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1. Obstructive sleep apnoea in adult patients post-tonsillectomy

Author

Riha, R, Kotoulas, S, Pataka, A, Kvamme, J, Joppa, P, Hedner, J, Anttalainen, U, Barbe, F, Bonsignore, M, Basoglu, O, Bielicki, P, Bouloukaki, I, Dogas, Z, Dorkova, Z, Escourrou, P, Fietze, I, Esquinas, C, Grote, L, Kent, B, Lena, L, Lavie, P, Levy, P, Lombardi, C, Marrone, O, Masa, J, Mcnicholas, W, Montserrat, J, Parati, G, Penzel, T, Pepin, J, Plywaczewski, R, Pretl, M, Rodenstein, D, Roisman, G, Ryan, S, Saaresranta, T, Schiza, S, Schulz, R, Sliwinski, P, Staats, R, Steiropoulos, P, Tasbakan, M, Tkacova, R, Varoneckas, G, Verbraecken, J, Vitols, A, Vrints, H, Zielinski, J, Riha R. L., Kotoulas S. -. C., Pataka A., Kvamme J. A., Joppa P., Hedner J., Anttalainen U., Barbe F., Bonsignore M. R., Basoglu O., Bielicki P., Bouloukaki I., Dogas Z., Dorkova Z., Escourrou P., Fietze I., Esquinas C., Grote L., Kent B. D., Lena L., Lavie P., Levy P., Lombardi C., Marrone O., Masa J. F., McNicholas W. T., Montserrat J. M., Parati G., Penzel T., Pepin J. L., Plywaczewski R., Pretl M., Rodenstein D., Roisman G., Ryan S., Saaresranta T., Schiza S. E., Schulz R., Sliwinski P., Staats R., Steiropoulos P., Tasbakan M. S., Tkacova R., Varoneckas G., Verbraecken J., Vitols A., Vrints H., Zielinski J., Riha, R, Kotoulas, S, Pataka, A, Kvamme, J, Joppa, P, Hedner, J, Anttalainen, U, Barbe, F, Bonsignore, M, Basoglu, O, Bielicki, P, Bouloukaki, I, Dogas, Z, Dorkova, Z, Escourrou, P, Fietze, I, Esquinas, C, Grote, L, Kent, B, Lena, L, Lavie, P, Levy, P, Lombardi, C, Marrone, O, Masa, J, Mcnicholas, W, Montserrat, J, Parati, G, Penzel, T, Pepin, J, Plywaczewski, R, Pretl, M, Rodenstein, D, Roisman, G, Ryan, S, Saaresranta, T, Schiza, S, Schulz, R, Sliwinski, P, Staats, R, Steiropoulos, P, Tasbakan, M, Tkacova, R, Varoneckas, G, Verbraecken, J, Vitols, A, Vrints, H, Zielinski, J, Riha R. L., Kotoulas S. -. C., Pataka A., Kvamme J. A., Joppa P., Hedner J., Anttalainen U., Barbe F., Bonsignore M. R., Basoglu O., Bielicki P., Bouloukaki I., Dogas Z., Dorkova Z., Escourrou P., Fietze I., Esquinas C., Grote L., Kent B. D., Lena L., Lavie P., Levy P., Lombardi C., Marrone O., Masa J. F., McNicholas W. T., Montserrat J. M., Parati G., Penzel T., Pepin J. L., Plywaczewski R., Pretl M., Rodenstein D., Roisman G., Ryan S., Saaresranta T., Schiza S. E., Schulz R., Sliwinski P., Staats R., Steiropoulos P., Tasbakan M. S., Tkacova R., Varoneckas G., Verbraecken J., Vitols A., Vrints H., and Zielinski J.

Abstract

Background: The impact of removing the upper airway lymphoid tissue and in particular, tonsillectomy, in adults with OSA has not been demonstrated in large populations. Aims: To compare the severity of OSA and the prevalence of cardiovascular, metabolic and respiratory co-morbidities between patients with OSA who had undergone previous tonsillectomy and those who had not. Methods: The 19,711 participants in this study came from the European sleep apnea database (ESADA) which comprises data from unselected adult patients aged 18–80 years with a history of symptoms suggestive of OSA referred to sleep centers throughout Europe. Results: There were no differences between the two groups in terms of sex ratio and age (146 patients with previous tonsillectomy vs. 19565 patients without). Patients who had undergone tonsillectomy had a lower body mass index (29.3 ± 5.2 kg/m2 vs 32.2 ± 6.6 kg/m2, p < 0.001), lower subjective sleep latency (17.1 ± 17.8 min vs 25.5 ± 30.4 min, p = 0.001), lower ODI (15.7 ± 18.3 events/hour vs 30.7 ± 26.1 events/hour, p < 0.001), and SpO2<90% time during sleep (21.8 ± 47.5 min vs 52.6 ± 80.8 min, p < 0.001). OSA patients with tonsillectomy had a lower prevalence of Type II diabetes mellitus (p = 0.001), hypertension (p < 0.001) and a higher prevalence of hyperlipidemia (p < 0.001) and were less likely to be commenced on CPAP (p < 0.001). Conclusion: In a large population of almost 20,000 OSA patients from across Europe, patients who had undergone tonsillectomy presented with less severe OSA at time of diagnosis, and had a lower prevalence of Type II diabetes mellitus and cardiovascular co-morbidities.

Published
2021

2. Insomnia symptoms combined with nocturnal hypoxia associate with cardiovascular comorbidity in the European sleep apnea cohort (ESADA)

Author

Anttalainen, Ulla, Grote, L., Fietze, I., Riha, R. L., Ryan, S., Staats, R., Hedner, J., Saaresranta, T., Anttalainen, U., Barbe, F., Bonsignore, M. R., Basoglu, O., Bielicki, P., Bouloukaki, I., Dogas, Z., Dorkova, Z., Escourrou, P., Fietze, I, Esquinas, C., Hayes, L., Joppa, P., Kurki, S., Kvamme, J. A., Tamisier, R., Lombardi, C., Marrone, O., Masa, J. F., McNicholas, W. T., Montserrat, J. M., Parati, G., Pataka, A., Penzel, T., Pepin, J. L., Pretl, M., Roisman, G., Schiza, S. E., Schulz, R., Sliwinski, P., Steiropoulos, P., Tasbakan, M. S., Tkacova, R., Varoneckas, G., Verbraecken, J., Vrints, H., Anttalainen, U, Grote, L, Fietze, I, Riha, R, Ryan, S, Staats, R, Hedner, J, Saaresranta, T, Barbe, F, Bonsignore, M, Basoglu, O, Bielicki, P, Bouloukaki, I, Dogas, Z, Dorkova, Z, Escourrou, P, Esquinas, C, Hayes, L, Joppa, P, Kurki, S, Kvamme, J, Tamisier, R, Lombardi, C, Marrone, O, Mcnicholas, W, Montserrat, J, Parati, G, Pataka, A, Penzel, T, Pepin, J, Pretl, M, Roisman, G, Schiza, S, Schulz, R, Sliwinski, P, Tasbakan, M, Tkacova, R, Varoneckas, G, Verbraecken, J, Vrints, H, Anttalainen U., Grote L., Fietze I., Riha R.L., Ryan S., Staats R., Hedner J., Saaresranta T., Barbe F., Bonsignore M.R., Basoglu O., Bielicki P., Bouloukaki I., Dogas Z., Dorkova Z., Escourrou P., Esquinas C., Hayes L., Joppa P., Kurki S., Kvamme J.A., Tamisier R., Lombardi C., Marrone O., McNicholas W.T., Montserrat J.M., Parati G., Pataka A., Penzel T., Pepin J.L., Pretl M., Roisman G., Schiza S.E., Schulz R., Sliwinski P., Tasbakan M.S., Tkacova R., Varoneckas G., Verbraecken J., Vrints H., Ege Üniversitesi, and ESADA Study Collaborators

Subjects
Adult, Male, medicine.medical_specialty, Insomnia, Neurology, Comorbidity, Settore MED/10 - Malattie Dell'Apparato Respiratorio, Nocturnal, Hypoxemia, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Sleep Initiation and Maintenance Disorders, Internal medicine, mental disorders, Prevalence, Humans, Medicine, Hypoxia, Sleep Apnea, Obstructive, business.industry, Sleep Breathing Physiology and Disorders • Original Article, Sleep apnea, Middle Aged, Cardiovascular disease, Phenotype, Hypoxia (medical), medicine.disease, Circadian Rhythm, nervous system diseases, Europe, 030228 respiratory system, Otorhinolaryngology, Cardiovascular Diseases, Cohort, Female, Human medicine, Neurology (clinical), medicine.symptom, business, 030217 neurology & neurosurgery
Abstract

WOS: 000482433800011, PubMed ID: 30467691, Purpose The aim of the current study was to further investigate the concept of previously reported high occurrence of comorbidities in obstructive sleep patients (OSA) with insomnia-like symptoms. We hypothesized that this finding at least partly is mediated by nocturnal hypoxia. Moreover, we speculated that the spectrum of the clinical OSA phenotypes differs between European geographical regions. Methods Cohort of the European Sleep Apnea Database (n = 17,325; 29.9% females) was divided into five subcohorts according to geographical region (North, East, South, West, Central) and further into four clinical presentation phenotypes based on daytime symptoms (EDS) and characteristics suggestive of insomnia. Results The insomnia phenotype (alone or together with EDS) dominated in all European regions. Isolated insomnia, however, was less common in the West. Insomnia phenotype was associated with the highest proportion of cardiovascular comorbidity (51.7% in the insomnia vs. 43.9% in the EDS type). Measures of nocturnal hypoxemia were independently associated with cardiovascular comorbidity in phenotypes with insomnia-like symptoms. The burden of comorbidities was high across all geographical regions and clinical phenotypes. Regional differences were clinically relevant for age (48 vs. 54 years), BMI (29 vs. 34 kg/m(2)), and ODI (15 vs. 32/h). Conclusion High prevalence of particularly cardiovascular comorbidity among patients with insomnia-like symptoms was linked to nocturnal hypoxemia. Considerable differences in clinical presentation were found among OSA patients across Europe. Our data underline that physicians should ask their patients with suspected OSA also for insomnia symptoms. It remains to be explored if a reduction of nocturnal hypoxemia predicts the improvement of insomnia symptoms., European Union COST action B26; European Respiratory Society (ERS); ResMed Inc.; Philips Respironics Inc., The ESADA network has received support from the European Union COST action B26. The European Respiratory Society (ERS) supports the ESADA for the second period as a Clinical Research Collaboration (CRC) (2015-2017 and 2018-2020). Unrestricted seeding grants from ResMed Inc. and Philips Respironics Inc. for establishment of the organization and the database are gratefully acknowledged.

