Effect of long-term CPAR therapy on metabolic profile of patients with mild obstructive sleep apnea


如何引用文章

全文:

开放存取 开放存取
受限制的访问 ##reader.subscriptionAccessGranted##
受限制的访问 订阅或者付费存取

详细

Background. Continuous Positive Airway Pressure (CPAP) therapy is a fundamental therapeutic doctrine for patients with obstructive sleep apnea (OSA). The effects of long-term CPAP therapy significantly depend on comorbid conditions and are poorly predictable and understood, especially in the case of mild OSA patients. Objective: to study the effect of 12-month CPAP therapy on the metabolic profile mild OSA patients. Methods. In a one-year cohort study we included 102 patients (100 men [98%]), with a median age of 44 years (40,3-50,0), who had a verified mild OSA (apnea-hypopnea index (AHI) from 5/h up to 15/h) and metabolic disorders, who signed an informed consent to participate. All patients with OSA were on selected antihypertensive and lipid-lowering therapy. The nature and severity of sleep apnea was verified by performing computer somnography (CSG) on the WatchPAT-200 hardware complex (ItamarMedical, Israel) with the original software PATTMSW ver. 7.1.77.7 (ItamarMedical, Israel) by registering the main respiratory polygraphic characteristics in the period 11:00 PM - 7:30 AM. The patient’s metabolic status was compiled according to the results of the assessment of lipid, carbohydrate, hormonal profiles based on standardized laboratory data on 0 - 3 - 6 - 12 months of observation. All patients underwent targeted ambulatory CPAP therapy to achieve optimal correction of sleep apnea with AHI <5/h. Results. The effects of long-term CPAP therapy occurring at 12 months are associated with a decrease in ESS, with a decrease in visceral adiposity index, with a decrease in insulin resistance, a decrease in the level of LDL, a decrease in the Apo-B index, as well as an increase in testosterone levels with a decrease in leptin levels. Conclusions. The positive effects of CPAP therapy on the “metabolic profile" of patients with mild OSA are associated with the elimination of sleep fragmentation and nocturnal hypoxemia when performed for more than 12 months.

全文:

受限制的访问

作者简介

M. Gorbunova

A.I. Evdokimov Moscow State University of Medicine and Dentistry

Moscow, Russia

Sergey Babak

A.I. Evdokimov Moscow State University of Medicine and Dentistry

Email: sergbabak@mail.ru
Dr. Sci. (Med.), Professor of the Department of Phthisiology and Pulmonology, Faculty of Medicine Moscow, Russia

