Fatigue and sleepiness determine respiratory quality of life among veterans evaluated for sleep apnea

Vinnikov, Denis; Blanc, Paul D.; Alilin, Alaena; Zutler, Moshe; Holty, Jon-Erik C

doi:10.1186/s12955-017-0624-x

Cited by 24 publications

(16 citation statements)

References 50 publications

(72 reference statements)

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“…The location of the enhanced inflammation varies with the type of autoimmune disease and the progression of the condition. Fatigue is observed in non-autoimmune disease and related conditions that have increased inflammation in the periphery and/or CNS, including cancer (38), sleep disorders (31, 39, 40), stroke (41, 42), and traumatic brain injury (43, 44). Several non-inflammatory factors are known to be affect fatigue including impairments in hydration status (45), pain (46), interactions from pharmaceuticals (47), muscle/exercise (48), hypothyroidism (49), radiation therapy (50), lung function, and cardiovascular characteristics such as blood pressure, heart rate, cardiac output, and stroke volume (51, 52).…”

Section: Inflammationmentioning

confidence: 99%

Fatigue, Sleep, and Autoimmune and Related Disorders

2019

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Profound and debilitating fatigue is the most common complaint reported among individuals with autoimmune disease, such as systemic lupus erythematosus, multiple sclerosis, type 1 diabetes, celiac disease, chronic fatigue syndrome, and rheumatoid arthritis. Fatigue is multi-faceted and broadly defined, which makes understanding the cause of its manifestations especially difficult in conditions with diverse pathology including autoimmune diseases. In general, fatigue is defined by debilitating periods of exhaustion that interfere with normal activities. The severity and duration of fatigue episodes vary, but fatigue can cause difficulty for even simple tasks like climbing stairs or crossing the room. The exact mechanisms of fatigue are not well-understood, perhaps due to its broad definition. Nevertheless, physiological processes known to play a role in fatigue include oxygen/nutrient supply, metabolism, mood, motivation, and sleepiness—all which are affected by inflammation. Additionally, an important contributing element to fatigue is the central nervous system—a region impacted either directly or indirectly in numerous autoimmune and related disorders. This review describes how inflammation and the central nervous system contribute to fatigue and suggests potential mechanisms involved in fatigue that are likely exhibited in autoimmune and related diseases.

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Section: Inflammationmentioning

confidence: 99%

Fatigue, Sleep, and Autoimmune and Related Disorders

2019

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“…The British Society of Sexual Medicine Guidelines [8] reports a prevalence ranging from 10 to 52% from several large studies, with a steep age-related increase. ED shares many associated physical conditions with OSA and both have also been demonstrated to affect psychosocial health [4][5][6][8][9][10][11].…”

Section: Journal Of Sleep Disorders and Therapy Review Articlementioning

confidence: 99%

“…It is estimated that the worldwide prevalence is between 9 and 38% [2], however the prevalence in the UK is thought to be just 4% [3]. Patients with OSA have reported increased fatigue, poor quality of life, deterioration of personal relationships, and reduced libido [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Erectile Dysfunction and Obstructive Sleep Apnoea-What is the Link and What can We do about it? A Descriptive Review of the Current Literature

Polson¹,

Ralph²,

Kalejaiye³

2019

J Sleep Disord Ther

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Erectile dysfunction (ED) and obstructive sleep apnoea (OSA) are increasingly common conditions seen in primary and secondary care. With shared risk factors and associated comorbidities men often suffer with both. The aim of this study is to review the literature to consider why there is a correlation, and clinically how assessment and management of such patients could be adjusted. A structured review of current literature was performed using search terms 'erectile dysfunction' or 'erectile function' or 'Erection' or 'Sexual dysfunction' AND 'Sleep apnoea/apnea' or 'sleep disorder'. Descriptive analysis categorized results into: The association between OSA and ED; the pathophysiological hypotheses; the role of OSA treatment; and the role of ED treatment. Higher prevalence of ED in patients with OSA is demonstrated, particularly in men with more severe OSA disease, reaching 80% in some studies. However, the pathophysiological explanation remains unclear with a number of hypotheses researched. CPAP is the mainstay of treatment for OSA, and short and long-term benefits to sexual function are demonstrated in men with severe OSA from it's use. Further improvement in ED and quality of life can be achieved by additional PDE5 inhibitor therapy. With the increasing evidence base showing higher rates of ED in OSA patients there is certainly a role for clinicians in both OSA and ED clinics to enquire about each condition. A referral to their counterpart for consideration of combination treatment with CPAP and a PDE5 inhibitor for both of these problematic, life changing diseases is recommended-particularly in those with severe disease. Further investigation is needed to try and establish any pathophysiological link, and the impact of treatment in less severe cases.