Published
2018
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3. Periodic limb movements during sleep and blood pressure changes in sleep apnoea: Data from the European Sleep Apnoea Database

Author

Lombardi, C, Parati, G, Soranna, D, Zambon, A, Sliwinski, P, Roisman, G, Pepin, J, Schiza, S, Riha, R, Joppa, P, Fietze, I, Hedner, J, Grote, L, Anttalainen, U, Barbe, F, Bonsignore, M, Basoglu, O, Bielicki, P, Dogas, Z, Dorkova, Z, Escourrou, P, Hein, H, Kvamme, J, Levy, P, Marrone, O, Masa, J, Mcnicholas, W, Montserrat, J, Pataka, A, Penzel, T, Petiet, E, Plywaczewski, R, Pretl, M, Ryan, S, Saaresranta, T, Schulz, R, Tasbakan, M, Tkacova, R, Staats, R, Steiropoulos, P, Varoneckas, G, Verbraecken, J, Lombardi C., Parati G., Soranna D., Zambon A., Sliwinski P., Roisman G., Pepin J. -L., Schiza S., Riha R., Joppa P., Fietze I., Hedner J., Grote L., Anttalainen U., Barbe F., Bonsignore M. R., Basoglu O. K., Bielicki P., Dogas Z., Dorkova Z., Escourrou P., Hein H., Kvamme J. A., Levy P., Marrone O., Masa J. F., McNicholas W. T., Montserrat J. M., Pataka A., Penzel T., Petiet E., Pepin J. L., Plywaczewski R., Pretl M., Riha R. L., Ryan S., Saaresranta T., Schulz R., Tasbakan M. S., Tkacova R., Staats R., Steiropoulos P., Varoneckas G., Verbraecken J., Lombardi, C, Parati, G, Soranna, D, Zambon, A, Sliwinski, P, Roisman, G, Pepin, J, Schiza, S, Riha, R, Joppa, P, Fietze, I, Hedner, J, Grote, L, Anttalainen, U, Barbe, F, Bonsignore, M, Basoglu, O, Bielicki, P, Dogas, Z, Dorkova, Z, Escourrou, P, Hein, H, Kvamme, J, Levy, P, Marrone, O, Masa, J, Mcnicholas, W, Montserrat, J, Pataka, A, Penzel, T, Petiet, E, Plywaczewski, R, Pretl, M, Ryan, S, Saaresranta, T, Schulz, R, Tasbakan, M, Tkacova, R, Staats, R, Steiropoulos, P, Varoneckas, G, Verbraecken, J, Lombardi C., Parati G., Soranna D., Zambon A., Sliwinski P., Roisman G., Pepin J. -L., Schiza S., Riha R., Joppa P., Fietze I., Hedner J., Grote L., Anttalainen U., Barbe F., Bonsignore M. R., Basoglu O. K., Bielicki P., Dogas Z., Dorkova Z., Escourrou P., Hein H., Kvamme J. A., Levy P., Marrone O., Masa J. F., McNicholas W. T., Montserrat J. M., Pataka A., Penzel T., Petiet E., Pepin J. L., Plywaczewski R., Pretl M., Riha R. L., Ryan S., Saaresranta T., Schulz R., Tasbakan M. S., Tkacova R., Staats R., Steiropoulos P., Varoneckas G., and Verbraecken J.

Abstract

Background and objective: OSA and PLMS are known to induce acute BP swings during sleep. Our current study aimed to address the independent effect of PLMS on BP in an unselected OSA patient cohort. Methods: This cross-sectional analysis included 1487 patients (1110 males, no previous hypertension diagnosis or treatment, mean age: 52.5 years, mean BMI: 30.5 kg/m2) with significant OSA (defined as AHI ≥ 10) recruited from the European Sleep Apnoea Cohort. Patients underwent overnight PSG. Patients were stratified into two groups: patients with significant PLMS (PLMSI > 25 events/hour of sleep) and patients without significant PLMS (PLMSI < 25 events/hour of sleep). SBP, DBP and PP were the variables of interest. For each of these, a multivariate regression linear model was fitted to evaluate the relationship between PLMS and outcome adjusting for sociodemographic and clinical covariates (gender, age, BMI, AHI, ESS, diabetes, smoking and sleep efficiency). Results: The univariate analysis of SBP showed an increment of BP equal to 4.70 mm Hg (P < 0.001) in patients with significant PLMS compared to patients without significant PLMS. This increment remained significant after implementing a multivariate regression model (2.64 mm Hg, P = 0.044). No significant increment of BP was observed for DBP and PP. Conclusion: PLMS is associated with a rise in SBP regardless of AHI, independent of clinical and sociodemographic confounders. A PLMS phenotype may carry an increased risk for cardiovascular disease in OSA patients.

Published
2020

4. Periodic limb movements during sleep and blood pressure changes in sleep apnoea: Data from the European Sleep Apnoea Database

Author

Lombardi C, Parati G, Soranna D, Zambon A, Sliwinski P, Roisman G, Pepin JL, Schiza S, Riha R, Joppa P, Fietze I, Hedner J, Grote L, European Sleep Apnoea Database (ESADA) Collaborators (ESADA Collaborators: Anttalainen U, Barbé F, Bonsignore MR, Basoglu OK, Bielicki P, Dogas Z, Dorkova Z, Escourrou P, Hein H, Kvamme JA, Levy P, Marrone O, Masa JF, McNicholas WT, Montserrat JM, Pataka A, Penzel T, Petiet E, Pépin JL, Plywaczewski R, Pretl M, Riha RL, Ryan S, Saaresranta T, Schulz R, Tasbakan MS, Tkacova R, Staats R, Steiropoulos P, Varoneckas G, Verbraecken J), Lombardi C., Parati G., Soranna D., Zambon A., Sliwinski P., Roisman G., Pepin J.-L., Schiza S., Riha R., Joppa P., Fietze I., Hedner J., Grote L., Anttalainen U., Barbe F., Bonsignore M.R., Basoglu O.K., Bielicki P., Dogas Z., Dorkova Z., Escourrou P., Hein H., Kvamme J.A., Levy P., Marrone O., Masa J.F., McNicholas W.T., Montserrat J.M., Pataka A., Penzel T., Petiet E., Pepin J.L., Plywaczewski R., Pretl M., Riha R.L., Ryan S., Saaresranta T., Schulz R., Tasbakan M.S., Tkacova R., Staats R., Steiropoulos P., Varoneckas G., Verbraecken J., Università degli Studi di Milano-Bicocca = University of Milano-Bicocca (UNIMIB), Institute of Tuberculosis and Lung Diseases [Warsaw, Poland] (ITLD), AP-HP - Hôpital Antoine Béclère [Clamart], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hypoxie et PhysioPathologie (HP2), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Grenoble Alpes (UGA), Centre Hospitalier Universitaire [Grenoble] (CHU), University of Crete [Heraklion] (UOC), Royal Infirmary of Edinburgh, Univerzitnej nemocnice L. Pasteura Košice [Košice, Slovakia]. (UNLPK), Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], University of Gothenburg (GU), Sahlgrenska Academy at University of Gothenburg [Göteborg], European Sleep Apnoea Database (ESADA) Collaborators: Anttalainen U, Barbé F, Bonsignore Mr, Basoglu Ok, Bielicki P, Dogas Z, Dorkova Z, Escourrou P, Fietze I, Grote L, Hedner J, Hein H, Joppa P, Kvamme Ja, Levy P, Lombardi C, Marrone O, Masa Jf, McNicholas Wt, Montserrat Jm, Parati G, Pataka A, Penzel T, Petiet E, Pépin Jl, Plywaczewski R, Pretl M, Riha Rl, Roisman G, Ryan S, Saaresranta T, Schiza S, Schulz R, Sliwinski P, Pepin Jl, Tasbakan Ms, Tkacova R, Staats R, Steiropoulos P, Varoneckas G, Verbraecken J, SALAS, Danielle, Lombardi, C, Parati, G, Soranna, D, Zambon, A, Sliwinski, P, Roisman, G, Pepin, J, Schiza, S, Riha, R, Joppa, P, Fietze, I, Hedner, J, Grote, L, Anttalainen, U, Barbe, F, Bonsignore, M, Basoglu, O, Bielicki, P, Dogas, Z, Dorkova, Z, Escourrou, P, Hein, H, Kvamme, J, Levy, P, Marrone, O, Masa, J, Mcnicholas, W, Montserrat, J, Pataka, A, Penzel, T, Petiet, E, Plywaczewski, R, Pretl, M, Ryan, S, Saaresranta, T, Schulz, R, Tasbakan, M, Tkacova, R, Staats, R, Steiropoulos, P, Varoneckas, G, and Verbraecken, J

