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autonomic alteration and OSA

Manoj K Sarma, Paul M Macey, Rajakumar Nagarajan, Ravi Aysola, Ronald M Harper, M Albert Thomas
UNLABELLED: Obstructive sleep apnea syndrome (OSAS) leads to neurocognitive and autonomic deficits that are partially mediated by thalamic and putamen pathology. We examined the underlying neurochemistry of those structures using compressed sensing-based 4D echo-planar J-resolved spectroscopic imaging (JRESI), and quantified values with prior knowledge fitting. Bilaterally increased thalamic mI/Cr, putamen Glx/Cr, and Glu/Cr, and bilaterally decreased thalamic and putamen tCho/Cr and GABA/Cr occurred in OSAS vs healthy subjects (p < 0...
2016: Scientific Reports
Eleonora Tobaldini, Giorgio Costantino, Monica Solbiati, Chiara Cogliati, Tomas Kara, Lino Nobili, Nicola Montano
Sleep deprivation (SD) has become a relevant health problem in modern societies. We can be sleep deprived due to lifestyle habits or due to sleep disorders, such as insomnia, obstructive sleep apnea (OSA) and neurological disorders. One of the common element of sleep disorders is the condition of chronic SD, which has complex biological consequences. SD is capable of inducing different biological effects, such as neural autonomic control changes, increased oxidative stress, altered inflammatory and coagulatory responses and accelerated atherosclerosis...
July 7, 2016: Neuroscience and Biobehavioral Reviews
Harneet K Walia, Mina K Chung, Sally Ibrahim, Reena Mehra
Accumulating data implicate obstructive sleep apnea (OSA) as a predisposing factor to the development of atrial fibrillation (AF), the latter representing the most common sustained cardiac arrhythmia. The postulated mechanisms leading to atrial arrhythmogenesis in OSA include alterations in intrathoracic pressures, intermittent hypoxemia, and autonomic nervous system fluctuations. Although these OSA-related pathophysiologic pathways may result in atrial structural and electrical remodeling, thereby predisposing to AF, there are data to suggest that the immediate influences of respiratory events may trigger arrhythmic events...
2016: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Bumhee Park, Jose A Palomares, Mary A Woo, Daniel W Kang, Paul M Macey, Frisca L Yan-Go, Ronald M Harper, Rajesh Kumar
INTRODUCTION: Obstructive sleep apnea (OSA) subjects show impaired autonomic, affective, executive, sensorimotor, and cognitive functions. Brain injury in OSA subjects appears in multiple sites regulating these functions, but the integrity of functional networks within the regulatory sites remains unclear. Our aim was to examine the functional interactions and the complex network organization of these interactions across the whole brain in OSA, using regional functional connectivity (FC) and brain network topological properties...
March 2016: Brain and Behavior
Bumhee Park, Jose A Palomares, Mary A Woo, Daniel W Kang, Paul M Macey, Frisca L Yan-Go, Ronald M Harper, Rajesh Kumar
STUDY OBJECTIVES: Obstructive sleep apnea (OSA) is accompanied by tissue injury to the insular cortices, areas that regulate autonomic pain, dyspnea, and mood, all of which are affected in the syndrome. Presumably, the dysregulation of insular-related functions are mediated by aberrant functional connections with other brain regions; however, the integrity of the functional connectivity (FC) to other sites is undescribed. Our aim was to examine resting-state FC of the insular cortices to other brain areas in OSA, relative to control subjects...
2016: Sleep
Valeria Bisogni, Martino F Pengo, Giuseppe Maiolino, Gian Paolo Rossi
Obstructive sleep apnoea (OSA) is the most common sleep disorder of breathing in middle-aged and overweight subjects. It features recurrent episodes of upper airway total (apnoea) o partial (hypopnea) collapse during sleep, which are associated with a reduction in blood oxygen saturation and with arousal from sleep to re-establish airway patency. An association of OSA with dysregulation of the autonomous nervous system (ANS) and altered catecholamines (CAs) metabolism has been contended for years. However, the pathophysiology mechanisms underlying these alterations remain to be fully clarified...
February 2016: Journal of Thoracic Disease
Paul M Macey, Manoj K Sarma, Rajakumar Nagarajan, Ravi Aysola, Jerome M Siegel, Ronald M Harper, M Albert Thomas
The insular cortex is injured in obstructive sleep apnea (OSA) and responds inappropriately to autonomic challenges, suggesting neural reorganization. The objective of this study was to assess whether the neural changes might result from γ-aminobutyric acid (GABA) and glutamate alterations. We studied 14 OSA patients [mean age ± standard deviation (SD): 47.5 ± 10.5 years; nine male; apnea-hypopnea index (AHI): 29.5 ± 15.6 events h(-1) ] and 22 healthy participants (47.5 ± 10.1 years; 11 male), using magnetic resonance spectroscopy to detect GABA and glutamate levels in insular cortices...
