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6. Use of the Clinical Global Impression scale in sleep apnea patients – Results from the ESADA database

Author

Steiropoulos, P., Verbraecken, J., Petiet, E., Trakada, Georgia, Montserrat, J.M., Fietze, I., Penzel, T., Ludka, Ondrej, Rodenstein, Daniel, Masa, J.F., Bouloukaki, I., Schiza, S., Kent, B., McNicholas, W.T., Ryan, S., Riha, R.L., Kvamme, J.A., Schulz, R., Grote, L., Hedner, J., Zou, Ding, Pépin, J.L., Levy, P., Bailly, Sebastian, Lavie, Lena, Lavie, Peretz, Hein, H., Basoglu, O.K., Tasbakan, M.S., Varoneckas, G., Joppa, P., Tkacova, Ra, Staats, R., Barbé, F., Lombardi, C., Parati, G., Drummond, Marta, van Zeller, Mafalda, Bonsignore, M.R., Marrone, O., Escourrou, P., Roisman, G., Pretl, M., Vitols, A., Dogas, Z., Galic, T., Pataka, A., Anttalainen, U., Saaresranta, T., Sliwinski, P., Plywaczewski, R., Bielicki, P., Zielinski, Jan, Dieltjens, Marijke, Verbraecken, Johan A., Hedner, Jan, Vanderveken, Olivier M., Steiropoulos, Paschalis, Kvamme, John A., Saaresranta, Tarja, Tkacova, Ruzena, Marrone, Oreste, Dogas, Zoran, Schiza, Sofia, and Grote, Ludger

Published
2019
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16. Are we getting enough sleep? Frequent irregular sleep found in an analysis of over 11 million nights of objective in-home sleep data

Author

Scott, Hannah, Naik, Ganesh, Lechat, Bastien, Manners, Jack, Fitton, Josh, Nguyen, Duc Phuc, Hudson, Anna L., Reynolds, Amy C., Sweetman, Alexander, Escourrou, Pierre, Catcheside, Peter, and Eckert, Danny J.

Abstract

Evidence-based guidelines recommend that adults should sleep 7-9 h/night for optimal health and function. This study used noninvasive, multinight, objective sleep monitoring to determine average sleep duration and sleep duration variability in a large global community sample, and how often participants met the recommended sleep duration range.

Published
2024
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19. Obstructive sleep apnoea in adult patients post-tonsillectomy

Author

Riha, R, Kotoulas, S, Pataka, A, Kvamme, J, Joppa, P, Hedner, J, Anttalainen, U, Barbe, F, Bonsignore, M, Basoglu, O, Bielicki, P, Bouloukaki, I, Dogas, Z, Dorkova, Z, Escourrou, P, Fietze, I, Esquinas, C, Grote, L, Kent, B, Lena, L, Lavie, P, Levy, P, Lombardi, C, Marrone, O, Masa, J, Mcnicholas, W, Montserrat, J, Parati, G, Penzel, T, Pepin, J, Plywaczewski, R, Pretl, M, Rodenstein, D, Roisman, G, Ryan, S, Saaresranta, T, Schiza, S, Schulz, R, Sliwinski, P, Staats, R, Steiropoulos, P, Tasbakan, M, Tkacova, R, Varoneckas, G, Verbraecken, J, Vitols, A, Vrints, H, Zielinski, J, Riha R. L., Kotoulas S. -. C., Pataka A., Kvamme J. A., Joppa P., Hedner J., Anttalainen U., Barbe F., Bonsignore M. R., Basoglu O., Bielicki P., Bouloukaki I., Dogas Z., Dorkova Z., Escourrou P., Fietze I., Esquinas C., Grote L., Kent B. D., Lena L., Lavie P., Levy P., Lombardi C., Marrone O., Masa J. F., McNicholas W. T., Montserrat J. M., Parati G., Penzel T., Pepin J. L., Plywaczewski R., Pretl M., Rodenstein D., Roisman G., Ryan S., Saaresranta T., Schiza S. E., Schulz R., Sliwinski P., Staats R., Steiropoulos P., Tasbakan M. S., Tkacova R., Varoneckas G., Verbraecken J., Vitols A., Vrints H., Zielinski J., Riha, R, Kotoulas, S, Pataka, A, Kvamme, J, Joppa, P, Hedner, J, Anttalainen, U, Barbe, F, Bonsignore, M, Basoglu, O, Bielicki, P, Bouloukaki, I, Dogas, Z, Dorkova, Z, Escourrou, P, Fietze, I, Esquinas, C, Grote, L, Kent, B, Lena, L, Lavie, P, Levy, P, Lombardi, C, Marrone, O, Masa, J, Mcnicholas, W, Montserrat, J, Parati, G, Penzel, T, Pepin, J, Plywaczewski, R, Pretl, M, Rodenstein, D, Roisman, G, Ryan, S, Saaresranta, T, Schiza, S, Schulz, R, Sliwinski, P, Staats, R, Steiropoulos, P, Tasbakan, M, Tkacova, R, Varoneckas, G, Verbraecken, J, Vitols, A, Vrints, H, Zielinski, J, Riha R. L., Kotoulas S. -. C., Pataka A., Kvamme J. A., Joppa P., Hedner J., Anttalainen U., Barbe F., Bonsignore M. R., Basoglu O., Bielicki P., Bouloukaki I., Dogas Z., Dorkova Z., Escourrou P., Fietze I., Esquinas C., Grote L., Kent B. D., Lena L., Lavie P., Levy P., Lombardi C., Marrone O., Masa J. F., McNicholas W. T., Montserrat J. M., Parati G., Penzel T., Pepin J. L., Plywaczewski R., Pretl M., Rodenstein D., Roisman G., Ryan S., Saaresranta T., Schiza S. E., Schulz R., Sliwinski P., Staats R., Steiropoulos P., Tasbakan M. S., Tkacova R., Varoneckas G., Verbraecken J., Vitols A., Vrints H., and Zielinski J.

