Objective To investigate the changes in mitochondrial morphology, structure and function in rats with severe intermittent hypoxia, as well as the effects of intermittent hypoxia and its severity on cognitive function. Methods A total of 18 rats were selected to construct a model of severe intermittent hypoxia, which were divided into a normal control group, an intermittent air control group, and a 5% intermittent hypoxia group for 8 weeks, with 6 rats in each group. The structural and functional changes of mitochondria in the hippocampal CA1 region were observed. A total of 30 rats were randomly divided into 5 groups: a normal control group, an intermittent air control group, a 5% intermittent hypoxia 4-week group, a 5% intermittent hypoxia 6-week group, and a 5% intermittent hypoxia 8-week group, with 6 rats in each group. The cognitive function of the rats in each group was evaluated by Morris water maze experiment. Results In the mitochondria of the hippocampal CA1 region of severely intermittent hypoxic rats, bilayer membranes or multilayer membranes were visible, the mitochondria were swollen, cristae were broken and vacuolated, and their respiratory function was significantly weakened, the membrane permeability was increased, and the membrane potential was reduced. In the Morris water maze, there was no significant difference in swimming speed between the rats. With the prolongation of intermittent hypoxia action time, the latency of finding the hidden platform in each group of rats increased significantly, and the residence time of the target quadrant decreased significantly. Conclusions Mitochondrial structure in the hippocampal CA1 region of the rat brain is destroyed during severe intermittent hypoxia, and dysfunction and cognitive impairment occur. With the prolongation of intermittent hypoxic injury, the degree of cognitive impairment worsens.
Objective To investigate the differences in clinical characteristics and polysomnographic characteristics between the elderly obstructive sleep apnea-hypopnea syndrome ( OSAHS) patients and the young and middle-aged OSAHS patients. Methods The clinical manifestations and the polysomnographic characteristics of 37 elderly OSAHS patients and 294 young and middle-aged patients were analyzed. The differences in polysomnographic indicators between two groups were compared according to the body mass index.Results The nocturia frequency in the elderly OSAHS patients was higher( P =0. 01) ,however, the othert clinical manifestations between the elderly group and the young and middle-aged group were not different significantly. The elderly group had a lower body mass index ( P =0. 018) , a smaller neck circumference ( P =0. 003) , and a larger chance of diabetes ( P = 0. 001) and hypertension( P lt; 0. 001) .The phase Ⅰ and phase Ⅱ sleep of the elderly group took a longer duration ( P lt; 0. 001) and a larger proportion( P lt;0. 001) . The sleep apnea-hypopnea index between two groups did not show any significant difference( P =0. 082) . The lowest night oxyhemoglobin saturation of the elderly group was higher than that of the young and middle-aged group( P =0. 009) , but such difference disappeared after adjustment by weight ( P =0. 114) . Conclusions The major clinical manifestations of the elderly OSAHS patients are similar to the young and middle-aged patients. The elderly patients are thinner than the young and middle-aged patients, but have more complications and a higher frequency of nocturia. The night oxyhemoglobin saturation is lower in young and middle-aged patients which is associated with higher body mass index.
Objective To investigate the changes and clinical relationship of plasma adrenomedullin( ADM) , atrial natriuretic polypeptide( ANP) , and heart rate variability( HRV) in patients with obstructive sleep apnea-hypopnea syndrome ( OSAHS) . Methods Seventy-five inpatients with OSAHS were enrolled in this study. According to the apnea hypopnea index ( AHI) by polysomnography, the subjects were divided into a mild group, a moderate group, and a severe group. Meanwhile, HRV was screened bydynamic electrocardiogram in sleep laboratory. HRV parameters were obtained including LF ( low frequency power) , HF( high frequency power) , pNN50( percentage of NN50 in the total number of N-N intervals) ,SDNN( standard deviation of the N-N intervals) , rMSSD( square root of the mean squared differences of successive N-N intervals ) . Plasma levels of ADM/ANP were measured by radioimmunoassay. Results The levels of SDNN ( P lt;0. 05) , rMSSD, pNN50, LF ( P lt; 0. 05) and HF were gradually reduced, and the levels of ADM ( P lt;0. 05) and ANP ( P lt; 0. 05) were increased with increasing severity of OSAHS. Linear correlation analysis demonstrated that SDNN was negatively correlated with ADM( r = - 0. 423, P lt;0. 05)and ANP( r = - 0. 452, P lt; 0. 05) , and LF was also negatively correlated with ADM( r = - 0. 348, P lt;0. 05) . Conclusion Lower HRV is associated with more sever OSAHS, and it may be modulated neurohumorally by ADM and ANP.
