ObjectiveTo systematically review the association between obstructive sleep apnea syndrome and levels of thyroid hormone.MethodsWe electronically searched databases including PubMed, The Cochrane Library (Issue 6, 2016), Web of Science, VIP, CNKI, WanFang Data, CBM and the relevant conference abstracts and unpublished literatures from inception to June, 2016 to collect the case-control studies about the levels of thyroid hormones with OSAS. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed by RevMan 5.2 software.ResultsA total of 8 RCTs involving 1 519 patients were included. The results of meta-analysis showed that: there were no significant differences of levels of FT3 between OSAS group and control group (mild: SMD=–0.01, 95%CI –0.21 to 0.20, P=0.93; moderate: SMD=0.15, 95%CI –0.34 to 0.64, P=0.55; severe: SMD=0.12, 95%CI –0.32 to 1.25, P=0.08). There were significant differences of levels of FT4 between mild and moderate OSAS groups with control group (mild: SMD=–0.49, 95%CI –0.74 to –0.25, P<0.000 1; moderate: SMD=–0.86, 95%CI –1.69 to –0.02, P=0.04), but no significant difference in severe group (SMD=–1.06, 95%CI –2.16 to 0.03, P=0.06). There were no significant differences of levels of TSH between OSAS group and control group (mild: SMD=–0.03, 95%CI –0.13 to 0.20, P=0.69; moderate: SMD=–0.09, 95%CI –0.27 to –0.10, P=0.35; severe: SMD=–0.02, 95%CI –0.26 to –0.22, P=0.88).ConclusionsThe current evidence shows that, OSAS is associated with lower levels of FT4. Due to the limited quality and quantity of included studies, the above results are needed to validate by more studies.
Objective To explore the correlation between physical activity, sleep and aging using a two-sample Mendelian randomization (MR) method. Methods The data through genome-wide association studies was summarized. The single nucleotide polymorphisms (SNPs) related to physical activity and sleep as instrumental variables was selected. The inverse variance weighting method was used for the main analyses, complemented by the weighted median method and MR Egger regression, and then sensitivity analyses were carried out in terms of multiplicity, heterogeneity and leave-one-out method. Finally, multivariate Mendelian methods were applied to eliminate confounders and find mediators. Results A total of two types of physical activity (strong physical activity, physical inactivity) and three sleep conditions (daytime naps, short sleep duration, adequate sleep duration) were found to have a causal relationship with frailty index (P<0.05), while physical inactivity was found to have a causal relationship with telomere length (P<0.05). A total of 167 SNPs were included in the analysis. Strong physical activity [correlation coefficient (β)=?1.26, 95% confidence interval (CI) (?1.60, ?0.96), P<0.0001], adequate sleep duration [β=?0.17, 95%CI (?0.26, ?0.09), P<0.001] were negatively correlated with the frailty index. Physical inactivity [β=1.47, 95%CI (0.85, 2.08), P<0.001], daytime naps [β=0.25, 95%CI (0.12, 0.39), P=0.0002], and short sleep duration [β=0.20, 95%CI (0.13, 0.27), P<0.0001] were positively associated with frailty index. Physical inactivity [β=?0.38, 95%CI (?0.69, ?0.07), P=0.02] was negatively correlated with telomere length. Percentage body fat, body fat mass, waist circumference, body weight and body mass index partially mediated 25.52%, 23.52%, 10.08%, 17.6% and 10.08% of the effect between daytime naps and frailty index, respectively. Conclusion There is a causal relationship between physical activity, sleep, and aging.
ObjectiveTo investigate the pathogenesis and treatment of obstructive sleep apnea hypopnea syndrome (OSAHS) by detecting the changes of serum interleukin-23 (IL-23) and C-reactive protein (CRP) levels of the OSAHS patients before and after treatment with continuous positive airway pressure (CPAP).MethodsFifty-eight patients with moderate to severe OSAHS diagnosed by polysomnography were recruited as an experimental group, 57 out-patient healthy subjects with matched age, sex and body mass index of the experimental group were enrolled as a control group. The serum concentrations of IL-23 and CRP in the experimental group were detected and compared before and after CPAP application for 3 months. The serum concentrations of IL-23 and CRP in the control group were also measured.ResultsThe serum levels of IL-23 and CRP in the OSAHS patients were significantly higher than those in the normal control subjects (P<0.05). The serum levels of IL-23 and CRP in the OSAHS patients after CPAP treatment were significantly lower than those before CPAP treatment (P<0.05). The serum concentrations of IL-23 and CRP were positively correlated with apnea hypopnea index (r=0.756, r=0.345, P<0.05, respectively), and negatively correlated with mean oxygen saturation (r=–0.715, r=–0.334, P<0.05, respectively).ConclusionsThe serum levels of IL-23 and CRP are positively correlated with the severity of OSAHS. After CPAP treatment, the levels of IL-23 and CRP decrease, which indicates that CPAP treatment may reduce the inflammatory reaction and correct anoxia of OSAHS patients.
