Sleep-disordered breathing, type 2 diabetes and the metabolic syndrome

Seetho, Ian; Wilding, John

doi:10.1177/1479972314552806

Cited by 47 publications

(31 citation statements)

References 163 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Other studies have described a strong association between OSA and diabetes (Ehrhardt et al, 2014; Seetho & Wilding, 2014) and cardiovascular disease (Kendzerska et al, 2014). While there was no statistically significant difference in rates of diabetes between those with and without an apnea diagnosis, this may be due to the established relationship between major depressive disorder and type 2 diabetes mellitus (Anderson et al, 2001).…”

Section: Discussionmentioning

confidence: 94%

“…While there was no statistically significant difference in rates of diabetes between those with and without an apnea diagnosis, this may be due to the established relationship between major depressive disorder and type 2 diabetes mellitus (Anderson et al, 2001). Because OSA is linked with these metabolic and cardiovascular conditions (Seetho & Wilding, 2014), in addition to depression, clinical care may be improved if physicians screen for OSA, especially because treatment of sleep-disordered breathing may improve management of other medical conditions such as hypertension (Denker & Cohen, 2014). …”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Self-reported obstructive sleep apnea is associated with nonresponse to antidepressant pharmacotherapy in late-life depression

et al. 2016

View full text Add to dashboard Cite

Background Obstructive sleep apnea (OSA) is frequently comorbid with late-life depression. The purpose of this project was to determine, using a sample of older adults with major depressive disorder, whether patient-reported diagnosis of OSA was associated with rate of response to venlafaxine. Methods Participants from this multisite study were adults ≥60 years old (n = 468) with major depressive disorder and a Montgomery Asberg Depression Rating Scale (MADRS) score of ≥15. Depression response was the outcome variable, defined as a MADRS score of ≤10 for two consecutive assessments at the end of 12 weeks of open-label treatment with venlafaxine 300 mg/day. To assess OSA, participants were asked if they had been diagnosed with OSA using polysomnography. Results Eighty participants (17.1%) reported a diagnosis of OSA prior to baseline. Participants with OSA were more likely to be male, report greater impairment on measures of health, experience a longer duration of the index episode, and receive an adequate antidepressant trial prior to entering the study. During the 12 weeks of treatment, 40.8% responded to treatment with venlafaxine (43.6%, n = 169/388 of the no OSA group, and 27.5%, n = 22/80 of the OSA group). Participants without OSA were 1.79 times more likely to respond to treatment (HR: 1.79 [95%CI: 1.13–2.86], P < .05) compared to those with OSA. Conclusions OSA may impair response to antidepressant pharmacotherapy in depressed older adults. Future studies of antidepressant response rates among depressed older adults with OSA should both prospectively diagnose OSA and monitor adherence to treatments such as continuous positive airway pressure.

show abstract

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Self-reported obstructive sleep apnea is associated with nonresponse to antidepressant pharmacotherapy in late-life depression

et al. 2016

View full text Add to dashboard Cite

show abstract

“…The main pathophysiological feature of OSA is repetitive narrowing (hypopnea) or closure (apnea) of the upper airway (UA) during sleep, causing intermittent hypoxia, intrathoracic pressure swings, sympathetic surges, and sleep fragmentation [2]. Due to these perturbations, OSA is linked to a range of harmful sequelae: excessive daytime sleepiness, fatigue, an impaired cognitive performance, a reduced quality of life, an increased risk of occupational and traffic accidents [3], metabolic disturbances [4], hypertension [5], cardio-and cerebrovascular morbidity, and OSA-related mortality [6].…”

Section: Introductionmentioning

confidence: 99%

Oral Appliances in Obstructive Sleep Apnea

Dieltjens

Vanderveken

2019

Healthcare

View full text Add to dashboard Cite

Oral appliance therapy is increasingly prescribed as a non-invasive treatment option for patients diagnosed with obstructive sleep apnea. The custom-made titratable mandibular advancement devices (MAD) are the recommended type of oral appliances. Mandibular advancement devices are efficacious in reducing the severity of obstructive sleep apnea, however, only to a lesser extent than standard therapy using continuous positive airway pressure (CPAP). Although oral appliance therapy is known to reduce the severity of obstructive sleep apnea in most of the patients, one out of three patients still show negligible improvement under MAD therapy. Therefore, the selection of the appropriate candidates for this therapy is imperative and several upfront prediction tools are described. Overall, the health outcome of mandibular advancement device therapy is similar to that of CPAP, probably due to the inferior compliance of CPAP compared to MAD therapy, resulting in similar clinical effectiveness.

show abstract

“…87,88 OSA is one of the major leading factors causing, hypertension, T2DM, metabolic syndrome, and cardiovascular diseases. 89 Patients with obesity and diabetes should be screened for OSA for better health outcomes as OSA is associated with diabetes and obesity and can lead to metabolic and cardiovascular complications in these patients. 45 CPAP treatment in OSA patients associated with T2DM can significantly improve hyperglycemia by improving insulin sensitivity and there could be a significant improvement in T2DM symptoms.…”

Section: Discussionmentioning

confidence: 99%