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101. Change in weight and central obesity by positive airway pressure treatment in obstructive sleep apnea patients: longitudinal data from the ESADA cohort

Author

Basoglu, Ozen K., Zou, Ding, Tasbakan, Mehmet S., Hedner, Jan, Ryan, Silke, Verbraecken, Johan, Escourrou, Pierre, Antalainen, Ulla, Kvamme, John A., Bonsignore, Maria R., Schiza, Sofia, Grote, Ludger, Anttalainen, U., Barbé, F., Bielicki, P., Dogas, Z., Fietze, I., Hein, H., Joppa, P., Levy, P., Lombardi, C., Marrone, O., Masa, J. F., McNicholas, W. T., Montserrat, J. M., Parati, G., Pataka, A., Penzel, T., Pépin, J. L., Petiet, E., Plywaczewski, R., Pretl, M., Riha, R. L., Roisman, G., Ryan, S., Saaresranta, T., Schulz, R., Sliwinski, P., Pepin, J. L., Tkacova, R., Staats, R., Steiropoulos, P., Varoneckas, G., Vitols, A., Basoglu OK, Zou D, Tasbakan MS, Hedner J, Ryan S, Verbraecken J, Escourrou P, Antalainen U, Kvamme JA, Bonsignore MR, Schiza S, Grote L, ESADA Study Group., ESADA Study Grp, Basoglu, O, Zou, D, Tasbakan, M, Hedner, J, Ryan, S, Verbraecken, J, Escourrou, P, Antalainen, U, Kvamme, J, Bonsignore, M, Schiza, S, Grote, L, Anttalainen, U, Barbé, F, Bielicki, P, Dogas, Z, Fietze, I, Hein, H, Joppa, P, Levy, P, Lombardi, C, Marrone, O, Masa, J, Mcnicholas, W, Montserrat, J, Parati, G, Pataka, A, Penzel, T, Pépin, J, Petiet, E, Plywaczewski, R, Pretl, M, Riha, R, Roisman, G, Saaresranta, T, Schulz, R, Sliwinski, P, Pepin, J, Tkacova, R, Staats, R, Steiropoulos, P, Varoneckas, G, and Vitols, A

Subjects
Data Analysis, Male, Time Factors, Excessive daytime sleepiness, Weight Gain, excessive daytime sleepine, Body Mass Index, Cohort Studies, Behavioral Neuroscience, 0302 clinical medicine, Positive airway pressure, Medicine, Longitudinal Studies, Prospective Studies, obstructive sleep apnea, Sleep Apnea, Obstructive, Continuous Positive Airway Pressure, Epworth Sleepiness Scale, Sleep apnea, General Medicine, Middle Aged, weight, central obesity, positive airway pressure, ESADA cohort, Europe, Obesity, Abdominal, Cardiology, Female, Waist Circumference, medicine.symptom, Adult, medicine.medical_specialty, Cognitive Neuroscience, Settore MED/10 - Malattie Dell'Apparato Respiratorio, 03 medical and health sciences, Internal medicine, Humans, Aged, business.industry, Body Weight, body weight, central obesity, excessive daytime sleepiness, obstructive sleep apnea, positive airway pressure, ta3121, medicine.disease, Obesity, respiratory tract diseases, Obstructive sleep apnea, 030228 respiratory system, Human medicine, business, Body mass index, Weight gain, 030217 neurology & neurosurgery
Abstract

The effect of positive airway pressure treatment on weight and markers of central obesity in patients with obstructive sleep apnea remains unclear. We studied the change in body weight and anthropometric measures following positive airway pressure treatment in a large clinical cohort. Patients with obstructive sleep apnea with positive airway pressure treatment from the European Sleep Apnea Database registry (n = 1, 415, 77% male, age 54 ± 11 [mean ± SD] years, body mass index 31.7 ± 6.4 kg/m2, apnea–hypopnea index 37 ± 24 n per hr, Epworth Sleepiness Scale 10.2 ± 5.0) were selected. Changes in body mass index and neck/waist/hip circumferences at baseline and at follow-up visit were analysed. Overall, body mass index (0.0 [95% confidence interval, −0.1 to 0.2] kg/m2) and neck circumference (0.0 (95% confidence interval, −0.1 to 0.1] cm) were unchanged after positive airway pressure treatment compared with baseline (follow-up duration 1.1 ± 1.0 years and compliance 5.2 ± 2.1 hr per day). However, in non- obese (body mass index

Published
2018

105. Positive airway pressure treatment reduces glycated hemoglobin (HbA1c) levels in obstructive sleep apnea patients: Longitudinal data from the ESADA

Author

Taşbakan, Mehmet Sezai, primary, Grote, Ludger, additional, Hedner, Jan, additional, Kvamme, John-Arthur, additional, Verbraecken, Johan, additional, Mcnicholas, Walter T., additional, Roisman, Gabriel, additional, Tkacova, Ruzena, additional, Bonsignore, Maria R., additional, Saaresranta, Tarja, additional, Steiropoulos, Paschalis, additional, and Basoglu, Ozen K., additional

Published
2019
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106. Hyperlipidemia Prevalence and Cholesterol Control in OSA: Data from European Sleep Apnea Database (ESADA)

