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Life
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Sleep Disordered Breathing and Related Comorbidities: From Bench to Beside
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Sleep Disordered Breathing and Related Comorbidities: From Bench to Beside

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

Deadline for manuscript submissions: closed (25 December 2022) | Viewed by 11222

Special Issue Editors

Dr. Jinkwan Kim

E-Mail Website
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
Special Issues, Collections and Topics in MDPI journals
Dr. Dae-Wui Yoon

E-Mail Website
Guest Editor
Department of Biomedical Laboratory Science, Jungwon University, 85, Munmu-ro, Goesan-eup, Goesan-gun, Chungbuk 28204, Republic of Korea
Interests: sleep fragmentation; epigenetics; cancer; proteomics; biomarkers
Special Issues, Collections and Topics in MDPI journals

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, and affects 2–4% of the global adult population. It is characterized by intermittent hypoxia and frequent arousals due to the repetitive collapse of the upper airway during sleep. These physiological properties lead to the activation and propagation of oxidative stress, inflammation, and sympathetic hyperactivity. Recent epidemiological and experimental studies also show a significant causal relationship between OSA and cancer. 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, pathophysiological mechanisms of 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 from bench to beside.

Dr. Dae-Wui Yoon
Dr. Jinkwan Kim
Guest Editors

Manuscript Submission Information

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  •  sleep disordered breathing
  •  sleep fragmentation
  •  cardiovascular disease
  •  epigenetics
  •  insulin resistance

Published Papers (5 papers)

