Changes of vitamin D levels and bone turnover markers after <scp>CPAP</scp> therapy: a randomized sham‐controlled trial

Theorell‐Haglöw, Jenny; Hoyos, Camilla M.; Phillips, Craig L.; Yee, Brendon J.; Herrmann, Markus; Brennan‐Speranza, Tara C.; Grunstein, Ronald R.; Liu, Yang

doi:10.1111/jsr.12606

Cited by 14 publications

(10 citation statements)

References 34 publications

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“…Liguori et al found increased levels of 25(OH)D after 7 nights of CPAP therapy in male OSA patients, and after 1 year of treatment mainly in obese OSA patients [ 27 , 28 ]. Similar conclusions were reached in a randomized sham-controlled trial, where 24 weeks of CPAP treatment improved Vit D serum levels ( p = 0.045) in patients with severe OSA [ 29 ]. In the present study, Vit D serum levels were strongly associated with AHI.…”

Section: Discussionsupporting

confidence: 75%

Vitamin D Levels in Patients with Overlap Syndrome, Is It Associated with Disease Severity?

Archontogeorgis

Voulgaris

Nena

et al. 2022

JPM

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Background: The coexistence of chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) has been defined as overlap syndrome (OVS). Recently, a link between OSA, COPD and Vitamin D (Vit D) serum concentration was reported, however, evidence regarding Vit D status in patients with OVS is scarce. The aim of the present study was to evaluate Vit D serum levels and to explore the association of those levels with anthropometric, pulmonary function and sleep parameters in patients with OVS. Methods: Vit D serum levels were measured in patients diagnosed with OVS, as confirmed by overnight polysomnography and pulmonary function testing. Results: A total of 90 patients (79 males and 11 females) were included in the analysis. The patients were divided into three groups matched for age, gender, and BMI: the control group that included 30 patients (27 males and 3 females), the OSA group that included 30 patients (26 males and 4 females), and the OVS group that included 30 patients (26 males and 4 females). Patients with OVS exhibited decreased serum 25(OH)D levels compared with OSA patients and controls (14.5 vs. 18.6 vs. 21.6 ng/mL, p < 0.001). In the OVS group, multiple linear regression analysis identified AHI and FEV1, as predictors of serum 25(OH)D levels (p = 0.041 and p = 0.038, respectively). Conclusions: Lower Vit D levels have been observed in patients with OVS compared with OSA patients and non-apneic controls, indicating an increased risk of hypovitaminosis D in this population which might be associated with disease severity.

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Section: Discussionsupporting

confidence: 75%

Vitamin D Levels in Patients with Overlap Syndrome, Is It Associated with Disease Severity?

Archontogeorgis

Voulgaris

Nena

et al. 2022

JPM

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“…[79] randomised 64 OSAS patients to either real or sham CPAP treatment for 12 weeks. All participants then received real CPAP therapy for an additional 12 weeks.…”

