Objective To investigate the differences in biological features between male and female patients with obstructive sleep apnea-hypopnea syndrome( OSAHS) . Methods 192 cases of patients with snoring were analyzed in the Sleep Medicine Center of West ChinaHospital fromSeptember 2004 to February 2005. The standard sleep disorder questionnaires, neck circumference, hight, weight, and all night polysomnography ( PSG) were evaluated. The clinical features of the male and female patients with OSAHS were compared. Results 170 cases of patients met the criteria of OSAHS for the apnea-hypopnea index ( AHI) more than 5 times per hour. Male gender accounted for 90% of the total patients ( male vs. female 153 vs. 17, 9∶1) . The age of male patients with OSAHS was younger than that of female ( 45. 7 ±11. 4 yearsvs. 58. 0 ±6. 1 years, P = 0. 000) . Parameters including neck circumference ( 37. 6 ±3. 2 cm vs. 35. 6 ±3. 2 cm, P =0. 000) , waist/hip rate ( 0. 94 ±0. 04 vs. 0. 9 ±0. 06, P = 0. 000) , AHI ( 36. 4 ±25. 7 vs.21. 4 ±17. 4, P =0. 004) , oxygen desaturation index ( 34. 5 ±27. 4 vs. 22. 2 ±20. 8, P =0. 035) , the number of smoking ( 52. 9% vs. 5. 9% , P = 0. 000) and drinking ( 46. 4% vs. 5. 9% , P = 0. 001) were different among the male and female patients with OSAHS. On the other hand, the morning headache ( 70. 6% vs.26. 1%, P = 0. 005) , mouth dry( 76. 5% vs. 47. 7% , P = 0. 025) , bad temper ( 52. 9% vs. 19. 0% , P =0. 004) , and hypertension ( 52. 9% vs. 20. 9% , P =0. 007) were more common in the female patients with OSAHS. Conclusion There are significant differences between male and female patients with OSAHS in prevalence, age, symptoms, and severity of the disease.
Objective To investigate the effect of continuous positive airway pressure (CPAP) on sleep disorder and neuropsychological characteristics in patients with early Alzheimer’s disease (AD) combined with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods A total of forty-two early AD patients with OSAHS were randomly divided into a CPAP combined treatment group (20 cases) and a simple medicine treatment group (22 cases). The changes of neurocognitive function were assessed by Montreal Cognitive Assessment (MoCA), Mini-mental State Examination (MMSE) and Hopkins Verbal Learning Test-revised (HVLT). Patient Health Questionnaire-9 (PHQ9) was used to evaluate the depression mood changes. The sleep characteristics and respiratory parameters were evaluated by polysomnography. The changes of the patients’ sleep status were assessed by Epworth Sleepiness Scale (ESS) and Pittsburgh Sleep Quality Index (PSQI). The changes of sleep status, cognitive function and mood in the CPAP combined treatment group were compared before and three months after CPAP treatment, and with the simple medicine treatment group. Results After three months of CPAP treatment, the ESS, PSQI and PHQ9 scores in the CPAP combined treatment group were significantly decreased compared with those before treatment, whereas MoCA, MMSE and HVLT (total scores and recall ) in the CPAP combined treatment group were increased compared with those before treatment (P<0.05). After CPAP treatment, the respiratory parameters apnea hypopnea index in the CPAP combined treatment group was significantly lower than that before treatment (P<0.05), and the minimum blood oxygen saturation was significantly higher than that before treatment (P<0.05). However, the sleep characteristics and parameters did not show statistically significant changes compared with those before treatment (P>0.05). The ESS, PSQI and PHQ9 scores were significantly reduced in the CPAP combined treatment group compared with the simple medicine treatment group (P<0.05), while there was no statistically significant changes of cognitive scores between the two groups (P>0.05). Conclusions The degree of low ventilation and hypoxia is alleviated, and the daytime sleepiness and depression is improved in early AD patients with OSAHS after three-month continuous CPAP treatment. Cognitive function is significantly improved, whereas there is no significant change in sleep structure disorder.
ObjectiveTo systematically review whether or not obstructive sleep apnea hypopnea syndrome (OSAHS) increases the incidence of atrial fibrillation in coronary artery disease patients.MethodsPubMed, EMbase, The Cochrane Library, SinoMed, CNKI, VIP and WanFang Data databases were searched for studies on the relationship between OSAHS and the incidence of atrial fibrillation in coronary artery disease patients from inception to July 2nd, 2018. Two reviewers independently screened literatures, extracted data, and assessed the risk of bias of included studies. Then, meta-analysis was performed by RevMan 5.3 software.ResultsIn total, 11 cohort studies were included, involving 709 in exposed group and 975 in non-exposed group. The results of meta-analysis indicated that OSAHS was associated with the incidence of atrial fibrillation in coronary artery disease patients (RR=2.01, 95%CI 1.72 to 2.36, P<0.000 01). The subgroup analysis showed that OSAHS of PSG diagnosis increased the risk of the incidence of atrial fibrillation in coronary artery disease patients (RR=2.40, 95%CI 1.84 to 3.12, P<0.000 01); moderate and severe OSAHS of PSG diagnosis had higher risk of the incidence of atrial fibrillation in coronary artery disease patients (RR=3.73, 95%CI 2.51 to 5.53, P<0.000 01); high risk OSAHS of Berlin questionnaire assessment increased the incidence of atrial fibrillation in CAD patients (RR=1.56, 95%CI 1.27 to 1.92, P<0.000 1).ConclusionThe current evidence indicates that OSAHS is associated with an increased risk of atrial fibrillation in coronary artery disease patients. Due to the limitation of quality and quantity of the included studies, more large-scale and fine quality research are needed to warrant the accuracy of conclusion above.
