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Management of Obstructive Sleep Apnea (OSA)
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Management of Obstructive Sleep Apnea (OSA)

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Neurology".

Deadline for manuscript submissions: closed (30 April 2021) | Viewed by 13451

Special Issue Editor

Prof. Dr. Frédéric Roche

E-Mail Website
Guest Editor
U1059, Sainbiose, Dysfonction Vasculaire et Hémostase, Université de Lyon, Université Jean Monnet Saint-Étienne, F-42270 Saint-Priest-en-Jarez, France
Interests: sleep disorders; autonomic nervous system function; brain MRI; cognitive disorders
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Obstructive sleep apnea represents a public health problem by its strong incidence with the aging of the population and the obesity epidemic, of which we are all witnesses. The cost-effectiveness of the diagnostic methods and the treatment modalities of this pathology should indisputably be rediciled. New and important information is expected on the factors of compliance with different treatments, but behavioral therapeutic methods will have to find their place in the future. Changes in lifestyle habits to fight against (increasing) sedentary lifestyle, but also the early management in childhood of developmental anomalies of the elements of the mandibular/masticatory system must be included in the management. Finally in adults at high cardiovascular risk and the elderly, clarification of the “good indications” of treatment (in particular for continuous positive pressure) should be proposed.

The purpose of this Special Issue will therefore be to present original research work centered around these new questions.

Prof. Dr. Frédéric Roche
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • obstructive sleep apnea
  • aging
  • high cardiovascular risk
  • early management

Published Papers (5 papers)

