uu.seUppsala universitets publikasjoner
Endre søk
RefereraExporteraLink to record
Permanent link

Direct link
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Annet format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annet språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf
Obstructive sleep apnea during rapid eye movement sleep is associated with early signs of atherosclerosis in women
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lung- allergi- och sömnforskning.
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lung- allergi- och sömnforskning.
Department of Surgical and Perioperative Sciences, Surgery, Umeå University, Sweden.
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Uppsala kliniska forskningscentrum (UCR).
Vise andre og tillknytning
2018 (engelsk)Inngår i: Sleep, ISSN 0161-8105, E-ISSN 1550-9109, Vol. 41, nr 7, artikkel-id zsy099Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Study Objectives: Although obstructive sleep apnea (OSA) is associated with overall cardiovascular disease and mortality, the association with atherosclerotic cardiovascular disease is less clear, especially in women. Recently, it has been suggested that OSA during rapid eye movement (REM) sleep, associated with long apneas and deep desaturations, could have severe cardiometabolic consequences. The aim of this study was to investigate whether OSA during REM sleep is associated with early signs of atherosclerosis in a population-based sample of women.

Methods: In the community-based "Sleep and Health in Women" (SHE) cohort study, 400 women underwent polysomnography, anthropometric measurements, blood sampling, blood pressure measurement, and answered questionnaires. Ten years later, 201 of the original participants, free of known atherosclerotic disease at baseline and without continuous positive airway pressure treatment for OSA, underwent a high-frequency ultrasound of the common carotid artery to assess the individual thickness of the layers of the artery wall.

Results: Severe OSA during REM sleep (REM apnea-hypopnea index [AHI] ≥ 30) was associated with a thicker intima. This association was still significant after adjustment for age, body mass index, alcohol, and smoking, as well as for further adjustment for systolic blood pressure, low-density lipoprotein, C-reactive protein, and diabetes (β-coefficient, 0.008; p-value, 0.022). The association between a REM AHI of ≥30 and intima thickness was also seen in women with no or mild OSA and normal non-REM AHI.

Conclusions: In this study of a community-based sample of women, severe OSA during REM sleep was independently associated with early signs of atherosclerosis.

sted, utgiver, år, opplag, sider
2018. Vol. 41, nr 7, artikkel-id zsy099
Emneord [en]
obstructive sleep apnea, cardiovascular morbidity, rapid eye movement-related sleep apnea, carotid artery intima thickness, atherosclerosis
HSV kategori
Identifikatorer
URN: urn:nbn:se:uu:diva-364687DOI: 10.1093/sleep/zsy099ISI: 000439187200018PubMedID: 29762755OAI: oai:DiVA.org:uu-364687DiVA, id: diva2:1259927
Forskningsfinansiär
Swedish Heart Lung Foundation, 19990029Swedish Heart Lung Foundation, 20100494Tilgjengelig fra: 2018-10-31 Laget: 2018-10-31 Sist oppdatert: 2019-07-03bibliografisk kontrollert
Inngår i avhandling
1. Sleep-disordered breathing in women: Associations with cardiovascular disease and the significance of sleep apnea during REM sleep
Åpne denne publikasjonen i ny fane eller vindu >>Sleep-disordered breathing in women: Associations with cardiovascular disease and the significance of sleep apnea during REM sleep
2019 (engelsk)Doktoravhandling, med artikler (Annet vitenskapelig)
Abstract [en]

Background: Sleep-disordered breathing (SDB) is associated with an increased risk of cardiovascular disease, but it is unclear which elements of SDB that are most harmful to the cardiovascular system and whether the associations observed in men also apply to women.

Aim: To investigate associations between different aspects of SDB and cardiovascular disease in women

Methods and results: All four papers were based on participants in “Sleep and Health in Women” (SHE), a population-based cohort study of women.

Paper I is a cross-sectional study of 349 women with polysomnographic assessments of obstructive sleep apnea (OSA) and measurements of plasma BNP, clinically used as a marker of heart failure, in the morning. There was a dose-response relationship between the severity of OSA and levels of BNP.

In Paper II, with a study population of 5,990 women, questionnaire data on symptoms of obstructive sleep apnea were combined with register data from the Swedish National Patient Register regarding a diagnosis of heart failure (mean follow-up 11.4 years). Women with the combination of snoring and daytime sleepiness had a two-fold increase in the risk of incident heart failure after adjustment for confounding.

Paper III was based on 201 women without known cardiovascular disease, with a polysomnography at baseline, assessing OSA during REM sleep, and a carotid artery ultrasound with measurements of intima thickness at follow-up. Severe OSA during REM sleep was associated with a thicker carotid intima.

Paper IV comprised 253 women with polysomnographic data on severe OSA and severe OSA during REM sleep, as well as proteomic analyses of cardiac and inflammatory proteins. After adjustment for confounding and multiple testing, severe OSA during REM sleep was associated with decreased levels of Sirt2, LAP-TGF-β1 and Axin1, while there were no significant associations for OSA based on a whole night and protein levels.

Conclusions: Women with symptoms of OSA run an increased risk of developing heart failure and OSA is associated with increased levels of BNP. Severe OSA during REM sleep is associated with an early sign of atherosclerosis and reduced levels of proteins with anti-inflammatory effects linked to atherosclerosis and metabolic regulation.

sted, utgiver, år, opplag, sider
Uppsala: Acta Universitatis Upsaliensis, 2019. s. 75
Serie
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1567
Emneord
Obstructive sleep apnea, REM sleep, cardiovascular disease, heart failure
HSV kategori
Forskningsprogram
Lungmedicin
Identifikatorer
urn:nbn:se:uu:diva-381416 (URN)978-91-513-0640-7 (ISBN)
Disputas
2019-06-05, Enghoffsalen, Akademiska sjukhuset, Ing 50 bv, Uppsala, 09:00 (svensk)
Opponent
Veileder
Tilgjengelig fra: 2019-05-15 Laget: 2019-04-09 Sist oppdatert: 2019-06-18

Open Access i DiVA

Fulltekst mangler i DiVA

Andre lenker

Forlagets fulltekstPubMed

Personposter BETA

Ljunggren, MirjamLindberg, EvaÖhagen, PatrikTheorell-Haglöw, JennyNaessén, Tord

Søk i DiVA

Av forfatter/redaktør
Ljunggren, MirjamLindberg, EvaÖhagen, PatrikTheorell-Haglöw, JennyNaessén, Tord
Av organisasjonen
I samme tidsskrift
Sleep

Søk utenfor DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetric

doi
pubmed
urn-nbn
Totalt: 192 treff
RefereraExporteraLink to record
Permanent link

Direct link
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Annet format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annet språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf