Continuous Positive Airway Pressure Effectively Alleviates Arrhythmias in Patients with Obstructive Sleep Apnea: Possible Relationship with Counteracting Oxidative Stress

Wang, Xiaoting; Zhao, Gang; Tu, Lei; Yue, Zhiyong; Liu, Zhenhua; Han, Jie; Gao, Kun; Zhou, Xinming; Xu, Shuai; Li, Jianfeng

doi:10.1007/s11596-019-1999-1

Cited by 10 publications

(11 citation statements)

References 29 publications

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“…One could speculate based on the higher efficacy of CPAP compared to OA in correcting hypoxaemia that there would be less patients that show a minimal amount of improvement in oxygenation levels when the AHI value is sufficiently rectified 33 . Studies based on CPAP showed a 9%–22% increase in min O 2 post‐treatment 34,35 . A low baseline min O 2 should not be a contra‐indication of OA treatment as we found that patients with an average min O 2 of <86% tend to show a greater response to OA treatment.…”

Section: Discussionmentioning

confidence: 72%

“…34,35 A low baseline min O 2 should not be a contra-indication of OA treatment as we found that patients with an average min O 2 of <86% tend to show a greater response to OA treatment. Polysomnographic characteristics according to responder group-respiratory parameters Differences among groups were tested with Chi-square test and pre-and post-OA data were tested with McNemar's and chi-square test.…”

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confidence: 74%

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Disparities in oxygen saturation and hypoxic burden levels in obstructive sleep apnoea patient’s response to oral appliance treatment

Park

Almeida

2022

J of Oral Rehabilitation

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Background Oxygen saturation indices show a strong correlation with long‐term health outcomes. Nonetheless, evidence on the relationship between reduction in respiratory events and increase in oxygenation levels following oral appliance (OA) treatment is scarce. Objectives To verify the relationship between reduction in the apnoea‐hypopnoea index (AHI) and oxygen saturation levels following OA treatment, we have conducted an evaluation of polysomnography (PSG) and clinical parameters associated with the improvement of oxygen desaturation. Methods OSA patients (n = 48) who received an OA and had pre‐ and post‐treatment PSG were classified into three responder groups according to the change in AHI and min O2 post‐treatment: responderAHIonly (decrease in AHI of ≥50% but increase in min O2 level of <4% or decrease); responderMinO2only (increase in min O2 level of ≥4% but decrease in AHI <50% or increase) and responderCongruous (decrease in AHI of ≥50% and increase in min O2 level of ≥4%). Various demographic and PSG variables were statistically compared among groups. Results There were 26 (54.17%) responderAHIonly, 9 (18.75%) responderMinO2only and 13 (27.08%) responderCongruous. Pre‐treatment min O2 was significantly lower in responderMinO2only. A higher pre‐treatment min O2 showed a significant correlation with a smaller amount of change in mean O2 (r = −.486) and min O2 (r = −.764) with treatment. Pre‐treatment min O2 showed the strongest ability to predict those who would show a ≥4% min O2 increase following treatment. Conclusion Certain patients do not show sufficient decrease in hypoxaemia in spite of the improvement in AHI. Pre‐treatment min O2 should be considered in OA treatment planning regarding its close relation to improvements in oxygenation levels with treatment.

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Section: Discussionmentioning

confidence: 72%

mentioning

confidence: 74%

Disparities in oxygen saturation and hypoxic burden levels in obstructive sleep apnoea patient’s response to oral appliance treatment

Park

Almeida

2022

J of Oral Rehabilitation

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“…Interestingly, the alleviating effects of CPAP were more pronounced in patients with congestive heart failure defined by an ejection fraction (EF) <45% of any cause (i.e., both ischemic and nonischemic) than in healthy controls [20]. Finally, OSA treated with CPAP has been shown to help maintain sinus rhythm after electrical cardioversion and improve catheter ablation success among patients with atrial fibrillation as well as significantly preventing the occurrence of arrhythmias through reduction in oxidative stress [21,22].…”

