0000000000022328
AUTHOR
Paschalis Steiropoulos
showing 25 related works from this author
Mild obstructive sleep apnea increases hypertension risk, challenging traditional severity classification
2020
STUDY OBJECTIVES: The association of mild obstructive sleep apnea (OSA) with important clinical outcomes remains unclear. We aimed to investigate the association between mild OSA and systemic arterial hypertension (SAH) in the European Sleep Apnea Database cohort. METHODS: In a multicenter sample of 4,732 participants, we analyzed the risk of mild OSA (subclassified into 2 groups: mild(AHI 5-<11/h) (apnea-hypopnea index [AHI], 5 to <11 events/h) and mild(AHI 11-<15/h) (AHI, ≥11 to <15 events/h) compared with nonapneic snorers for prevalent SAH after adjustment for relevant confounding factors including sex, age, smoking, obesity, daytime sleepiness, dyslipidemia, chronic obstructive pulmona…
Is kidney a new organ target in patients with obstructive sleep apnea? Research priorities in a rapidly evolving field.
2021
Abstract The bidirectional relationship between sleep disordered breathing and chronic kidney disease (CKD) has recently gained a lot of interest. Several lines of evidence suggest the high prevalence of coexistent obstructive sleep apnea (OSA) in patients with CKD and end-stage renal disease (ESRD). In addition, OSA seems to result in loss of kidney function in some patients, especially in those with cardio-metabolic comorbidities. Treatment of CKD/ESRD and OSA can alter the natural history of each other; still better phenotyping with selection of appropriate treatment approaches is urgently needed. The aim of this narrative review is to provide an update of recent studies on epidemiologic…
Age–sex differences in the global burden of lower respiratory infections and risk factors, 1990–2019: results from the Global Burden of Disease Study…
2022
Funding: Bill & Melinda Gates Foundation. Background: The global burden of lower respiratory infections (LRIs) and corresponding risk factors in children older than 5 years and adults has not been studied as comprehensively as it has been in children younger than 5 years. We assessed the burden and trends of LRIs and risk factors across all age groups by sex, for 204 countries and territories. Methods: In this analysis of data for the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we used clinician-diagnosed pneumonia or bronchiolitis as our case definition for LRIs. We included International Classification of Diseases 9th edition codes 079.6, 466–469, 470.0, 480–4…
Metabolic syndrome
2015
OSA is a common disorder with major cardiovascular and metabolic consequences. OSA is often associated with metabolic syndrome, a cluster of cardiometabolic risk factors, and prevalence of metabolic syndrome is particularly high in OSA patients. The role of obesity as a risk factor for OSA has been shown in population and clinical studies, and increased adipose tissue volume and neck circumference are closely linked with OSA, even though major sex-related differences exist. Besides OSA treatment, cardiometabolic risk factors should be assessed and possibly corrected in all OSA patients in order to reduce adverse events. Occurrence of metabolic syndrome should be investigated, and modifiable…
Positive Airway Pressure Treatment Reduces Glycated Hemoglobin (HbA1c) Levels in Obstructive Sleep Apnea Patients: Longitudinal Data from the Esada
2019
European-Respiratory-Society (ERS) International Congress -- SEP 28-OCT 02, 2019 -- Madrid, SPAIN
Burden of Comorbidities in Patients with OSAS and COPD-OSAS Overlap Syndrome
2021
Background and Objectives: Obstructive sleep apnea syndrome (OSAS) and chronic obstructive pulmonary disease (COPD) are usually associated with multi-morbidity. The aim of this study was to retrospectively investigate the prevalence of comorbidities in a cohort of patients with OSAS and COPD-OSAS overlap syndrome (OS) patients and to explore differences between these two groups. Materials and Methods: Included were consecutive OS patients and OSAS patients who had been referred to our sleep laboratory, and were matched in terms of sex, age, BMI, and smoking history. Presence of comorbidities was recorded based on their medical history and after clinical and laboratory examination. Results: …
Vitamin D deficiency in patients evaluated for obstructive sleep apnea: is it associated with disease severity?
