Snoring-related energy transmission to the carotid artery in rabbits

Amatoury, Jason; Howitt, Lauren; Wheatley, John R.; Avolio, Alberto; Amis, Terence C.

doi:10.1152/japplphysiol.01439.2005

Cited by 67 publications

(62 citation statements)

References 44 publications

(42 reference statements)

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“…Snoring may also contribute to cardiovascular risk. 16,17 Effective positional therapy to reduce AHI but with only a small reduction in snoring may be of greatest benefit to patients who regularly sleep alone (5/15 patients in this study and 17% to 25% in others 39,40 ). However, for the majority of positional OSA patients, adjunct or alternative therapies are likely necessary to relieve snoring if snoring is a primary complaint or significant clinical concern.…”

Section: Discussionmentioning

confidence: 86%

“…13,14 Snoring is a cardinal feature of OSA and results from vibrations of a partially obstructed upper airway during sleep. 15 Snoring may have deleterious health consequences in its own right, including vibration damage-induced carotid atherosclerosis 16,17 and potentially carotid plaque rupture and stroke. Snoring very frequently disrupts the sleep of others, particularly affecting bed partner sleep and quality of life.…”

Section: Subjectsmentioning

confidence: 99%

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Accurate Position Monitoring and Improved Supine-Dependent Obstructive Sleep Apnea with a New Position Recording and Supine Avoidance Device

Bignold

Mercer

Antic³

et al. 2011

Journal of Clinical Sleep Medicine

124

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Study Objectives: Approximately 30% of obstructive sleep apnea (OSA) patients have supine-predominant OSA, and simply avoiding supine sleep should normalise respiratory disturbance event rates. However, traditional supineavoidance therapies are inherently uncomfortable, and treatment adherence is poor and diffi cult to monitor objectively. This study evaluated the effi cacy of a novel, potentially more acceptable position monitor and supine-avoidance device for managing supine-predominant OSA and snoring. Design and Setting: In-laboratory evaluation of position recording accuracy versus video recordings (validation study), and randomized controlled crossover trial of active versus inactive supine-avoidance therapy in the home setting (effi cacy study). Patients: 17 patients undergoing in-laboratory sleep studies (validation) and 15 patients with supine-predominant OSA (effi cacy). Interventions: Effi cacy study: 1 week of inactive and 1 week of active treatment in randomized order, separated by 1 week. Measurements and Results: Agreement between 30-sec epoch-based posture classifi cations from device versus video records was high (median κ 0.95, interquartile range: 0.88-1.00), and there was good supine time agreement (bias 0.3%, 95%CI: −4.0% to 4.6%). In the effi cacy study, apnea-hypopnea index (AHI) and snoring frequency were measured in-home using a nasal pressure and microphone based system during inactive and active treatment weeks. The position monitoring and supine alarm device markedly inhibited supine time (mean ± SEM 19.3% ± 4.3% to 0.4% ± 0.3%, p < 0.001) and reduced AHI (25.0 ± 1.7 to 13.7 ± 1.1 events/h, p = 0.030) but not snoring frequency.

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Section: Discussionmentioning

confidence: 86%

Section: Subjectsmentioning

confidence: 99%

Accurate Position Monitoring and Improved Supine-Dependent Obstructive Sleep Apnea with a New Position Recording and Supine Avoidance Device

Bignold

Mercer

Antic³

et al. 2011

Journal of Clinical Sleep Medicine

124

View full text Add to dashboard Cite

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“…11 Recent evidence in rabbits suggests that snoring promotes energy transmission to the carotid artery that could also be involved in atherosclerosis progression. 33 In addition, the association between OSA and atherosclerosis could be mediated by the presence of HTN, a condition that is also associated with proatherogenic factors, such as endothelial dysfunction and inflammation. 34 Typical patients with OSA share several risk factors for cardiovascular disease, including obesity and HTN, well established causes of atherosclerosis.…”

Section: Discussionmentioning

confidence: 99%

Additive Effects of Obstructive Sleep Apnea and Hypertension on Early Markers of Carotid Atherosclerosis

et al. 2009

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Abstract-Obstructive sleep apnea (OSA) has emerged as an independent risk factor for atherosclerosis. However, OSA is frequently associated with several risk factors for atherosclerosis, including hypertension (HTN). The impact of OSA and HTN alone compared with the association of both conditions on carotid atherosclerosis is not understood. We studied 94 middle-aged participants free of smoking and diabetes mellitus who were divided into 4 groups: controls (nϭ22), OSA (nϭ25), HTN (nϭ20), and OSAϩHTN (nϭ27). All of the participants underwent polysomnography and carotid measurements of intima-media thickness, diameter, and distensibility with an echo-tracking device. Compared with controls, intima-media thickness and carotid diameter were similarly higher in OSA (713Ϯ117 and 7117Ϯ805 m), and HTN groups (713Ϯ182 and 7191Ϯ818 m), with a further significant increase in OSAϩHTN patients (837Ϯ181 and 7927Ϯ821 m, respectively; PϽ0.01). Carotid distensibility was significantly lower in HTN (PϽ0.05) and OSAϩHTN subjects (PϽ0.001) compared with controls. In the OSAϩHTN group, carotid distensibility was significantly lower than in the OSA group and controls (PϽ0.05 for each comparison). Multivariate analysis showed that intima-media thickness was positively related to systolic blood pressure and apnea-hypopnea index. Apnea-hypopnea index was the only factor related to carotid diameter. Age and systolic blood pressure were independently related to carotid distensibility. In conclusion, the association of OSA and HTN has additive effects on markers of carotid atherosclerosis. Because early markers of carotid atherosclerosis predict future cardiovascular events, including not only stroke but also myocardial infarction, these findings may help to explain the increased risk of cardiovascular disease in patients with OSA. O bstructive sleep apnea (OSA) is characterized by recurrent episodes of partial or complete obstruction of the upper airway during sleep resulting in oxygen desaturation and arousal from sleep. 1 More than a local obstructive phenomenon in the upper airway, evidence exists indicating that OSA is independently associated with increased cardiovascular risk, including myocardial infarction and stroke. [2][3][4][5][6] Carotid atherosclerosis is an attractive mechanism to explain not only the link between OSA and stroke 7 but also the link between OSA and myocardial infarction. 8 Increased markers of atherosclerosis have been described in a subgroup of young and apparently healthy patients with OSA. 9 Moreover, the treatment with continuous positive airway pressure decreased carotid intima-media thickness (IMT), a validated marker of atherosclerosis. 10 This evidence suggests that OSA is an independent risk factor for atherosclerosis. 11 However, in clinical practice, several comorbidities are commonly associated with OSA. OSA and hypertension (HTN) are tightly linked. 12 In patients with OSA, the prevalence of HTN is Ϸ40%, and the presence of HTN could be the result of the interaction of environmental and genetic ...

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“…It has been suggested that the efficiency of the baroreflex may be disrupted by continuously heightened sympathetic output in snorers (66). Although it is possible that intermittent hypoxia, repetitive desaturations and resultant increased sympathetic activity may contribute to cardiovascular complications, it has been suggested that snoring vibrations themselves have the potential to damage carotid arterial walls and contribute to plaque rupture as observed in atherosclerosis (67). A further possibility is that the association between snoring and cardiovascular events is mediated by obesity.…”

Section: Cardiovascular Andmentioning

confidence: 99%