Abstract

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 of sex ratio and age (146 patients with previous tonsillectomy vs. 19565 patients without). Patients who had undergone tonsillectomy had a lower body mass index (29.3 ± 5.2 kg/m2 vs 32.2 ± 6.6 kg/m2, p < 0.001), lower subjective sleep latency (17.1 ± 17.8 min vs 25.5 ± 30.4 min, p = 0.001), lower ODI (15.7 ± 18.3 events/hour vs 30.7 ± 26.1 events/hour, p < 0.001), and SpO2<90% time during sleep (21.8 ± 47.5 min vs 52.6 ± 80.8 min, p < 0.001). OSA patients with tonsillectomy had a lower prevalence of Type II diabetes mellitus (p = 0.001), hypertension (p < 0.001) and a higher prevalence of hyperlipidemia (p < 0.001) and were less likely to be commenced on CPAP (p < 0.001). Conclusion: In a large population of almost 20,000 OSA patients from across Europe, patients who had undergone tonsillectomy presented with less severe OSA at time of diagnosis, and had a lower prevalence of Type II diabetes mellitus and cardiovascular co-morbidities.

Published
2021

21. Insomnia symptoms combined with nocturnal hypoxia associate with cardiovascular comorbidity in the European sleep apnea cohort (ESADA)

Author

Anttalainen, Ulla, Grote, L., Fietze, I., Riha, R. L., Ryan, S., Staats, R., Hedner, J., Saaresranta, T., Anttalainen, U., Barbe, F., Bonsignore, M. R., Basoglu, O., Bielicki, P., Bouloukaki, I., Dogas, Z., Dorkova, Z., Escourrou, P., Fietze, I, Esquinas, C., Hayes, L., Joppa, P., Kurki, S., Kvamme, J. A., Tamisier, R., Lombardi, C., Marrone, O., Masa, J. F., McNicholas, W. T., Montserrat, J. M., Parati, G., Pataka, A., Penzel, T., Pepin, J. L., Pretl, M., Roisman, G., Schiza, S. E., Schulz, R., Sliwinski, P., Steiropoulos, P., Tasbakan, M. S., Tkacova, R., Varoneckas, G., Verbraecken, J., Vrints, H., Anttalainen, U, Grote, L, Fietze, I, Riha, R, Ryan, S, Staats, R, Hedner, J, Saaresranta, T, Barbe, F, Bonsignore, M, Basoglu, O, Bielicki, P, Bouloukaki, I, Dogas, Z, Dorkova, Z, Escourrou, P, Esquinas, C, Hayes, L, Joppa, P, Kurki, S, Kvamme, J, Tamisier, R, Lombardi, C, Marrone, O, Mcnicholas, W, Montserrat, J, Parati, G, Pataka, A, Penzel, T, Pepin, J, Pretl, M, Roisman, G, Schiza, S, Schulz, R, Sliwinski, P, Tasbakan, M, Tkacova, R, Varoneckas, G, Verbraecken, J, Vrints, H, Anttalainen U., Grote L., Fietze I., Riha R.L., Ryan S., Staats R., Hedner J., Saaresranta T., Barbe F., Bonsignore M.R., Basoglu O., Bielicki P., Bouloukaki I., Dogas Z., Dorkova Z., Escourrou P., Esquinas C., Hayes L., Joppa P., Kurki S., Kvamme J.A., Tamisier R., Lombardi C., Marrone O., McNicholas W.T., Montserrat J.M., Parati G., Pataka A., Penzel T., Pepin J.L., Pretl M., Roisman G., Schiza S.E., Schulz R., Sliwinski P., Tasbakan M.S., Tkacova R., Varoneckas G., Verbraecken J., Vrints H., Ege Üniversitesi, and ESADA Study Collaborators

Subjects
Adult, Male, medicine.medical_specialty, Insomnia, Neurology, Comorbidity, Settore MED/10 - Malattie Dell'Apparato Respiratorio, Nocturnal, Hypoxemia, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Sleep Initiation and Maintenance Disorders, Internal medicine, mental disorders, Prevalence, Humans, Medicine, Hypoxia, Sleep Apnea, Obstructive, business.industry, Sleep Breathing Physiology and Disorders • Original Article, Sleep apnea, Middle Aged, Cardiovascular disease, Phenotype, Hypoxia (medical), medicine.disease, Circadian Rhythm, nervous system diseases, Europe, 030228 respiratory system, Otorhinolaryngology, Cardiovascular Diseases, Cohort, Female, Human medicine, Neurology (clinical), medicine.symptom, business, 030217 neurology & neurosurgery
Abstract

