The role of dry mouth in screening sleep apnea

Zhang, Cheng; Shen, Yane; Feng, Lei; Ma, Jing; Wang, GuangFa

doi:10.1136/postgradmedj-2020-137619

Cited by 17 publications

(20 citation statements)

References 23 publications

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“…In responses to acute intermittent hypoxia, POMC protein content within ARC was previously reported to increase (Moreau and Ciriello, 2013). Leptin, which is elevated during this period in acute intermittent hypoxia (Moreau and Ciriello, 2013) has been shown to increase the activity of ARC POMC-containing neurons (Wang et al, 2008), while increased POMC activity induces hypophagia (Zhang et al, 2021). Acute intermittent hypoxia induced both an increase in the ARC POMC, as well as hypophagia (Moreau and Ciriello, 2013).…”

Section: Discussionmentioning

confidence: 96%

“…The finding in this study that water intake was increased in the CIH group after long-term exposure was unexpected. Previous studies have demonstrated in OSA patients that the patients often report of waking with a dry mouth and feeling thirsty (Oksenberg et al, 2006;Zhang et al, 2021). The findings that following an overnight bout of intermittent hypoxia plasma levels of both leptin and angiotensin II increased (Moreau et al, 2015) suggest that direct activation of the sympathetic nervous system by leptin may contribute to the feeling of a dry mouth by altering saliva production, while the elevated levels of angiotensin II likely activate central neuronal systems driving thirst (Gutman et al, 1986(Gutman et al, , 1988.…”

Section: Discussionmentioning

confidence: 97%

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Leptin: A Potential Link Between Obstructive Sleep Apnea and Obesity

et al. 2022

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Chronic intermittent hypoxia (CIH), a pathophysiological manifestation of obstructive sleep apnea (OSA), is strongly correlated with obesity, as patients with the disease experience weight gain while exhibiting elevated plasma levels of leptin. This study was done to determine whether a relationship may exist between CIH and obesity, and body energy balance and leptin signaling during CIH. Sprague-Dawley rats were exposed to 96 days of CIH or normoxic control conditions, and were assessed for measures of body weight, food and water intake, and food conversion efficiency. At the completion of the study leptin sensitivity, locomotor activity, fat pad mass and plasma leptin levels were determined within each group. Additionally, the hypothalamic arcuate nucleus (ARC) was isolated and assessed for changes in the expression of proteins associated with leptin receptor signaling. CIH animals were found to have reduced locomotor activity and food conversion efficiency. Additionally, the CIH group had increased food and water intake over the study period and had a higher body weight compared to normoxic controls at the end of the study. Basal plasma concentrations of leptin were significantly elevated in CIH exposed animals. To test whether a resistance to leptin may have occurred in the CIH animals due to the elevated plasma levels of leptin, an acute exogenous (ip) leptin (0.04 mg/kg carrier-free recombinant rat leptin) injection was administered to the normoxic and CIH exposed animals. Leptin injections into the normoxic controls reduced their food intake, whereas CIH animals did not alter their food intake compared to vehicle injected CIH animals. Within ARC, CIH animals had reduced protein expression of the short form of the obese (leptin) receptor (isoform OBR100) and showed a trend toward an elevated protein expression of the long form of obese (leptin) receptor (OBRb). In addition, pro-opiomelanocortin (POMC) protein expression was reduced, but increased expression of the phosphorylated extracellular-signal-regulated kinase 1/2 (pERK1/2) and of the suppressor of cytokine signaling 3 (SOCS3) proteins was observed in the CIH group, with little change in phosphorylated signal transducer and activator of transcription 3 (pSTAT3). Taken together, these data suggest that long-term exposure to CIH, as seen in obstructive sleep apnea, may contribute to a state of leptin resistance promoting an increase in body weight.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 97%

Leptin: A Potential Link Between Obstructive Sleep Apnea and Obesity

et al. 2022

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“…Existing screening tools have limited subjective and objective assessments of sleep during pregnancy and are usually conducted by recording clinical data and standardising scale questionnaires. By contrast, the STOP-BANG questionnaire is simple to operate and has high sensitivity and speci city [39] . In future studies, more appropriate screening tools should be developed for use during pregnancy, or PSG should be used to demonstrate the relationship between OSAHS and GDM.…”

Section: Discussionmentioning

confidence: 99%

Sleep quality in women with diabetes in pregnancy: a single-centre retrospective study

