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.
Objective To explore effects of edaravone on apoptosis and expressions of apoptotic proteins Smac and XIAP in hippocampal CA1 pyramidal cell of rats under intermittent hypoxia. Methods A total of 96 adult male Wistar rats were randomly divided into control group, 5% intermittent hypoxic group and edaravone group, and each group was divided into 4 time groups at 7 d, 14 d, 21 d and 28 d, respectively, with 8 rats in each subgroup. The content of reactive oxygen species (ROS) in hippocampal tissues of the experimental rats was detected by the reactive oxygen species detection kit. Immunohistochemistry and Western blot were used to detect the expressions of Smac and XIAP protein in hippocampal CA1 region. The Tunel method detected the apoptosis of neurons. Results Compared with the control group, the content of ROS, the expressions of Smac and XIAP proteins and the neuronal apoptosis index in the hippocampus were increased in the 5% intermittent hypoxia group and the edaravone group at each time point (all P<0.05). The content of ROS, the Smac protein expression and the neuronal apoptosis index in the edaravone group were significantly lower than those in the 5% intermittent hypoxia group (all P<0.05). The expression of XIAP protein in the edaravone group was significantly higher than that in the 5% intermittent hypoxia group (P<0.05). Conclusion Edaravone may improve the antioxidant capacity of the body by scavenging oxygen free radicals and regulate Smac and XIAP- mediated apoptosis, thus playing a protective role on neurons.
Objective To study the differences of obstructive sleep apnea hypopnea syndrome (OSAHS)-related indexes between Uyghur and Han, and to provide evidence for the development of individualized treatment measures for different ethnic groups. Methods 224 Han OSAHS patients were collected from Guangdong Provincial Hospital of Chinese Medicine, and 178 Uygur OSAHS patients were collected from The First People’s Hospital of Kashi between January 2018 and December 2019. The collected data information included age, sex, nationality, body mass index (BMI), apnea hypopnea index (AHI), lowest oxygen saturation (LSaO2), OSAHS stage, mean corpuscular hemoglobin concentration (MCHC), triglyceride (TG), total cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein (LDL), fasting blood glucose (FBG), and glycosylated hemoglobin (HbAlc). After using propensity matching scores to reduce confounding factors, differences in above indicators between different nationalities were compared. Results The mean values of MCHC, TC and HDL in Uygur OSAHS patients were lower than those in Han patients at the same stage, and the mean values of LSaO2 and LDL in mild and severe Uygur OSAHS patients were lower than those in Han patients at the same stage, with statistically significant differences (all P<0.05). There were no significant differences in AHI, TG, FBG or HbAlc between Uygur and Han patients with OSAHS. Conclusion There are significant differences in LSaO2, LDL, MCHC, TC and HDL between Uygur and Han Chinese patients with OSAHS.
Objective To study the correlation between smoking and obstructive sleep apnea (OSA). Methods A total of 454 patients from October 2015 to July 2021 were retrospectively collected for nocturnal polysomnography monitoring (no less than 7 hours). The patients were divided into an OSA group (n=405) and a control group (n=49, patients with primary snoring) according to the results of polysomnography monitoring. According to the apnea hypopnea index (AHI) and the lowest oxygen saturation during sleep, the severity of OSA was classified into a mild to moderate group (5 times/h ≤ AHI<30 times/h) and a severe group (AHI ≥30 times/h). The patients were inquired about their smoking history, then the patients diagnosed with OSA were further divided into a smoking group, a smoking cessation group, and a non-smoking group based on their smoking history. Results The smoking rate of the patients in the OSA group was higher than that in the control group (50.9% vs. 32.7%, P<0.05), while the smoking rate in the severe OSA group was higher than that in the mild to moderate group (55.7% vs. 39.8%, P<0.05). Smoking was positively correlated with AHI, cumulative percentages of time spent at oxygen saturation below 90% (Ts90%), and total apnea time (r value was 0.196, 0.197, 0.163, P<0.05), while negatively correlated with the lowest and average SpO2 during sleep (r value was –0.202, –0.214, P<0.05). The logistic regression analysis with severe OSA as the outcome variable showed that smoking (OR=1.781) and obesity (OR=1.930) were independent risk factors of severe OSA (P<0.05). The comparison between groups of the OSA patients with different smoking states showed that the proportion of severe OSA, AHI, Ts90%, and total apnea time (77.8%, 53.55 times/h, 18.35%, and 111.70 minutes, respectively) of the smoking group were higher than those of the non-smoking group (62.8%, 40.20 times/h, 8.40%, and 76.20 minutes, respectively, P<0.05). The lowest SpO2 and average SpO2 during sleep (69.50%, 93.00%, respectively) of the smoking group were lower than those of the non-smoking group (75.00%, 94.00%, respectively, both P<0.05). The average SpO2 of the smoking cessation group was higher than that of the smoking group (94.00% vs. 93.00%, P<0.05), and the Ts90% of the smoking cessation group was lower than that of the smoking group (6.75% vs. 18.35%, P<0.05). Conclusions Smoking significantly affects the degree of sleep-disordered breathing and may be an independent risk factor for severe OSA. Smoking can exacerbate the severity of OSA and the degree of hypoxia, while smoking cessation can improve the degree of hypoxia in OSA patients.