2019
Purpose: The aim of the present study was to assess vitamin D levels in a large cohort of OSA patients and to investigate possible correlations with clinical and polysomnographic parameters. Methods: In this cross-sectional study, 685 consecutive patients underwent type 1 polysomnography (PSG) for OSA diagnosis. They were grouped according to apnea–hypopnea index (AHI) as mild, moderate, and severe. Patients with AHI < 5 served as controls. Demographic, PSG data, and serum levels of vitamin D were measured and compared between groups. Results: OSA was diagnosed in 617 of the patients (90%). Of those, 94 (15%) had mild OSA, 150 (24%) moderate OSA, and 373 (61%) severe OSA. The risk of vit…
Long-term positive airway pressure therapy is associated with reduced total cholesterol levels in patients with obstructive sleep apnea : data from t…
2020
Background and aim: Obstructive sleep apnea (OSA) is an independent risk factor for dyslipidemia. The current study examined the effects of positive airway pressure (PAP) treatment on lipid status in the European Sleep Apnea Database (ESADA). Methods: The prospective cohort study enrolled 1564 OSA subjects (74% male, mean age 54 ± 11y, body mass index (BMI) 32.7 ± 6.6 kg/m2 and apnea-hypopnea index (AHI) 40.3 ± 24.4 n/h) undergoing PAP therapy for at least three months (mean 377.6 ± 419.5 days). Baseline and follow-up total cholesterol (TC) from nine centers were analyzed. Repeated measures and logistic regression tests (adjusted for age, sex, weight changes, lipid lowering medication, PAP …
Chronic kidney disease in patients with obstructive sleep apnea. A narrative review.
2018
Prevalence of both chronic kidney disease (CKD) and obstructive sleep apnea (OSA) is continuously increasing. Moreover, the prevalence of OSA increases as kidney function declines and is higher among patients with end-stage renal disease (ESRD). In addition, OSA is recognized as a potential nontraditional risk factor for development and progression of CKD. Continuous positive airway pressure (CPAP) plays a pivotal role in the management of OSA, eliminating patients' symptoms and improving their quality of life. Recent studies suggested that CPAP treatment may have beneficial effects on kidney function among patients with OSA. This narrative review summarizes the existing knowledge on the as…
Mild obstructive sleep apnoea (OSA) and arterial hypertension in the EuropeanSleep Apnoea Database (ESADA) cohort study.
2018
Background: Mild obstructive sleep apnoea (OSA) is highly prevalent, however its association with important clinical outcomes like arterial hypertension remains unknown. Aims and Objectives: To investigate the association between mild OSA and arterial hypertension in the European Sleep Apnoea Database (ESADA) cohort after adjusting for relevant confounding factors. Methods: A multicentric sample of 4974 adults from the ESADA cohort who showed simple snoring or mild OSA at cardiorespiratory polygraphy was studied. We compared the predictive value of mild OSA (AHI 5- Results: Arterial hypertension prevalence was 37% in mild OSA patients (n=2457) compared to 20% in non-apnoeic snorers (n=2517,…
Prevalence of physician-diagnosed asthma in patients with suspected obstructive sleep apnea syndrome: A cross-sectional analysis of the ESADA database
2015
It has been reported that bronchial asthma is often associated with obstructive sleep apnea (OSA) and daytime sleepiness. We analyzed the prevalence of physician-diagnosed asthma in 4929 subjects with suspected obstructive sleep apnea (OSA) in the European Sleep Apnea database (ESADA) Cohort. Patients were studied by respiratory polygraphy (PG: n=1624, 66.6% males) or full polysomnography (PSG: n=3305, 70.4% males), and the clinical characteristics of asthmatic (A) and non-asthmatic (non-A) patients were analyzed according to OSA severity. Significance was at p 2 , p=0.0004) and showed more severe daytime sleepiness (Epworth score: 10.4±5.6 vs 9.5±5.3, p=0.0015) and a trend for worse noctur…
Metabolic Syndrome and Vitamin D Levels in Patients with Obstructive Sleep Apnea Syndrome
2018
Numerous studies have indicated that obstructive sleep apnea syndrome (OSAS), may contribute to the development of metabolic syndrome (MetS) and diabetes. Moreover, OSAS has been associated with lowered vitamin D (Vit D) levels, but reports are inconclusive. Aim of the study was to compare Vit D levels according to the presence of MetS and its components in OSAS patients.The presence of MetS was evaluated and serum 25-hydroxy vitamin D [25(OH)D] levels were measured in consecutive newly diagnosed, by polysomnography, subjects with OSAS.A total of 107 subjects (88 men) with OSAS were included in the study. Patients were divided into group A (OSAS with MetS group: 55 subjects) and group B (OS…
