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  • Oxford University Press (OUP)  (7)
  • 1
    Online Resource
    Online Resource
    Oxford University Press (OUP) ; 2024
    In:  SLEEP Vol. 47, No. Supplement_1 ( 2024-04-20), p. A194-A194
    In: SLEEP, Oxford University Press (OUP), Vol. 47, No. Supplement_1 ( 2024-04-20), p. A194-A194
    Abstract: Obstructive sleep apnea (OSA) is causally associated with hypertension. However, the differential mechanisms underlying OSA related hypertension between normal-weight vs. obese patients is limited. Methods We studied 92 consecutive patients with OSA. Blood pressure (BP) was measured twice during awake and continuously monitored during nighttime sleep. Obesity and normal weight were defined as body mass index ≥ and & lt; 28 kg/m2. Serum metabolite levels were assessed by metabolomics. Results Among 59 normal-weight and 33 obese patients, 639 and 174 metabolites showed differences between hypertension and normotension or were associated with systolic and diastolic BP (SBP, DBP) after controlling for confounders. These metabolites were significantly involved in 16 and 12 Kyoto Encyclopedia of Genes and Genomes enrichment pathways in normal-weight and obese patients, whereas 6 pathways overlapped between these two phenotypes. Among these 6 overlapping pathways, 4 pathways were related to homocysteine metabolism and the other two were non-specific pathways. In homocysteine metabolism pathway, 13 metabolites were identified by metabolomics. Interestingly, the change trends of 7 metabolites associated with SBP (all interaction-p≤0.081) and 8 metabolites associated with DBP (all interaction-p≤0.034) were opposite between normal-weight and obese patients. Specifically, in normal-weight patients increased BP was associated with down-regulated folate-dependent remethylation and accelerated transsulfuration whereas in obese patients increased BP was associated with enhanced betaine-dependent remethylation and reduced transsulfuration. Similar findings were observed in ambulatory BP during sleep. Conclusion Mechanisms in OSA related hypertension differ between normal-weight and obese patients, which can be primarily explained by the different systematic changes in homocysteine metabolism. Assessing the metabolites in homocysteine metabolism pathway may benefit personalized treatments for hypertension in these two OSA phenotypes. Support (if any) This study was supported by the National Natural Science Foundation of China (81970087, 82270105, 82300117), 2020 Li Ka Shing Foundation Cross-Disciplinary Research Grant (2020LKSFG05B) and China Postdoctoral Science Foundation (2022M712010).
    Type of Medium: Online Resource
    ISSN: 0161-8105 , 1550-9109
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2024
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  • 2
    Online Resource
    Online Resource
    Oxford University Press (OUP) ; 2019
    In:  Sleep Vol. 42, No. Supplement_1 ( 2019-04-13), p. A191-A192
    In: Sleep, Oxford University Press (OUP), Vol. 42, No. Supplement_1 ( 2019-04-13), p. A191-A192
    Type of Medium: Online Resource
    ISSN: 0161-8105 , 1550-9109
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2019
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  • 3
    In: SLEEP, Oxford University Press (OUP), Vol. 46, No. Supplement_1 ( 2023-05-29), p. A375-A376
    Abstract: Insomnia with objective short sleep duration (ISSD) has been associated with higher risk of cardiometabolic morbidity. In this study, we examined the association between ISSD, also based on subjective sleep duration, with incident hypertension in the Sleep Heart Health Study (SHHS). Methods We analyzed data from 1413 participants free of hypertension or sleep apnea at baseline from the SHHS with a median follow-up duration of 5.1 years. Insomnia symptoms were defined based on difficulty falling asleep, difficulty returning to sleep, early morning awakening, or sleeping pill use more than half days in a month. Objective short sleep duration was defined as polysomnography-measured total sleep time & lt; 6 hours. Incident hypertension was defined based on blood pressure measures and/or use of antihypertensive medications at follow-up. Results Insomnia subjects who slept objectively & lt; 6 hours had significantly higher odds of incident hypertension compared to normal sleeping subjects who slept ≥6 hours (OR=2.00, 95% CI=1.09-3.65) or & lt; 6 hours (OR=2.00, 95%CI=1.06-3.79) or insomnia subjects who slept ≥6 hours (OR=2.79, 95%CI= 1.24-6.30). Insomnia subjects who slept ≥6 hours or normal sleepers who slept & lt; 6 hours were not associated with increased risk of incident hypertension compared to normal sleepers who slept ≥6 hours. Finally, insomnia subjects who self-reported sleeping & lt; 6 hours were not associated with significantly increased odds of incident hypertension. Conclusion These data further support that the ISSD phenotype based on objective, but not subjective measures is, similar to sleep apnea. Support (if any) The Sleep Heart Health Study (SHHS) was supported by National Heart, Lung, and Blood Institute cooperative agreements U01HL53916 (University of California, Davis), U01HL53931 (New York University), U01HL53934 (University of Minnesota), U01HL53937 and U01HL64360 (Johns Hopkins University), U01HL53938 (University of Arizona), U01HL53940 (University of Washington), U01HL53941 (Boston University), and U01HL63463 (Case Western Reserve University). The National Sleep Research Resource was supported by the National Heart, Lung, and Blood Institute (R24 HL114473, 75N92019R002).
