Sleep Apnea in Caucasian and Asian Climacteric Women

The aim of our study was to define the structure of sleep in Caucasian and Asian peri- and postmenopausal women with sleep apnea. Materials and Methods: Two hundred and forty-seven menopausal women between 45 and 60 years of age participated in this study. The participants were divided into 2 ethnic groups, taking into account the genealogy (the representatives having in two generations of parents of one ethnic group) and self-identification, taking into account phenotype elements. Caucasians were represented by the Russian ethnic group (n=115) and Asians by the Buryat ethnic group (n=132). The study included the collection of anamnestic data, physical examinations, clinical (Berlin questionnaire, general medical examination, gynecological examination, polysomnographic monitoring according to American Academy of Sleep Medicine recommendations), and biochemical laboratory methods. Results: Sleep complaints, such as difficulty falling asleep, frequent night awakenings (more than 2 times), difficulties of morning awakening or problems waking up too early, were increased in perimenopausal Caucasian women. We found ethnic differences in a greater frequency of complaints in Caucasian women, but Asian women also showed a tendency to increased complaints about poor sleep. Polysomnographic monitoring revealed that OSA was more common in Asian postmenopausal women than in Caucasians. However, in structure of sleep we have not seen distinctions. Conclusion: For improving the quality of life, it is necessary not only to pay attention to menopausal problems, but also to solve the sleep problems associated with various strategies, both age management and lifestyle

Obstructive Sleep Apnea and Hypertension in Adolescents: Effect on Neurobehavioral and Cognitive Functioning

Background. There are limited published data in regard to the relationship between obstructive sleep apnea (OSA) and hypertension and neurobehavioral and mental status in adolescence. The aim of our study was to evaluate neurobehavioral patterns and cognitive functions in adolescents with hypertension according to absence or presence of OSA. Methods. This was a retrospective cohort study completed at the Scientific Center for Family Health and Human Reproduction Problems. Participants included adolescents aged 14–17 years and referred for 24-hour ambulance blood pressure monitoring (ABPM) and polysomnographic (PSG) studies between 2007 and 2009, inclusive. Results. 18 hypertensive OSA (the 1st group) and 20 hypertensive non-OSA adolescents (the 2nd group) were included in the study. Significant changes of neurobehavioral functioning in OSA patients were shown. Cognitive abilities also were impaired. Verbal and visual memory indexes and attention index were 2.1 and 2.2 times lower, accordingly, in the 1st group than in the 2nd group (P<0.05). Speech index was significantly 2.8 times lower in OSA patients than in non-OSA patients (P<0.05). In hypertensive OSA adolescents more significant Spearman correlations between classic sleep parameters and cognitive measures were found compared to patients without OSA. Conclusions. These results suggest that OSA is closely associated with neurobehavioral and cognitive functioning in hypertensive adolescents

CLOCK 3111TT Genotype Is Associated with Increased Total Cholesterol and Low-Density Lipoprotein Levels in Menopausal Women with a Body Mass Index of at Least 25 kg/m2

Lipid profile comparative analysis was performed to reveal the interdependence of lipids with Circadian locomoter output cycles protein kaput (CLOCK) 3111T/C gene polymorphism in menopausal women with/without a body mass index (BMI) of &ge;25 kg/m2. Methods: A total of 193 female volunteers aged 45 to 60 years were divided into two groups: Those with BMI &lt; 25 kg/m2 (control) and those with BMI &ge; 25 kg/m2. Each group was then divided into two subgroups: Those with the CLOCK TT-genotype and those with the CLOCK TC-, CC-genotypes. Lipid metabolism parameters were determined by the enzymatic method. Single-nucleotide polymorphisms (SNPs) were detected via polymerase chain reaction&ndash;restriction fragment length polymorphism technology. Results: There were no differences in CLOCK 3111T/C genotypes or allele frequency between the control and main groups. In addition, there were no differences in lipid profile parameters between women of the control group and different CLOCK 3111T/C genotypes. The total cholesterol (p = 0.041) and low-density lipoprotein cholesterol (p = 0.036) levels were higher in the subgroup of women with a BMI &ge; 25 kg/m2 and CLOCK TT-genotype as compared to the subgroup with a BMI &ge; 25 kg/m2 and minor allele 3111C. Conclusions: SNP 3111T/C of the CLOCK gene is not associated with BMI however, data suggest that the minor allele of the CLOCK 3111T/C gene polymorphism may have a protective role in atherogenic lipid levels in women with a BMI greater than or equal to 25 kg/m2

Sleep EEG oscillation associations with plasma amyloid-β42 in apneic adolescents: a cross section study

