Arousal index as a marker of carotid artery atherosclerosis in patients with obstructive sleep apnea syndrome

Suzuki, Mayumi; Shimamoto, Ken; Sekiguchi, Hiroyuki; Harada, Tomoki; Satoya, Natsumi; Inoue, Yoshio; Yamaguchi, Kazuhiro; Kawana, Masatoshi

doi:10.1007/s11325-018-1664-0

Cited by 14 publications

(9 citation statements)

References 29 publications

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“…We previously reported that the arousal index, diabetes mellitus status, and age were independent predictors of an ICA-MaxIMT of !1.5 mm in patients with OSA. 31 In the current study, carotid artery atherosclerosis was mild before treatment, the deterioration in glucose metabolism was limited, and the IMT was not different between the REM OSA and non-REM OSA groups.…”

Section: Discussionmentioning

confidence: 41%

Long-term outcomes regarding arterial stiffness and carotid artery atherosclerosis in female patients with rapid eye movement obstructive sleep apnea

et al. 2022

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Objective Rapid eye movement (REM) obstructive sleep apnea (OSA) is associated with the risk of cardiovascular events. Arterial stiffness and carotid artery intima-media thickness (IMT) predict these events, but few relevant studies have been conducted. We compared long-term changes in arterial stiffness and IMT between patients with REM OSA and non-REM (NREM) OSA receiving continuous positive airway pressure (CPAP) or oral appliance (OA) therapy. Methods Newly diagnosed female patients with OSA received CPAP (n = 6) or OA (n = 7). Pulse wave velocity (PWV) and carotid artery ultrasound were performed before and 60 months after treatment. Results There were no differences in baseline characteristics (mean age: 56.0 vs. 61.3 years; mean body mass index: 22.6 vs. 21.7 kg/m2) between the REM OSA and non-REM OSA groups. The median apnea-hypopnea index was lower in the REM OSA group than in the non-REM OSA group. Increased PWV (12.92 ± 1.64 to 14.56 ± 2.73 m/s) and deteriorated glucose metabolism were observed in the REM OSA group after treatment. PWV, IMT, and cardiovascular risk factors were unaffected in the non-REM OSA group. Conclusion Arterial stiffness and glucose metabolism are deteriorated in patients with REM OSA compared with these parameters in patients with non-REM OSA after CPAP or OA treatment.

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Section: Discussionmentioning

confidence: 41%

Long-term outcomes regarding arterial stiffness and carotid artery atherosclerosis in female patients with rapid eye movement obstructive sleep apnea

et al. 2022

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“…The present study involved self-reported variables of whether a participant had a sleep disorder, the frequency of sleep deprivation, frequency of early morning wakefulness, and frequency of middle of the night wakefulness, which could evaluate the sleep disorder of the included participants in a more in-depth and detailed manner. Sleep disorders could cause dyslipidemia, including the level of total cholesterol, triglycerides, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol changes, leading to a lipid disorder promoting the deposition of fat in the arterial endothelium, causing atherosclerosis [ 29 , 30 ]. Also, stroke is considered to be highly related to atherosclerosis [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

Association Between Sleep Duration and Sleep Disorder Data from the National Health and Nutrition Examination Survey and Stroke Among Adults in the United States

Wang¹,

Ren²

2022

Med Sci Monit

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Background We aimed to explore the association between sleep duration and sleep disorder variables obtained from the National Health and Nutrition Examination Survey (NHANES) and stroke. Material/Methods This cross-sectional study enrolled 10 442 participants from the United States. The outcome variable was stroke diagnosed by a doctor. Sleep disorder variables were assessed via self-report questionnaires and included sleep duration, the time required to fall asleep, frequency of sleep deprivation, frequency of early morning wakefulness, and frequency of middle of the night wakefulness. The odds ratio (OR) and 95% confidence intervals (CIs) were calculated by multivariate logistic regression models. Results Compared with participants with 6 to 7 h of sleep duration, participants with less than 6 h of sleep duration had an increased risk of stroke of 0.97 times (OR=1.97, 95% CI: 1.19–3.29). Participants with a sleep disorder had 0.71 times (OR=1.71, 95% CI: 1.04–2.82) the risk of stroke than those without a sleep disorder. Stroke was significantly associated with sleep deprivation 16 to 30 times a month (OR=1.99, 95% CI: 1.14–3.46), early morning wakefulness 16 to 30 times a month (OR=1.97, 95% CI: 1.20–3.25), and middle of the night wakefulness 16 to 30 times a month (OR=1.81, 95% CI: 1.05–3.09), compared with no sleep deprivation, early-morning wakefulness, or middle of the night wakefulness. Conclusions Short sleep duration and sleep disorder were associated with an increased risk of stroke, suggesting healthy sleep behaviors may reduce the risk of stroke. However, further studies are needed to confirm the causality and underlying mechanism.