Objective To investigate the implication of oxidation protein product ( advanced oxidation protein product, AOPP) , an index of oxidative stress in obstructive sleep apnea-hypopnea syndrome ( OSAHS) . Methods 47 patients with OSAHS and 48 normal controls were enrolled. The concentration of AOPP was measured by spextrophotometry after ameliorated, while superoxide ( SOD) , malonaldehyde ( MDA) , glutathione peroxidase ( GSH-PX) in morning blood samples were detected by Xanthine oxidase test. Results ( 1) Plasma AOPP and MDA were significantly elevated in OSAHS compared with those in control group ( both P lt;0. 01) . Plasma SOD and GSH-PX were significantly lower in OSAHS compared with those in control group ( both P lt;0. 01) . There were significant differences in the plasma AOPP, MDA, SODand GSH-PX among different severity of OSAHS ( all P lt; 0. 01) . Plasma AOPP and MDA were increased and SOD and GSH-PX were gradually decreased with the progression of OSAHS. ( 2) Plasma AOPP correlated well with MDA, SOD and GSH-PX, moreover, AOPP was positively correlated with apnea hyponea index or lowest oxygen saturation. Conclusion AOPP is an alternative index reflecting both oxidative streess and tissue injury in patients with OSAHS.
Objective To investigate the role of red cell distribution width ( RDW) in coronary artery diseases patients complicated with obstructive sleep apnea-hypopnea syndrome ( OSAHS) . Methods 134 coronary artery diseases patients who had at least one-vessel disease confirmed by coronary angiography were investigated by polysomnography for OSAHS. The patients were classified according to theapneahypopnea index(AHI) . The level of RDW, triglyceride, cholesterol, high density lipoprotein, low density lipoprotein, hemoglobin, white blood cells and hematocritwere measured. The receiver operating characteristic curve was drawn to predict the moderate-severe OSAHS in coronary artery diseases patients according to RDW value. Results When 134 coronary artery diseases patients were classified into a control group and an OSAHS group according to the AHI, the level of RDW in two groups was not significantly different [ ( 13.44 ±1.30) % vs. ( 13.12 ±0.92) % , P gt; 0.05] . When 134 coronary artery diseases patients were classified into a control and mild OSAHS group and a moderate-severe OSAHS group according to the AHI, the level of RDW in two groups was significantly different [ ( 13.07 ±0.94) vs. ( 14.02 ±1.41) % , P lt; 0.05] . And no difference was found in hemoglobin, triglyceride, cholesterol, high density lipoprotein, low density lipoprotein, platelet, and hematocrit between two groups. The ROC curve analysis revealed that the area under ROC curve was 0.748 ( 0.523-0.972) , and the best cut-off for moderate-severe OSAHS was 13.95% with sensitivity of 71.43% and specificity of 82.98% . Conclusion RDW may be a useful and simple tool to predict moderate-severe OSAHS in coronary artery diseases patients.
Objective To investigate the changes of steps walks daily in patients with obstructive sleep apnea-hypopnea syndrome ( OSAHS) before and after the initiation of nasal continuous positive airway pressure ( nCPAP) ventilation. Methods 62 patients diagnosed by polysomnogaphy ( PSG) in the sleep respiratory disease center of Nanjing FirstHospital Affiliated to Nanjing Medical University were recruited as the OSAHS group, and divided into mild,moderate, and severe subgroups according to apnea-hypopnea index ( AHI) .28 subjects without OSAHS were recruited as the control group. All the subjects were evaluated by Epworth Sleepiness Scale ( ESS) and Functional Outcomes of Sleep Questionnaire ( FOSQ) . Steps walked daily were measured by electronic pedometer.10 patients with moderate and severe OSAHS were treated with nCPAP. Results Compared with the control group and the mild OSAHS patients, ESS scores were significantly higher while FOSQ scores and steps walked daily were significantly lower in the moderate and severe OSAHS patients ( P lt; 0. 05) . In the OSAHS patients, steps walked daily were correlated positively with FOSQ scores but negatively with BMI, ESS scores, AHI, oxygen desaturation index ( ODI) and saturation impair time below 90% ( SIT90) ( P lt; 0.05) . After one month of nCPAP therapy, ESS scores were significantly decreased, FOSQ scores and steps walked daily were significantly increased (Plt;0.05) . Conclusions Increased OSAHS severity is associated with decreased steps walked daily which is an objective index of routine physical activity. Untreated OSAHS may negatively impact the patients’ability to have an active lifestyle. nCPAP therapy can significantly improve steps walks daily of patients with OSAHS.
