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Leukocyte telomere length predicts oxidative stress and the severity of obstructive sleep apnea syndrome
Abstracts/Sleep Medicine 16 (2015) S2–S199
present study was to examine the independent association between snoring, objectively measured by microphones, and carotid atherosclerosis, after minimizing the possible confounding effect of OSA. Materials and methods: Two hundred thirteen men and 91 women who underwent a full-night home-based sleep study between 2012 and 2013 were enrolled. Respiratory events, including snoring and apnea/hypopnea, were measured using a portable sleep device (T3, Noxmedical). Snoring sound was objectively measured by a builtin microphone and then manually scored. Percentage of snoring time was calculated by dividing the total duration of three or more consecutive snore events by total sleep time and multiplying by 100. According to snoring time across night, participants were divided into three groups: nonsnorers (0%), mild (snoring time: 1–25%), and moderate to heavy snorers (≥25%). Carotid atherosclerosis was defined as mean intima-media thickness (IMT) and presence of plaque on both common carotid arteries. Results: The three snoring groups were matched by age, bodymass index, cholesterol, blood pressure, and glucose levels, using weights from generalized boosted-propensity score models. After excluding those who have OSA, diagnosed by a high apnea/hypopnea index (AHI) greater than 5, mean IMT increased with increasing time of snoring across the night in women: nonsnorers (0.707 mm), mild (0.718 mm), and moderate to heavy snorers (0.774 mm). Moderate to heavy snorers had significantly higher IMT than nonsnorers (p = 0.0075) and mild snorers (p = 0.0239). However, the study revealed no significant difference in carotid IMT between male snorers and nonsnorers. Prevalence of plaque on carotid arteries was not different among the three groups with different snoring times for both genders. Conclusion: Our findings suggest that snoring at least one fourth of a night’s sleep may accelerate subclinical changes in carotid atherosclerosis in women, but not in men. Further investigation is needed to identify underlying mechanisms as well as clarify gender differences. Acknowledgements: This study was supported by a fund (2011E71004-00, 2012-E71005-00, 2013-E71005-00) by Research of Korea Centers for Disease Control and Prevention and partly by NIH/ NINR (K99-NR013177) in the United States. http://dx.doi.org/10.1016/j.sleep.2015.02.065
Leukocyte telomere length predicts oxidative stress and the severity of obstructive sleep apnea syndrome H. Kim Chung-Ang University College of Medicine, South Korea
Introduction: We aimed to assess whether systemic oxidative stress is increased in patients with obstructive sleep apnea syndrome (OSA) and whether excessive telomere length shortening is a characteristic feature of OSA patients that can predict oxidative stress levels. Materials and methods: We used quantitative PCR to measure telomere length using peripheral blood genomic DNA. Telomere lengths were compared in an age- and body mass index (BMI)-dependent manner in 34 healthy volunteers and 43 OSA subjects. We also performed reactive oxygen species assay to examine the concentration of hydrogen peroxide in the peripheral blood of healthy volunteers and OSA subjects. Results: We found that the serum concentration of hydrogen peroxide was considerably higher in OSA patients, and that this was closely related with the severity of OSA. Significantly shortened telomere length was observed in the circulating leukocytes of the
S27
peripheral blood of OSA patients, and telomere length decreased more acutely in an age- and BMI-dependent manner. An inverse correlation was observed between the concentration of hydrogen peroxide and the telomere length of OSA patients and excessive telomere length shortening was linked to respiratory disturbance index of OSA patients. Conclusion: The results provided evidence that telomere length shortening is associated with the apneic events of OSA and may be an important biomarker for predicting the burden of oxidative stress in the peripheral blood of OSA patients. Acknowledgements: This work was supported by funds from the Alumni Association of the Department of Otolaryngology and Head & Neck Surgery at Chung-Ang University, College of Medicine. http://dx.doi.org/10.1016/j.sleep.2015.02.066
Provoked periodic breathing in simulated moderate and high altitude in healthy young adults S. Pramsohler 1, H. Gatterer 2, M. Faulhaber 2, N. Netzer 2 1 Hermann Buhl Institute for Hypoxia and Sleep Medicine Research, Germany 2 Department of Sports Science and Psychology, University of Innsbruck, Austria
Introduction: It is common sense that periodic breathing increases linear with greater heights. Cut off points for periodic breathing at specific altitudes are not known and seem to be very individualized. Our aim was to study the difference of breathing patterns in healthy adults between simulated 3500 and 4500 m. Materials and methods: Twelve male and six female subjects with a mean age of 24.78 ± 1.86 had a 12 channel PSG randomly assigned at either 3500 or 4500 m simulated altitude (normobaric hypoxia, Low Oxygen Systems; Berlin-Buch, Germany). 3500 m
TST SaO2 HR AHI
4500 m
Mean Stdv.