WOS: 000482433800011, PubMed ID: 30467691, Purpose The aim of the current study was to further investigate the concept of previously reported high occurrence of comorbidities in obstructive sleep patients (OSA) with insomnia-like symptoms. We hypothesized that this finding at least partly is mediated by nocturnal hypoxia. Moreover, we speculated that the spectrum of the clinical OSA phenotypes differs between European geographical regions. Methods Cohort of the European Sleep Apnea Database (n = 17,325; 29.9% females) was divided into five subcohorts according to geographical region (North, East, South, West, Central) and further into four clinical presentation phenotypes based on daytime symptoms (EDS) and characteristics suggestive of insomnia. Results The insomnia phenotype (alone or together with EDS) dominated in all European regions. Isolated insomnia, however, was less common in the West. Insomnia phenotype was associated with the highest proportion of cardiovascular comorbidity (51.7% in the insomnia vs. 43.9% in the EDS type). Measures of nocturnal hypoxemia were independently associated with cardiovascular comorbidity in phenotypes with insomnia-like symptoms. The burden of comorbidities was high across all geographical regions and clinical phenotypes. Regional differences were clinically relevant for age (48 vs. 54 years), BMI (29 vs. 34 kg/m(2)), and ODI (15 vs. 32/h). Conclusion High prevalence of particularly cardiovascular comorbidity among patients with insomnia-like symptoms was linked to nocturnal hypoxemia. Considerable differences in clinical presentation were found among OSA patients across Europe. Our data underline that physicians should ask their patients with suspected OSA also for insomnia symptoms. It remains to be explored if a reduction of nocturnal hypoxemia predicts the improvement of insomnia symptoms., European Union COST action B26; European Respiratory Society (ERS); ResMed Inc.; Philips Respironics Inc., The ESADA network has received support from the European Union COST action B26. The European Respiratory Society (ERS) supports the ESADA for the second period as a Clinical Research Collaboration (CRC) (2015-2017 and 2018-2020). Unrestricted seeding grants from ResMed Inc. and Philips Respironics Inc. for establishment of the organization and the database are gratefully acknowledged.

Published
2018
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24. Sleep Irregularity Is Associated With Hypertension: Findings From Over 2 Million Nights With a Large Global Population Sample.

Author

Scott, Hannah, Lechat, Bastien, Guyett, Alisha, Reynolds, Amy C., Lovato, Nicole, Naik, Ganesh, Appleton, Sarah, Adams, Robert, Escourrou, Pierre, Catcheside, Peter, and Eckert, Danny J.

Abstract

Background: Irregularities in sleep duration and sleep timing have emerged as potential risk factors for hypertension. This study examined associations between irregularity in sleep duration and timing with hypertension in a large, global sample over multiple months. Methods: Data from 12 287 adults, who used an under-mattress device to monitor sleep duration and timing and also provided blood pressure recordings on ≥5 separate occasions, were analyzed. Sleep duration irregularity was assessed as the SD in total sleep time across the ≈9-month recording period. Sleep timing irregularity was assessed as SDs in sleep onset time, sleep midpoint, and sleep offset time. Logistic regressions were conducted to investigate associations between sleep irregularity and hypertension, defined as median systolic blood pressure ≥140 mm Hg or median diastolic blood pressure ≥90 mm Hg. Results: Participants were middle-aged (mean±SD, 50±12 years), mostly men (88%) and overweight (body mass index, 28±6 kg/m−2). Sleep duration irregularity was consistently associated with an ≈9% to 17% increase in hypertension independently of the total sleep time. A ≈34-minute increase in sleep onset time irregularity was associated with a 32% increase in hypertension (1.32 [1.20–1.45]). A 32-minute increase in sleep midpoint irregularity was associated with an 18% increase in hypertension (1.18 [1.09–1.29]), while a 43-minute increase in sleep offset time irregularity was associated with an 8.9% increase in hypertension (1.09 [1.001–1.18]). Conclusions: These findings support that sleep irregularity, both in duration and timing, is a risk marker for poor cardiovascular health. Further mechanistic investigations of temporal relationships between day-to-day fluctuations in sleep duration and timing, next-day blood pressure, and other cardiovascular outcomes are warranted. [ABSTRACT FROM AUTHOR]

Published
2023
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25. Periodic limb movements during sleep and blood pressure changes in sleep apnoea: Data from the European Sleep Apnoea Database