Subjects
Male, Pulmonary and Respiratory Medicine, Multivariate statistics, medicine.medical_specialty, obstructive sleep apnoea, Systole, Movement, [SDV]Life Sciences [q-bio], Blood Pressure, Comorbidity, Settore MED/10 - Malattie Dell'Apparato Respiratorio, Cohort Studies, 03 medical and health sciences, Sleep Apnea Syndromes, 0302 clinical medicine, Diastole, cardiovascular disease, Diabetes mellitus, Internal medicine, medicine, Humans, 030212 general & internal medicine, sleep disorder, Sleep disorder, Univariate analysis, business.industry, Confounding, Extremities, clinical epidemiology, Middle Aged, medicine.disease, Sleep in non-human animals, Europe, [SDV] Life Sciences [q-bio], Cross-Sectional Studies, Blood pressure, Databases as Topic, 030228 respiratory system, Cohort, Female, Sleep, business
Abstract

International audience; Background and objective: OSA and PLMS are known to induce acute BP swings during sleep. Our current study aimed to address the independent effect of PLMS on BP in an unselected OSA patient cohort.Methods: This cross-sectional analysis included 1487 patients (1110 males, no previous hypertension diagnosis or treatment, mean age: 52.5 years, mean BMI: 30.5 kg/m2 ) with significant OSA (defined as AHI ≥ 10) recruited from the European Sleep Apnoea Cohort. Patients underwent overnight PSG. Patients were stratified into two groups: patients with significant PLMS (PLMSI > 25 events/hour of sleep) and patients without significant PLMS (PLMSI < 25 events/hour of sleep). SBP, DBP and PP were the variables of interest. For each of these, a multivariate regression linear model was fitted to evaluate the relationship between PLMS and outcome adjusting for sociodemographic and clinical covariates (gender, age, BMI, AHI, ESS, diabetes, smoking and sleep efficiency).Results: The univariate analysis of SBP showed an increment of BP equal to 4.70 mm Hg (P < 0.001) in patients with significant PLMS compared to patients without significant PLMS. This increment remained significant after implementing a multivariate regression model (2.64 mm Hg, P = 0.044). No significant increment of BP was observed for DBP and PP.Conclusion: PLMS is associated with a rise in SBP regardless of AHI, independent of clinical and sociodemographic confounders. A PLMS phenotype may carry an increased risk for cardiovascular disease in OSA patients.

Published
2020
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5. Obstructive sleep apnoea independently predicts lipid levels: Data from the European Sleep Apnea Database

Author

Gündüz, Canan, Basoglu, Ozen K., Hedner, Jan, Zou, Ding, Bonsignore, Maria R., Hein, Holger, Staats, Richard, Pataka, Athanasia, Barbe, Ferran, Sliwinski, Pavel, Kent, Brian D., Pepin, Jean Lois, Grote, Ludger, Anttalainen, U., Barbé, F., Bonsignore, M. R., Basoglu, O. K., Bielicki, P., Bouloukaki, I., Dogas, Z., Dorkova, Z., Escourrou, P., Fietze, I., Grote, L., Hedner, J., Hein, H., Joppa, P., Kvamme, J. A., Levy, P., Lombardi, C., Marrone, O., Masa, J. F., McNicholas, W. T., Montserrat, J. M., Parati, G., Pataka, A., Penzel, T., Pépin, J. L., Plywaczewski, R., Pretl, M., Riha, R. L., Roisman, G., Ryan, S., Saaresranta, T., Schiza, S., Schulz, R., Sliwinski, P., Pepin, J. L., Petiet, Erna, Tasbakan, M. S., Tkacova, R., Staats, R., Steiropoulos, P., Varoneckas, G., Verbraecken, J., Vitols, A., Gündüz, C, Basoglu, O, Hedner, J, Zou, D, Bonsignore, M, Hein, H, Staats, R, Pataka, A, Barbe, F, Sliwinski, P, Kent, B, Pepin, J, Grote, L, Anttalainen, U, Barbé, F, Bielicki, P, Bouloukaki, I, Dogas, Z, Dorkova, Z, Escourrou, P, Fietze, I, Joppa, P, Kvamme, J, Levy, P, Lombardi, C, Marrone, O, Masa, J, Mcnicholas, W, Montserrat, J, Parati, G, Penzel, T, Pépin, J, Plywaczewski, R, Pretl, M, Riha, R, Roisman, G, Ryan, S, Saaresranta, T, Schiza, S, Schulz, R, Petiet, E, Tasbakan, M, Tkacova, R, Steiropoulos, P, Varoneckas, G, Verbraecken, J, Vitols, A, Gunduz, C, Hender, J, and Lepin, J

Subjects
Male, obesity, Databases, Factual, cholesterol, dyslipidemia, hypoxia, obesity, sleep apnoea, Gastroenterology, Cohort Studies, chemistry.chemical_compound, 0302 clinical medicine, Risk Factors, Hypolipidemic Agents, Oxygen saturation (medicine), Sleep Apnea, Obstructive, medicine.diagnostic_test, Sleep apnea, Middle Aged, Europe, Quartile, Cardiovascular Diseases, Cohort, Female, lipids (amino acids, peptides, and proteins), Adult, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Settore MED/10 - Malattie Dell'Apparato Respiratorio, 03 medical and health sciences, Internal medicine, medicine, Humans, Triglycerides, Dyslipidemias, hypoxia, Cholesterol, business.industry, Cholesterol, HDL, dyslipidemia, cholesterol, Cholesterol, LDL, ta3121, medicine.disease, Obesity, nervous system diseases, respiratory tract diseases, Cross-Sectional Studies, 030228 respiratory system, chemistry, Lipid profile, business, sleep apnoea, 030217 neurology & neurosurgery, Dyslipidemia
Abstract

Background and objective: Obstructive sleep apnoea (OSA) and dyslipidaemia are independent risk factors for cardiovascular disease. This study investigates the association between OSA and plasma lipid concentrations in patients enrolled in the European Sleep Apnea Database (ESADA) cohort. Methods: The cross-sectional analysis included 8592 patients without physician-diagnosed hyperlipidaemia or reported intake of a lipid-lowering drug (age 50.1 ± 12.7 years, 69.1% male, BMI: 30.8 ± 6.6 kg/m2, mean apnoea–hypopnoea index (AHI): 25.7 ± 25.9 events/h). The independent relationship between measures of OSA (AHI, oxygen desaturation index (ODI), mean and lowest oxygen saturation) and lipid profile (total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and fasting triglycerides (TG)) was determined by means of general linear model analysis. Results: There was a dose response relationship between TC and ODI (mean ± SE (mg/dL): 180.33 ± 2.46, 184.59 ± 2.42, 185.44 ± 2.42 and 185.73 ± 2.44; P < 0.001 across ODI quartiles I–IV). TG and LDL concentrations were better predicted by AHI than by ODI. HDL-C was significantly reduced in the highest AHI quartile (mean ± SE (mg/dL): 48.8 ± 1.49 vs 46.50 ± 1.48; P = 0.002, AHI quartile I vs IV). Morbid obesity was associated with lower TC and higher HDL-C values. Lipid status was influenced by geographical location with the highest TC concentration recorded in Northern Europe. Conclusion: OSA severity was independently associated with cholesterol and TG concentrations.

Published
2018
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6. Obstructive sleep apnoea in adult patients post-tonsillectomy

Author

Anttalainen, U., Barbé, F., Bonsignore, M.R., Basoglu, O., Bielicki, P., Bouloukaki, I., Dogas, Z., Dorkova, Z., Escourrou, P., Fietze, I., Esquinas, C., Grote, L., Kent, B.D., Lena, Lavie, Lavie, P., Levy, P., Lombardi, C., Marrone, O., Masa, J.F., McNicholas, W.T., Montserrat, J.M., Parati, G., Penzel, T., Pépin, J.L., Plywaczewski, R., Pretl, M., Rodenstein, D., Roisman, G., Ryan, S., Saaresranta, T., Schiza, S.E., Schulz, R., Sliwinski, P., Staats, R., Steiropoulos, P., Tasbakan, M.S., Tkacova, R., Varoneckas, G., Verbraecken, J., Vitols, A., Vrints, H., Zielinski, J., Riha, Renata L., Kotoulas, Serafeim – Chrysovalantis, Pataka, Athanasia, Kvamme, John Arthur, Joppa, Pavol, and Hedner, Jan

Published
2021
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7. Clinical presentation of patients with suspected obstructive sleep apnea and self-reported physician-diagnosed asthma in the ESADA cohort

Author

Bonsignore, Maria R., Pepin, Jean-Louis, Anttalainen, Ulla, Schiza, Sophia E., Basoglu, Ozen K., Pataka, Athanasia, Steiropoulos, Paschalis, Dogas, Zoran, Grote, Ludger, Hedner, Jan, McNicholas, Walter T., Marrone, Oreste, Barbé, F., Bielicki, P., Bouloukaki, I., Dorkova, Z., Escourrou, P., Fietze, I., Esquinas, C., Hayes, L., Kent, B. D., Kumor, M., Kurki, S., Kvamme, J. A., Lavie, L., Lavie, P., Levy, P., Lombardi, C., Masa, J. F., Montserrat, J. M., Parati, G., Penzel, T., Pépin, J. L., Plywaczewski, R., Pretl, M., Riha, R. L., Rodenstein, D., Roisman, G., Ryan, S., Saaresranta, T., Schulz, R., Sliwinski, P., Staats, R., Tasbakan, M. S., Tkacova, R., Varoneckas, G., Verbraecken, J., Vitols, A., Vrints, H., Zielinski, J., Bonsignore, M, Pepin, J, Anttalainen, U, Schiza, S, Basoglu, O, Pataka, A, Steiropoulos, P, Dogas, Z, Grote, L, Hedner, J, Mcnicholas, W, Marrone, O, Barbé, F, Bielicki, P, Bouloukaki, I, Dorkova, Z, Escourrou, P, Fietze, I, Esquinas, C, Hayes, L, Kent, B, Kumor, M, Kurki, S, Kvamme, J, Lavie, L, Lavie, P, Levy, P, Lombardi, C, Masa, J, Montserrat, J, Parati, G, Penzel, T, Pépin, J, Plywaczewski, R, Pretl, M, Riha, R, Rodenstein, D, Roisman, G, Ryan, S, Saaresranta, T, Schulz, R, Sliwinski, P, Staats, R, Tasbakan, M, Tkacova, R, Varoneckas, G, Verbraecken, J, Vitols, A, Vrints, H, Zielinski, J, Bonsignore, Maria R., Pepin, Jean-Loui, Anttalainen, Ulla, Schiza, Sophia E., Basoglu, Ozen K., Pataka, Athanasia, Steiropoulos, Paschali, Dogas, Zoran, Grote, Ludger, Hedner, Jan, McNicholas, Walter T., Marrone, Oreste, Barbé, F., Bielicki, P., Bouloukaki, I., Dorkova, Z., Escourrou, P., Fietze, I., Esquinas, C., Hayes, L., Kent, B.D., Kumor, M., Kurki, S., Kvamme, J.A., Lavie, L., Lavie, P., Levy, P., Lombardi, C., Masa, J.F., Montserrat, J.M., Parati, G., Penzel, T., Pépin, J.L., Plywaczewski, R., Pretl, M., Riha, R.L., Rodenstein, D., Roisman, G., Ryan, S., Saaresranta, T., Schulz, R., Sliwinski, P., Staats, R., Tasbakan, M.S., Tkacova, R., Varoneckas, G., Verbraecken, J., Vitols, A., Vrints, H., and Zielinski, J.

