Biomedicines

Research

10 pages, 657 KiB

Open AccessArticle

The Relationship between the Plasma Concentration of Electrolytes and Intensity of Sleep Bruxism and Blood Pressure Variability among Sleep Bruxers

by Justyna Kanclerska, Mieszko Wieckiewicz, Anna Szymanska-Chabowska, Rafal Poreba, Pawel Gac, Anna Wojakowska, Grzegorz Mazur and Helena Martynowicz

Biomedicines 2022, 10(11), 2804; https://doi.org/10.3390/biomedicines10112804 - 04 Nov 2022

Cited by 2 | Viewed by 1954

Abstract

Plasma sodium plays a major role in regulating blood pressure (BP). An augmented variability of BP is considered a risk factor for the development of arterial hypertension, which is prevalent among patients with suspected sleep bruxism (SB). The aims of this study were [...] Read more.

Plasma sodium plays a major role in regulating blood pressure (BP). An augmented variability of BP is considered a risk factor for the development of arterial hypertension, which is prevalent among patients with suspected sleep bruxism (SB). The aims of this study were to assess the plasma concentration of electrolytes and their effect on the intensity of SB and BP variability among sleep bruxers. A total of 51 patients were enrolled in this prospective, observational study. A single full-night polysomnographic examination was conducted in the Wroclaw Medical University Sleep Laboratory, Poland, and based on the guidelines of the American Academy of Sleep Medicine, the results were analyzed. The monitoring of ambulatory BP was performed the next day, and the plasma levels of sodium, potassium, magnesium, and calcium were measured. The mean age of the studied group was 33.9 ± 11.2 years, and the mean bruxism episode index (BEI) was 4.94 ± 3.53. The study revealed statistically significant differences in the plasma concentrations of sodium in the SB group. A decreased sodium concentration was observed in the group of mild bruxers (2 ≤ BEI < 4) (139.7 ± 1.4 vs. 142.8 ± 3.2, p = 0.002) and severe bruxers (BEI ≥ 4) (140.5 ± 2.0 vs. 142.8 ± 3.2, p = 0.016) compared to nonbruxers (BEI < 2). A statistically significant positive linear correlation was found between plasma sodium concentration and daytime systolic BP variability (r = 0.32, p < 0.05) as well as between plasma sodium concentration and nighttime diastolic BP variability (r = 0.31, p < 0.05). The preliminary results suggest the probable relationship between the lower plasma concentration of sodium and increased intensity of SB and BP variability among suspected sleep bruxers. Full article

(This article belongs to the Special Issue Sleep Disorders: An Interdisciplinary Approach)

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10 pages, 283 KiB

Open AccessArticle

Genetic Variants of the TERT Gene and Telomere Length in Obstructive Sleep Apnea

by Piotr Macek, Rafal Poreba, Pawel Gac, Katarzyna Bogunia-Kubik, Marta Dratwa, Mieszko Wieckiewicz, Anna Wojakowska, Monika Michalek-Zrabkowska, Grzegorz Mazur and Helena Martynowicz

Biomedicines 2022, 10(11), 2755; https://doi.org/10.3390/biomedicines10112755 - 30 Oct 2022

Cited by 1 | Viewed by 1560

Abstract

Introduction: Obstructive sleep apnea (OSA) is a worldwide breathing disorder that has been diagnosed globally in almost 1 billion individuals aged 30–69 years. It is characterized by repeated upper airway collapses during sleep. Telomerase reverse transcriptase (TERT) is involved in the prevention of [...] Read more.

Introduction: Obstructive sleep apnea (OSA) is a worldwide breathing disorder that has been diagnosed globally in almost 1 billion individuals aged 30–69 years. It is characterized by repeated upper airway collapses during sleep. Telomerase reverse transcriptase (TERT) is involved in the prevention of telomere shortening. This prospective, observational study aimed to investigate the relationship between single nucleotide polymorphisms (SNPs) of TERT and the severity of OSA, taking into account hypertension and diabetes prevalence. Methods: A total of 149 patients with OSA were diagnosed using one-night video-polysomnography based on the American Academy of Sleep Medicine guidelines. The TERT SNPs and telomere length (TL) were detected using real-time quantitative polymerase chain reaction. Results: Statistical analysis showed that there is no relationship between the rs2853669 and rs2736100 polymorphisms of TERT, and the severity of OSA (p > 0.05). Moreover, no relationship between TL and the severity of OSA was observed. The G allele in the locus of rs2736100 TERT was associated with hypertension prevalence and was more prevalent in hypertensives patients (46.00% vs. 24.49%, p = 0.011). The prevalence of hypertension was higher in patients with the C allele in the locus of rs2853669 than in patients without this allele (50.79% vs. 30.23%, p = 0.010). Moreover, a lower prevalence of diabetes was observed in homozygotes of rs2736100 TERT than in heterozygotes (5.63% vs. 15.38%, p = 0.039). Conclusion: This study showed no relationship between OSA and TERT SNPs. However, SNPs of the TERT gene (rs2736100 and rs2853669) were found to affect arterial hypertension and diabetes prevalence. Full article

