[Changes the level of differentiating growth factor - GDF 15 in patients with sleep apnea syndrome after aPAP-therapy: pilot study]. / Izmenenie urovnya differentsirovochnogo faktora rosta ­ GDF 15 u patsientov s sindromom apnoe sna na fone aPAP-terapii: pilotnoe issledovanie.

OBJECTIVE: Comparative assessment of the level of differentiating growth factor 15 (GDF 15 ) against the background of a 6-month course of respiratory support in the mode of automatic positive pressure in the airways therapy (aPAP therapy) in patients with obstructive sleep apnea syndrome (OSA). MATERIAL AND METHODS: 59 men participated in the study, the average age was 51.9±2.4 years. The main group (MG1) consisted of 30 patients with a verified diagnosis of moderate OSA. 29 men of comparable age and body weight made up the control group (CG) without an objectively confirmed diagnosis of OSA. After the stage of introduction into the study, the type of respiratory support with individual pressure settings was selected for patients with MG1. After 6 months of aPAP therapy with high compliance (at least 85%), the same patients who made up MG2 after treatment underwent repeated polysomnography (PSG) and the GDF 15 content was evaluated. Methods: questionnaire, examination, polysomnography, enzyme immunoassay of blood serum to determine the content of GDF 15. RESULTS: A 6-month course of aPAP therapy with a high degree of compliance significantly improved the sleep structure and breathing pattern: the representation of NREM 3 increased from 79.2±15.6 to 102.6±21.6 minutes and the REM phase from 56.9± 13.6 to 115.6±26.8. Episodes of apnea were eliminated - apnea-hypopnea index decreased from 21.1 [17.3; 39.1] to 2.5 [1.8; 4.6] and the average values of SaO2 increased from 85.9% to 91.5%. At the same time, a statistically significant excess of GDF 15 was revealed in MG1 - 20.4 [14.16; 31.71] and MG2 - 17.2 [13.63; 24.44]) in comparison with CG - 13.65 [10.7; 17.09]. Despite the lack of statistical significance, a change in the level of GDF 15 was revealed in the form of a decrease in its concentration after a 6-month course of aPAP therapy. CONCLUSION: A 6-month course of aPAP therapy made it possible to eliminate intermittent nocturnal hypoxia and improve sleep structure in patients with OSA, as well as reduce the content of GDF 15 protein in blood serum in patients with OSA. However, the tendency to decrease the content of this protein, despite the lack of statistical reliability, confirms the effectiveness of OSA therapy and the possibility of preventing early and pathological aging from the standpoint of somnology and molecular biogerontology.

The State of the LPO-AOD System and the Relative Length of Telomeric Repeats in the Chromosomes of Blood Leukocytes in Obstructive Sleep Apnea Syndrome.

We analyzed the relative length of telomeric repeats in peripheral blood leukocytes and indicators of oxidative stress in 32 men (mean age 51.2±3.1 years) with obstructive sleep apnea syndrome (OSAS). The control group consisted of volunteers without OSAS. The relative length of telomeres was determined in a DNA sample isolated from venous whole blood samples. The length of telomeric repeats of chromosomes was determined using quantitative real-time PCR (3 times for each DNA sample); albumin served as an internal control. The intensity of LPO processes and antioxidant protection was assessed by conventional spectrophotometric methods. It was found that in patients with OSAS, the relative length of telomeric repeats was lower by 48%, the levels of substrates and products of LPO were higher (double bonds and diene conjugates by 34 and 19%, respectively), and antioxidant protection indicators were lower (concentrations of fat-soluble vitamins α-tocopherol and retinol by 18 and 19.3%, respectively, total antioxidant activity by 32.9%) than in volunteers of the control group. Thus, we can conclude that the nucleotide sequences are reduced in patients with OSAS under conditions of intensified free radical oxidation.

[Glutathione unit of the antioxidant system activity in pregnant women depending on the sleep quality]. / Aktivnost' glutationovogo zvena antioksidantnoi sistemy u beremennykh v zavisimosti ot kachestva sna.