August 2016: Journal of Sleep Research
Henrik Winther Schytz
The purpose of this thesis was to explore and develop methods, where continuous wave near infrared spectroscopy (CW-NIRS) can be applied in different neurovascular diseases, in order to find biological markers that are useful in clinical neurology. To develop a new method to detect changes in cerebral blood flow (CBF), the first study investigated a multi-source detector separation configuration and indocyanine green (ICG) as a tracer to calculate a corrected blood flow index (BFI) value. The study showed no correlation between CBF changes measured by 133Xenon single photon emission computer tomography (133Xe-SPECT) and the corrected BFI value...
December 2015: Danish Medical Journal
Mona F Philby, Secil Aydinoz, David Gozal, Selim Kilic, Rakesh Bhattacharjee, Hari P Bandla, Leila Kheirandish-Gozal
BACKGROUND: Obstructive sleep apnea (OSA) leads to intermittent hypoxia, activation of the sympathetic nervous system, and eventually cardiovascular morbidity. Alterations in autonomic nervous system (ANS) tone and reflexes are likely to play major roles in OSA-associated morbidities, and have been identified in a subset of children with OSA. OBJECTIVES: To evaluate whether pupillometry, a noninvasive and rapid bedside test for the assessment of autonomic nervous system dysfunction (ANS), would detect abnormal ANS function in children with OSA...
October 2015: Sleep Medicine
Jose A Palomares, Sudhakar Tummala, Danny J J Wang, Bumhee Park, Mary A Woo, Daniel W Kang, Keith S St Lawrence, Ronald M Harper, Rajesh Kumar
BACKGROUND AND PURPOSE: Obstructive sleep apnea (OSA) subjects show brain injury in sites that control autonomic, cognitive, and mood functions that are deficient in the condition. The processes contributing to injury may include altered blood-brain barrier (BBB) actions. Our aim was to examine BBB function, based on diffusion-weighted pseudo-continuous arterial spin labeling (DW-pCASL) procedures, in OSA compared to controls. METHODS: We performed DW-pCASL imaging in nine OSA and nine controls on a 3...
November 2015: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
Sudhakar Tummala, Jose Palomares, Daniel W Kang, Bumhee Park, Mary A Woo, Ronald M Harper, Rajesh Kumar
STUDY OBJECTIVES: Obstructive sleep apnea (OSA) patients show brain structural injury and functional deficits in autonomic, affective, and cognitive regulatory sites, as revealed by mean diffusivity (MD) and other imaging procedures. The time course and nature of gray and white matter injury can be revealed in more detail with mean kurtosis (MK) procedures, which can differentiate acute from chronic injury, and better show extent of damage over MD procedures. Our objective was to examine global and regional MK changes in newly diagnosed OSA, relative to control subjects...
January 2016: Sleep
Ottavio Vitelli, Marco Del Pozzo, Giorgio Baccari, Jole Rabasco, Nicoletta Pietropaoli, Mario Barreto, Maria Pia Villa
OBJECTIVES: To investigate the activity of the autonomic nervous system (ANS) during sleep in children with obstructive sleep apnea (OSA), in order to detect a possible cardiac ANS imbalance analyzing heart rate variability (HRV). METHODS: 43 subjects between 4 and 12 years of age (7.26 ± 2.8 years), undergoing a diagnostic assessment for OSA were evaluated. A time domain index (R-apnea index) was developed to evaluate HRV strictly related to obstructive events during sleep...
January 2016: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
Rodrigo Iturriaga, David C Andrade, Rodrigo Del Rio
The carotid body (CB) plays a main role in the maintenance of the oxygen homeostasis. The hypoxic stimulation of the CB increases the chemosensory discharge, which in turn elicits reflex sympathetic, cardiovascular, and ventilatory adjustments. An exacerbate carotid chemosensory activity has been associated with human sympathetic-mediated diseases such as hypertension, insulin resistance, heart failure, and obstructive sleep apnea (OSA). Indeed, the CB chemosensory discharge becomes tonically hypereactive in experimental models of OSA and heart failure...
2014: Frontiers in Physiology
Sally L Davidson Ward, Raouf Amin, Raanan Arens, Zhongping Chen, Stephanie Davis, Ephraim Gutmark, Richard Superfine, Brian Wong, Carlton Zdanski, Michael C K Khoo
We understand now that sleep of sufficient length and quality is required for good health. This is particularly true for infants and children, who have the added physiologic task of growth and development, as compared to their adult counterparts. Sleep-related breathing disorders (SRBDs) are common in childhood and if unrecognized and not treated can result in significant morbidity. For example, children with obstructive sleep apnea (OSA) can exhibit behavioral, mood, and learning difficulties. If left untreated, alterations in the function of the autonomic nervous system and a chronic inflammatory state result, contributing to the risk of heart disease, stroke, glucose intolerance, and hypertension in adulthood...