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Research

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11 pages, 718 KiB  
Article
Triglyceride-Glucose Index in Non-Diabetic, Non-Obese Patients with Obstructive Sleep Apnoea
by Andras Bikov, Stefan M. Frent, Martina Meszaros, Laszlo Kunos, Alexander G. Mathioudakis, Alina Gabriela Negru, Laura Gaita and Stefan Mihaicuta
J. Clin. Med. 2021, 10(9), 1932; https://doi.org/10.3390/jcm10091932 - 29 Apr 2021
Cited by 13 | Viewed by 3142
Abstract
Obstructive sleep apnoea (OSA) is associated with increased insulin resistance. Triglyceride-glucose index (TyG) is a simple marker of insulin resistance; however, it has been investigated only by two studies in OSA. The aim of this study was to evaluate TyG in non-diabetic, non-obese [...] Read more.
Obstructive sleep apnoea (OSA) is associated with increased insulin resistance. Triglyceride-glucose index (TyG) is a simple marker of insulin resistance; however, it has been investigated only by two studies in OSA. The aim of this study was to evaluate TyG in non-diabetic, non-obese patients with OSA. A total of 132 patients with OSA and 49 non-OSA control subjects were included. Following a diagnostic sleep test, fasting blood was taken for the analysis of the lipid profile and glucose concentrations. TyG was calculated as ln(triglyceride [mg/dL] × glucose [mg/dL]/2). Comparison analyses between OSA and control groups were adjusted for age, gender, body mass index (BMI) and smoking. TyG was higher in men (p < 0.01) and in ever-smokers (p = 0.02) and it was related to BMI (ρ = 0.33), cigarette pack-years (ρ = 0.17), apnoea–hypopnoea index (ρ = 0.38), oxygen desaturation index (ρ = 0.40), percentage of total sleep time spent with oxygen saturation below 90% (ρ = 0.34), and minimal oxygen saturation (ρ = −0.29; all p < 0.05). TyG values were significantly higher in OSA (p = 0.02) following adjustment for covariates. OSA is independently associated with higher TyG values which are related to disease severity in non-obese, non-diabetic subjects. However, the value of TyG in clinical practice should be evaluated in follow-up studies in patients with OSA. Full article
(This article belongs to the Special Issue Management of Obstructive Sleep Apnea (OSA))
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11 pages, 824 KiB  
Article
Long-Term Changes in Sleep Disordered Breathing in Renal Transplant Patients: Relevance of the BMI
by Francesca Mallamaci, Rocco Tripepi, Graziella D’Arrigo, Gaetana Porto, Maria Carmela Versace, Carmela Marino, Maria Cristina Sanguedolce, Giovanni Tripepi and Carmine Zoccali
J. Clin. Med. 2020, 9(6), 1739; https://doi.org/10.3390/jcm9061739 - 04 Jun 2020
Cited by 5 | Viewed by 1653
Abstract
Sleep disordered breathing (SDB), as defined by the Apnea Hypopnea Index (AHI), is a highly prevalent disturbance in end stage kidney disease. SDB improves early on after renal transplantation but long-term changes in AHI in these patients have not been studied. We studied [...] Read more.
Sleep disordered breathing (SDB), as defined by the Apnea Hypopnea Index (AHI), is a highly prevalent disturbance in end stage kidney disease. SDB improves early on after renal transplantation but long-term changes in AHI in these patients have not been studied. We studied the long-term changes in AHI in a series of 221 renal transplant patients (mean age: 47 ± 12 years; 70% males) over a median follow up of 35 months. Data analysis was made by the generalized estimating equations method (GEE). On longitudinal observation, the median AHI rose from 1.8 (Interquartile range: 0.6–5.0) to 2.9 (IQR: 1.0–6.6) and to 3.6 (IQR: 1.7–10.4) at the second and third visit, respectively (p = 0.009 by the GEE model and the proportion of patients with moderate to severe SDB rose from 8% to 20%. Longitudinal changes in minimum oxygen saturation (minSaO2) mirrored those in the AHI. In adjusted analyses, repeated measurements of BMI (p < 0.009) emerged as the strongest independent longitudinal correlate of AHI and MinSaO2. The AHI worsens over time in renal transplant patients and longitudinal changes of this biomarker are directly related to simultaneous changes in BMI. Overweight/obesity, a potentially modifiable risk factor, is an important factor underlying the risk of SDB in this population. Full article
(This article belongs to the Special Issue Management of Obstructive Sleep Apnea (OSA))
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9 pages, 901 KiB  
Article
Multidimensional Evaluation of Continuous Positive Airway Pressure (CPAP) Treatment for Sleep Apnea in Different Clusters of Couples
by Monique Mendelson, Thibaut Gentina, Elodie Gentina, Renaud Tamisier, Jean-Louis Pépin and Sébastien Bailly
J. Clin. Med. 2020, 9(6), 1658; https://doi.org/10.3390/jcm9061658 - 01 Jun 2020
Cited by 12 | Viewed by 2237
Abstract
Continuous positive airway pressure (CPAP) is the most efficient treatment of obstructive sleep apnea (OSA). Little is known about the impact of spousal relationship profiles on CPAP adherence. We aimed to identify clusters of couples of OSA patients, and their association with CPAP [...] Read more.
Continuous positive airway pressure (CPAP) is the most efficient treatment of obstructive sleep apnea (OSA). Little is known about the impact of spousal relationship profiles on CPAP adherence. We aimed to identify clusters of couples of OSA patients, and their association with CPAP adherence 120 days after CPAP initiation. In a multicenter prospective study, OSA patients recently prescribed CPAP were enrolled with their spouses. Data about spousal relationships were collected at inclusion and at day 120. Latent class analysis was performed to determine homogeneous groups of spousal relationships. The 290 participants were predominantly males (77%), median age was 53 years and interquartile range (IQR) 46–62, median body mass index (BMI) was 32 kg/m2 (IQR: 28.6–35.9) and median apnea–hypopnea index: 43 events per hour (IQR: 33–58). Three couple clusters were identified: (1) older retired couples, (2) young working couples, and (3) mature active couples. Patients in the older retired couples cluster presented the highest CPAP adherence (p < 0.01) independently of initial complaints, OSA severity, and degree of improvement under CPAP. In a large cohort of OSA patients in whom clusters of couples were determined, there was a significant difference in CPAP adherence at day-120 after CPAP initiation. Full article
(This article belongs to the Special Issue Management of Obstructive Sleep Apnea (OSA))
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7 pages, 784 KiB  
Communication
Relationship between HIF-1 and Circadian Clock Proteins in Obstructive Sleep Apnea Patients—Preliminary Study
by Agata Gabryelska, Marcin Sochal, Szymon Turkiewicz and Piotr Białasiewicz
J. Clin. Med. 2020, 9(5), 1599; https://doi.org/10.3390/jcm9051599 - 25 May 2020
Cited by 45 | Viewed by 3393
Abstract
Obstructive sleep apnea (OSA) is characterized by intermittent hypoxia and associated with the disruption of circadian rhythm. The study aimed to assess the relationship between hypoxia-inducible factor (HIF) subunits, circadian clock proteins, and polysomnography (PSG) variables, in healthy individuals and severe OSA patients. [...] Read more.
Obstructive sleep apnea (OSA) is characterized by intermittent hypoxia and associated with the disruption of circadian rhythm. The study aimed to assess the relationship between hypoxia-inducible factor (HIF) subunits, circadian clock proteins, and polysomnography (PSG) variables, in healthy individuals and severe OSA patients. The study included 20 individuals, who underwent PSG and were divided into severe OSA group (n = 10; AHI ≥ 30) and healthy control (n = 10; AHI < 5) based on apnea-hypopnea index (AHI). All participants had their peripheral blood collected in the evening before and the morning after the PSG. HIF-1α, HIF-1β, BMAL1, CLOCK, CRY1, and PER1 protein concertation measurements were performed using ELISA. In a multivariate general linear model with the concentration of all circadian clock proteins as dependent variables, evening HIF-1α protein level was the only significant covariant (p = 0.025). Corrected models were significant for morning and evening PER1 (p = 0.008 and p = 0.006, respectively), evening (p = 0.043), and evening BMAL protein level (p = 0.046). In corrected models, evening HIF-1α protein level had an influence only on the evening PER1 protein level. Results suggest that OSA patients are at risk for developing circadian clock disruption. This process might be mediated by subunit α of HIF-1, as its increased protein level is associated with overexpression of circadian clock proteins. Full article
(This article belongs to the Special Issue Management of Obstructive Sleep Apnea (OSA))
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Review

