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Liguori C, Fernandes M, Spanetta M, Zanovello M, Giambrone MP, Lupo C, Placidi F, Izzi F, Mercuri NB, Pierantozzi M. Brainstem impairment in obstructive sleep apnoea and the effect of CPAP treatment: an electrophysiological blink reflex study. Sleep Breath 2024; 28:691-696. [PMID: 37923871 DOI: 10.1007/s11325-023-02944-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 10/16/2023] [Accepted: 10/23/2023] [Indexed: 11/06/2023]
Abstract
PURPOSE This study aimed to evaluate the functionality of the brainstem structures through the blink reflex (BR) test in patients with obstructive sleep apnoea (OSA) and to assess the effects of continuous positive airway pressure (CPAP) treatment on BR responses. METHODS Patients with moderate-severe OSA and controls underwent BR testing. Patients with OSA who were adherent to CPAP therapy repeated BR testing at 6 months follow-up. CPAP adherence was defined as CPAP use for ≥ 4 hour per night on > 5 nights per week with residual apnoea-hypopnea index less than 5 events per hour. RESULTS A total of 22 patients with OSA (86% male, mean age 57.8 ± 10.6 years) and 20 controls (60% male, mean age 55.3 ± 9.3 years) were included. Patients with OSA showed longer right and left R1 latency, as well as delayed right ipsilateral and contralateral R2 latencies compared to controls. Patients with OSA who were compliant with CPAP treatment (n = 16; 88% men, mean age 58.8 ± 9.7 years) showed a significant decrease in latency of the right ipsilateral and contralateral R2 responses at 6 months. CONCLUSION This study showed an abnormal pattern of BR responses in patients with OSA, consistent with a significant impairment of brainstem functionality in OSA. CPAP treatment partially improved the BR responses, suggesting the importance of treating OSA.
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Affiliation(s)
- Claudio Liguori
- Sleep Medicine Centre, University Hospital of Rome 'Tor Vergata', Rome, Italy.
- Neurology Unit, University Hospital of Rome 'Tor Vergata', Rome, Italy.
- Department of Systems Medicine, University of Rome 'Tor Vergata', Rome, Italy.
| | - Mariana Fernandes
- Department of Systems Medicine, University of Rome 'Tor Vergata', Rome, Italy
| | - Matteo Spanetta
- Department of Systems Medicine, University of Rome 'Tor Vergata', Rome, Italy
| | - Martina Zanovello
- Sleep Medicine Centre, University Hospital of Rome 'Tor Vergata', Rome, Italy
| | - Maria Pia Giambrone
- Sleep Medicine Centre, University Hospital of Rome 'Tor Vergata', Rome, Italy
| | - Clementina Lupo
- Department of Systems Medicine, University of Rome 'Tor Vergata', Rome, Italy
| | - Fabio Placidi
- Sleep Medicine Centre, University Hospital of Rome 'Tor Vergata', Rome, Italy
- Neurology Unit, University Hospital of Rome 'Tor Vergata', Rome, Italy
- Department of Systems Medicine, University of Rome 'Tor Vergata', Rome, Italy
| | - Francesca Izzi
- Sleep Medicine Centre, University Hospital of Rome 'Tor Vergata', Rome, Italy
- Neurology Unit, University Hospital of Rome 'Tor Vergata', Rome, Italy
| | - Nicola Biagio Mercuri
- Sleep Medicine Centre, University Hospital of Rome 'Tor Vergata', Rome, Italy
- Neurology Unit, University Hospital of Rome 'Tor Vergata', Rome, Italy
- Department of Systems Medicine, University of Rome 'Tor Vergata', Rome, Italy
| | - Mariangela Pierantozzi
- Neurology Unit, University Hospital of Rome 'Tor Vergata', Rome, Italy
- Department of Systems Medicine, University of Rome 'Tor Vergata', Rome, Italy
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Carpi M, Cordella A, Placidi F, Izzi F, Piccirilli E, Mercuri NB, Tarantino U, Liguori C. Continuous positive airway pressure treatment improves bone mineral density in men affected by severe obstructive sleep apnea syndrome. J Clin Sleep Med 2024; 20:67-73. [PMID: 37677073 PMCID: PMC10758556 DOI: 10.5664/jcsm.10796] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 08/27/2023] [Accepted: 09/01/2023] [Indexed: 09/09/2023]
Abstract
