Roles of hypertension and serum leptin in obstructive sleep apnea hypopnea syndrome / 中国医学科学院学报

<p><b>OBJECTIVE</b>To explore the roles of hypertension and serum leptin in obstructive sleep apnea hypopnea syndrome (OSAHS).</p><p><b>METHODS</b>Totally 60 patients with OSAHS (OSAHS group) and 40 age- and body mass index (BMI)-matched non-OSAHS individuals (non-OSAHS group) were enrolled in this study. The neck circumference (NC), waist/hip rate (WHR), systolic blood pressure (SBP), diastolic blood pressure (DBP), leptin, fasting blood glucose (FBG), triglyceral (TG), cholesterol (Chol), and true insulin (TI) were measured before and after sleep . The correlations between hypertension/serum leptin level and OSAHS were analyzed.</p><p><b>RESULTS</b>The blood pressure(in the morning), especially DBP was significantly higher in OSAHS group than in non-OSAHS control group (89.75+/-2.04) mmHg vs. (81.63+/-1.91) mmHg, P<0.01. DBP in OSAHS group was positively correlated with serum leptin and apnea hypopnea index (AHI) (r=0.282, P<0.05; r=0.318, P<0.01). Logistic regression analysis showed that BMI (P=0.029), heart rate in the morning (P =0.030), and leptin (P=0.049) were independently correlated with the development of hypertension.</p><p><b>CONCLUSIONS</b>OSAHS may independently affect blood pressure, especially DBP, after waking up. BMIHR in the morning and serum leptin may be the independent correlates of hypertension.</p>

Cognitive and emotional impairment in obstructive sleep apnea syndrome / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To evaluate the emotional and cognitive status in patients with obstructive sleep apnea syndrome (OSAS), using neuropsychological tests and evoked-related potential (P3).</p><p><b>METHODS</b>Sixteen patients diagnosed of OSAS were tested by Hamilton rating scale for anxiety (HRSA) and Hamilton rating scale for depression (HRSD). Other three groups, OSAS patient group (n = 21), snoring group (n = 21), and control group (n = 21), were administered polysomnography (PSG), auditory evoked event-related potential (P3), and clinic memory test. The results were analyzed using general linear model (GLM) analysis and Post Hoc test.</p><p><b>RESULTS</b>Twelve OSAS patients' scores of HRSA and HRSD were beyond the normal range, 26.42 +/- 4.48 and 22.08 +/- 3.97 respectively. The auditory P3 latency in OSAS group was 363.1 +/- 22.9 ms (Fz), 368.57 +/- 28.03 ms (Cz), in snoring group 336.57 +/- 31.08 ms (Fz), 339.81 +/- 31.76 ms (Cz), in control group 340.8 +/- 28.7 ms (Fz), 338.29 +/- 29.21 ms (Cz). There were significant differences between OSAS group and snoring group, as well as control group (P < 0.05). No significant difference was seen between snoring group and control group. No significant difference was noted in P3 amplitude among three groups. Memory quotient (MQ) reduced in snoring group compared with control group.</p><p><b>CONCLUSIONS</b>Emotional disturbances are common clinical features in OSAS patients. Abnormal auditory P3 latency indicates the cognitive dysfunction in OSAS patients. Nocturnal hypoxaemia may play an important role on it. Snorers should be monitored because of the tendency to develop cognitive impairment.</p>

Effects of nasal continuous positive airway pressure on serum leptin concentration and the metabolic parameters in obstructive sleep apnea hypopnea syndrome / 中国医学科学院学报

<p><b>OBJECTIVE</b>To evaluate the effects of nasal continuous positive airway pressure (nCPAP) on serum leptin concentration and the metabolic parameters in patients with obstructive sleep apnea/hypopnea syndrome (OSAHS).</p><p><b>METHODS</b>Serum leptin levels and true insulin (TI) levels were measured before and after one night nCPAP therapy in 18 patients. Eight patients received regular nCPAP treatment and had no change of body weight (BMI change < or = 1.5 kg/m2 from baseline) were recruited to the reassessment study 7.5 months after therapy.</p><p><b>RESULTS</b>After one night use of nCPAP, there was a significant decrease in serum leptin [(8.47 +/- 0.62) microg/L vs (7.32 +/- 0.64) microg/L, P = 0.022] without change in other parameters. After 7.5 months of nCPAP treatment, serum leptin levels continued to decrease significantly without changes in BMI [(8.35 +/- 0.83) microg/L vs (6.05 +/- 0.78) microg/L; P = 0.036), and fast blood glucose (FBG) and true insulin (TI) also decreased significantly (P = 0.036) in OSAHS patients. However, triglyceral (TG) and cholesterol (Chol) maintained the pretreatment level (P > 0.05).</p><p><b>CONCLUSIONS</b>OSAHS may have significant effects on the serum leptin levels and the correction of sleep disordered breathing by nCPAP can reduce the serum leptin levels. Decrease of leptin was independent of BMI change. The glucose metabolic disturbance and insulin resistance in OSAHS were improved after 7.5 months of nCPAP treatment.</p>

The relationship between the changes of upper airway and genioglossus muscle activity after the treatment with Snoreguard / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the relationship between the changes of upper airway and genioglossus muscle activity after the treatment with Snoreguard.</p><p><b>METHODS</b>31 patients with OSAS or snoring were treated with Snoreguard Cephalometric analysis was carried out to compare the changes of the upper airway before and after the treatment. The relationship between the change in morphology and that of genioglossus muscle activity among 22 patients was investigated.</p><p><b>RESULTS</b>(1) The size of upper airway decreased significantly with Snoreguard. SPP-SPPW increased from (9.14 +/- 3.79) mm to (12.36 +/- 3.74) mm and TB-TPPW increased from (10.63 +/- 3.71) mm to (11.90 +/- 4.33) mm. UC-LC decreased from (21.96 +/- 11.06) mm to (10.48 +/- 8.55) mm and H-MP decreased from (20.60 +/- 6.65) mm to (11.01 +/- 6.84) mm. (2) The size of upper airway in part of the patients decreased with Snoreguard, but good treatment efficiency remained.</p><p><b>CONCLUSION</b>The mechanism of Snoreguard is caused by the mechanical enlargement of upper airway.</p>

Relationship of changes in sleep architecture and cognitive function in patients with obstructive sleep apnea syndrome / 中国医学科学院学报

<p><b>OBJECTIVES</b>To explore the relationship between sleep architecture changes and cognitive impairment in patients with obstructive sleep apnea syndrome (OSAS).</p><p><b>METHODS</b>Thirty-six patients with OSAS and 18 controls were administered polysomnography and neuropsychological tests of visual regeneration, digital symbol, comprehensive memory and digital span.</p><p><b>RESULTS</b>Performances on the visual regeneration test and digital symbol test in patients with OSAS were impaired significantly compared with the control group (P < 0.01). Patients' performance on the visual regeneration test was significantly associated with slow wave sleep duration (r = 0.423, P < 0.05) and that on the digital symbol test was significantly associated with REM sleep duration (r = 0.378, P < 0.05).</p><p><b>CONCLUSIONS</b>Slow wave sleep and REM sleep derivation may play a role in the cognitive impairment in patients with OSAS.</p>