Obstructive sleep apnea, shift work and cardiometabolic risk

A Reappraisal on the Associations between Sleep-disordered Breathing, Insomnia, and Cardiometabolic Risk

“…Excessive Diurnal Sleepiness (EDS) scores were higher in COMISA and SDB groups when compared with the insomnia group (Table 1). Significant reductions in daily total sleep duration emerged in the COMISA patients compared to SDB and Insomnia groups (p=0.001), which could independently, or via interactions with the circadian timing system, influence several cardiometabolic outcomes (8,9). Also, the trend toward later sleep onset times in the COMISA group may also operate as an important cardiometabolic risk factor (11).…”

“…The hypothesis has been put forth of mutually interactive, bidirectional effects between insomnia and SDB, in which the adverse consequences of COMISA will be enhanced, particularly regarding the cardiovascular system (5,6). Additionally, alterations in the circadian timing system may also interfere with the mechanisms underlying COMISA-associated end-organ morbidities, and ultimately potentiate such risks (7)(8)(9).…”

Bifurcated sleep in night shift workers alters circadian relationships in cardiovascular and temperature rhythms

“…On Day 1, observations of BMI (body mass index) were taken. Sleep, temperature, food charts and Horne-Ostberg morningness-eveningness (M-E) questionnaires 7 were given. M-E questionnaires are standard scoring procedures of precalibrated questions on diurnal preferences which were not the primary questions investigated; therefore, reliability testing was not needed.…”

“…A biological disturbance in sleep behaviour due to organismal or societal factors is incongruous with daily rhythm in temperature 6 . Phase alterations in closely related cardio-physiological variables due to sleep disruption exhibit dissociative properties due to non-coherence among the underlying phenomena 7 . Systolic (SBP) and diastolic (DBP) blood pressure represent maxima/minima of pressure within the CV system when the heart pumps blood into the arteries and rests to ll with blood before the next contraction.…”

Impact of CBTi in COMISA: Could it mean a “masking effect” of the circadian time machinery on psychosocial stress factors?

“…4 An interactive relationship between the circadian timing system and sleep-related breathing control is further highlighted by the severity of obstructive sleep apnea, with a lower and prolonged apnea-hypopnea index in patients with a morning circadian phase, contrasting with a shorter and higher apnea-hypopnea index in patients with a circadian phase corresponding to late afternoon and evening. 5 All of this interactive role-play between clocks and the pathophysiological aspects of insomnia, sleep-disordered breathing, and psychosocial stressors is potentially exacerbated in patients with comorbid insomnia and sleep apnea, leading to a wider risk spectrum associated with either cardiometabolic health 6 or cognitive and emotional dysfunction. 1 We therefore hypothesize a more aggressive impact of cognitive-behavioral therapy for insomnia-related strategies in patients with comorbid insomnia and sleep apnea when compared with patients with insomnia.…”