Objective To evaluate the effectiveness of oral appliance (OA) vs. continuous positive airway pressure (CPAP) in treating patients with mild to moderate obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods The following databases including PubMed, EMbase, The Cochrane Library, CBM, VIP, WanFang data and CNKI were searched from inception to November 30, 2012 to collect the randomized controlled trials (RCTs) on OA vs. CPAP in treating OSAHS. The relevant conference proceedings were also retrieved without limitation of type and publication time. In accordance with the inclusion and exclusion criteria, two reviewers independently screened studies, extracted data, and evaluated quality. And then meta-analysis was performed using RevMan 5.1 software. Besides, the level of evidence was graded using GRADEpro 3.6 software. Results A total of 7 RCTs were included. The results of meta-analysis showed that: a) compared with OA, CPAP significantly reduced the degree of apnea-hypopnea index (AHI) (WMD=9.13, 95%CI 8.77 to 9.50, Plt;0.000 01); and b) there was no significant difference in the Epworth sleeping scale (ESS) between OA and CPAP (WMD=0.00, 95%CI −0.12 to 0.12, P=0.97). Conclusion Compared with OA, CPAP takes remarkable effects in improving AHI for mild to moderate OSAHS, but it shows no significant difference in improving ESS. For the quality and quantity limitation of the included studies, this conclusion still needs to be proved by conducting more high quality RCTs.
Objective To study the relationships among health-related quality of life( HRQL) ,social support, excessive daytime sleepiness ( EDS) and PSG parameters in patients with obstructive sleep apnea-hypopnea syndrome ( OSAHS) . Methods Eighty-five patients were recruited who were diagnosed as OSAHS by overnight polysomnography from August 2007 through November 2007 in West China Hospital.The Calgary sleep apnea quality of life index ( SAQLI) was used for HRQL, social support rating scale ( SSRS) was used for social support, and Epworth sleepiness scale( ESS) was used for EDS. The Pearson linear correlation and stepwise multiple regression analysis were used to analyze the correlation among SAQLI, SSRS, ESS, and PSG. Results The SAQLI was correlated with SSRS score ( r =0. 402, P lt;0. 01) ;ESS score ( r = - 0. 505, P lt;0. 01) ; apnea-hypopnea index ( AHI) ( r = - 0. 269, P lt; 0. 05) and lowest artery oxygen saturation ( LSaO2) ( r = 0. 226, P lt; 0. 05) . Stepwise multiple regression analysis determined two variables, the SSRS and ESS score, as independent factors for predicting the total score of SAQLI which accounted for 37. 3% of the total variance in the total score on SAQLI ( R2 = 0. 373, P lt; 0.001) .Conclusions The HRQL of patients with OSAHS was correlated with the SSRS score, ESS score and PSG parameters. The former two were the more important factors to affect the HRQL of patients with OSAHS.
Objective To investigate the clinical efficacy and safety of coblation-assisted adenotonsillectomy for treatment of children with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods From June 2007 to May 2008, after monitoring polysomnography (PSG) confirmed 82 cases of OSAHS in children aged 3 to 14 years, with an average age of 6.2 years old, the ENT CoblatorII surgical instrument made by Arthrocare in the US and one-time EVac 70 T amp; A segment was used under complete anesthesia to remove tonsils and(or)adenoid ablation. Polysomnography monitoring was used preoperatively and 6 months postoperatively to determine the therapeutic effect. Results No significant complications occurred among the children both during the operation and postoperatively. Patients were followed for 6 months, and a satisfactory effect was achieved. The lowest oxygen saturation (LSaO2) improved significantly (Plt;0.001); the apnea-hypopnea index (AHI) decreased significantly after the operation (Plt;0.001). In accordance with OSAHS diagnosis and efficacy evaluation standards, 45 patients were cured after 6 months, 21 patients showed an excellent effect, 10 patients showed a good effect, six patients had no effect, and the total effective rate was 92.6%. Conclusion Low-temperature coblation-assisted adenotonsillectomy has good clinical efficacy with a shortened surgical time, less intraoperative and postoperative blood loss, less postoperative pain, few complications, and a simple operation procedure. It can effectively expand the nasopharynx, oropharynx ventilation cross-sectional area, lift the upper airway obstruction, and can be especially suitable for surgical treatment of children with OSAHS.
Obstructive sleep apnea hypopnea syndrome (OSAHS) is a disease in which apnea and hypopnea occur during sleep, and the main symptoms are sleep snoring. OSAHS is not only closely related to the occurrence of various eye diseases, but also the severity of OSAHS can affect the progression of related eye diseases. At present, continuous positive airway pressure (CPAP) is an effective means to treat OSAHS, and the progression of related eye diseases has been improved correspondingly after CPAP treatment. In the future, it is necessary to further study the pathogenesis of OSAHS and enrich the research evidence of the association between OSAHS and eye diseases, so as to provide more comprehensive theoretical evidence for the prevention and treatment of OSAHS-related eye diseases.