Subjects
Adult, Male, obesity, medicine.medical_specialty, Cognitive Neuroscience, Polysomnography, Population, Settore MED/10 - Malattie Dell'Apparato Respiratorio, ta3111, Cohort Studies, 03 medical and health sciences, Behavioral Neuroscience, 0302 clinical medicine, obstructive sleep apnea, asthma, ESADA cohort, Internal medicine, Epidemiology, gender, Medicine, Humans, Prospective Studies, education, Physician's Role, Asthma, Aged, education.field_of_study, Sleep Apnea, Obstructive, medicine.diagnostic_test, business.industry, ta1184, sleep-disordered breathing, Sleep apnea, General Medicine, Middle Aged, medicine.disease, Obesity, respiratory tract diseases, Obstructive sleep apnea, Europe, Cross-Sectional Studies, 030228 respiratory system, Cohort, epidemiology, Female, Self Report, business, 030217 neurology & neurosurgery
Abstract

Obstructive sleep apnea (OSA) and asthma are often associated and several studies suggest a bidirectional relationship between asthma and OSA. This study analyzed the characteristics of patients with suspected OSA from the European Sleep Apnea Database according to presence/absence of physician-diagnosed asthma. Cross-sectional data in 16,236 patients (29.1% female) referred for suspected OSA were analyzed according to occurrence of physician-diagnosed asthma for anthropometrics, OSA severity and sleepiness. Sleep structure was assessed in patients studied by polysomnography (i.e. 48% of the sample). The prevalence of physician-diagnosed asthma in the entire cohort was 4.8% (7.9% in women, 3.7% in men, p&nbsp

Published
2018

8. Insomnia symptoms combined with nocturnal hypoxia associate with cardiovascular comorbidity in the European sleep apnea cohort (ESADA)

Author

Anttalainen, U, Grote, L, Fietze, I, Riha, R, Ryan, S, Staats, R, Hedner, J, Saaresranta, T, Barbe, F, Bonsignore, M, Basoglu, O, Bielicki, P, Bouloukaki, I, Dogas, Z, Dorkova, Z, Escourrou, P, Esquinas, C, Hayes, L, Joppa, P, Kurki, S, Kvamme, J, Tamisier, R, Lombardi, C, Marrone, O, Mcnicholas, W, Montserrat, J, Parati, G, Pataka, A, Penzel, T, Pepin, J, Pretl, M, Roisman, G, Schiza, S, Schulz, R, Sliwinski, P, Tasbakan, M, Tkacova, R, Varoneckas, G, Verbraecken, J, Vrints, H, Anttalainen U., Grote L., Fietze I., Riha R. L., Ryan S., Staats R., Hedner J., Saaresranta T., Barbe F., Bonsignore M. R., Basoglu O., Bielicki P., Bouloukaki I., Dogas Z., Dorkova Z., Escourrou P., Esquinas C., Hayes L., Joppa P., Kurki S., Kvamme J. A., Tamisier R., Lombardi C., Marrone O., McNicholas W. T., Montserrat J. M., Parati G., Pataka A., Penzel T., Pepin J. L., Pretl M., Roisman G., Schiza S. E., Schulz R., Sliwinski P., Tasbakan M. S., Tkacova R., Varoneckas G., Verbraecken J., Vrints H., Anttalainen, U, Grote, L, Fietze, I, Riha, R, Ryan, S, Staats, R, Hedner, J, Saaresranta, T, Barbe, F, Bonsignore, M, Basoglu, O, Bielicki, P, Bouloukaki, I, Dogas, Z, Dorkova, Z, Escourrou, P, Esquinas, C, Hayes, L, Joppa, P, Kurki, S, Kvamme, J, Tamisier, R, Lombardi, C, Marrone, O, Mcnicholas, W, Montserrat, J, Parati, G, Pataka, A, Penzel, T, Pepin, J, Pretl, M, Roisman, G, Schiza, S, Schulz, R, Sliwinski, P, Tasbakan, M, Tkacova, R, Varoneckas, G, Verbraecken, J, Vrints, H, Anttalainen U., Grote L., Fietze I., Riha R. L., Ryan S., Staats R., Hedner J., Saaresranta T., Barbe F., Bonsignore M. R., Basoglu O., Bielicki P., Bouloukaki I., Dogas Z., Dorkova Z., Escourrou P., Esquinas C., Hayes L., Joppa P., Kurki S., Kvamme J. A., Tamisier R., Lombardi C., Marrone O., McNicholas W. T., Montserrat J. M., Parati G., Pataka A., Penzel T., Pepin J. L., Pretl M., Roisman G., Schiza S. E., Schulz R., Sliwinski P., Tasbakan M. S., Tkacova R., Varoneckas G., Verbraecken J., and Vrints H.

Abstract

Purpose: The aim of the current study was to further investigate the concept of previously reported high occurrence of comorbidities in obstructive sleep patients (OSA) with insomnia-like symptoms. We hypothesized that this finding at least partly is mediated by nocturnal hypoxia. Moreover, we speculated that the spectrum of the clinical OSA phenotypes differs between European geographical regions. Methods: Cohort of the European Sleep Apnea Database (n = 17,325; 29.9% females) was divided into five subcohorts according to geographical region (North, East, South, West, Central) and further into four clinical presentation phenotypes based on daytime symptoms (EDS) and characteristics suggestive of insomnia. Results: The insomnia phenotype (alone or together with EDS) dominated in all European regions. Isolated insomnia, however, was less common in the West. Insomnia phenotype was associated with the highest proportion of cardiovascular comorbidity (51.7% in the insomnia vs. 43.9% in the EDS type). Measures of nocturnal hypoxemia were independently associated with cardiovascular comorbidity in phenotypes with insomnia-like symptoms. The burden of comorbidities was high across all geographical regions and clinical phenotypes. Regional differences were clinically relevant for age (48 vs. 54 years), BMI (29 vs. 34 kg/m2), and ODI (15 vs. 32/h). Conclusion: High prevalence of particularly cardiovascular comorbidity among patients with insomnia-like symptoms was linked to nocturnal hypoxemia. Considerable differences in clinical presentation were found among OSA patients across Europe. Our data underline that physicians should ask their patients with suspected OSA also for insomnia symptoms. It remains to be explored if a reduction of nocturnal hypoxemia predicts the improvement of insomnia symptoms.

Published
2019

9. Obstructive sleep apnoea in adult patients post-tonsillectomy

Author

Riha, Renata L., primary, Kotoulas, Serafeim – Chrysovalantis, additional, Pataka, Athanasia, additional, Kvamme, John Arthur, additional, Joppa, Pavol, additional, Hedner, Jan, additional, Anttalainen, U., additional, Barbé, F., additional, Bonsignore, M.R., additional, Basoglu, O., additional, Bielicki, P., additional, Bouloukaki, I., additional, Dogas, Z., additional, Dorkova, Z., additional, Escourrou, P., additional, Fietze, I., additional, Esquinas, C., additional, Grote, L., additional, Kent, B.D., additional, Lena, Lavie, additional, Lavie, P., additional, Levy, P., additional, Lombardi, C., additional, Marrone, O., additional, Masa, J.F., additional, McNicholas, W.T., additional, Montserrat, J.M., additional, Parati, G., additional, Penzel, T., additional, Pépin, J.L., additional, Plywaczewski, R., additional, Pretl, M., additional, Rodenstein, D., additional, Roisman, G., additional, Ryan, S., additional, Saaresranta, T., additional, Schiza, S.E., additional, Schulz, R., additional, Sliwinski, P., additional, Staats, R., additional, Steiropoulos, P., additional, Tasbakan, M.S., additional, Tkacova, R., additional, Varoneckas, G., additional, Verbraecken, J., additional, Vitols, A., additional, Vrints, H., additional, and Zielinski, J., additional

Published
2021
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11. Clinical presentation of patients with suspected obstructive sleep apnea and self-reported physician-diagnosed asthma in the ESADA cohort

