Effect of sleep surgery on blood pressure in adults with obstructive sleep apnea: A Systematic Review and meta-analysis

Kang, Kun‐Tai; Yeh, Te‐Huei; Ko, Jenq‐Yuh; Lee, Chia‐Hsuan; Lin, Ming‐Tzer; Hsu, Wei‐Chung

doi:10.1016/j.smrv.2022.101590

Cited by 14 publications

(15 citation statements)

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“…Third, positive airway pressure for OSA may reduce cardiovascular event risks in adults 66–68 . Future studies can further explore associations between cytokine changes and major cardiovascular events in adults receiving sleep surgery for OSA 69–71 . Fourth, surgical efficacy may decrease over time 72 .…”

Section: Discussionmentioning

confidence: 99%

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Effect of Sleep Surgery on Inflammatory Cytokines in Adult Obstructive Sleep Apnea: A Systematic Review and Meta‐Analysis

et al. 2022

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Objective To evaluate whether sleep surgery is associated with inflammatory cytokine changes. This study hypothesizes cytokines may change after surgery in adult obstructive sleep apnea (OSA). Study Design Systematic review and meta‐analysis. Methods The study protocol was registered on PROSPERO (CRD42020154425). Two authors independently searched PubMed, Embase, and Cochrane review databases from their inception to June 2021. The keywords used were sleep apnea, inflammatory markers, cytokines, and surgery. The effects of sleep surgery on the apnea–hypopnea index (AHI) and inflammatory cytokines were evaluated using a random‐effects model. Both mean difference (MD) and standardized mean difference (SMD) of the changes in cytokines were calculated. Results Nine studies with 235 adults were included (mean age: 43 years; 82% were men). After sleep surgery, AHI significantly reduced by −11.3 events/h (95% confidence interval [CI], −15.8 to −6.9). In total, 8 and 6 studies were pooled for examining tumor necrosis factor‐alpha (TNF‐α) and interleukin‐6 (IL‐6) levels, respectively. Sleep surgery significantly reduced TNF‐α levels, with an MD of −2.8 pg/ml (95% CI, −5.1 to −0.6) and an SMD of −0.56 (95% CI, −0.85 to −0.27). Furthermore, sleep surgery reduced IL‐6 levels, with an MD of −0.6 pg/ml (95% CI, −1.0 to −0.2) and an SMD of −0.66 (95% CI, −0.89 to −0.43). No covariates were identified to be correlated with cytokine changes in subgroup and meta‐regression analyses. Funnel plots showed possible publication bias in current data. Conclusions In adults, OSA treatment with sleep surgery improves inflammatory cytokines. Laryngoscope, 132:2275–2284, 2022

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Section: Discussionmentioning

confidence: 99%

“…[66][67][68] Future studies can further explore associations between cytokine changes and major cardiovascular events in adults receiving sleep surgery for OSA. [69][70][71] Fourth, surgical efficacy may decrease over time. 72 Current studies only investigated short-term cytokine changes after sleep surgery.…”

Section: Limitations and Future Directionsmentioning

confidence: 99%

Effect of Sleep Surgery on Inflammatory Cytokines in Adult Obstructive Sleep Apnea: A Systematic Review and Meta‐Analysis

et al. 2022

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“…It causes a sudden and frequent reduction in blood oxygen level, which may lead to awakening from sleep and reduce sleep quality (Abrishami et al, 2010;Franklin & Lindberg, 2015;Mirrakhimov et al, 2013). If blood oxygen saturation declines to less than 30% of normal condition during sleep apnea and continues for more than 15 s, it will be of paramount clinical importance (de Carvalho et al, 2022;Fernandes Fagundes et al, 2022;Freire et al, 2022; K.-T. Kang et al, 2022). In addition, increased sympathetic activation due to sleep apnea followed by hormonal disorders, in the long term can lead to the development of metabolic disorders, such as resistance to insulin, diabetes, and obesity (de Carvalho et al, 2022;Fernandes Fagundes et al, 2022;Freire et al, 2022; K.-T. Kang et al, 2022).…”

Section: Introductionmentioning

confidence: 99%

“…CSA happens when the brainstem is damaged in the region that controls breathing such that the brain cannot send the proper signals to the muscles to control breath (Bradley & Phillipson, 1992;Javaheri & Dempsey, 2013). OSA syndrome (OSAS) is the most common sleep apnea in which the airways through the mouth and nose are completely obstructed for 10 s or more due to large tonsils, tongue, or tissue in the airway (de Carvalho et al, 2022;Fernandes Fagundes et al, 2022;Freire et al, 2022; K.-T. Kang et al, 2022). Almost 5% of people worldwide suffer from OSAS.…”

Section: Introductionmentioning

confidence: 99%

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Automatic diagnosis of sleep apnea from biomedical signals using artificial intelligence techniques: Methods, challenges, and future works