OBJECTIVE: To assess the enzymatic and non-enzymatic links of the glutathione system in pregnant women depending on the sleep quality. MATERIAL AND METHODS: The study included 64 pregnant women aged 18 to 40 years. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). The results of the clinical and anamnestic examination made it possible to divide the subjects into the control group (PSQI≤5, n=31, mean age 32±5.2 years, body mass index (BMI) 30.86±8.41 kg/m2) and the main group (PSQI>5, n=33, mean age 33±5.23 years, BMI 30.88±7.47 kg/m2). The distribution of women by trimesters between the groups was statistically comparable: I (48.4%), II (32.3%), III (19.3%) in the control group and 1 (48.5%), 2 (36.4%), 3 (15.1%) in the main group. Glutathione status was determined by the content of reduced, oxidized glutathione and their ratio, glutathione peroxidase and glutathione reductase activities. The content of lipid peroxidation products was determined by the levels of diene conjugates and TBA-active products. RESULTS: PSQI was 3.81±1.30 points in the control and 8.88±3.12 points in the main group (p<0.001). There was an increase in the glutathione peroxidase activity (1349 [790.3; 2006] U/l, p=0.016) and oxidized glutathione level (2.17 [1.85; 2.33] mmol/l, p=0.048) in the main group compared with the control group (560 [438.1; 1462] U/l and 1.85 [1.53; 2.25] mmol/l, respectively). There were no statistically significant differences between the groups in the content of lipid peroxidation products such as diene conjugates and TBA-active products. CONCLUSION: The decrease of sleep quality in pregnant women is accompanied by changes in the glutathione component of antioxidant protection activation, which indicates the need to take measures to improve the sleep quality and correct the antioxidant status in these women.

[Activity of the telomerase complex before and after CPAP therapy in patients with obstructive sleep apnea syndrome]. / Aktivnost' telomeraznogo kompleksa na fone SIPAP-terapii u patsientov s sindromom obstruktivnogo apnoe sna.

OBJECTIVE: To evaluate changes in the activity of the telomerase complex in patients with obstructive sleep apnea (OSA) before and after continuous positive airway pressure (CPAP) therapy. MATERIAL AND METHODS: In accordance with the objectives of the stages of the study of telomers-telomerase relationships, we maintained the unified design of the study described earlier. The main group 1 (MG1), n=35, consisted of men, aged 53.4 [45.5-60.1] years with characteristic complaints indicating of OSA. The main group 2 (MG2) included the same patients before and after 6 months of CPAP therapy. Blood sampling was performed after the first diagnostic polysomnography (PSG) and after 6 months of CPAP in the morning after the second PSG. The control group (CG) consisted of 26 men, comparable in age and the presence of chronic diseases. Questionnaire, PSG and blood sampling were conducted in CG as well. All participants signed an informed consent. RESULTS: As a result of the STOP-BANG questionnaire conducted before PSG, all patients in the MG1 had scores from 5 to 8. The scores on the Epworth scale were more than 5 points. In the MG2 apnea-hypopnea index decreased from 20.1 to 6.4 ev/hour, the desaturation index decreased from 15.6 to 7.1 ev/hour after 6 months of CPAP. Statistically significant differences in changes in the activity of the telomerase complex were revealed, which after treatment significantly exceed the values of these indicators before treatment. So, telomerase reverse transcriptase value was 0.04 (0.009; 0.06) in the MG1, after treatment it was 0.07 (0.06; 0.09) in the MG2 and 0.134 (0.009; 0.18) in the CG. Telomerase RNA subunit TER1 values were 0.06 (0.03; 0.09), 0.07 (0.05; 0.09) and 0.136 (0.04; 0.17), respectively. However, despite the activation of the telomerase complex during CPAP therapy in patients with OSA, in the CG its activity is significantly higher in comparison with the MG1 and MG2. CONCLUSION: In OSA accompanied by intermittent hypoxia, a decrease in the activity of the telomerase complex was shown. Elimination of nocturnal hypoxia and improvement of breathing during sleep is accompanied by an increase in the activity of the components of the telomerase complex.

Glutathione Component of Antioxidant Status in Menopausal Women with Insomnia.

The study involved 138 women aged 45-60 years in perimenopause (n=55) and postmenopause (n=83) with insomnia (main groups) and without it (control). The levels of reduced (GSH) and oxidized (GSSG) glutathione and glutathione peroxidase activity were determined in erythrocytes; activities of glutathione S-transferase and glutathione reductase were measured in blood serum. The differences with the control groups were found only in perimenopause: higher glutathione reductase activity and reduced GSSG level and GSH/GSSG ratio in women with insomnia (p<0.05). The results of the comparative analysis between the main groups showed lower glutathione reductase activity, increased GSSG level, and a decrease the GSH/GSSG ratio in the postmenopausal period compared with the perimenopause (p<0.05). These results can be used in choosing the tactics for complex therapy of insomnia in menopausal women to correct free radical homeostasis and prevention of oxidative stress.