(This article belongs to the Special Issue Sleep Disorders: An Interdisciplinary Approach)

24 pages, 1131 KiB

Open AccessArticle

Sleep Bruxism Contributes to Motor Activity Increase during Sleep in Apneic and Nonapneic Patients—A Polysomnographic Study

by Tomasz Wieczorek, Monika Michałek-Zrąbkowska, Mieszko Więckiewicz, Grzegorz Mazur, Joanna Rymaszewska, Joanna Smardz, Anna Wojakowska and Helena Martynowicz

Biomedicines 2022, 10(10), 2666; https://doi.org/10.3390/biomedicines10102666 - 21 Oct 2022

Cited by 3 | Viewed by 1828

Abstract

Background: Jaw motor activity (MA) in sleep bruxism (SB) has been demonstrated to accompany lower limb movements. However, it remains unknown whether SB activity coexists with other types of movements and what the possible underlying mechanisms of such temporal coexistence are. In obstructive [...] Read more.

Background: Jaw motor activity (MA) in sleep bruxism (SB) has been demonstrated to accompany lower limb movements. However, it remains unknown whether SB activity coexists with other types of movements and what the possible underlying mechanisms of such temporal coexistence are. In obstructive sleep apnea (OSA), increased movement activity is also reported, including SB activity; however, no studies have compared MA in apneic and nonapneic SB patients. Aim: This cross-sectional study focused on the phenomenon of “big body movements” in patients with either SB or OSA (or both) and intended to identify the primary factors contributing to their appearance, using polysomnography (PSG) recording. Methods: A whole-night videoPSG was carried out in 287 participants, and 124 apneic and 146 nonapneic participants were selected for the study. In both groups, participants were further divided into no SB, moderate SB, and severe SB (SSB) subgroups based on their bruxism episode index (BEI). MA was recorded using a built-in sensor of the central PSG unit located on the participant’s chest during the examination. Results: The presence of SB was related to the higher intensity of MA in both apneic and nonapneic participants, though in general the MA level was higher in apneic participants, with the highest level observed in SSB apneic participants. Conclusions: SB might contribute to MA. The prevalence of SB might be higher in nonapneic patients due to phasic and mixed SB activity, whereas the SB phenotype seems to be less relevant in apneic patients. SB activity is likely to increase MA in non-REM 1 sleep. Full article

(This article belongs to the Special Issue Sleep Disorders: An Interdisciplinary Approach)

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10 pages, 2810 KiB

Open AccessArticle

Dynamics of Circulating CD14/CD16 Monocyte Subsets in Obstructive Sleep Apnea Syndrome Patients upon Hypoglossal Nerve Stimulation

by Ralph Pries, Christian Lange, Nicole Behn, Karl-Ludwig Bruchhage and Armin Steffen

Biomedicines 2022, 10(8), 1925; https://doi.org/10.3390/biomedicines10081925 - 09 Aug 2022

Cited by 4 | Viewed by 1538

Abstract

Background: Obstructive sleep apnea syndrome (OSAS) is a widespread respiratory disease that is associated with recurrent breathing intermissions at night. The corresponding oxidative stress triggers a low-grade systemic inflammation which leads to alterations of different immune cells in the peripheral blood. The current [...] Read more.

Background: Obstructive sleep apnea syndrome (OSAS) is a widespread respiratory disease that is associated with recurrent breathing intermissions at night. The corresponding oxidative stress triggers a low-grade systemic inflammation which leads to alterations of different immune cells in the peripheral blood. The current standard treatment for OSAS is continuous positive airway pressure (CPAP), whereas hypoglossal nerve stimulation (HNS) has been established as a second-line treatment option for CPAP failure. The aim of the study was to investigate the influence of HNS for OSAS patients on the distribution and differentiation of circulating monocyte subsets in connection with the clinical parameters. Materials and Methods: Therefore, a detailed analysis of the distribution of CD14/CD16 characterized monocyte subsets in the peripheral blood of OSAS patients before and after HNS therapy was performed by flow cytometry. Furthermore, values of BMI (body mass index), ODI (oxygen desaturation index), and ESS (Epworth Sleepiness Scale) were measured. Results: These OSAS patients significantly improved AHI and ESS scores under HNS. In addition, HNS revealed the potential to ensure normal distributions of blood monocyte subsets and even improved the monocyte dynamics in selected OSAS patients, but there were no significant correlations with AHI, ODI, HNS usage, and daytime sleepiness. Conclusions: We conclude that HNS-related positive effects on the oxygenation of the peripheral blood as well as affect the distribution of circulating monocyte subsets, but clinical OSAS correlations are missing. Far more individual clinical, cellular and molecular factors are involved in this sensitive and complex regulatory network and have to be elucidated in further studies. Full article