Section: Introductionmentioning

confidence: 99%

Treatment of Sleep Apnea with Positive Airway Pressure and Its Association with Diastolic Dysfunction: A Systematic Review and Meta-Analysis

et al. 2021

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Background: This meta-analysis assessed the effect of long-term (>6 weeks) noninvasive positive airway pressure (PAP) on diastolic function in patients with obstructive sleep apnea (OSA). Methods: We searched the databases for randomized clinical trials including Ovid MEDLINE, Ovid Embase Scopus, Web of Science, Google Scholar, and EBSCO CINAHL from inception up to December 20, 2019. The search was not restricted to time, publication status, or language. Two independent investigators screened the studies and extracted the data, in duplicate. Risk of bias was assessed using Cochrane collaboration tools. Results: A total of 2,753 abstracts were resulted from literature search. A total of 9 randomized clinical trials assessing the effect of long-term (>6 weeks) PAP on diastolic function in patients with OSA including 833 participants were included. The following echo parameters were found in treated patients: a decrease in deceleration time (−39.49 ms CI [−57.24, −21.74]; p = 0.000), isovolumic relaxation time (−9.32 ms CI [−17.08, −1.57]; p = 0.02), and the ratio of early mitral inflow velocity to mitral annular early diastolic velocity (−1.38 CI [−2.6, −0.16]; p = 0.03). However, changes in left-atrial volume index and the ratio of early to late mitral inflow velocities were not statistically different. The risk of bias was mild to moderate among the studies. Conclusion: Our results suggest that chronic treatment of moderate to severe OSA with noninvasive PAP is associated with improvement in echocardiographic findings of diastolic dysfunction.

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“…More specifically, CPAP treatment significantly changed the profile of endothelial function, improved blood flow in both macro- and microcirculation and lowered the inflammatory mediator level in a review conducted by Klaudia et al [ 5 ]. In addition, proper use of CPAP therapy provided significant benefits for the treatment of arrhythmia in patients with OSA [ 6 ]. However, CPAP is not to date the only possible treatment in patients with obstructive sleep apnea.…”

Section: Introductionmentioning

confidence: 99%

Identification of key genes and immune infiltration modulated by CPAP in obstructive sleep apnea by integrated bioinformatics analysis

et al. 2021

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Patients with obstructive sleep apnea (OSA) experience partial or complete upper airway collapses during sleep resulting in nocturnal hypoxia-normoxia cycling, and continuous positive airway pressure (CPAP) is the golden treatment for OSA. Nevertheless, the exact mechanisms of action, especially the transcriptome effect of CPAP on OSA patients, remain elusive. The goal of this study was to evaluate the longitudinal alterations in peripheral blood mononuclear cells transcriptome profiles of OSA patients in order to identify the hub gene and immune response. GSE133601 was downloaded from Gene Expression Omnibus (GEO). We identified black module via weighted gene co-expression network analysis (WGCNA), the genes in which were correlated significantly with the clinical trait of CPAP treatment. Finally, eleven hub genes (TRAV10, SNORA36A, RPL10, OBP2B, IGLV1-40, H2BC8, ESAM, DNASE1L3, CD22, ANK3, ACP3) were traced and used to construct a random forest model to predict therapeutic efficacy of CPAP in OSA with a good performance with AUC of 0.92. We further studied the immune cells infiltration in OSA patients with CIBERSORT, and monocytes were found to be related with the remission of OSA and partially correlated with the hub genes identified. In conclusion, these key genes and immune infiltration may be of great importance in the remission of OSA and related research of these genes may provide a new therapeutic target for OSA in the future.

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Continuous Positive Airway Pressure Effectively Alleviates Arrhythmias in Patients with Obstructive Sleep Apnea: Possible Relationship with Counteracting Oxidative Stress

Cited by 10 publications

References 29 publications

Disparities in oxygen saturation and hypoxic burden levels in obstructive sleep apnoea patient’s response to oral appliance treatment

Disparities in oxygen saturation and hypoxic burden levels in obstructive sleep apnoea patient’s response to oral appliance treatment

Treatment of Sleep Apnea with Positive Airway Pressure and Its Association with Diastolic Dysfunction: A Systematic Review and Meta-Analysis

Identification of key genes and immune infiltration modulated by CPAP in obstructive sleep apnea by integrated bioinformatics analysis

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