Author

Lombardi, C, Parati, G, Soranna, D, Zambon, A, Sliwinski, P, Roisman, G, Pepin, J, Schiza, S, Riha, R, Joppa, P, Fietze, I, Hedner, J, Grote, L, Anttalainen, U, Barbe, F, Bonsignore, M, Basoglu, O, Bielicki, P, Dogas, Z, Dorkova, Z, Escourrou, P, Hein, H, Kvamme, J, Levy, P, Marrone, O, Masa, J, Mcnicholas, W, Montserrat, J, Pataka, A, Penzel, T, Petiet, E, Plywaczewski, R, Pretl, M, Ryan, S, Saaresranta, T, Schulz, R, Tasbakan, M, Tkacova, R, Staats, R, Steiropoulos, P, Varoneckas, G, Verbraecken, J, Lombardi C., Parati G., Soranna D., Zambon A., Sliwinski P., Roisman G., Pepin J. -L., Schiza S., Riha R., Joppa P., Fietze I., Hedner J., Grote L., Anttalainen U., Barbe F., Bonsignore M. R., Basoglu O. K., Bielicki P., Dogas Z., Dorkova Z., Escourrou P., Hein H., Kvamme J. A., Levy P., Marrone O., Masa J. F., McNicholas W. T., Montserrat J. M., Pataka A., Penzel T., Petiet E., Pepin J. L., Plywaczewski R., Pretl M., Riha R. L., Ryan S., Saaresranta T., Schulz R., Tasbakan M. S., Tkacova R., Staats R., Steiropoulos P., Varoneckas G., Verbraecken J., Lombardi, C, Parati, G, Soranna, D, Zambon, A, Sliwinski, P, Roisman, G, Pepin, J, Schiza, S, Riha, R, Joppa, P, Fietze, I, Hedner, J, Grote, L, Anttalainen, U, Barbe, F, Bonsignore, M, Basoglu, O, Bielicki, P, Dogas, Z, Dorkova, Z, Escourrou, P, Hein, H, Kvamme, J, Levy, P, Marrone, O, Masa, J, Mcnicholas, W, Montserrat, J, Pataka, A, Penzel, T, Petiet, E, Plywaczewski, R, Pretl, M, Ryan, S, Saaresranta, T, Schulz, R, Tasbakan, M, Tkacova, R, Staats, R, Steiropoulos, P, Varoneckas, G, Verbraecken, J, Lombardi C., Parati G., Soranna D., Zambon A., Sliwinski P., Roisman G., Pepin J. -L., Schiza S., Riha R., Joppa P., Fietze I., Hedner J., Grote L., Anttalainen U., Barbe F., Bonsignore M. R., Basoglu O. K., Bielicki P., Dogas Z., Dorkova Z., Escourrou P., Hein H., Kvamme J. A., Levy P., Marrone O., Masa J. F., McNicholas W. T., Montserrat J. M., Pataka A., Penzel T., Petiet E., Pepin J. L., Plywaczewski R., Pretl M., Riha R. L., Ryan S., Saaresranta T., Schulz R., Tasbakan M. S., Tkacova R., Staats R., Steiropoulos P., Varoneckas G., and Verbraecken J.

Abstract

Background and objective: OSA and PLMS are known to induce acute BP swings during sleep. Our current study aimed to address the independent effect of PLMS on BP in an unselected OSA patient cohort. Methods: This cross-sectional analysis included 1487 patients (1110 males, no previous hypertension diagnosis or treatment, mean age: 52.5 years, mean BMI: 30.5 kg/m2) with significant OSA (defined as AHI ≥ 10) recruited from the European Sleep Apnoea Cohort. Patients underwent overnight PSG. Patients were stratified into two groups: patients with significant PLMS (PLMSI > 25 events/hour of sleep) and patients without significant PLMS (PLMSI < 25 events/hour of sleep). SBP, DBP and PP were the variables of interest. For each of these, a multivariate regression linear model was fitted to evaluate the relationship between PLMS and outcome adjusting for sociodemographic and clinical covariates (gender, age, BMI, AHI, ESS, diabetes, smoking and sleep efficiency). Results: The univariate analysis of SBP showed an increment of BP equal to 4.70 mm Hg (P < 0.001) in patients with significant PLMS compared to patients without significant PLMS. This increment remained significant after implementing a multivariate regression model (2.64 mm Hg, P = 0.044). No significant increment of BP was observed for DBP and PP. Conclusion: PLMS is associated with a rise in SBP regardless of AHI, independent of clinical and sociodemographic confounders. A PLMS phenotype may carry an increased risk for cardiovascular disease in OSA patients.

Published
2020

26. Periodic limb movements during sleep and blood pressure changes in sleep apnoea: Data from the European Sleep Apnoea Database