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“…Excessive daytime sleepiness (EDS), is estimated to affect between 10 to 20% of the population 1,2 . EDS is associated with numerous adverse clinical, behavioral and public health outcomes, including work and vehicular accidents 3-10 ; reduced health-related quality of life 11-13 ; cognitive and performance deficits 14,15 ; and increased rates of stroke and total and cardiovascular mortality 16,17 . There are multiple mechanisms for EDS, including insufficient sleep duration due to behavioral, social or work-related factors; sleep disruption due to a sleep disorder (sleep apnea, periodic limb movement disorder); circadian misalignment; or the presence of a primary disorder of hypersomnia that affects the central sleep-wake control processes (e.g., narcolepsy).…”

Section: Introductionmentioning

confidence: 99%

Epigenome-wide association analysis of daytime sleepiness in the Multi-Ethnic Study of Atherosclerosis reveals African-American specific associations

Barfield

Wang

Liu

et al. 2018

Preprint

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3 Study Objectives: Excessive daytime sleepiness (EDS) is a consequence of inadequate sleep, or of a primary disorder of sleep-wake control. Population variability in prevalence of EDS and susceptibility to EDS are likely due to genetic and biological factors as well as social and environmental influences. Epigenetic modifications (such as DNA methylation-DNAm) are potential influences on a range of health outcomes. Here, we explored the association between DNAm and daytime sleepiness quantified by the Epworth Sleepiness Scale (ESS). Methods:We performed multi-ethnic and ethnic-specific epigenome-wide association studies for DNAm and ESS in 619 individuals from the Multi-Ethnic Study of Atherosclerosis. Replication was assessed in the Cardiovascular Health Study (CHS). Genetic variants in genes proximal to ESS-associated DNAm were analyzed to identify methylation quantitative trait loci and followed with replication of genotype-sleepiness associations in the UK Biobank.Results: 61 methylation sites were associated with ESS (FDR ≤ 0.1) in African Americans only, including an association in KCTD5, a gene strongly implicated in sleep. One association (cg26130090) replicated in CHS African Americans (p-value 0.0004). We identified a sleepinessassociated methylation site in the gene RAI1, a gene associated with sleep and circadian phenotypes. In a follow-up analysis, a genetic variant within RAI1 associated with both DNAm and sleepiness score. The variant's association with sleepiness was replicated in the UK Biobank. Conclusions:Our analysis identified methylation sites in multiple genes that may be implicated in EDS. These sleepiness-methylation associations were specific to African Americans. Future work is needed to identify mechanisms driving ancestry-specific methylation effects. 4Excessive daytime sleepiness is associated with negative health outcomes such as reduction in quality of life, increased workplace accidents, and cardiovascular mortality. There are race/ethnic disparities in excessive daytime sleepiness, however, the environmental and biological mechanisms for these differences are not yet understood. We performed an association analysis of DNA methylation, measured in monocytes, and daytime sleepiness within a racially diverse study population. We detected numerous DNA methylation markers associated with daytime sleepiness in African Americans, but not in European and Hispanic Americans. Future work is required to elucidate the pathways between DNA methylation, sleepiness, and related behavioral/environmental exposures. analysis using the lumi Bioconductor package 37 . These included color bias adjustments via smooth quantile normalization, median background adjustment, standard quantile adjustment, checks for potential sex or race mismatches, and outlier detection via multidimensional plots.Additional details on pre-processing of the DNAm data can be found in Liu et al 34 . Following DNAm preprocessing, each of 484,882 methylation probes for each person has a Beta-value, representing the proportion ...

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Fatigue and sleepiness determine respiratory quality of life among veterans evaluated for sleep apnea

Cited by 24 publications

References 50 publications

Fatigue, Sleep, and Autoimmune and Related Disorders

Fatigue, Sleep, and Autoimmune and Related Disorders

Erectile Dysfunction and Obstructive Sleep Apnoea-What is the Link and What can We do about it? A Descriptive Review of the Current Literature

Epigenome-wide association analysis of daytime sleepiness in the Multi-Ethnic Study of Atherosclerosis reveals African-American specific associations

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