Obstructive sleep apnoea in adult patients post-tonsillectomy
2021
Background: The impact of removing the upper airway lymphoid tissue and in particular, tonsillectomy, in adults with OSA has not been demonstrated in large populations. Aims: To compare the severity of OSA and the prevalence of cardiovascular, metabolic and respiratory co-morbidities between patients with OSA who had undergone previous tonsillectomy and those who had not. Methods: The 19,711 participants in this study came from the European sleep apnea database (ESADA) which comprises data from unselected adult patients aged 18–80 years with a history of symptoms suggestive of OSA referred to sleep centers throughout Europe. Results: There were no differences between the two groups in terms…
Fixed But Not Autoadjusting Positive Airway Pressure Attenuates the Time-dependent Decline in Glomerular Filtration Rate in Patients With OSA
2018
Abstract: BACKGROUND: The impact of treating OSA on renal function decline is controversial. Previous studies usually included small samples and did not consider specific effects of different CPAP modalities. The aim of this study was to evaluate the respective influence of fixed and autoadjusting CPAP modes on estimated glomerular filtration rate (eGFR) in a large sample of patients derived from the prospective European Sleep Apnea Database cohort. METHODS: In patients of the European Sleep Apnea Database, eGFR prior to and after follow-up was calculated by using the Chronic Kidney Disease-Epidemiology Collaboration equation. Three study groups were investigated: untreated patients (n = 14…
Metabolic Syndrome in Patients with Coexistent Obstructive Sleep Apnea Syndrome and Chronic Obstructive Pulmonary Disease (Overlap Syndrome).
2020
Background: Evidence suggests that metabolic syndrome (MetS) is highly prevalent in patients with obstructive sleep apnea syndrome (OSAS) and chronic obstructive pulmonary disease (COPD). However, ...
Obstructive sleep apnoea and metabolic syndrome in Mediterranean countries.
2011
To the Editors: Obstructive sleep apnoea (OSA) is often associated with metabolic disturbances, including altered glucose metabolism and dyslipidaemia, which probably contribute to the increased cardiovascular risk in these patients 1. The concept of the metabolic syndrome (MetS) as a cluster of cardiometabolic risk factors has gained popularity in recent years, and a much higher prevalence of the MetS has been found in OSA patients compared with the general population in several studies 1. While the MetS largely reflects the effects of visceral obesity, environmental factors, i.e. the type of diet, could also play some role. The Mediterranean diet, rich in olive oil and fish, is protective…
The burden of injury in Central, Eastern, and Western European sub-region: a systematic analysis from the Global Burden of Disease 2019 Study
2022
Abstract Background Injury remains a major concern to public health in the European region. Previous iterations of the Global Burden of Disease (GBD) study showed wide variation in injury death and disability adjusted life year (DALY) rates across Europe, indicating injury inequality gaps between sub-regions and countries. The objectives of this study were to: 1) compare GBD 2019 estimates on injury mortality and DALYs across European sub-regions and countries by cause-of-injury category and sex; 2) examine changes in injury DALY rates over a 20 year-period by cause-of-injury category, sub-region and country; and 3) assess inequalities in injury mortality and DALY rates across the countries…
OSA and cancer in Europe: the European Sleep Apnea Database (ESADA) experience
2017
Background: Experimental and clinical studies suggest a relationship between Obstructive Sleep Apnea (OSA) and cancer development or progression Objectives: To explore the association between the severity of OSA and prevalence of cancer among patients reported to the European Sleep Apnea Database (ESADA) after control of several known risk factors for cancer development Methods: A prospective multicentre cohort study of adult patients with OSA (Apnea/Hypopnea Index, AHI≥5). OSA severity was classified according to AHI, Oxygen Desaturation Index (ODI) and % night-time spent with oxygen saturation Results: Of 19,556 participants, 357 (1.8%, 59.4% male) had been diagnosed with malignancy. Pati…
Mild OSA and arterial hypertension in the European Sleep Apnoea Database cohort study
2019
