Incidence of Obstructive Sleep Apnea in Elderly Edentulous Patients and the Possible Correlation of Serum Serotonin and Apnea‐Hypopnea Index

Tripathi, Arvind; Bagchi, Soumyojeet; Singh, Juhi; Tripathi, Suryakant; Gupta, N. K.; Arora, Varun

doi:10.1111/jopr.12654

Cited by 12 publications

(15 citation statements)

References 36 publications

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“…80 Tripathi et al conducted a study on 381 elderly patients and showed that in this group the level of serum serotonin was inversely correlated to OSA severity; therefore, the estimation of serum serotonin is a viable biomarker for diagnosing OSA. 81 Serotonin also influences other aspects of sleep and therefore, as shown in the article of Brummet et al, the 5-HTTLPR S allele was associated with worsened insomnia in patients suffering from depression, poor sleep quality, and chronic stress. 82 Even if, as Yue et al showed, the L allele of 5-HTTLPR was associated with OSA in male patients but not in female patients, Deuschle approved that the S allele of 5-HTTLPR was associated with primary insomnia in female subjects.…”

Section: Dovepressmentioning

confidence: 98%

Polymorphism of the Serotonin Transporter Gene and the Peripheral 5-Hydroxytryptamine in Obstructive Sleep Apnea: What Do We Know and What are We Looking for? A Systematic Review of the Literature

Maierean¹,

Bordea²,

Sălăgean³

et al. 2021

NSS

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Background: Obstructive sleep apnea (OSA) is a highly prevalent disease with substantial public health burden. In most of the cases, there is a genetic predisposition to OSA. Serotonin/T-HydroxyTriptamine (5-HT) plays a key role in ventilatory stimulation, while the polymorphism of the serotonin transporter gene (STG) leads to alterations in serotonin level, making it important in OSA. Objective: To examine whether the 5-HydroxyTriptamine and the genetic predisposition influence the incidence and evolution of OSA, we reviewed randomized, controlled trials and observational studies on the selected topic. The secondary objective was to determine the metabolic effects of the circulating serotonin in other tissues (liver, pancreas, gut, brown adipose tissue, and white adipose tissue) and its role in the development of obesity. Data Sources: A systematic review of English articles was performed based on PubMed and the Cochrane Library databases. Search filters included randomized controlled trial, controlled clinical trial, random allocation, double-blind method, and case-control studies and used the following keywords: Brain Serotonin OR Serotonin Transporter Gene Polymorphism OR Peripheral 5-HydroxyTryptamine AND Obstructive Sleep Apnea OR Sleep Disorder Breathing OR brain serotonin AND OSA OR serotonin transporter gene OR Peripheral 5-Hydroxytryptamine AND Sleep. Study Eligibility Criteria: The inclusion criteria for the current review were previous diagnosis of OSA, age above 18 years, and articles including quantitative data about serotonin transporter gene or peripheral serotonin. Language and time criteria were added-English articles published in the last 15 years. Studies that were not included were reviews and case reports. Study Appraisal and Synthesis Methods: In order to study the serotonin function, a literature research was conducted in the databases Pubmed and Cochrane Library. The following search terms were used: serotonin, 5-hydroxytryptamine, serotonin transporter gene. A critical appraisal of the included studies was performed with the Newcastle-Ottawa scale (NOS) and Delphi list. Results: The search yielded 1210 articles, from which 43 were included. The included studies suggest that the two polymorphisms of serotonin transporter gene (5HTT)-variable number of tandem repeats (VNTR) and linked polymorphic region (LPR)-are strong candidates in the pathogenesis of OSA. The allele 10 of 5HTTVNTR and the long/long

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Section: Dovepressmentioning

confidence: 98%

Polymorphism of the Serotonin Transporter Gene and the Peripheral 5-Hydroxytryptamine in Obstructive Sleep Apnea: What Do We Know and What are We Looking for? A Systematic Review of the Literature

Maierean¹,

Bordea²,

Sălăgean³

et al. 2021

NSS

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“…Depression, a low 5-HT state, is often associated with reduced olfactory function [54] , [55] and fluoxetine [54] , a selective serotonin reuptake inhibitor (SSRI), and venlafaxine [56] , a serotonin-norepinephrine reuptake inhibitor (SNRI), have been reported to regenerate the lost olfactory acuity in depressed patients along with the improvement in depression. Patients of obstructive sleep apnea (also a low 5-HT state) show reduced olfactory function which improves after treatment with SSRIs [57] , [58] , [59] . An interesting observation is the improvement in olfactory sensitivity during fasting [60] and, incidentally, 5-HT in fasting state is significantly increased [61] .…”

Section: Implications and Importance Of The Hypothesismentioning

confidence: 99%

Does serotonin deficiency lead to anosmia, ageusia, dysfunctional chemesthesis and increased severity of illness in COVID-19?