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Research

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13 pages, 966 KiB  
Article
Continuous Positive Airway Pressure Reduces Plasma Neurochemical Levels in Patients with OSA: A Pilot Study
by Wen-Te Liu, Huei-Tyng Huang, Hsin-Yi Hung, Shang-Yang Lin, Wen-Hua Hsu, Fang-Yu Lee, Yi-Chun Kuan, Yin-Tzu Lin, Chia-Rung Hsu, Marc Stettler, Chien-Ming Yang, Jieni Wang, Ping-Jung Duh, Kang-Yun Lee, Dean Wu, Hsin-Chien Lee, Jiunn-Horng Kang, Szu-Szu Lee, Hsiu-Jui Wong, Cheng-Yu Tsai and Arnab Majumdaradd Show full author list remove Hide full author list
Life 2023, 13(3), 613; https://doi.org/10.3390/life13030613 - 22 Feb 2023
Cited by 1 | Viewed by 1729
Abstract
Obstructive sleep apnea (OSA) is a risk factor for neurodegenerative diseases. This study determined whether continuous positive airway pressure (CPAP), which can alleviate OSA symptoms, can reduce neurochemical biomarker levels. Thirty patients with OSA and normal cognitive function were recruited and divided into [...] Read more.
Obstructive sleep apnea (OSA) is a risk factor for neurodegenerative diseases. This study determined whether continuous positive airway pressure (CPAP), which can alleviate OSA symptoms, can reduce neurochemical biomarker levels. Thirty patients with OSA and normal cognitive function were recruited and divided into the control (n = 10) and CPAP (n = 20) groups. Next, we examined their in-lab sleep data (polysomnography and CPAP titration), sleep-related questionnaire outcomes, and neurochemical biomarker levels at baseline and the 3-month follow-up. The paired t-test and Wilcoxon signed-rank test were used to examine changes. Analysis of covariance (ANCOVA) was performed to increase the robustness of outcomes. The Epworth Sleepiness Scale and Pittsburgh Sleep Quality Index scores were significantly decreased in the CPAP group. The mean levels of total tau (T-Tau), amyloid-beta-42 (Aβ42), and the product of the two (Aβ42 × T-Tau) increased considerably in the control group (ΔT-Tau: 2.31 pg/mL; ΔAβ42: 0.58 pg/mL; ΔAβ42 × T-Tau: 48.73 pg2/mL2), whereas the mean levels of T-Tau and the product of T-Tau and Aβ42 decreased considerably in the CPAP group (ΔT-Tau: −2.22 pg/mL; ΔAβ42 × T-Tau: −44.35 pg2/mL2). The results of ANCOVA with adjustment for age, sex, body mass index, baseline measurements, and apnea–hypopnea index demonstrated significant differences in neurochemical biomarker levels between the CPAP and control groups. The findings indicate that CPAP may reduce neurochemical biomarker levels by alleviating OSA symptoms. Full article
(This article belongs to the Special Issue Sleep Disordered Breathing and Related Comorbidities: From Bench to Beside)
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14 pages, 1329 KiB  
Article
Coexistence of Moderate-to-Severe Obstructive Sleep Apnea and Inflammation Accelerates the Risk of Progression of Arterial Stiffness: A Prospective 6-Year Study
by Jinkwan Kim, Dae Wui Yoon, Sungmin Myoung, Seung Ku Lee and Chol Shin
Life 2022, 12(11), 1823; https://doi.org/10.3390/life12111823 - 08 Nov 2022
Cited by 1 | Viewed by 1238
Abstract
Both obstructive sleep apnea (OSA) and inflammation have now been recognized as imposing substantial cardiometabolic risk. However, no prospective study has reported whether the coexistence of OSA and inflammation exacerbates the progressive arterial stiffening. Thus, the purpose of this study is to examine [...] Read more.
Both obstructive sleep apnea (OSA) and inflammation have now been recognized as imposing substantial cardiometabolic risk. However, no prospective study has reported whether the coexistence of OSA and inflammation exacerbates the progressive arterial stiffening. Thus, the purpose of this study is to examine whether these conditions increase the risk of the progression of arterial stiffening. A total of 1945 participants were randomly selected for the study. Subjects with elevated inflammation were divided by high-sensitivity C-reactive protein (hsCRP) levels. A polysomnography and brachial–ankle pulse wave velocity (baPWV) were performed. The elevation of the baPWV was defined as the levels in the highest quartile of the baPWV. The percentage of the elevated baPWV and the change in the baPWV (ΔbaPWV) were higher in individuals with OSA and higher hsCRP levels. After adjusting for confounders, the participants with OSA and inflammation in the groups not treated with antihypertensive medication had a higher risk of an elevated ΔbaPWV in contrast to those with neither variable. Particularly, the alteration in the baPWV differed significantly based on the existence of moderate-to-severe OSA and inflammation at the 6-year follow-up. In combination, these conditions are associated with an accelerated risk of a future burden of the progression of the arterial stiffness, suggesting a potential important role in the increased risk of CVD. Full article
(This article belongs to the Special Issue Sleep Disordered Breathing and Related Comorbidities: From Bench to Beside)
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26 pages, 6604 KiB  
Article
A Deep Learning Framework for Automatic Sleep Apnea Classification Based on Empirical Mode Decomposition Derived from Single-Lead Electrocardiogram
by Febryan Setiawan and Che-Wei Lin
Life 2022, 12(10), 1509; https://doi.org/10.3390/life12101509 - 27 Sep 2022
Cited by 6 | Viewed by 2301
Abstract
Background: Although polysomnography (PSG) is a gold standard tool for diagnosing sleep apnea (SA), it can reduce the patient’s sleep quality by the placement of several disturbing sensors and can only be interpreted by a highly trained sleep technician or scientist. In recent [...] Read more.
Background: Although polysomnography (PSG) is a gold standard tool for diagnosing sleep apnea (SA), it can reduce the patient’s sleep quality by the placement of several disturbing sensors and can only be interpreted by a highly trained sleep technician or scientist. In recent years, electrocardiogram (ECG)-derived respiration (EDR) and heart rate variability (HRV) have been used to automatically diagnose SA and reduce the drawbacks of PSG. Up to now, most of the proposed approaches focus on machine-learning (ML) algorithms and feature engineering, which require prior expert knowledge and experience. The present study proposes an SA detection algorithm to differentiate a normal and apnea event using a deep-learning (DL) framework based on 1D and 2D deep CNN with empirical mode decomposition (EMD) of a preprocessed ECG signal. The EMD is ideally suited to extract essential components which are characteristic of the underlying biological or physiological processes. In addition, the simple and compact architecture of 1D deep CNN, which only performs 1D convolutions, and pretrained 2D deep CNNs, are suitable for real-time and low-cost hardware implementation. Method: This study was validated using 7 h to nearly 10 h overnight ECG recordings from 33 subjects with an average apnea-hypopnea index (AHI) of 30.23/h originated from PhysioNet Apnea-ECG database (PAED). In preprocessing, the raw ECG signal was normalized and filtered using the FIR band pass filter. The preprocessed ECG signal was then decomposed using the empirical mode decomposition (EMD) technique to generate several features. Several important generated features were selected using neighborhood component analysis (NCA). Finally, deep learning algorithm based on 1D and 2D deep CNN were used to perform the classification of normal and apnea event. The synthetic minority oversampling technique (SMOTE) was also applied to evaluate the influence of the imbalanced data problem. Results: The segment-level classification performance had 93.8% accuracy with 94.9% sensitivity and 92.7% specificity based on 5-fold cross-validation (5fold-CV), meanwhile, the subject-level classification performance had 83.5% accuracy with 75.9% sensitivity and 88.7% specificity based on leave-one-subject-out cross-validation (LOSO-CV). Conclusion: A novel and robust SA detection algorithm based on the ECG decomposed signal using EMD and deep CNN was successfully developed in this study. Full article
(This article belongs to the Special Issue Sleep Disordered Breathing and Related Comorbidities: From Bench to Beside)
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10 pages, 262 KiB  
Article
Mandibular Advancement Device Therapy in Japanese Rugby Athletes with Poor Sleep Quality and Obstructive Sleep Apnea
by Hiroshi Suzuki, Toshiyuki Nakayama, Arisa Sawa, Tatsuo Yagi, Yoshihiro Iwata, Hiroki Takeuchi, Miho Motoyoshi, Chin-Moi Chow and Osamu Komiyama
Life 2022, 12(9), 1299; https://doi.org/10.3390/life12091299 - 24 Aug 2022
Cited by 1 | Viewed by 2354
Abstract
Obstructive sleep apnea (OSA) may contribute to poor sleep quality. This study assessed subjective sleep quality, the Respiratory Event Index (REI), reaction times, and the therapeutic effects of a custom-made mandibular advancement device (MAD) in male Japanese elite rugby athletes. The Pittsburgh Sleep [...] Read more.
Obstructive sleep apnea (OSA) may contribute to poor sleep quality. This study assessed subjective sleep quality, the Respiratory Event Index (REI), reaction times, and the therapeutic effects of a custom-made mandibular advancement device (MAD) in male Japanese elite rugby athletes. The Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and level III sleep test (REI and minimum oxygen saturation [SpO2 min]) were used to evaluate sleep quality. MAD therapy was used daily for 3 weeks. A telephone-based reaction time test of kinetic vision (the ability to identify moving objects) was recorded within 15 min of waking and over 5 days of pre- and post-MAD therapy. Differences in variables were evaluated using paired t-tests. Of the 42 players (mean age, 26.3 ± 3.7 years; mean body mass index, 28.7 ± 3.2 kg/m2) included in this study, 29 (69.0%) had poor sleep quality (PSQI > 5.5), and 27 were diagnosed with OSA (64.3%) (mild = 16/moderate = 9/severe = 2). Six were treated with MAD therapy, which significantly improved the REI (p < 0.01), SpO2 min (p < 0.001), ESS score (p < 0.001), reaction times (p < 0.01), and sleep quality. A significant reduction in reaction times suggests that OSA treatment can improve kinetic vision. Future studies should systematically evaluate the impact of sleep-disordered breathing on kinetic vision in athletes. Full article
(This article belongs to the Special Issue Sleep Disordered Breathing and Related Comorbidities: From Bench to Beside)

