Impact of obstructive sleep apnea on silent cerebral small vessel disease: a systematic review and meta-analysis

Chokesuwattanaskul, Anthipa; Lertjitbanjong, Ploypin; Thongprayoon, Charat; Bathini, Tarun; Sharma, Konika; Mao, Michael A; Cheungpasitporn, Wisit; Chokesuwattanaskul, Ronpichai

doi:10.1016/j.sleep.2019.11.1262

Cited by 32 publications

(22 citation statements)

References 73 publications

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“…In addition, we quantified for the first time B-WMH demonstrating a significant association in patients with OSAHS compared to controls. These findings agree with previous studies [22][23][24] showing an association between SVD and OSAHS, suggesting also that vascular factors could be involved in the pathogenesis of SVD in patients. Lobar microbleeds were not associated with OSAHS [22,23].…”

Section: Discussionsupporting

confidence: 93%

“…These findings agree with previous studies [22][23][24] showing an association between SVD and OSAHS, suggesting also that vascular factors could be involved in the pathogenesis of SVD in patients. Lobar microbleeds were not associated with OSAHS [22,23].…”

Section: Discussionsupporting

confidence: 93%

“…Similar results seem to emerge from the study of Chokesuwattanaskul et al, who observed an association between OSAHS and CSVD MRI findings of WMH and asymptomatic lacunar infarction (ALI) when compared to patients without OSAHS [22]. A recent meta-analysis supports that moderate to severe sleep apnea is positively related to WMH and silent brain infarction (SBI), which suggests that OSAHS probably plays an important role to the pathogenesis of CSVD [23].…”

Section: Discussionsupporting

confidence: 68%

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Clinically Silent Small Vessel Disease of the Brain in Patients with Obstructive Sleep Apnea Hypopnea Syndrome

et al. 2021

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Obstructive sleep apnea hypopnea syndrome (OSAHS) is associated with increased risk of cerebrovascular disease. The aim of the present study was to investigate the association between the presence of the small vessel disease (SVD) of the brain in patients with OSAHS. The study included 24 patients with moderate to severe OSAHS and 34 healthy volunteers. All the subjects underwent magnetic resonance imaging (MRI) of the brain, in order to sought periventricular white matter (PVWM), deep white matter (DWM) and brainstem SVD. Among patients with OSAHS, 79.1% had SVD (grade 1–3, Fazekas score) in DWM and 91.7% in PVWM while 22.4% had brainstem—white matter hyperintensities (B-WMH). Patients with OSAHS had a much higher degree of SVD in the DWM and PVWM compared to the control group (p < 0.001). The multivariate analysis showed an independent significant association of OSAHS with SVD (DWM and PVWM) (p = 0.033, OR 95% CI: 8.66 (1.19–63.08) and: p = 0.002, OR 95% CI: 104.98 (5.15–2141)). The same analysis showed a moderate association of OSAHS with B-WMH (p = 0.050, OR 15.07 (0.97–234.65)). Our study demonstrated an independent significant association of OSAHS with SVD and a moderate association of OSAHS with B-WMH.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 68%

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Clinically Silent Small Vessel Disease of the Brain in Patients with Obstructive Sleep Apnea Hypopnea Syndrome

et al. 2021

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“…For heterogeneity, 5 results in 5 articles were reanalyzed owing to that they did not exhibit the outcomes of heterogeneity [ 22 , 36 , 46 , 59 , 64 ]. Among the 136 outcomes including the reanalyzed articles, 47 outcomes showed no heterogeneity between researches ( p ≥ 0.1 of Q test), whereas 69 indicated significant heterogeneity ( p < 0.1 of Q test).…”

Section: Resultsmentioning

confidence: 99%

An umbrella review of systematic reviews and meta-analyses of observational investigations of obstructive sleep apnea and health outcomes