Meng

Liu

et al. 2022

Preprint

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Purpose Sleep quality is an important indicator of individual quality of life, which not only affects people's mental health but is also closely related to the occurrence of many diseases. Sleep disorders associated with diabetes in pregnancy (DIP) can greatly endanger the health of mothers and babies, and the relationship between their hazards and blood glucose levels is very close. This study explored the quality of sleep in patients with DIP while analyzing the clinical features and related factors of their sleep disorders. Methods From June 2020 to July 2021, a total of 693 patients diagnosed with diabetes in pregnancy (DIP) in Gansu Provincial Maternal and Child Health Hospital were used as the experiment group, including 626 patients with gestational diabetes mellitus (GDM) and 67 patients with pregestational diabetes mellitus (PGDM). At the same time, 709 non-DIP women were randomly selected as the control group. To obtain the general situation of the participants, the participants were surveyed using the Pittsburgh Sleep Quality Index (PSQI) and the STOP-Bang questionnaire. The differences in sleep quality and obstructive sleep apnea-hypopnea syndrome (OSAHS) were analyzed between the experiment group and the control group using rank and chi-square test, and the clinical features and related factors of sleep disorder were analyzed. Results Compared with the control group, the experiment group had a larger age, pre-pregnancy weight, body mass index (BMI), and large neck circumference (P < 0.05). The PSQI scores for sleep quality, sleep duration, sleep efficiency, sleep disorder, and daytime dysfunction were higher compared with the control group (P < 0.05). Specific analysis of the clinical features of sleep disorders found that the experimental group had higher scores compared with the control group in terms of difficulty falling asleep, ease of waking up at night or waking up early, poor breathing, cough or snoring effects, feeling hot, nightmares, pain and discomfort, and other events that affected sleep (P < 0.05). The analysis of the types of daytime dysfunction found that the experiment group scored higher in terms of frequently feeling sleepy and lack of energy to do things than the control group (P < 0.05). Analysis of STOP-BANG scores indicated that the proportion of patients with GDM or PGDM having fatigue, hypertension, BMI > 35 kg/m2, and neck circumference > 40 cm was higher than that of the control group (P < 0.05). Conclusions Patients with DIP had more sleep disorders and a higher risk of developing OSAHS than non-diabetic pregnant women. There may be some link between sleep quality and the onset of DIP. This study lays the foundation for further studies and provides new ideas for the prevention and treatment of DIP.

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“…Some potential mechanisms have been introduced in the direction of the association between the two diseases. Oxidative stress, inflammation response and oral dryness maybe the bridges between them ( 20 – 22 , 24 ). However, other studies have found that SDB was not related to periodontal diseases ( 29 , 47 ).…”

Section: Discussionmentioning

confidence: 99%

“…Another potential mechanism is oral dryness due to mouth breathing. Dry mouth symptoms caused by prolonged oral breathing are common in patients with SDB ( 22 ), which leads to greater bacterial colonization and accumulation, as well as increased risk of periodontal diseases ( 23 , 24 ).…”

Section: Introductionmentioning

confidence: 99%

Association between sleep-disordered breathing and periodontal diseases: A systematic review protocol

Chen

Meng²,

Zhao³

et al. 2022

Front. Med.

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BackgroundSleep-disordered breathing (SDB) is a chronic sleep-related breathing disorder, considered associated with increased risk of cardiovascular disorders, metabolic disorders, cognitive dysfunction and behavior changes. Periodontal diseases are chronic infectious diseases that are also believed to be associated with cardiovascular diseases, metabolic syndrome and cognitive dysfunction. Several studies have indicated that SDB may be associated with periodontal diseases through certain mechanisms such as inflammation response, oxidative stress and oral dryness. The aim of this systematic review is to explore the association between SDB and periodontal diseases in an integrated approach.Materials and MethodsThis systematic review will include cohort studies, cross-sectional studies and case-control studies that are identified by electronic and manual searches. Electronic searches will be conducted in the following databases: PubMed, Embase, Scopus and Web of Science. Our search will cover articles published from inception of databases to March 2022 without restrictions in language and settings. Pre-determined eligibility criteria include: participants (participants without a history of respiratory diseases, history of periodontal treatment within the past 6 months and history of medication that is known to influence SDB or periodontal diseases); exposure (participants who have been diagnosed with SDB or at high-risk for SDB); comparison (participants without SDB); and outcome (periodontal parameters, such as probing depth, clinical attachment level, bleeding on probing, radiographic bone loss). Two authors will perform study screening and data extraction independently and in duplicate. All discrepancies will be solved by discussion. The methodological quality of included studies will be assessed using the Newcastle-Ottawa Scale.DiscussionThis systematic review will summarize the existing evidence on the association between SDB and periodontal diseases, a topic of controversy and clinical significance. Its findings can provide evidence for the development of relevant prevention and treatment strategies. The results will be disseminated through peer-reviewed journals.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42022313024. Registered on March 28th 2022.

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The role of dry mouth in screening sleep apnea

Cited by 17 publications

References 23 publications

Leptin: A Potential Link Between Obstructive Sleep Apnea and Obesity

Leptin: A Potential Link Between Obstructive Sleep Apnea and Obesity

Sleep quality in women with diabetes in pregnancy: a single-centre retrospective study

Association between sleep-disordered breathing and periodontal diseases: A systematic review protocol

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