Chronic intermittent hypoxia impaired collagen synthesis in mouse genioglossus via ROS accumulation: A transcriptomic analysis

The impact of obstructive sleep apnea on early surgical site infections in elderly PLIF patients: a retrospective propensity score-matched analysis

BACKGROUND

Obstructive sleep apnea (OSA) is a prevalent sleep disorder associated with intermittent hypoxia, oxidative stress, and systemic inflammation, posing risks for adverse postoperative outcomes, including surgical site infections (SSIs). Elderly patients undergoing posterior lumbar interbody fusion (PLIF) are particularly susceptible to SSIs due to advanced age, comorbidities, and prolonged surgical times. However, the role of OSA in increasing SSI risk among this population remains unclear.

METHODS

This retrospective cohort study analyzed 478 elderly PLIF patients from a single institution between May 2016 and June 2024. Of these, 113 were diagnosed with OSA. Propensity score matching (PSM) was performed to balance baseline characteristics, resulting in 83 matched pairs. SSI rates, hospital stays, and readmission rates were compared between the OSA and non-OSA groups. Subgroup analysis was conducted to evaluate the effects of continuous positive airway pressure (CPAP) or automatic positive airway pressure (APAP) therapy on postoperative outcomes.

RESULTS

After PSM, OSA patients demonstrated a significantly higher SSI incidence (13.3% vs. 3.6%, p = 0.04) compared to non-OSA patients. On multivariate analysis, OSA was the only factor that remained significantly associated with an increased risk of SSIs (Odds Ratio = 4.509, 95% CI: 1.283-21.504, p = 0.03). OSA patients also experienced longer hospital stays (10.1 ± 2.9 vs. 9.1 ± 2.0 days, p = 0.01) and elevated 30-day readmission rates (9.6% vs. 1.2%, p = 0.02). Subgroup analysis revealed that CPAP/APAP therapy reduced SSI incidence (3.9% vs. 17.5%, p = 0.08) and shortened hospital stays (9.1 ± 1.5 vs. 10.5 ± 3.2 days, p = 0.03) among OSA patients.

CONCLUSION

OSA significantly increases the risk of early SSIs and prolongs hospital stays in elderly PLIF patients. Subgroup analysis suggests that CPAP/APAP therapy may have benefits to OSA patients, though this association requires validation through prospective studies. These findings emphasize the importance of preoperative OSA screening and management to improve surgical outcomes in this high-risk population.

Effects of Mandibular Advancement Device on Genioglossus of Rabbits in Obstructive Sleep Apnea Through PINK1/Parkin Pathway

BACKGROUND

Early treatment of mandibular advancement device (MAD) reverses the abnormal changes resulting from obstructive sleep apnoea (OSA), but the underlying mechanism is not clear. We analysed the changes of genioglossus function before and after MAD treatment in OSA rabbits and explored the mechanism of mitochondrial autophagy.

METHODS

Eighteen male New Zealand rabbits were randomised into three groups: the control group, Group OSA, and Group MAD. After successful modelling, all animals were induced sleep in supine positions for 4-6 h per day for 8 weeks. Cone beam computed tomography (CBCT) and polysomnography (PSG) were performed to record sleep conditions. The genioglossus contractile force and the levels of LC3-I, LC3-II, Beclin-1, PINK1 and Parkin were detected in three groups. In vitro, C2C12 myoblast cells were cultured under normoxic or hypoxic conditions for 24 h, and then the changes in mitochondrial structure and accumulation of autolysosomes were detected by transmission electron microscopy (TEM).

RESULTS

The contractile tension of the genioglossus in Group OSA was significantly lower than that in the control group. The ratio of LC3II/LC3I and the levels of Beclin-1, PINK1 and Parkin were higher in Group OSA than that in the control group. And the abnormal changes were tended to be normal after MAD treatment. The mitochondrial structure was disrupted, and the number of autolysosomes increased in C2C12 after 24 h of hypoxia.