Sen¹

2021

Medical Hypotheses

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Different mechanisms forwarded to understand anosmia and ageusia in coronavirus patients are not adequate to explain reversible anosmia and ageusia, which are resolved quickly. In addition, the reason behind the impaired chemesthetic sensations in some coronavirus patients remains unknown. In the present paper it is proposed that SARS-CoV-2 patients suffer from depletion of tryptophan, as ACE2, a key element in the process of absorption of tryptophan from the food, is significantly reduced in the patients as coronavirus uses ACE2 as the receptor to enter the host cells. The tryptophan depletion leads to a deficit of serotonin (5-HT) in SARS-COV-2 patients because tryptophan is the precursor in the synthesis of 5-HT. Such 5-HT deficiency can explain anosmia, ageusia and dysfunctional chemesthesis in COVID-19, given the fact that 5-HT is an important neuromodulator in the olfactory neurons, taste receptor cells and transient receptor potential channels (TRP channels) involved in chemesthesis. In addition, 5-HT deficiency worsens silent hypoxemia and depresses hypoxic pulmonary vasoconstriction leading to increased severity of the disease. Also, the levels of anti-inflammatory melatonin (synthesized from 5-HT) and nicotinamide adenine dinucleotide (NAD + , produced from niacin whose precursor is the tryptophan) might decrease in coronavirus patients resulting in the aggravation of the disease. Interestingly, selective serotonin reuptake inhibitors (SSRIs) may not be of much help in correcting the 5-HT deficiency in COVID-19 patients, as their efficacy goes down significantly when there is depletion of tryptophan in the system. Hence, tryptophan supplementation may herald a radical change in the treatment of COVID-19 and accordingly, clinical trials (therapeutic / prophylactic) should be conducted on coronavirus patients to find out how tryptophan supplementation (oral or parenteral, the latter in severe cases where there is hardly any absorption of tryptophan from the food) helps in curing, relieving or preventing the olfactory, gustatory and chemesthetic dysfunctions and in lessening the severity of the disease.

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“…Our results confirm the hypothesis about a change in serum serotonin levels upon elimination of intermittent hypoxia during the night in patients with OSA. Tripathi et al [45] also confirmed this hypothesis by finding an inverse correlation between the severity of OSA and the concentration of serum serotonin in elderly patients with orthodontic pathology and obesity [45].…”

Section: Discussionmentioning

confidence: 89%

Sleep Apnea and Serum Serotonin Level Pre- and Post-PAP Therapy: A Preliminary Study

et al. 2021

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Introduction:The high prevalence of obstructive sleep apnea (OSA), which impairs quality of life for numerous patients and leads to various OSA complications, has contributed to the continued interest in this disorder. The role of serotonin (5-HT) in many physiological processes, studies on its connection with the circadian system, and relationship to changes in sleep architecture are insufficient to assess the interaction of this neurotransmitter with nocturnal hypoxia. The aim of this study was to determine changes in sleep patterns and serum serotonin levels before and after positive airway pressure (PAP) therapy in patients with OSA. Methods: The study involved 30 OSA patients (27 men and 3 women) who were treated with PAP for 3 months. Polysomnography using the GRASS TELEFACTOR (USA) and blood collection were conducted before and after PAP courses. Determination of serum serotonin was performed by high-performance liquid chromatography (HPLC). PAP therapy was performed using an automatic Prisma 20A (Germany) continuous positive airway pressure (CPAP) device. Results: The use of PAP for 3 months revealed a significant improvement as measured by sleep data and serotonin levels (before: apnea index [AI] 17.2 eV/h, after: 2.4 eV/h p = 0.001; SpO 2 \ 90% -45.7 min vs. 6.2 min p = 0.001; serotonin 20.3 ng/mL vs. 26.03 ng/mL p = 0.036]. Conclusion: Our results demonstrate an improvement in sleep patterns. There was an increase in serum serotonin levels in OSA patients following PAP therapy, which could be an effect of intermittent hypoxia decline, and could be used as criteria for the effectiveness of PAP and an improvement in sleep quality.

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Incidence of Obstructive Sleep Apnea in Elderly Edentulous Patients and the Possible Correlation of Serum Serotonin and Apnea‐Hypopnea Index

Abstract: OSA was found to be prevalent in edentulous subjects due to pharyngeal collapse and decreased neuromuscular control. An inverse relationship of serum serotonin levels and AHI scores was established.

Cited by 12 publications

References 36 publications

Polymorphism of the Serotonin Transporter Gene and the Peripheral 5-Hydroxytryptamine in Obstructive Sleep Apnea: What Do We Know and What are We Looking for? A Systematic Review of the Literature

Polymorphism of the Serotonin Transporter Gene and the Peripheral 5-Hydroxytryptamine in Obstructive Sleep Apnea: What Do We Know and What are We Looking for? A Systematic Review of the Literature

Does serotonin deficiency lead to anosmia, ageusia, dysfunctional chemesthesis and increased severity of illness in COVID-19?

Sleep Apnea and Serum Serotonin Level Pre- and Post-PAP Therapy: A Preliminary Study

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