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“…22 Reduction in arousal index may clinically benefit since prior studies demonstrated detrimental effect of arousal. [23][24][25] Prior study conducted in healthy volunteers demonstrated that arousal index is a single strongest polysomnographic predictor of daytime sympathetic discharge which could pose risk of increased blood pressure. 23 In studies conducted in obstructive sleep apnea population, arousal index was demonstrated to be marker of carotid artery atherosclerosis, 24 risk of acute coronary syndrome, transient ischemic attack, and stroke or death.…”

Section: Discussionmentioning

confidence: 99%

“…[23][24][25] Prior study conducted in healthy volunteers demonstrated that arousal index is a single strongest polysomnographic predictor of daytime sympathetic discharge which could pose risk of increased blood pressure. 23 In studies conducted in obstructive sleep apnea population, arousal index was demonstrated to be marker of carotid artery atherosclerosis, 24 risk of acute coronary syndrome, transient ischemic attack, and stroke or death. 25 Furthermore, our study also demonstrated a trend toward increase in activity with the use of earplugs and eye masks compared to control group (p = 0.059).…”

Section: Discussionmentioning

confidence: 99%

Effect of Nighttime Earplugs and Eye Masks on Sleep Quality in Intensive Care Unit Patients

Arttawejkul¹,

Reutrakul²,

Muntham³

et al. 2019

Indian Journal of Critical Care Medicine

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Purpose: Poor sleep quality in intensive care unit (ICU) can be associated with poor outcome. Excessive noise and lights in ICU are known to disrupt patients' sleep by causing arousals. Study design: A prospective randomized controlled study. Materials and methods:The patients admitted to the medical ICU were prospectively included and randomized to receive earplugs and eye masks or no intervention during their first 5 nights in ICU. Their arousal index and other sleep parameters were measured during the first night by polysomnography. Secondary outcomes including wrist actigraphy profiles and subjective sleep quality were recorded during all study nights. Results: Seventeen patients were enrolled. Eight patients were randomized to earplugs and eye masks group and nine patients were randomized to control group during their first 5 nights in the ICU. The use of earplugs and eye masks demonstrated the trend toward lower arousal index during the first night (21.15 (14.60) vs 42.10 (18.20) events per hour, p = 0.086) and increased activity index (activity count/hour) (16.12 (7.99) vs 10.84 (10.39) count/hour, p = 0.059) compared to control group. Polysomnography and actigraphy did not demonstrate good agreement. Conclusion:The use of earplugs and eye masks has a trend toward reduction in arousal index and increased activity in patients admitted to ICU. Limited sample size most likely explained insignificant difference in outcomes. Wrist actigraphy did not accurately measure sleep parameters in ICU patients. Trial registration: www.clinicaltrials.in.th, TCTR20170727003.

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Arousal index as a marker of carotid artery atherosclerosis in patients with obstructive sleep apnea syndrome

Abstract: Several PSG variables that are indicative of sleep fragmentation, sleep disordered breathing, and poor sleep quality correlated with the occurrence of atherosclerosis, but total arousal index was the only independent predictive factor.

Cited by 14 publications

References 29 publications

Long-term outcomes regarding arterial stiffness and carotid artery atherosclerosis in female patients with rapid eye movement obstructive sleep apnea

Long-term outcomes regarding arterial stiffness and carotid artery atherosclerosis in female patients with rapid eye movement obstructive sleep apnea

Association Between Sleep Duration and Sleep Disorder Data from the National Health and Nutrition Examination Survey and Stroke Among Adults in the United States

Effect of Nighttime Earplugs and Eye Masks on Sleep Quality in Intensive Care Unit Patients

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