Sleep and Breathing最新文献

Background: This study aimed to investigate the association between Obstructive Sleep Apnea (OSA) and Tinnitus using NHANES data from 2005 to 2020.

Methods: This study analyzed data from NHANES (National Health and Nutrition Examination Surveys) conducted between 2005 and 2020, and included 4871 participants aged 16 or older. OSA was assessed using the Multivariate Apnea Prediction Index and the variables from the National Health and Nutrition Examination Survey. Tinnitus was defined as participants who reported being bothered by a ringing, roaring, or buzzing sound in the ears or head lasting 5 min or more during the past 12 months. Logistic regression models were employed to examine the association between OSA and Tinnitus.

Results: The study cohort had an overall prevalence of Tinnitus of 16.5%, with 53.51% for males and 46.49% for females. After controlling for potential confounders, there was a significant association between Tinnitus and OSA (odds ratio = 1.43, 95% confidence interval = 1.05-1.94, P = 0.03).

Conclusion: These findings indicate that OSA is a risk factor for the development of Tinnitus.

Background: Our previous study have demonstrated chronic intermittent hypoxia (CIH) induced cardiomyocyte apoptosis and cardiac dysfunction. However, the molecular mechanisms are complicated and varied. In this study, we first investigated the CaMKIIγ expression and signaling pathway in the pathogenesis of cardiomyocyte apoptosis after CIH.

Methods: Rats were separated into CIH and Normoxia groups, and H9c2 cells were divided into Control and CIH + 8 h groups. Rat body weight (BW) was markedly gained from two to six weeks. Furthermore, CIH decreased cardiac dysfunction, damaged cellular structure, induced myocardial fibrosis, and promoted cardiomyocyte apoptosis by HE, masson, sirius-red, and TUNEL staining. Western blot, immunohistochemical, immunofluorescence, double immunofluorescence staining were performed to investigate CaMKIIγ, Bcl-2, Bax, Caspase 3, HIF-1 protein expression.

Results: Heart weight (HW) and HW/BW ratio in CIH group was markedly gained compared with the Normoxia group. CaMKIIγ expression was notably increased after CIH, and mainly expressed in the cytoplasm in vivo and vitro. The results of HIF-1 expression have the same trend of CaMKIIγ expression and cardiomyocyte apoptosis. In addition, the co-localizations of CaMKIIγ with Caspase 3, and CaMKIIγ with HIF-1 were observed by double immunofluorescence staining.

Conclusions: These results indicated increased CaMKIIγ expression advances CIH-induced cardiomyocyte apoptosis via HIF-1 signaling pathway, which afford a new insight and provide a potential therapy for OSA patients.

Background: The repeated airway obstructions in the common disorder Obstructive Sleep Apnea (OSA) cause health risks. Continuous Positive Airway Pressure (CPAP), the standard treatment, faces adherence challenges. Mandibular Advancement Devices (MADs) have been used successfully for mild to moderate OSA, as a good alternative for these patients.

Objective: to evaluate the effectiveness of MADs in reducing the Apnea-Hypopnea Index (AHI) and improving symptoms in patients with very severe OSA unable to tolerate CPAP.

Methods: This retrospective study included 22 patients with very severe OSA (AHI ≥ 50) treated with MADs. Baseline characteristics, including: age, sex, BMI, and AHI, were recorded, and changes in AHI following treatment were assessed. Adherence was monitored using patient-reported data. Unlike previous studies, this research focuses exclusively on the efficacy of MADs in treating patients with very severe OSA, a population often excluded from similar inspections.

Results: median AHI significantly decreased from 60.0 (IQR: 57.0-65.0) to 15.0 (IQR: 10.0-24.0) after treatment (P < 0.001), with a mean reduction of 72.5% (± 14.3). Notably, 95.5% of patients achieved at least a 50% reduction in AHI. Symptom improvements, including reduced snoring and daytime tiredness, were reported by 72.7% of patients. BMI positively correlated with baseline AHI, and significant AHI reductions were observed across overweight and obese categories, although some patients remained in the severe AHI range post-treatment. Adherence varied, with 63.6% continuing to use the device.

