltner, Rachel Palmieri Weber, Marina Arvanitis, Alexander Stine, Linda Lux, Russell P Harris
Importance: Many adverse health outcomes are associated with obstructive sleep apnea (OSA). Objective: To review primary care-relevant evidence on screening adults for OSA, test accuracy, and treatment of OSA, to inform the US Preventive Services Task Force. Data Sources: MEDLINE, Cochrane Library, EMBASE, and trial registries through October 2015, references, and experts, with surveillance of the literature through October 5, 2016. Study Selection: English-language randomized clinical trials (RCTs); studies evaluating accuracy of screening questionnaires or prediction tools, diagnostic accuracy of portable monitors, or association between apnea-hypopnea index (AHI) and health outcomes among community-based participants...
24, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28117120/critical-review-cpap-and-weight-management-of-obstructive-sleep-apnea-cardiovascular-co-morbidities
#13
REVIEW
David W Hudgel
The cardiovascular co-morbidities of obstructive sleep apnea (OSA) are similar to those of obesity. Cardiovascular co-morbidities often are the cause of adverse outcomes in overweight/obese OSA patients. Continuous positive airway pressure (CPAP) therapy resolves the symptoms of OSA, but may, or may not lead to improvement of a given cardiovascular co-morbidity. The impact of CPAP on cardiovascular risk variables, adverse cardiovascular events in overweight/obese OSA patients has been evaluated primarily in prospective, uncontrolled cohort studies...
December 18, 2016: Sleep Medicine Reviews
https://www.readbyqxmd.com/read/28109722/sleep-insomnia-and-hypertension-current-findings-and-future-directions
#14
REVIEW
S Justin Thomas, David Calhoun
Blood pressure (BP) varies over 24 hours. During normal sleep, BP typically decreases by 10% or more. Research suggests that disordered sleep, particularly sleep deprivation and obstructive sleep apnea, is associated with increased BP and risk of hypertension. Less is known about the relationship between insomnia and hypertension. Population-based studies have reported an association between insomnia symptoms and both prevalent and incident hypertension, particularly in the context of short sleep duration...
December 29, 2016: Journal of the American Society of Hypertension: JASH
https://www.readbyqxmd.com/read/28104016/-effect-of-the-obstructive-sleep-apnea-hypopnea-syndrome-treatment-on-blood-pressure-in-patients-with-resistant-hypertension
#15
H W Wang, H M Liu, Z Y Zheng, Y Z Jia, H R Li
Objective: To investigate the effect of the treatments for obstructive sleep apnea hypopnea syndrome (OSAHS) on the resistant hypertension (RH) of patients. Methods: Eighty patients with OSAHS and RH (blood pressure could not be controlled under 140/90 mmHg (1 mmHg=0.133 kPa) even with more than three kinds of antihypertensive drugs including diuretics) received surgery or continuous positive airway pressure (CPAP) treatment. The results of polysomnography monitoring, ambulatory blood pressure monitoring, and the dosage of antihypertensive medication were recorded before and six months after the treatment...
January 7, 2017: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
https://www.readbyqxmd.com/read/28095965/vamonos-veterans-affairs-metabolism-obstructed-and-non-obstructed-sleep-study-effects-of-cpap-therapy-on-glucose-metabolism-in-patients-with-obstructive-sleep-apnea
#16
Octavian C Ioachimescu, Jeremy Anthony, Tina Constantin, Mary-Margaret Ciavatta, Kandace McCarver, Mary Ellen Sweeney
STUDY OBJECTIVES: Obstructive sleep apnea (OSA) and type 2 diabetes mellitus (T2DM) are prevalent disorders that pose increased risk of cardiovascular disease and death. The objective of this study was to clarify if continuous positive airway pressure (CPAP) therapy for OSA affects T2DM control and emergence. METHODS: Point-of-care, comparative effectiveness study; cross-sectional and longitudinal analyses. RESULTS: Our cohort included 928 consecutive patients; 13% were women; 36% were Caucasians and 61% African-Americans...
