Impact of sleep apnea and treatments on cardiovascular disease

Faria, André Luiz Lopes de; Macedo, Arthur Cassa; Castro, Carolina De; Valle, Elke; Lacerda, Raquel; Ayas, Najib; Laher, Ismail

doi:10.5935/1984-0063.20220047

Cited by 8 publications

(10 citation statements)

References 119 publications

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“…First, the use of common wristwatch devices for SA screening is to increase the likelihood of detecting SA, especially in those who do not recognize the need for specialized equipment or access to laboratories for SA detection. Given that the majority of SA patients (over 80%) are undiagnosed 6 and the serious impact of SA on patients’ quality of life and social and health economics 3 , increasing SA screening opportunities is an important social need.…”

Section: Discussionmentioning

confidence: 99%

“…Sleep apnea (SA) is characterized by repeated episodes of apnea and hypopnea due to upper airway collapse and obstruction or cessation of central respiratory drive during sleep associated with subsequent arousal from sleep. SA is a common health problem affecting 10–30% of adults 1 , 2 , but the consequences are serious 3 . For instance, poor sleep quality due to SA is associated with daytime sleepiness that reduces work performance and cognitive ability and increases the risk of traffic accidents 4 – 6 .…”

Section: Introductionmentioning

confidence: 99%

“…However, patients with SA, even if they have symptoms such as insomnia or daytime sleepiness, are unlikely to be examined with those SA testing devices, unless they suspect that their symptoms may be caused by SA. In fact, the majority (over 80%) of SA patients still remains undiagnosed 6 and potential patients with SA are considered a major burden of the healthcare system 3 . There is a need to develop screening methods for SA that have the opportunity to be accessed by more people, including those who may be unaware that they have SA or unaware of the need for SA testing.…”

Section: Introductionmentioning

confidence: 99%

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Quantitative detection of sleep apnea in adults using inertial measurement unit embedded in wristwatch wearable devices

Hayano,

Adachi,

Sasaki

et al. 2024

Sci Rep

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Sleep apnea (SA) is associated with risk of cardiovascular disease, cognitive decline, and accidents due to sleepiness, yet the majority (over 80%) of patients remain undiagnosed. Inertial measurement units (IMUs) are built into modern wearable devices and are capable of long-term continuous measurement with low power consumption. We examined if SA can be detected by an IMU embedded in a wristwatch device. In 122 adults who underwent polysomnography (PSG) examinations, triaxial acceleration and triaxial gyro signals from the IMU were recorded during the PSG. Subjects were divided into a training group and a test groups (both n = 61). In the training group, an algorithm was developed to extract signals in the respiratory frequency band (0.13–0.70 Hz) and detect respiratory events as transient (10–90 s) decreases in amplitude. The respiratory event frequency estimated by the algorithm correlated with the apnea–hypopnea index (AHI) of the PSG with r = 0.84 in the test group. With the cutoff values determined in the training group, moderate-to-severe SA (AHI ≥ 15) was identified with 85% accuracy and severe SA (AHI ≥ 30) with 89% accuracy in the test group. SA can be quantitatively detected by the IMU embedded in wristwatch wearable devices in adults with suspected SA.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Quantitative detection of sleep apnea in adults using inertial measurement unit embedded in wristwatch wearable devices

Hayano,

Adachi,

Sasaki

et al. 2024

Sci Rep

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“…These regions are critical for sustained attention and attention allocation (Chang et al., 2020 ; Orosz et al., 2012 ; Schneider et al., 2022 ; Zhang et al., 2018 ). The hypoperfusion in these attention networks could contribute to the impaired attention and vigilance commonly reported in OSA patients (Faria et al., 2021 ; Legault et al., 2021 ). The reduced CBF and CBV were also associated with OSA severity measures like lower minimum SpO 2 and sleep fragmentation, suggesting that the neural abnormalities are related to the physiological impacts of OSA (L'Heureux et al., 2021 ; Macey, 2015 ).…”

Section: Discussionmentioning

confidence: 99%

Obstructive sleep apnea and attention deficits: A systematic review of magnetic resonance imaging biomarkers and neuropsychological assessments

