Sleep-Disordered Breathing in the Usual Lifestyle Setting as Detected with Home Monitoring in a Population of Working Men in Japan

Nakayama-Ashida, Yukiyo; Takegami, Misa; Chin, Kazuo; Sumi, Kensuke; Nakamura, Takaya; Takahashi, Ken­ichi; Wakamura, Tomoko; Horita, Shoichiro; Oka, Yasunori; Minami, Itsunari; Fukuhara, Shunichi; Kadotani, Hiroshi

doi:10.1093/sleep/31.3.419

Cited by 99 publications

(87 citation statements)

References 25 publications

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“…The recognition of sleep apnea syndrome (SAS) as a common and serious public health problem has become widespread, and the prevalence of SAS in the Japanese male working population has increased during the past decade, being recently estimated at 22.3% (Hida 1998, Nakayama-Ashida et al 2008. SAS has conventionally been divided into two categories: obstructive sleep apnea syndrome (OSAS) and central sleep apnea syndrome (CSAS) including CheyneStokes respiration.…”

Section: Study Subjectsmentioning

confidence: 99%

Prevalence of Complex Sleep Apnea Among Japanese Patients with Sleep Apnea Syndrome

Endo

Suzuki

Inoue

et al. 2008

Tohoku J. Exp. Med.

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Sleep apnea syndrome (SAS) is basically divided into two types: obstructive and central SAS. Recently, the concept of complex SAS has been advocated. Complex SAS is defined as SAS that initially manifests as primarily obstructive SAS, but is characterized by the frequent central apneas after the removal of upper airway obstruction. To determine the prevalence and clinical significance of complex SAS among Japanese patients with SAS, 1,312 patients with SAS were enrolled in this study. Diagnosis of central SAS was made based on diagnostic polysomnography, and differentiation of obstructive SAS from complex SAS was made from polysomnographic findings for treatment with continuous positive airway pressure, which resolved upper airway obstruction. As a result, obstructive SAS was found in 1,232 of 1,312 patients with SAS (93.9%) and central SAS was found in 14 patients (1.1%). The overall prevalence of complex SAS was 5.0% (n = 66). The prevalence of complex SAS among 1,218 male and 94 female patients with SAS were 5.3% and 1.1%, respectively. Patients with complex SAS had significantly higher apnea/ hypopnea indices than patients with either obstructive or central SAS, but were similar in both mean age and average body mass index to obstructive SAS patients. There were no significant between-group differences in numbers of patients with clinical complications including hypertension, cardiac diseases, or cerebrovascular diseases. In conclusion, the prevalence of complex SAS in Japanese SAS patients is 5.0%, which is lower than previously reported prevalence of complex SAS in the USA and Australia. obstructive sleep apnea syndrome; central sleep apnea syndrome; hypertension; cardiac disease; cerebrovascular disease.

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Section: Study Subjectsmentioning

confidence: 99%

Prevalence of Complex Sleep Apnea Among Japanese Patients with Sleep Apnea Syndrome

Endo

Suzuki

Inoue

et al. 2008

Tohoku J. Exp. Med.

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“…Therefore, it is likely that many people with OSAS remain undiagnosed. 11,12 Nocturia is another multifactorial disorder that can be caused by hypertension, diabetes, heart failure, or sleeping disorders. 13,14 OSAS can be an underlying cause of nocturia, although it is infrequently recognized, even in the field of urology.…”

Section: Introductionmentioning

confidence: 99%

Obstructive sleep apnea syndrome should be considered as a cause of nocturia in younger patients without other voiding symptoms

Maeda

Fukunaga

Nagata

et al. 2016

CUAJ

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Introduction: This study aimed to evaluate urination frequency among patients with obstructive sleep apnea syndrome (OSAS) and the effect of continuous positive airway pressure (CPAP) treatment.Methods: We evaluated 138 men with moderate-to-severe OSAS by using polysomnography. Urination status was assessed at baseline and three months using the International Prostate Symptom Score and Overactive Bladder Symptom Score. Nocturia was defined as ≥2 nighttime urinations and patients were classified into Group A (<50 years old with nocturia), Group B (≥50 years old with nocturia), and Group C (patients without nocturia). OSAS severity and other urinary symptoms were also evaluated.Results: Patients with nocturia exhibited more severe OSAS, compared to patients without nocturia (apnea-hypopnea index [AHI]: 52.0 vs. 44.7; p=0.021). Group A had the worst AHI, but did not have additional voiding symptoms, compared to Group B (p<0.001). The number of urinations was significantly correlated with OSAS severity in <50-year-old patients (p=0.013). CPAP reduced the number of urinations in Group A (75% of patients) and Group B (90% of patients). Patients with and without improved nocturia exhibited significant differences in their baseline OSAS severity (AHI: 53.7 vs. 37.3; p=0.042).Conclusions: OSAS severity was associated with the number of urinations in <50-year-old patients. CPAP decreased the nocturia frequency in 85% of patients with nocturia and was most effective in patients with severe AHI. However, additional studies should evaluate voiding volume in order to elucidate the mechanism of nocturia in patients with OSAS.