Author

Gunduz, Canan, primary, Basoglu, Ozen K., additional, Hedner, Jan, additional, Bonsignore, Maria R, additional, Hein, Holger, additional, Staats, Richard, additional, Bouloukaki, Izoldi, additional, Roisman, Gabriel, additional, Pataka, Athanasia, additional, Sliwinski, Pavel, additional, Ludka, Ondrej, additional, Pepin, Jean Louis, additional, and Grote, Ludger, additional

Published
2019
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108. Obstructive sleep apnea and objective sleep quality in non-dialyzed patients with chronic kidney disease: an ESADA study

Author

Marrone, Oreste, primary, Cibella, Fabio, additional, Donic, Viliam, additional, Roisman, Gabriel, additional, Sliwinski, Pawel, additional, Basoglu, Ozen K, additional, Schiza, Sophia, additional, Bouloukaki, Izolthi, additional, Pataka, Athanasia, additional, Staats, Richard, additional, Verbraecken, Johan, additional, Grote, Ludger, additional, Hedner, Jan, additional, and Bonsignore, Maria R, additional

Published
2019
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112. Cancer prevalence is increased in females with sleep apnoea: data from the ESADA study

Author

Pataka, Athanasia, primary, Bonsignore, Maria R., additional, Ryan, Silke, additional, Riha, Renata L., additional, Pepin, Jean-Louis, additional, Schiza, Sofia, additional, Basoglu, Ozen K., additional, Sliwinski, Pawel, additional, Ludka, Ondrej, additional, Steiropoulos, Paschalis, additional, Anttalainen, Ulla, additional, McNicholas, Walter T., additional, Hedner, Jan, additional, and Grote, Ludger, additional

Published
2019
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113. Clusters of sleep apnoea phenotypes: A large pan‐European study from the European Sleep Apnoea Database (ESADA).

Author

Bailly, Sébastien, Grote, Ludger, Hedner, Jan, Schiza, Sofia, McNicholas, Walter T., Basoglu, Ozen K., Lombardi, Carolina, Dogas, Zoran, Roisman, Gabriel, Pataka, Athanasia, Bonsignore, Maria R, Pepin, Jean‐Louis, Steiropoulos, P, Verbraecken, J, Georgia, Trakada, Penzel, T, Ondrej, Ludka, Bouloukaki, I, Ryan, S, and Riha, RL

Subjects
SLEEP apnea syndromes, PATIENT compliance, PHENOTYPES, CLUSTER analysis (Statistics), DATABASES
Abstract

Background and objective: To personalize OSA management, several studies have attempted to better capture disease heterogeneity by clustering methods. The aim of this study was to conduct a cluster analysis of 23 000 OSA patients at diagnosis using the multinational ESADA. Methods: Data from 34 centres contributing to ESADA were used. An LCA was applied to identify OSA phenotypes in this European population representing broad geographical variations. Many variables, including symptoms, comorbidities and polysomnographic data, were included. Prescribed medications were classified according to the ATC classification and this information was used for comorbidity confirmation. Results: Eight clusters were identified. Four clusters were gender‐based corresponding to 54% of patients, with two clusters consisting only of men and two clusters only of women. The remaining four clusters were mainly men with various combinations of age range, BMI, AHI and comorbidities. The preferred type of OSA treatment (PAP or mandibular advancement) varied between clusters. Conclusion: Eight distinct clinical OSA phenotypes were identified in a large pan‐European database highlighting the importance of gender‐based phenotypes and the impact of these subtypes on treatment prescription. The impact of cluster on long‐term treatment adherence and prognosis remains to be studied using the ESADA follow‐up data set. A cluster analysis of a pan‐European database of over 23 000 OSA patients found eight distinct clinical phenotypes, with clear gender‐based differences and implications for more personalized treatment prescriptions. See relatedEditorial [ABSTRACT FROM AUTHOR]

Published
2021
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114. Challenges and perspectives in obstructive sleep apnoea Report by an ad hoc working group of the Sleep Disordered Breathing Group of the European Respiratory Society and the European Sleep Research Society

Author

Randerath, Winfried, Bassetti, Claudio L., Bonsignore, Maria R., Farre, Ramon, Ferini-Strambi, Luigi, Grote, Ludger, Hedner, Jan, Kohler, Malcolm, Martinez-Garcia, Miguel-Angel, Mihaicuta, Stefan, Montserrat, Josep, Pepin, Jean-Louis, Pevernagie, Dirk, Pizza, Fabio, Polo, Olli, Riha, Renata, Ryan, Silke, Verbraecken, Johan, McNicholas, Walter T., Randerath, Winfried, Bassetti, Claudio L., Bonsignore, Maria R., Farre, Ramon, Ferini-Strambi, Luigi, Grote, Ludger, Hedner, Jan, Kohler, Malcolm, Martinez-Garcia, Miguel-Angel, Mihaicuta, Stefan, Montserrat, Josep, Pepin, Jean-Louis, Pevernagie, Dirk, Pizza, Fabio, Polo, Olli, Riha, Renata, Ryan, Silke, Verbraecken, Johan, and McNicholas, Walter T.

