Cardiovascular Consequences of Obstructive Sleep Apnea

Dredla, Brynn K.; Castillo, Pablo R.

doi:10.1007/s11886-019-1228-3

Cited by 43 publications

(30 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…2 Obstructive sleep apnea (OSA) is probably the most common sleep breathing disorder, and it has been identified as a risk factor for hypertension, heart disease, stroke, and obesity among others. [2][3][4] The laboratory overnight polysomnography (PSG) also called type 1 study, is the standard diagnostic test for identifying OSA. Nevertheless, this test can be expensive and time-consuming.…”

Section: Introductionmentioning

confidence: 99%

<p>The Evaluation of Autonomic Arousals in Scoring Sleep Respiratory Disturbances with Polysomnography and Portable Monitor Devices: A Proof of Concept Study</p>

Mayer

Babiloni

Beetz

et al. 2020

NSS

View full text Add to dashboard Cite

Background: Autonomic arousals can be considered as surrogates of electroencephalography (EEG) arousals when calculating respiratory disturbance index (RDI). The main objective of this proof of concept study was to evaluate the use of heart rate acceleration (HRa) arousals associated with sleep respiratory events in a population undergoing full polysomnography (type 1) and in another undergoing portable monitor study (type 3). Our hypothesis is that when compared to other commonly used indexes, RDI based on HRa will capture more events in both types of recording. Materials and Methods: A retrospective analysis was performed in two different populations of patients with suspected OSA: a) 72 patients undergoing one night of type 1 recording and b) 79 patients undergoing one night of type 3 recording. Variables for type 1 were 4% oxygen desaturation index (ODI), apnea/hypopnea index (AHI), RDI based on EEG arousals (RDIe), and RDI based on HRa with threshold of 5bpm (RDIa5). For type 3, variables were 4% ODI, AHI, and RDIa5 (it is not possible to calculate RDIe due to the absence of EEG). Calculated data were 1) Mean values for each sleep disturbance index in type 1 and 3 recordings; 2) Frequency of migration from lower to higher OSA severity categories using RDIa5 in comparison to AHI (thresholds: ≥5/h mild, ≥15/h moderate, ≥30/h severe); and 3) Bland-Altman plots to assess agreement between AHI vs RDIe and RDIa5 in type 1 population, and AHI vs RDIa5 in type 3 populations. Results: More respiratory disturbance events were captured with RDIa5 index in both type 1 and type 3 recordings when compared to the other indexes. In type 1 recording, when using RDIa5 37% of patients classified as not having OSA with AHI were now identified as having OSA, and a total of 59% migrated to higher severity categories. In type 3 recording, similar results were obtained, as 37% of patients classified as not having OSA with AHI were now identified as having OSA using RDIa5, and a total of 55% patients migrated to higher severity categories. Mean differences for RDIa5 and AHI in type 1 and 3 populations were similar. Conclusion: The use of autonomic arousals such as HRa can help to detect more respiratory disturbance events when compared to other indexes, being a variable that may help to capture borderline mild cases. This becomes especially relevant in type 3 recordings. Future research is needed to determine its validity, optimization, and its clinical significance.

show abstract

Section: Introductionmentioning

confidence: 99%

<p>The Evaluation of Autonomic Arousals in Scoring Sleep Respiratory Disturbances with Polysomnography and Portable Monitor Devices: A Proof of Concept Study</p>

Mayer

Babiloni

Beetz

et al. 2020

NSS

View full text Add to dashboard Cite

show abstract

“…3 It is also known that OSA increases risk of resistant arterial hypertension, coronary artery disease, heart failure, pulmonary hypertension, and various cardiovascular conditions. 4 Moreover, investigations demonstrated the association between OSA and cardiac remodeling. However, these studies were usually concentrated on left ventricular (LV) structure and function, which mainly included basic echocardiographic parameters such as LV hypertrophy, LV ejection fraction, and several basic parameters of LV diastolic (dys)function.…”

mentioning

confidence: 99%

“…The percentage of OSA in patients with resistant arterial hypertension is remarkable. 4 The RESIST-POL study included patients with resistant hypertension and divided them into four groups using OSA and metabolic syndrome as criteria and found that patients with OSA and metabolic syndrome had the lowest LV longitudinal strain, even though blood pressure level, LV mass index, and prevalence | 121 CUSPIDI anD TaDIC of LV hypertrophy was similar between four groups. 9 Interestingly, the authors did not find significant difference between patients with isolated OSA and isolated metabolic syndrome.…”

mentioning

confidence: 99%

Obstructive sleep apnea and left ventricular strain: Useful tool or fancy gadget?

