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1. Arterial bicarbonate is associated with hypoxic burden and uncontrolled hypertension in obstructive sleep apnea - The ESADA cohort

Author

Ding Zou, Ludger Grote, Ozen K. Basoglu, Johan Verbraecken, Sophia Schiza, Pawel Sliwinski, Paschalis Steiropoulos, Carolina Lombardi, Holger Hein, Jean-Louis Pépin, Gianfranco Parati, Walter T. McNicholas, Jan Hedner, P. Steiropoulos, J. Verbraecken, E. Petiet, Georgia Trakada, I. Fietze, T. Penzel, Ondrej Ludka, I. Bouloukaki, S. Schiza, W.T. McNicholas, S. Ryan, R.L. Riha, J.A. Kvamme, L. Grote, J. Hedner, D. Zou, Dirk Pevernagie, S. Bailly, J.L. Pépin, R. Tamisier, H. Hein, O.K. Basoglu, M.S. Tasbakan, J. Buskova, P. Joppa, R. Staats, Dries Testelmans, Haralampos Gouveris, K. Ludwig, C. Lombardi, G. Parati, M.R. Bonsignore, Francesco Fanfulla, M. Drummond, M. van Zeller, W. Randerath, Marcel Treml, Z. Dogas, R. Pecotic, A. Pataka, S. Mihaicuta, U. Anttalainen, T. Saaresranta, P. Sliwinski, SALAS, Danielle, MIAI @ Grenoble Alpes - - MIAI2019 - ANR-19-P3IA-0003 - P3IA - VALID, University of Gothenburg (GU), Ege University [Izmir], University of Antwerp (UA), University of Crete [Heraklion] (UOC), Institute of Tuberculosis and Lung Diseases [Warsaw, Poland] (ITLD), Democritus University of Thrace (DUTH), Istituto Auxologico Italiano IRCCS Ospedale San Luca [Milan, Italy] (IAI), Sleep Disorders Center [Reinbeck, Germany] (SDC), Hypoxie et PhysioPathologie (HP2), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Grenoble Alpes (UGA), University College Dublin [Dublin] (UCD), ESADA collaborators: P Steiropoulos , J Verbraecken , E Petiet , Georgia Trakada , I Fietze , T Penzel , Ondrej Ludka , I Bouloukaki , S Schiza , W T McNicholas , S Ryan , R L Riha , J A Kvamme , L Grote , J Hedner , D Zou , Dirk Pevernagie , S Bailly , J L Pépin , R Tamisier , H Hein , O K Basoglu , M S Tasbakan , J Buskova , P Joppa , R Staats , Dries Testelmans , Haralampos Gouveris , K Ludwig , C Lombardi , G Parati , M R Bonsignore , Francesco Fanfulla , M Drummond , M van Zeller , W Randerath , Marcel Treml , Z Dogas , R Pecotic , A Pataka , S Mihaicuta , U Anttalainen , T Saaresranta , P Sliwinski, ANR-19-P3IA-0003,MIAI,MIAI @ Grenoble Alpes(2019), ESADA Collaborators, and Testelmans, D

Subjects
[SDV] Life Sciences [q-bio], [SDV]Life Sciences [q-bio], Human medicine, General Medicine
Abstract

Objective: Blood bicarbonate concentration plays an important role for obstructive sleep apnea (OSA) patients to maintain acid-base balance. We investigated the association between arterial standard bicarbonate ([HCO3-]) and nocturnal hypoxia as well as comorbid hypertension in OSA.Methods: A cross-sectional analysis of 3329 patients in the European Sleep Apnea Database (ESADA) was performed. Arterial blood gas analysis and lung function test were performed in conjunction with polysomnographic sleep studies. The 4% oxygen desaturation index (ODI), mean and minimum oxygen saturation (SpO2), and percentage of time with SpO2 below 90% (T90%) were used to reflect nocturnal hypoxic burden. Arterial hypertension was defined as a physician diagnosis of hypertension with ongoing antihypertensive medication. Hypertensive patients with SBP/DBP below or above 140/90 mmHg were classified as controlled-, uncontrolled hypertension, respectively.Results: The [HCO3-] level was normal in most patients (average 24.0 +/- 2.5 mmol/L). ODI, T90% increased whereas mean and minimum SpO2 decreased across [HCO3-] tertiles (ANOVA, p = 0.030

