SEARCH · PubMed Health

Results for “OSA”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 37 records · Page 2Linked to original sources

PubMed2005

Depression and Obstructive Sleep Apnea (OSA).

For over two decades clinical studies have been conducted which suggest the existence of a relationship between depression and Obstructive Sleep Apnea (OSA). Recently, Ohayon underscored the evidence for a link between these two disorders in the general population, showing that 800 out of 100,000 individuals had both, a breathing-related sleep disorder and a major depressive disorder, with up to 20% of the subjects presenting with one of these disorders also having the other. In some populations, depending on age, gender and other demographic and health characteristics, the prevalence of both disorders may be even higher: OSA may affect more than 50% of individuals over the age of 65, and significant depressive symptoms may be present in as many as 26% of a community-dwelling population of older adults. In clinical practice, the presence of depressive symptomatology is often considered in patients with OSA, and may be accounted for and followed-up when considering treatment approaches and response to treatment. On the other hand, sleep problems and specifically OSA are rarely assessed on a regular basis in patients with a depressive disorder. However, OSA might not only be associated with a depressive syndrome, but its presence may also be responsible for failure to respond to appropriate pharmacological treatment. Furthermore, an undiagnosed OSA might be exacerbated by adjunct treatments to antidepressant medications, such as benzodiazepines. Increased awareness of the relationship between depression and OSA might significantly improve diagnostic accuracy as well as treatment outcome for both disorders. In this review, we will summarize important findings in the current literature regarding the association between depression and OSA, and the possible mechanisms by which both disorders interact. Implications for clinical practice will be discussed.

Journal Article↗

PubMed1997

Avoiding the supine position during sleep lowers 24 h blood pressure in obstructive sleep apnea (OSA) patients.

Obstructive sleep apnea (OSA), is a common clinical condition affecting at least 2-4% of the adult population. Hypertension is found in about half of all OSA patients, and about one-third of all patients with essential hypertension have OSA. There is growing evidence that successful treatment of OSA can reduce systemic blood pressure (BP). Body position appears to have an important influence on the incidence and severity of these sleep-related breathing disturbances. We have investigated the effect of avoiding the supine position during sleep for a 1 month period on systemic BP in 13 OSA patients (six hypertensives and seven normotensives) who by polysomnography (PSG) were found to have their sleep-related breathing disturbances mainly in the supine position. BP monitoring was performed by 24-h ambulatory BP measurements before and after a 1 month intervention period. We used a simple, inexpensive method for avoiding the supine posture during sleep, namely the tennis ball technique. Of the 13 patients, all had a reduction in 24-h mean BP (MBP). The mean 24-h systolic/diastolic (SBP/DBP) fell by 6.4/2.9 mm Hg, the mean awake SBP/DBP fell by 6.6/3.3 mm Hg and the mean sleeping SBP/DBP fell by 6.5/2.7 mm Hg, respectively. All these reductions were significant (at least P < 0.05) except for the sleeping DBP. The magnitude of the fall in SBP was significantly greater in the hypertensive than in the normotensive group for the 24 h period and for the awake hours. In addition, a significant reduction in BP variability and load were found. Since the majority of OSA patients have supine-related breathing abnormalities, and since about a third of all hypertensive patients have OSA, avoiding the supine position during sleep, if confirmed by future studies, could become a new non-pharmacological form of treatment for many hypertensive patients.

Adult↗

PubMed1996

The cephalometric morphology of patients with obstructive sleep apnoea (OSA).

