• intermittent hypoxia
• muscle sympathetic nerve activity
• women

• Adaptation, Physiological
• Adult
• Biomarkers/blood
• Female
• Heart Rate
• Humans
• Hypoxia/blood
• Hypoxia/physiopathology
• Lung/innervation
• Male
• Muscle, Skeletal/innervation
• Oxygen/blood
• Respiratory Mechanics
• Sex Factors
• Sympathetic Nervous System/physiopathology
• Time Factors
• Young Adult

• U54 AG044170 NIA NIH HHS
• R01 HL153523 NHLBI NIH HHS
• K99 HL130339 NHLBI NIH HHS
• UL1 TR002345 NCATS NIH HHS
• R00 HL130339 NHLBI NIH HHS
• HHS | National Institutes of Health (NIH)
• Mayo Clinic (The Mayo Clinic)
• Washington University in St. Louis (WUSTL)

• non-dipping pattern
• pulse transit time
• rapid eye movement-related obstructive sleep apnea
• systolic blood pressure variability

• animal models
• inflammasome
• intermittent hypoxia
• neuroinflammation
• sexual dimorphism

• Alzheimer Disease/complications
• Alzheimer Disease/pathology
• Animals
• Humans
• Inflammation/complications
• Inflammation/pathology
• Male
• Mice, Inbred C57BL
• Microglia/pathology
• Nerve Degeneration/complications
• Nerve Degeneration/pathology
• Risk Factors
• Sleep Apnea Syndromes/complications
• Sleep Apnea Syndromes/pathology
• Mice

• R01 HL142752 NHLBI NIH HHS
• P30AG534255 NIH HHS

The current study aimed to explore the relationship between OSAS and hypertension and whether polysomnography (PSG) indices were independently associated with hypertension in patients with type 2 diabetes (T2DM).

This study recruited 316 T2DM patients. Multivariable logistic regression analyses were performed to determine the independent association of apnea-hypopnea index (AHI) and oxygen desaturation index (ODI) with hypertension with adjustment for potential confounders.

Among 316 patients, 130 (41.1%) and 204 (64.6%) had hypertension and OSAS, respectively. T2DM patients with hypertension showed significantly increased levels of AHI ((median (interquartile range)): 17.2 (5.7–34.9) vs. 5.7 (2.1–17.3) events/hour, p < 0.001), nonrapid eye movement AHI (NREM-AHI) (17.6 (5.5–36.5) vs. 5.2 (2.2–16.6) events/hour, p < 0.001), ODI (48.4 (21.9–78.0) vs. 22.6 (10.8–48.1) events/hour, p < 0.001), and severities of OSAS and decreased levels of lowest SaO₂ ((mean ± standard deviation): 74.0 ± 10.4 vs. 77.3 ± 9.8, p = 0.004). Multivariable logistic regression analysis showed that higher levels of AHI, NREM-AHI, and ODI were significantly associated with increased risks of hypertension, and the adjusted odds ratios (ORs) with 95% CI were 1.026 (1.008–1.044, p = 0.004), 1.026 (1.009–1.044, p = 0.003), and 1.005 (1.001–1.010, p = 0.040), respectively. Compared with non-OSAS, severe OSAS was significantly associated with the risk of hypertension with the adjusted OR (95% CI) of 3.626 (1.609–8.172, p = 0.002), but associations of rapid eye movement AHI (REM-AHI) and lowest SaO₂ with hypertension were not statistically significant.

Increased AHI, NREM-AHI, ODI, and severities of OSAS were significantly associated with higher risks of hypertension in T2DM patients. Detection and treatment of OSAS are needed to prevent hypertension in T2DM patients.