Cuspidi

Tadić

2019

J of Clinical Hypertension

View full text Add to dashboard Cite

Obstructive sleep apnea (OSA) syndrome is the most common sleep-breathing disorder, which is characterized with snoring, interruptions in breading during sleeping, or daytime sleepiness, and choking or gasping during sleep. Polysomnography defined OSA as 5 or more episodes of obstructive apneas/hypopneas per hour during sleep. 1,2 There are many risk factors for OSA, but the most important is obesity, and therefore, many studies are devoted to the assessment of the influence of weight reduction in OSA. 3 It is also known that OSA increases risk of resistant arterial hypertension, coronary artery disease, heart failure, pulmonary hypertension, and various cardiovascular conditions. 4 Moreover, investigations demonstrated the association between OSA and cardiac remodeling. However, these studies were usually concentrated on left ventricular (LV) structure and function, which mainly included basic echocardiographic parameters such as LV hypertrophy, LV ejection fraction, and several basic parameters of LV diastolic (dys)function. 5 Investigations regarding LV mechanics in patients with OSA are scarce.Altekin et al 6 included 58 OSA patients with different severity of OSA. Patients were classified as mild OSA when the apnea-hypopnea index (AHI) was between 5 and 15, moderate OSA was diagnosed in patients with AHI between 15 and 30 and severe OSA was defined as AHI higher than 30. 6 The authors reported that main parameters of LV diastolic function (E/A, E/e′, mitral deceleration time, left atrial volume index) deteriorated gradually from mild to severe OSA. 6 More interestingly, the authors found gradual reduction in LV longitudinal strain from mild, across moderate, to severe OSA. The reduction in LV circumferential and radial strain was revealed in moderate and severe OSA patients, but not in those with mild OSA. However, strain rates referring to LV mechanics during early and late diastole also gradually deteriorated from mild to severe OSA in all three directions-longitudinal, circumferential, and radial. 6 The correlation between AHI and LV longitudinal strain and strain rates was significantly stronger than between AHI and parameters of LV diastolic function. 6 On the other hand, there was no correlation between AHI and LV ejection fraction and only weak correlation with LV mass index. 6 One should underline that there was no significant difference in body mass index (BMI) between three observed groups. However, the authors did not perform multivariate regression analysis including BMI in the model in order to exclude potential effect of obesity on the final results. Varghese et al 7 also reported significantly lower LV longitudinal strain in patients with severe OSA, but without significant difference in LV circumferential strain. LV longitudinal strain, but not circumferential strain, was found to correlate significantly with AHI. 7 Cho et al 8 included 25 patients with OSA and compared LV remodeling in these patients with healthy controls and obese patients, as well as the impact of bariatric surgery in pati...

show abstract

“…b Usually prohibit daily activities. 4 Case Reports in Otolaryngology damage, platelet aggregation, and chronic systemic and pulmonary hypertension [5]. Migraine, perhaps through the mechanism of ischaemia from vasospasm, frequently occurred in OSA particularly in the younger patients [15].…”

Section: Discussionmentioning

confidence: 99%

Concomitant Obstructive Sleep Apnoea in Patients with Meniere’s Disease: A Case Report and Literature Review

Low

Lim

2021

Case Reports in Otolaryngology

View full text Add to dashboard Cite

Meniere’s disease (MD) is a condition characterised by fluctuating and progressive hearing loss, aural fullness, tinnitus, and intermittent attacks of vertigo. The disabling vertigo symptoms can be controlled in most patients by lifestyle changes and medications such as diuretics. Should standard medical therapy fail, the patient may require surgery in order to control the disease, but such surgical procedures can be functionally destructive. Obstructive sleep apnoea syndrome (OSAS) is common, especially in people who are grossly overweight. Up to 15% of patients with MD may have concomitant OSA. Unless the OSA is well controlled, such patients may continue to experience MD symptoms despite receiving adequate standard medical therapy for MD. Moreover, MD patients may experience insomnia as a result of vertigo and/or tinnitus where sedatives are indicated. The use of sedatives with muscle relaxant properties may inadvertently further aggravate OSA resulting in a vicious cycle of symptoms. Symptoms suggestive of concomitant OSA must be proactively sought as these patients do not necessarily exhibit the obvious phenotypic features of OSA. This is especially so in Asians where OSAS is commonly observed in people who are not overly obese. We report a case of a female patient who presented with recalcitrant MD disease and was later found to have concomitant OSA. The relevant literature will be reviewed, and learning points will be discussed from the perspective of the otologist/neurotologist. The clinician must always be mindful of the existence of concomitant “silent” OSAS as this impacts the management of patients with MD.

show abstract

Cardiovascular Consequences of Obstructive Sleep Apnea

Cited by 43 publications

References 46 publications

<p>The Evaluation of Autonomic Arousals in Scoring Sleep Respiratory Disturbances with Polysomnography and Portable Monitor Devices: A Proof of Concept Study</p>

<p>The Evaluation of Autonomic Arousals in Scoring Sleep Respiratory Disturbances with Polysomnography and Portable Monitor Devices: A Proof of Concept Study</p>

Obstructive sleep apnea and left ventricular strain: Useful tool or fancy gadget?

Concomitant Obstructive Sleep Apnoea in Patients with Meniere’s Disease: A Case Report and Literature Review

Contact Info

Product

Resources

About