This prospective study analysed the lateral cephalometric radiographs of 59 dentate, white, Caucasian males. Thirty-five patients with proven obstructive sleep apnoea (OSA) formed the experimental group, while 24 subjects with no history of respiratory disease acted as controls. Radiographs were traced and digitized, and both hard and soft tissue features were compared between the groups. The pooled data were then subjected to discriminate analysis. Although conventional cephalometric measurements did not differ between the two groups, significant reductions were found in the lengths of the mandibular body and cranial base and in cranial base angulation in OSA subjects. The width of the oropharynx was significantly narrower in this group, particularly in the post-palatal region. The area of the soft palate was increased although that of the tongue was not. Intermaxillary space length (the distance between the posterior pharyngeal wall and the tip of the lower incisor) was decreased, and thus the area in which the tongue had to function was smaller in OSA subjects. From the discriminant analysis, two four-variable models were derived, both of which provided 100 per cent discrimination between the OSA and normal subjects. For the first model the entire OSA group was used: for the second, only obese OSA subjects (those a body mass index > 25) were chosen. The combination off a short mandible and intermaxillary space, with an enlarged soft palate but decreased pharyngeal airway has relevance to the effective management of OSA. In selected patients, advancement of the lower jaw by a nocturnal mandibular repositioning splint may be indicated. The orthodontist would seem to be in a unique position to assist in both the identification and treatment of these subjects.

Adult↗

PubMed1999

Osa associates with the Brahma chromatin remodeling complex and promotes the activation of some target genes.

The yeast SWI/SNF complex and its Drosophila and mammalian homologs are thought to control gene expression by altering chromatin structure, but the mechanism and specificity of this process are not fully understood. The Drosophila osa gene, like yeast SWI1, encodes an AT-rich interaction (ARID) domain protein. We present genetic and biochemical evidence that Osa is a component of the Brahma complex, the Drosophila homolog of SWI/SNF. The ARID domain of Osa binds DNA without sequence specificity in vitro, but it is sufficient to direct transcriptional regulatory domains to specific target genes in vivo. Endogenous Osa appears to promote the activation of some of these genes. We show evidence that some Brahma-containing complexes do not contain Osa and that Osa is not required to localize Brahma to chromatin. These data suggest that Osa modulates the function of the Brahma complex.

Animals↗

PubMed2005

Influence of HLA antigens and OSAS in childhood: a preliminary report.

Several studies have emphasized the role of familial factors and familial aggregation in increasing susceptibility to obstructive sleep apnea syndrome (OSAS); the aim of the present study was to investigate the possible influence of human leukocyte antigen (HLA) in the development of sleep disordered breathing and OSAS of children. Between January 2000 and January 2003, all the 370 children [193 males; median age: 5.2 years (range: 1-12 years)] with sleep disordered breathing referred to our Center were screened by a 41-item multiple-choice questionnaire. All habitual snores children underwent a polisomnographic evaluation, and those with an apnea/hypopnea index >3 were diagnosed as having OSAS. All children with OSAS or primary snoring were HLA typed for class I and II. According to nocturnal polygraphic monitoring study, 41 patients were diagnosed as having OSAS and 32 as primary snoring. Patients in the two diagnostic groups were homogeneous for demographic and clinical characteristics. HLA-B65 was found to be significantly more expressed in children with sleep disordered breathing as compared with controls (10.5% versus 3.61; Pypc < 0.04) while no difference was found for the other tested antigens. A logistic regression analysis found cough (P < 0.02) and persistent wheeze (P < 0.008) the sole risk factors for OSAS development. Our preliminary data suggest that HLA does not play a key role in the pathogenesis of OSAS, however more studies are needed to clarify this issue.

Child↗

PubMed1999

Effects of nasal CPAP therapy on respiratory and spontaneous arousals in infants with OSA.

Obstructive sleep apnea (OSA) in infants has been shown to resolve frequently without a cortical arousal. It is unknown whether infants do not require arousal to terminate apneas or whether this is a consequence of the OSA. We studied the apnea and arousal patterns of eight infants with OSA before and after treatment with nasal continuous positive airway pressure (CPAP). These infants were age matched to eight untreated infants with OSA and eight normal infants. Polysomnographic studies were performed on each infant. We found that the majority of central and obstructive apneas were terminated without arousal in all OSA infants. After several weeks of nasal CPAP treatment, the proportion of apneas terminating with an arousal during rapid-eye-movement sleep increased in treated infants compared with untreated infants. Spontaneous arousals during rapid-eye-movement sleep were reduced in all OSA infants; however, during CPAP treatment, the spontaneous arousals increased to the normal control level. We conclude that OSA in infants possibly depresses the arousal response and treatment of these infants with nasal CPAP partially reverses this depression.