Ghaderi,

Mohammadi,

Mohammadi

2023

Brain and Behavior

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Background and objectiveObstructive sleep apnea (OSA) is a common sleep disorder that causes intermittent hypoxia and sleep fragmentation, leading to attention impairment and other cognitive deficits. Magnetic resonance imaging (MRI) is a powerful modality that can reveal the structural and functional brain alterations associated with attention impairment in OSA patients. The objective of this systematic review is to identify and synthesize the evidence on MRI biomarkers and neuropsychological assessments of attention deficits in OSA patients.MethodsWe searched the Scopus and PubMed databases for studies that used MRI to measure biomarkers related to attention alteration in OSA patients and reported qualitative and quantitative data on the association between MRI biomarkers and attention outcomes. We also included studies that found an association between neuropsychological assessments and MRI findings in OSA patients with attention deficits.ResultsWe included 19 studies that met our inclusion criteria and extracted the relevant data from each study. We categorized the studies into three groups based on the MRI modality and the cognitive domain they used: structural and diffusion tensor imaging MRI findings, functional, perfusion, and metabolic MRI findings, and neuropsychological assessment findings.ConclusionsWe found that OSA is associated with structural, functional, and metabolic brain alterations in multiple regions and networks that are involved in attention processing. Treatment with continuous positive airway pressure can partially reverse some of the brain changes and improve cognitive function in some domains and in some studies. This review suggests that MRI techniques and neuropsychological assessments can be useful tools for monitoring the progression and response to treatment of OSA patients.

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“…One of the hallmarks of OSA is chronic intermittent hypoxia (CIH), which plays a major role in pathogenesis and deleterious consequences of cardiovascular diseases (CVD) and neurocognitive dysfunction. Indeed, previous research has firmly established the existence of relatively strong and independent associations between CIH and cardiovascular comorbidities, such as systemic hypertension, coronary artery disease, ischaemic stroke, arrhythmia and heart failure (Faria et al., 2022; Javaheri et al., 2017). This is associated with autonomic dysregulation expressed as increased sympathetic discharge and a shift in heart rate variability from high to low‐frequency bands (related to sympathetic overactivity) (Floras & Ponikowski, 2015).…”

Section: Introductionmentioning

confidence: 99%

Chronic intermittent hypoxia remodels catecholaminergic nerve innervation in mouse atria

Bizanti,

Zhang,

Toledo

et al. 2023

The Journal of Physiology

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Chronic intermittent hypoxia (CIH, a model for sleep apnoea) is a major risk factor for several cardiovascular diseases. Autonomic imbalance (sympathetic overactivity and parasympathetic withdrawal) has emerged as a causal contributor of CIH‐induced cardiovascular disease. Previously, we showed that CIH remodels the parasympathetic pathway. However, whether CIH induces remodelling of the cardiac sympathetic innervation remains unknown. Mice (male, C57BL/6J, 2–3 months) were exposed to either room air (RA, 21% O2) or CIH (alternating 21% and 5.7% O2, every 6 min, 10 h day–1) for 8–10 weeks. Flat‐mounts of their left and right atria were immunohistochemically labelled for tyrosine hydroxylase (TH, a sympathetic marker). Using a confocal microscope (or fluorescence microscope) and Neurlocudia 360 digitization and tracing system, we scanned both the left and right atria and quantitatively analysed the sympathetic axon density in both groups. The segmentation data was mapped onto a 3D mouse heart scaffold. Our findings indicated that CIH significantly remodelled the TH immunoreactive (‐IR) innervation of the atria by increasing its density at the sinoatrial node, the auricles and the major veins attached to the atria (P < 0.05, n = 7). Additionally, CIH increased the branching points of TH‐IR axons and decreased the distance between varicosities. Abnormal patterns of TH‐IR axons around intrinsic cardiac ganglia were also found following CIH. We postulate that the increased sympathetic innervation may further amplify the effects of enhanced CIH‐induced central sympathetic drive to the heart. Our work provides an anatomical foundation for the understanding of CIH‐induced autonomic imbalance. imageKey points Chronic intermittent hypoxia (CIH, a model for sleep apnoea) causes sympathetic overactivity, cardiovascular remodelling and hypertension. We determined the effect of CIH on sympathetic innervation of the mouse atria. In vivo CIH for 8–10 weeks resulted in an aberrant axonal pattern around the principal neurons within intrinsic cardiac ganglia and an increase in the density, branching point, tortuosity of catecholaminergic axons and atrial wall thickness. Utilizing mapping tool available from NIH (SPARC) Program, the topographical distribution of the catecholaminergic innervation of the atria were integrated into a novel 3D heart scaffold for precise anatomical distribution and holistic quantitative comparison between normal and CIH mice. This work provides a unique neuroanatomical understanding of the pathophysiology of CIH‐induced autonomic remodelling.

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Impact of sleep apnea and treatments on cardiovascular disease

Cited by 8 publications

References 119 publications

Quantitative detection of sleep apnea in adults using inertial measurement unit embedded in wristwatch wearable devices

Quantitative detection of sleep apnea in adults using inertial measurement unit embedded in wristwatch wearable devices

Obstructive sleep apnea and attention deficits: A systematic review of magnetic resonance imaging biomarkers and neuropsychological assessments

Chronic intermittent hypoxia remodels catecholaminergic nerve innervation in mouse atria

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