Obstructive sleep apnea (OSA) is very serious and multifactorial sleep disorder in both adults and children. Growing evidence suggests some pathophysiological links between OSA and cognitive decline or Alzheimer's disease (AD). Based on associations between sleep homeostasis alteration in OSA and cognition, here we evaluated potential relationships between plasma Aβ42 levels with biophysical properties of slow wave sleep (SWS) and sleep spindles (SSs) in adolescent samples which different in weight and the presence of OSA. One-night in-lab polysomnography and morning blood collection were performed to estimate sleep EEG oscillation patterns and measure plasma Aβ42 levels. SWS was significantly negatively correlated with plasma Aβ42 in OSA patients only (with and without obesity). Despite a significant association between all SSs parameters and Aβ levels in both obese group (OSA + and OSA−) stronger correlations were observed in obese OSA + patients. So, spindle number, density and duration were positively correlated with Aβ42 levels, and spindle amplitude and frequency were negatively correlated with they. There was only one strong positive correlation between plasma amyloid and spindle number in the OSA non-obese adolescents. Altered SW and spindles activity during sleep in OSA may represent an early dysfunction related to amyloid, possibly reflecting brain damage through hypoxia and metabolic stress, or increased amyloid secretion and reduced Aβ clearance. So, SWA and SSs play important role in neuroplasticity and memory consolidation and they may represent a putative mechanism by which amyloid impairs cognition, as well as rendering it potentially new biomarkers for early neuronal dysfunction in young age

Association of nocturnal intermittent hypoxia with heat shock protein 70 in patients with obstructive sleep apnea: a pilot study

Introduction — Nocturnal intermittent hypoxia in obstructive sleep apnea (OSA) causes cellular stress and consequent change in inducible heat shock protein 70 (HSP70) level. Thus, the objective of this study was to determine the relationship among nocturnal hypoxia and the serum HSP70 level in patients with severe OSA. Material and Methods — The study involved 34 patients with a clinical diagnosis of moderate to severe OSA (24 men and 10 women). Patients without OSA (10 men and 5 women) were included as a control group. The groups were similar in age. The polysomnographic monitoring was carried by standart methodology. Blood sampling for determining the HSP70 level was carried out between 8:00 and 9:00 am after polysomnographic monitoring. Results — The results of this study demonstrated a high apnea/hypopnea index (AHI), which determined the OSA severity and decreased the blood oxygen saturation (SaO2) (p<0.05). Sleep fragmentation in OSA patients confirmed an increase in respiratory arousal index (ArI). The HSP70 level significantly increased in OSA patients compared with the control group. Correlation analysis showed a positive relationship between HSP70 and AHI (R=0.5) in patients with OSAS, as well as a negative relationship between HSP70 and SaO2 (R=-0.3). Conclusion — Our results demonstrated a high level of HSP70 in patients with severe OSA syndrome vs. those without it. In OSA patients, a direct correlation was found between the HSP70 level and AHI, as well as an inverse correlation between the AHI level and SaO2. These findings suggested an association between the level of inducible HSP70 and nocturnal hypoxia in OSA patients

Circadian Rhythms of Melatonin Secretion in Peri- and Postmenopausal Women with Insomnia

The aim of this study was to assess complaints about sleep quality and to investigate circadian rhythms of melatonin secretion in peri- and postmenopausal women. Material and Methods: A total of 146 climacteric women were examined. All patients were divided into 2 groups: Group1 included 72 perimenopausal women and Group 2 included 74 postmenopausal women. Women were surveyed with special questionnaires: PSQI, FFS, ESS, Daytime Feeling and Functioning Scale. Insomnia Severity Index was calculated. Salivary melatonin content was determined (4 times a day) by immunoassay using Microplate Reader EL×808 (USA). Results: Perimenopausal women often complained about difficulties falling asleep (more than 20 minutes from the moment the light was turned off) and difficulties awakening in the morning, while postmenopausal women often complained about snoring and frequent awakenings during sleep(≥2 times). ISI was 21.3±0.54 in Group 1 and 24.8±0.31 in Group 2, which corresponded to insomnia. Daily melatonin secretion in perimenopausal patients with insomnia was altered – the maximal level was registered in the morning hours. The circadian rhythms of melatonin secretion in the group of postmenopausal women did not correlate to the occurrence of insomnia. Conclusion: We can recommend administration of melatonin in the evening time and light therapy in the early morning hours in the complex treatment of SDs in perimenopausal women for normalizing and shifting the chronobiological rhythms of melatonin secretion, and specific therapy is aimed to eliminate snoring for postmenopausal women

Circadian melatonin secretion in obese adolescents with or without obstructive sleep apnea