    Type of Medium: Online Resource
    ISSN: 0161-8105 , 1550-9109
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
    detail.hit.zdb_id: 2056761-3
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  • 4
    Online Resource
    Online Resource
    Oxford University Press (OUP) ; 2023
    In:  SLEEP Vol. 46, No. Supplement_1 ( 2023-05-29), p. A365-A365
    In: SLEEP, Oxford University Press (OUP), Vol. 46, No. Supplement_1 ( 2023-05-29), p. A365-A365
    Abstract: Insomnia with objective short sleep duration (ISSD) has been proposed as the most biologically severe phenotype of the disorder associated with cardiometabolic morbidity in population-based samples. Methods In this study, we investigated the association between ISSD and hypertension in a large clinical sample. We studied 348 patients diagnosed with chronic insomnia disorder (CID) based on International Classification of Sleep Disorders (ICSD-3) criteria and 150 normal sleepers. Objective short sleep duration was defined by the median total sleep time (TST) of the sample ( & lt; 7 hours) measured with 1-night polysomnography. Hypertension was defined based on blood pressure (BP) levels, antihypertensive medication use and/or a physician diagnosis. Results After adjusting for potential confounders, patients with CID who slept & lt; 7 hours were associated with 2.8-fold increased odds of hypertension compared to normal sleepers who slept ≥7 hours (odds ratio [OR]=2.81, 95% confidence interval [95%CI] =1.068–7.411) or & lt; 7 hours (OR=2.75, 95%CI=1.005-7.542), whereas patients with CID who slept ≥ 7 hours (OR=1.52, 95%CI=0.537-4.285) or normal sleepers who slept & lt; 7 hours (OR=1.07, 95%CI=0.294-3.904) were not significantly associated with increased odds of hypertension compared to normal sleepers who slept ≥ 7 hours. Linear regression analyses showed that, for every hour decrease in TST, systolic and diastolic blood pressure increased by 1.014 mmHg (p=0.045) and 0.923 mmHg (p=0.015), respectively, in patients with CID but not in normal sleepers. Conclusion Our findings further support that ISSD is a risk factor for hypertension and objective short sleep duration may be a useful marker of the biological severity of CID in clinical practice. Support (if any) This study was supported by the National Natural Science Foundation of China (81970087), Guangdong Province Science and Technology Special Fund Project (200115165870512), and the 2020 Li Ka Shing Foundation Cross-Disciplinary Research Grant (2020LKSFG05B). The authors report no conflict of interest.
    Type of Medium: Online Resource
    ISSN: 0161-8105 , 1550-9109
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
    detail.hit.zdb_id: 2056761-3
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  • 5
    In: Sleep, Oxford University Press (OUP), Vol. 45, No. 7 ( 2022-07-11)
    Abstract: Objective excessive daytime sleepiness (EDS) is associated with systemic inflammation and a higher risk of cardiometabolic morbidity in obstructive sleep apnea (OSA). We hypothesized that OSA with objective EDS is associated with higher levels of sympathetic nerve activity (SNA) when compared with self-reported EDS. We, therefore, examined the associations between objective and self-reported EDS with SNA in patients with OSA. Methods We studied 147 consecutive male patients with OSA from the institutional sleep clinic. Objective EDS and self-reported EDS were defined based on Multiple Sleep Latency Test (MSLT) latency ≤ 8 minutes and Epworth Sleepiness Scale (ESS) & gt; 10, respectively. Twenty-four-hour urinary norepinephrine was used for assessing SNA. Blood pressure (BP) was measured both in the evening and in the morning. Results Twenty-four-hour urinary norepinephrine was significantly higher in patients with OSA with objective EDS compared with those without objective EDS (p = 0.034), whereas it was lower in patients with OSA with self-reported EDS compared with those without self-reported EDS (p = 0.038) after adjusting for confounders. Differences in the sympathetic drive were most striking in those with an objective but not self-reported EDS versus those with self-reported but not objective EDS (p = 0.002). Moreover, shorter MSLT latency was significantly associated with higher diastolic BP (β = −0.156, p = 0.049) but not systolic BP. No significant association between ESS scores and BP was observed. Conclusions Objective, but not self-reported EDS, is associated with increased SNA and diastolic BP among males with OSA, suggesting that objective EDS is a more severe phenotype of OSA that is accompanied by higher sympathetic drive, higher BP, and possibly greater cardiovascular morbidity and mortality.
    Type of Medium: Online Resource
    ISSN: 0161-8105 , 1550-9109
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
    detail.hit.zdb_id: 2056761-3
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  • 6
    In: Sleep, Oxford University Press (OUP), Vol. 42, No. Supplement_1 ( 2019-04-13), p. A176-A177
    Type of Medium: Online Resource
    ISSN: 0161-8105 , 1550-9109
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2019
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  • 7
    In: Sleep, Oxford University Press (OUP), Vol. 42, No. Supplement_1 ( 2019-04-13), p. A178-A178
    Type of Medium: Online Resource
    ISSN: 0161-8105 , 1550-9109
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2019
    detail.hit.zdb_id: 2056761-3
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