Objective To investigate the effect of angiopoietin-like protein 3 (ANGPTL3) on lipid metabolism in patients with obstructive sleep apnea (OSA). Methods A total of 59 OSA patients and 20 healthy controls from the First Affiliated Hospital of Zhengzhou University between May 2023 and February 2024 were included in the study. All participants underwent overnight polysomnography (PSG). Based on the apnea-hypopnea index (AHI), the OSA patients were divided into a mild group and a moderate-to-severe group. Morning blood samples were collected after an 8-hour fast to measure lipid profiles and ANGPTL3 levels. Statistical analyses were performed using SPSS 25.0 software. Results The levels of total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and ANGPTL3 were significantly higher, while high-density lipoprotein cholesterol (HDL-C) was significantly lower in the OSA group compared with the control group (P<0.05). ANGPTL3 level was higher in the moderate-to-severe OSA group than that in the mild OSA group and the control group, and higher in the mild OSA group than that in the control group (P<0.05). In the severe hypoxemia group, ANGPTL3 level was significantly higher than that in the mild-to-moderate hypoxemia group (P<0.05). The ANGPTL3 level was also significantly higher in the hyperlipidemia group compared wiht the non-hyperlipidemia group (P<0.05). In the OSA group, ANGPTL3 was positively correlated with TC, TG, percentage of cumulative time with oxygen saturation below 90% in total sleep time (T90) and oxygen desaturation index (ODI), and negatively correlated with lowest arterial oxygen saturation (LSaO2) and mean arterial oxygen saturation (MSaO2). After adjusting for relevant confounding factors, logistic regression analysis indicated that ANGPTL3 might be a potential independent risk factor for OSA, with an odds ratio of 1.021 (95%CI 1.002 - 1.040). Conclusions The level of ANGPTL3 is elevated in OSA patients. The elevation of blood lipid levels in OSA patients may be associated with chronic intermittent hypoxia-induced regulation of ANGPTL3 levels.
ObjectiveTo Affiliated systematically review the efficacy of continuous positive airway pressure (CPAP) for resistant hypertension (RH) patients with obstructive sleep apnea (OSA). MethodsWe electronically searched databases including PubMed, EMbase, The Cochrane Library (Issue 10, 2015), CBM, CNKI and WanFang Data from inception to March 2016, to collect randomized controlled trials (RCTs) about CPAP for RH patients with OSA. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software. ResultsA total of 5 RCTs involving 395 patients were included. The results of meta-analysis showed that: After 3 months of follow-up, compared with the antihypertensive drug therapy alone, CPAP plus antihypertensive drug therapy could significantly reduce the 24 h diastolic blood pressure (DBP), day DBP, night DBP, 24 h diastolic blood pressure (SBP) and night SBP of RH patients with OSA (MD=-4.79, 95%CI -7.39 to -2.18, P=0.000 3; MD=-2.94, 95%CI -4.99 to -0.89, P=0.005; MD=-3.19, 95%CI -5.84 to -0.55, P=0.02; MD=-4.36, 95%CI -7.38 to -1.33, P=0.005; MD=-4.90, 95%CI -8.72, -1.08, P=0.01), but there was no significant difference between the two groups in day SBP. After 6 months of follow-up, compared with the antihypertensive drug therapy alone, CPAP plus antihypertensive drug therapy could significantly reduce the 24 h DBP, day DBP of RH patients with OSA (MD=-4.89, 95%CI -6.76 to -3.02, P<0.000 01; MD=-5.01, 95%CI -9.58 to -0.45, P=0.03), but there were no significant differences between the two groups in night DBP, 24 h SBP, day SBP, and night SBP. ConclusionCurrent evidence suggests that CPAP on the basis of antihypertensive drug therapy could effectively reduce the DBP and SBP of RH patients with OSA at short-term follow-up, but the long-term effect on SBP is not obvious. Due to limited quality and quantity of the included studies, the above conclusions need to be verified by more high quality studies.