Objective — To compare melatonin levels in saliva during a 24-hr day in order to identify the specificities of circadian melatonin secretion in obese adolescents with or without obstructive sleep apnea (OSA). Material and Methods — We examined 18 obese adolescents with OSA, 12 obese adolescents without OSA, and 15 healthy adolescents with a normal body weight, from whom saliva was sampled four time during the 24-hr day. Polysomnography was used to diagnose OSA. Saliva samples (n=180) were subjected to enzyme-linked immunosorbent assay. Results — Obese adolescents with OSA had higher evening melatonin levels than obese adolescents without OSA. For example, this indicator in OSA patients was 5.3 times higher than in participants without OSA, who had the lowest evening melatonin level among all groups. In both obese groups, nighttime melatonin levels were significantly lower than in the control group. A positive correlation was detected between the levels of morning and afternoon melatonin and body mass index only in obese adolescents without OSA (r=0.58; p=0.03 and r=0.68; p=0.01, respectively). It was found that evening melatonin correlated with minimum blood oxygen saturation (SaO2) in the entire sample of adolescents with OSA (r=-0.69; p=0.008), and it also correlated with time with SaO2 <90% in the group with clinical manifestations of OSA (r=0.76; p=0.003). Nighttime melatonin levels negatively correlated with the minimum SaO2 value solely in the group with clinical manifestations of OSA (r=-0.58; p=0.035). Conclusion — The circadian melatonin secretion in obese adolescents differed, depending on the presence or absence of OSA, and correlated with the level of oxygen desaturation in OSA patients, to a greater extent – in the presence of clinical manifestations

Синдром обструктивного апноэ сна: ассоциация уровня сывороточного мелатонина, повышенной дневной сонливости и интермиттирующей ночной гипоксемии

The relevance of studies related to the features of respiratory disorders during sleep is undeniable due to the steady growth of the worldwide prevalence of apnea syndrome, which leads to a decrease in quality of life, the risk of early cardiovascular diseases together with cerebrovascular, endocrine, and pulmonary disorders.The aim of this study was to determine the relationship between the morning serum melatonin, blood oxygen saturation (SрO2), and increased daytime sleepiness in patients with SOAS, as well as to assess changes in the production of endogenous melatonin after eliminating clinical manifestations of nocturnal hypoxemia, through a 3-month course of non-invasive continuous positive airway pressure (CPAP) therapy. The study enrolled 30 male patients who came to the Federal State Public Scientific Institution “Scientific Centre of Family Health and Human Reproduction Problems” because of snoring, sleep apnea, and increased daytime sleepiness.Methods. Polysomnography, questionnaire, HPLC-MS/MS analysis of serum melatonin levels, CPAP-therapy for the respiratory support at home for 3 months, monitoring of the sleep scores, serum melatonin, and daytime sleepiness after the treatment.Results. A comparative assessment of the sleep scores before and after the respiratory support for 3 months revealed a significant improvement in sleep structure, elimination of the apnea episodes, and restoration of blood SрO2 after the therapy. Analysis of the serum melatonin vales confirmed a statistically significant increase of melatonin level against baseline in patients with SOAS after the treatment. A correlation analysis showed a relationship between the melatonin level, daytime sleepiness, and blood SрO2.Conclusion. The results of this study and the data of other researchers demonstrate that the elimination of intermittent nocturnal hypoxia in patients with SOAS allows reducing the morning serum melatonin level, thereby reducing the daytime sleepiness and subsequently improving the quality of life.Актуальность исследований, связанных с особенностями нарушений дыхания во время сна, неоспорима в связи с неуклонным ростом числа случаев синдрома обструктивного апноэ сна (СОАС) в мире, который приводит к снижению качества жизни, риску раннего формирования сердечно-сосудистых заболеваний с развитием цереброваскулярных, эндокринных и бронхолегочных нарушений.Целью исследования явилось определение взаимосвязи утреннего сывороточного мелатонина (СМ), уровня насыщения артериальной крови кислородом (SрO2) во время сна и повышенной дневной сонливости у пациентов с СОАС, а также оценка изменений продукции эндогенного мелатонина после устранения ночной гипоксемии посредством 3-месячного курса респираторной поддержки во время сна в режиме неинвазивной вентиляции легких с постоянным положительным давлением в дыхательных путях (Continuous Positive Airway Pressure — СРАР).Материалы и методы. В исследовании принимали участие пациенты (n = 30) мужского пола, обратившиеся в Иркутский сомнологический центр Федерального государственного бюджетного научного учреждения «Научный центр проблем здоровья семьи и репродукции человека» с жалобами на храп, остановку дыхания во время сна, повышенную дневную сонливость. Проводились полисомнографическое исследование, анкетирование, исследование СМ с помощью высокоэффективной жидкостной хроматографии, респираторная поддержка во время сна в домашних условиях посредством СРАР в течение 3 мес., контроль показателей сна, СМ и оценка дневной сонливости после лечения.Результаты. При проведении сравнительной оценки показателей сна до и после респираторной поддержки во время сна в течение 3 мес. значительно улучшилась структура сна, прекратились эпизоды апноэ и восстановился уровень SрO2 на фоне терапии. При сравнении полученных результатов показателей СМ выявлено статистически достоверное увеличение уровня СМ у пациентов с СОАС в сравнении результатами после лечения По результатам корреляционного анализа выявлена взаимосвязь между уровнем СМ, дневной сонливостью и SрO2.Заключение. На основании полученных результатов и данных других исследований сделано заключение о том, что при устранении ночной интермиттирующей гипоксемии у пациентов с СОАС уменьшаются уровень утреннего СМ и дневная сонливость с последующим улучшением качества жизни