Author

Lombardi C, Parati G, Soranna D, Zambon A, Sliwinski P, Roisman G, Pepin JL, Schiza S, Riha R, Joppa P, Fietze I, Hedner J, Grote L, European Sleep Apnoea Database (ESADA) Collaborators (ESADA Collaborators: Anttalainen U, Barbé F, Bonsignore MR, Basoglu OK, Bielicki P, Dogas Z, Dorkova Z, Escourrou P, Hein H, Kvamme JA, Levy P, Marrone O, Masa JF, McNicholas WT, Montserrat JM, Pataka A, Penzel T, Petiet E, Pépin JL, Plywaczewski R, Pretl M, Riha RL, Ryan S, Saaresranta T, Schulz R, Tasbakan MS, Tkacova R, Staats R, Steiropoulos P, Varoneckas G, Verbraecken J), Lombardi C., Parati G., Soranna D., Zambon A., Sliwinski P., Roisman G., Pepin J.-L., Schiza S., Riha R., Joppa P., Fietze I., Hedner J., Grote L., Anttalainen U., Barbe F., Bonsignore M.R., Basoglu O.K., Bielicki P., Dogas Z., Dorkova Z., Escourrou P., Hein H., Kvamme J.A., Levy P., Marrone O., Masa J.F., McNicholas W.T., Montserrat J.M., Pataka A., Penzel T., Petiet E., Pepin J.L., Plywaczewski R., Pretl M., Riha R.L., Ryan S., Saaresranta T., Schulz R., Tasbakan M.S., Tkacova R., Staats R., Steiropoulos P., Varoneckas G., Verbraecken J., Università degli Studi di Milano-Bicocca = University of Milano-Bicocca (UNIMIB), Institute of Tuberculosis and Lung Diseases [Warsaw, Poland] (ITLD), AP-HP - Hôpital Antoine Béclère [Clamart], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hypoxie et PhysioPathologie (HP2), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Grenoble Alpes (UGA), Centre Hospitalier Universitaire [Grenoble] (CHU), University of Crete [Heraklion] (UOC), Royal Infirmary of Edinburgh, Univerzitnej nemocnice L. Pasteura Košice [Košice, Slovakia]. (UNLPK), Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], University of Gothenburg (GU), Sahlgrenska Academy at University of Gothenburg [Göteborg], European Sleep Apnoea Database (ESADA) Collaborators: Anttalainen U, Barbé F, Bonsignore Mr, Basoglu Ok, Bielicki P, Dogas Z, Dorkova Z, Escourrou P, Fietze I, Grote L, Hedner J, Hein H, Joppa P, Kvamme Ja, Levy P, Lombardi C, Marrone O, Masa Jf, McNicholas Wt, Montserrat Jm, Parati G, Pataka A, Penzel T, Petiet E, Pépin Jl, Plywaczewski R, Pretl M, Riha Rl, Roisman G, Ryan S, Saaresranta T, Schiza S, Schulz R, Sliwinski P, Pepin Jl, Tasbakan Ms, Tkacova R, Staats R, Steiropoulos P, Varoneckas G, Verbraecken J, SALAS, Danielle, Lombardi, C, Parati, G, Soranna, D, Zambon, A, Sliwinski, P, Roisman, G, Pepin, J, Schiza, S, Riha, R, Joppa, P, Fietze, I, Hedner, J, Grote, L, Anttalainen, U, Barbe, F, Bonsignore, M, Basoglu, O, Bielicki, P, Dogas, Z, Dorkova, Z, Escourrou, P, Hein, H, Kvamme, J, Levy, P, Marrone, O, Masa, J, Mcnicholas, W, Montserrat, J, Pataka, A, Penzel, T, Petiet, E, Plywaczewski, R, Pretl, M, Ryan, S, Saaresranta, T, Schulz, R, Tasbakan, M, Tkacova, R, Staats, R, Steiropoulos, P, Varoneckas, G, and Verbraecken, J

Subjects
Male, Pulmonary and Respiratory Medicine, Multivariate statistics, medicine.medical_specialty, obstructive sleep apnoea, Systole, Movement, [SDV]Life Sciences [q-bio], Blood Pressure, Comorbidity, Settore MED/10 - Malattie Dell'Apparato Respiratorio, Cohort Studies, 03 medical and health sciences, Sleep Apnea Syndromes, 0302 clinical medicine, Diastole, cardiovascular disease, Diabetes mellitus, Internal medicine, medicine, Humans, 030212 general & internal medicine, sleep disorder, Sleep disorder, Univariate analysis, business.industry, Confounding, Extremities, clinical epidemiology, Middle Aged, medicine.disease, Sleep in non-human animals, Europe, [SDV] Life Sciences [q-bio], Cross-Sectional Studies, Blood pressure, Databases as Topic, 030228 respiratory system, Cohort, Female, Sleep, business
Abstract

International audience; Background and objective: OSA and PLMS are known to induce acute BP swings during sleep. Our current study aimed to address the independent effect of PLMS on BP in an unselected OSA patient cohort.Methods: This cross-sectional analysis included 1487 patients (1110 males, no previous hypertension diagnosis or treatment, mean age: 52.5 years, mean BMI: 30.5 kg/m2 ) with significant OSA (defined as AHI ≥ 10) recruited from the European Sleep Apnoea Cohort. Patients underwent overnight PSG. Patients were stratified into two groups: patients with significant PLMS (PLMSI > 25 events/hour of sleep) and patients without significant PLMS (PLMSI < 25 events/hour of sleep). SBP, DBP and PP were the variables of interest. For each of these, a multivariate regression linear model was fitted to evaluate the relationship between PLMS and outcome adjusting for sociodemographic and clinical covariates (gender, age, BMI, AHI, ESS, diabetes, smoking and sleep efficiency).Results: The univariate analysis of SBP showed an increment of BP equal to 4.70 mm Hg (P < 0.001) in patients with significant PLMS compared to patients without significant PLMS. This increment remained significant after implementing a multivariate regression model (2.64 mm Hg, P = 0.044). No significant increment of BP was observed for DBP and PP.Conclusion: PLMS is associated with a rise in SBP regardless of AHI, independent of clinical and sociodemographic confounders. A PLMS phenotype may carry an increased risk for cardiovascular disease in OSA patients.

