In obese male subjects, visceral adiposity has been associated with obstructive sleep apnoea (OSA), while studies in overweight males and females are limited. Our goal was to examine the association between OSA and visceral fat in a relatively nonobese population and assess the effects of 2 months placebo-controlled continuous positive airway pressure (CPAP) use on abdominal fat.81 subjects, 22 middle-aged males and 20 post-menopausal females with OSA, and 19 male and 20 female controls were studied in the sleep laboratory for four nights. Abdominal (visceral (VAT) and subcutaneous (SAT) adipose tissue) and liver fat were assessed with computed tomography. OSA patients were re-assessed post-CPAP and post sham-CPAP.Apnoeic males had significantly higher VAT than controls, while apnoeic females had higher SAT than controls. In both sexes, OSA was associated with increased liver fat. In males, apnoea was associated with VAT whereas in females it was associated with subcutaneous, visceral and total fat. CPAP did not affect abdominal and liver fat.In overweight males, visceral adiposity is associated with OSA whereas in females it is associated with global adiposity. In overweight males, our therapeutic goal should be the reduction of visceral adiposity and its metabolic correlates, whereas, in females, weight loss may be sufficient. Shortterm CPAP treatment does not affect general, abdominal or intra-hepatic adiposity.

Pain perception while off HD may be of more importance to patients than pain during HD. The mechanisms underlying the association are unknown but may involve linkage of pain with severity of medical illness or the generation of a maladaptive cytokine response. Multicenter prospective studies of pain interventions using well-validated pain perception tools are needed to establish causal relationships. Interventions directed toward treating pain on non-HD days may improve ESRD patient survival.

Objective Migraine is a common co-morbidity of bipolar disorder (BD), and is more prevalent in women than men. We hypothesized co-morbid migraine would be associated with features of illness and psychosocial risk factors which would differ by gender and impact outcome. Methods A retrospective analysis was conducted to assess association between self-reported, physician-diagnosed migraine, clinical variables of interest and mood outcome in subjects with DSM-IV BD (N=412) and healthy controls (HC, N=157) from the Prechter Longitudinal Study of Bipolar Disorder, 2005–2010. Informed consent was obtained from all participants. Results Migraine was more common in BD (31%) than HC (6%), and had elevated risk in BD women compared to men (OR 3.5, CI 2.1, 5.8). In men, migraine was associated with BPII (OR 9.9, CI 2.3, 41.9) and mixed symptoms (OR 3.5, CI 1.0, 11.9). Migraine was associated with an earlier age at onset of BD by 2 years, more severe depression (B =.13, p=.03), and more frequent depression longitudinally (B =.13, p=.03). Migraine was associated with childhood trauma (p<.02) and high neuroticism (p<.01), and protective factors included high family adaptability (p=.05) and high extraversion (p=.01). Conclusion Migraine is a common co-morbidity with BD and may impact long-term outcome of BD, particularly depression. Clinicians should be alert for migraine co-morbidity in women, and in men with BPII. Effective treatment of migraine may impact mood outcome in BD as well as headache outcome. Joint pathophysiological mechanisms between migraine and BD may be important pathways for future study of treatments for both disorders.

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