Arousal↗

PubMed2004

[Right ventricle structure and function in patients with obstructive sleep apnea (OSA)].

UNLABELLED: The structure and function of right ventricle was echocardiographically assessed in patients (pts) with OSA and analyzed taking into account the presence of obesity and/or systemic hypertension (SH). Therefore, 118 pts (98 M, 20 F, aged 48,5 8,4 yr) were divided into OH = obese with z OSA and SH (n = 22), ON = obese with OSA, and no SH (n = 20), OC = OSA without either obesity and SH (n = 21), GH = obese without OSA but with SH (n = 18), GN = obese without either OSA or SH (n =17). Control group (ZZ) comprised 20 healthy subjects (14M,6F). Right ventricular diameter (RVD), diastolic (DRVW), and systolic right ventricle free wall thickness (SRVW) were measured and its systolic thickening (ST-RVW) was calculated. Acceleration time of ejection into pulmonary artery (AcT) was measured with Doppler echocardiography. RESULTS: St. sign. p < 0.05 between: 1: all groups except OH and ON, GH and GN, GH and OC, GN and OC; 2--like 1 except ZZ and OC; 3--OH and all subgroup except ON, ON and GH, ON and ZZ, OC and GN; 4-- ON and all subgroups except OH, OH and OC, OH and GH, OH and GN. CONCLUSIONS: Enlargement and functionally compromised RV is found in OBS mostly with concomitant obesity. Pulmonary hypertension at rest in patients with isolated OSA is rare and also requires additional contributing factors.

Adult↗

PubMed1989

Obstructive sleep apnea (OSA)-implications in maternal-fetal medicine. A hypothesis.

During the past fifteen years the obstructive sleep apnea syndrome (OSAS) has become widely recognized as a quite common disorder with a wide range of serious clinical complications (1, 2, 3). This syndrome arises as a result of sleep related changes in upper airway muscle function and progressive narrowing of the oropharyngeal lumen. The resulting hypoxia (or asphyxia) leads to an arousal response that terminates the initial obstructive event. The exact incidence and prevalence of OSAS is currently unknown. Lavie (4) concluded its prevalence to be 1.26 percent. Others (5, 6) found that the prevalence of heavy regular snoring (taken as an index of at least a partially obstructed airway) increased with age including 40 percent of women and 50 percent of men over 60 years of age. Polygraphically documented OSAS showed incidence of 0.99 percent in an unselected population. Postmenopausal women have frequent episodes. of OSA in contrast with their premenopausal counterparts, who very rarely have any apnea. Since we could not find in the literature any documented OSAS studies in pregnancy, we would like to base our hypothesis on our previously published clinical observations and our recent findings. In the present paper we would like to suggest that pathophysiologic changes of OSAS prolonged throughout many weeks of pregnancy may have an adverse effect upon the feto-placental unit.

Adult↗

PubMed2005

The relationship between extraesophageal reflux (EER) and obstructive sleep apnea (OSA).

Obstructive sleep apnea (OSA) and extraesophageal reflux (EER) are common chronic diseases and share several similar risk factors. The prevalence of gastroesophogeal (GERD) in OSA patients is significantly higher than the general population; however, no temporal or causal relationship has ever been demonstrated between the two. The purpose of this review is to understand the association between obstructive sleep apnea (OSA) and extraesophageal reflux disease (EER) in the adult population. We conclude that CPAP treatment of OSA significantly reduces GERD symptoms and acidic pH exposure in the esophagus and this improvement with CPAP physiologically occurs in the presence or absence of OSA; and treatment of GERD in OSA patients improves the number of arousals during sleep, but only one study showed a significant difference in apnea.