STUDY OBJECTIVES Obstructive sleep apnea (OSA) and low bone mineral density (BMD) are 2 prevalent conditions with a significant negative impact on patients' well-being and quality of life. Recent research has shown low BMD at different bone sites in male patients with OSA. Although the efficacy of continuous positive airway pressure (CPAP) treatment for OSA has been widely demonstrated, the evidence for understanding its impact on BMD and other bone-related outcomes is insufficient. The aim of this observational study was to investigate the effect of 12 months of CPAP treatment on lumbar and femur BMD and bone-related serum biomarkers in male patients with severe OSA. METHODS Sixty patients (mean age: 55.1 ± 9.9 years) were consecutively included and underwent BMD measurement with dual-energy x-ray absorptiometry at baseline and after 12 months of CPAP treatment. Vitamin D, parathyroid hormone, and calcium serum levels were examined at the same time points. RESULTS A significant increase in BMD in the L1 (P < .001, d = 0.27) and L2 (P < .001, d = 0.26) vertebrae was observed after CPAP treatment, along with an increase in vitamin D (P < .001, d = 0.71) and calcium (P < .001, d = 0.73) levels and a decrease in parathyroid hormone levels (P < .001, d = 0.60). The increase in BMD in L1 was significantly correlated with the decrease in parathyroid hormone serum levels (r = -.50, P < .001). CONCLUSIONS Overall, these findings showed that beneficial OSA treatment might restore bone health and support CPAP treatment as a feasible strategy to improve BMD in male patients with severe OSA. Accordingly, diagnosing and targeting OSA may be warranted in the treatment of male patients with undetermined osteopenia and osteoporosis. CITATION Carpi M, Cordella A, Placidi F, et al. Continuous positive airway pressure treatment improves bone mineral density in men affected by severe obstructive sleep apnea syndrome. J Clin Sleep Med. 2024;20(1):67-73.
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Affiliation(s)
- Matteo Carpi
- Sleep Medicine Centre, Neurology Unit, University Hospital of Rome “Tor Vergata,” Rome, Italy
| | | | - Fabio Placidi
- Sleep Medicine Centre, Neurology Unit, University Hospital of Rome “Tor Vergata,” Rome, Italy
- Department of Systems Medicine, University of Rome “Tor Vergata,” Rome, Italy
| | - Francesca Izzi
- Sleep Medicine Centre, Neurology Unit, University Hospital of Rome “Tor Vergata,” Rome, Italy
| | - Eleonora Piccirilli
- Department of Orthopedics and Traumatology, University Hospital of Rome “Tor Vergata,” Rome, Italy
| | - Nicola Biagio Mercuri
- Sleep Medicine Centre, Neurology Unit, University Hospital of Rome “Tor Vergata,” Rome, Italy
- Department of Systems Medicine, University of Rome “Tor Vergata,” Rome, Italy
| | - Umberto Tarantino
- Department of Orthopedics and Traumatology, University Hospital of Rome “Tor Vergata,” Rome, Italy
| | - Claudio Liguori
- Sleep Medicine Centre, Neurology Unit, University Hospital of Rome “Tor Vergata,” Rome, Italy
- Department of Systems Medicine, University of Rome “Tor Vergata,” Rome, Italy
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Singh M, Deokar K, Sinha BP, Keena M, Desai G. Ocular manifestations of common pulmonary diseases: a narrative review. Monaldi Arch Chest Dis 2023; 94. [PMID: 36867059 DOI: 10.4081/monaldi.2023.2535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 02/22/2023] [Indexed: 03/04/2023] Open
Abstract
Several pulmonary disorders can cause ocular involvement. Understanding these manifestations is critical for early diagnosis and treatment. Hence, we set out to examine the most common ocular manifestations of asthma, chronic obstructive pulmonary disease (COPD), sarcoidosis, obstructive sleep apnea (OSA), and lung cancer. Allergic keratoconjunctivitis and dry eye are two ocular manifestations of bronchial asthma. The inhaled corticosteroids used to treat asthma can cause cataract formation. COPD is associated with ocular microvascular changes as a result of chronic hypoxia and systemic inflammation spillover into the eyes. Its clinical significance, however, is unknown. Ocular involvement is common in sarcoidosis, occurring in 20% of cases of pulmonary sarcoidosis. It can affect nearly any anatomical structure of the eye. Obstructive sleep apnea has been linked to floppy eye syndrome, glaucoma, non-arteritic anterior ischemic optic neuropathy, keratoconus, retinal vein occlusion, and central serous retinopathy, according to research. However, while an association has been established, causality has yet to be established. The effect of positive airway pressure (PAP) therapy used to treat OSA on the aforementioned ocular conditions is unknown. PAP therapy can cause eye irritation and dryness. Lung cancer can affect the eyes through direct nerve invasion, ocular metastasis, or as part of a paraneoplastic syndrome. The goal of this narrative review is to raise awareness about the link between ocular and pulmonary disorders in order to aid in the early detection and treatment of these conditions.
