The Burden of Respiratory Alterations during Sleep on Comorbidities in Obstructive Sleep Apnoea (OSA)

Abstract

Background: Obstructive sleep apnoea (OSA) has an important impact on the risk of morbidity and mortality, so we have designed the present study to understand which factor is most involved in the risk of developing a comorbidity between OSA severity and nocturnal hypoxemia. Methods: A retrospective study was conducted on 617 adult subjects who were referred to our unit for a suspicion of OSA between January 2018 and January 2020. Results: Sleep investigations performed by participants (72% male and obese in 70% of cases) reported an overall mean apnoea–hypopnoea index (AHI) of 44.0 ± 24.8 events·h−1. Overall, 66% were classified as severe OSA and 76% experienced nocturnal hypoxemia. By analysing the burden of OSA severity and nocturnal hypoxemia on the comorbidities risk, multivariate analysis highlighted the predominant role of age and obesity. Accordingly, after the exclusion of the older and obese participants from the analyses, we noticed that severe OSA was related to the risk of hypertension (odds ratio (OR) = 3.0 [95% confidence interval [CI] 1.4–6.2], p = 0.004) as well as nocturnal hypoxemia (OR = 2.6 [95% CI 1.2–5.4], p = 0.01). Conclusions: The study seems to suggest that in young, non-obese subjects, OSA is a predisposing factor for the risk of developing hypertension.

APAP Treatment Acceptance Rate and Cost-Effectiveness of Telemedicine in Patients with Obstructive Sleep Apnea: A Randomized Controlled Trial

“…The demand for OSA treatment has increased with its rising incidence, and the consequences of its social and multiorgan damage have increased the economic burden on society. 13 , 14 It has been reported that the cost of OSA diagnosis and treatment can reach up to US $12.4 billion. 13 Traditional diagnosis and treatment models find it difficult to meet the huge needs regarding the diagnosis, treatment, and chronic disease management of OSA.…”

Sleep Apnea and Heart Failure—Current State-of-The-Art

“…Intermittent hypoxia enhances the sensitivity of carotid chemoreceptors through several mechanisms. Firstly, it induces oxidative stress, leading to the production of angiotensin-II and endothelin-1 [21]. Angiotensin-II inhibits nitric oxide (NO), a known inhibitor of carotid body activity [21].…”

“…Firstly, it induces oxidative stress, leading to the production of angiotensin-II and endothelin-1 [21]. Angiotensin-II inhibits nitric oxide (NO), a known inhibitor of carotid body activity [21]. Additionally, endothelin-1 stimulates carotid chemoreceptors and acts as a vasoconstrictor peptide, contributing to vascular restructuring and elevating blood pressure [21].…”

Prevalence and clinical impacts of obstructive sleep apnea in patients with idiopathic pulmonary fibrosis: A single-center, retrospective study

“…OSA is known to affect over a billion people worldwide, according to recent studies [ 14 , 15 ]. In addition, previous studies found the negative impact of OSA on cardiovascular disease, diabetes, malignancy, immune system, systemic inflammation, and even in pain response [ 16 ]. The main clinical features of OSA are caused by repetitive episodes of upper airway collapse that result in hypoxemia and hypercapnia due to apnea or hypopnea, marked intrathoracic pressure swings, and sleep fragmentation that occurs with arousal due to obstructive respiratory events [ 17 ].…”