Abstract

Obstructive sleep apnoea (OSA) is a major challenge for physicians and healthcare systems throughout the world. The high prevalence and the impact on daily life of OSA oblige clinicians to offer effective and acceptable treatment options. However, recent evidence has raised questions about the benefits of positive airway pressure therapy in ameliorating comorbidities. An international expert group considered the current state of knowledge based on the most relevant publications in the previous 5 years, discussed the current challenges in the field, and proposed topics for future research on epidemiology, phenotyping, underlying mechanisms, prognostic implications and optimal treatment of patients with OSA. The group concluded that a revision to the diagnostic criteria for OSA is required to include factors that reflect different clinical and pathophysiological phenotypes and relevant comorbidities (e.g. nondipping nocturnal blood pressure). Furthermore, current severity thresholds require revision to reflect factors such as the disparity in the apnoea-hypopnoea index (AHI) between polysomnography and sleep studies that do not include sleep stage measurements, in addition to the poor correlation between AHI and daytime symptoms such as sleepiness. Management decisions should be linked to the underlying phenotype and consider outcomes beyond AHI.

Published
2018

115. Clinical presentation of patients with suspected obstructive sleep apnea and self-reported physician-diagnosed asthma in the ESADA cohort

Author

Bonsignore, M, Pepin, J, Anttalainen, U, Schiza, S, Basoglu, O, Pataka, A, Steiropoulos, P, Dogas, Z, Grote, L, Hedner, J, Mcnicholas, W, Marrone, O, Barbé, F, Bielicki, P, Bouloukaki, I, Dorkova, Z, Escourrou, P, Fietze, I, Esquinas, C, Hayes, L, Kent, B, Kumor, M, Kurki, S, Kvamme, J, Lavie, L, Lavie, P, Levy, P, Lombardi, C, Masa, J, Montserrat, J, Parati, G, Penzel, T, Pépin, J, Plywaczewski, R, Pretl, M, Riha, R, Rodenstein, D, Roisman, G, Ryan, S, Saaresranta, T, Schulz, R, Sliwinski, P, Staats, R, Tasbakan, M, Tkacova, R, Varoneckas, G, Verbraecken, J, Vitols, A, Vrints, H, Zielinski, J, Bonsignore, Maria R., Pepin, Jean-Louis, Anttalainen, Ulla, Schiza, Sophia E., Basoglu, Ozen K., Pataka, Athanasia, Steiropoulos, Paschalis, Dogas, Zoran, Grote, Ludger, Hedner, Jan, McNicholas, Walter T., Marrone, Oreste, Barbé, F., Bielicki, P., Bouloukaki, I., Dorkova, Z., Escourrou, P., Fietze, I., Esquinas, C., Hayes, L., Kent, B. D., Kumor, M., Kurki, S., Kvamme, J. A., Lavie, L., Lavie, P., Levy, P., Lombardi, C., Masa, J. F., Montserrat, J. M., Parati, G., Penzel, T., Pépin, J. L., Plywaczewski, R., Pretl, M., Riha, R. L., Rodenstein, D., Roisman, G., Ryan, S., Saaresranta, T., Schulz, R., Sliwinski, P., Staats, R., Tasbakan, M. S., Tkacova, R., Varoneckas, G., Verbraecken, J., Vitols, A., Vrints, H., Zielinski, J., Bonsignore, M, Pepin, J, Anttalainen, U, Schiza, S, Basoglu, O, Pataka, A, Steiropoulos, P, Dogas, Z, Grote, L, Hedner, J, Mcnicholas, W, Marrone, O, Barbé, F, Bielicki, P, Bouloukaki, I, Dorkova, Z, Escourrou, P, Fietze, I, Esquinas, C, Hayes, L, Kent, B, Kumor, M, Kurki, S, Kvamme, J, Lavie, L, Lavie, P, Levy, P, Lombardi, C, Masa, J, Montserrat, J, Parati, G, Penzel, T, Pépin, J, Plywaczewski, R, Pretl, M, Riha, R, Rodenstein, D, Roisman, G, Ryan, S, Saaresranta, T, Schulz, R, Sliwinski, P, Staats, R, Tasbakan, M, Tkacova, R, Varoneckas, G, Verbraecken, J, Vitols, A, Vrints, H, Zielinski, J, Bonsignore, Maria R., Pepin, Jean-Louis, Anttalainen, Ulla, Schiza, Sophia E., Basoglu, Ozen K., Pataka, Athanasia, Steiropoulos, Paschalis, Dogas, Zoran, Grote, Ludger, Hedner, Jan, McNicholas, Walter T., Marrone, Oreste, Barbé, F., Bielicki, P., Bouloukaki, I., Dorkova, Z., Escourrou, P., Fietze, I., Esquinas, C., Hayes, L., Kent, B. D., Kumor, M., Kurki, S., Kvamme, J. A., Lavie, L., Lavie, P., Levy, P., Lombardi, C., Masa, J. F., Montserrat, J. M., Parati, G., Penzel, T., Pépin, J. L., Plywaczewski, R., Pretl, M., Riha, R. L., Rodenstein, D., Roisman, G., Ryan, S., Saaresranta, T., Schulz, R., Sliwinski, P., Staats, R., Tasbakan, M. S., Tkacova, R., Varoneckas, G., Verbraecken, J., Vitols, A., Vrints, H., and Zielinski, J.

Abstract

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, 3.7% in men, p < 0.0001), and decreased from subjects without OSA to patients with mild–moderate and severe OSA (p = 0.02). Obesity was highly prevalent in asthmatic women, whereas BMI distribution was similar in men with and without physician-diagnosed asthma. Distribution of OSA severity was similar in patients with and without physician-diagnosed asthma, and unaffected by treatment for asthma or gastroesophageal reflux. Asthma was associated with poor sleep quality and sleepiness. Physician-diagnosed asthma was less common in a sleep clinic population than expected from the results of studies in the general population. Obesity appears as the major factor raising suspicion of OSA in asthmatic women, whereas complaints of poor sleep quality were the likely reason for referral in asthmatic men.