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Affiliation(s)
- Mamta Singh
- Department of Ophthalmology, All India Institute of Medical Sciences, Rajkot.
| | - Kunal Deokar
- Department of Pulmonary Medicine, All India Institute of Medical Sciences, Rajkot.
| | - Bibhuti Prassan Sinha
- Regional Institute of Ophthalmology, Indira Gandhi Institute of Medical Sciences, Patna.
| | - Monika Keena
- Department of Pulmonary Medicine, Railway hospital, Jodhpur.
| | - Govind Desai
- Department of Pulmonary Medicine, S.Nijalingappa Medical College and H.S.K Hospital, Bagalkot.
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Yang C, Wang C, Chen X, Xiao B, Fu N, Ren B, Liu Y. Event-Related Potential Assessment of Visual Perception Abnormality in Patients With Obstructive Sleep Apnea: A Preliminary Study. Front Hum Neurosci 2022; 16:895826. [PMID: 35845244 PMCID: PMC9280288 DOI: 10.3389/fnhum.2022.895826] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 06/02/2022] [Indexed: 11/13/2022] Open
Abstract
This study investigated the effect of obstructive sleep apnea (OSA) on the neural mechanism of visual perception. A preliminary case-control study was conducted. Seventeen patients with moderate to severe OSA in the sleep center of Civil Aviation General Hospital and 20 healthy controls matched for age, sex, and education were recruited. The participants accepted the perceptual contour integration task, compared the differences in behavioral indicators between the two groups, and compared the differences in electroencephalography (EEG) data between the two groups through event-related potential (ERP) technology. The groups did not differ significantly in age and gender, but they differed significantly in body mass index (BMI) (OSA higher than healthy controls, p < 0.05). The groups were not statistically different in terms of sleep structure and total sleep time. AHI, sleep efficiency, and minimal SaO2 value in the OSA group were significantly different from those of the control group. The results showed that the average reaction time of the OSA group was significantly longer than that of the healthy control group in the contour integration task. There was no significant difference in the accuracy rate. The results of EEG showed that the amplitudes of N100 of the OSA group were significantly higher than those of the control group at O1, Oz, and O2 electrodes. There was no significant difference in latency between the two groups. At the FCz electrode, the amplitudes of N200 of the OSA group were significantly higher than those of the control group. Therefore, we concluded that in the early stage of the perceptual integration task, although the neural response activity of patients with moderate and severe OSA was not accelerated, they need to call on more psychological resources, activate more neurons in the contour global recognition processing stage, and the compensatory effect of frontal lobe appeared in the stage of visual perception.
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Affiliation(s)
- Chao Yang
- College of Psychology and Mental Health, North China University of Science and Technology, Tangshan, China
- Department of Respiratory Medicine, Civil Aviation General Hospital, Beijing, China
| | - Changming Wang
- Department of Neurosurgery, National Center for Neurological Disorders, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Xuanyu Chen
- Personality Development and Social Adjustment Lab, Faculty of Psychology, Southwest University, Chongqing, China
| | - Bing Xiao
- Department of Respiratory Medicine, Civil Aviation General Hospital, Beijing, China
| | - Na Fu
- Department of Respiratory Medicine, Civil Aviation General Hospital, Beijing, China
| | - Bo Ren
- College of Psychology and Mental Health, North China University of Science and Technology, Tangshan, China
| | - Yi Liu
- Department of Respiratory Medicine, Civil Aviation General Hospital, Beijing, China
- *Correspondence: Yi Liu,
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Liu PK, Chiu TY, Wang NK, Levi SR, Tsai MJ. Ocular Complications of Obstructive Sleep Apnea. J Clin Med 2021; 10:jcm10153422. [PMID: 34362205 PMCID: PMC8348497 DOI: 10.3390/jcm10153422] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 07/20/2021] [Accepted: 07/28/2021] [Indexed: 12/13/2022] Open
Abstract
Obstructive sleep apnea (OSA), the most common form of sleep-disordered breathing, is characterized by repetitive episodes of paused breathing during sleep, which in turn induces transient nocturnal hypoxia and hypercapnia. The high prevalence of OSA and its associated health consequences place a heavy burden on the healthcare system. In particular, the consequent episodic oxygenic desaturation/reoxygenation series and arousals from sleep in patients with OSA have the potential to trigger oxidative stress, elevated systemic inflammatory responses, and autonomic dysfunction with sympathetic activation. Given these adverse side-effects, OSA is highly correlated to many eye diseases that are common in everyday ophthalmic practices. Some of these ocular consequences are reversible, but they may permanently threaten a patient’s vision if not treated appropriately. Here, this article seeks to review the ocular consequences and potential pathophysiologic associations in patients with OSA. Understanding these OSA-related eye diseases may help clinicians provide comprehensive care to their patients.