Objective To investigate the correlation between serum level of visfatin and obesity in patients with obstructive sleep apnea hypopnea syndrome ( OSAHS) . Methods Forty-seven patients with OSAHS and 20 healthy controls were recruited in this study. Polysomnography was performed in all subjects to detect apnea-hypopnea index ( AHI) . The serumlevels of cisfatin, C-reactive protein ( CRP) , TNF-α, and IL-6 were measured by enzyme linked immunosorbent assay. The body mass inex ( BMI) was calculated.The level of cisfatin was compared between the OSAHS patients with different severity and the controls, and its relationship with the levels of AHI, BMI, CRP, TNF-α, and IL-6 was analyzed. Results The serumlevel of visfatin in the OSAHS patients was higher significantly than that in the controls ( P lt;0. 01) and increased by the severity of OSAHS. There were positive correlations between the serum level of visfatin and AHI,BMI, CRP, TNF-α, IL-6 in the OSAHS patients ( P lt;0. 05) . Conclusion The expression of visfatin may play an important role in the pathogenesis of OSAHS.
ObjectiveTo investigate the causal relationship between gastroesophageal reflux disease (GERD) and obstructive sleep apnea (OSA) with its typical symptoms (snoring and daytime sleepiness) by using Mendelian randomization (MR). MethodsThe inverse-variance weighted method was used as the main analysis method to assess the causal effect. Sensitivity and pleiotropy analyses were carried out using leave-one-out and MR-Egger analysis, and then heterogeneity tests were conducted. ResultsIn the MR analysis, genetically predicted GERD was associated with a greater risk of OSA (IVW: OR=1.528, 95%CI 1.374 to 1.699, P=5.315E?15). Additional MR results were consistent with the IVW results, and no pleiotropy or heterogeneity was found. We also discovered a significant causal relationship between GRED and snoring (IVW: OR=0.959, 95%CI 0.949 to 0.969, P=1.507E?15), and daytime sleepiness (IVW: OR=1.024, 95%CI 1.021 to 1.036, P=4.580E?5), with no evidence of pleiotropy. ConclusionThe MR study supports a causal effect between GERD and OSA with its typical symptoms (daytime sleepiness and snoring).
ObjectiveTo analyze the the characteristics of pulse oximetry (SpO2) curve changes in patients with obstructive sleep apnea (OSA), hypoxic parameters and to explore the difference and connection between obstructive apnea (OA) events and hypopnea (Hyp) events, evaluate the impact of different types of obstructive respiratory events on hypoxia, and provide a theoretical basis for exploration of hypoxic differences in each type of respiratory events and construction of prediction models for respiratory event types in the future. MethodsSixty patients with OSA diagnosed by polysomnography (PSG) were selected for retrospective analysis, and all respiratory events with oxygen drop in the recorded data overnight were divided into OA group (5972) according to the type of events and Hyp group (4110), recorded and scored events were exported from the PSG software as comma-separated variable (.csv) files, which were then imported and analyzed using the in-house built Matlab software. Propensity score matching was performed on the duration of respiratory events and whether they were accompanied by arousal in the two groups, and minimum oxygen saturation of events (e-minSpO2), the depth of desaturation (ΔSpO2), the duration of desaturation and resaturation (DSpO2), the duration of desaturation (d.DSpO2), duration of resaturation (r.DSpO2), duration of SpO2<90% (T90), duration of SpO2<90% during desaturation (d.T90), duration of SpO2<90% during resaturation (r.T90), area under the curve of SpO2<90% (ST90), area under the curve of SpO2<90% during desaturation (d.ST90), area under the curve of SpO2<90% during resaturation (r.ST90), oxygen desaturation rate (ODR) and oxygen resaturation rate (ORR), a total of 13 hypoxic parameters differences. ResultsVarious hypoxic parameters showed that more severe SpO2 desaturation in severe OSA patients, compared with mild and moderate OSA patients (P<0.05); There were statistically significant differences in the respiratory events duration and whether accompanied by arousal between the Hyp group and OA group (P<0.05), and the respiratory events duration and whether accompanied by arousal were significantly correlated with most hypoxic parameters; After accounting for respiratory events duration and whether accompanied by arousal by propensity score matching, compared with the Hyp group, e-minSpO2 was significantly lower in the OA group, ΔSpO2, d.DSpO2, r.DSpO2, ODR, ORR, T90, d.T90, r.T90, ST90, d.ST90, r.ST90 were significantly increased (P<0.05). ConclusionsDue to pathophysiological differences, all hypoxic parameters suggest that OA events will result in a more severe desaturation than Hyp events. Clinical assessment of OSA severity should not equate OA with Hyp events, which may cause more damage to the organism, establishing a basis for applying nocturnal SpO2 to automatically identify the type of respiratory event.