【摘要】 目的 觀察低溫等離子射頻治療阻塞性睡眠呼吸暫停低通氣綜合征（obstructive sleep apnea-hypopnea syndrome，OSAHS）合并變應性鼻炎的療效。 方法 對2010年1－5月收治的42例OSAHS合并變應性鼻炎患者，采用低溫等離子射頻雙下鼻甲減容、鼻腔內蝶腭神經及篩前神經末梢阻滯，并配合鼻中隔成形等手術。使用Epworth嗜睡評分量表（epworth sleepiness scale， ESS）和視覺模擬評分法（visual analogue scale，VAS）對治療前及治療3個月后的總體感受評分。 結果 ESS評分與VAS評分均符合正態分布，手術前、后ESS評分[（14.22±4.21）分，（6.78±4.12）分]與VAS評分[（8.34±2.72）分，（3.96±1.02）分]差異有統計學意義（Plt;0.05）。 結論 低溫等離子射頻治療OSAHS合并變應性鼻炎療效較好。【Abstract】 Objective To observe the clinical effect of treatment by low-temperature plasma radio frequency on obstructive sleep apnea-hypopnea syndrome (OSAHS) complicated with allergic rhinitis. Methods A total of 42 patients with OSAHS complicated with allergic rhinitis between January 2010 and May 2010 were chosen. All of the patients were treated by low-temperature plasma radio frequency nerve block, concha nasalis inferior ablation and other operations such as nasal septal construction. The nerve terminals of sphenopalatine nerve and anterior ethmoid nerve were blocked by ablation. Epworth sleepiness scale (ESS) and visual analogue scale (VAS) were used to estimate the curative effects. Results The results of ESS and VAS were consistent with gaussian distribution. There were statistical significant difference between the scores of pre-and post-operation (Plt;0.05). Conclusion The low-temperature plasma radio frequency treatment for OSAHS complicated with allergic rhinitis is easy，safe and efficient.
Objective To investigate the prevalence of obstructive sleep apnea hypopnea syndrome ( OSAHS) in patients with idiopathic pulmonary fibrosis ( IPF) and its clinical significance. Methods Sleep quality and breathing disorders were measured by polysomnography and the relationship with lung function was analyzed in 20 IPF patients. Results Thirteen of 20 subjects ( 65% ) had OSAHS as defined by an AHI ≥5 events per hour. Three subjects ( 15% ) had mild OSAHS ( AHI,5 to 20 events per hour) , and 10 subjects ( 50% ) had moderate-to-severe OSAHS ( AHI≥20 events per hour) . The sleep architecture in these patients showed a reduction in sleep efficiency, rapid eye movement ( REM) sleep and slow wave sleep, and a marked sleep fragmentation due to an increased arousal index. The AHI was negatively correlated with FVC% pred ( r =-0.672, P=0.001) and FEV1% pred ( r =-0.659, P=0.002) , and positively correlated with body mass index ( BMI) ( r=0.791, Plt;0.0001) . Conclusions OSAHS is a common comorbidity in IPF. Early treatment of OSAHS may improve quality of life and the prognosis of patients with IPF.
Sleep electroencephalogram (EEG) is an important index in diagnosing sleep disorders and related diseases. Manual sleep staging is time-consuming and often influenced by subjective factors. Existing automatic sleep staging methods have high complexity and a low accuracy rate. A sleep staging method based on support vector machines (SVM) and feature selection using single channel EEG single is proposed in this paper. Thirty-eight features were extracted from the single channel EEG signal. Then based on the feature selection method F-Score's definition, it was extended to multiclass with an added eliminate factor in order to find proper features, which were used as SVM classifier inputs. The eliminate factor was adopted to reduce the negative interaction of features to the result. Research on the F-Score with an added eliminate factor was further accomplished with the data from a standard open source database and the results were compared with none feature selection and standard F-Score feature selection. The results showed that the present method could effectively improve the sleep staging accuracy and reduce the computation time.
The peak period of cardiovascular disease (CVD) is around the time of awakening in the morning, which may be related to the surge of sympathetic activity at the end of nocturnal sleep. This paper chose 140 participants as study object, 70 of which had occurred CVD events while the rest hadn’t during a two-year follow-up period. A two-layer model was proposed to investigate whether hypnopompic heart rate variability (HRV) was informative to distinguish these two types of participants. In the proposed model, the extreme gradient boosting algorithm (XGBoost) was used to construct a classifier in the first layer. By evaluating the feature importance of the classifier, those features with larger importance were fed into the second layer to construct the final classifier. Three machine learning algorithms, i.e., XGBoost, random forest and support vector machine were employed and compared in the second layer to find out which one can achieve the highest performance. The results showed that, with the analysis of hypnopompic HRV, the XGBoost+XGBoost model achieved the best performance with an accuracy of 84.3%. Compared with conventional time-domain and frequency-domain features, those features derived from nonlinear dynamic analysis were more important to the model. Especially, modified permutation entropy at scale 1 and sample entropy at scale 3 were relatively important. This study might have significance for the prevention and diagnosis of CVD, as well as for the design of CVD-risk assessment system.
Obstructive sleep apnea hypopnea syndrome (OSAHS) is a disease in which apnea and hypopnea occur during sleep, and the main symptoms are sleep snoring. OSAHS is not only closely related to the occurrence of various eye diseases, but also the severity of OSAHS can affect the progression of related eye diseases. At present, continuous positive airway pressure (CPAP) is an effective means to treat OSAHS, and the progression of related eye diseases has been improved correspondingly after CPAP treatment. In the future, it is necessary to further study the pathogenesis of OSAHS and enrich the research evidence of the association between OSAHS and eye diseases, so as to provide more comprehensive theoretical evidence for the prevention and treatment of OSAHS-related eye diseases.
