Obstructive Sleep Apnea and Related Disorders: Pathophysiological Traits and Strategies for Treatment

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Physiology and Pathology".

Deadline for manuscript submissions: 24 July 2024 | Viewed by 4101

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Guest Editor
Department of Biomedical Laboratory Science, Jungwon University 85, Munmu-ro, Goesan-eup, Goesan-gun 28204, Chungbuk, Republic of Korea
Interests: obstructive sleep apnoea; sleep fragmentation; inflammation; exosome and biomarkers; cardio-metabolic disease; epigenetics; mesenchymal stem cell
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Special Issue Information

Dear Colleagues,

Obstructive sleep apnea (OSA) is a common disease that can lead to serious health problems, such as hypertension, diabetes mellitus, dyslipidemia, and neurocognitive dysfunction. OSA affects up to 1 billion people worldwide and is a complex and heterogeneous disorder. It is characterized by intermittent hypoxia and sleep fragmentation due to repetitive collapse of upper airway during sleep. These physiological properties lead to activation and propagation of oxidative stress, inflammation, and sympathetic hyperactivity. Due to the lack of experimental models that can mimic OSA, the underlying mechanisms linking OSA and comorbidities are not clearly elucidated. However, advances in molecular and biological technologies have made it possible to better understand the pathophysiological phenomena of OSA-related diseases. In this Special Issue, we will cover recent outstanding findings regarding treatment strategies, biomarkers, and pathophysiological mechanisms of various diseases associated with OSA, important clinical and epidemiological results, and big data analysis. This integrated approach is expected to provide readers with a better understanding of the pathophysiologic consequences of OSA and related disorders.

Dr. Jinkwan Kim
Guest Editor

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Keywords

  • obstructive sleep apnea
  • sleep fragmentation
  • cardiometabolic dysfunction
  • inflammation
  • co-morbidities

Published Papers (4 papers)

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Research

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14 pages, 419 KiB  
Article
Impact of Intermittent Hypoxia Related to Obstructive Sleep Apnoea Syndrome on Low-Grade Inflammation in Hypertensive Patients: Potential Implications for Cardiovascular Risk
by Matthieu Hein, Benjamin Wacquier, Matteo Conenna, Jean-Pol Lanquart and Camille Point
Life 2024, 14(5), 592; https://doi.org/10.3390/life14050592 - 6 May 2024
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Abstract
There is evidence for a particular relationship between low-grade inflammation (LGI) and intermittent hypoxia (IH) related to obstructive sleep apnoea syndrome (OSAS). However, despite the potential deleterious cardiovascular consequences associated with this LGI in hypertensive patients, few studies have investigated the impact of [...] Read more.
There is evidence for a particular relationship between low-grade inflammation (LGI) and intermittent hypoxia (IH) related to obstructive sleep apnoea syndrome (OSAS). However, despite the potential deleterious cardiovascular consequences associated with this LGI in hypertensive patients, few studies have investigated the impact of IH related to OSAS on CRP levels in this subpopulation. In total, 1404 hypertensive patients were selected retrospectively from the Sleep Laboratory database. CRP levels ≥3 mg/L but <10 mg/L were used as cut-offs to identify hypertensive patients with LGI. Logistic regressions were conducted to examine the risk of LGI associated with IH related to OSAS in hypertensive patients. LGI was frequent (33.8%) in hypertensive patients. After adjustment for confounders, multivariate logistic regressions revealed that only moderate to severe OSAS (apnoea–hypopnoea index ≥ 15/h) with high IH (oxygen desaturation index ≥ 15/h) [OR 1.51 (95% CI 1.06–2.14)] was significantly associated with LGI in hypertensive patients (p-value = 0.045). Consistent with our hypothesis, our results demonstrated the existence of a particular subtype of hypertensive patients at high cardiovascular risk characterised by the presence of LGI induced by IH hypoxia related to moderate to severe OSAS, which justifies the establishment of adequate management of this pathology to allow better cardiovascular prevention in this subpopulation. Full article
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15 pages, 1011 KiB  
Article
Prevalence and Characteristics of Patients with Obstructive Sleep Apnea and Chronic Obstructive Pulmonary Disease: Overlap Syndrome
by Michail Fanaridis, Izolde Bouloukaki, Georgios Stathakis, Paschalis Steiropoulos, Nikos Tzanakis, Violeta Moniaki, Eleni Mavroudi, Ioanna Tsiligianni and Sophia Schiza
Life 2024, 14(5), 547; https://doi.org/10.3390/life14050547 - 25 Apr 2024
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Abstract
Overlap syndrome (OVS) is a distinct clinical entity that seems to result in potential cardiovascular consequences. We aimed to estimate the prevalence and risk factors for OVS in OSA patients and analyze clinical and PSG characteristics associated with OVS. In this cross-sectional study, [...] Read more.
Overlap syndrome (OVS) is a distinct clinical entity that seems to result in potential cardiovascular consequences. We aimed to estimate the prevalence and risk factors for OVS in OSA patients and analyze clinical and PSG characteristics associated with OVS. In this cross-sectional study, 2616 patients evaluated for OSA underwent type-1 polysomnography (PSG). They were grouped as pure OSA (AHI > 15/h) and OVS patients. Demographics, PSG data, pulmonary function tests and arterial blood gases (ABGs) were compared between groups after adjustments for confounders. OSA was diagnosed in 2108 out of 2616 patients. Of those, 398 (19%) had OVS. Independent predictors of OVS were older age [OR: 5.386 (4.153–6.987)], current/former smoking [OR: 11.577 (7.232–18.532)], BMI [OR: 2.901 (2.082–4.044)] and ABG measurements [PaCO2 ≥ 45 OR: 4.648 (3.078–7.019), PO2 [OR: 0.934 (0.920–0.949)], HCO3 [OR: 1.196 (1.133–1.263), all p < 0.001]. OVS was also associated with prevalent hypertension [OR: 1.345 (1.030–1.758), p = 0.03] and cardiovascular disease [OR: 1.617 (1.229–2.126), p < 0.001], depressive symptoms [OR: 1.741 (1.230–2.465), p = 0.002] and nocturia [OR: 1.944 (1.378–2.742), p < 0.001], as well as with indices of OSA severity. Disturbances in sleep architecture were more prominent in OVS expressed by lower %N3 and REM% and higher arousal index. Our data suggest that OVS is prevalent among OSA patients, with distinct clinical and PSG characteristics. These characteristics could be utilized as predictive factors for early identification and further evaluation of these patients towards desirable patient-reported outcomes. Full article
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Review