Chen

Guo

et al. 2021

Sleep Breath

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Purpose The previous analysis of systematic reviews and meta-analyses have illustrated that obstructive sleep apnea (OSA) is correlated with multiple health outcomes. In the present research, our main aim was to execute an umbrella review to assess the available evidence for the associations between OSA and health outcomes. Methods Herein, a meta-analysis of previous observational investigations that have reported associations between OSA and health outcomes in all human populations and settings was performed. We used these studies to execute an umbrella review of available meta-analyses and systematic reviews. Results Sixty-six articles comprising 136 unique outcomes were enrolled in this analysis. Of the 136 unique outcomes, 111 unique outcomes had significant associations (p < 0.05). Only 7 outcomes (coronary revascularization after PCI, postoperative respiratory failure, steatosis, alaninetrans aminase (ALT) elevation, metabolic syndrome (MS), psoriasis, and Parkinson’s disease) had a high quality of evidence. Twenty-four outcomes had a moderate quality of evidence, and the remaining 80 outcomes had a weak quality of evidence. Sixty-nine outcomes exhibited significant heterogeneity. Twenty-five outcomes exhibited publication bias. Sixty-three (95%) studies showed critically low methodological quality. Conclusion Among the 66 meta-analyses exploring 136 unique outcomes, only 7 statistically significant outcomes were rated as high quality of evidence. OSA may correlate with an increased risk of coronary revascularization after PCI, postoperative respiratory failure, steatosis, ALT elevation, MS, psoriasis, and Parkinson’s disease.

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“…1 SAHS is one form of sleep-related breathing disorder, which encompasses obstructive sleep apnoea (OSA), 2 3 mixed sleep apnoea, 4 central sleep apnoea (CSA) 5 and sleep-related hypoventilation. 1 SAHS is a common comorbidity in patients with various diseases and is a risk factor for congestive heart failure, 6 7 myocardial infarction, 8 9 hypertension, [10][11][12] diabetes mellitus, [13][14][15] chronic obstructive pulmonary disease (COPD) [16][17][18][19] and cerebral disease, 20 which are also reasons for intensive care unit (ICU) admission.…”

Section: Introductionmentioning

confidence: 99%

Association between comorbid sleep apnoea–hypopnoea syndrome and prognosis of intensive care patients: a retrospective cohort study

et al. 2021

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ObjectiveIn this study, we investigated the association between comorbid sleep apnoea–hypopnoea syndrome (SAHS) and the prognosis of patients in an intensive care unit (ICU) to determine whether this relationship varies between different disease subgroups.MethodsWe conducted a retrospective cohort study using publicly available information from the critical care database Medical Information Mart for Intensive Care III. Adults (≥18 years of age) who attended the ICU for the first time were enrolled. Demographic information and clinical data were obtained from each patient. The primary outcome was 30-day mortality after ICU admission, and the secondary outcomes were in-hospital and ICU mortality. Multivariate logistic regression and Cox regression analyses were used to examine the associations between SAHS comorbidities and the research outcomes. Propensity score matching was used to adjust for potential confounding variables.ResultsOf the 32 989 patients enrolled, 1918 (5.81%) were diagnosed with SAHS as a comorbid condition. Patients with SAHS had a significantly lower 30-day mortality rate compared with those without SAHS (5.27% vs 13.65%, respectively; p<0.001). The frequency of chronic obstructive pulmonary disease, cerebral disease, cardiovascular disease, hypertension, diabetes mellitus and renal failure was significantly different between the two groups. Patients with SAHS demonstrated significantly longer survival compared with patients without SAHS. Multivariate Cox proportional hazards regression identified a significant relationship between SAHS and mortality within 30 days (adjusted HR=0.610, 95% CI 0.499 to 0.747, p<0.0001).ConclusionSAHS as a comorbid condition decreases the risk of 30-day mortality, in-hospital mortality and ICU mortality among ICU patients.

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Impact of obstructive sleep apnea on silent cerebral small vessel disease: a systematic review and meta-analysis

Cited by 32 publications

References 73 publications

Clinically Silent Small Vessel Disease of the Brain in Patients with Obstructive Sleep Apnea Hypopnea Syndrome

Clinically Silent Small Vessel Disease of the Brain in Patients with Obstructive Sleep Apnea Hypopnea Syndrome

An umbrella review of systematic reviews and meta-analyses of observational investigations of obstructive sleep apnea and health outcomes

Association between comorbid sleep apnoea–hypopnoea syndrome and prognosis of intensive care patients: a retrospective cohort study

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