Moridian

Shoeibi

Khodatars

et al. 2022

WIREs Data Min & Knowl

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Apnea is a sleep disorder that stops or reduces airflow for a short time during sleep. Sleep apnea may last for a few seconds and happen for many while sleeping. This reduction in breathing is associated with loud snoring, which may awaken the person with a feeling of suffocation. So far, a variety of methods have been introduced by researchers to diagnose sleep apnea, among which the polysomnography (PSG) method is known to be the best. Analysis of PSG signals is very complicated. Many studies have been conducted on the automatic diagnosis of sleep apnea from biological signals using artificial intelligence (AI), including machine learning (ML) and deep learning (DL) methods. This research reviews and investigates the studies on the diagnosis of sleep apnea using AI methods. First, computer aided diagnosis system (CADS) for sleep apnea using ML and DL techniques along with its parts including dataset, preprocessing, and ML and DL methods are introduced. This research also summarizes the important specifications of the studies on the diagnosis of sleep apnea using ML and DL methods in a table. In the following, a comprehensive discussion is made on the studies carried out in this field. The challenges in the diagnosis of sleep apnea using AI methods are of paramount importance for researchers. Accordingly, these obstacles are elaborately addressed. In another section, the most important future works for studies on sleep apnea detection from PSG signals and AI techniques are presented. Ultimately, the essential findings of this study are provided in the conclusion section. This article is categorized under: Technologies > Artificial Intelligence Application Areas > Data Mining Software Tools Algorithmic Development > Biological Data Mining

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Hypoglossal Nerve Stimulation and Cardiovascular Outcomes for Patients With Obstructive Sleep Apnea

Dedhia,

Bliwise,

Quyyumi

et al. 2024

JAMA Otolaryngol Head Neck Surg

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ImportanceSham-controlled trials are needed to characterize the effect of hypoglossal nerve stimulation (HGNS) therapy on cardiovascular end points in patients with moderate-severe obstructive sleep apnea (OSA).ObjectiveTo determine the effect of therapeutic levels of HGNS, compared to sham levels, on blood pressure, sympathetic activity, and vascular function.Design, Setting, and ParticipantsThis double-blind, sham-controlled, randomized crossover therapy trial was conducted from 2018 to 2022 at 3 separate academic medical centers. Adult patients with OSA who already had an HGNS device implanted and were adherent and clinically optimized to HGNS therapy were included. Participants who had fallen asleep while driving within 1 year prior to HGNS implantation were excluded from the trial. Data analysis was performed from January to September 2022.InterventionsParticipants underwent a 4-week period of active HGNS therapy and a 4-week period of sham HGNS therapy in a randomized order. Each 4-week period concluded with collection of 24-hour ambulatory blood pressure monitoring (ABPM), pre-ejection period (PEP), and flow-mediated dilation (FMD) values.Main Outcomes and MeasuresThe change in mean 24-hour systolic blood pressure was the primary outcome, with other ABPM end points exploratory, and PEP and FMD were cosecondary end points.ResultsParticipants (n = 60) were older (mean [SD] age, 67.3 [9.9] years), overweight (mean [SD] body mass index, calculated as weight in kilograms divided by height in meters squared, 28.7 [4.6]), predominantly male (38 [63%]), and had severe OSA at baseline (mean [SD] apnea-hypopnea index, 33.1 [14.9] events/h). There were no differences observed between active and sham therapy in 24-hour systolic blood pressure (mean change on active therapy, −0.18 [95% CI, −2.21 to 1.84] mm Hg), PEP (mean change on active therapy, 0.11 [95% CI, −5.43 to 5.66] milliseconds), or FMD (mean change on active therapy, −0.17% [95% CI, −1.88% to 1.54%]). Larger differences between active and sham therapy were observed in a per-protocol analysis set (n = 20) defined as experiencing at least a 50% reduction in apnea-hypopnea index between sham and active treatment.Conclusions and RelevanceIn this sham-controlled HGNS randomized clinical trial, mean 24-hour systolic blood pressure and other cardiovascular measures were not significantly different between sham and active HGNS therapy. Several methodologic lessons can be gleaned to inform future HGNS randomized clinical trials.Trial RegistrationClinicalTrials.gov Identifier: NCT03359096

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Effect of sleep surgery on blood pressure in adults with obstructive sleep apnea: A Systematic Review and meta-analysis

Cited by 14 publications

References 77 publications

Effect of Sleep Surgery on Inflammatory Cytokines in Adult Obstructive Sleep Apnea: A Systematic Review and Meta‐Analysis

Effect of Sleep Surgery on Inflammatory Cytokines in Adult Obstructive Sleep Apnea: A Systematic Review and Meta‐Analysis

Automatic diagnosis of sleep apnea from biomedical signals using artificial intelligence techniques: Methods, challenges, and future works

Hypoglossal Nerve Stimulation and Cardiovascular Outcomes for Patients With Obstructive Sleep Apnea

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