Published
2020
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29. Obstructive sleep apnoea independently predicts lipid levels: Data from the European Sleep Apnea Database

Author

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, Gunduz, C, Hender, J, and Lepin, J

Subjects
Male, obesity, Databases, Factual, cholesterol, dyslipidemia, hypoxia, obesity, sleep apnoea, Gastroenterology, Cohort Studies, chemistry.chemical_compound, 0302 clinical medicine, Risk Factors, Hypolipidemic Agents, Oxygen saturation (medicine), Sleep Apnea, Obstructive, medicine.diagnostic_test, Sleep apnea, Middle Aged, Europe, Quartile, Cardiovascular Diseases, Cohort, Female, lipids (amino acids, peptides, and proteins), Adult, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Settore MED/10 - Malattie Dell'Apparato Respiratorio, 03 medical and health sciences, Internal medicine, medicine, Humans, Triglycerides, Dyslipidemias, hypoxia, Cholesterol, business.industry, Cholesterol, HDL, dyslipidemia, cholesterol, Cholesterol, LDL, ta3121, medicine.disease, Obesity, nervous system diseases, respiratory tract diseases, Cross-Sectional Studies, 030228 respiratory system, chemistry, Lipid profile, business, sleep apnoea, 030217 neurology & neurosurgery, Dyslipidemia
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
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34. Obstructive sleep apnoea in adult patients post-tonsillectomy

Author

Anttalainen, U., Barbé, F., Bonsignore, M.R., Basoglu, O., Bielicki, P., Bouloukaki, I., Dogas, Z., Dorkova, Z., Escourrou, P., Fietze, I., Esquinas, C., Grote, L., Kent, B.D., Lena, Lavie, Lavie, P., Levy, P., Lombardi, C., Marrone, O., Masa, J.F., McNicholas, W.T., Montserrat, J.M., Parati, G., Penzel, T., Pépin, J.L., Plywaczewski, R., Pretl, M., Rodenstein, D., Roisman, G., Ryan, S., Saaresranta, T., Schiza, S.E., Schulz, R., Sliwinski, P., Staats, R., Steiropoulos, P., Tasbakan, M.S., Tkacova, R., Varoneckas, G., Verbraecken, J., Vitols, A., Vrints, H., Zielinski, J., Riha, Renata L., Kotoulas, Serafeim – Chrysovalantis, Pataka, Athanasia, Kvamme, John Arthur, Joppa, Pavol, and Hedner, Jan

Published
2021
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36. Consensus en endoscopie digestive (CED): Les prothèses biliaires

Author

Escourrou, Jean, Laugier, René, Heresbach, Denis, Arpurt, Jean-Pierre, Barrioz, Thierry, Barthet, Marc, Boustière, Christian, Cellier, Christophe, Croguennec, Bernard, Dalbiès, Pierre, Gay, Gérard, Letard, Jean-Christophe, Marchetti, Bernard, Napoléon, Bertrand, Pienkowski, Patrice, Ponchon, Thierry, Richard-Molard, Bruno, Tucat, Gilbert, and Védrenne, Bruno

Published
2009
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37. Use of the Clinical Global Impression scale in sleep apnea patients – Results from the ESADA database

Author

Dieltjens, M, Verbraecken, J, Hedner, J, Vanderveken, O, Steiropoulos, P, Kvamme, J, Saaresranta, T, Tkacova, R, Marrone, O, Dogas, Z, Schiza, S, Grote, L, Petiet, E, Trakada, G, Montserrat, J, Fietze, I, Penzel, T, Ludka, O, Rodenstein, D, Masa, J, Bouloukaki, I, Kent, B, Mcnicholas, W, Ryan, S, Riha, R, Schulz, R, Zou, D, Pepin, J, Levy, P, Bailly, S, Lavie, L, Lavie, P, Hein, H, Basoglu, O, Tasbakan, M, Varoneckas, G, Joppa, P, Staats, R, Barbe, F, Lombardi, C, Parati, G, Drummond, M, van Zeller, M, Bonsignore, M, Escourrou, P, Roisman, G, Pretl, M, Vitols, A, Galic, T, Pataka, A, Anttalainen, U, Sliwinski, P, Plywaczewski, R, Bielicki, P, Zielinski, J, Dieltjens M., Verbraecken J. A., Hedner J., Vanderveken O. M., Steiropoulos P., Kvamme J. A., Saaresranta T., Tkacova R., Marrone O., Dogas Z., Schiza S., Grote L., Verbraecken J., Petiet E., Trakada G., Montserrat J. M., Fietze I., Penzel T., Ludka O., Rodenstein D., Masa J. F., Bouloukaki I., Kent B., McNicholas W. T., Ryan S., Riha R. L., Schulz R., Zou D., Pepin J. L., Levy P., Bailly S., Lavie L., Lavie P., Hein H., Basoglu O. K., Tasbakan M. S., Varoneckas G., Joppa P., Staats R., Barbe F., Lombardi C., Parati G., Drummond M., van Zeller M., Bonsignore M. R., Escourrou P., Roisman G., Pretl M., Vitols A., Galic T., Pataka A., Anttalainen U., Sliwinski P., Plywaczewski R., Bielicki P., Zielinski J., Dieltjens, M, Verbraecken, J, Hedner, J, Vanderveken, O, Steiropoulos, P, Kvamme, J, Saaresranta, T, Tkacova, R, Marrone, O, Dogas, Z, Schiza, S, Grote, L, Petiet, E, Trakada, G, Montserrat, J, Fietze, I, Penzel, T, Ludka, O, Rodenstein, D, Masa, J, Bouloukaki, I, Kent, B, Mcnicholas, W, Ryan, S, Riha, R, Schulz, R, Zou, D, Pepin, J, Levy, P, Bailly, S, Lavie, L, Lavie, P, Hein, H, Basoglu, O, Tasbakan, M, Varoneckas, G, Joppa, P, Staats, R, Barbe, F, Lombardi, C, Parati, G, Drummond, M, van Zeller, M, Bonsignore, M, Escourrou, P, Roisman, G, Pretl, M, Vitols, A, Galic, T, Pataka, A, Anttalainen, U, Sliwinski, P, Plywaczewski, R, Bielicki, P, Zielinski, J, Dieltjens M., Verbraecken J. A., Hedner J., Vanderveken O. M., Steiropoulos P., Kvamme J. A., Saaresranta T., Tkacova R., Marrone O., Dogas Z., Schiza S., Grote L., Verbraecken J., Petiet E., Trakada G., Montserrat J. M., Fietze I., Penzel T., Ludka O., Rodenstein D., Masa J. F., Bouloukaki I., Kent B., McNicholas W. T., Ryan S., Riha R. L., Schulz R., Zou D., Pepin J. L., Levy P., Bailly S., Lavie L., Lavie P., Hein H., Basoglu O. K., Tasbakan M. S., Varoneckas G., Joppa P., Staats R., Barbe F., Lombardi C., Parati G., Drummond M., van Zeller M., Bonsignore M. R., Escourrou P., Roisman G., Pretl M., Vitols A., Galic T., Pataka A., Anttalainen U., Sliwinski P., Plywaczewski R., Bielicki P., and Zielinski J.