Published
2018

116. Change in weight and central obesity by positive airway pressure treatment in obstructive sleep apnea patients: longitudinal data from the ESADA cohort

Author

Basoglu, O, Zou, D, Tasbakan, M, Hedner, J, Ryan, S, Verbraecken, J, Escourrou, P, Antalainen, U, Kvamme, J, Bonsignore, M, Schiza, S, Grote, L, Anttalainen, U, Barbé, F, Bielicki, P, Dogas, Z, Fietze, I, Hein, H, Joppa, P, Levy, P, Lombardi, C, Marrone, O, Masa, J, Mcnicholas, W, Montserrat, J, Parati, G, Pataka, A, Penzel, T, Pépin, J, Petiet, E, Plywaczewski, R, Pretl, M, Riha, R, Roisman, G, Saaresranta, T, Schulz, R, Sliwinski, P, Pepin, J, Tkacova, R, Staats, R, Steiropoulos, P, Varoneckas, G, Vitols, A, Basoglu, Ozen K., Zou, Ding, Tasbakan, Mehmet S., Hedner, Jan, Ryan, Silke, Verbraecken, Johan, Escourrou, Pierre, Antalainen, Ulla, Kvamme, John A., Bonsignore, Maria R., Schiza, Sofia, Grote, Ludger, Anttalainen, U., Barbé, F., Bielicki, P., Dogas, Z., Fietze, I., Hein, H., Joppa, P., Levy, P., Lombardi, C., Marrone, O., Masa, J. F., McNicholas, W. T., Montserrat, J. M., Parati, G., Pataka, A., Penzel, T., Pépin, J. L., Petiet, E., Plywaczewski, R., Pretl, M., Riha, R. L., Roisman, G., Ryan, S., Saaresranta, T., Schulz, R., Sliwinski, P., Pepin, J. L., Tkacova, R., Staats, R., Steiropoulos, P., Varoneckas, G., Vitols, A., Basoglu, O, Zou, D, Tasbakan, M, Hedner, J, Ryan, S, Verbraecken, J, Escourrou, P, Antalainen, U, Kvamme, J, Bonsignore, M, Schiza, S, Grote, L, Anttalainen, U, Barbé, F, Bielicki, P, Dogas, Z, Fietze, I, Hein, H, Joppa, P, Levy, P, Lombardi, C, Marrone, O, Masa, J, Mcnicholas, W, Montserrat, J, Parati, G, Pataka, A, Penzel, T, Pépin, J, Petiet, E, Plywaczewski, R, Pretl, M, Riha, R, Roisman, G, Saaresranta, T, Schulz, R, Sliwinski, P, Pepin, J, Tkacova, R, Staats, R, Steiropoulos, P, Varoneckas, G, Vitols, A, Basoglu, Ozen K., Zou, Ding, Tasbakan, Mehmet S., Hedner, Jan, Ryan, Silke, Verbraecken, Johan, Escourrou, Pierre, Antalainen, Ulla, Kvamme, John A., Bonsignore, Maria R., Schiza, Sofia, Grote, Ludger, Anttalainen, U., Barbé, F., Bielicki, P., Dogas, Z., Fietze, I., Hein, H., Joppa, P., Levy, P., Lombardi, C., Marrone, O., Masa, J. F., McNicholas, W. T., Montserrat, J. M., Parati, G., Pataka, A., Penzel, T., Pépin, J. L., Petiet, E., Plywaczewski, R., Pretl, M., Riha, R. L., Roisman, G., Ryan, S., Saaresranta, T., Schulz, R., Sliwinski, P., Pepin, J. L., Tkacova, R., Staats, R., Steiropoulos, P., Varoneckas, G., and Vitols, A.

Abstract

The effect of positive airway pressure treatment on weight and markers of central obesity in patients with obstructive sleep apnea remains unclear. We studied the change in body weight and anthropometric measures following positive airway pressure treatment in a large clinical cohort. Patients with obstructive sleep apnea with positive airway pressure treatment from the European Sleep Apnea Database registry (n = 1,415, 77% male, age 54 ± 11 [mean ± SD] years, body mass index 31.7 ± 6.4 kg/m2, apnea–hypopnea index 37 ± 24 n per hr, Epworth Sleepiness Scale 10.2 ± 5.0) were selected. Changes in body mass index and neck/waist/hip circumferences at baseline and at follow-up visit were analysed. Overall, body mass index (0.0 [95% confidence interval, −0.1 to 0.2] kg/m2) and neck circumference (0.0 (95% confidence interval, −0.1 to 0.1] cm) were unchanged after positive airway pressure treatment compared with baseline (follow-up duration 1.1 ± 1.0 years and compliance 5.2 ± 2.1 hr per day). However, in non-obese (body mass index <30 kg/m2) patients, positive airway pressure treatment was associated with an increased body mass index and waist circumference (0.4 [0.3–0.5] kg/m2 and 0.8 [0.4–1.2] cm, respectively, all p < 0.05), and weight gain was significantly associated with higher positive airway pressure compliance and longer positive airway pressure treatment duration. In the obese subgroup, body mass index was reduced after positive airway pressure treatment (−0.3 [−0.5 to −0.1] kg/m2, p < 0.05) mainly in patients with a strong reduction in Epworth Sleepiness Scale. In conclusion, positive airway pressure therapy was not found to systematically change body mass index in the European Sleep Apnea Database cohort, but the response was heterogeneous. Our findings suggest that weight gain may be restricted to an obstructive sleep apnea phenotype without established obesity. Lifestyle intervention needs to be considered in both lean and obese patients with obstructive slee