• Clinical presentation
• Gender
• Obstructive sleep apnea
• Outcomes
• Therapy

• Female
• Humans
• Menopause
• Polysomnography
• Primary Health Care
• Quality of Life
• Sex Factors
• Sleep Apnea, Obstructive/diagnosis
• Sleep Apnea, Obstructive/therapy
• Sleep Initiation and Maintenance Disorders
• Sleep Wake Disorders/diagnosis
• Sleep Wake Disorders/therapy

• baroreceptors
• baroreflex
• hypoxia
• intermittent hypoxia
• muscle sympathetic nerve activity
• sympathetic nervous system

Background: Gender affects the clinical presentation of obstructive sleep apnea (OSA). The classic OSA symptoms, such as sleepiness, snoring, and apnea, are not so frequent in women. Objectives: To evaluate possible gender differences in questionnaires used for OSA prediction, such as the Epworth Sleepiness Scale (ESS), STOP, STOP Bang (SB), Berlin Questionnaire (BQ), Athens Insomnia Scale (AIS), and Fatigue Scale (FS). Methods: 350 males were matched with 350 women referred to a sleep clinic, according to OSA severity. All responded to the questionnaires and underwent a sleep study. Cardiovascular disease (CVD) patients were separately analyzed. Results: ESS did not differ between genders. SB was higher in males, whereas STOP, BQ, AIS, and FS were higher in females. BQ presented the highest sensitivity in both genders, whereas STOP exhibited the highest specificity in males and ESS in females. AIS and FS were more sensitive and SB more specific in females, whereas BQ was more specific in males. For severe OSA, the predictive values of SB and BQ were almost similar for both genders; however AIS and FS were higher in women. CVD patients presented higher scores, independent of gender, except for AIS, which was higher in females. Conclusion: Gender-specific evaluation of questionnaires is necessary to prevent OSA under-diagnosis.

• Athens Insomnia Scale
• Berlin
• Epworth
• Fatigue Scale
• Stop Bang
• gender
• questionnaires
• sleep apnea

• cohort study
• habitual snoring
• hypertension
• incidence
• sleep-disordered breathing

We aimed to delineate sex-based differences in neuroplasticity that may be associated with previously reported sex-based differences in physiological alterations caused by repetitive succession of hypoxemia-reoxygenation encountered during obstructive sleep apnea (OSA). We examined long-term changes in the activity of brainstem and diencephalic cardiorespiratory neuronal populations induced by chronic intermittent hypoxia (CIH) in male and female mice by analyzing Fosb expression. Whereas the overall baseline and CIH-induced Fosb expression in females was higher than in males, possibly reflecting different neuroplastic dynamics, in contrast, structures responded to CIH by Fosb upregulation in males only. There was a sex-based difference at the level of the rostral ventrolateral reticular nucleus of the medulla, with an increase in the number of FOSB/ΔFOSB-positive cells induced by CIH in males but not females. This structure contains neurons that generate the sympathetic tone and which are involved in CIH-induced sustained hypertension during waking hours. We suggest that the sex-based difference in neuroplasticity of this structure contributes to the reported sex-based difference in CIH-induced hypertension. Moreover, we highlighted a sex-based dimorphic phenomenon in serotoninergic systems induced by CIH, with increased serotoninergic immunoreactivity in the hypoglossal nucleus and a decreased number of serotoninergic cells in the dorsal raphe nucleus in male but not female mice. We suggest that this dimorphism in the neuroplasticity of serotoninergic systems predisposes males to a greater alteration of neuronal control of the upper respiratory tract associated with the greater collapsibility of upper airways described in male OSA subjects.

• FOSB/ΔFOSB
• chronic intermittent hypoxia
• neuroplasticity
• serotonin
• sex hormones

• Androgens
• Chronic intermittent hypoxia
• Estrogens
• Hypertension
• Inflammation
• Oxidative stress

• Comorbidity
• Humans
• Neurodegenerative Diseases/epidemiology
• Sex Distribution
• Sleep Apnea Syndromes/epidemiology

• R01 NS091359 NINDS NIH HHS
• T32 AG020494 NIA NIH HHS

• a portable sleep monitoring device
• apnea-hypopnea index
• excessive daytime sleepiness
• obstructive sleep apnoea
• oxygen desaturation index
• sleep quality
• the obstructive sleep apnoea severity

Obstructive Sleep Apnea (OSA) is a common sleep disorder requiring the time/money consuming polysomnography for diagnosis. Alternative methods for initial evaluation are sought. Our aim was the prediction of Apnea-Hypopnea Index (AHI) in patients potentially suffering from OSA based on nonlinear analysis of respiratory biosignals during sleep, a method that is related to the pathophysiology of the disorder.

