Obstructive sleep apnea and comorbidities: a dangerous liaison
Maria R. Bonsignore,Maria R. Bonsignore,Pierpaolo Baiamonte,Emilia Mazzuca,Alessandra Castrogiovanni,Oreste Marrone +5 more
TLDR
A narrative review of recent studies on OSA patients, with special attention to cardiovascular and cerebrovascular comorbidities, the metabolic syndrome and type 2 diabetes, asthma, COPD and cancer, to provide an update on recent studies.Abstract:
Obstructive sleep apnea (OSA) is a highly prevalent disease, and is traditionally associated with increased cardiovascular risk. The role of comorbidities in OSA patients has emerged recently, and new conditions significantly associated with OSA are increasingly reported. A high comorbidity burden worsens prognosis, but some data suggest that CPAP might be protective especially in patients with comorbidities. Aim of this narrative review is to provide an update on recent studies, with special attention to cardiovascular and cerebrovascular comorbidities, the metabolic syndrome and type 2 diabetes, asthma, COPD and cancer. Better phenotypic characterization of OSA patients, including comorbidities, will help to provide better individualized care. The unsatisfactory adherence to CPAP in patients without daytime sleepiness should prompt clinicians to examine the overall risk profile of each patient in order to identify subjects at high risk for worse prognosis and provide the optimal treatment not only for OSA, but also for comorbidities.read more
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References
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TL;DR: It was agreed that there should not be an obligatory component, but that waist measurement would continue to be a useful preliminary screening tool, and a single set of cut points would be used for all components except waist circumference, for which further work is required.
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Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study
TL;DR: In men, severe obstructive sleep apnoea-hypopNoea significantly increases the risk of fatal and non-fatal cardiovascular events and CPAP treatment reduces this risk.
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Insulin sensitivity: modulation by nutrients and inflammation.
TL;DR: The hypothesis that the macrophage is an important cell type in the propagation of inflammation and induction of insulin resistance in obesity is focused on, which provides the integrative perspective regarding how nutrients and obesity interact to regulate insulin sensitivity.
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Obstructive sleep apnoea syndrome
Patrick Levy,Malcolm Kohler,Walter T. McNicholas,Ferran Barbé,R. Doug McEvoy,Virend K. Somers,Lena Lavie,Jean-Louis Pépin +7 more
TL;DR: Continuous positive airway pressure (CPAP) is the primary treatment modality in patients with severe OSAS, whereas oral appliances are also widely used in mild to moderate forms, and combining different treatment modalities such as CPAP and weight control is beneficial, but need to be evaluated in randomized controlled trials.