Published
2018

117. Obstructive sleep apnoea independently predicts lipid levels: Data from the European Sleep Apnea Database

Author

Gündüz, C, Basoglu, O, Hedner, J, Zou, D, Bonsignore, M, Hein, H, Staats, R, Pataka, A, Barbe, F, Sliwinski, P, Kent, B, Pepin, J, Grote, L, Anttalainen, U, Barbé, F, Bielicki, P, Bouloukaki, I, Dogas, Z, Dorkova, Z, Escourrou, P, Fietze, I, Joppa, P, Kvamme, J, Levy, P, Lombardi, C, Marrone, O, Masa, J, Mcnicholas, W, Montserrat, J, Parati, G, Penzel, T, Pépin, J, Plywaczewski, R, Pretl, M, Riha, R, Roisman, G, Ryan, S, Saaresranta, T, Schiza, S, Schulz, R, Petiet, E, Tasbakan, M, Tkacova, R, Steiropoulos, P, Varoneckas, G, Verbraecken, J, Vitols, A, Gündüz, Canan, Basoglu, Ozen K., Hedner, Jan, Zou, Ding, Bonsignore, Maria R., Hein, Holger, Staats, Richard, Pataka, Athanasia, Barbe, Ferran, Sliwinski, Pavel, Kent, Brian D., Pepin, Jean Lois, Grote, Ludger, Anttalainen, U., Barbé, F., Bonsignore, M. R., Basoglu, O. K., Bielicki, P., Bouloukaki, I., Dogas, Z., Dorkova, Z., Escourrou, P., Fietze, I., Grote, L., Hedner, J., Hein, H., Joppa, P., Kvamme, J. A., Levy, P., Lombardi, C., Marrone, O., Masa, J. F., McNicholas, W. T., Montserrat, J. M., Parati, G., Pataka, A., Penzel, T., Pépin, J. L., Plywaczewski, R., Pretl, M., Riha, R. L., Roisman, G., Ryan, S., Saaresranta, T., Schiza, S., Schulz, R., Sliwinski, P., Pepin, J. L., Petiet, Erna, Tasbakan, M. S., Tkacova, R., Staats, R., Steiropoulos, P., Varoneckas, G., Verbraecken, J., Vitols, A., Gündüz, C, Basoglu, O, Hedner, J, Zou, D, Bonsignore, M, Hein, H, Staats, R, Pataka, A, Barbe, F, Sliwinski, P, Kent, B, Pepin, J, Grote, L, Anttalainen, U, Barbé, F, Bielicki, P, Bouloukaki, I, Dogas, Z, Dorkova, Z, Escourrou, P, Fietze, I, Joppa, P, Kvamme, J, Levy, P, Lombardi, C, Marrone, O, Masa, J, Mcnicholas, W, Montserrat, J, Parati, G, Penzel, T, Pépin, J, Plywaczewski, R, Pretl, M, Riha, R, Roisman, G, Ryan, S, Saaresranta, T, Schiza, S, Schulz, R, Petiet, E, Tasbakan, M, Tkacova, R, Steiropoulos, P, Varoneckas, G, Verbraecken, J, Vitols, A, Gündüz, Canan, Basoglu, Ozen K., Hedner, Jan, Zou, Ding, Bonsignore, Maria R., Hein, Holger, Staats, Richard, Pataka, Athanasia, Barbe, Ferran, Sliwinski, Pavel, Kent, Brian D., Pepin, Jean Lois, Grote, Ludger, Anttalainen, U., Barbé, F., Bonsignore, M. R., Basoglu, O. K., Bielicki, P., Bouloukaki, I., Dogas, Z., Dorkova, Z., Escourrou, P., Fietze, I., Grote, L., Hedner, J., Hein, H., Joppa, P., Kvamme, J. A., Levy, P., Lombardi, C., Marrone, O., Masa, J. F., McNicholas, W. T., Montserrat, J. M., Parati, G., Pataka, A., Penzel, T., Pépin, J. L., Plywaczewski, R., Pretl, M., Riha, R. L., Roisman, G., Ryan, S., Saaresranta, T., Schiza, S., Schulz, R., Sliwinski, P., Pepin, J. L., Petiet, Erna, Tasbakan, M. S., Tkacova, R., Staats, R., Steiropoulos, P., Varoneckas, G., Verbraecken, J., and Vitols, A.

