RESEARCH PAPER
Assessment of microcirculation among patients with obstructive sleep apnea after CPAP treatment
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1
Chair and Department of Internal Medicine, Medical University, Lublin, Poland
2
Departament of Internal Medicine, 1st Military Hospital, Lublin, Poland
3
Department of Functional Research, Institute of Rural Health, Lublin, Poland
Corresponding author
Klaudia Brożyna-Tkaczyk
Chair and Department of Internal Medicine, Medical University of Lublin, Staszica 16 St., 20-081, Lublin, Poland
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ABSTRACT
Introduction and objective:
Obstructive sleep apnea (OSA) is distinguished by recurrent partial or complete obstruction of the upper airways during sleep. The prevalence of OSA worldwide is estimated at 3–24% of the general population. Patients with OSA are predisposed to having endothelial dysfunction due to different mechanisms. The aim of a study was to assess the impact of 3 -month CPAP treatment on microcirculation among patients with OSA, and to determine changes in blood pressure after implemented therapy.
Material and methods:
The study included 30 patients with newly-diagnosed OSA. Microcirculation assessment was performed by Laser Doppler Flowmetry before and 3 months after implementation of CPAP therapy. Patients were also asked to perform measurements of blood pressure twice, 7 days prior to the appointment.
Results:
Improvement was observed in selected PORH parameters, such as AH, which was significantly increased after 3 months of treatment of CPAP (p<0.05). There was also a significant decrease in the RL/BZ parameter. Other PORH parameters did not differ significantly. Blood pressure, both diastolic and systolic, significantly decreased after therapy.
Conclusions:
Current study does not exactly explain the accurate mechanism underlying the changes of PORH after CPAP treatment among patients with OSA. However, it was demonstrated that 3 months adequate treatment improved endothelial function among the studied group. Assessment of microcirculation by LDF PORH protocol is a promising method, due to simplicity for the examinator, and non-invasive procedure. Due to the small study group, further investigation of microcirculation among patients with OSA should be performed, including the influence of co-morbidities and medications intake.
REFERENCES (23)
1.
Bjork S, Jain D, Marliere MH, et al. Obstructive Sleep Apnea, Obesity Hypoventilation Syndrome, and Pulmonary Hypertension: A State-of-the-Art Review. Sleep Med Clin. 2024;19(2):307–325. doi:10.1016/j.jsmc.2024.02.009.
2.
Lv R, Liu X, Zhang Y, et al. Pathophysiological mechanisms and therapeutic approaches in obstructive sleep apnea syndrome. Signal Transduct Target Ther. 2023;8(1):218. doi:10.1038/s41392-023-01496-3.
3.
Liu L, Wang Y, Hong L, et al. Obstructive Sleep Apnea and Hypertensive Heart Disease: From Pathophysiology to Therapeutics. Rev Cardiovasc Med. 2023;24(12):342. doi:10.31083/j.rcm2412342.
4.
Chiu HY, Chen PY, Chuang LP, et al. Diagnostic Accuracy of the Berlin Questionnaire, STOP-BANG, STOP, and Epworth Sleepiness Scale in Detecting Obstructive Sleep Apnea: A Bivariate Meta-Analysis. Sleep Med Rev. 2017;36:57–70.
https://doi.org/10.1016/j.smrv....
5.
Platon AL, Stelea CG, Boișteanu O, et al. An Update on Obstructive Sleep Apnea Syndrome-A Literature Review. Medicina (Kaunas). 2023;59(8):1459. doi:10.3390/medicina59081459.
6.
Yan Z, Xu Y, Li K, et al. The correlation between frailty index and incidence, mortality in obstructive sleep apnea: Evidence from NHANES. Heliyon. 2024;10(12):e32514. doi:10.1016/j.heliyon.2024.e32514.
7.
Spille J, Conrad J, Sengebusch A, et al. Preferences and experiences regarding the treatment of obstructive sleep apnea with mandibular advancement splints – a cross-sectional pilot survey. Cranio. 2024;42(3):298–304. doi:10.1080/08869634.2021.1962148.
8.
Mastino P, Rosati D, de Soccio G, et al. Oxidative Stress in Obstructive Sleep Apnea Syndrome: Putative Pathways to Hearing System Impairment. Antioxidants (Basel). 2023;12(7):1430. doi:10.3390/antiox12071430.