Published
2023

3. 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)

Author

Patrick Levy, Tarja Saaresranta, Renata L. Riha, G. Roisman, Mehmet Sezai Taşbakan, Ulla Anttalainen, Holger Hein, Sébastien Bailly, H. Hein, J.A. Kvamme, F. Barbé, Ding Zou, Silke Ryan, Johan Verbraecken, Pavol Joppa, Paschalis Steiropoulos, Jan Hedner, M. Petitjean, L. Ondrej, P. Steiropoulos, Martin Pretl, Walter T. McNicholas, Canan Gunduz, Piotr Bielicki, Thomas Penzel, E. Petiet, Ludger Grote, G. Varoneckas, P. Sliwinski, J. Verbraecken, O.K. Basoglu, A. Vitols, R. Staats, T. Galic, Izolde Bouloukaki, Athanasia Pataka, M. Drummond, Daniel Rodenstein, Gabriel Roisman, R. Plywaczewski, O. Marrone, Gianfranco Parati, Peretz Lavie, M. van Zeller, Lena Lavie, Carolina Lombardi, Zoran Dogas, J.M. Montserrat, Oreste Marrone, Sofia Schiza, J.F. Masa, R. Tkacova, Georgia Trakada, Marisa Bonsignore, Ozen K. Basoglu, P. Joppa, Rainer Schulz, John A. Kvamme, J.L. Pépin, G. Trakada, Brian D. Kent, Ingo Fietze, U. Anttalainen, European Sleep Apnea Database, UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie, UCL - (SLuc) Service de pneumologie, Gunduz C., Basoglu O.K., Kvamme J.A., Verbraecken J., Anttalainen U., Marrone O., Steiropoulos P., Roisman G., Joppa P., Hein H., Trakada G., Hedner J., Grote L., Petiet E., Montserrat J.M., Fietze I., Penzel T., Ondrej L., Rodenstein D., Masa J.F., Bouloukaki I., Schiza S., 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., Tasbakan M.S., Varoneckas G., Tkacova R., Staats R., Barbe F., Lombardi C., Parati G., Drummond M., van Zeller M., Bonsignore M.R., Petitjean M., Pretl M., Vitols A., Dogas Z., Galic T., Pataka A., Saaresranta T., Plywaczewski R., Sliwinski P., Bielicki P., Gunduz, C, Basoglu, O, Kvamme, J, Verbraecken, J, Anttalainen, U, Marrone, O, Steiropoulos, P, Roisman, G, Joppa, P, Hein, H, Trakada, G, Hedner, J, Grote, L, Petiet, E, Montserrat, J, Fietze, I, Penzel, T, Ludka, O, Rodenstein, D, Masa, J, Bouloukaki, I, Schiza, S, Kent, B, Mcnicholas, W, Ryan, S, Riha, R, Schulz, R, Zou, D, Pepin, J, Levy, P, Bailly, S, Lavie, L, Lavie, P, Tasbakan, M, Varoneckas, G, Tkacova, R, Staats, R, Barbe, F, Lombardi, C, Parati, G, Drummond, M, van Zeller, M, Bonsignore, M, Petitjean, M, Pretl, M, Vitols, A, Dogas, Z, Galic, T, Pataka, A, Saaresranta, T, Plywaczewski, R, Sliwinski, P, Bielicki, P, and Ege Üniversitesi