Conclusions: MADs are effective in managing very severe OSA, providing significant reductions in AHI and symptom improvements. MADs may be a viable alternative for patients unable to tolerate CPAP. Further investigations into the long-term efficacy and impact on quality of life are needed.

Purpose: This study aimed to validate the new DormoTech Vlab device's performance, usability, and validity as a sleep test and physiological data recorder. The novel device has been designed for patient comfort, ease of use, and home-based assessment of sleep disordered breathing and other sleep-related measurements.

Methods: Forty-seven adults (mean age = 52 years, 42% female, body mass index 29.4 kg/m²) underwent simultaneous testing with the DormoTech Vlab device and routine full polysomnography (PSG) using the Nox A1 system (K192469, Nox Medical). The sleep studies were manually and independently scored according to recommended guidelines. The primary outcome measure was the apnea-hypopnea index (AHI) and its corresponding conventional severity level (i.e., normal, mild, moderate, severe). Secondary endpoints included other standard PSG parameters.

Results: The AHI was 21.7 ± 24.2 events/h (mean ± standard deviation) using the Vlab device versus 21.5 ± 23.9 events/h for gold standard PSG Nox A1 (p = 0.7). When AHI was grouped by severity, inter-test agreement was high (Cohen's kappa = 0.97). Results between the two systems were largely similar in the secondary endpoints, with high correlation between the two systems, and statistically significant (p < 0.05) differences only in REM latency measurements. The Vlab device provides similar sleep study data to conventional gold standard PSG and clinically near-identical test interpretation in almost all cases.

Conclusion: Based on these results, the Vlab device can be considered substantially equivalent to the reference Nox A1 system in terms of usability, efficacy, and validity.

Clinical trial registration: Trial name: Evaluation of the Usability and Performance Assessment of the DormoTech VLAB Device as a Home Sleep Test Identification number: NCT06224972. Date of Registration: 2023-12-06.

Purpose: To investigate the relationship between obstructive sleep apnea hypopnea syndrome (OSAHS) severity and fat, bone, and muscle indices.

Methods: This study included 102 patients with OSAHS and retrospectively reviewed their physical examination data. All patients underwent polysomnography, body composition analysis, dual-energy X-ray absorptiometry, computed tomography (CT) and blood test. Correlation and multiple linear regression analyses were performed using SPSS 22.0.

Results: Among the fat indices, fat mass (FM) (r = 0.27-0.43), body fat percentage (BFP) (r = 0. 25-0.35), visceral fat area (VFA) (r = 0.28-0.40) and trunk fat mass (TFM) (r = 0.26-0.34) were positively correlated with hypopnea index (HI), apnea-hypopnea index (AHI), oxygen desaturation index (ODI), and percent of time spent with oxygen saturation below 90% (T90%), respectively, and negatively correlated with mean pulse oxygen saturation (SpO₂) (r= -0.28--0.41). For bone indexes, T8, T9, T11, L1-CT value, mean vertebral CT value and 25-Hydroxyvitamin D3 were positively correlated with mean SpO₂ (r = 0.23-0.32), respectively. For muscle indexes, pectoralis muscle density (PMD) was negatively correlated with HI, AHI, and ODI (r= -0.20--0.36) and positively correlated with mean SpO₂ (r = 0.26). In separate models predicting sleep measures, AHI increased by 0.36, 0.29, 0.34 and 0.25 events/h per unit increase in FM, BFP, VFA, and triglyceride (TG), respectively. AHI decreased by 0.27 per unit increase in PMD. T90% increased with FM, BFP, VFA, WHR, TG and total cholesterol (TC), but decreased with appendicular skeletal muscle mass (ASM) and PMD respectively.

Conclusion: Higher fat levels and lower vertebral CT values, muscle mass and density correlated with a higher degree of OSAHS severity. Intermittent hypoxia may affect fat, bone, and muscle metabolism in patients with OSAHS.

