Is Sleep Apnea a Winter Disease?

Cassol, Cristiane Maria; Martinez, Dênis; Silva, Fernando Augusto Boeira Sabino da; Fischer, Maria Clara Bueno; Lenz, Maria do Carmo Sfreddo; Bós, Ângelo José Gonçalves

doi:10.1378/chest.11-0493

Cited by 72 publications

(22 citation statements)

References 26 publications

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“…Additional risk factors include older age, male sex, ethnicity and family history [4]. Of interest, OSAS seems to exhibit a seasonal predominance pattern with higher incidence and severity occurring in winter [5]. Data from the literature emphasise the association between OSAS and a number of disorders, such as cardiovascular disease, impaired glucose metabolism and other endocrinopathies, such as hypercortisolism and osteoporosis [4, 6].…”

Section: Introductionmentioning

confidence: 99%

The role of vitamin D in obstructive sleep apnoea syndrome

Archontogeorgis

Nena

Παπάνας

et al. 2018

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Obstructive sleep apnoea syndrome (OSAS) is a common disorder of multifactorial pathogenesis and is associated with obesity, diabetes and cardiovascular disease. Vitamin D is a fat-soluble vitamin with an important function in calcium absorption and homeostasis, which is also implicated in several nonskeletal conditions. The prevalence of vitamin D deficiency is increasing worldwide and is associated with similar metabolic disturbances to OSAS. Moreover, recent data suggest that in OSAS patients serum levels of vitamin D are lower compared with non-apnoeic subjects. However, the mechanisms linking vitamin D deficiency and OSAS are not completely understood and several hypotheses have been advanced. To date, a limited number of studies have assessed the association between lower serum concentrations of vitamin D and OSAS, and have reported inconsistent results. Similarly, contradictory results have been produced by studies which evaluated the effect of continuous positive airway pressure treatment on serum vitamin D levels. The aim of this review is to summarise current knowledge on the association between OSAS and vitamin D levels.Key pointsVitamin D insufficiency prevalence is increasing worldwide and presents with similar comorbidities and risk factors to OSAS.The nonskeletal actions of vitamin D may contribute to the development of OSAS through immune system modulation, myopathy and inflammation.Studies evaluating serum vitamin D concentrations in OSAS patients and the effect of CPAP treatment report contradictory results, often influenced by confounding factors, such as obesity.There appears to be potential for use of vitamin D supplementation in OSAS patients as a means of reducing the incidence of cardiovascular disease, a comorbidity common in both conditions.Educational aimsTo assess the potential association between OSAS and serum levels of vitamin D.To discuss the pathogenetic mechanisms linking OSAS and vitamin D insufficiency.To illustrate the effect of CPAP treatment on vitamin D concentration in OSAS patients.

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Section: Introductionmentioning

confidence: 99%

The role of vitamin D in obstructive sleep apnoea syndrome

Archontogeorgis

Nena

Παπάνας

et al. 2018

Breathe

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“…Cassol CM et al [ 16 ], retrospectively analyzed 7.523 adult patients. They reported a circannual pattern of AHI, with acrophase in winter and nadir during summer.…”

Section: Discussionmentioning

confidence: 99%

“…Seasonal variability on OSA has already been studied by polysomnography both in adults and children [ 16 – 20 ]. Winter and spring season emerged as critical periods.…”

Section: Introductionmentioning

confidence: 99%

“…Especially for children, repetitive viral infections and allergies were postulated as major causes of winter seasonal OSA worseness. Unfortunately, no data are available for at-home pulse oximetry performed in children referred for suspected OSA [ 16 – 20 ]. However, we believe that it is important for clinicians to know all factors that can affect the results of all diagnostic tests for a more appropriate interpretation which will determine a correct medical action.…”