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17 pages, 3069 KiB  
Review
Possible Molecular Mechanisms of Hypertension Induced by Sleep Apnea Syndrome/Intermittent Hypoxia
by Yoshinori Takeda, Fuminori Kimura and Shin Takasawa
Life 2024, 14(1), 157; https://doi.org/10.3390/life14010157 - 22 Jan 2024
Cited by 1 | Viewed by 1223
Abstract
Intermittent hypoxia (IH) is a central characteristic of sleep apnea syndrome (SAS), and it subjects cells in the body to repetitive apnea, chronic hypoxia, oxygen desaturation, and hypercapnia. Since SAS is linked to various serious cardiovascular complications, especially hypertension, many studies have been [...] Read more.
Intermittent hypoxia (IH) is a central characteristic of sleep apnea syndrome (SAS), and it subjects cells in the body to repetitive apnea, chronic hypoxia, oxygen desaturation, and hypercapnia. Since SAS is linked to various serious cardiovascular complications, especially hypertension, many studies have been conducted to elucidate the mechanism of hypertension induced by SAS/IH. Hypertension in SAS is associated with numerous cardiovascular disorders. As hypertension is the most common complication of SAS, cell and animal models to study SAS/IH have developed and provided lots of hints for elucidating the molecular mechanisms of hypertension induced by IH. However, the detailed mechanisms are obscure and under investigation. This review outlines the molecular mechanisms of hypertension in IH, which include the regulation systems of reactive oxygen species (ROS) that activate the renin–angiotensin system (RAS) and catecholamine biosynthesis in the sympathetic nervous system, resulting in hypertension. And hypoxia-inducible factors (HIFs), Endotheline 1 (ET-1), and inflammatory factors are also mentioned. In addition, we will discuss the influences of SAS/IH in cardiovascular dysfunction and the relationship of microRNA (miRNA)s to regulate the key molecules in each mechanism, which has become more apparent in recent years. These findings provide insight into the pathogenesis of SAS and help in the development of future treatments. Full article
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Other

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9 pages, 227 KiB  
Opinion
Non-Invasive Positive Pressure Ventilation Use—Practice Recommendations of the Slovak Society of Pulmonology and Phthisiology
by Pavol Pobeha, Imrich Mucska, Robert Vysehradsky, Marta Hajkova, Ivana Paranicova and Pavol Joppa
Life 2024, 14(3), 376; https://doi.org/10.3390/life14030376 - 13 Mar 2024
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Abstract
Non-invasive positive pressure ventilation (NIPPV) is increasingly used as a treatment method for patients with respiratory failure. The first recommendations for the use of NIPPV in Slovakia were developed by the Slovak Society of Pulmonology and Phthisiology in 2007 and were partially revised [...] Read more.
Non-invasive positive pressure ventilation (NIPPV) is increasingly used as a treatment method for patients with respiratory failure. The first recommendations for the use of NIPPV in Slovakia were developed by the Slovak Society of Pulmonology and Phthisiology in 2007 and were partially revised in 2015. New scientific evidence prompted the present update, which is based on widely accepted international guidelines and was adapted to address local needs. Important features of the present update include a classification of acute indications for NIPPV into three categories based on the level of supporting evidence, namely 1. definite indications for in-hospital use of NIPPV; 2. possible indications for in-hospital use of NIPPV; and 3. disorders and states in which in-hospital use of NIPPV is not recommended. The current update also reflects the importance of comorbid sleep-related breathing disorders and other chronic respiratory conditions, as well as the use and limitations of continuous positive airway pressure therapy. Since oxygen therapy is often administered along with NIPPV, guidance on the safe use of oxygen in NIPPV-treated patients has also been included. Also, the present update extends the range of its users, addressing the needs of specialists in pediatric respiratory medicine as a novelty. Full article
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