January 11, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/28091858/will-wearing-dentures-affect-edentulous-patients-breathing-during-sleep
#17
Qiuwen Chen, Dong Zou, Hailan Feng, Shaoxia Pan
PURPOSES: The purpose of this study is to investigate the effect of wearing dentures on obstructive sleep apnea and hypopnea among completely edentulous patients. METHODS AND MATERIALS: A self-controlled study was conducted among 30 edentulous patients. Polysomnograms were recorded in the sleep laboratory on two consecutive nights. Participants slept with their dentures in one night and without dentures in the other. The apnea and hypopnea index (AHI), lowest oxygen saturation (L-SpO2), and morning blood pressure (MBP) were collected for statistical analysis...
January 14, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/28081532/cardiovascular-events-in-moderately-to-severely-obese-obstructive-sleep-apnea-patients-on-positive-airway-pressure-therapy
#18
Anna Maria Marotta, Jean-Christian Borel, Louis M Galerneau, Renaud Tamisier, Maria R Bonsignore, Jean Louis Pépin
BACKGROUND: In moderately to severely obese patients with obstructive sleep apnea (OSA), the effects of long-term positive airway pressure (PAP) treatment on cardiovascular risk are poorly defined. PURPOSE: To assess the effect of continuous positive airway pressure (CPAP) or noninvasive ventilation (NIV) on the occurrence of cardiovascular events in obese OSA patients. METHODS: We performed a noninterventional observational study in obese OSA patients recruited between 2007 and 2010 at the Sleep Center, University of Grenoble, treated with CPAP or NIV, and followed for 5...
2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/28081171/a-higher-proportion-of-metabolic-syndrome-in-chinese-subjects-with-sleep-disordered-breathing-a-case-control-study-based-on-electrocardiogram-derived-sleep-analysis
#19
Ping-Huei Tseng, Pei-Lin Lee, Wei-Chung Hsu, Yan Ma, Yi-Chia Lee, Han-Mo Chiu, Yi-Lwun Ho, Ming-Fong Chen, Ming-Shiang Wu, Chung-Kang Peng
OBJECTIVE: The prevalence of metabolic syndrome (MS) has increased rapidly in Taiwan and worldwide. We aim to determine the association between sleep-disordered breathing (SDB) and MS in a Chinese general population. METHODS: This case-control study recruited subjects who have undergone a prospective electrocardiogram-based cardiopulmonary coupling (CPC) sleep spectrogram as part of the periodic health check-ups at the National Taiwan University Hospital. Comprehensive anthropometrics, blood biochemistry, prevalence of MS and its individual components were compared with Bonferroni correction between 40 subjects with SDB, defined as the CPC-derived apnea-hypopnea index (CPC-AHI) >5 event/hour and 80 age- and sex-matched controls, defined as CPC-AHI <1 event/hour...
2017: PloS One
https://www.readbyqxmd.com/read/28078487/the-role-of-the-nox4-derived-ros-mediated-rhoa-rho-kinase-pathway-in-rat-hypertension-induced-by-chronic-intermittent-hypoxia
#20
Wen Lu, Jing Kang, Ke Hu, Si Tang, Xiufang Zhou, Lifang Xu, Yuanyuan Li, Shuhui Yu
BACKGROUND: Obstructive sleep apnea syndrome, which is a risk factor for resistant hypertension, is characterized by chronic intermittent hypoxia (CIH) and is associated with many cardiovascular diseases. CIH elicits systemic oxidative stress and sympathetic hyperactivity, which lead to hypertension. Rho kinases (ROCKs) are considered to be major effectors of the small GTPase RhoA and have been extensively studied in the cardiovascular field. Upregulation of the RhoA/ROCK signaling cascade is observed in various cardiovascular disorders, such as atherosclerosis, pulmonary hypertension, and stroke...
January 11, 2017: Sleep & Breathing, Schlaf & Atmung
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