Author

Bonsignore, M, Pepin, J, Anttalainen, U, Schiza, S, Basoglu, O, Pataka, A, Steiropoulos, P, Dogas, Z, Grote, L, Hedner, J, Mcnicholas, W, Marrone, O, Barbé, F, Bielicki, P, Bouloukaki, I, Dorkova, Z, Escourrou, P, Fietze, I, Esquinas, C, Hayes, L, Kent, B, Kumor, M, Kurki, S, Kvamme, J, Lavie, L, Lavie, P, Levy, P, Lombardi, C, Masa, J, Montserrat, J, Parati, G, Penzel, T, Pépin, J, Plywaczewski, R, Pretl, M, Riha, R, Rodenstein, D, Roisman, G, Ryan, S, Saaresranta, T, Schulz, R, Sliwinski, P, Staats, R, Tasbakan, M, Tkacova, R, Varoneckas, G, Verbraecken, J, Vitols, A, Vrints, H, Zielinski, J, Bonsignore, Maria R., Pepin, Jean-Louis, Anttalainen, Ulla, Schiza, Sophia E., Basoglu, Ozen K., Pataka, Athanasia, Steiropoulos, Paschalis, Dogas, Zoran, Grote, Ludger, Hedner, Jan, McNicholas, Walter T., Marrone, Oreste, Barbé, F., Bielicki, P., Bouloukaki, I., Dorkova, Z., Escourrou, P., Fietze, I., Esquinas, C., Hayes, L., Kent, B. D., Kumor, M., Kurki, S., Kvamme, J. A., Lavie, L., Lavie, P., Levy, P., Lombardi, C., Masa, J. F., Montserrat, J. M., Parati, G., Penzel, T., Pépin, J. L., Plywaczewski, R., Pretl, M., Riha, R. L., Rodenstein, D., Roisman, G., Ryan, S., Saaresranta, T., Schulz, R., Sliwinski, P., Staats, R., Tasbakan, M. S., Tkacova, R., Varoneckas, G., Verbraecken, J., Vitols, A., Vrints, H., Zielinski, J., Bonsignore, M, Pepin, J, Anttalainen, U, Schiza, S, Basoglu, O, Pataka, A, Steiropoulos, P, Dogas, Z, Grote, L, Hedner, J, Mcnicholas, W, Marrone, O, Barbé, F, Bielicki, P, Bouloukaki, I, Dorkova, Z, Escourrou, P, Fietze, I, Esquinas, C, Hayes, L, Kent, B, Kumor, M, Kurki, S, Kvamme, J, Lavie, L, Lavie, P, Levy, P, Lombardi, C, Masa, J, Montserrat, J, Parati, G, Penzel, T, Pépin, J, Plywaczewski, R, Pretl, M, Riha, R, Rodenstein, D, Roisman, G, Ryan, S, Saaresranta, T, Schulz, R, Sliwinski, P, Staats, R, Tasbakan, M, Tkacova, R, Varoneckas, G, Verbraecken, J, Vitols, A, Vrints, H, Zielinski, J, Bonsignore, Maria R., Pepin, Jean-Louis, Anttalainen, Ulla, Schiza, Sophia E., Basoglu, Ozen K., Pataka, Athanasia, Steiropoulos, Paschalis, Dogas, Zoran, Grote, Ludger, Hedner, Jan, McNicholas, Walter T., Marrone, Oreste, Barbé, F., Bielicki, P., Bouloukaki, I., Dorkova, Z., Escourrou, P., Fietze, I., Esquinas, C., Hayes, L., Kent, B. D., Kumor, M., Kurki, S., Kvamme, J. A., Lavie, L., Lavie, P., Levy, P., Lombardi, C., Masa, J. F., Montserrat, J. M., Parati, G., Penzel, T., Pépin, J. L., Plywaczewski, R., Pretl, M., Riha, R. L., Rodenstein, D., Roisman, G., Ryan, S., Saaresranta, T., Schulz, R., Sliwinski, P., Staats, R., Tasbakan, M. S., Tkacova, R., Varoneckas, G., Verbraecken, J., Vitols, A., Vrints, H., and Zielinski, J.

Abstract

Obstructive sleep apnea (OSA) and asthma are often associated and several studies suggest a bidirectional relationship between asthma and OSA. This study analyzed the characteristics of patients with suspected OSA from the European Sleep Apnea Database according to presence/absence of physician-diagnosed asthma. Cross-sectional data in 16,236 patients (29.1% female) referred for suspected OSA were analyzed according to occurrence of physician-diagnosed asthma for anthropometrics, OSA severity and sleepiness. Sleep structure was assessed in patients studied by polysomnography (i.e. 48% of the sample). The prevalence of physician-diagnosed asthma in the entire cohort was 4.8% (7.9% in women, 3.7% in men, p < 0.0001), and decreased from subjects without OSA to patients with mild–moderate and severe OSA (p = 0.02). Obesity was highly prevalent in asthmatic women, whereas BMI distribution was similar in men with and without physician-diagnosed asthma. Distribution of OSA severity was similar in patients with and without physician-diagnosed asthma, and unaffected by treatment for asthma or gastroesophageal reflux. Asthma was associated with poor sleep quality and sleepiness. Physician-diagnosed asthma was less common in a sleep clinic population than expected from the results of studies in the general population. Obesity appears as the major factor raising suspicion of OSA in asthmatic women, whereas complaints of poor sleep quality were the likely reason for referral in asthmatic men.

Published
2018

12. Obstructive sleep apnoea independently predicts lipid levels: Data from the European Sleep Apnea Database

Author

Gündüz, C, Basoglu, O, Hedner, J, Zou, D, Bonsignore, M, Hein, H, Staats, R, Pataka, A, Barbe, F, Sliwinski, P, Kent, B, Pepin, J, Grote, L, Anttalainen, U, Barbé, F, Bielicki, P, Bouloukaki, I, Dogas, Z, Dorkova, Z, Escourrou, P, Fietze, I, Joppa, P, Kvamme, J, Levy, P, Lombardi, C, Marrone, O, Masa, J, Mcnicholas, W, Montserrat, J, Parati, G, Penzel, T, Pépin, J, Plywaczewski, R, Pretl, M, Riha, R, Roisman, G, Ryan, S, Saaresranta, T, Schiza, S, Schulz, R, Petiet, E, Tasbakan, M, Tkacova, R, Steiropoulos, P, Varoneckas, G, Verbraecken, J, Vitols, A, Gündüz, Canan, Basoglu, Ozen K., Hedner, Jan, Zou, Ding, Bonsignore, Maria R., Hein, Holger, Staats, Richard, Pataka, Athanasia, Barbe, Ferran, Sliwinski, Pavel, Kent, Brian D., Pepin, Jean Lois, Grote, Ludger, Anttalainen, U., Barbé, F., Bonsignore, M. R., Basoglu, O. K., Bielicki, P., Bouloukaki, I., Dogas, Z., Dorkova, Z., Escourrou, P., Fietze, I., Grote, L., Hedner, J., Hein, H., Joppa, P., Kvamme, J. A., Levy, P., Lombardi, C., Marrone, O., Masa, J. F., McNicholas, W. T., Montserrat, J. M., Parati, G., Pataka, A., Penzel, T., Pépin, J. L., Plywaczewski, R., Pretl, M., Riha, R. L., Roisman, G., Ryan, S., Saaresranta, T., Schiza, S., Schulz, R., Sliwinski, P., Pepin, J. L., Petiet, Erna, Tasbakan, M. S., Tkacova, R., Staats, R., Steiropoulos, P., Varoneckas, G., Verbraecken, J., Vitols, A., Gündüz, C, Basoglu, O, Hedner, J, Zou, D, Bonsignore, M, Hein, H, Staats, R, Pataka, A, Barbe, F, Sliwinski, P, Kent, B, Pepin, J, Grote, L, Anttalainen, U, Barbé, F, Bielicki, P, Bouloukaki, I, Dogas, Z, Dorkova, Z, Escourrou, P, Fietze, I, Joppa, P, Kvamme, J, Levy, P, Lombardi, C, Marrone, O, Masa, J, Mcnicholas, W, Montserrat, J, Parati, G, Penzel, T, Pépin, J, Plywaczewski, R, Pretl, M, Riha, R, Roisman, G, Ryan, S, Saaresranta, T, Schiza, S, Schulz, R, Petiet, E, Tasbakan, M, Tkacova, R, Steiropoulos, P, Varoneckas, G, Verbraecken, J, Vitols, A, Gündüz, Canan, Basoglu, Ozen K., Hedner, Jan, Zou, Ding, Bonsignore, Maria R., Hein, Holger, Staats, Richard, Pataka, Athanasia, Barbe, Ferran, Sliwinski, Pavel, Kent, Brian D., Pepin, Jean Lois, Grote, Ludger, Anttalainen, U., Barbé, F., Bonsignore, M. R., Basoglu, O. K., Bielicki, P., Bouloukaki, I., Dogas, Z., Dorkova, Z., Escourrou, P., Fietze, I., Grote, L., Hedner, J., Hein, H., Joppa, P., Kvamme, J. A., Levy, P., Lombardi, C., Marrone, O., Masa, J. F., McNicholas, W. T., Montserrat, J. M., Parati, G., Pataka, A., Penzel, T., Pépin, J. L., Plywaczewski, R., Pretl, M., Riha, R. L., Roisman, G., Ryan, S., Saaresranta, T., Schiza, S., Schulz, R., Sliwinski, P., Pepin, J. L., Petiet, Erna, Tasbakan, M. S., Tkacova, R., Staats, R., Steiropoulos, P., Varoneckas, G., Verbraecken, J., and Vitols, A.

Abstract

Background and objective: Obstructive sleep apnoea (OSA) and dyslipidaemia are independent risk factors for cardiovascular disease. This study investigates the association between OSA and plasma lipid concentrations in patients enrolled in the European Sleep Apnea Database (ESADA) cohort. Methods: The cross-sectional analysis included 8592 patients without physician-diagnosed hyperlipidaemia or reported intake of a lipid-lowering drug (age 50.1 ± 12.7 years, 69.1% male, BMI: 30.8 ± 6.6 kg/m2, mean apnoea–hypopnoea index (AHI): 25.7 ± 25.9 events/h). The independent relationship between measures of OSA (AHI, oxygen desaturation index (ODI), mean and lowest oxygen saturation) and lipid profile (total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and fasting triglycerides (TG)) was determined by means of general linear model analysis. Results: There was a dose response relationship between TC and ODI (mean ± SE (mg/dL): 180.33 ± 2.46, 184.59 ± 2.42, 185.44 ± 2.42 and 185.73 ± 2.44; P < 0.001 across ODI quartiles I–IV). TG and LDL concentrations were better predicted by AHI than by ODI. HDL-C was significantly reduced in the highest AHI quartile (mean ± SE (mg/dL): 48.8 ± 1.49 vs 46.50 ± 1.48; P = 0.002, AHI quartile I vs IV). Morbid obesity was associated with lower TC and higher HDL-C values. Lipid status was influenced by geographical location with the highest TC concentration recorded in Northern Europe. Conclusion: OSA severity was independently associated with cholesterol and TG concentrations.