Adult↗

PubMed2000

A clinical investigation of obstructive sleep apnea syndrome (OSAS) and upper airway resistance syndrome (UARS) patients.

Objective: (i) Evaluation of the clinical differences and similarities presented by patients diagnosed as OSAS and UARS subjects. (ii) Evaluation of the ability of a sleep disorders specialist to dissociate the two syndromes based upon clinical evaluation.Population: 314 subjects were included. They were referred to a sleep disorders clinic with complaints of loud snoring during a 3 month period.Method: The evaluation consisted of: (i) Clinical interview and evaluation. (ii) Administration of validated questionnaires (Sleep Disorders Questionnaire and Epworth Sleepiness Scale). (iii) Establishment of clinical diagnostic and results of polygraphic recording.Results: After clinical evaluation and polygraphic recordings (performed within 3 weeks of initial evaluation) patients were subdivided into two groups: 176 OSAS and 128 UARS. The misclassification of patients by specialists correlated with body mass index (BMI) measurement, with an over classification of patient as OSAS when a high BMI was noted and vice-versa for UARS. The only significant difference between OSAS and UARS patients was an older age and a wider neck circumference in the OSAS group than in UARS patients.Conclusion: Clinical presentation including daytime sleepiness complaint and ESS score is similar for patients with and without drop of oxygen saturation below 90% during sleep. There was always a male predominance within both syndromes, but more women were diagnosed with UARS than with OSAS.

Journal Article↗

PubMed2003

nCPAP improves abnormal autonomic function in at-risk-for-SIDS infants with OSA.

We evaluated cardiovascular autonomic control and arousability during sleep in infants with obstructive sleep apnea (OSA) before and after 10 +/- 4 (mean +/- SD) days of treatment with nasal continuous positive airway pressure (nCPAP). Six OSA infants and 12 age-matched control infants were studied with polygraphic sleep studies at the age of 13 +/- 4 wk. During the study, 45 degrees head-up tilt tests were performed in slow-wave and rapid eye movement sleep. Blood pressure (BP) and heart rate (HR) were continuously monitored. All OSA infants had decreased initial BP and HR responses, followed by hypotension in two and hypertension in two. OSA infants displayed higher arousal thresholds in response to the tilt in rapid eye movement sleep (P < 0.005) and higher baseline HR (P < 0.05) than controls. nCPAP treatment normalized BP and HR responses as well as arousal thresholds to tilting and stabilized HR levels. OSA in infants may be linked with cardiovascular autonomic control disturbances and decreased arousability during sleep. These defects are improved by control of OSA with nCPAP.

Arousal↗

PubMed1999

The trithorax group gene osa encodes an ARID-domain protein that genetically interacts with the brahma chromatin-remodeling factor to regulate transcription.

The trithorax group gene brahma (brm) encodes the ATPase subunit of a chromatin-remodeling complex involved in homeotic gene regulation. We report here that brm interacts with another trithorax group gene, osa, to regulate the expression of the Antennapedia P2 promoter. Regulation of Antennapedia by BRM and OSA proteins requires sequences 5' to the P2 promoter. Loss of maternal osa function causes severe segmentation defects, indicating that the function of osa is not limited to homeotic gene regulation. The OSA protein contains an ARID domain, a DNA-binding domain also present in the yeast SWI1 and Drosophila DRI proteins. We propose that the OSA protein may target the BRM complex to Antennapedia and other regulated genes.

Animals↗

PubMed1993

Obstructive sleep apnea and blood pressure elevation: what is the relationship? Working Group on OSA and Hypertension.

