Renal functions in obstructive sleep apnea patients.

PURPOSE: The aim of this study is to investigate possible factors influencing glomerular filtration rate (GFR) in obstructive sleep apnea (OSA). METHODS: Data of OSA patients admitted to Gaziantep University sleep clinic from January 2005 to January 2010 were retrospectively evaluated. GFR is calculated with the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Patients younger than 18 years old were excluded. RESULTS: The mean age of OSA (n = 634) and control group (n = 62) were 51.13 ± 11.61 and 50.69 ± 13.88 years, respectively (p = 0.81). The mean estimated GFR (eGFR) was 90.73 ± 19.59 ml/min/1.73 m(2) in OSA patients and 94.14 ± 18.81 ml/min/1.73 m(2) in control subjects (p = 0.19). GFR was 84.25 ± 20.87 ml/min/1.73 m(2) in patients with left ventricular hypertrophy (LVH) while it was 93.94 ± 18.44 ml/min/1.73 m(2) in patients without LVH (p = 0.00). GFR of male subjects was 92.1 ± 19.23 in OSA and 95.84 ± 20.08 ml/min/1.73 m(2) in controls (p = 0.33). GFR of female and male patients in the OSA were 87.45 ± 20.10 and 92.91 ± 18.02 ml/min/1.73 m(2), respectively (p = 0.13). Serum creatinine was higher in OSA patients compared to controls (p = 0.01). GFR was 92.30 ± 19.27 in male and 88.33 ± 19.84 ml/min/1.73 m(2) in female subjects (p = 0.01). GFR was 84.86 ± 19.95 in hypertensive patients while it was 95.11 ± 18.20 ml/min/1.73 m(2) in normotensive subjects (p = 0.00). GFR was 89.30 ± 19.96 in patients with metabolic syndrome (MetS) and it was 93.46 ± 18.68 ml/min/1.73 m(2) in patients without MetS (p = 0.00). CONCLUSIONS: GFR values were lower in sleep apneic patients with MetS as well as in patients with hypertension and LVH.

Effects of positive airway pressure therapy on exercise parameters in obstructive sleep apnea.

BACKGROUND AND OBJECTIVES: Obstructive sleep apnea (OSA) is common in adult population and may cause many adverse clinical results. We aimed to investigate possible changes in cardiopulmonary exercise capacity in OSA patients after positive airway pressure treatment. DESIGN AND SETTINGS: Patients who were admitted to Gaziantep University Pulmonary Diseases Sleep Center and diagnosed OSA were included. Studies carried out between May 2010 and July 2011. Sixty-five consecutive patients were included in this prospective study. PATIENTS AND METHODS: Sixty-five adult sleep clinic patients diagnosed with OSA by polysomnography and in whom continuous positive airway pressure (CPAP) ventilation therapy was indicated were included. Cardiopulmonary exercise capacity was assessed by bicycle ergometry during diagnostic workup and at least 4 weeks later. RESULTS: There were 57 (87.7%) males. The mean age was 45.29 (10.57) years, apnea-hypopnea index 38.02 (23.19 events/h, body mass index 31.72 (4.87) kg/m2. Patients were grouped with respect to compliance with CPAP. The peak oxygen consumption (VO2) did not change in the CPAP compliant group (n=33) (22.52 [6.62] mL/[min.kg] to 21.32 [5.26] mL/[min.kg]; P=.111), and decreased from 21.31 (5.66) mL/(min.kg) to 19.92 (5.40) mL/(min.kg) (P=.05) in the CPAP noncompliant group. Work rate increased from 84.0% to 85.0% in the CPAP compliant group and decreased from 79.6% to 77.1% in the noncompliant group (P=.041). In the group that used the device, ventilation (VE)/VCO2 at anaerobic threshold (AT) declined from 28.42 to 27.36; however, it increased from 27.41 to 27.81 in the group that did not use the device (P=.033). CONCLUSIONS: Decline in the exercise capacity was prevented in patients with OSA after 4 weeks of CPAP therapy. The changes in VE/VCO2 at AT suggest the reversal of pathophysiologic changes in OSA with the CPAP therapy that may improve cardiac function and cause more efficient ventilation.

Obstructive sleep apnea is prevalent in patients with pulmonary embolism.

PURPOSE: Obstructive sleep apnea (OSA) syndrome causes systemic consequences due to hypoxia and endothelial dysfunction. The purpose of this study was to investigate whether OSA is more common in subjects with pulmonary embolism (PE). METHODS: This prospective study was conducted between November 2009 and December 2010 in the Department of Pulmonary Medicine of Gaziantep University. Twenty-eight patients with PE were included in the study group along with forty-five subjects with OSA as the control group. The control group was selected from among subjects who were referred to the sleep clinic. Full night polysomnography was performed for each subject. RESULTS: Mean apnea-hypopnea index (AHI) was found to be higher in the PE group compared with the control group (p=0.010). Severe OSA was detected in 21.4% of the PE group but in no controls (p=0.015). Sleep stage 2 was longer in control group whereas stage 1 and rapid eye movement (REM) sleep was longer in the PE group. Snoring and excessive daytime sleepiness were more common in the control group compared with the study group. AHI severity and thrombus localization were not significantly different between the groups (p=0.350). CONCLUSION: Our study findings suggest that OSA is more prevalent and severe in subjects with PE compared with control subjects. The clinical significance of less prevalent excessive daytime sleepiness and snoring in subjects with PE should be evaluated in further studies.