Objectives: Sleep is often compromised in adolescents, affecting their health and quality of life. This pilot-study was conducted to evaluate if implementing brief-behavioral and sleep-hygiene education with mindfulness intervention may positively affect sleep-health in adolescents.

Method: Participants in this community-based non-randomized cohort-study volunteered for intervention (IG)- or control-group (CG). Sleep was recorded during regular school-schedule for 3-school-nights and 2-non-school-nights with an FDA-cleared/EU-Medical Device Regulation (CE-2862) compliant home sleep test, and Questionnaires were utilized to evaluate chronotype, sleepiness, insomnia-, anxiety- and depression-symptoms. The four-week intervention included sleep-hygiene education, mindfulness- and breathing-practices for one-hour, twice weekly. Data was collected during the last-week of February and first two-weeks of March 2023 and repeated after intervention.

Results: Fifty-five participants completed the study, IG (86%) and CG (77%). Average age was 17.3-years and prevalence of severe social-jetlag (SJL) 72%. Participants who quit participation (n = 10) after baseline data-collection all females (3-IG/7-CG) in comparison to participants who completed the study were sleepier than the IG and CG (+ 2.6-p = 0.04; + 3.8-p = 0.001), with more symptoms of insomnia- (+ 3.8-p = 0.002; + 4.7-p < 0.0001), and depression (+ 16.7-p < 0.0001; + 19.6-p < 0.0001), and report being later-chronotypes, (-18.2, p < 0.0001;-13.1, p < 0.0001). On average the IG advanced sleep-onset (32-min; p = 0.030), decreased SJL (37-min; p = 0.011) and increased total sleep time (TST, 29-min; p = 0.088) compared to the CG. Average sleep duration did not differ significantly comparing IG and CG after intervention. Stratifying participants with severe SJL (> 2-h) at baseline; 1) responders (61%) advanced sleep-onset on non-school-nights (96-min) and decreased SJL (103-min; p < 0.001) 2) non-responders (39%) increased sleep-duration on school-nights (36-min) and non-school-nights (63-min) but maintained severe-SJL.

Conclusion: Teacher-lead sleep-education and mindfulness program can improve TST and SJL in adolescence.

Purpose: A high proportion of obstructive sleep apnea (OSA) remains undiagnosed. The main objectives of this study were to measure the prevalence of diagnosed OSA and determine OSA predictors in patients who underwent bariatric surgery, who are predominantly female and pre-menopausal and represent an understudied population in OSA literature.

Methods: This was a cross-sectional population-based study using the Ontario Bariatric Registry (OBR) from 2010 to 2016, linked to ICES databases which include health administrative data on all encounters within a single public-payer system. Multiple logistic regression was used to measure OSA predictors.

Results: Out of a total of 18,074 patients who underwent bariatric surgery, OSA was diagnosed in 47% (95% confidence interval [CI]: 46 to 47), and OSA was the second most common comorbidity within this population. Only 63% of OSA diagnoses were recorded in the OBR at the time of initial bariatric consultation. Based on interaction, it was found that, in females, OSA predictors included social inequality, diabetes and chronic obstructive pulmonary disease, in addition to the predictors measured in males (age, body mass index and comorbidity burden).

Conclusion: A significant proportion of patients presenting for initial bariatric surgery consultation have undiagnosed OSA. OSA screening and testing may lead to underdiagnosis of OSA, especially in pre-menopausal females who represent the majority of the population undergoing bariatric surgery.

Purpose: In heart failure (HF) and chronic obstructive pulmonary disease (COPD) populations, sleep-disordered breathing (SDB) is associated with impaired health outcomes. We evaluated whether in patients with HF, concomitant HF and COPD or COPD, the number of hospitalizations would be reduced in the year after testing for SDB with and without treatment initiation compared to the year before.

Methods: We performed a multicentre retrospective study of 390 consecutive sleep-clinic patients who had a primary diagnosis of chronic HF, HF and COPD or COPD and a secondary diagnosis of SDB. The date of SDB-testing was defined as the index date. Data on healthcare utilization was extracted for the 12-month period prior to and after this date.