Sleep disordered breathing has increasingly been recognised as a frequent cause of ill-health in the community. Moderate or severe forms of the most common condition, obstructive sleep apnea (OSA), occur in up to 12% of the adult male population. A substantial body of literature has been published on the potential relationship between OSA and cardiovascular disease. In particular, OSA has been associated with cardiac failure, stroke, myocardial infarction and hypertension. Part of this association may be explained by other confounders, mainly obesity, which is common in OSA patients. The present review was prepared following a workshop aimed to critically review available scientific evidence suggesting that hypertension is a direct consequence of OSA. In addition, pathophysiologic mechanisms that may be involved in the relationship between OSA and cardiovascular disease, particularly brief intermittent elevation of blood pressure and sustained systemic hypertension, are discussed.

Adult↗

PubMed2024

Effect of inflammatory cytokines and plasma metabolome on OSA: a bidirectional two- sample Mendelian randomization study and mediation analysis.

BACKGROUND: Obstructive sleep apnea (OSA) is a common sleep disorder. Inflammatory factors and plasma metabolites are important in assessing its progression. However, the causal relationship between them and OSA remains unclear, hampering early clinical diagnosis and treatment decisions. METHODS: We conducted a large-scale study using data from the FinnGen database, with 43,901 cases and 366,484 controls for our discovery MR analysis. We employed 91 plasma proteins from 11 cohorts (totaling 14,824 participants of European descent) as instrumental variables (IVs). Additionally, we conducted a GWAS involving 13,818 cases and 463,035 controls to replicate the MR analysis. We primarily used the IVW method, supplemented by MR Egger, weighted median, simple mode, and weighted mode methods. Meta-analysis was used to synthesize MR findings, followed by tests for heterogeneity, pleiotropy, and sensitivity analysis (LOO). Reverse MR analysis was also performed to explore causal relationships. RESULTS: The meta-analysis showed a correlation between elevated Eotaxin levels and an increased risk of OSA (OR=1.050, 95% CI: 1.008-1.096; p < 0.05). Furthermore, we found that the increased risk of OSA could be attributed to reduced levels of X-11849 and X-24978 (decreases of 7.1% and 8.4%, respectively). Sensitivity analysis results supported the reliability of these findings. CONCLUSIONS: In this study, we uncovered a novel biomarker and identified two previously unknown metabolites strongly linked to OSA. These findings underscore the potential significance of inflammatory factors and metabolites in the genetic underpinnings of OSA development and prognosis.

Female↗

PubMed2002

[The relationship of lingua and uvula in OSAS].

OBJECTIVE: To observe the relationship between lingual base and uvula, the relationship between lingua and jaw dentition in normal adults, snorers and patients with obstructive sleep apnea syndrome (OSAS) and to study the difference of the relationships among them. METHOD: 21 patients with OSAS, 25 snorer and 30 normal adults were included in the study. The relationship between lingua and uvula and the relationship between lingual base and jaw dentition were observed. The difference of the relationships among the OSAS patients, snorers and normal adults were studied. RESULT: Among the OSAS patients, snorer and normal adults, there are obviously difference in the relationship between lingua and uvula and the relationships between lingual base and jaw dentition. In normal adults, the lingua below to jaw dentition and the uvula is visible at opening of mouth; in snorers, the lingua match the jaw dentition and the uvula is visible at pronunciation; in OSAS patients, the lingua tower above the jaw dentition and the uvula is sightless at pronunciation. CONCLUSION: The study suggests that the enlarge of lingua and uvula be the one of etiology of OSAS.

Adolescent↗

PubMed2004

Histologic evaluation of nasal epithelium of the middle turbinate in untreated OSAS patients and during nCPAP therapy.