Patients referred to a Sleep Unit (135) underwent full polysomnography. Three nonlinear indices (Largest Lyapunov Exponent, Detrended Fluctuation Analysis and Approximate Entropy) extracted from two biosignals (airflow from a nasal cannula, thoracic movement) and one linear derived from Oxygen saturation provided input to a data mining application with contemporary classification algorithms for the creation of predictive models for AHI.

A linear regression model presented a correlation coefficient of 0.77 in predicting AHI. With a cutoff value of AHI = 8, the sensitivity and specificity were 93% and 71.4% in discrimination between patients and normal subjects. The decision tree for the discrimination between patients and normal had sensitivity and specificity of 91% and 60%, respectively. Certain obtained nonlinear values correlated significantly with commonly accepted physiological parameters of people suffering from OSA.

We developed a predictive model for the presence/severity of OSA using a simple linear equation and additional decision trees with nonlinear features extracted from 3 respiratory recordings. The accuracy of the methodology is high and the findings provide insight to the underlying pathophysiology of the syndrome.

Reliable predictions of OSA are possible using linear and nonlinear indices from only 3 respiratory signals during sleep. The proposed models could lead to a better study of the pathophysiology of OSA and facilitate initial evaluation/follow up of suspected patients OSA utilizing a practical low cost methodology.

ClinicalTrials.gov NCT01161381

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Decision Support Systems, Clinical
• Female
• Humans
• Male
• Middle Aged
• Nonlinear Dynamics
• Polysomnography
• ROC Curve
• Respiratory Rate
• Sensitivity and Specificity
• Severity of Illness Index
• Sleep Apnea, Obstructive/diagnosis
• Sleep Apnea, Obstructive/physiopathology
• Statistics, Nonparametric
• Young Adult

Advances in research relating to pulmonary embolisms (PE) can assist physicians in selecting the best management strategies for PE patients. However, the symptoms, signs, disease history, lesion position and pathophysiology linked to different genders in patients with PE have rarely been evaluated. One hundred and forty-nine PE patients (73 males and 76 females) were sequentially recruited to this study over the last five years whilst attending our Emergency Department. Data relating to the symptoms, signs, disease history, biochemical testing, cardiac electrophysiology, imaging detection, treatment and outcome were collected and the gender differences were analyzed. We found that embolisms occurred significantly more frequently in the right lung (89.7%) than in the left lung (42.6%). The presence of dyspnea, the number of patients presenting with tumors, the number of patients with chronic pulmonary disease, those with emboli in the right pulmonary artery and emboli in the right lung, as well as the average systolic and diastolic blood pressure were: 78.1%, 15.1%, 31.5%, 32.9%, 94.5%, 129.9+20.0 and 75.0+11.2 in the male patients and 59.2%, 1.3%, 14.5%, 17.1%, 69.7%, 125.1+14.6 and 69.3+11.0 in the female patients. These indicators were found to be significantly higher in male patients. In contrast, the rate of V1-V4 T-wave inversion and level of D-dimer in the blood were significantly lower in males than in females. No significant difference was observed in the remaining observational indicators. Gender differences regarding the symptoms, signs, disease history, lesion position and pathophysiology exist in patients with PE and should be considered in clinical practice.

• Aged
• Aged, 80 and over
• Female
• Humans
• Male
• Middle Aged
• Pulmonary Embolism/diagnosis
• Pulmonary Embolism/pathology
• Sex Factors

Otolaryngologists play a pivotal role in the diagnosis and management of sleep-related breathing disorders (SRBD) in both adults and children. Otolaryngologists are often the first medical specialists to be contacted by patients with complaints as snoring, episodic sleep apnea observed by the bed partners with or without reported excessive daytime sleepiness and therefore emerge as important gatekeepers of the general health of an individual by means of an active preventive, and in many cases therapeutic, role. Comprehensive diagnosis and treatment of SRBD requires a team approach and hence building interdisciplinary teams with other involved relevant specialties is necessary from the patients’ perspective.

• Apnea
• Surgery
• Obstructive
• Continuous positive airway pressure
• Sleep