Mean Stdv
417 min ± 45,5 min 84,8% ± 2,7% 69,2 bpm ± 8,3 bpm 44,1 ± 37,6
325,17 min ± 85,8 min 76,8% ± 3,5% 78,6 bpm ± 10,1 bpm 68,6 ± 48,3
Results: We have seen a highly significant decrease in total sleeping time and arterial oxygen saturation as well as an increase of the heart rate (HF) on 4500 m compared with 3500 m. No significant difference in the AHI and frequency of arousals could be seen. Central hypopneas changed to central apneas with the higher altitude. Conclusion: Sleep overnight in increasing simulated altitude at the cut off from moderate to high altitude goes along with decreasing oxygen saturation at a higher HF and reduced TST but with an unchanged total AHI. http://dx.doi.org/10.1016/j.sleep.2015.02.067
Nocturnal blood pressure fluctuations: Superposition phenomena in patients with obstructive sleep apnea syndrome – Risk factor for nocturnal cardiovascular events? A. Patzak 1, G. Küchler 2, I. Fietze 3, H. Hein 4 1 Charité-Universitätsmedizin Berlin, Germany 2 Somnomedics GmbH, Randersacker, Germany 3 Interdisziplinäres Schlafmedizinisches Zentrum, CharitéUniversitätsmedizin Berlin, Germany 4 Schlaflabor Reinbeck, Germany
present study was to examine the independent association between snoring, objectively measured by microphones, and carotid atherosclerosis, after minimizing the possible confounding effect of OSA. Materials and methods: Two hundred thirteen men and 91 women who underwent a full-night home-based sleep study between 2012 and 2013 were enrolled. Respiratory events, including snoring and apnea/hypopnea, were measured using a portable sleep device (T3, Noxmedical). Snoring sound was objectively measured by a builtin microphone and then manually scored. Percentage of snoring time was calculated by dividing the total duration of three or more consecutive snore events by total sleep time and multiplying by 100. According to snoring time across night, participants were divided into three groups: nonsnorers (0%), mild (snoring time: 1–25%), and moderate to heavy snorers (≥25%). Carotid atherosclerosis was defined as mean intima-media thickness (IMT) and presence of plaque on both common carotid arteries. Results: The three snoring groups were matched by age, bodymass index, cholesterol, blood pressure, and glucose levels, using weights from generalized boosted-propensity score models. After excluding those who have OSA, diagnosed by a high apnea/hypopnea index (AHI) greater than 5, mean IMT increased with increasing time of snoring across the night in women: nonsnorers (0.707 mm), mild (0.718 mm), and moderate to heavy snorers (0.774 mm). Moderate to heavy snorers had significantly higher IMT than nonsnorers (p = 0.0075) and mild snorers (p = 0.0239). However, the study revealed no significant difference in carotid IMT between male snorers and nonsnorers. Prevalence of plaque on carotid arteries was not different among the three groups with different snoring times for both genders. Conclusion: Our findings suggest that snoring at least one fourth of a night’s sleep may accelerate subclinical changes in carotid atherosclerosis in women, but not in men. Further investigation is needed to identify underlying mechanisms as well as clarify gender differences. Acknowledgements: This study was supported by a fund (2011E71004-00, 2012-E71005-00, 2013-E71005-00) by Research of Korea Centers for Disease Control and Prevention and partly by NIH/ NINR (K99-NR013177) in the United States. http://dx.doi.org/10.1016/j.sleep.2015.02.065
Leukocyte telomere length predicts oxidative stress and the severity of obstructive sleep apnea syndrome H. Kim Chung-Ang University College of Medicine, South Korea