Objective To investigate the differences in clinical characteristics and polysomnographic characteristics between the elderly obstructive sleep apnea-hypopnea syndrome ( OSAHS) patients and the young and middle-aged OSAHS patients. Methods The clinical manifestations and the polysomnographic characteristics of 37 elderly OSAHS patients and 294 young and middle-aged patients were analyzed. The differences in polysomnographic indicators between two groups were compared according to the body mass index.Results The nocturia frequency in the elderly OSAHS patients was higher( P =0. 01) ,however, the othert clinical manifestations between the elderly group and the young and middle-aged group were not different significantly. The elderly group had a lower body mass index ( P =0. 018) , a smaller neck circumference ( P =0. 003) , and a larger chance of diabetes ( P = 0. 001) and hypertension( P lt; 0. 001) .The phase Ⅰ and phase Ⅱ sleep of the elderly group took a longer duration ( P lt; 0. 001) and a larger proportion( P lt;0. 001) . The sleep apnea-hypopnea index between two groups did not show any significant difference( P =0. 082) . The lowest night oxyhemoglobin saturation of the elderly group was higher than that of the young and middle-aged group( P =0. 009) , but such difference disappeared after adjustment by weight ( P =0. 114) . Conclusions The major clinical manifestations of the elderly OSAHS patients are similar to the young and middle-aged patients. The elderly patients are thinner than the young and middle-aged patients, but have more complications and a higher frequency of nocturia. The night oxyhemoglobin saturation is lower in young and middle-aged patients which is associated with higher body mass index.
Objective To assess the effectiveness of the auto-continuous positive airway pressure (Auto-CPAP) versus the fixed-continuous positive airway pressure (Fixed-CPAP) in patients with obstructive sleep Apnea syndrome (OSAS). Methods Such databases as PubMed (1990 to 2010), SpringerLink (1995 to 2010), CNKI (1990 to 2010), WanFang Data (1995 to 2010), and Google academic (1994 to 2010) were searched, the relevant conference theses were retrieved, and the experts in this field were enquired to collect the randomized controlled trials (RCTs) on Auto-CPAP versus Fixed-CPAP for patients with OSAS. Two reviewers independently screened the trials according to inclusion and exclusion criteria, abstracted the data, and assessed the methodology quality. Meta-analyes was performed using RevMan 5.0 software. Results A total of 11 RCTs involving 327 patients were included. The results of meta-analyses showed that, compared with the Fixed-CPAP group after treatment, the Auto-CPAP group significantly reduced the mean effective therapeutic pressure (WMD=-1.79, 95%CI -3.39 to -0.20), won much better treatment adherence (WMD=0.43, 95%CI 0.30 to 0.56), but got much higher scores of the Apnea-hypopnea index (AHI) (WMD=1.17, 95%CI 0.25 to 2.08) and Epworth Sleepiness Scale (ESS) (WMD=0.88, 95%CI 0.42 to 1.33) as well. There was no significant difference between those two groups in patients’ subjective preference for treatment (OR=2.06, 95%CI 0.46 to 9.10). Conclusion Compared to the Fixed-CPAP, the Auto-CPAP significantly reduces the mean effective therapeutic pressure and improves the treatment adherence of the patients, but is inferior in decreasing AHI and ESS. However, more high-quality and large-scale RCTs are required to verify the above conclusion because of the limitation of research quality and sample at present.
Objective To explore the causal association between obstructive sleep apnea (OSA) and venous thromboembolism (VTE). Methods Using the summary statistical data from the FinnGen biological sample library and IEU OpenGWAS database, the relationship between OSA and VTE, including deep vein thrombosis (DVT) and pulmonary embolism, was explored through Mendelian randomization (MR) method, with inverse variance weighted (IVW) as the main analysis method. Results The results of univariate MR analysis using IVW method showed that OSA was associated with VTE and pulmonary embolism (P<0.05), with odds ratios and 95% confidence intervals of 1.204 (1.067, 1.351) and 1.352 (1.179, 1.544), respectively. There was no correlation with DVT (P>0.05). Multivariate MR analysis showed that after adjustment for confounding factors (smoking, diabetes, obesity and cancer), OSA was associated with VTE, DVT and pulmonary embolism (P<0.05), with odds ratios and 95% confidence intervals of 1.168 (1.053, 1.322), 1.247 (1.064, 1.491) and 1.158 (1.021, 1.326), respectively. Conclusion OSA increases the risk of VTE, DVT, and pulmonary embolism.
