0000000000893550

AUTHOR

Marisa Bonsignore

Change in weight and central obesity by positive airway pressure treatment in obstructive sleep apnea patients: Longitudinal data from the European Sleep Apnea Database (ESADA)

Introduction: The effect of continuous positive airway pressure (CPAP) treatment on body weight and central obesity in obstructive sleep apnea (OSA) patients is still unclear. Objectives: We aimed to study body composition change during CPAP treatment in the European Sleep Apnea Database (ESADA). Methods: OSA patients with a CPAP treatment follow-up time of more than 30 days in the ESADA registry were selected (n=2015). Body mass index (BMI), body weight, waist-, hip- and neck-circumferences were assessed at baseline and follow-up (median [interquartile range], 242 [380] days). Predictors for body composition changes with CPAP were analyzed adjusting for confounders. Results: Overall, there…

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Vitamin D deficiency in patients evaluated for obstructive sleep apnea: is it associated with disease severity?

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…

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Long-term positive airway pressure therapy is associated with reduced total cholesterol levels in patients with obstructive sleep apnea : data from the European Sleep Apnea Database (ESADA)

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 …

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Rigidité artérielle chez les patients obèses traités par PPC pour un syndrome d’apnées obstructives du sommeil (SAOS) : étude longitudinale prospective sur sept ans

Introduction La rigidite arterielle mesuree par la vitesse de l’onde de pouls carotido-femorale (VOP) est elevee dans le SAOS severe. Une augmentation de 1 m/s de VOP est associee a un risque accru de 15 % de mortalite. Une diminution de la VOP a ete decrite apres quelques mois de traitement par pression positive continue (PPC), mais il existe peu de donnees concernant l’evolution a long terme de la VOP dans le SAOS traite par PPC [1] . L’objectif de l’etude est de mesurer l’evolution et les determinants de la VOP dans le SOAS traite par PPC. Methodes Dans une cohorte prospective d’obeses avec un SAOS, nous avons recueilli des donnees cliniques et biologiques ainsi que les donnees de VOP, d…

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THE EUROPEAN SLEEP APNOEA DATABASE (ESADA) -- Report from 22 European Sleep Laboratories

The European Sleep Apnoea Database (ESADA) reflects a network of 22 sleep disorder centres in Europe enabled by a COST action B26 programme. This ongoing project aims to describe differences in standard clinical care of patients with obstructive sleep apnoea (OSA) and to establish a resource for genetic research in this disorder. Patients with suspected OSA are consecutively included and followed up according to local clinical standards. Anthropometrics, medical history, medication, daytime symptoms and sleep data (polysomnography or cardiorespiratory polygraphy) are recorded in a structured web-based report form. 5,103 patients (1,426 females, mean±SD age 51.8±12.6 yrs, 79.4% with apnoea/h…

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Long-term variations of arterial stiffness in patients with obesity and obstructive sleep apnea treated with continuous positive airway pressure

BackgroundObstructive sleep apnea (OSA) is associated with cardiovascular co-morbidities and mortality. Arterial stiffness is an independent predictor of cardiovascular risk and mortality, and is influenced by the presence of OSA and related comorbidities. There is a paucity of data regarding long-term evolution of arterial stiffness in CPAP-treated OSA patients. We aimed to prospectively study long term PWV variations and determinants of PWV deterioration.MethodsIn a prospective obese OSA cohort, at time of diagnosis and after several years of follow-up we collected arterial stiffness measured by carotid-femoral pulse wave velocity (PWV), clinical and metabolic parameters, and CPAP adheren…

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Mild obstructive sleep apnoea (OSA) and arterial hypertension in the EuropeanSleep Apnoea Database (ESADA) cohort study.

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,…

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Severity Of Sleep Disordered Breathing Is An Independent Predictor Of Glycemic Health: The European Sleep Cohort (ESADA) Study

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Regional differences in characteristics of patients referred to European sleep centers. Results from the European Sleep Apnea Database (ESADA)

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Blood pressure reduction following treatment with positive airway pressure in sleep apnea: data from the European Sleep Apnea Database

Abstract Introduction Positive airway pressure (PAP) treatment modifies blood pressure (BP) in patients with obstructive sleep apnea (OSA). We aimed to explore which factors that influence the BP response to PAP therapy in the European Sleep Apnea Database (ESADA). Methods A total of 2662 OSA patients with PAP therapy ≥90 days were included in the analysis (74% male, age 55±11 years, body mass index 32.3±6.1 kg/m2, 47% hypertensives, apnea-hypopnea index 40±24 events/h, treatment duration 1.0±1.1 years, PAP compliance 5.2±1.9 h/day). Anthropometric data, co-medications and office BP were assessed at baseline and follow-up visit. Results Systolic and diastolic BP were modestly reduced after …

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Obstructive sleep apnoea in adult patients post-tonsillectomy

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…

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Reference values for mean overnight saturation in sleep apnoea – the European Sleep Apnoea Database (ESADA)

Introduction: Normative values for mean overnight oxygen saturation during sleep in apnoea patients stratified for age, BMI, and sleep apnoea severity are lacking. Aim: To establish reference intervals for overnight mean saturation in a large sleep apnoea patient cohort. Methods: Mean overnight oxygen saturation was analysed in adult patients (n=23,220) from the European Sleep Apnoea Database (ESADA, 30 sleep centres, 18 European countries). Data were classified according to age, gender, BMI ( Results: Mean overnight saturation was 93.0% (95% confidence interval (CI) 92.9 to 93.1%). Age influenced the adjusted mean nocturnal saturation (93.6%, 93.2%, 92.9%, 92.5%, 92.2% and 91.9% for those …

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Mild OSA and arterial hypertension in the European Sleep Apnoea Database cohort study

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…

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