Environmental Factors as Modulators of the Relationship between Obstructive Sleep Apnea and Lesions in the Circulatory System

Urbanik, Dominika; Martynowicz, Helena; Mazur, Grzegorz; Poręba, Rafał; Gać, Paweł

doi:10.3390/jcm9030836

Cited by 19 publications

(12 citation statements)

References 68 publications

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“…Anthropogenic behaviors have been interfering with such biological events, undermining planetary health. Climate change, through a complex series of either direct or indirect mechanisms, including (i) pollution- and poor air quality-induced oxygen saturation variability/hypoxia ( 113 ), (ii) changes in light conditions and increases in the nighttime, (iii) fluctuating temperatures, warmer values, and heat due to extreme weather ( 114 ), and (iv) psychological distress imposed by disasters (like floods, wildfires, droughts, hurricanes, and infectious outbreaks/ERIDs–such as water, food-, vector-borne diseases and zoonotic spillovers) ( 94 ), may contribute to inducing mismatches between internal time and external environment, and disrupting sleep, causing insomnia, and sleep-related breathing issues. Climate change is expected to pose a marked burden in terms of circadian impairments and sleep disturbances, generating relevant costs ( 115 ), and impacting more vulnerable populations from underserved areas and territories, thus, widening already existing global geographic inequalities, and age-, sex- and gender-related disparities ( 116 – 118 ).…”

Section: Discussionmentioning

confidence: 99%

Planetary sleep medicine: Studying sleep at the individual, population, and planetary level

Bragazzi

Garbarino

Puce

et al. 2022

Front. Public Health

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Circadian rhythms are a series of endogenous autonomous oscillators that are generated by the molecular circadian clock which coordinates and synchronizes internal time with the external environment in a 24-h daily cycle (that can also be shorter or longer than 24 h). Besides daily rhythms, there exist as well other biological rhythms that have different time scales, including seasonal and annual rhythms. Circadian and other biological rhythms deeply permeate human life, at any level, spanning from the molecular, subcellular, cellular, tissue, and organismal level to environmental exposures, and behavioral lifestyles. Humans are immersed in what has been called the “circadian landscape,“ with circadian rhythms being highly pervasive and ubiquitous, and affecting every ecosystem on the planet, from plants to insects, fishes, birds, mammals, and other animals. Anthropogenic behaviors have been producing a cascading and compounding series of effects, including detrimental impacts on human health. However, the effects of climate change on sleep have been relatively overlooked. In the present narrative review paper, we wanted to offer a way to re-read/re-think sleep medicine from a planetary health perspective. Climate change, through a complex series of either direct or indirect mechanisms, including (i) pollution- and poor air quality-induced oxygen saturation variability/hypoxia, (ii) changes in light conditions and increases in the nighttime, (iii) fluctuating temperatures, warmer values, and heat due to extreme weather, and (iv) psychological distress imposed by disasters (like floods, wildfires, droughts, hurricanes, and infectious outbreaks by emerging and reemerging pathogens) may contribute to inducing mismatches between internal time and external environment, and disrupting sleep, causing poor sleep quantity and quality and sleep disorders, such as insomnia, and sleep-related breathing issues, among others. Climate change will generate relevant costs and impact more vulnerable populations in underserved areas, thus widening already existing global geographic, age-, sex-, and gender-related inequalities.

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Section: Discussionmentioning

confidence: 99%

Planetary sleep medicine: Studying sleep at the individual, population, and planetary level

Bragazzi

Garbarino

Puce

et al. 2022

Front. Public Health

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“…Avoiding allergens and environmental exposures to tobacco smoke and air pollutants can decrease the frequency and severity of asthma exacerbation [ 60 ]. At the same time, decreased environmental exposure to tobacco smoke and pollution will decrease upper airway inflammation and nasal obstruction decreasing the severity of upper airway obstruction for OSA patients [ 60 , 61 ].…”

Section: Outcome Of Treatment For Osa In Asthma Controlmentioning

confidence: 99%

The Association between Asthma and OSA in Children

et al. 2022

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Obstructive sleep apnea (OSA) and asthma are two of the most prevalent and commonly co-existing respiratory conditions seen in the pediatric population. Studies linking asthma and OSA in children are limited but indicate that there is a bi-directional relationship between them with significant overlap in the symptoms, risk factors, pathophysiology, comorbidities, and management. It is suggested that there is a reciprocal association between asthma predisposing to OSA, and OSA worsening symptom control and outcomes from asthma. It stands to reason that inflammation in the upper and/or lower airways can influence each other. Most of the pediatric literature that is available evaluates each aspect of this relationship independently such as risk factors, mechanisms, and treatment indications. This article highlights the relationship between OSA and asthma in the context of shared risk factors, pathophysiology, and available management recommendations in the pediatric population. Early recognition of the co-existence and association between OSA and asthma could ideally improve the treatment outcomes for these two conditions. Gaining a better understanding of the mechanism of this relationship can help identify nuances for medical management, optimize treatment and protect this population at risk from associated morbidity.

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“…CPAP therapy also has the capability to decrease the QT-corrected interval dispersion present at baseline in patients with moderate to severe OSA (23). The latter might have implications in preventing the related bradycardia early after depolarizations and the ventricular arrhythmias leading to nocturnal sudden death (24).…”

Section: Extended Cardiac Monitoring In Csamentioning

confidence: 99%

Heart failure and central sleep apnea in the era of implantable recorders

Cabac-Pogorevici

Revenco

2021

Anatolian J Cardiol

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Sleep-disordered breathing (SDB) is a complex syndrome with a high prevalence and a significant impact on the general well-being of the overall population. Heart failure (HF) is a major health issue with an increasing incidence, a high rate of hospitalizations, and high mortality in developing countries. Focusing on early recognition and management of HF comorbidities may have an important role in reducing the economic burden and public health impact of HF. The close interconnection between HF, heart rhythm disturbances, and sleep apnea is supported by the mutual risk factors such as age, smoking, obesity, and male sex. Central sleep apnea (CSA) may be considered a marker of advanced HF, often being associated with elevated pulmonary capillary wedge pressure, brain natriuretic peptide (BNP), and noradrenaline levels and with low left ventricular ejection fraction. In the same way, there is an important correlation between CSA and different types of arrhythmias. The large intraindividual rhythm variability reported in patients with SDB who underwent continuous monitoring by implantable loop recorder (ILR) demonstrated the incapacity of 24-hour and 48-hour Holter monitoring to accurately determine the incidence of cardiac arrhythmias. In patients with HF and CSA, the extended cardiac monitoring by ILR becomes compulsory because in-time interventions could be life saving, but with the absolute lack of solid evidence in this field, there is an acute need for extensive randomized trials to further highlight the potential beneficial effect of ILR monitoring in patients with CSA and HF.

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Environmental Factors as Modulators of the Relationship between Obstructive Sleep Apnea and Lesions in the Circulatory System

Cited by 19 publications

References 68 publications

Planetary sleep medicine: Studying sleep at the individual, population, and planetary level

Planetary sleep medicine: Studying sleep at the individual, population, and planetary level

The Association between Asthma and OSA in Children

Heart failure and central sleep apnea in the era of implantable recorders

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