V. Borovitsky

Kirov State Medical University

Kirov, Russia

A. Malyavin

A.I. Evdokimov Moscow State University of Medicine and Dentistry

Moscow, Russia

参考

  1. Memon J., Manganaro S.N. Obstructive Sleep-disordered Breathing. 2020 Aug 14. In: StatPearls [Internet]. Treasure Island (FL): Stat. Pearls Publishing. 2021 Jan. PMID: 28722938.
  2. Li M., Li X., Lu Y Obstructive Sleep Apnea Syndrome and Metabolic Diseases. Endocrinol.2018;159(7):2670-75. doi: 10.1210/en.2018-00248.
  3. Wang F, Xiong X., Xu H., et al. The association between obstructive sleep apnea syndrome and metabolic syndrome: a confirmatory factor analysis. Sleep Breath. 2019;23(3):1011-19. doi: 10.1007/s11325-019-01804-8
  4. Xia F., Sawan M. Clinical and Research Solutions to Manage Obstructive Sleep Apnea: A Review. Sensors (Basel). 2021;21(5):1784. doi: 10.3390/s21051784.
  5. Pleava R., Mihaicuta S., Serban C.L., et al. Long- Term Effects of Continuous Positive Airway Pressure (CPAP) Therapy on Obesity and Cardiovascular Comorbidities in Patients with Obstructive Sleep Apnea and Resistant Hypertension-An Observational Study. J Clin Med. 2020;9(9):2802. doi: 10.3390/jcm9092802.
  6. Labarca G., Dreyse J., Drake L., et al. Efficacy of continuous positive airway pressure (CPAP) in the prevention of cardiovascular events in patients with obstructive sleep apnea: Systematic review and meta-analysis. Sleep Med Rev. 2020;52:101312. doi: 10.1016/j.smrv.2020.101312.
  7. Littner M., Hirshkowitz M., Davila D., et al. Standards of Practice Committee of the American Academy of Sleep Medicine. Practice parameters for the use of auto-titrating continuous positive airway pressure devices for titrating pressures and treating adult patients with obstructive sleep apnea syndrome. An Am Acad Sleep Med Rep Sleep. 2002;25(2):143-47. Doi: 10.1093/ sleep/25.2.143.
  8. Kapur V.K., Auckley D.H., Chowdhuri S., et al. Clinical Practice Guideline for Diagnostic Test-ing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline. J Clin. Sleep Med. 2017;13(3):479-504. doi: 10.5664/jcsm.6506.
  9. Choi J.H., Lee B., Lee J.Y., et al. Validating the Watch-PAT for Diagnosing Obstructive Sleep Apnea in Adolescents. J Clin Sleep Med. 2018;14(10):1741-47. Doi: 10.5664/ jcsm.7386.
  10. Zhang Z., Sowho M., Otvos T., et al. A comparison of automated and manual sleep staging and respiratory event recognition in a portable sleep diagnostic device with in-lab sleep study. J Clin Sleep Med. 2020;16(4):563-73. Doi: 10.5664/ jcsm.8278.
  11. Pillar G., Berall M., Berry R., et al. Detecting central sleep apnea in adult patients using Watch-PAT-a multicenter validation study. Sleep Breath. 2020;24(1):387-98. doi: 10.1007/s11325-019-01904-5.
  12. Mehrtash M., Bakker J.P., Ayas N. Predictors of Continuous Positive Airway Pressure Adherence in Patients with Obstructive Sleep Apnea. Lung. 2019;197(2):115-21. doi: 10.1007/s00408-018-00193-1.
  13. Drager L.F., Togeiro S.M., Polotsky V.Y., Lorenzi-Filho G. Obstructive sleep apnea: a cardiometabolic risk in obesity and the metabolic syndrome. J Am Coll Cardiol. 2013;62(7):569-76. doi: 10.1016/j.jacc.2013.05.045.
  14. Salman L.A., Shulman R., Cohen J.B. Obstructive Sleep Apnea, Hypertension, and Cardiovascular Risk: Epidemiology, Pathophysiology, and Management. Curr Cardiol Rep. 2020;22(2):6. doi: 10.1007/s11886-020-1257-y.
  15. Zampogna E., Spanevello A., Lucioni A.M., et al. Adherence to Continuous Positive Airway Pressure in patients with Obstructive Sleep Apnoea. A ten-year real-life study. Respir Med. 2019;150:95-100. doi: 10.1016/j.rmed.2019.02.017.
  16. Xu H., Liang C., Zou J., et al. Interaction between obstructive sleep apnea and short sleep duration on insulin resistance: a large-scale study: OSA, short sleep duration and insulin resistance. Respir Res. 2020;21(1):151. doi: 10.1186/s12931-020-01416-x.
  17. Knowlden A.P., Higginbotham J.C., Grandner M.A., Allegrante J.P. Modeling Risk Factors for Sleep-and Adiposity-Related Cardiometabolic Disease: Protocol for the Short Sleep Undermines Cardiometabolic Health (SLUMBRx) Observational Study. JMIR. Res Protoc. 2021;10(3):e27139. doi: 10.2196/27139.
  18. Drager L.F., Santos R.B., Silva W.A., et al. OSA, Short Sleep Duration, and Their Interactions With Sleepiness and Cardiometabolic Risk Factors in Adults: The ELSA-Brasil Study. Chest. 2019;155(6):1190-98. Doi: 10.1016/j. chest.2018.12.003.

补充文件

附件文件
动作
1. JATS XML
下载

版权所有 © Bionika Media, 2021
##common.cookie##