Abstract

Background and objective: Obstructive sleep apnoea (OSA) and dyslipidaemia are independent risk factors for cardiovascular disease. This study investigates the association between OSA and plasma lipid concentrations in patients enrolled in the European Sleep Apnea Database (ESADA) cohort. Methods: The cross-sectional analysis included 8592 patients without physician-diagnosed hyperlipidaemia or reported intake of a lipid-lowering drug (age 50.1 ± 12.7 years, 69.1% male, BMI: 30.8 ± 6.6 kg/m2, mean apnoea–hypopnoea index (AHI): 25.7 ± 25.9 events/h). The independent relationship between measures of OSA (AHI, oxygen desaturation index (ODI), mean and lowest oxygen saturation) and lipid profile (total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and fasting triglycerides (TG)) was determined by means of general linear model analysis. Results: There was a dose response relationship between TC and ODI (mean ± SE (mg/dL): 180.33 ± 2.46, 184.59 ± 2.42, 185.44 ± 2.42 and 185.73 ± 2.44; P < 0.001 across ODI quartiles I–IV). TG and LDL concentrations were better predicted by AHI than by ODI. HDL-C was significantly reduced in the highest AHI quartile (mean ± SE (mg/dL): 48.8 ± 1.49 vs 46.50 ± 1.48; P = 0.002, AHI quartile I vs IV). Morbid obesity was associated with lower TC and higher HDL-C values. Lipid status was influenced by geographical location with the highest TC concentration recorded in Northern Europe. Conclusion: OSA severity was independently associated with cholesterol and TG concentrations.

Published
2018

118. Unique sleep‐stage transitions determined by obstructive sleep apnea severity, age and gender.

Author

Wächter, Marcel, Kantelhardt, Jan W., Bonsignore, Maria R., Bouloukaki, Izolde, Escourrou, Pierre, Fietze, Ingo, Grote, Ludger, Korzybski, Damian, Lombardi, Carolina, Marrone, Oreste, Paranicova, Ivana, Pataka, Athanasia, Ryan, Silke, Schiza, Sophia E., Sliwinski, Pawel, Steiropoulos, Paschalis, Verbraecken, Johan, Penzel, Thomas, Steiropoulos, P, and Verbraecken, J

Subjects
SLEEP apnea syndromes, HYPERTENSION, NON-REM sleep, MORNINGNESS-Eveningness Questionnaire, GENDER
Abstract

Summary: 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 = 209), moderate (n = 222) and severe (n = 272) 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 anthropometric factors. Two‐step transition patterns were examined for an association to arterial hypertension or daytime sleepiness. We also tested cumulative distributions of wake as well as sleep‐states for power‐laws (exponent α) and exponential distributions (decay time τ) in dependency on obstructive sleep apnea severity and potential confounders. Independent of obstructive sleep apnea severity and potential confounders, wake‐state durations followed a power‐law distribution, while sleep‐state durations were characterized by an exponential distribution. Sleep‐stage transitions are influenced by obstructive sleep apnea severity, age and gender. N2 → N3 → wake transitions were associated with high diastolic blood pressure. We observed higher frequencies of alternating (symmetric) patterns (e.g. N2 → N1 → N2, N2 → wake → N2) in sleepy patients both in the development cohort and in a validation cohort (n = 425). In conclusion, effects of obstructive sleep apnea severity and potential confounders on sleep architecture are small, but transition patterns still link sleep fragmentation directly to obstructive sleep apnea‐related clinical outcomes like arterial hypertension and daytime sleepiness. [ABSTRACT FROM AUTHOR]

Published
2020
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120. Determinants of daytime sleepiness in mild obstructive sleep apnoea syndrome. Data from the European Sleep Apnoea Database (ESADA) cohort study.

Author

Steiropoulos, Paschalis, primary, Schiza, Sophia, additional, Bonsignore, Maria R., additional, Verbraecken, Johan, additional, Hedner, Jan, additional, Grote, Ludger, additional, Oreste, Marrone, additional, Basoglu, Ozen K., additional, Parati, Gianfranco, additional, Lombardi, Carolina, additional, Holger, Holger, additional, Dogas, Zoran, additional, Pataka, Athanasia, additional, Bouloukaki, Izolde, additional, Staats, Richard, additional, Penzel, Thomas, additional, and Mc Nicholas, Walter, additional

Published
2018
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121. Fixed But Not Autoadjusting Positive Airway Pressure Attenuates the Time-dependent Decline in Glomerular Filtration Rate in Patients With OSA

Author

Marrone, Oreste, primary, Cibella, Fabio, additional, Pépin, Jean-Louis, additional, Grote, Ludger, additional, Verbraecken, Johan, additional, Saaresranta, Tarja, additional, Kvamme, John A., additional, Basoglu, Ozen K., additional, Lombardi, Carolina, additional, McNicholas, Walter T., additional, Hedner, Jan, additional, Bonsignore, Maria R., additional, Anttalainen, Ulla, additional, Barbè, Ferran, additional, Tasbakan, Sezai, additional, Bielicki, Piotr, additional, Kumor, Marta, additional, Bouloukaki, Izolde, additional, Schiza, Sophia, additional, Marrone, Oreste, additional, Escourrou, Pierre, additional, Roisman, Gabriel, additional, Fietze, Ingo, additional, Penzel, Thomas, additional, Kent, Brian D., additional, Ryan, Silke, additional, Lévy, Patrick, additional, Tamisier, Renaud, additional, Parati, Gianfranco, additional, Masa, Juan Fernando, additional, Montserrat, Josep M., additional, Pataka, Athanasia, additional, Plywaczewski, Robert, additional, Sliwinski, Pawel, additional, Pretl, Martin, additional, Riha, Renata, additional, Staats, Richard, additional, Steiropoulos, Paschalis, additional, Tkacova, Ruzena, additional, and Varoneckas, Giedvar, additional

Published
2018
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123. Challenges and perspectives in obstructive sleep apnoea