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Affiliation(s)
- Pei-Kang Liu
- Department of Ophthalmology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (P.-K.L.); (T.-Y.C.)
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung 804, Taiwan
- Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University, New York, NY 10032, USA; (N.-K.W.); (S.R.L.)
| | - Tzu-Yu Chiu
- Department of Ophthalmology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (P.-K.L.); (T.-Y.C.)
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Nan-Kai Wang
- Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University, New York, NY 10032, USA; (N.-K.W.); (S.R.L.)
| | - Sarah R. Levi
- Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University, New York, NY 10032, USA; (N.-K.W.); (S.R.L.)
| | - Ming-Ju Tsai
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Sleep Disorders Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Department of Respiratory Care, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Correspondence: ; Tel.: +886-7-3121101 (ext. 5601)
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Laganà G, Venza N, Malara A, Liguori C, Cozza P, Pisano C. Obstructive Sleep Apnea, Palatal Morphology, and Aortic Dilatation in Marfan Syndrome Growing Subjects: A Retrospective Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18063045. [PMID: 33809552 PMCID: PMC8002313 DOI: 10.3390/ijerph18063045] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 02/22/2021] [Accepted: 03/08/2021] [Indexed: 12/14/2022]
Abstract
The main cause of mortality in Marfan syndrome (MS) is aortic disease. Obstructive sleep apnea (OSA) is highly prevalent in MS, and it is also associated with cardiovascular risk and maxillary deformities. The aim of this research was to analyze the possible relations between OSA, palatal morphology, and aortic root diameters in growing subjects. A group of 15 growing subjects with MS and a control group of healthy peers was selected. All of them underwent nocturnal polygraphic monitoring, digital dental casts, and transthoracic echocardiography. The results showed that OSA indexes and aortic diameters were significantly higher in the study group. Transversal palatal dimension was smaller in MS patients. Moreover, OSA severity was not related with maxillary contraction severity in MS. No correlation between OSA severity and increased aortic diameters occurred. A high prevalence of OSA, increased aortic dimensions, and significant contraction of palatal dimensions were observed in MS compared with the control group. None of these single factors may directly be associated with aortic dilation, but together, they might contribute to the development and progression of aortic aneurysm from a young age.
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Affiliation(s)
- Giuseppina Laganà
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (G.L.); (A.M.); (P.C.)
| | - Nicolò Venza
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (G.L.); (A.M.); (P.C.)
- Correspondence: ; Tel.: +0039-3290247674
| | - Arianna Malara
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (G.L.); (A.M.); (P.C.)
| | - Claudio Liguori
- Sleep Medicine Centre, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy;
| | - Paola Cozza
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (G.L.); (A.M.); (P.C.)