Results: The initiation of adaptive servoventilation (ASV) and non-invasive ventilation (NIV) treatment resulted in a statistically significant reduction in the number of hospitalisations. While continuous positive airway pressure (CPAP) treatment also demonstrated a reduction in hospitalisations, the observed effect did not reach the level of statistical significance. After accounting for demographics and comorbidities in multivariable regression analyses, only NIV was significantly associated with a reduction in hospitalizations, while CPAP or ASV were not. NIV appears to be underutilized in COPD.

Conclusions: Our data indicate, that patients with HF or COPD and concomitant SDB may benefit from the initiation of appropriate PAP-therapy. Whether treating SDB in HF- and COPD-patients influences healthcare utilization merits further investigation.

Objective: This study aims to investigate the effects of video scenario-based breathing training on interleukin-4 (IL-4), interleukin-6 (IL-6), interleukin-10 (IL-10), tumor necrosis factor-α (TNF-α), and interferon-γ (IFN-γ) in children with Mycoplasma pneumonia.

Methods: A total of 106 children with Mycoplasma pneumonia treated in our hospital from February 2022 to April 2024 were selected. According to different nursing methods, children receiving routine intervention were assigned to the control group, while those undergoing video scenario-based breathing training were assigned to the training group. The serum inflammatory indexes, improvement time of clinical symptoms and lung function recovery were compared between the two groups before training, and at 1 and 2 weeks after training.

Results: Before training, there was no statistically significant difference in serum inflammatory and lung function indexes between the two groups (p > 0.05). After 1 and 2 weeks of training, the forced expiratory volume in 1 s (FEV1), peak expiratory flow rate (PEF), and the ratio of FEV1 to forced vital capacity (FEV1/FVC) in both groups increased, with higher values in the training group than in the control group, and the difference was statistically significant (p < 0.05). The time for cough disappearance, wheezing disappearance, lung rales disappearance and high fever abatement in the training group was lower than that in the control group, with statistically significant differences (p < 0.05). The levels of IL-4, IL-6, IL-10, TNF-α, and IFN-γ decreased in both groups, with lower levels in the training group than in the control group, and the difference was statistically significant (p < 0.05).

Conclusion: Video scenario-based breathing training can improve lung function, alleviate clinical symptoms and signs, and reduce serum inflammatory levels of IL-4, IL-6, IL-10, TNF-α and IFN-γ in children with Mycoplasma pneumonia.

Purpose: Comorbid insomnia and obstructive sleep apnea (COMISA) present significant clinical challenges, given their overlapping symptoms and detrimental effects on health. Only a few studies have explored sex differences in patients with obstructive sleep apnea (OSA) and COMISA. This retrospective study investigated sex differences in psychiatric symptoms and polysomnographic findings between patients with COMISA and those with OSA alone.

Methods: Patients who underwent polysomnography (PSG) and completed questionnaires at a single tertiary hospital sleep center were enrolled. Patients diagnosed with OSA using PSG (apnea-hypopnea index ≥ 5) were categorized based on the Insomnia Severity Index-Korean version (ISI) into OSA without insomnia (OSA-only group; ISI < 15) and OSA with insomnia (COMISA group; ISI ≥ 15).

Results: This study included 1,096 adult patients diagnosed with OSA, of whom 426 (38.9%) were in the COMISA group. COMISA was more common in women than in men (50.7% vs. 34.5%, p < 0.001). The COMISA group reported more severe subjective psychiatric symptoms, including depression, anxiety, and daytime sleepiness in both men and women. The male COMISA group had lower sleep efficiency (p = 0.02) and longer sleep latency (p = 0.002) than those had by the OSA-only group. The male COMISA group had a higher apnea-hypopnea index (p = 0.04) and a lower mean oxygen saturation (p = 0.004) than those had by the OSA-only group.

Conclusion: These findings highlight the importance of considering sex-specific clinical and polysomnographic characteristics when managing patients with COMISA.