Abstract

Objective/Background: The Clinical Global Impression scale (CGI) reflects the clinician's assessment of the disease impact on patient's global functioning. We assessed predictors of CGI scale rating in patients with obstructive sleep apnea (OSA). Patients/Methods: Consecutive patients with suspected OSA (n = 7581) were identified in the European Sleep Apnea Database (ESADA). Anthropometrics, comorbidities, apnea severity obtained by polygraphy or polysomnography, and daytime sleepiness [Epworth Sleepiness Scale (ESS)] were assessed. The CGI 7-point scale was completed at the end of the diagnostic process (CGI-severity, ie, CGI-S) and, in a subpopulation, at treatment follow-up (CGI-Improvement). Results: CGI-S was rated mild to moderate in 44% of patients. CGI rating at any given apnea intensity was worse in women than in men (p < 0.01). Patients undergoing polygraphy (n = 5075) were more frequently rated as severely ill compared to those studied with polysomnography (19.0% vs 13.0%, p < 0.001). In patients aged ≤65 years, CGI scoring was generally better than in the elderly despite a similar degree of OSA (eg, ‘normal, not ill’ 24.2% vs 15.3%, p < 0.01, respectively). Independent predictors of CGI rating included age, BMI, AHI, ESS, cardio-metabolic comorbidities, and diagnosis based on polygraphy. CGI-improvement rating (Beta = −0.406, p < 0.01) was superior to sleep apnea severity or ESS-score (Beta = 0.052 and −0.021, p = 0.154 and 0.538 respectively) at baseline for prediction of good CPAP compliance at follow-up. Conclusions: CGI rating is confounded by gender, age class and the type of sleep diagnostic method. As OSA phenotypes differ, CGI may contribute as a clinical tool to reflect the significance of clinical disease.

Published
2019

38. Insomnia symptoms combined with nocturnal hypoxia associate with cardiovascular comorbidity in the European sleep apnea cohort (ESADA)