Section: Cpap Treatment and Vitamin Dmentioning

confidence: 99%

The role of vitamin D in obstructive sleep apnoea syndrome

Archontogeorgis

Nena

Παπάνας

et al. 2018

Breathe

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Obstructive sleep apnoea syndrome (OSAS) is a common disorder of multifactorial pathogenesis and is associated with obesity, diabetes and cardiovascular disease. Vitamin D is a fat-soluble vitamin with an important function in calcium absorption and homeostasis, which is also implicated in several nonskeletal conditions. The prevalence of vitamin D deficiency is increasing worldwide and is associated with similar metabolic disturbances to OSAS. Moreover, recent data suggest that in OSAS patients serum levels of vitamin D are lower compared with non-apnoeic subjects. However, the mechanisms linking vitamin D deficiency and OSAS are not completely understood and several hypotheses have been advanced. To date, a limited number of studies have assessed the association between lower serum concentrations of vitamin D and OSAS, and have reported inconsistent results. Similarly, contradictory results have been produced by studies which evaluated the effect of continuous positive airway pressure treatment on serum vitamin D levels. The aim of this review is to summarise current knowledge on the association between OSAS and vitamin D levels.Key pointsVitamin D insufficiency prevalence is increasing worldwide and presents with similar comorbidities and risk factors to OSAS.The nonskeletal actions of vitamin D may contribute to the development of OSAS through immune system modulation, myopathy and inflammation.Studies evaluating serum vitamin D concentrations in OSAS patients and the effect of CPAP treatment report contradictory results, often influenced by confounding factors, such as obesity.There appears to be potential for use of vitamin D supplementation in OSAS patients as a means of reducing the incidence of cardiovascular disease, a comorbidity common in both conditions.Educational aimsTo assess the potential association between OSAS and serum levels of vitamin D.To discuss the pathogenetic mechanisms linking OSAS and vitamin D insufficiency.To illustrate the effect of CPAP treatment on vitamin D concentration in OSAS patients.

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“…We also lacked information on OSA treatment, although prior research suggests that OSA treatment did not change bone turnover markers. ( 69 ) Of note, despite lack of data on OSA severity or nocturnal hypoxia burden, the difference seen by OSA symptoms (eg, EDS and snoring) suggest potential dose–response relationships between OSA severity and VF, providing additional biologic plausibility for this association. Third, our definition of clinical VF required coming to medical attention, which limited our ability to identify asymptomatic cases or confirm certain self‐reported cases (eg, we did not have permission, were unable to obtain the medical record, or there was insufficient evidence in the record to make a definitive VF diagnosis).…”

Section: Discussionmentioning

confidence: 99%

Obstructive Sleep Apnea and Risk for Incident Vertebral and Hip Fracture in Women

Huang

Tworoger

Redline

et al. 2020

Journal of Bone and Mineral Research

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Recent studies suggest a positive association between obstructive sleep apnea (OSA), a disorder associated with intermittent hypoxia and sleep fragmentation, and derangements in bone metabolism. However, no prospective study to date has investigated the association between OSA and fracture risk in women. We conducted a prospective study examining the relation between OSA and risk of incident vertebral fracture (VF) and hip fracture (HF) in the Nurses' Health Study. History of physician-diagnosed OSA was assessed by self-reported questionnaires. A previous validation study demonstrated high concordance between self-reports and medical record identification of OSA. OSA severity was further categorized according to the presence or absence of self-reported sleepiness. Selfreports of VF were confirmed by medical record review. Self-reported HF was assessed by biennial questionnaires. Cox proportional-hazards models estimated the hazard ratio for fracture according to OSA status, adjusted for potential confounders, including BMI, physical activity, calcium intake, history of osteoporosis, and falls, and use of sleep medications. Among 55,264 women without prior history of fracture, physician-diagnosed OSA was self-reported in 1.3% in 2002 and increased to 3.3% by 2012. Between 2002 and 2014, 461 incident VF cases and 921 incident HF cases were documented. The multivariable-adjusted hazard ratio (HR) for confirmed VF for women with history of OSA was 2.00 (95% CI, 1.29-3.12) compared with no OSA history, with the strongest association observed for OSA with daytime sleepiness (HR 2.86; 95% CI, 1.31-6.21). No association was observed between OSA history and self-reported HF risk (HR 0.83; 95% CI, 0.49-1.43). History of OSA is independently associated with higher risk of confirmed VF but did not have a statistically significant association with self-reported HF in women. Further research is warranted in understanding the role of OSA and intermittent hypoxia in bone metabolism and health that may differ by fracture site.

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Changes of vitamin D levels and bone turnover markers after CPAP therapy: a randomized sham‐controlled trial

Cited by 14 publications

References 34 publications

Vitamin D Levels in Patients with Overlap Syndrome, Is It Associated with Disease Severity?

Vitamin D Levels in Patients with Overlap Syndrome, Is It Associated with Disease Severity?

The role of vitamin D in obstructive sleep apnoea syndrome

Obstructive Sleep Apnea and Risk for Incident Vertebral and Hip Fracture in Women

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