| | - Calogera Pisano
- Centre for Rare Diseases for Marfan Syndrome and Related Disorders, Department of Cardiac Surgery Unit, University of Tor Vergata General Hospital, 00133 Rome, Italy;
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Batum M, Kısabay A, Mayalı H, Göktalay T, Kurt E, Selçuki D, Yılmaz H. Evaluation of effects of positive airway pressure treatment on retinal fiber thickness and visual pathways using optic coherence tomography and visual evoked potentials in the patients with severe obstructive sleep apnea syndrome. Int Ophthalmol 2020; 40:2475-2485. [PMID: 32506292 DOI: 10.1007/s10792-020-01426-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Accepted: 05/13/2020] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Hypoxia during sleep in obstructive sleep apnea syndrome (OSAS) increases intracranial pressure, decreases cerebral perfusion pressure, and alters vascular supply to the optic nerve. Pattern visual evoked potential (pVEP) has revealed that it causes alterations in the optic nerve, and optic coherence tomography has shown that it causes alterations in the retinal and macular layers. OBJECTIVES To detect and compare possible alterations in macula and peripapillary retinal nerve fiber thickness (pRNFL) using OCT and in the optic nerve pathways using pVEP before and after positive airway pressure (PAP) in the patients with severe OSAS. MATERIALS AND METHODS Thirty patients who were diagnosed as having severe OSAS in the neurology-sleep outpatient clinic and 30 healthy control subjects were included in the study. Ophthalmic examinations were performed prior to (month 0) and after (month 6) PAP treatment, and pVEP (peak time [PT] and amplitude) and OCT parameters (peripapillary retinal-macular layers) were compared. RESULTS In the comparison between the severe OSAS (before treatment) and control groups, thinning was found in pRNFL (average, nasal, inferior) and in the macular layers (external and internal superior quadrants) (p < 0.05). pVEP investigation revealed increased PT in P100 and N145 waves and decreased amplitude of N75-P100 waves. In the comparisons before and after PAP treatment, a decrease in PT of N75 and P100 waves and increase in N75-P100 amplitudes were found. In the pRNFL, significant thickening was found in the layers with thinning before treatment, whereas no significant thickening was found in macular layers, except for the fovea. DISCUSSION It was shown that PAP treatment in patients with severe OSAS prevents hypoxia without causing alterations in intraocular pressure and thus reduces inflammation and causes thickening in the pRNFL and macular layers.
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Affiliation(s)
- Melike Batum
- Department of Neurology, Celal Bayar University, 45000, Manisa, Turkey.
| | - Ayşın Kısabay
- Department of Neurology, Celal Bayar University, 45000, Manisa, Turkey
| | - Hüseyin Mayalı
- Department of Ophthalmology, Celal Bayar University, 45000, Manisa, Turkey
| | - Tuğba Göktalay
- Department of Chest Diseases, Celal Bayar University, 45000, Manisa, Turkey
| | - Emin Kurt
- Department of Ophthalmology, Celal Bayar University, 45000, Manisa, Turkey
| | - Deniz Selçuki
- Department of Neurology, Celal Bayar University, 45000, Manisa, Turkey
| | - Hikmet Yılmaz
- Department of Neurology, Celal Bayar University, 45000, Manisa, Turkey
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Kısabay Ak A, Batum M, Göktalay T, Mayali H, Kurt E, Selçuki D, Yılmaz H. Evaluation of retinal fiber thickness and visual pathways with optic coherence tomography and pattern visual evoked potential in different clinical stages of obstructive sleep apnea syndrome. Doc Ophthalmol 2020; 141:33-43. [PMID: 31981012 DOI: 10.1007/s10633-020-09749-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 01/09/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE To investigate the possible changes in retinal nerve fiber layer (RNFL) by optic coherence tomography and in the amplitudes and peak times (PTs) in pattern visual evoked potential (pVEP) and to compare them in obstructive sleep apnea syndrome (OSAS). METHODS This prospective study included patients with mild OSAS (n = 30), severe OSAS (n = 30), and 30 control subjects. All patients were assessed after obtaining the approval from our hospital's ethics committee. RESULTS There was no difference in age and gender between the groups (p = 0.184, p = 0.954). By analysis of variance, there was a significant difference in RNFL values among patients with mild OSAS, severe OSAS, and control for three measures of RNFL (average p = 0.044, nasal p = 0.003, inferior p = 0.027). In severe OSAS group, nasal and inferior quadrants of the RNFL were found to be thinner than the control group (p = 0.008, p = 0.031). We showed that the PT of P100 and N145 was prolonged in severe OSAS compared to the control group (p < 0.001) and that PT of P100 was prolonged in mild OSAS compared to the control group (p < 0.05). The amplitude of N75-P100 was significantly decreased in patients with both severe OSAS and mild OSAS compared to the control group (p < 0.001). Correlation of RNFL and pVEP values showed that the inferior quadrant RNFL thickness is correlated with both P100 and N145 PTs (r = 0.271*, p = 0.036 and r = 0.290*, p = 0.043, respectively) and N75-P100 amplitude (r = 0.378**, p = 0.003) in severe OSAS group. CONCLUSIONS In mild and severe stages of the disease, edema and inflammation were evident and VEP PT and amplitudes were affected in both groups. Furthermore, thinning in RNFL in the severe stage of the disease might be associated with higher atrophy levels and prolonged exposure to hypoxia.