Objective To investigate the role of plasma neuropeptide Y ( NPY) level in obstructive sleep apnea-hypopnea syndrome ( OSAHS) . Methods The patients underwent polysomnography ( PSG)monitoring in the sleep disorder center of Zhongda Hospital from January 2008 to December 2009 were analyzed. Plasma NPY levels were compared between different groups allocated according to apnea-hypopnea index ( AHI) and body mass index ( BMI) . Plasma NPY levels were measured by enzyme-linked immunoassay. Results The plasmaNPY levels in the severe and moderate OSAHS groups were significantly higher than the groups withoutOSAHS of the same weight degree ( P lt;0. 05) . The plasmaNPY levels in the severe OSAHS groups were significantly higher than the groups with mild and moderate OSAHS of the sameweight degree. In the severe OSAHS patients, the plasma NPY level of the obese group was significantly higher than the overweight group and the normal weight group( P lt;0. 05) . In the non-OSAHS and mild to moderate OSAHS patients, there was no significant difference among different groups of weight ( P gt;0. 05) .Plasma NPY level in the OSAHS patients was correlated positively with AHI ( r =0. 667, P lt;0. 05) and BMI( r =0. 265, P lt;0. 05) , but negatively with LSaO2 ( r = - 0. 523, P lt; 0. 05) and MSaO2 ( r = - 0. 422, P lt;0. 05) . Conclusion Plasma NPY level is correlated with OSAHS, and increases with the severity of OSAHS. Plasma NPY level has no correlation with obesity.
Objective To investigate the relatingship between leptin receptor gene Gln223Arg polymorphism and obstructive sleep apnea hyponea syndrome (OSAHS) in Han population in Southwest China. Methods Two hundred and fifteen cases of subjects (including 116 cases in OSAHS group and 99 cases in control group) were selected in Han population in Southwest China. Polymerase chain reaction (PCR) was used to analyse Gln223Arg leptin receptor gene polymorphism. The levels of serum LEP and TI were determined by double antibody sandwich enzyme-linked immunosorbent assay (ELISA). Simultaneous determination of body mass index (BMI) and neck circumference (NC) and waist circumference (WC) were conducted. Results In the OSAHS group, the leptin receptor gene polymorphism Gln223Arg GG, AA and GA genotype frequency was 0.854, 0.017 and 0.129, respectively. G allele and A allele frequency frequency was 0.918 and 0.082, respectively. In the control group, leptin receptor gene polymorphisms Gln223Arg GG, AA and GA genotype frequency was 0.840, 0.020 and 0.14,respectively. G allele and A allele frequency was 0.90 and 0.10, respectively. Genotype frequencies of the two groups were not statistically significant (χ2=0.784, P>0.05). There were differences in BMI, WC and NC between the OSAHS patients with GG and the OSAHS patients with (GA+AA) genotype (P<0.05), but no difference was found in LEP and TI levels (allP>0.05). In control, mild, moderate and severe OSAHS group, the levels of serum LEP and TI were increased gradually, and the difference was statistically significant (allP<0.05). Conclusions Gln223Arg leptin receptor genotype polymorphisms may be involved in obesity, but they have no relationship with the incidence of OSAHS in Han population in Southwest China. In OSAHS patients, Gln223Arg polymorphism has no relationship with LEP or TI. Patients with OSAHS have hyperleptinemia and hyperinsulinemia.
ObjectiveTo establish a screening model for obstructive sleep apnea hypopnea syndrome (OSAHS) through data analysis, and explore the risk factors of OSAHS. MethodsA total of 558 patients who underwent polysomnography in the Sleep Monitoring Room of Zigong Fourth People’s Hospital were recruited in the study. Among them there were 163 cases in a snore group and 395 cases in an OSAHS group. Risk factors of OSAHS were screened by both univariate analysis and multivariate analysis, then the model was established by means of binary logistic regression analysis. Finally, the screening model was evaluated by receiver operating characteristic (ROC) curve of the combined predictive factor. ResultsThe screening model of OSAHS was established as: X=–10.286+0.280×body mass index+1.057×snoring degree+1.124×sex+0.085×Epworth score+0.036×age. In this equation, sex value was 1 for men and 0 for women. If the value of X is higher than 1.123, it is likely that OSAHS would occur, and the probability (P)=ex/(1+ex). The sensitivity of the screening model was 77.70%, the specificity was 85.89%, the area under the ROC curve was 0.890, and the 95% confidence interval ranged from 0.862 to 0.918. ConclusionThis study demonstrates that a screening model based on the snoring degree, Epworth score, and body measurement data is a valuable tool to predict and screen OSAHS in patients with snoring, and the screening model could be useful in clinical diagnosis of OSAHS.
Objective To explore the diagnosis and treatment of critically ill patients suffering from obstructive sleep apnea-hypopnea syndrome ( OSAHS) . Methods Critically ill patients with OSAHS admitted in intensive care unit from January 2003 to December 2007 were retrospectively analyzed. Results Seventy-nine critically ill patients were diagnosed as OSAHS. The initial diagnosis of OSAHS was made by history requiring, physical examination, and Epworth sleepiness score evaluation. The final diagnosis was comfirmed by polysomnography thereafter. Base on the treatment of primary critical diseases, the patients were given respiratory support either with continuous positive airway pressure ( CPAP) or with bi-level positive airway pressure ventilation ( BiPAP) . Two cases died and the remaining 77 patients were cured anddischarged. Conclusions Timely diagnosis of OSAHS is important to rescue the critically ill patients. Respiratory support combined with treatment of primary critical diseases can improve the outcomes of these patients.
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.