OSA is common in ILD. PSG or at minimum nocturnal oximetry should be performed, particularly in patients with functionally and radiologically severe disease.
In patients with moderate-to-severe obstructive sleep apnea, compliant CPAP usage may improve insulin secretion capacity, reduce leptin, total cholesterol, and low-density lipoprotein levels. Leptin showed significant relationship with insulin resistance, and this relationship remained after 8 weeks of CPAP therapy.
Introduction Obstructive sleep apnea-hypopnea syndrome (OSAHS) may have a significant negative effect on sexual function. Aim To evaluate female sexual function in women with OSAHS. Methods Twenty-six patients with OSAHS were evaluated in two groups according to apnea-hypopnea index as mild (5–15, Group I, N = 16) or moderate-severe (≥15, Group II, N = 10). A third group (N = 10) of patients suspected of sleeping disorders other than OSAHS who also underwent polysomnographic studies served as the control group. All women were evaluated with a detailed sexual history including Female Sexual Function Index (FSFI) questionnaire and Beck Depression Inventory (BDI). Meanwhile, serum levels of estradiol, prolactin, total and free testosterone and dihydroepiandrostenedione-S were determined. Main Outcome Measures FSFI, BDI, and serum hormonal levels. Results The mean ages and total FSFI scores of Group I, Group II and the control group were 46 ± 7.1, 45 ± 3.8, and 41 ± 5.4 (P > 0.05); 24.7 ± 5.3, 24.5 ± 6.3, and 30.0 ± 2.5 (P < 0.05), respectively. The mean FSFI domain scores were not statistically different between Groups I and II (P > 0.05) (desire, 3.18 ± 1.2 vs. 2.92 ± 1.6; arousal, 3.96 ± 1.1 vs. 3.67 ± 1.2; lubrication, 4.83 ± 1.0 vs. 4.12 ± 1.1; orgasm 4.0 ± 1.1 vs. 5.15 ± 2.9; satisfaction 3.96 ± 1.1 vs. 4.05 ± 1.4 pain; 4.84 ± 1.2 vs. 4.65 ± 1.3). However, the mean scores of desire (3.18 ± 1.2 vs. 3.96 ± 0.7), orgasm (4.0 ± 1.1 vs. 5.0 ± 1.1), and satisfaction (3.96 ± 1.1 vs. 4.76 ± 1.0) domains of Group I were significantly lower than the control group. Meanwhile, the mean scores of desire (2.92 ± 1.6 vs. 3.96 ± 0.7) and lubrication (4.12 ± 1.1 vs. 5.22 ± 0.9) domains were statistically different between Group II and the control group. The mean BDI scores of patients in Group I, Group II and the control group were 19.3 ± 6.3, 20.2 ± 6.6, and 11.0 ± 7.1, respectively (P < 0.01). In addition, the mean levels of hormonal parameters were not significantly different from the control group (P > 0.05). Conclusions OSAHS is associated with a significant decrease in female sexual function. However, severity of OSAHS is not related with the degree of female sexual dysfunction (FSD). This situation reveals that both organic and psychogenic issues are being involved in FSD related with OSAHS.
Background: Obstructive sleep apnea syndrome (OSAS) influences endothelial function and causes hypertension. Objectives: Our aim was to evaluate the role of endothelial dysfunction in the pathogenesis of hypertension in OSAS. Methods: Twenty-three patients with OSAS but without hypertension and 15 healthy normotensive subjects were investigated. The presence or absence of OSAS was evaluated with a sleep study. Endothelial function was investigated with brachial artery ultrasound examination. Results: Baseline characteristics were equivalent between the two groups. Minimal oxygen saturation and apnea-hypopnea indexes in the OSAS and control groups were 62.9 ± 16.5 versus 94.9 ± 1.1% (p < 0.0001) and 53.1 ± 20.3 versus 3.8 ± 0.9 (p < 0.0001), respectively. There was not statistically significant difference between basal brachial artery diameters measured in the morning and in the evening in all groups. Flow-mediated dilation (FMD) values measured in the morning were lower than those measured in the evening in both OSAS patients and the control group: FMD of OSAS patients was 6.04 ± 3.18% in the morning and 10.38 ± 4.23% in the evening hours (p = 0.001), and FMD of control subjects was 10.9 ± 2.6% in the morning and 13.9 ± 2.32 in the evening hours (p = 0.002). Differences in FMD values measured both in the morning and evening hours in OSAS patients were lower compared with those in control subjects (p < 0.0001 in the morning hours and p = 0.003 in the evening hours). Conclusions: We detected a prominent diurnal deterioration in endothelial function in normotensive OSAS patients compared with healthy subjects. This deterioration may occur due to ongoing hypoxemia during the night and it may be a possible cause of hypertension and atherosclerotic cardiovascular diseases in patients with OSAS.
Results with conventional CPAP titration and endoscopy-assisted CPAP titration showed no statistically significant difference. Endoscopy-assisted CPAP is a cheaper and less time consuming alternative to conventional CPAP and has similar results.
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