9.
de Lima EA, Castro SS, Viana-Júnior AB, et al. Could an increased risk of obstructive sleep apnoea be one of the determinants associated with disability in individuals with cardiovascular and cerebrovascular diseases? Sleep Breath. 2024;28(3):1187–1195. doi:10.1007/s11325-024-02989-3.
10.
Di Lorenzo B, Scala C, Mangoni AA, et al. A Systematic Review and Meta-Analysis of Mean Platelet Volume and Platelet Distribution Width in Patients with Obstructive Sleep Apnoea Syndrome. Biomedicines. 2024;12(2):270. doi:10.3390/biomedicines12020270.
11.
Zhang Y, Wang H, Yang J, et al. Obstructive Sleep Apnea Syndrome and Obesity Indicators, Circulating Blood Lipid Levels, and Adipokines Levels: A Bidirectional Two-Sample Mendelian Randomization Study. Nat Sci Sleep. 2024;16:573–583. doi:10.2147/NSS.S460989.
12.
Lin PW, Lin HC, Chang CT, et al. Decreased Peripapillary and Macular Vascular Densities in Patients with Moderate/Severe Obstructive Sleep Apnea/Hypopnea Syndrome. Nat Sci Sleep. 2023;15:1–12. doi:10.2147/NSS.S384372.
13.
Pinilla L, Benítez ID, Gracia-Lavedan E, et al. Metabolipidomic Analysis in Patients with Obstructive Sleep Apnea Discloses a Circulating Metabotype of Non-Dipping Blood Pressure. Antioxidants (Basel). 2023;12(12):2047. doi:10.3390/antiox12122047.
14.
Cracowski JL, Roustit M. Current Methods to Assess Human Cutaneous Blood Flow: An Updated Focus on Laser-Based-Techniques. Microcirculation. 2016;23(5):337–344.
https://doi.org/10.1111/micc.1....
15.
Tessema B, Sack U, König B, et al. Effects of Intermittent Hypoxia in Training Regimes and in Obstructive Sleep Apnea on Aging Biomarkers and Age-Related Diseases: A Systematic Review. Front Aging Neurosci. 2022;14:878278. doi:10.3389/fnagi.2022.878278.
16.
Iredahl F, Löfberg A, Sjöberg F, et al. Non-Invasive Measurement of Skin Microvascular Response during Pharmacological and Physiological Provocations. PLoS One. 2015;10(8):e0133760. doi:10.1371/journal.pone.0133760.
17.
Balasubramanian G, Chockalingam N, Naemi R. A systematic evaluation of cutaneous microcirculation in the foot using post-occlusive reactive hyperemia. Microcirculation. 2021;28(5):e12692. doi:10.1111/micc.12692.
18.
Shirazi BR, Valentine RJ, Lang JA. Reproducibility and normalization of reactive hyperemia using laser speckle contrast imaging. PLoS One. 2021;16(1):e0244795. doi:10.1371/journal.pone.0244795.
19.
Caballero-Eraso C, Muñoz-Hernández R, Asensio Cruz MI, et al. Relationship between the endothelial dysfunction and the expression of the β1-subunit of BK channels in a non-hypertensive sleep apnea group. PLoS One. 2019;14(6):e0217138. doi:10.1371/journal.pone.0217138.
20.
Muñoz-Hernandez R, Vallejo-Vaz AJ, Sanchez Armengol A, et al. Obstructive sleep apnoea syndrome, endothelial function and markers of endothelialization. Changes after CPAP. PLoS One. 2015;10(3):e012209. doi:10.1371/journal.pone.0122091.
21.
Gryglewska B, Głuszewska A, Zarzycki B, et al. Post-occlusive reactive hyperemic response of skin microcirculation among extremely obese patients in the short and long term after bariatric surgery. Microcirculation. 2020;27(3):e12600. doi:10.1111/micc.126001.
22.
Lavalle S, Masiello E, Iannella G, et al. Unraveling the Complexities of Oxidative Stress and Inflammation Biomarkers in Obstructive Sleep Apnea Syndrome: A Comprehensive Review. Life (Basel). 2024;14(4):425. doi: 10.3390/life14040425.
23.
Bakker JP, Baltzis D, Tecilazich F, et al. The Effect of Continuous Positive Airway Pressure on Vascular Function and Cardiac Structure in Diabetes and Sleep Apnea. A Randomized Controlled Trial. Ann Am Thorac Soc. 2020;17(4):474–483. doi:10.1513/AnnalsATS.201905-378OC.