Author

Randerath, Winfried, primary, Bassetti, Claudio L., additional, Bonsignore, Maria R., additional, Farre, Ramon, additional, Ferini-Strambi, Luigi, additional, Grote, Ludger, additional, Hedner, Jan, additional, Kohler, Malcolm, additional, Martinez-Garcia, Miguel-Angel, additional, Mihaicuta, Stefan, additional, Montserrat, Josep, additional, Pepin, Jean-Louis, additional, Pevernagie, Dirk, additional, Pizza, Fabio, additional, Polo, Olli, additional, Riha, Renata, additional, Ryan, Silke, additional, Verbraecken, Johan, additional, and McNicholas, Walter T., additional

Published
2018
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125. Pulmonary vascular endothelium: the orchestra conductor in respiratory diseases

Author

Huertas, Alice, primary, Guignabert, Christophe, additional, Barberà, Joan A., additional, Bärtsch, Peter, additional, Bhattacharya, Jahar, additional, Bhattacharya, Sunita, additional, Bonsignore, Maria R., additional, Dewachter, Laurence, additional, Dinh-Xuan, Anh Tuan, additional, Dorfmüller, Peter, additional, Gladwin, Mark T., additional, Humbert, Marc, additional, Kotsimbos, Tom, additional, Vassilakopoulos, Theodoros, additional, Sanchez, Olivier, additional, Savale, Laurent, additional, Testa, Ugo, additional, and Wilkins, Martin R., additional

Published
2018
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126. Use of autobilevel ventilation in patients with obstructive sleep apnea: An observational study

Author

Baiamonte, Pierpaolo, primary, Mazzuca, Emilia, additional, Gruttad'Auria, Claudia I., additional, Castrogiovanni, Alessandra, additional, Marino, Claudia, additional, Lo Nardo, Davide, additional, Basile, Marco, additional, Algeri, Margherita, additional, Battaglia, Salvatore, additional, Marrone, Oreste, additional, Gagliardo, Andrea, additional, and Bonsignore, Maria R., additional

Published
2018
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132. Estimated glomerular filtration rate (eGFR) changes after obstructive sleep apnea (OSA) treatment by positive airway pressure: data from the European Sleep Apnea Database (ESADA)

Author

Marrone, Oreste, primary, Cibella, Fabio, additional, Pépin, Jean-Louis, additional, Verbraecken, Johan, additional, Saaresranta, Tarja, additional, Kvamme, John A., additional, Grote, Ludger, additional, Basoglu, Ozen K., additional, Lombardi, Carolina, additional, McNicholas, Walter, additional, and Bonsignore, Maria R., additional

Published
2017
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136. Mild Aerobic Exercise Training Hardly Affects the Diaphragm of mdx Mice

Author

Morici, Giuseppe, primary, Frinchi, Monica, additional, Pitruzzella, Alessandro, additional, Di Liberto, Valentina, additional, Barone, Rosario, additional, Pace, Andrea, additional, Di Felice, Valentina, additional, Belluardo, Natale, additional, Cappello, Francesco, additional, Mudò, Giuseppa, additional, and Bonsignore, Maria R., additional

Published
2017
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139. Clinical Phenotypes and Comorbidity in European Sleep Apnoea Patients.

Author

UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie, UCL - (SLuc) Service de pneumologie, Saaresranta, Tarja, Hedner, Jan, Bonsignore, Maria R, Riha, Renata L, McNicholas, Walter T, Penzel, Thomas, Anttalainen, Ulla, Kvamme, John Arthur, Pretl, Martin, Sliwinski, Pawel, Verbraecken, Johan, Grote, Ludger, ESADA Study Group, Rodenstein, Daniel, UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie, UCL - (SLuc) Service de pneumologie, Saaresranta, Tarja, Hedner, Jan, Bonsignore, Maria R, Riha, Renata L, McNicholas, Walter T, Penzel, Thomas, Anttalainen, Ulla, Kvamme, John Arthur, Pretl, Martin, Sliwinski, Pawel, Verbraecken, Johan, Grote, Ludger, ESADA Study Group, and Rodenstein, Daniel

Abstract

BACKGROUND: Clinical presentation phenotypes of obstructive sleep apnoea (OSA) and their association with comorbidity as well as impact on adherence to continuous positive airway pressure (CPAP) treatment have not been established. METHODS: A prospective follow-up cohort of adult patients with OSA (apnoea-hypopnoea index (AHI) of ≥5/h) from 17 European countries and Israel (n = 6,555) was divided into four clinical presentation phenotypes based on daytime symptoms labelled as excessive daytime sleepiness ("EDS") and nocturnal sleep problems other than OSA (labelled as "insomnia"): 1) EDS (daytime+/nighttime-), 2) EDS/insomnia (daytime+/nighttime+), 3) non-EDS/non-insomnia (daytime-/nighttime-), 4) and insomnia (daytime-/nighttime+) phenotype. RESULTS: The EDS phenotype comprised 20.7%, the non-EDS/non-insomnia type 25.8%, the EDS/insomnia type 23.7%, and the insomnia phenotype 29.8% of the entire cohort. Thus, clinical presentation phenotypes with insomnia symptoms were dominant with 53.5%, but only 5.6% had physician diagnosed insomnia. Cardiovascular comorbidity was less prevalent in the EDS and most common in the insomnia phenotype (48.9% vs. 56.8%, p<0.001) despite more severe OSA in the EDS group (AHI 35.0±25.5/h vs. 27.9±22.5/h, p<0.001, respectively). Psychiatric comorbidity was associated with insomnia like OSA phenotypes independent of age, gender and body mass index (HR 1.5 (1.188-1.905), p<0.001). The EDS phenotype tended to associate with higher CPAP usage (22.7 min/d, p = 0.069) when controlled for age, gender, BMI and sleep apnoea severity. CONCLUSIONS: Phenotypes with insomnia symptoms comprised more than half of OSA patients and were more frequently linked with comorbidity than those with EDS, despite less severe OSA. CPAP usage was slightly higher in phenotypes with EDS.