Introduction: We aimed to assess whether systemic oxidative stress is increased in patients with obstructive sleep apnea syndrome (OSA) and whether excessive telomere length shortening is a characteristic feature of OSA patients that can predict oxidative stress levels. Materials and methods: We used quantitative PCR to measure telomere length using peripheral blood genomic DNA. Telomere lengths were compared in an age- and body mass index (BMI)-dependent manner in 34 healthy volunteers and 43 OSA subjects. We also performed reactive oxygen species assay to examine the concentration of hydrogen peroxide in the peripheral blood of healthy volunteers and OSA subjects. Results: We found that the serum concentration of hydrogen peroxide was considerably higher in OSA patients, and that this was closely related with the severity of OSA. Significantly shortened telomere length was observed in the circulating leukocytes of the
S27
peripheral blood of OSA patients, and telomere length decreased more acutely in an age- and BMI-dependent manner. An inverse correlation was observed between the concentration of hydrogen peroxide and the telomere length of OSA patients and excessive telomere length shortening was linked to respiratory disturbance index of OSA patients. Conclusion: The results provided evidence that telomere length shortening is associated with the apneic events of OSA and may be an important biomarker for predicting the burden of oxidative stress in the peripheral blood of OSA patients. Acknowledgements: This work was supported by funds from the Alumni Association of the Department of Otolaryngology and Head & Neck Surgery at Chung-Ang University, College of Medicine. http://dx.doi.org/10.1016/j.sleep.2015.02.066
Provoked periodic breathing in simulated moderate and high altitude in healthy young adults S. Pramsohler 1, H. Gatterer 2, M. Faulhaber 2, N. Netzer 2 1 Hermann Buhl Institute for Hypoxia and Sleep Medicine Research, Germany 2 Department of Sports Science and Psychology, University of Innsbruck, Austria
Introduction: It is common sense that periodic breathing increases linear with greater heights. Cut off points for periodic breathing at specific altitudes are not known and seem to be very individualized. Our aim was to study the difference of breathing patterns in healthy adults between simulated 3500 and 4500 m. Materials and methods: Twelve male and six female subjects with a mean age of 24.78 ± 1.86 had a 12 channel PSG randomly assigned at either 3500 or 4500 m simulated altitude (normobaric hypoxia, Low Oxygen Systems; Berlin-Buch, Germany). 3500 m
TST SaO2 HR AHI
4500 m
Mean Stdv.
Mean Stdv
417 min ± 45,5 min 84,8% ± 2,7% 69,2 bpm ± 8,3 bpm 44,1 ± 37,6
325,17 min ± 85,8 min 76,8% ± 3,5% 78,6 bpm ± 10,1 bpm 68,6 ± 48,3
Results: We have seen a highly significant decrease in total sleeping time and arterial oxygen saturation as well as an increase of the heart rate (HF) on 4500 m compared with 3500 m. No significant difference in the AHI and frequency of arousals could be seen. Central hypopneas changed to central apneas with the higher altitude. Conclusion: Sleep overnight in increasing simulated altitude at the cut off from moderate to high altitude goes along with decreasing oxygen saturation at a higher HF and reduced TST but with an unchanged total AHI. http://dx.doi.org/10.1016/j.sleep.2015.02.067
Nocturnal blood pressure fluctuations: Superposition phenomena in patients with obstructive sleep apnea syndrome – Risk factor for nocturnal cardiovascular events? A. Patzak 1, G. Küchler 2, I. Fietze 3, H. Hein 4 1 Charité-Universitätsmedizin Berlin, Germany 2 Somnomedics GmbH, Randersacker, Germany 3 Interdisziplinäres Schlafmedizinisches Zentrum, CharitéUniversitätsmedizin Berlin, Germany 4 Schlaflabor Reinbeck, Germany