(This article belongs to the Special Issue Sleep Disorders: An Interdisciplinary Approach)

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10 pages, 785 KiB

Open AccessArticle

Interactions between Obstructive Sleep Apnea Syndrome Severity, Obesity, Sex Difference and Attention-Deficit/Hyperactivity Disorder on Health-Related Quality of Life: A Non-Interventional Prospective Observational Study

by Yu-Hsuan Chen, Ming-Feng Wu, Chih-Yu Wen, Shih-Pei Chang, Ching-Yi Lin, Yi-Chan Chen, Ching-Cheng Lin, Hui-Chen Chen, Wei-Chang Huang and Kai-Ming Chang

Biomedicines 2022, 10(7), 1576; https://doi.org/10.3390/biomedicines10071576 - 01 Jul 2022

Cited by 4 | Viewed by 1646

Abstract

Obstructive sleep apnea syndrome (OSAS) severity, obesity, sex difference, and attention-deficit/hyperactivity disorder (ADHD) had a complex impact on health-related quality of life (HRQoL). However, the interactive effects among these features on HRQoL remained to be clarified. This study aimed to investigate the individual [...] Read more.

Obstructive sleep apnea syndrome (OSAS) severity, obesity, sex difference, and attention-deficit/hyperactivity disorder (ADHD) had a complex impact on health-related quality of life (HRQoL). However, the interactive effects among these features on HRQoL remained to be clarified. This study aimed to investigate the individual and interactive associations between the four characteristics of interest and HRQoL as determined by 36-Item Short Form Health Survey, Pittsburgh Sleep Quality Index (PSQI), and Epworth Sleepiness Scale (ESS). This non-interventional, prospective, observational study enrolled a total of 132 patients with suspected OSAS for analysis. While OSAS severity and ADHD detected by adult ADHD Self-Report Scale, termed as screened ADHD, interact with each other, all the four studied features were individually associated with HRQoL. After adjusting for potential physiological and polysomnographic confounders, screened ADHD was independently correlated with PSQI > 5 (OR = 4.126, 95% CI, 1.490–11.424), mental component score < 50 (OR = 5.873, 95% CI, 2.262–15.251) and ESS > 10 (OR = 3.648, 95% CI, 1.738–7.657). Our results show that ADHD detection is necessary and should be incorporated into clinical practice for OSAS management. Full article

(This article belongs to the Special Issue Sleep Disorders: An Interdisciplinary Approach)

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13 pages, 279 KiB

Open AccessArticle

Telemetric Assessment of Continuous Positive Airways Pressure (CPAP) Effectiveness and Adherence in Obstructive Sleep Apnea during COVID-19 Pandemic

by Monika Michalek-Zrabkowska, Rafal Poreba, Pawel Gac, Weronika Frosztega, Anna Wojakowska, Mieszko Wieckiewicz, Justyna Kanclerska, Piotr Macek, Wlodzimierz Wieckiewicz, Grzegorz Mazur and Helena Martynowicz

Biomedicines 2022, 10(5), 1011; https://doi.org/10.3390/biomedicines10051011 - 27 Apr 2022

Cited by 2 | Viewed by 1648

Abstract

Obstructive sleep apnea is the most common sleep-related breathing disorder. In the pandemic times of the new coronavirus SARS-CoV-2, CPAP (Continuous Positive Airway Pressure) therapy of obstructive sleep apnea became even more challenging. After the pandemic outbreak in March 2020, most CPAP treatment [...] Read more.

Obstructive sleep apnea is the most common sleep-related breathing disorder. In the pandemic times of the new coronavirus SARS-CoV-2, CPAP (Continuous Positive Airway Pressure) therapy of obstructive sleep apnea became even more challenging. After the pandemic outbreak in March 2020, most CPAP treatment recommendations changed because of rising concerns about CPAP usage safety for patients and their families. Therefore, we examined the effectiveness of CPAP and adherence to the therapy of 149 adults with obstructive sleep apnea in the period of two years from 4 March 2019 to 3 March 2021 (before pandemic breakout and during the first year of pandemic). Data on CPAP parameters and adherence to therapy were obtained via a telemetric system. Together, our results demonstrated that the COVID-19 pandemic had no significant impact on CPAP therapy parameters and adherence in whole study group. However, detailed analysis acknowledged that some demographic and clinical features influenced CPAP therapy. The results showed that across subgroups of patients differentiated on the basis of age, gender, co-existing diabetes mellitus, or hypertension, the COVID-19 pandemic seemed to affect CPAP effectiveness. Our results provide a good starting point for discussion on CPAP therapy recommendations during pandemic times. Full article