Published
2016

140. Airway inflammation in nonasthmatic amateur runners

Author

BONSIGNORE, MARIA R., MORICI, GIUSEPPE, RICCOBONO, LOREDANA, INSALACO, GIUSEPPE, BONANNO, ANNA, PROFITA, MIRELLA, PATERNO, ALESSANDRA, VASSALLE, CRISTINA, MIRABELLA, ANGELA, and VIGNOLA, A. MAURIZIO

Subjects
Athletes -- Health aspects, Asthma -- Physiological aspects, Airway obstruction (Medicine) -- Physiological aspects, Cell adhesion molecules -- Physiological aspects, Biological sciences
Abstract

Elite athletes show a high prevalence of symptoms and signs of asthma, but no study has assessed the acute effects of endurance exercise on airway cells in nonasthmatic athletes. We measured exhaled nitric oxide (NO) and collected samples of induced sputum after 3% NaCl aerosol administration for 20 min in nonasthmatic middle-aged amateur runners after the Fourth Palermo International Marathon and 6-9 wk later (habitual training period) at baseline. After the marathon, exhaled NO (n = 9 subjects) was higher [27 [+ or -] 9 parts/billion (ppb)] than at baseline (12 [+ or -] 4 ppb; P [is less than] 0.0005). Polymorphonuclear neutrophil (PMN) counts in induced sputum were much higher in runners (91.2 [+ or -] 3.6% of total cells postmarathon and 78.7 [+ or -] 9.1% at baseline) than in sedentary control subjects (9.9 [+ or -] 5.9%; P [is less than] 0.001). Expression of L-selectin and CD11b/CD18 in sputum PMNs was lower after the race than at baseline and inversely related to the amount of exhaled NO (r = -0.66 and -0.69, respectively; P [is less than] 0.05). Our data indicate that sputum PMNs are increased in nonasthmatic runners both after a marathon and at baseline and suggest that NO may modulate exercise-associated inflammatory airway changes. polymorphonuclear neutrophil; nitric oxide; adhesion molecules; elastase

Published
2001

142. Endurance training: is it bad for you?

Author

Morici, Giuseppe, primary, Gruttad’Auria, Claudia I., additional, Baiamonte, Pierpaolo, additional, Mazzuca, Emilia, additional, Castrogiovanni, Alessandra, additional, and Bonsignore, Maria R., additional

Published
2016
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144. Lack of Dystrophin Affects Bronchial Epithelium in mdx Mice

Author

Morici, Giuseppe, primary, Rappa, Francesca, additional, Cappello, Francesco, additional, Pace, Elisabetta, additional, Pace, Andrea, additional, Mudò, Giuseppa, additional, Crescimanno, Grazia, additional, Belluardo, Natale, additional, and Bonsignore, Maria R., additional

Published
2016
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149. Similar cellular composition of induced sputum in Marathon and Half-Marathon runners

Author

Bonsignore, Maria R., Gagliardo, Rosalia, Paterno, Alessandra, Bono, Simonetta, Riccobono, Loredana, Santagata, Roberta, Rinoldo, Danila, Davi, Michele, Bonanno, Anna, Scichilone, Nicola, Mirella Profita, Morici, Giuseppe, Bonsignore,MR, Gagliardo,R, Paterno',A, Bono,S, Riccobono,L, Santagata,R, Rinoldo,D, Davì,M, Bonanno,A, Scichilone,NA, Profita,M, and Morici,G

Subjects
Induced sputum, Marathon, Half Marathon
Abstract

In our previous studies, we reported increased neutrophil (PMN) differential counts in induced sputum of marathon (M) runners (Bonsignore et al, 2001). Conversely, increased bronchial epithelial cell (BEC) differential counts were found in half-marathon (HM) runners (Chimenti et al, 2010). To better understand the differences previously found between M and HM runners, we studied 11 non-asthmatic amateur athletes (HM n=6, M n=5, age: 44.5±6.7 yrs, race time: HM 101±18 min, M 218±35 min) participating to the 2012 Palermo Marathon. We collected induced sputum samples 4 to 5 days before the race (PRE), 2 hours after the race (RACE), and the following morning (POST). Induced sputum was processed according to the plug technique. In both HM and M runners, PMN differential counts increased from PRE to RACE and remained elevated in POST, whereas BEC differential counts increased from PRE to RACE, but returned to baseline at POST. These preliminary results indicate that BEC damage, possibly induced by hyperosmolar exposure during exercise hyperpnea, occurs for the entire duration of endurance exercise but is transient. Conversely, PMNs were recruited in the airways for a longer time, possibly secondary to chemiotactic stimuli released by BEC during exercise. Lack of differences between HM and M runners suggests that duration of the endurance race does not affect the airway cell response to exercise.

Published
2013

150. Effects of Exercise on the Airways

Author

Bonsignore, Maria R.

Subjects
Science / Life Sciences / Human Anatomy & Physiology
Abstract

Effects of Exercise on the Airways

Published
2012

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