Author

Anttalainen, U, Grote, L, Fietze, I, Riha, R, Ryan, S, Staats, R, Hedner, J, Saaresranta, T, Barbe, F, Bonsignore, M, Basoglu, O, Bielicki, P, Bouloukaki, I, Dogas, Z, Dorkova, Z, Escourrou, P, Esquinas, C, Hayes, L, Joppa, P, Kurki, S, Kvamme, J, Tamisier, R, Lombardi, C, Marrone, O, Mcnicholas, W, Montserrat, J, Parati, G, Pataka, A, Penzel, T, Pepin, J, Pretl, M, Roisman, G, Schiza, S, Schulz, R, Sliwinski, P, Tasbakan, M, Tkacova, R, Varoneckas, G, Verbraecken, J, Vrints, H, Anttalainen U., Grote L., Fietze I., Riha R. L., Ryan S., Staats R., Hedner J., Saaresranta T., Barbe F., Bonsignore M. R., Basoglu O., Bielicki P., Bouloukaki I., Dogas Z., Dorkova Z., Escourrou P., Esquinas C., Hayes L., Joppa P., Kurki S., Kvamme J. A., Tamisier R., Lombardi C., Marrone O., McNicholas W. T., Montserrat J. M., Parati G., Pataka A., Penzel T., Pepin J. L., Pretl M., Roisman G., Schiza S. E., Schulz R., Sliwinski P., Tasbakan M. S., Tkacova R., Varoneckas G., Verbraecken J., Vrints H., Anttalainen, U, Grote, L, Fietze, I, Riha, R, Ryan, S, Staats, R, Hedner, J, Saaresranta, T, Barbe, F, Bonsignore, M, Basoglu, O, Bielicki, P, Bouloukaki, I, Dogas, Z, Dorkova, Z, Escourrou, P, Esquinas, C, Hayes, L, Joppa, P, Kurki, S, Kvamme, J, Tamisier, R, Lombardi, C, Marrone, O, Mcnicholas, W, Montserrat, J, Parati, G, Pataka, A, Penzel, T, Pepin, J, Pretl, M, Roisman, G, Schiza, S, Schulz, R, Sliwinski, P, Tasbakan, M, Tkacova, R, Varoneckas, G, Verbraecken, J, Vrints, H, Anttalainen U., Grote L., Fietze I., Riha R. L., Ryan S., Staats R., Hedner J., Saaresranta T., Barbe F., Bonsignore M. R., Basoglu O., Bielicki P., Bouloukaki I., Dogas Z., Dorkova Z., Escourrou P., Esquinas C., Hayes L., Joppa P., Kurki S., Kvamme J. A., Tamisier R., Lombardi C., Marrone O., McNicholas W. T., Montserrat J. M., Parati G., Pataka A., Penzel T., Pepin J. L., Pretl M., Roisman G., Schiza S. E., Schulz R., Sliwinski P., Tasbakan M. S., Tkacova R., Varoneckas G., Verbraecken J., and Vrints H.

Abstract

Purpose: The aim of the current study was to further investigate the concept of previously reported high occurrence of comorbidities in obstructive sleep patients (OSA) with insomnia-like symptoms. We hypothesized that this finding at least partly is mediated by nocturnal hypoxia. Moreover, we speculated that the spectrum of the clinical OSA phenotypes differs between European geographical regions. Methods: Cohort of the European Sleep Apnea Database (n = 17,325; 29.9% females) was divided into five subcohorts according to geographical region (North, East, South, West, Central) and further into four clinical presentation phenotypes based on daytime symptoms (EDS) and characteristics suggestive of insomnia. Results: The insomnia phenotype (alone or together with EDS) dominated in all European regions. Isolated insomnia, however, was less common in the West. Insomnia phenotype was associated with the highest proportion of cardiovascular comorbidity (51.7% in the insomnia vs. 43.9% in the EDS type). Measures of nocturnal hypoxemia were independently associated with cardiovascular comorbidity in phenotypes with insomnia-like symptoms. The burden of comorbidities was high across all geographical regions and clinical phenotypes. Regional differences were clinically relevant for age (48 vs. 54 years), BMI (29 vs. 34 kg/m2), and ODI (15 vs. 32/h). Conclusion: High prevalence of particularly cardiovascular comorbidity among patients with insomnia-like symptoms was linked to nocturnal hypoxemia. Considerable differences in clinical presentation were found among OSA patients across Europe. Our data underline that physicians should ask their patients with suspected OSA also for insomnia symptoms. It remains to be explored if a reduction of nocturnal hypoxemia predicts the improvement of insomnia symptoms.

Published
2019

41. La désinfection du matériel en endoscopie digestive

Author

Marchetti, B., Boustière, C., Chapuis, Catherine, Systchenko, R., Arpurt, J. -P., Barrioz, T., Barthet, M., Cellier, C., Croguennec, B., Dalbiès, P. -A., Escourrou, J., Gay, G., Heresbach, D., Laugier, R., Letard, J. -C., Napoléon, B., Pienkowski, P., Ponchon, T., Richard-Molard, B., Tucat, G., and Védrenne, B.

Published
2007
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42. Diagnostic et surveillance de l’endobrachyœsophage

Author

Boyer, J., Laugier, R., Arpurt, J. -P., Boustière, C., Canard, J. -M., Cassigneul, J., Dalbiès, P. -A., Gay, G., Escourrou, J., Letard, J. -C., Napoléon, B., Palazzo, L., Ponchon, T., Richard-Molard, B., Sautereau, D., Tucat, G., and Vedrenne, B.

Published
2006
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46. Chiari malformation and sleep related breathing disorders

Author

Dauvilliers, Y., Stal, V., Abril, B., Coubes, P., Bobin, S., Touchon, J., Escourrou, P., Parker, F., and Bourgin, P.

Subjects
Arnold-Chiari deformity -- Diagnosis, Arnold-Chiari deformity -- Care and treatment, Arnold-Chiari deformity -- Research, Sleep apnea syndromes -- Physiological aspects, Sleep apnea syndromes -- Diagnosis, Respiratory insufficiency -- Causes of, Health, Psychology and mental health
Published
2007

49. L’accréditation des centres du sommeil d’activité adulte et enfant (CDS mixte) en France par la Société française de recherche et médecine du sommeil

Author

Hartley, S., primary, Vecchierini, M.-F., additional, Drouot, X., additional, Escourrou, P., additional, Martin, F., additional, Franco, P., additional, Trang, H., additional, Lecendreux, M., additional, Faroux, B., additional, Charley-Monaca, C., additional, Philippe, C., additional, Leger, D., additional, and Gagnadoux, F., additional

Published
2021
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