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- Karimi, Mahssa, et al.
(författare)
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Attention deficits detected in cognitive tests differentiate between sleep apnea patients with or without a motor vehicle accident
- 2015
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Ingår i: Sleep Medicine. - : Elsevier BV. - 1389-9457. ; 16:4, s. 528-533
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Obstructive sleep apnea (OSA) is associated with an increased motor vehicle accident (MVA) risk. Conventional measures of OSA severity do not predict individual risk. Cognitive function tests have failed to incorporate outcomes in risk prediction. We aimed to identify markers of cognitive function for MVA risk prediction in OSA. Methods: OSA patients [n = 114, 75% male, median age 51 (43-61) years, body mass index (BMI) 30 (27-33) kg/m(2), apnea-hypopnea index 25 (6-49) n/h, and Epworth Sleepiness (ESS) score 11 (8-16)] were recruited from a sleep laboratory. Two cognitive function tests, the Attention Network Test (ANT) and a modified Oxford Sleep Resistance Test (OSLER) test (GOSLING), were assessed. Results: OSA patients with (n = 11) or without (n = 103) a MVA record in the Swedish traffic accident registry were identified. In patients with a MVA, 64% were commercial drivers. In patients with a MVA history, more lapses [42 (5-121) vs. 5 (1-25), P = 0.02] and fewer responses [238 (158-272) vs. 271 (256-277), P = 0.03] to stimuli in the ANT were found. In the GOSLING, the number of lapses was higher (29 (10-97) vs. 7 (2-19), P = 0.01) and the reaction time was longer [462 (393-551) vs. 407 (361-449) ms, P = 0.05]. OSA severity and ESS score poorly predicted MVAs (P > 0.2). Conclusions: We have demonstrated that deficit in sustained attention, assessed by daytime neurocognitive function tests, was associated with MVA risk in OSA patients. We were unable to detect an association between MVA history and severity of OSA or the ESS score. The findings provide a rationale for further development of objective MVA risk assessment tools in OSA. (C) 2014 Elsevier B.V. All rights reserved.
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| 2. |
- Wang, Tengyu, et al.
(författare)
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Increased Carbonic Anhydrase Activity is Associated with Sleep Apnea Severity and Related Hypoxemia
- 2015
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Ingår i: Sleep. - : Oxford University Press (OUP). - 0161-8105 .- 1550-9109. ; 38:7
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Tidskriftsartikel (refereegranskat)abstract
- Study Objectives: The catalytic function of the enzyme carbonic anhydrase (CA) plays a fundamental role in carbon dioxide (CO2), proton (H+), and bicarbonate (HCO3-) homeostasis. Hypoxia and tissue acidosis have been proposed to increase physiological CA activity in various compartments of the body. We hypothesized that CA activity in blood is upregulated in patients with obstructive sleep apnea (OSA). Participants: Seventy referred patients with suspected OSA (48 males, age 54 +/- 13 y, apnea-hypopnea index (AHI) median [interquartile range] 21 [8-41] n/h). Measurements and Results: In-laboratory cardiorespiratory polygraphy was used to assess OSA. CA activity was determined by an in vitro assay that quantifies the pH change reflecting the conversion of CO2 and H2O to HCO3- and H+. CA activity was positively associated with AHI and 4% oxygen desaturation index (ODI4) (Spearman correlation r = 0.44 and 0.47, both P < 0.001). The associations (CA activity versus logAHI and CA versus logODI4) were independent of sex, age, body mass index, presleep oxygen saturation, nocturnal oxygen saturation, hypertension status, and use of diuretic medication in two generalized linear models (P = 0.007 and 0.011, respectively). Sitting diastolic blood pressure was associated with CA activity after adjustment of sex, age, body mass index, mean oxygen saturation, and AHI (P = 0.046). Conclusions: Carbonic anhydrase (CA) activity increased with apnea-hypopnea index and related nocturnal hypoxemia measures in patients with obstructive sleep apnea (OSA). Altered CA activity may constitute a component that modulates respiratory control and hemodynamic regulation in patients with OSA.
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