September 2014: IEEE Pulse
Juan Idiaquez, Irving Santos, Julia Santin, Rodrigo Del Rio, Rodrigo Iturriaga
OBJECTIVE: Obstructive sleep apnea (OSA) is associated with sympathetic hyperactivity, excessive nocturnal sweating, sleepiness, and neurobehavioral cognitive alterations. However, it is not well known if cognitive consequences of OSA are independent from autonomic alterations. Thus, we assessed the association between polysomnographic, autonomic, and cognitive tests performance in OSA patients. METHODS: Fifty eight OSA patients (53 male) were administered with questionnaires assessing demographic, Epworth, Beck Depression Inventory, Syndrom Kurz test (SKT), Trail Making part B (TMT-B), and Frontal Assessment Battery (FAB) tests...
November 2014: Sleep Medicine
Paul M Macey, Rajesh Kumar, Jennifer A Ogren, Mary A Woo, Ronald M Harper
Obstructive sleep apnea (OSA) is accompanied by brain injury, perhaps resulting from apnea-related hypoxia or periods of impaired cerebral perfusion. Perfusion changes can be determined indirectly by evaluation of cerebral blood volume and oxygenation alterations, which can be measured rapidly and non-invasively with the global blood oxygen level dependent (BOLD) signal, a magnetic resonance imaging procedure. We assessed acute BOLD responses in OSA subjects to pressor challenges that elicit cerebral blood flow changes, using a two-group comparative design with healthy subjects as a reference...
2014: PloS One
Meghna P Mansukhani, Tomas Kara, Sean M Caples, Virend K Somers
Obstructive sleep apnea (OSA) and hypertension are closely linked conditions. Disordered breathing events in OSA are characterized by increasing efforts against an occluded airway while asleep, resulting in a marked sympathetic response. This is predominantly due to hypoxemia activating the chemoreflexes, resulting in reflex increases in sympathetic neural outflow. In addition, apnea - and the consequent lack of inhibition of the sympathetic system that occurs with lung inflation during normal breathing - potentiates central sympathetic outflow...
September 2014: Current Hypertension Reports
Jing Zhao, Wei Xu, Fengxiang Yun, Hongwei Zhao, Wenpeng Li, Yongtai Gong, Yue Yuan, Sen Yan, Song Zhang, Xue Ding, Dingyu Wang, Chaowei Zhang, Deli Dong, Chunhong Xiu, Ning Yang, Lei Liu, Jingyi Xue, Yue Li
Obstructive sleep apnea (OSA) is closely related to atrial fibrillation (AF). However, the roles and mechanisms of chronic OSA in atrial remodeling are still unclear. Canine model of chronic OSA was simulated by stopping the ventilator and closing the airway for 4 h per day and lasting for 12 weeks. AF inducibility and duration was increased while atrial effective refractory period (AERP) was shortened after chronic apnea. Meanwhile, upregulation of proteins encoding inward rectifier K(+) current (IK1), delayed rectifier K(+) current (IKr and IKs), acetylcholine activated K(+) current (IKACh), transient outward K(+) current (Ito) and ultra-rapid delayed rectifier potassium current (IKur) as well as downregulation of protein encoding L-type Ca(2+) current (ICa,L) were found after chronic OSA...
2014: Basic Research in Cardiology
Aikaterini Flevari, Emmanouil Vagiakis, Spyridon Zakynthinos
PURPOSE: Data on cardiac autonomic functioning, as expressed by heart rate variability (HRV), in patients with positional obstructive sleep apnea (p-OSA) disorder are lacking. The purpose of the study was to compare HRV indices between sleep segments derived from supine body position and another body position with and without apneic events, respectively. Our intention was to find some correlation between HRV indices and the pathophysiological characteristics of the corresponding temporal period...
March 2015: Sleep & Breathing, Schlaf & Atmung
Gianfranco Parati, Juan Eugenio Ochoa, Grzegorz Bilo, Paola Mattaliano, Paolo Salvi, Kazuomi Kario, Carolina Lombardi
Evidence has consistently supported the association of obstructive sleep apnea syndrome (OSAS) with an increased prevalence of hypertension. It has also been shown that the severity of OSAS is directly correlated with the degree of blood pressure (BP) elevation and that hypertension occurring in subjects with OSAS is more likely to be severe, resistant to antihypertensive treatment and associated with alterations in day-to-night BP changes. Proposed mechanisms for the pathogenesis of OSAS-related hypertension include the activation of the sympathetic nervous system, alterations in autonomic cardiovascular (CV) modulation, the activation of the renin-angiotensin-aldosterone system, endothelial dysfunction, systemic and vascular inflammation, oxidative stress, metabolic abnormalities, arterial stiffness and alterations in cardiac function and structure...
July 2014: Hypertension Research: Official Journal of the Japanese Society of Hypertension
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