Features of the EEG Pattern of Sleep Spindles and Its Diagnostic Significance in Ontogeny.

Analysis of the microstructure of sleep using extended EEG monitoring can provide deep understanding of the neuronal activity of the brain. Sleep spindles (SS) are one of the main EEG patterns occurring during the non-rapid eye movement sleep. SS reflect the process of synchronization and provide sleep initiation and maintenance by suppressing sensory information. SS are associated with a wide range of brain functions, such as memory and neuroplasticity, general intelligence and cognitive performance, which undergo various changes throughout the life. In this review we discuss the features of the formation and regression of SS in humans during ontogeny on the basis of published data of the last 5-6 years and fundamental results of previous studies at the Scientific Centre for Family Health and Human Reproduction Problems that formed the basis of the modern study of neurophysiological phenomena of the wakefulness and sleep. The search for diagnostic patterns and prognostic markers of the pathology of higher nervous activity remains a priority in fundamental studies and medical practice. Modern methods for studying sleep and its EEG patterns are the next step in understanding the neurophysiological aspects of the sleep-wake cycle. This will open prospects for predicting postnatal maturation, understanding the mechanisms of brain neuroplasticity in the "sleep-wakefulness" continuum, which is one of the tasks of modern somnology and neurophysiology.

[Changes in the telomeres length in patients with obstructive sleep apnea after continuous positive airway pressure therapy: a pilot study]. / Izmenenie otnositel'noi dliny telomer u patsientov s sindromom obstruktivnogo apnoe sna na fone SIPAP-terapii: pilotnoe issledovanie.

OBJECTIVE: To evaluate a relative telomere length in patients with obstructive sleep apnea (OSA) before and after a 6-month course of continuous positive airway pressure (CPAP) therapy. MATERIAL AND METHODS: Seventy-five men participated in the study, including 50 men with OSA (the main group 1) and 25 men without OSA (the control group). The average age in the total group was 53.4±3.6 years. Thirty-five men completed the study (the main group 2). According to the design, night polysomnography (PSG) was performed for all the subjects, blood sampling to assess the length of telomeres was carried out in the morning according to the standard method. The values of the relative telomere length were obtained using the difference between the values of the threshold cycles for telomeric DNA and the reference gene albumin (∆CCt). After clarifying the diagnosis, CPAP was applied for 6 months. RESULTS: Statistically significant indicators of PSG were revealed: a decrease in NREM 3 in patients with OSA compared to controls (89.3±15.8 versus 150±23.4 minutes), an increase in NREM1-2 in OSA (296.2±31.1 and 170.1±24.5, respectively), REM was 84.6±15.4 in the main group and 118.5±19.5 in the control group. CPAP therapy conducted for 6 months (at least 4-5 nights a week, lasting at least 5-6 hours of night sleep) demonstrated a significant improvement in the qualitative and quantitative parameters of sleep. In patients of the main group 1, there is a shortening of the telomere length compared with the control group (p<0.001). With the elimination of hypoxia and improvement of the structure of sleep after CPAP, there was an increase in the telomere lengths in the main group 1 from 0.28 [0.24-0.29] to 0.32 [0.30-0.34] in the main group 2 (p=0.03). The telomers length in the control group was 0.53 [0.50-0.55]. CONCLUSION: Intermittent hypoxia and fragmentation of sleep in OSA leads to shortening of telomeres. CPAP, by eliminating the pathophysiological triggers of OSA, contributes to an increase in telomeres lengths and can slow down the premature aging in OSA.

Glutathione system activity in the blood of overweight postmenopausal women.

One of the important components of the antioxidant defense system is the glutathione system, the activity of which, when overweight, changes direction depending on gender and ethnicity. The results of studies involving overweight menopausal women are mixed. The study involved 61 postmenopausal women, who, after clinical and anamnestic examination, were divided into 2 groups: control (BMI = 19-24.9 kg / m2) and overweight group (BMI = 25-29.9 kg/m2). The use of hormone replacement therapy; the use of antioxidant drugs; diseases of endocrine genesis; exacerbation of chronic diseases; premature early menopause; surgical menopause was the exclusion criteria for women from the study. The lipid profile parameters with the calculation of the atherogenic coefficient; reduced and oxidized glutathione levels with the calculation of their ratio, the glutathione S-transferase and glutathione reductase activities were determined in the blood. Overweight women showed an increase in the triacylglycerols (p = 0.041) and cholesterol in very low density lipoproteins levels (p = 0.044). When assessing the glutathione system activity in women of the main group, compared with the control, an increase in the glutathione-S-transferase (p = 0.023) and glutathione reductase (p = 0.022) activities was noted, however, the reduced and oxidized glutathione levels, as well as their ratio did not differ from the control values. The results obtained indicate the activation of the glutathione system enzymatic link in response to changes in lipid status in postmenopausal women with overweight.

