Ventilatory support or respiratory muscle training as adjuncts to exercise in obese CPAP-treated patients with obstructive sleep apnoea: a randomised controlled trial

Vivodtzev, Isabelle; Tamisier, Renaud; Croteau, Marilie; Borel, Jean‐Christian; Grangier, Angélique; Wuyam, Bernard; Lévy, Patrick; Minville, Caroline; Sériès, Frédéric; Maltais, François; Pépin, Jean‐Louis

doi:10.1136/thoraxjnl-2017-211152

Cited by 26 publications

(23 citation statements)

References 35 publications

(28 reference statements)

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“…In multivariate analysis, determinants of PWV progression are old age and hypertension. Optimal management of OSA-associated comorbidities is needed for patients on CPAP treatment [60,61] in order to slow deterioration in arterial stiffness, reduce the occurrence of late cardiovascular events and to improve survival.…”

Section: Discussionmentioning

confidence: 99%

Long-term variations of arterial stiffness in patients with obesity and obstructive sleep apnea treated with continuous positive airway pressure

et al. 2020

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Background Obstructive sleep apnea (OSA) is associated with cardiovascular co-morbidities and mortality. Arterial stiffness is an independent predictor of cardiovascular risk and mortality, and is influenced by the presence of OSA and related comorbidities. There is a paucity of data regarding long-term evolution of arterial stiffness in CPAP-treated OSA patients. We aimed to prospectively study long term PWV variations and determinants of PWV deterioration.

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Section: Discussionmentioning

confidence: 99%

Long-term variations of arterial stiffness in patients with obesity and obstructive sleep apnea treated with continuous positive airway pressure

et al. 2020

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“…Moreover, weight loss plus CPAP have synergistic effects on weight and metabolic parameters compared with each intervention alone [83]. In obese patients with OSA on CPAP, noninvasive ventilation or respiratory muscle training as adjuncts to exercise have recently been shown to significantly reduce waist circumference and blood pressure [84].The evidence supports a combined treatment strategy in obese OSA.…”

Section: Impact Of Cpap Treatment On Adipose Tissue and Ectopic Fatmentioning

confidence: 99%

Adipose tissue as a key player in obstructive sleep apnoea

et al. 2019

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Obstructive sleep apnoea (OSA) is a major health concern worldwide and adversely affects multiple organs and systems. OSA is associated with obesity in >60% of cases and is independently linked with the development of numerous comorbidities including hypertension, arrhythmia, stroke, coronary heart disease and metabolic dysfunction. The complex interaction between these conditions has a significant impact on patient care and mortality. The pathophysiology of cardiometabolic complications in OSA is still incompletely understood; however, the particular form of intermittent hypoxia (IH) observed in OSA, with repetitive short cycles of desaturation and re-oxygenation, probably plays a pivotal role. There is fast growing evidence that IH mediates some of its detrimental effects through adipose tissue inflammation and dysfunction. This article aims to summarise the effects of IH on adipose tissue in experimental models in a comprehensive way. Data from well-designed controlled trials are also reported with the final goal of proposing new avenues for improving phenotyping and personalised care in OSA.

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“…In a previous study, we have demonstrated that OSA phenotypes are specifically influenced by the above-mentioned environmental factors [9]. Thus, taking into consideration the patient's ecosystem will provide a sound basis for personalized medicine and a multimodal management of OSA, including lifestyle interventions and an exercise programme to complement continuous positive airway pressure (CPAP) treatment [35]. Whereas OSA severity assessed by AHI was similar in both groups, OVS patients exhibited less symptoms related to sleep-disordered breathing and reported less excessive daytime sleepiness compared to the OSA alone population.…”

Section: Plos Onementioning

confidence: 99%

Clinical presentation and comorbidities of obstructive sleep apnea-COPD overlap syndrome

et al. 2020

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Background More advanced knowledge is needed on how COPD alters the clinical presentation of obstructive sleep apnea (OSA) and how the association of both diseases, known as 'overlap syndrome' (OVS), impacts on cardiovascular health. Objective To investigate differences between patients with OVS and those with moderate-to-severe OSA alone. Methods A cross-sectional study conducted in the French National Sleep Apnea Registry between January 1997 and January 2017. Univariable and multivariable logistic regression models were used to compare OVS versus OSA alone on symptoms and cardiovascular health. Results 46,786 patients had moderate-to-severe OSA. Valid spirometry was available for 16,466 patients: 14,368 (87%) had moderate-to-severe OSA alone and 2098 (13%) had OVS. A lower proportion of OVS patients complained of snoring, morning headaches and excessive daytime sleepiness compared to OSA alone (median Epworth Sleepiness Scale score: 9 [interquartile range (IQR) 6-13] versus 10 (IQR 6-13), respectively; P <0.02). Similarly, a lower proportion of OVS patients (35.6% versus 39.4%, respectively; P <0.01) experienced sleepiness while driving. In contrast, 63.5% of the OVS population experienced nocturia compared to 58.0% of the OSA population (P<0.01). Apnea hypopnea index (36 [25; 52] vs 33.1 [23.3; 50]), oxygen desaturation index (28 [15; 48] vs 25.2 [14; 45]) and mean nocturnal

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Ventilatory support or respiratory muscle training as adjuncts to exercise in obese CPAP-treated patients with obstructive sleep apnoea: a randomised controlled trial

Abstract: Results, NCT01155271.

Cited by 26 publications

References 35 publications

Long-term variations of arterial stiffness in patients with obesity and obstructive sleep apnea treated with continuous positive airway pressure

Long-term variations of arterial stiffness in patients with obesity and obstructive sleep apnea treated with continuous positive airway pressure

Adipose tissue as a key player in obstructive sleep apnoea

Clinical presentation and comorbidities of obstructive sleep apnea-COPD overlap syndrome

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