CONCLUSIONS

MAD treatment in male rabbits may decrease the contractile tension of the genioglossus and increase the level of mitochondrial autophagy caused by OSA. And the mechanism of mitochondrial autophagy was mediated by the PINK1/Parkin pathway in male rabbits.

Genome-wide association analysis of composite sleep health scores in 413,904 individuals

Recent genome-wide association studies (GWASs) of several individual sleep traits have identified hundreds of genetic loci, suggesting diverse mechanisms. Moreover, sleep traits are moderately correlated, so together may provide a more complete picture of sleep health, while illuminating distinct domains. Here we construct novel sleep health scores (SHSs) incorporating five core self-report measures: sleep duration, insomnia symptoms, chronotype, snoring, and daytime sleepiness, using additive (SHS-ADD) and five principal components-based (SHS-PCs) approaches. GWASs of these six SHSs identify 28 significant novel loci adjusting for multiple testing on six traits (p < 8.3e-9), along with 341 previously reported loci (p < 5e-08). The heritability of the first three SHS-PCs equals or exceeds that of SHS-ADD (SNP-h2 = 0.094), while revealing sleep-domain-specific genetic discoveries. Significant loci enrich in multiple brain tissues and in metabolic and neuronal pathways. Post-GWAS analyses uncover novel genetic mechanisms underlying sleep health and reveal connections (including potential causal links) to behavioral, psychological, and cardiometabolic traits.

Dental pulp stem cells promote genioglossus repair and systemic amelioration in chronic intermittent hypoxia

Obstructive sleep apnea (OSA) leads to chronic intermittent hypoxia (CIH) and is not well addressed by current therapies. The genioglossus (GG) is the largest upper airway dilator controlling OSA pathology, making its repair a potential treatment. This study investigates dental pulp stem cells (DPSCs) in repairing GG injury in a CIH mouse model. We induced DPSCs to myogenic lineage cells (iDPSCs) and transplanted them into GG of CIH mice. DPSCs/iDPSCs grafts improved EMGGG and muscle type transitions while reducing tumor necrosis factor α (TNF-α), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), and creatine kinase (CK) levels, improving body weight. Moreover, iDPSCs increased Pax7+/Ki67+ and human-derived STEM121 cells in the GG compared with DPSCs. DPSCs/iDPSCs enhanced Desmin+ myotube formation in myoblasts under hypoxia in vitro, with iDPSCs increased human-derived myogenic markers and nuclei in myotubes. These results indicate that iDPSCs, beyond their paracrine effects like DPSCs, directly participate in myogenic differentiation, supporting the potential use of DPSCs for OSA treatment.

Obstructive sleep apnea affects cognition: dual effects of intermittent hypoxia on neurons

Obstructive sleep apnea (OSA) is a common respiratory disorder. Multiple organs, especially the central nervous system (CNS), are damaged, and dysfunctional when intermittent hypoxia (IH) occurs during sleep for a long time. The quality of life of individuals with OSA is significantly impacted by cognitive decline, which also escalates the financial strain on their families. Consequently, the development of novel therapies becomes imperative. IH induces oxidative stress, endoplasmic reticulum stress, iron deposition, and neuroinflammation in neurons. Synaptic dysfunction, reactive gliosis, apoptosis, neuroinflammation, and inhibition of neurogenesis can lead to learning and long-term memory impairment. In addition to nerve injury, the role of IH in neuroprotection was also explored. While causing neuron damage, IH activates the neuronal self-repairing mechanism by regulating antioxidant capacity and preventing toxic protein deposition. By stimulating the proliferation and differentiation of neural stem cells (NSCs), IH has the potential to enhance the ratio of neonatal neurons and counteract the decline in neuron numbers. This review emphasizes the perspectives and opportunities for the neuroprotective effects of IH and informs novel insights and therapeutic strategies in OSA.