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Obstructive Sleep Apnea: diagnosis, prevalence, treatment, clinical presentation, comorbidities, and responsible mechanisms

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: closed (31 December 2021) | Viewed by 15124

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Special Issue Editors

Dr. Agata Gabryelska

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Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 90-151 Lodz, Poland
Interests: sleep; obstructive sleep apnea; insomnia; affective disorders; circadian rhythm
Special Issues, Collections and Topics in MDPI journals

Dr. Marcin Sochal

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Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, Poland
Interests: sleep apnea; OSA comorbidities; insomnia; psychoneuroimmunology; inflammation
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Obstructive sleep apnea (OSA) is a chronic condition characterized by recurrent pauses in breathing during sleep caused by repeating the collapse of the upper airways resulting in intermittent hypoxia. In recent decades prevalence of OSA has greatly increased, making it one of the most commonly diagnosed sleep disorders, thus affecting the life quality of a vast number of individuals. It is associated with cardiovascular, metabolic, and cognitive disorders, such as atrial hypertension, insulin resistance, or diabetes mellitus. To achieve a more personalized approach, different clinical phenotypes of OSA have been defined, allowing for a more in-depth examination of the mechanism responsible for the development of the disorder itself as well as its wide spectrum of complications.This Special Issue welcomes all types of papers on undertaking the topic of prevalence, treatment, clinical characteristics, comorbidities, and involved pathomechanisms of OSA. We invite you to contribute to this Special Issue high-quality original research, review papers, and meta-analysis. Dr. Agata GabryelskaDr. Marcin SochalGuest Editors

Dr. Agata Gabryelska
Dr. Marcin Sochal
Guest Editors

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Keywords

Obstructive sleep apnea (OSA)
Polysomnography (PSG)
Continuous positive air pressure (CPAP)
Hypoxia
Sleep disorders
Clinical phenotypes
Pathomechanism
Diagnosis
Biomarkers
Cognitive disorders

Published Papers (5 papers)

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Research

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12 pages, 968 KiB

Open AccessArticle

Impact of Exposome Factors on Epidermal Barrier Function in Patients with Obstructive Sleep Apnea Syndrome

by Maria Romera-Vilchez, Trinidad Montero-Vilchez, Manuel Herrero-Fernandez, Juan-Angel Rodriguez-Pozo, Gonzalo Jimenez-Galvez, Concepcion Morales-Garcia, Agustin Buendia-Eisman and Salvador Arias-Santiago

Int. J. Environ. Res. Public Health 2022, 19(2), 659; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19020659 - 07 Jan 2022

Cited by 1 | Viewed by 1895

Abstract

Exposome factors, such as sleep deprivation and diet, could affect skin barrier function. The objectives of this study are to compare skin barrier function between patients with Obstructive Sleep Apnea Syndrome (OSAS) and healthy individuals, and to evaluate the effect of other exposome factors on skin. A cross-sectional study was conducted. Patients with OSAS and healthy volunteers matched by age and sex were included. OSAS severity was assessed by the Apnea-Hypopnea Index (AHI). Validated questionnaires were used to assess diet, anxiety, depression, and psychological stress. Skin barrier function parameters including temperature, erythema, melanin, pH, transepidermal water loss (TEWL), and stratum corneum hydration (SCH) were measured on the volar forearm. A total of 86 participants were included, 56 patients with OSAS and 30 healthy volunteers. TEWL was higher in OSAS patients than in healthy individuals (8.01 vs. 8.68 g·m⁻²·h⁻¹). Regarding disease severity, severe patients had higher TEWL values (9.31 vs. 8.46 vs. 7.08 g·m⁻²·h⁻¹) compared to moderate and mild patients. Patients with OSAS had significantly lower sleep quality (11.89 vs. 6.47 Pittsburgh Sleep Quality Index score; p < 0.001), poor adherence to the Mediterranean Diet (8.46 vs. 9.77; p = 0.005), and significantly higher anxiety and depression levels than healthy individuals. In conclusion, patients with OSAS may have skin barrier impairment, reflected in higher TEWL values. These patients also have higher levels of anxiety, depression, stress, and a lower adherence to a Mediterranean Diet, all exposome factors that might impact on skin barrier function. Full article