Published
2018

15. Clinical phenotypes and comorbidity in European sleep apnoea patients

Author

Saaresranta T., Hedner J., Bonsignore M. R., Riha R. L., McNicholas W. T., Penzel T., Anttalainen U., Kvamme J. A., Pretl M., Sliwinski P., Verbraecken J., Grote L., Barbe F., Basoglu B., Bielicki P., Dorkova Z., Escourrou P., Fietze I., Esquinas C., Hayes L., Kumor M., Kurki S., Lavie L., Lavie P., Levy P., Lombardi C., Marrone O., Masa J. F., Montserrat J. M., Parati G., Pataka A., Pepin J. L., Plywaczewski R., Rodenstein D., Roisman G., Ryan S., Schulz R., Tkacova R., Staats R., Steiropoulos P., Varoneckas G., Vitols A., Vrints H., Zielinski J., Saaresranta, T, Hedner, J, Bonsignore, M, Riha, R, Mcnicholas, W, Penzel, T, Anttalainen, U, Kvamme, J, Pretl, M, Sliwinski, P, Verbraecken, J, Grote, L, Barbe, F, Basoglu, B, Bielicki, P, Dorkova, Z, Escourrou, P, Fietze, I, Esquinas, C, Hayes, L, Kumor, M, Kurki, S, Lavie, L, Lavie, P, Levy, P, Lombardi, C, Marrone, O, Masa, J, Montserrat, J, Parati, G, Pataka, A, Pepin, J, Plywaczewski, R, Rodenstein, D, Roisman, G, Ryan, S, Schulz, R, Tkacova, R, Staats, R, Steiropoulos, P, Varoneckas, G, Vitols, A, Vrints, H, Zielinski, J, ESADA Study Group, Ege Üniversitesi, ESADA Study Grp, UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie, UCL - (SLuc) Service de pneumologie, Saaresranta, T., Hedner, J., Bonsignore, M., Riha, R., Mcnicholas, W., Penzel, T., Anttalainen, U., Kvamme, J., Pretl, M., Sliwinski, P., Verbraecken, J., Grote, L., Barbé, F., Basoglu, B., Bielicki, P., Dorkova, Z., Escourrou, P., Fietze, I., Esquinas, C., Hayes, L., Kumor, M., Kurki, S., Lavie, L., Lavie, P., Levy, P., Lombardi, C., Marrone, O., Masa, J., Montserrat, J., Parati, G., Pataka, A., Pépin, J., Plywaczewski, R., Rodenstein, D., Roisman, G., Ryan, S., Schulz, R., Tkacova, R., Staats, R., Steiropoulos, P., Varoneckas, G., Vitols, A., Vrints, H., and Zielinski, J.

Subjects
Male, Pulmonology, Physiology, Apnea, medicine.medical_treatment, lcsh:Medicine, Comorbidity, Polysomnography, Cardiovascular Medicine, Medicine (all), Biochemistry, Genetics and Molecular Biology (all), Agricultural and Biological Sciences (all), THERAPY, Body Mass Index, 0302 clinical medicine, Risk Factors, Positive airway pressure, Medicine and Health Sciences, Insomnia, Medicine, Prospective Studies, Continuous positive airway pressure, lcsh:Science, Prospective cohort study, Clinical Neurophysiology, Aged, 80 and over, Hypersomnia, Multidisciplinary, medicine.diagnostic_test, Sleep apnea, Middle Aged, DEPRESSION, PREVALENCE, ComputingMilieux_MANAGEMENTOFCOMPUTINGANDINFORMATIONSYSTEMS, Phenotype, Neurology, Physiological Parameters, Cardiovascular Diseases, CARDIOVASCULAR-DISEASE, Female, InformationSystems_MISCELLANEOUS, medicine.symptom, Engineering sciences. Technology, Hypopnea, INSOMNIA SYMPTOMS, Research Article, Adult, medicine.medical_specialty, Sleep Apnea, Adolescent, POSITIVE AIRWAY PRESSURE, Settore MED/10 - Malattie Dell'Apparato Respiratorio, White People, Young Adult, 03 medical and health sciences, Sleep Apnea Syndromes, DAYTIME, stomatognathic system, Comorbiditat, Diagnostic Medicine, Internal medicine, mental disorders, Humans, COMMON, Aged, HYPOPNEA, HYPERTENSION, business.industry, lcsh:R, Body Weight, ComputerSystemsOrganization_COMPUTER-COMMUNICATIONNETWORKS, Biology and Life Sciences, ta3121, medicine.disease, Dyssomnias, respiratory tract diseases, nervous system diseases, ComputingMethodologies_PATTERNRECOGNITION, 030228 respiratory system, Physical therapy, lcsh:Q, Sleep Disorders, Physiological Processes, Sleep, business, 030217 neurology & neurosurgery, Follow-Up Studies
Abstract

PubMed ID: 27701416, Background Clinical presentation phenotypes of obstructive sleep apnoea (OSA) and their association with comorbidity as well as impact on adherence to continuous positive airway pressure (CPAP) treatment have not been established. Methods A prospective follow-up cohort of adult patients with OSA (apnoea-hypopnoea index (AHI) of ?5/h) from 17 European countries and Israel (n = 6,555) was divided into four clinical presentation phenotypes based on daytime symptoms labelled as excessive daytime sleepiness ("EDS") and nocturnal sleep problems other than OSA (labelled as "insomnia"): 1) EDS (daytime+/nighttime-), 2) EDS/insomnia (daytime+/nighttime+), 3) non-EDS/noninsomnia (daytime-/nighttime-), 4) and insomnia (daytime-/nighttime+) phenotype. Results The EDS phenotype comprised 20.7%, the non-EDS/non-insomnia type 25.8%, the EDS/ insomnia type 23.7%, and the insomnia phenotype 29.8% of the entire cohort. Thus, clinical presentation phenotypes with insomnia symptoms were dominant with 53.5%, but only 5.6% had physician diagnosed insomnia. Cardiovascular comorbidity was less prevalent in the EDS and most common in the insomnia phenotype (48.9% vs. 56.8%, p

Published
2016
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16. Clinical phenotypes and comorbidity in European sleep apnoea patients

Author

Saaresranta, T, Hedner, J, Bonsignore, M, Riha, R, Mcnicholas, W, Penzel, T, Anttalainen, U, Kvamme, J, Pretl, M, Sliwinski, P, Verbraecken, J, Grote, L, Barbe, F, Basoglu, B, Bielicki, P, Dorkova, Z, Escourrou, P, Fietze, I, Esquinas, C, Hayes, L, Kumor, M, Kurki, S, Lavie, L, Lavie, P, Levy, P, Lombardi, C, Marrone, O, Masa, J, Montserrat, J, Parati, G, Pataka, A, Pepin, J, Plywaczewski, R, Rodenstein, D, Roisman, G, Ryan, S, Schulz, R, Tkacova, R, Staats, R, Steiropoulos, P, Varoneckas, G, Vitols, A, Vrints, H, Zielinski, J, Saaresranta T., Hedner J., Bonsignore M. R., Riha R. L., McNicholas W. T., Penzel T., Anttalainen U., Kvamme J. A., Pretl M., Sliwinski P., Verbraecken J., Grote L., Barbe F., Basoglu B., Bielicki P., Dorkova Z., Escourrou P., Fietze I., Esquinas C., Hayes L., Kumor M., Kurki S., Lavie L., Lavie P., Levy P., Lombardi C., Marrone O., Masa J. F., Montserrat J. M., Parati G., Pataka A., Pepin J. L., Plywaczewski R., Rodenstein D., Roisman G., Ryan S., Schulz R., Tkacova R., Staats R., Steiropoulos P., Varoneckas G., Vitols A., Vrints H., Zielinski J., Saaresranta, T, Hedner, J, Bonsignore, M, Riha, R, Mcnicholas, W, Penzel, T, Anttalainen, U, Kvamme, J, Pretl, M, Sliwinski, P, Verbraecken, J, Grote, L, Barbe, F, Basoglu, B, Bielicki, P, Dorkova, Z, Escourrou, P, Fietze, I, Esquinas, C, Hayes, L, Kumor, M, Kurki, S, Lavie, L, Lavie, P, Levy, P, Lombardi, C, Marrone, O, Masa, J, Montserrat, J, Parati, G, Pataka, A, Pepin, J, Plywaczewski, R, Rodenstein, D, Roisman, G, Ryan, S, Schulz, R, Tkacova, R, Staats, R, Steiropoulos, P, Varoneckas, G, Vitols, A, Vrints, H, Zielinski, J, Saaresranta T., Hedner J., Bonsignore M. R., Riha R. L., McNicholas W. T., Penzel T., Anttalainen U., Kvamme J. A., Pretl M., Sliwinski P., Verbraecken J., Grote L., Barbe F., Basoglu B., Bielicki P., Dorkova Z., Escourrou P., Fietze I., Esquinas C., Hayes L., Kumor M., Kurki S., Lavie L., Lavie P., Levy P., Lombardi C., Marrone O., Masa J. F., Montserrat J. M., Parati G., Pataka A., Pepin J. L., Plywaczewski R., Rodenstein D., Roisman G., Ryan S., Schulz R., Tkacova R., Staats R., Steiropoulos P., Varoneckas G., Vitols A., Vrints H., and Zielinski J.