Subjects
cardiovascular risk, Adult, Male, medicine.medical_specialty, Settore MED/10 - Malattie Dell'Apparato Respiratorio, Positive airway pressure, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Cardiovascular risk, Cholesterol, Hypoxia, Sleep apnea, Humans, positive airway pressure, Prospective Studies, Risk factor, Prospective cohort study, Hypoxia, Aged, Sleep Apnea, Obstructive, Framingham Risk Score, Continuous Positive Airway Pressure, business.industry, hypoxia, Sleep apnea, cholesterol, General Medicine, Middle Aged, medicine.disease, sleep apnea, Cardiovascular risk, Obstructive sleep apnea, Cholesterol, 030228 respiratory system, Patient Compliance, Female, Human medicine, business, Body mass index, 030217 neurology & neurosurgery, Dyslipidemia
Abstract

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 compliance, and treatment duration) were used to compare changes in TC concentration. Incident risk for a coronary heart disease event (CHD) was used to compute a Framingham CHD risk score (estimated from age, BMI, blood pressure, and TC). Results: Adjusted means of TC decreased from 194.2 mg/dl to 189.3 mg/dl during follow-up (p = 0.019). A clinically significant (10%) reduction of TC at PAP follow-up was observed in 422 patients (27%). Duration of PAP therapy was identified as independent predictor for TC reduction, which implies an approximately 10% risk reduction for incident CHD events (from 26.7% to 24.1% in men and from 11.2% to 10.1% in women, p < 0.001 respectively). Conclusion: This observational study demonstrates a reduction of TC after long-term PAP treatment. The close association between TC concentration and cardiovascular (CV) mortality suggests that identification and treatment of OSA may have a beneficial effect on overall CV risk due to this mechanism. This possibility needs to be evaluated in prospective randomized studies. © 2020 Elsevier B.V., ResMed Foundation European Respiratory Society, ERS European Respiratory Society, ERS European Respiratory Society, ERS, The ESADA network has received support from the European Union COST action B26 and the European Respiratory Society (ERS) funded Clinical Research Collaboration (CRC). Unrestricted seeding grants from the ResMed Foundation and the Philips Respironics Foundation for establishment of the database in 2007 and 2011 are gratefully acknowledged. The ESADA network has a scientific collaboration with Bayer AG., Nonfinancial support was provided by the European Sleep Research Society (ESRS) and the European Respiratory Society (ERS) in terms of logistics for communication, meetings and data presentations for the ESADA collaborators., Dr. Verbraecken reports grants and personal fees from ResMed, Bioprojet, Jazz Pharmaceutics; personal fees from Philips, Sanofi, Agfa-Gevaert, grants from AirLiquide; personal fees from Springer, Westfalen Medical, SomnoMed, Vivisol, Total Care, Medidis, Fisher & Paykel, Wave Medical, OSG, Mediq Tefa, NightBalance, Heinen & Löwenstein, AstraZen, Accuramed, Bekaert Deslee Academy and UCB Pharma, outside the submitted work. Dr. Hedner reports grants from ResMed, Philips Respironics, and the European Respiratory Society all related to maintenance of database on behalf of the ESADA group during the conduct of the study. Dr. Grote reports grants from Bayer, Resmed, Respironics/Philips, and from the European Respiratory Society during the conduct of the study; non-financial support and other from Itamar Medical, Resmed, Philips, and Astra Zeneca, outside the submitted work. In addition, Dr. Grote has a patent on sleep apnea therapy licensed. The remaining co-authors have no conflict of interest to declare.

Published
2020

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

Author

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

Subjects
Adult, Male, Databases, Factual, Polysomnography, Disease, Comorbidity, computer.software_genre, Severity of Illness Index, Comorbidities, 03 medical and health sciences, 0302 clinical medicine, Age, health services administration, mental disorders, Diagnosis, medicine, Humans, Prospective Studies, Disease severity, Aged, Sleep Apnea, Obstructive, Database, medicine.diagnostic_test, business.industry, Epworth Sleepiness Scale, Sleep apnea, Apnea, Gender, General Medicine, Anthropometry, Middle Aged, medicine.disease, ta3124, humanities, respiratory tract diseases, Obstructive sleep apnea, 030228 respiratory system, Clinical Global Impression, Female, Human medicine, Comorbiditie, medicine.symptom, business, computer, 030217 neurology & neurosurgery, Diagnosi
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 sub-population, 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

Published
2019

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