(This article belongs to the Special Issue Obstructive Sleep Apnea: diagnosis, prevalence, treatment, clinical presentation, comorbidities, and responsible mechanisms)

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10 pages, 1329 KiB

Open AccessArticle

Prevalence of Obstructive Sleep Apnea Syndrome: A Single-Center Retrospective Study

by Manlio Santilli, Eugenio Manciocchi, Gianmaria D’Addazio, Erica Di Maria, Michele D’Attilio, Beatrice Femminella and Bruna Sinjari

Int. J. Environ. Res. Public Health 2021, 18(19), 10277; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph181910277 - 29 Sep 2021

Cited by 23 | Viewed by 3910

Abstract

Obstructive sleep apnea syndrome (OSAS) is a sleep breathing disorder that often remains undiagnosed and untreated. OSAS prevalence is increasing exponentially. Starting on the dentist’s role as an epidemiological and diagnostic “sentinel”, the purpose of this study was to assess the prevalence of OSAS. The clinical diaries of 4659 patients were reviewed through a single-center retrospective analytic study. Descriptive statistical analysis was performed. Only 0.26% of patients reported to suffer from sleep apnea and were then diagnosed with OSAS. It was found that, out of 4487 patients, 678 suffered from hypertension (14.80%), 188 from gastro-esophageal-reflux-disease (GERD = 4.10%) and 484 from gastritis (10.78%). These results could be related to a difficult diagnosis of OSAS and to the absence of a dedicated section on sleep disorders in medical records. Therefore, the introduction of a question dedicated to sleep disorders, the administration of questionnaires (such as the STOP-BANG questionnaire) for early diagnosis, a multidisciplinary approach and pneumological examination could support the dentist in identifying patients at risk of OSAS. Full article

(This article belongs to the Special Issue Obstructive Sleep Apnea: diagnosis, prevalence, treatment, clinical presentation, comorbidities, and responsible mechanisms)

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17 pages, 1506 KiB

Open AccessArticle

Hypertension in Children with Obstructive Sleep Apnea Syndrome—Age, Weight Status, and Disease Severity

by Hai-Hua Chuang, Jen-Fu Hsu, Chao-Yung Wang, Li-Pang Chuang, Min-Chi Chen, Ning-Hung Chen, Yu-Shu Huang, Hsueh-Yu Li and Li-Ang Lee

Int. J. Environ. Res. Public Health 2021, 18(18), 9602; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18189602 - 12 Sep 2021

Cited by 13 | Viewed by 2651

Abstract

Older age, obesity, and obstructive sleep apnea syndrome (OSAS) are known to increase the risk of hypertension in adults. However, data for children are scarce. This study aimed to investigate the relationships between hypertension, age, weight status, and disease severity in 396 children with OSAS. The prevalence rates of hypertension, obesity, and severe OSAS (apnea-hypopnea index ≥10) were 27.0%, 28.0%, and 42.9%, respectively. Weight z-score and apnea-hypopnea index were independently correlated with systolic blood pressure z-score, and minimal blood oxygen saturation (SpO₂) was independently associated with diastolic blood pressure z-score. Overall, late childhood/adolescence (odds ratio (OR) = 1.72, 95% CI = 1.05–2.81), obesity (OR, 2.58, 95% CI = 1.58–4.22), and severe OSAS (OR = 2.38, 95% CI = 1.48–3.81) were independent predictors of pediatric hypertension. Furthermore, late childhood/adolescence (OR = 2.50, 95% CI = 1.10–5.71) and abnormal SpO₂ (mean SpO₂ < 95%; OR = 4.91, 95% CI = 1.81–13.27) independently predicted hypertension in obese children, and severe OSAS (OR = 2.28, 95% CI = 1.27–4.10) independently predicted hypertension in non-obese children. In conclusion, obesity, OSAS severity, and abnormal SpO₂ are potentially modifiable targets to improve hypertension while treating children with OSAS. Full article

