The effect of continuous positive airway pressure therapy on early atherosclerosis in patients with severe obstructive sleep apnea-hypopnea syndrome.

IF 2.1 4区医学 Q3 CLINICAL NEUROLOGY

Sleep and Breathing Pub Date : 2025-01-08 DOI:10.1007/s11325-024-03189-9

Dóra Sulina, Szilvia Puskás, Mária Tünde Magyar, László Oláh, Norbert Kozák

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引用次数: 0

Abstract

Purpose: Obstructive sleep apnea-hypopnea syndrome (OSAHS) is the most common sleep-related breathing disorder. Longer term, repeated episodes of hypercapnia and hypoxemia during sleep are associated with inflammatory and atherosclerosis-related factors. The aim of this study was to explore the effect of continuous positive airway pressure (CPAP) therapy on cerebral vasoreactivity and early atherosclerosis in patients with severe OSAHS.

Methods: Forty-one patients with severe OSAHS were enrolled. The mean follow-up time was 39.8 ± 9.1 months. Cardiovascular risk factors were assessed, and laboratory tests, carotid artery intima-media thickness (CIMT) measurement and cerebrovascular reserve capacity (CRC) measurement were performed. After the baseline examination, 28 patients received CPAP therapy (treated group), which was not available for 13 patients (untreated group). Parameters were compared before and after treatment, between treated and untreated patients.

Results: Cardiovascular risk factors, baseline polysomnographic parameters, laboratory values, CIMT and CRC of the two groups were similar at baseline. At the follow-up, CRC did not differ between the two groups, but CIMT was significantly lower in the treated group than in the untreated group (0.73 ± 0.11 mm vs. 0.84 ± 0.21 mm, p = 0.027). The CIMT of both groups increased significantly during the follow-up period (from 0.65 ± 0.11 mm to 0.73 ± 0.11 mm in the treated group, and from 0.69 ± 0.11 mm to 0.84 ± 0.21 mm in the untreated group), but the increase in the treated group was smaller than in the untreated group (0.09 ± 0.09 mm vs. 0.15 ± 0.15 mm).

Conclusion: In patients with severe OSAHS, CPAP treatment significantly reduced the progression of CIMT.

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持续气道正压治疗对重度阻塞性睡眠呼吸暂停低通气综合征患者早期动脉粥样硬化的影响。

目的：阻塞性睡眠呼吸暂停低通气综合征（OSAHS）是最常见的睡眠相关呼吸障碍。长期来看，睡眠期间反复发作的高碳酸血症和低氧血症与炎症和动脉粥样硬化相关因素有关。本研究旨在探讨持续气道正压（CPAP）治疗对重度OSAHS患者脑血管反应性及早期动脉粥样硬化的影响。方法：选取41例重度OSAHS患者。平均随访时间39.8±9.1个月。评估心血管危险因素，并进行实验室检查、颈动脉内膜-中膜厚度（CIMT）测量和脑血管储备容量（CRC）测量。基线检查后，28例患者接受CPAP治疗（治疗组），13例患者未接受CPAP治疗（未治疗组）。比较治疗前后、治疗组与未治疗组的参数。结果：两组的心血管危险因素、基线多导睡眠图参数、实验室值、CIMT和CRC在基线时相似。随访时，两组间CRC无差异，但治疗组的CIMT明显低于未治疗组（0.73±0.11 mm比0.84±0.21 mm, p = 0.027）。在随访期间，两组患者的CIMT均显著增高（治疗组从0.65±0.11 mm增高至0.73±0.11 mm，未治疗组从0.69±0.11 mm增高至0.84±0.21 mm），但治疗组增高幅度小于未治疗组（0.09±0.09 mm vs 0.15±0.15 mm）。结论：在重度OSAHS患者中，CPAP治疗可显著降低CIMT的进展。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Sleep and Breathing 医学-呼吸系统

CiteScore

5.20

自引率

4.00%

发文量

222

审稿时长

3-8 weeks

期刊介绍： The journal Sleep and Breathing aims to reflect the state of the art in the international science and practice of sleep medicine. The journal is based on the recognition that management of sleep disorders requires a multi-disciplinary approach and diverse perspectives. The initial focus of Sleep and Breathing is on timely and original studies that collect, intervene, or otherwise inform all clinicians and scientists in medicine, dentistry and oral surgery, otolaryngology, and epidemiology on the management of the upper airway during sleep. Furthermore, Sleep and Breathing endeavors to bring readers cutting edge information about all evolving aspects of common sleep disorders or disruptions, such as insomnia and shift work. The journal includes not only patient studies, but also studies that emphasize the principles of physiology and pathophysiology or illustrate potentially novel approaches to diagnosis and treatment. In addition, the journal features articles that describe patient-oriented and cost-benefit health outcomes research. Thus, with peer review by an international Editorial Board and prompt English-language publication, Sleep and Breathing provides rapid dissemination of clinical and clinically related scientific information. But it also does more: it is dedicated to making the most important developments in sleep disordered breathing easily accessible to clinicians who are treating sleep apnea by presenting well-chosen, well-written, and highly organized information that is useful for patient care.