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19 pages, 388 KiB  
Review
Role of the Cyclooxygenase Pathway in the Association of Obstructive Sleep Apnea and Cancer
by César Picado and Jordi Roca-Ferrer
J. Clin. Med. 2020, 9(10), 3237; https://doi.org/10.3390/jcm9103237 - 10 Oct 2020
Cited by 7 | Viewed by 2253
Abstract
The objective of this review is to examine the findings that link obstructive sleep apnea (OSA) with cancer and the role played by the cyclooxygenase (COX) pathway in this association. Epidemiological studies in humans suggest a link between OSA and increased cancer incidence [...] Read more.
The objective of this review is to examine the findings that link obstructive sleep apnea (OSA) with cancer and the role played by the cyclooxygenase (COX) pathway in this association. Epidemiological studies in humans suggest a link between OSA and increased cancer incidence and mortality. Studies carried out in animal models have shown that intermittent hypoxia (IH) induces changes in several signaling pathways involved in the regulation of host immunological surveillance that results in tumor establishment and invasion. IH induces the expression of cyclooxygenase 2 (COX-2) that results in an increased synthesis of prostaglandin E2 (PGE2). PGE2 modulates the function of multiple cells involved in immune responses including T lymphocytes, NK cells, dendritic cells, macrophages, and myeloid-derived suppressor cells. In a mouse model blockage of COX-2/PGE2 abrogated the pro-oncogenic effects of IH. Despite the fact that aspirin inhibits PGE2 production and prevents the development of cancer, none of the epidemiological studies that investigated the association of OSA and cancer included aspirin use in the analysis. Studies are needed to investigate the regulation of the COX-2/PGE2 pathway and PGE2 production in patients with OSA, to better define the role of this axis in the physiopathology of OSA and the potential role of aspirin in preventing the development of cancer. Full article
(This article belongs to the Special Issue Management of Obstructive Sleep Apnea (OSA))
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