(This article belongs to the Special Issue Sleep Disorders: An Interdisciplinary Approach)

Review

Jump to: Research, Other

31 pages, 1680 KiB

Open AccessReview

Obstructive Sleep Apnoea and Lipid Metabolism: The Summary of Evidence and Future Perspectives in the Pathophysiology of OSA-Associated Dyslipidaemia

by Martina Meszaros and Andras Bikov

Biomedicines 2022, 10(11), 2754; https://doi.org/10.3390/biomedicines10112754 - 29 Oct 2022

Cited by 16 | Viewed by 2982

Abstract

Obstructive sleep apnoea (OSA) is associated with cardiovascular and metabolic comorbidities, including hypertension, dyslipidaemia, insulin resistance and atherosclerosis. Strong evidence suggests that OSA is associated with an altered lipid profile including elevated levels of triglyceride-rich lipoproteins and decreased levels of high-density lipoprotein (HDL). [...] Read more.

Obstructive sleep apnoea (OSA) is associated with cardiovascular and metabolic comorbidities, including hypertension, dyslipidaemia, insulin resistance and atherosclerosis. Strong evidence suggests that OSA is associated with an altered lipid profile including elevated levels of triglyceride-rich lipoproteins and decreased levels of high-density lipoprotein (HDL). Intermittent hypoxia; sleep fragmentation; and consequential surges in the sympathetic activity, enhanced oxidative stress and systemic inflammation are the postulated mechanisms leading to metabolic alterations in OSA. Although the exact mechanisms of OSA-associated dyslipidaemia have not been fully elucidated, three main points have been found to be impaired: activated lipolysis in the adipose tissue, decreased lipid clearance from the circulation and accelerated de novo lipid synthesis. This is further complicated by the oxidisation of atherogenic lipoproteins, adipose tissue dysfunction, hormonal changes, and the reduced function of HDL particles in OSA. In this comprehensive review, we summarise and critically evaluate the current evidence about the possible mechanisms involved in OSA-associated dyslipidaemia. Full article

(This article belongs to the Special Issue Sleep Disorders: An Interdisciplinary Approach)

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19 pages, 1171 KiB

Open AccessSystematic Review

A Systematic Review of Sleep–Wake Disorder Diagnostic Criteria Reliability Studies

by Christophe Gauld, Régis Lopez, Pierre Philip, Jacques Taillard, Charles M. Morin, Pierre Alexis Geoffroy and Jean-Arthur Micoulaud-Franchi

Biomedicines 2022, 10(7), 1616; https://doi.org/10.3390/biomedicines10071616 - 06 Jul 2022

Cited by 4 | Viewed by 2401

Abstract

The aim of this article is to provide a systematic review of reliability studies of the sleep–wake disorder diagnostic criteria of the international classifications used in sleep medicine. Electronic databases (ubMed (1946–2021) and Web of Science (—2021)) were searched up to December 2021 [...] Read more.

The aim of this article is to provide a systematic review of reliability studies of the sleep–wake disorder diagnostic criteria of the international classifications used in sleep medicine. Electronic databases (ubMed (1946–2021) and Web of Science (—2021)) were searched up to December 2021 for studies computing the Cohen’s kappa coefficient of diagnostic criteria for the main sleep–wake disorder categories described in the principal classifications. Cohen’s kappa coefficients were extracted for each main sleep–wake disorder category, for each classification subtype, and for the different types of methods used to test the degree of agreement about a diagnosis. The database search identified 383 studies. Fifteen studies were analyzed in this systematic review. Insomnia disorder (10/15) and parasomnia disorder (7/15) diagnostic criteria were the most studied. The reliability of all sleep–wake disorders presented a Cohen’s kappa with substantial agreement (Cohen’s kappa mean = 0.66). The two main reliability methods identified were “test–retest reliability” (11/15), principally used for International Classification of Sleep Disorders (ICSD), and “joint interrater reliability” (4/15), principally used for Diagnostic and Statistical Manual of Mental Disorders (DSM) subtype diagnostic criteria, in particularl, the DSM-5. The implications in terms of the design of the methods used to test the degree of agreement about a diagnosis in sleep medicine are discussed. Full article

(This article belongs to the Special Issue Sleep Disorders: An Interdisciplinary Approach)

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