Abstract

Background Clinical presentation phenotypes of obstructive sleep apnoea (OSA) and their association with comorbidity as well as impact on adherence to continuous positive airway pressure (CPAP) treatment have not been established. Methods A prospective follow-up cohort of adult patients with OSA (apnoea-hypopnoea index (AHI) of ≥5/h) from 17 European countries and Israel (n = 6,555) was divided into four clinical presentation phenotypes based on daytime symptoms labelled as excessive daytime sleepiness ("EDS") and nocturnal sleep problems other than OSA (labelled as "insomnia"): 1) EDS (daytime+/nighttime-), 2) EDS/insomnia (daytime+/nighttime+), 3) non-EDS/noninsomnia (daytime-/nighttime-), 4) and insomnia (daytime-/nighttime+) phenotype. Results The EDS phenotype comprised 20.7%, the non-EDS/non-insomnia type 25.8%, the EDS/ insomnia type 23.7%, and the insomnia phenotype 29.8% of the entire cohort. Thus, clinical presentation phenotypes with insomnia symptoms were dominant with 53.5%, but only 5.6% had physician diagnosed insomnia. Cardiovascular comorbidity was less prevalent in the EDS and most common in the insomnia phenotype (48.9% vs. 56.8%, p<0.001) despite more severe OSA in the EDS group (AHI 35.0±25.5/h vs. 27.9±22.5/h, p<0.001, respectively). Psychiatric comorbidity was associated with insomnia like OSA phenotypes independent of age, gender and body mass index (HR 1.5 (1.188-1.905), p<0.001). The EDS phenotype tended to associate with higher CPAP usage (22.7 min/d, p = 0.069) when controlled for age, gender, BMI and sleep apnoea severity. Conclusions Phenotypes with insomnia symptoms comprised more than half of OSA patients and were more frequently linked with comorbidity than those with EDS, despite less severe OSA. CPAP usage was slightly higher in phenotypes with EDS.

Published
2016

19. Risk factors and severity of obstructive sleep apnoea in central European Roma and non-Roma patients referred for a diagnostic polysomnography [corrected].

Author

Dorkova Z, Sopkova Z, Tkacova R, Dorkova, Zuzana, Sopkova, Zuzana, and Tkacova, Ruzena

Abstract

Objective: Obesity and metabolic syndrome are common among Roma subjects in Slovakia. We hypothesised that Roma subjects are at high risk to suffer from severe obstructive sleep apnoea (OSA).Methods: 137 non-Roma and 23 Roma subjects referred for a diagnostic polysomnography were consecutively recruited. Overnight polysomnography, anthropometric variables and standard biochemical analyses were analysed.Results: Obstructive sleep apnoea was diagnosed in 91% Roma and 65% non-Roma subjects (p < 0.001). Roma subjects had higher apnoea-hypopnoea index (AHI) (61.2 ± 7.9 vs. 22.8 ± 2.3 events/h, p < 0.001), lower dip oxygen saturation (56.7 ± 4.9 vs. 79.3 ± 1.3%, p < 0.001), and higher waist circumference as compared to non-Roma subjects (121.3 ± 3.1 vs. 105.2 ± 2.4 cm, p < 0.001). In multiple regression analysis, Roma background (p < 0.001) and waist circumference (p < 0.001) were independent predictors of AHI (R (2) = 0.330). Roma background was associated with significantly higher risk of severe OSA (odds ratio 3.73; 95% confidence interval 1.20-11.65, p = 0.023), independently of age, gender and waist circumference.Conclusions: Among subjects referred for polysomnography, Roma background is associated with significantly higher risk of severe OSA. Knowledge of common OSA pattern in Roma patients may help in identifying high risk individuals and guide early therapy of this disease. [ABSTRACT FROM AUTHOR]

Published
2010
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20. Size and subclasses of low-density lipoproteins in patients with obstructive sleep apnea

Author

Ruzena Tkacova, Zuzana Sopkova, Zuzana Dorkova, Giatgen A. Spinas, Kaspar Berneis, Manfredi Rizzo, Radovan Tisko, Sopkova, Z, Berneis, K, Rizzo, M, Spinas, GA, Dorkova, Z, Tisko, R, Tkacova, R, University of Zurich, and Tkacova, Ruzena

Subjects
medicine.medical_specialty, Cross-sectional study, Polysomnography, 10265 Clinic for Endocrinology and Diabetology, 610 Medicine & health, 2705 Cardiology and Cardiovascular Medicine, Internal medicine, medicine, Low density, obstructive sleep apnea, metabolic syndrome, low-density lipoprotein size, small, dense low-density lipoprotein, atherosclerosis, Humans, In patient, Dyslipidemias, Metabolic Syndrome, Sleep Apnea, Obstructive, medicine.diagnostic_test, business.industry, Sleep apnea, medicine.disease, Lipoproteins, LDL, Obstructive sleep apnea, Cross-Sectional Studies, Endocrinology, Linear Models, lipids (amino acids, peptides, and proteins), Metabolic syndrome, Cardiology and Cardiovascular Medicine, business, Dyslipidemia
Abstract

Patients with obstructive sleep apnea (OSA) have proatherogenic dyslipidemia. We analyzed predictors of low-density lipoproteins' (LDLs) size in patients with OSA. In a cross-sectional study including 58 participants with OSA (30 without the metabolic syndrome [MetS] and 28 with MetS), we evaluated the size of LDL by gradient gel electrophoresis. Compared with patients without the MetS, those with MetS showed lower LDL size ( P = .007), due to a reduction in large LDL-I particles ( P = .002) and an increase in small, dense LDL-IIIA ( P = .048) and LDL-IIIB ( P = .037). The size of LDL correlated inversely with age ( r = −.268, P = .042) and serum triglycerides ( r = −.364, P = .005), and positively with serum high-density lipoprotein cholesterol levels ( r = .335, P = .010). In multiple regression analysis, the presence of the MetS was the only independent predictor of LDL size ( P = 0.015). In patients with OSA, MetS is an independent predictor of LDL size and subclasses, whereas the severity of OSA does not contribute independently to alterations in LDL phenotype.

Published
2012

21. Effects of apolipoprotein E genotype on serum lipids in obstructive sleep apnoea.

Author

Tisko R, Sopkova Z, Habalova V, Dorkova Z, Slaba E, Javorsky M, Tkac I, Riha RL, and Tkacova R

Subjects
Adult, Alleles, Dyslipidemias complications, Female, Genetic Predisposition to Disease, Genotype, Heterozygote, Humans, Hypoxia, Male, Middle Aged, Oxygen chemistry, Polymorphism, Genetic, Polysomnography, Prospective Studies, Real-Time Polymerase Chain Reaction, Risk Factors, Sleep, Sleep Apnea, Obstructive complications, Tertiary Care Centers, Triglycerides blood, Apolipoproteins E genetics, Dyslipidemias blood, Dyslipidemias genetics, Lipids blood, Sleep Apnea, Obstructive blood, Sleep Apnea, Obstructive genetics
Abstract

There is increasing evidence that intermittent hypoxia resulting from obstructive sleep apnoea (OSA) is independently associated with dyslipidaemia. Currently, no data exist on potential links between OSA-related dyslipidaemia and susceptibility genes for dyslipidaemia in such patients. Our aim was to study the effects of the apolipoprotein E (APOE) genotype and sleep apnoea severity on atherogenic dyslipidaemia in patients with OSA. 519 clinically stable subjects prospectively recruited at a tertiary referral teaching hospital underwent full polysomnography. APOE gene polymorphisms were assessed using real-time PCR. In all APOE genotype groups, serum triglycerides increased while high-density lipoprotein (HDL) cholesterol was reduced with increasing severity of OSA in each APOE genotype group, whereas the deleterious effects of OSA on serum apolipoprotein (Apo)B levels were observed in ε2 carriers and the ε3/ε3 genotype only. Nevertheless, the ε4 allele carriers had ApoB levels within the risk range, irrespective of nocturnal hypoxia. In addition, among patients with the high-risk ε4 genotype, those with the most severe nocturnal hypoxia had significantly higher triglyceride and lower HDL cholesterol levels compared with nonhypoxic ε4 subjects. APOE genotype and the oxygen desaturation index were both independent predictors of serum triglyceride levels (p=0.009 and p<0.001, respectively; R(2)=0.148) and ApoB levels (p=0.001 and p=0.003, respectively; R(2)=0.104). Our findings suggest that OSA has adverse effects on several lipid parameters over and above the effects carried by APOE genotype. Further st1udies are needed to analyse the effects of high-risk genotypes on metabolic and cardiovascular outcomes in patients with OSA.

Published
2014
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22. Size and subclasses of low-density lipoproteins in patients with obstructive sleep apnea.

Author

Sopkova Z, Berneis K, Rizzo M, Spinas GA, Dorkova Z, Tisko R, and Tkacova R

Subjects
Cross-Sectional Studies, Dyslipidemias blood, Dyslipidemias complications, Humans, Linear Models, Polysomnography, Sleep Apnea, Obstructive complications, Lipoproteins, LDL blood, Metabolic Syndrome blood, Sleep Apnea, Obstructive blood
Abstract

Patients with obstructive sleep apnea (OSA) have proatherogenic dyslipidemia. We analyzed predictors of low-density lipoproteins' (LDLs) size in patients with OSA. In a cross-sectional study including 58 participants with OSA (30 without the metabolic syndrome [MetS] and 28 with MetS), we evaluated the size of LDL by gradient gel electrophoresis. Compared with patients without the MetS, those with MetS showed lower LDL size (P = .007), due to a reduction in large LDL-I particles (P = .002) and an increase in small, dense LDL-IIIA (P = .048) and LDL-IIIB (P = .037). The size of LDL correlated inversely with age (r = -.268, P = .042) and serum triglycerides (r = -.364, P = .005), and positively with serum high-density lipoprotein cholesterol levels (r = .335, P = .010). In multiple regression analysis, the presence of the MetS was the only independent predictor of LDL size (P = 0.015). In patients with OSA, MetS is an independent predictor of LDL size and subclasses, whereas the severity of OSA does not contribute independently to alterations in LDL phenotype.