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Affiliation(s)
- Ayşın Kısabay Ak
- Department of Neurology, Celal Bayar University Medical School Hafsa Sultan Hospital, Manisa, Turkey
| | - Melike Batum
- Department of Neurology, Celal Bayar University Medical School Hafsa Sultan Hospital, Manisa, Turkey.
| | - Tuğba Göktalay
- Department of Pulmonary Diseases, Celal Bayar University Medical School Hafsa Sultan Hospital, Manisa, Turkey
| | - Hüseyin Mayali
- Department of Eye Diseases, Celal Bayar University Medical School Hafsa Sultan Hospital, Manisa, Turkey
| | - Emin Kurt
- Department of Eye Diseases, Celal Bayar University Medical School Hafsa Sultan Hospital, Manisa, Turkey
| | - Deniz Selçuki
- Department of Neurology, Celal Bayar University Medical School Hafsa Sultan Hospital, Manisa, Turkey
| | - Hikmet Yılmaz
- Department of Neurology, Celal Bayar University Medical School Hafsa Sultan Hospital, Manisa, Turkey
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Mahjoob M, Heravian Shandiz J, Mirzajani A, Ehsaei A, Jafarzadehpur E. Normative values of visual evoked potentials in Northeastern of Iran. JOURNAL OF OPTOMETRY 2019; 12:192-197. [PMID: 31028015 PMCID: PMC6612035 DOI: 10.1016/j.optom.2018.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 10/16/2018] [Accepted: 12/01/2018] [Indexed: 06/09/2023]
Abstract
PURPOSE Visual evoked potentials (VEPs) provide important diagnostic information related to the functional integrity of the visual pathways. The aim of this study was to establish normative values of different components of pattern reversal VEPs on Iranian normal adult subjects. METHODS Monocular and binocular pattern reversal VEPs were recorded on 59 healthy participants (22.55±3.79 years old) using the Roland RETI system for two check sizes of 15 and 60min of arc. The measured VEP components were the latencies of N75, P100, N135 and amplitude of N75-P100. RESULTS Repeated measures ANOVA showed that viewing eye condition has a significant impact on the amplitude of N75-P100 (P<0.001, F=13.89). Also, the effect of check size on the latencies of N75, P100, N135, amplitude of N75-P100 (P≤0.010), as well as the intraocular difference of P100 latency and amplitude N75-P100 (P=0.007) was significant. More specifically, the amplitude of N75-P100 in both check sizes significantly differed between gender groups (P<0.023). CONCLUSION According to the results of this study, VEPs components are affected by the stimulus size, monocular and binocular recording conditions and gender. Therefore, it is necessary to determine the normative values of VEPs in each population, so that the results could be used in clinical studies.