Section: Introductionmentioning

confidence: 99%

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Age and seasons influence on at-home pulse oximetry results in children evaluated for suspected obstructive sleep apnea

et al. 2017

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BackgroundSeasonal variability on obstructive sleep apnea has already been studied by polysomnography in children. Winter and spring season emerged as critical periods. No data are currently available for pulse oximetry performed at home. The aim of our study was to evaluate the effect of seasonality and age on the results of at-home pulse oximetry performed in children referred for suspected OSA.MethodsWe retrospectively studied 781 children (64.3% Males), aged 4.9 ± 2.5 years. For all patients, we evaluated both pulse oximetry metrics and the McGill Oximetry Score. Variables for seasonal groups were assessed using Kruskal-Wallis test. A logistic regression model was performed to assess the relationship between patients’ main characteristics, season period and the likelihood to have an abnormal McGill Oximetry Score.ResultsPatients recorded during winter were significantly younger (p < 0.02), nadir SpO2 was significantly lower (p < 0.002) and DI4 significantly higher than during others seasons (p < 0.005). Moreover, patients recorded during winter were nearly 2 times more likely to have an abnormal MOS (aOR 1.949). The logistic regression showed that also younger age (p < 0.0001) was associated with a higher risk to find an abnormal pulse oximetry.ConclusionsIn our study, the winter season confirms to be a critical period for pulse-oximetry and it should be taken into account by clinicians for a correct interpretation of tests. Our data show that also younger age affects the prevalence of abnormal at-home pulse oximetry in children.

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“…Расчеты показали, что во всех исследованных регионах максимальная ρO 2 наблюдается зимой, а минимальная -летом. В работе Cassol CM, et al индекс апноэ у взрослых пациентов имел сезонную динамику, при этом обратно коррелировал с температурой воздуха и прямо коррелировал с величиной атмосферного давления и относительной влажности воздуха [59]. В исследованиях на здоровых детях (без респираторной патологии) было обнаружено, что зимой, по сравнению с другими сезонами, изменяются показатели кислородной сатурации гемоглобина -снижается надир SpO 2 и увеличивается DI4 (количество падений сатурации более чем на 4% за час) [60].…”

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The dependence of сircannual dynamics of blood pressure on seasonal fluctuations of meteorological and heliophysical factors. Meta-analysis

2019

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Many clinical studies have shown seasonal dynamics of blood pressure (BP), which most authors attribute to seasonal variations in air temperature. However, the fact that in the conditions of modern urban society the influence on the person of air temperature on the street is minimized, as well as the fact that the seasonal dynamics of BP is observed and in a tropical climate contradict this statement. It is known, that the length of the day, the atmospheric pressure, the relative humidity, geomagnetic activity are subject to seasonal dynamics. Studies have shown that fluctuations in these meteorological factors can cause change in blood pressure.Aim.To use meta-analysis of the results of studies, conducted in different climatic zones (from subarctic to tropical) and devoted to seasonal dynamics of BP, to determine which meteorological conditions most often corresponded to the annual maximum of BP and which to the annual minimum of BP.Material and methods. We selected 15 publications about seasonal dynamics of BP and seasonal exacerbations of arterial hypertension in 21 regions of the Northern Hemisphere of the Earth.Results.We confirmed that, in addition to air temperature, other factors are also subject to seasonal dynamics (atmospheric pressure, relative humidity, partial oxygen density in the air). No correlation was found between the amplitude of seasonal fluctuations in air temperature and the amplitude of seasonal fluctuations in BP. In addition, the amplitude of drcannual blood pressure fluctuations was greater in regions with a clear seasonal dynamics of the average monthly atmospheric pressure, compared with regions in which the this parameter does not have a clear seasonal dynamics. Also, in some regions, the seasonal maximum of BP coincided with high geomagnetic activity.Conclusion. According to the results, we concluded that seasonal fluctuations of BP are not a reaction of the cardiovascular system to seasonal dynamics of air temperature only. Most likely, seasonal fluctuations of BP are caused by changes in all meteorological factors that have seasonal dynamics.

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Is Sleep Apnea a Winter Disease?

Cited by 72 publications

References 26 publications

The role of vitamin D in obstructive sleep apnoea syndrome

The role of vitamin D in obstructive sleep apnoea syndrome

Age and seasons influence on at-home pulse oximetry results in children evaluated for suspected obstructive sleep apnea

The dependence of сircannual dynamics of blood pressure on seasonal fluctuations of meteorological and heliophysical factors. Meta-analysis

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