OSAS-patients complain about nasal disorders. Irritation of the nasal mucosa often leads to termination of nCPAP treatment. The aim of this study is to evaluate whether symptoms are related to histologic changes of the nasal mucosa of the head of the middle turbinate in OSAS-patients. Semi-thin sections of epon-embedded middle turbinate biopsy samples from 35 male patients (age 51-75 yr) with OSAS were compared with those of 10 healthy men (age 51-75 yr). In untreated OSAS-patients atrophic epithelium is common whereas ciliated epithelial types are rare. After short-time nCPAP therapy (mean 581h) patches of ciliated epithelium and squamous metaplasia reappear. Short-term nCPAP leads to a partially restoration of the mucosal architecture. During long-time nCPAP therapy (mean 6.737h) squamous metaplasia with conspicuous intraepithelial connective tissue papillae predominates whereas pseudostratified ciliated epithelium is missing. Dense round cell infiltrates in the lamina propria are frequently found. Rhinitic symptoms in OSAS-patients are correlated with marked histological changes of the respiratory epithelium of the head of the middle turbinate. Histological changes in untreated OSAS differ from those of patients during nCPAP-treatment.

Aged↗

PubMed1986

Muscle activity in the legs (MAL) associated with frequent arousals in narcoleptics, nocturnal myoclonus and obstructive sleep apnea (OSA) patients.

"Muscle activity in the legs (MAL)" is an extension of the classification, nocturnal myoclonus, to include all phasic muscle activity in the legs during sleep, irrespective of the repetitiveness, periodicity, or minimum duration of the muscle events. This report examined the number of MAL events and, especially, MAL events associated with arousals (MAL arousals) and awakenings (MAL awakenings) in the clinical records of 9 narcoleptics, 42 obstructive sleep apnea (OSA) patients, and 12 nocturnal myoclonus patients. The mean MAL arousals/hr for narcoleptics, OSA patients, and nocturnal myoclonus patients were 20.5, 3.0, and 12.9, respectively; the mean MAL awakenings/hr were 2.5, 0.2, and 1.3, respectively. Both the narcoleptics and nocturnal myoclonus patients had significantly more MAL arousals/hr and MAL awakenings/hr of sleep than OSA patients. Nonetheless, 62% of the OSA patients had greater than or equal to 1 MAL arousal/hr. Narcoleptics had significantly more MAL awakenings/hr than nocturnal myoclonus patients; narcoleptics also had more MAL arousals/hr of sleep than nocturnal myoclonus patients, but this difference was not significant. Most, 89%, of the narcoleptics, 22% of the OSA patients, and 100% of the nocturnal myoclonus patients had greater than or equal to 5 MAL arousals/hr of sleep. These findings suggest that there may be a relationship between the pathogenesis of MAL, narcolepsy, and OSA.

Arousal↗

PubMed2005

Influence of subclinical hypothyroidism and T4 treatment on the prevalence and severity of obstructive sleep apnoea syndrome (OSAS).

BACKGROUND: Obstructive sleep apnoea (OSA) and subclinical hypothyroidism are relatively frequent disorders that may be causally linked. However, discordant results exist on the prevalence and severity of OSA in subclinical hypothyroidism. The aim of this study was to compare the prevalence and severity of sleep-disordered breathing in individuals with or without subclinical hypothyroidism, and to investigate the possible effect of levothyroxine treatment on these patients. PATIENTS AND METHODS: One hundred and eight subjects were consecutively enrolled and divided in 3 groups, according to the TSH levels and levothyroxine therapy. The first group (Group A) was represented by 63 subjects with normal TSH and thyroid function. The other two groups included patients affected by subclinical hypothyroidism; one group (Group B) treated with levothyroxine, while the other group (Group C) was never treated with levothyroxine. Anthropometric, respiratory and polysomnographic data were evaluated in all individuals. RESULTS: The percentage of OSA, neck circumference, and body mass index (BMI) were not statistically different among the 3 groups. Respiratory disturbance index (RDI) as well as the percentage of the total number of events (apnoea-hypopnoea) by total sleep time (TST) with <90% oxyhemoglobin saturation (TSTSaO2 <90%) were not different among the groups. When we observed OSA patients, the only significant difference between groups B and C was represented by the Epworth Sleepiness Scale (ESS) (p=0.005). CONCLUSION: This study shows that subclinical hypothyroidism and treatment with levothyroxine do not influence the prevalence and severity of OSA, while sleep propensity is increased by untreated subclinical hypothyroidism.

Adult↗