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Affiliation(s)
- Monireh Mahjoob
- Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Javad Heravian Shandiz
- Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran; Refractive Errors Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Ali Mirzajani
- Department of Optometry, Iran University of Medical Sciences, Tehran, Iran
| | - Asieh Ehsaei
- Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran; Refractive Errors Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Kim DJ, Choi BG, Cho JW, Mun SJ, Lee MW, Kim HW. Comparison for the Optimal Pressure between Manual CPAP and APAP Titration with Obstructive Sleep Apnea Patients. KOREAN JOURNAL OF CLINICAL LABORATORY SCIENCE 2019. [DOI: 10.15324/kjcls.2019.51.2.191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Dae Jin Kim
- Department of Neurology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Byoung Geol Choi
- Research Institute of Health Sciences, Graduate School, Korea University, Seoul, Korea
| | - Jae Wook Cho
- Department of Neurology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Sue Jean Mun
- Department of Otorhinolaryngology-Head & Neck Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Min Woo Lee
- Research Institute of Health Sciences, Graduate School, Korea University, Seoul, Korea
| | - Hyun-Woo Kim
- Department of Neurology, Pusan National University Yangsan Hospital, Yangsan, Korea
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Bonsignore MR, Baiamonte P, Mazzuca E, Castrogiovanni A, Marrone O. Obstructive sleep apnea and comorbidities: a dangerous liaison. Multidiscip Respir Med 2019; 14:8. [PMID: 30809382 PMCID: PMC6374907 DOI: 10.1186/s40248-019-0172-9] [Citation(s) in RCA: 118] [Impact Index Per Article: 23.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 01/20/2019] [Indexed: 12/16/2022] Open
Abstract
Obstructive sleep apnea (OSA) is a highly prevalent disease, and is traditionally associated with increased cardiovascular risk. The role of comorbidities in OSA patients has emerged recently, and new conditions significantly associated with OSA are increasingly reported. A high comorbidity burden worsens prognosis, but some data suggest that CPAP might be protective especially in patients with comorbidities. Aim of this narrative review is to provide an update on recent studies, with special attention to cardiovascular and cerebrovascular comorbidities, the metabolic syndrome and type 2 diabetes, asthma, COPD and cancer. Better phenotypic characterization of OSA patients, including comorbidities, will help to provide better individualized care. The unsatisfactory adherence to CPAP in patients without daytime sleepiness should prompt clinicians to examine the overall risk profile of each patient in order to identify subjects at high risk for worse prognosis and provide the optimal treatment not only for OSA, but also for comorbidities.
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Affiliation(s)
- Maria R. Bonsignore
- Division of Respiratory Medicine, Biomedical Department of Internal Medicine and Medical Specialties (Di.Bi.M.I.S), University Hospital Paolo Giaccone, University of Palermo, Piazza delle Cliniche, 2, 90100 Palermo, Italy
- National Research Council (CNR), Institute of Biomedicine and Molecular Immunology (IBIM), Palermo, Italy
| | - Pierpaolo Baiamonte
- Division of Respiratory Medicine, Biomedical Department of Internal Medicine and Medical Specialties (Di.Bi.M.I.S), University Hospital Paolo Giaccone, University of Palermo, Piazza delle Cliniche, 2, 90100 Palermo, Italy
| | - Emilia Mazzuca
- Division of Respiratory Medicine, Biomedical Department of Internal Medicine and Medical Specialties (Di.Bi.M.I.S), University Hospital Paolo Giaccone, University of Palermo, Piazza delle Cliniche, 2, 90100 Palermo, Italy
| | - Alessandra Castrogiovanni
- Clinic for Pneumology und Allergology, Center of Sleep Medicine and Respiratory Care, Bethanien Hospital, Solingen, Germany
| | - Oreste Marrone
- National Research Council (CNR), Institute of Biomedicine and Molecular Immunology (IBIM), Palermo, Italy
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12
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Postural and vestibular changes related to CPAP treatment in moderate-to-severe OSA patients: a 12-month longitudinal study. Sleep Breath 2018; 23:665-672. [PMID: 30456739 DOI: 10.1007/s11325-018-1754-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 10/18/2018] [Accepted: 11/13/2018] [Indexed: 11/27/2022]
Abstract
PURPOSE To assess whether vestibulo-ocular reflex (VOR) gain, posturography parameters and related clinical outcomes can improve in OSA patients after 12 months of CPAP treatment, taking into consideration that a certain degree of vestibular dysfunction has been identified in these subjects. METHODS Vestibular, postural, clinical, and polygraphic parameters were assessed in 32 OSA patients before and after beneficial CPAP treatment by means of video head impulse test (vHIT), static posturography (SP), Dizziness Handicap Inventory (DHI), Epworth Sleepiness Scale (ESS), and Apnea-Hypopnea Index (AHI), respectively, and were compared by means of a "within-subject" ANOVA model and Spearman's rank correlation. RESULTS After the 12-month period of treatment, OSA patients demonstrated a significant reduction in AHI values, in both opened and closed eyes conditions of surface and length as well as in power spectra recorded in low, middle, and high frequency interval. Although a significant improvement was also recorded among DHI and ESS scores, VOR gain increase did not survive to post-hoc corrections. Finally, positive correlations between the differences between pre- and post-treatment AHI, ESS, and PS values were found. CONCLUSIONS The present work highlighted that postural instability and dizziness-related conditions due to OSA may improve after 12 months of CPAP treatment. Although VOR gain did not demonstrate significant improvement, this study might open future perspectives directed to assessing VOR gain changes after longer periods of CPAP treatment.
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