Association of sleep-disordered breathing with severe chronic vascular disease in patients with type 2 diabetes

Stadler, Stefan; Jalili, Shabnam; Schreib, Andreas; Zeman, Florian; Böger, Carsten A.; Heid, Iris M.; Arzt, Michael; Andreae, Axel; Haas, Gerhard; Haas, Sabine; Manz, Jochen; Nusser, J.; Kreisel, Günther; Bawidamann, Gerhard; Mader, Frederik; Kißkalt, Susanne; Hartl, Johann; Segiet, Thomas; Gleixner, Christiane; Scholz, Christian W.; Schober, Monika; Heinrich, C.; Bohnhoff, Thomas; Heilmann, Thomas; Stern, Stefan; Utz, Andreas; Zellner, G. E.; Ettl, Werner; Buck, Thomas; Bleek, Rainer; Blaudzun, Ulrich

doi:10.1016/j.sleep.2018.05.001

Cited by 15 publications

(15 citation statements)

References 43 publications

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“…Treatment of OSA may help to prevent severe consequences of diabetes. This might indeed be the case, since although glycemic control does not improve during CPAP treatment according to meta-analyses [78, 79], untreated OSA in diabetic patients is associated with increased prevalence of neuropathy [80], peripheral arterial disease [81], diabetic retinopathy [82] and diabetic nephropathy [83–85]. Data on the effects of CPAP on diabetic complications are scarce.…”

Section: Common Comorbidities In Osa Patientsmentioning

confidence: 99%

Obstructive sleep apnea and comorbidities: a dangerous liaison

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Baiamonte

Mazzuca

et al. 2019

Multidiscip Respir Med

179

132

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Obstructive sleep apnea (OSA) is a highly prevalent disease, and is traditionally associated with increased cardiovascular risk. The role of comorbidities in OSA patients has emerged recently, and new conditions significantly associated with OSA are increasingly reported. A high comorbidity burden worsens prognosis, but some data suggest that CPAP might be protective especially in patients with comorbidities. Aim of this narrative review is to provide an update on recent studies, with special attention to cardiovascular and cerebrovascular comorbidities, the metabolic syndrome and type 2 diabetes, asthma, COPD and cancer. Better phenotypic characterization of OSA patients, including comorbidities, will help to provide better individualized care. The unsatisfactory adherence to CPAP in patients without daytime sleepiness should prompt clinicians to examine the overall risk profile of each patient in order to identify subjects at high risk for worse prognosis and provide the optimal treatment not only for OSA, but also for comorbidities.

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Section: Common Comorbidities In Osa Patientsmentioning

confidence: 99%

Obstructive sleep apnea and comorbidities: a dangerous liaison

Bonsignore

Baiamonte

Mazzuca

et al. 2019

Multidiscip Respir Med

179

132

View full text Add to dashboard Cite

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“…A further 525 records were removed after screening by titles and abstracts. We carefully read the full texts of the remaining 16 papers and then excluded 8 additional articles [11][12][13][14][15][16][17][18] for the following reasons: (1) a review, (2) no extractable data, (3) overlapping data, (4) Burger disease, and (5) PAD not clearly identified as a cardiovascular event. Ultimately, the review included 8 articles.…”

Section: Search Resultsmentioning

confidence: 99%

Sleep-Disordered Breathing and Peripheral Arterial Disease: Current Evidence

et al. 2019

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Introduction: Sleep-disordered breathing (SDB) is associated with atherosclerosis. Peripheral arterial disease (PAD) is a manifestation of atherosclerosis in lower extremity arteries. No systematic review addressing the relationship between PAD and SDB was found. We performed this study aimed to summarize the relationship between SDB and PAD described in current clinical studies. Material and Methods: PubMed and Embase electronic databases were searched for clinical articles (published before 3 April, 2019) describing studies that evaluated the association between SDB and PAD. We showed the results involved in the association in clinical studies. Results: In total, 8 clinical studies have been included, and most of them were cross-sectional studies. Six articles demonstrated the coexistence of SDB and PAD, evidenced by high prevalence of SDB in patients with PAD and vice versa. Meanwhile, the included studies exhibited independent positive associations between SDB or sleep parameters and PAD after adjusting for multiple confounders. Conclusion: From present clinical prospective, positive association between SDB and PAD was shown. More prospective, randomized controlled studies are needed to establish the cause–effect relationships involved.

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“…Monitoring for SDB was not conducted in the study centre in Mannheim. Of the 1036 individuals invited to participate in the DIACORE-SDB sub-study [ 17 , 18 ], 721 agreed and were tested with a two-channel ambulatory SDB-monitoring device (ApneaLink, ResMed, 70%). Complete SDB parameters were recorded for 679 patients (94% of the 721 tested participants) [ 17 , 18 ].…”

Section: Methodsmentioning

confidence: 99%

“…Of the 1036 individuals invited to participate in the DIACORE-SDB sub-study [ 17 , 18 ], 721 agreed and were tested with a two-channel ambulatory SDB-monitoring device (ApneaLink, ResMed, 70%). Complete SDB parameters were recorded for 679 patients (94% of the 721 tested participants) [ 17 , 18 ]. The protocol, the data protection strategy, and the study procedures were approved by the Ethics Committees of the participating institutions and were in accordance with the Declaration of Helsinki.…”

Section: Methodsmentioning

confidence: 99%

Periodic breathing is associated with blood pressure above the recommended target in patients with type 2 diabetes

et al. 2020

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Background Due to its prognostic importance for patients with type 2 diabetes (DM2), current guidelines recommend a systolic <130 mm Hg and diastolic <80 mm Hg blood pressure target. Periodic breathing, a form of sleep-disordered breathing, acutely causes repetitive hypoxia, sympathetic nervous system activation as well as oscillations of heart rate and blood pressure. However, limited data on the association of periodic breathing and control of blood pressure (BP) in patients with DM2 are available. Thus, the aim of the present study was to assess whether there is an association between periodic breathing and increased BP above the recommended target in DM2. Methods Cross-sectional data of 679 patients with DM2 from the DIACORE-SDB sub-study were analysed for association of periodic breathing with BP. Sleep-disordered breathing was assessed with a 2-channel ambulatory monitoring device including validated automatic pattern recognition for periodic breathing. BP values were determined in a standardized manner with three repeated measurements at rest. Results Of the 679 analysed individuals (61% male, age 66 ± 9 years, Body Mass Index [BMI] 31.0 ± 5.4 kg/m 2 ), 11% had periodic breathing. Patients with periodic breathing had significantly higher systolic BP values (144 ± 19 mm Hg vs. 137 ± 18 mm Hg, p = 0.003). Multivariable regression analysis revealed that periodic breathing was associated with higher systolic BP (B [95% confidence interval, CI] = 4.4 [0.1; 8.7], p = 0.043) and not meeting the recommended BP target for patients with diabetes (<130/80 mmHg) (odds ratio, OR [95%CI] = 2.1 [1.1; 4.0], p = 0.026) independent of sex, age, high density lipoproteins, renal function, coronary heart disease and antihypertensive treatment. Conclusion Periodic breathing is associated with higher systolic BP in patients with DM2.

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Association of sleep-disordered breathing with severe chronic vascular disease in patients with type 2 diabetes

Cited by 15 publications

References 43 publications

Obstructive sleep apnea and comorbidities: a dangerous liaison

Obstructive sleep apnea and comorbidities: a dangerous liaison

Sleep-Disordered Breathing and Peripheral Arterial Disease: Current Evidence

Periodic breathing is associated with blood pressure above the recommended target in patients with type 2 diabetes

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