Background: Mild obstructive sleep apnoea (OSA) is highly prevalent; however its association with important clinical outcomes like arterial hypertension remains unknown. Aims: To investigate the association between mild OSA and hypertension in the European Sleep Apnoea Database (ESADA) cohort after adjusting for relevant confounding factors. Methods: A multicentric sample of 7995 adults from the ESADA cohort with simple snoring or mild OSA at PG or PSG was studied. We compared the predictive value of mild OSA (AHI 5- Results: Arterial hypertension prevalence was 37% in mild OSA (n=1566) compared to 22% in non-apnoeic snorers (n=793, p Conclusion: Our results suppport the hypothesis that mi…
Beliefs and preferences regarding biological treatments for severe asthma
2020
Background: Severe asthma is a serious condition with a significant burden on patients' morbidity, mortality, and quality of life. Some biological therapies targeting the IgE and interleukin-5 (IL5) mediated pathways are now available. Due to the lack of direct comparison studies, the choice of which medication to use varies. We aimed to explore the beliefs and practices in the use of biological therapies in severe asthma, hypothesizing that differences will occur depending on the prescribers’ specialty and experience. Methods: We conducted an online survey composed of 35 questions in English. The survey was circulated via the INterasma Scientific Network (INESNET) platform as well as throu…
Clinical presentation of patients with suspected obstructive sleep apnea and self-reported physician-diagnosed asthma in the ESADA cohort.
2018
Obstructive sleep apnea (OSA) and asthma are often associated and several studies suggest a bidirectional relationship between asthma and OSA. This study analyzed the characteristics of patients with suspected OSA from the European Sleep Apnea Database according to presence/absence of physician-diagnosed asthma. Cross-sectional data in 16,236 patients (29.1% female) referred for suspected OSA were analyzed according to occurrence of physician-diagnosed asthma for anthropometrics, OSA severity and sleepiness. Sleep structure was assessed in patients studied by polysomnography (i.e. 48% of the sample). The prevalence of physician-diagnosed asthma in the entire cohort was 4.8% (7.9% in women, …
Burden of non-communicable diseases among adolescents aged 10-24 years in the EU, 1990-2019: a systematic analysis of the Global Burden of Diseases S…
2022
Background: Disability and mortality burden of non-communicable diseases (NCDs) have risen worldwide; however, the NCD burden among adolescents remains poorly described in the EU. Methods: Estimates were retrieved from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. Causes of NCDs were analysed at three different levels of the GBD 2019 hierarchy, for which mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) were extracted. Estimates, with the 95% uncertainty intervals (UI), were retrieved for EU Member States from 1990 to 2019, three age subgroups (10–14 years, 15–19 years, and 20–…
Cancer prevalence is increased in females with sleep apnoea: data from the ESADA study
2019
[No abstract available]
Unique sleep-stage transitions determined by obstructive sleep apnea severity, age and gender
2019
In obstructive sleep apnea, patients' sleep is fragmented leading to excessive daytime sleepiness and co-morbidities like arterial hypertension. However, traditional metrics are not always directly correlated with daytime sleepiness, and the association between traditional sleep quality metrics like sleep duration and arterial hypertension is still ambiguous. In a development cohort, we analysed hypnograms from mild (n = 213), moderate (n = 235) and severe (n = 277) obstructive sleep apnea patients as well as healthy controls (n = 105) from the European Sleep Apnea Database. We assessed sleep by the analysis of two-step transitions depending on obstructive sleep apnea severity and anthropom…
Global burden of chronic respiratory diseases and risk factors, 1990-2019: an update from the Global Burden of Disease Study 2019
2023
Background: Updated data on chronic respiratory diseases (CRDs) are vital in their prevention, control, and treatment in the path to achieving the third UN Sustainable Development Goals (SDGs), a one-third reduction in premature mortality from non-communicable diseases by 2030. We provided global, regional, and national estimates of the burden of CRDs and their attributable risks from 1990 to 2019.Methods: Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we estimated mortality, years lived with disability, years of life lost, disability-adjusted life years (DALYs), prevalence, and incidence of CRDs, i.e. chronic obstructive pulmonary disease (COPD)…