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19 pages, 3287 KiB  
Systematic Review
Evaluation of Plasma/Serum Adiponectin (an Anti-Inflammatory Factor) Levels in Adult Patients with Obstructive Sleep Apnea Syndrome: A Systematic Review and Meta-Analysis
by Amir Najafi, Iman Mohammadi, Masoud Sadeghi, Annette Beatrix Brühl, Dena Sadeghi-Bahmani and Serge Brand
Life 2022, 12(5), 738; https://doi.org/10.3390/life12050738 - 16 May 2022
Cited by 14 | Viewed by 2760
Abstract
Background and objective: A variety of diseases, including obesity, type ‖ diabetes, and cardiovascular diseases are associated with obstructive sleep apnea syndrome (OSAS), and decreased adiponectin levels have been shown to be associated with an increased risk of these diseases. However, the association [...] Read more.
Background and objective: A variety of diseases, including obesity, type ‖ diabetes, and cardiovascular diseases are associated with obstructive sleep apnea syndrome (OSAS), and decreased adiponectin levels have been shown to be associated with an increased risk of these diseases. However, the association of blood levels of adiponectin in OSAS patients is a challenging and unknown issue with conflicting results. Therefore, we performed a systematic review and a meta-analysis to evaluate plasma/serum adiponectin levels in adult patients with OSAS. Materials and methods: A comprehensive search in four databases (PubMed/Medline, Web of Science, Scopus, and Cochrane Library) was performed in literature dated older than 12 March 2022, to retrieve the relevant articles. Effect sizes were calculated to show the standardized mean difference (SMD) along with a 95% confidence interval (CI) of plasma/serum of adiponectin between the OSAS patients and controls. The software RevMan 5.3, NCSS 21.0.2, CMA 2.0, trial sequential analysis (TSA) 0.9.5.10 beta, and GetData Graph Digitizer 2.26 were used for data synthesis in the meta-analysis. Results: A total of 28 articles including 36 studies were entered into the meta-analysis. The results showed that pooled SMD was −0.71 (95% CI: −0.92, 0.50; p < 0.00001; I2 = 79%) for plasma/serum levels of adiponectin in OSAS cases compared to the controls. The subgroup analyses showed that the geographical region and the Apnea-Hypopnea-Index (AHI) could be confounding factors in the pooled analysis of plasma/serum adiponectin levels. The sensitivity analysis showed the stability of the results. The radial and L’Abbé plots confirmed evidence of heterogeneity. Trial sequential analysis showed sufficient cases in the meta-analysis. Conclusions: With sufficient cases and stable results, the main finding of the meta-analysis identified significantly reduced plasma/serum levels of adiponectin in OSAS cases compared with the controls. This result suggests a potential role of adiponectin in the pathogenesis of OSAS. Full article
(This article belongs to the Special Issue Sleep Disordered Breathing and Related Comorbidities: From Bench to Beside)
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