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“…3,9 The result of this study demonstrated higher sleep BP in SAS patients with CKD compared with those without CKD, even though the severity of SAS was similar. This result suggested that SAS and CKD might synergistically induce nocturnal hypertension, which probably increases the risk of onset of cardiovascular disease.…”

Section: Discussionmentioning

confidence: 58%

“…2 Nocturnal hypertension and morning BP surge are induced by sleep disordered breathing, which can be observed in 22% of Japanese adult males. 3 Typical clinical features of BP changes in patients with sleep disordered breathing and those with sleep apnea syndrome (SAS) are nocturnal hypertension and non-dipper patterns of circadian BP. As the severity of SAS increases, sleep BP is elevated even in a patient whose BP is within the normal range in the clinic.…”

mentioning

confidence: 99%

Relationship between chronic kidney disease and sleep blood pressure in patients with sleep apnea syndrome

et al. 2010

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Chronic kidney disease (CKD) is common disease in patients with sleep apnea syndrome (SAS), which is considered to be responsible for secondary and nocturnal hypertension. In this study, we assessed blood pressure (BP) changes in SAS patients with CKD. Of 460 Japanese outpatients with suspected SAS who underwent ambulatory BP monitoring within 3 months of overnight polysomnography, 198 patients (172 males and 26 females) who were not receiving treatment with antihypertensives or nitroglycerin were enrolled. The estimated glomerular filtration rate (eGFR) was calculated, and the patients were stratified into the high (H; eGFRX60 ml min À1 per 1.73 m 2 ) or the low (L; eGFRo60 ml min À1 per 1.73 m 2 ) group. The patients in the L group were significantly older than those in the H group (Po0.001), and body mass index was significantly smaller in the L group than in the H group (P¼0.025). The rate of patients treated with statin (P¼0.030) and the levels of both triglyceride (P¼0.006) and creatinine (Po0.001) differed significantly between the two groups. The sleep data, 24-h BP, awake BP and morning BP showed no significant differences between the two groups. However, sleep systolic and diastolic BPs were significantly higher in the L group (122.5±16.7 mm Hg and 81.1±12.2 mm Hg, respectively) than in the H group (117.1±11.8 mm Hg, P¼0.033; and 76.1±9.5 mm Hg, P¼0.012, respectively). SAS patients with CKD had elevated sleep BP. This result suggests that appropriate treatments for both SAS and CKD prevent sleep BP elevation, which is considered a risk factor for the onset risk of a cardiovascular event. Keywords: ambulatory blood pressure monitoring; circadian blood pressure; estimated glomerular filtration rate; nocturnal hypertension; polysomnography INTRODUCTIONIt is important to consider blood pressure (BP) outside of a clinic setting when treating patients with hypertension, because BP measurements obtained in a clinic setting are not representative of BP outside of the clinic setting. Abnormal changes in circadian BP are considered to increase the risk of cardiovascular event. Patients with nocturnal hypertension or a morning BP surge tend to have a higher incidence of silent cerebrovascular disease 1 and greater intima-media and relative wall thickness compared with normotensive patients. 2 Nocturnal hypertension and morning BP surge are induced by sleep disordered breathing, which can be observed in 22% of Japanese adult males. 3 Typical clinical features of BP changes in patients with sleep disordered breathing and those with sleep apnea syndrome (SAS) are nocturnal hypertension and non-dipper patterns of circadian BP. As the severity of SAS increases, sleep BP is elevated even in a patient whose BP is within the normal range in the clinic. Moreover, the incidence of nocturnal cardiovascular events while sleeping increases in these patients. [4][5][6] Chronic kidney disease (CKD) seems to be tightly linked with nocturnal hypertension and morning BP surge. 7 CKD poses a high risk for the onset of cardiovascu...

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Sleep-Disordered Breathing in the Usual Lifestyle Setting as Detected with Home Monitoring in a Population of Working Men in Japan

Cited by 99 publications

References 25 publications

Prevalence of Complex Sleep Apnea Among Japanese Patients with Sleep Apnea Syndrome

Prevalence of Complex Sleep Apnea Among Japanese Patients with Sleep Apnea Syndrome

Obstructive sleep apnea syndrome should be considered as a cause of nocturia in younger patients without other voiding symptoms

Relationship between chronic kidney disease and sleep blood pressure in patients with sleep apnea syndrome

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