Serum Serotonin as a Biomarker of the Efficacy of PAP-Therapy in Sleep Apnea Syndrome.

Serum serotonin levels were determined by HPLC in 30 patients with diagnosed obstructive sleep apnea syndrome before and after 3-month course of PAP-therapy and in 14 subjects without obstructive sleep apnea symptoms. It was found that elimination of hypoxic conditions was associated with an increase in serotonin level. The results demonstrate the effectiveness of PAP-therapy during sleep and allow assessing the role of serotonin as a potential biomarker of intermittent hypoxia during sleep.

8-Hydroxy-2'-Deoxyguanosine as an Oxidative Stress Marker in Insomnia.

We performed comparative analysis of 8-hydroxy-2'-deoxyguanosine in women in different climax stages with and without insomnia. The study involved 90 women aged 45 to 60 years divided into perimenopausal (n=30) and postmenopausal (n=60) groups. After questioning using special sleep questionnaires (Insomnia Severity Index, Epworth Sleepiness Scale, Munich Chronotype Questionnaire), the groups were divided into subgroups with insomnia and without it (control). 8-Hydroxy-2'-deoxyguanosine was assayed in blood serum by ELISA. The higher levels of 8-hydroxy-2'-deoxyguanosine in postmenopausal women with insomnia in comparison with the control and perimenopausal patients (p<0.05) attested to oxidative DNA damage in this cohort of patients.

[Sleep apnea syndrome, pregnancy and fetal condition]. / Sindrom obstruktivnogo apnoe sna, beremennost' i sostoyanie ploda.

OBJECTIVE: To assess fetal cardiac activity with simultaneous polysomnographic (PSG) study of pregnancy with obstructive sleep apnea syndrome (OSAS). MATERIALS AND METHODS: Forty-nine women, aged 18-30 years, 30-34 weeks pregnant, complaining of snoring, with a positive rating in 2 and/or 3 sections of the Berlin Sleep Questionnaire were included in the study. Sixteen pregnant women with the corresponding gestational age, without complaints of snoring, made up the control group. All participants underwent PSG monitoring and fetal cardiotocography (CTG) according to standard techniques. RESULTS: PSG results demonstrate significant changes in sleep patterns in pregnant women with OSAS. There is a significant reduction in SWS 3, REM. High AHI, accompanied by desaturation and the appearance of activation EEG- patterns of cyclic alternations are characterized the sleep of pregnant women with OSAS. Analysis of CTG results shows that the average values of the basal rhythm are statistically higher in women with OSAS than in the control group. Also, the indicators of the amplitude of the oscillations, the frequency of oscillations and the number of movements in 30 minutes are statistically significantly different. Reaction of the fetus to episodes of apnea in the form of active perturbation, changes in heart rate as bradycardia (to 105-110 beats per minute) or tachycardia (to 155-160 beats per minute) compared to basal level (140 beats per minute) are noted. CONCLUSION: OSAS during nocturnal sleep in pregnant women causes the changes in motor activity and cardiac activity of the fetus that indicates fetal hypoxemia.

[Novel coronavirus disease (COVID-19) and obstructive sleep apnea: age aspects of comorbidity]. / Novaya koronavirusnaya infektsiya (COVID-19) i sindrom obstruktivnogo apnoe sna: vozrastnye aspekty komorbidnosti.

In connection with the spread of the novel coronavirus infection (COVID-19) pandemic and the increase in the development of severe acute respiratory syndrome, works are published around the world that determined the risk factors for complications and poor outcomes in this disease. Among the main comorbidities in COVID-19, scientists distinguish hypertension, diabetes, obesity, etc. Recently, more and more physicians and researchers are concerned about the high frequency of severe and critical complications of COVID-19 in patients with obstructive sleep apnea (OSA). In this review, we present some data on COVID-19 and OSA in the age aspect, show the general pathophysiological pathways leading to increased systemic inflammation and adverse consequences in the comorbid course of these diseases. Special attention is paid to such studies in the pediatric population, but only a few works of foreign scientists were found that did not reveal the essence of the problem under discussion, which requires further research in this area.