Published
2012
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23. Predictors of compliance with continuous positive airway pressure treatment in patients with obstructive sleep apnea and metabolic syndrome.

Author

Sopkova Z, Dorkova Z, and Tkacova R

Subjects
Body Mass Index, Comorbidity, Diabetes Mellitus, Type 2 psychology, Diabetes Mellitus, Type 2 therapy, Equipment Failure, Female, Humans, Male, Middle Aged, Oxygen blood, Polysomnography, Prospective Studies, Continuous Positive Airway Pressure psychology, Metabolic Syndrome psychology, Metabolic Syndrome therapy, Patient Compliance psychology, Sleep Apnea, Obstructive psychology, Sleep Apnea, Obstructive therapy
Abstract

Objective: Continuous positive airway pressure (CPAP) applied via a tight-fitting mask is the most effective treatment for obstructive sleep apnea (OSA) and has potential to improve the cardiovascular prognosis in such patients. Adequate compliance with the use of CPAP is essential for achieving the cardiovascular and metabolic benefits of this treatment. This prospective study aimed to assess factors related to objective compliance with CPAP treatment in Slovakian patients with metabolic syndrome and newly diagnosed OSA., Patients and Methods: Fifty-one patients (42 men) with metabolic syndrome and OSA (mean age, 54.5 +/- 1.5 years; mean apnea-hypopnea index 59.0 +/- 3.9 events/h of sleep; mean lowest sleep transcutaneous oxygen saturation [SpO(2)] 66.0 +/- 2.7%) underwent pressure titration during overnight polysomnography using the Autoset self-adjusting CPAP device. Metabolic syndrome was diagnosed according to the recent definition of the International Diabetes Federation. Objective compliance was assessed electronically at the 8-week follow-up visit., Results: Obesity was present in all (100%) the patients and arterial hypertension in 48 (94%); fasting plasma glucose levels were increased in 27 (55%) patients and serum triglycerides in 36 (71%); serum HDL cholesterol was reduced in 30 (59%) patients. Two patients did not use CPAP at all and were excluded from further analyses. The remaining 49 patients were divided into two groups: CPAP compliant (>or=4 h/night, mean use 5.52 +/- 0.19 h/night, n = 30) and CPAP non-compliant (< 4 h/night; mean use 1.94 +/- 0.27 h/night, n = 19). Mask leak was significantly higher in the non-compliant patients (43.0 +/- 4.4 vs. 31.9 +/- 2.7 l/min, P = 0.027). No relationships were observed between CPAP compliance and age, apnea-hypopnea index, arousal index or variables of sleep architecture. In contrast, CPAP compliance was significantly related to mean sleep SpO(2) (r = 0.314, P = 0.028), the lowest sleep SpO(2) (r = 0.297, P = 0.038) and mask leak (r = -0.376, P = 0.008). A close relationship between BMI and mask leak was also observed (r = 0.579, P < 0.001). In multiple linear regression analyses with CPAP compliance as an independent variable, and age, sex, mask leak, BMI and mean sleep SpO(2) as dependent variables, mask leak was the only independent predictor of CPAP compliance (R(2) = 0.382, P = 0.009)., Conclusion: The study demonstrates the relationship between reductions in mask leak and good compliance with CPAP treatment in central European patients with OSA and concurrent metabolic syndrome. Strategies to maintain low leakage of the CPAP mask are warranted, particularly in grossly overweight patients.

Published
2009
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24. Effects of continuous positive airway pressure on cardiovascular risk profile in patients with severe obstructive sleep apnea and metabolic syndrome.

Author

Dorkova Z, Petrasova D, Molcanyiova A, Popovnakova M, and Tkacova R

Subjects
Adult, Blood Glucose metabolism, Cardiovascular Diseases blood, Cohort Studies, Cytokines blood, Female, Humans, Lipids blood, Male, Metabolic Syndrome complications, Middle Aged, Oxidative Stress physiology, Patient Compliance, Risk Factors, Sleep Apnea, Obstructive complications, Time Factors, Cardiovascular Diseases etiology, Continuous Positive Airway Pressure, Metabolic Syndrome blood, Sleep Apnea, Obstructive blood, Sleep Apnea, Obstructive therapy
Abstract

Background: The increased risk of atherosclerotic morbidity and mortality in patients with obstructive sleep apnea (OSA) has been linked to arterial hypertension, insulin resistance, systemic inflammation, and oxidative stress. We aimed to determine the effects of 8 weeks of therapy with continuous positive airway pressure (CPAP) on glucose and lipid profile, systemic inflammation, oxidative stress, and global cardiovascular disease (CVD) risk in patients with severe OSA and metabolic syndrome., Methods: In 32 patients, serum cholesterol, triglycerides, high-density lipoprotein cholesterol, fibrinogen, apolipoprotein A-I, apolipoprotein B (ApoB), high-sensitivity C-reactive protein, interleukin-6, tumor necrosis factor (TNF)-alpha, leptin, malondialdehyde (MDA), and erythrocytic glutathione peroxidase (GPx) activity were measured at baseline and after 8 weeks of CPAP. The insulin resistance index (homeostasis model assessment [HOMA-IR]) was based on the homeostasis model assessment method, the CVD risk was calculated using the multivariable risk factor algorithm., Results: In patients who used CPAP for > or = 4 h/night (n = 16), CPAP therapy reduced systolic BP and diastolic BP (p = 0.001 and p = 0.006, respectively), total cholesterol (p = 0.002), ApoB (p = 0.009), HOMA-IR (p = 0.031), MDA (p = 0.004), and TNF-alpha (p = 0.037), and increased erythrocytic GPx activity (p = 0.015), in association with reductions in the global CVD risk (from 18.8 +/- 9.8 to 13.9 +/- 9.7%, p = 0.001). No significant changes were seen in patients who used CPAP for < 4 h/night. Mask leak was the strongest predictor of compliance with CPAP therapy., Conclusions: In patients with severe OSA and metabolic syndrome, good compliance to CPAP may improve insulin sensitivity, reduce systemic inflammation and oxidative stress, and reduce the global CVD risk.

Published
2008
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25. Cardiovascular risk and insulin resistance in patients with obstructive sleep apnea.

Author

Tkacova R, Dorkova Z, Molcanyiova A, Radikova Z, Klimes I, and Tkac I

Subjects
Adult, Cardiovascular Diseases physiopathology, Cross-Sectional Studies, Female, Homeostasis, Humans, Insulin metabolism, Lipid Metabolism, Male, Metabolic Syndrome etiology, Metabolic Syndrome physiopathology, Middle Aged, Obesity complications, Polysomnography, Risk Factors, Sleep Apnea, Obstructive physiopathology, Cardiovascular Diseases etiology, Insulin Resistance, Sleep Apnea, Obstructive complications
Abstract

Background: Obstructive sleep apnea (OSA) has been linked to cardiovascular and cerebrovascular diseases in previous studies. However, it remains unclear whether OSA relates to cardiovascular outcomes independently of obesity and/or insulin resistance., Material/methods: At a tertiary referral teaching hospital, this cross-sectional analysis of 98 subjects (28 without, 39 with mild-moderate, and 31 with severe OSA) aimed to determine whether OSA relates to National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) cardiovascular risk independently of obesity and insulin resistance. OSA was diagnosed by attended polysomnography. The insulin resistance index (HOMA-IR) was based on a homeostasis model assessment method., Results: Of the patients without to those with mild-moderate to those with severe OSA, significant increases were observed in NCEP ATP III risk [median (25%, 75% quartiles) from 2.0 (1.0, 8.0) to 3.0 (1.0, 12.0) to 16.0 (5.3, 20.0)%, p <0.001 for the trend] in association with increases in HOMA-IR (p<0.001), diastolic (p=0.039) and mean blood pressure (p=0.016), serum triglycerides (p=0.047), apolipoprotein B (p=0.039), plasma fibrinogen (p=0.013), and fasting glucose levels (p=0.002). Compared with subjects without sleep apnea, patients with severe OSA had significantly higher odds for NCEP ATP III risk higher than 10% (moderately high and high cardiovascular risk) (odds ratio: 4.06, 95% confidence interval: 1.02-16.25, p=0.048) after adjustment for body mass index and HOMA-IR., Conclusions: These findings suggest that severe OSA is related to higher cardiovascular risk independently of obesity and insulin resistance.

Published
2008

26. Endobronchial actinomycosis presenting as haemoptysis.

Author

Toth S, Cavarga I, Boor A, Gmitter F, Legathova B, Kluchova Z, Dorkova Z, Somos A, and Tkacova R

Subjects
Actinomycosis complications, Aged, Bronchial Diseases complications, Humans, Male, Actinomycosis diagnosis, Bronchial Diseases diagnosis, Hemoptysis etiology
Abstract

Actinomycosis is an infrequent chronic progressive granulomatous and suppurative disease caused by Actinomyces israelii, a natural inhabitant of the gastrointestinal tract. We report a rare case of a 68-year-old man with primary endobronchial actinomycosis who presented in the emergency respiratory ward with massive hemoptysis and dyspnea. An urgent fiberoptic bronchoscopy revealed hypertrophic mucosa and a narrowed lingular bronchus with a pale extruding exophyt. Diffuse bleeding from the mucosa adjacent to the exophyt was present. Histopathologic evaluation revealed chronic inflammation with abscess formation and clusters of Actinomyces colonies. Therapy with clindamycin maintained for 7 weeks prevented recurrence of the disease. In the light of our case and the review of literature we conclude that early recognition of primary endobronchial actinomycosis associated with hemoptysis and proper antibiotic treatment are essential to prevent undesirable complications including unwarranted surgery (Fig. 2, Ref. 30). Full Text (Free, PDF) www.bmj.sk.

Published
2007

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