(This article belongs to the Special Issue Obstructive Sleep Apnea: diagnosis, prevalence, treatment, clinical presentation, comorbidities, and responsible mechanisms)

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Graphical abstract

12 pages, 788 KiB

Open AccessArticle

CPAP Treatment Improves Pure Tone Audiometry Threshold in Sensorineural Hearing Loss Patients with Sleep-Disordered Breathing

by Jessie Chao-Yun Chi, Shin-Da Lee, Ren-Jing Huang, Ching-Hsiang Lai, Stanley Yung Liu, Yih-Jeng Tsai, Po-Han Fu and Hua Ting

Int. J. Environ. Res. Public Health 2021, 18(13), 6768; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18136768 - 24 Jun 2021

Cited by 1 | Viewed by 2378

Abstract

This article investigates the effects of continuous positive airway pressure (CPAP) on hearing impairment in sensorineural hearing loss (SNHL) patients with sleep-disordered breathing (SDB). This retrospective and observational study took place from September 2016 to February 2021, accumulating 77 subjects with SNHL and SDB (60.7 ± 11.1 years). Of which, 28 received CPAP treatment (63.0 ± 8.5 years). In our methodology, hearing thresholds at low, medium, high, and average frequencies are assessed by pure-tone audiometry at baseline (BL), three (3 m), six (6 m), and 12 (12 m) months. Our results show that the BL of at least three frequencies in all subjects is positively associated with old age, males, smoking, alcohol, coronary artery disease, hypertension, and apnea-hypopnea index [AHI] (all p < 0.05). Moreover, low, medium, and average frequencies are negatively correlated at CPAP-6 m (−5.60 ± 2.33, −5.82 ± 2.56, and −5.10 ± 2.26 dB; all p < 0.05) and CPAP-12 m (−7.97 ± 2.74, −8.15 ± 2.35, and −6.67 ± 2.37 dB; all p < 0.01) against corresponding measures of CPAP-BL. High, medium, and average frequencies positively correlated with age (p < 0.001 for high and average frequencies and <0.01 for medium frequencies). We conclude that in SNHL patients with SDB, hearing thresholds at low and medium frequencies improves under CPAP use after six months, which persists at least to the end of one year. Full article

(This article belongs to the Special Issue Obstructive Sleep Apnea: diagnosis, prevalence, treatment, clinical presentation, comorbidities, and responsible mechanisms)

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Review

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13 pages, 692 KiB

Open AccessReview

Adolescent Congenital Central Hypoventilation Syndrome: An Easily Overlooked Diagnosis

by Marta Ditmer, Szymon Turkiewicz, Agata Gabryelska, Marcin Sochal and Piotr Białasiewicz

Int. J. Environ. Res. Public Health 2021, 18(24), 13402; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182413402 - 20 Dec 2021

Cited by 3 | Viewed by 3596

Abstract

Congenital central hypoventilation syndrome (CCHS), also known as Ondine’s curse, is a rare, potentially fatal genetic disease, manifesting as a lack of respiratory drive. Most diagnoses are made in pediatric patients, however late-onset cases have been rarely reported. Due to the milder symptoms at presentation that might easily go overlooked, these late-onset cases can result in serious health consequences later in life. Here, we present a case report of late-onset CCHS in an adolescent female patient. In this review we summarize the current knowledge about symptoms, as well as clinical management of CCHS, and describe in detail the molecular mechanism responsible for this disorder. Full article

(This article belongs to the Special Issue Obstructive Sleep Apnea: diagnosis, prevalence, treatment, clinical presentation, comorbidities, and responsible mechanisms)

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