Free Radical Oxidation of Lipids as an Indicator of the Effectiveness of CPAP Therapy in Apnea Syndrome.

The processes of free radical lipid oxidation were studied in 47 patients with moderate to severe obstructive sleep apnea syndrome before and after 1-month course of CPAP-therapy (continuous positive airway pressure). The control group consisted of 13 people without clinically confirmed apnea. The material for the study was serum, blood plasma, and erythrocyte hemolysate. The levels of LPO products and antioxidant defense were determined spectrophotometrically and spectrofluorometrically. The changes revealed in patients with obstructive sleep apnea syndrome after CPAP therapy indicate a decrease in the intensity of LPO and restoration of the balance in the "LPO-antioxidant defense" system.

[Deletion polymorphism of GSTT1 gene and lipid peroxidation hyperactivation in menopausal insomnia]. / Deletsionnyi polimorfizm GSTT1 i giperaktivatsiya protsessov lipoperoksidatsii pri insomnii klimaktericheskogo perioda.

OBJECTIVE: A comparative analysis of the parameters of lipid peroxidation - antioxidant defense system in menopausal women with- and without insomnia, depending on the GSTT1 polymorphism. MATERIAL AND METHODS: The study included 181 menopausal Caucasian women (ethnic group - Russians), who according to the results of the clinical-anamnestic examinations were divided into insomnia group (n=120, age 53.68±4.61 years, body mass index 26.47±3.73 kg/m2) and control group (n=61, age 52.64±4.91 years, body mass index 27.69±3.11 kg/m2). The insomnia group was formed according to the clinical guidelines for the diagnosis and treatment of chronic insomnia in adults, and scores of the Insomnia Severity Index. The study of the GSTT1 gene polymorphism was carried out using polymerase chain reaction. The lipid peroxidation - antioxidant system parameters were determined by spectrofluorophotometric methods. RESULTS: In the insomnia group, carriers of the normal GSTT1 genotype had higher diene conjugates with lower glutathione peroxidase activity as compared to controls. When comparing groups of women with the deletion in GSTT1, an increase in the content of substrates and lipid peroxidation products was observed at all stages of lipid peroxidation, oxidized glutathione, glutathione S-transferase activity with a decrease in the content of reduced glutathione and retinol in the insomnia group as compared to controls. In the insomnia group, carriers of the deletion genotype had a higher content of ketodienes/conjugated trienes and active products of thiobarbituric acid, a lower content of retinol and α-tocopherol as compared to the patients with normal GSTT1 genotype. Conclusions. Insomnia in the menopausal women is accompanied with the intensification of lipid peroxidation only in the carriers of the GSTT1 deletion genotype.

[Evaluation of the structural organization of sleep in obstructive apnea syndrome from the perspective of modern pathophysiology]. / Otsenka osobennostei strukturnoi organizatsii sna pri sindrome obstruktivnogo apnoe s pozitsii sovremennoi patofiziologii.

OBJECTIVE: To evaluate the features of structural organization of sleep in men 35-55 years of age with varying degrees of severity and duration of clinical manifestations of obstructive sleep apnea syndrome (OSAS) from the perspective of modern pathophysiology. MATERIAL AND METHODS: The study included 49 male patients, aged 35-55 years (average age was 43.4±9.2 years), with a body mass index (BMI) of 33.64±1.2 kg/m2 with complaints of snoring of varying degrees of intensity, daytime sleepiness, arrest of breathing during sleep (according to others). The control group consisted of 15 healthy men who did not have complaints of sleep disorders and clinical manifestations of OSAS. The Pittsburgh sleep quality index (PSQI) questionnaire and polysomnographic monitoring study (PSG) were used. According to the results of the polysomnographic study, all patients were divided into 2 subgroups: 12 men of group 1with moderate OSAS (duration of clinical manifestations 4.5±1.0 years) and 37 men of group 2 with severe OSAS (duration 1.5±1.5 years). RESULTS: A decrease in the sleep quality was detected in 61.9% of patients in the group 1 and 89.2% of patients in the group 2. Significantly higher scores for the components of «sleep disturbance¼ and «daytime dysfunction¼ in patients with a longer duration of clinical manifestations were detected. Changes in the structure of sleep were identified in patients compared with controls. A statistically significant increase in WASO led to the reduction of sleep efficiency. In patients of group 2, a deficiency of the deep stages and REM-sleep was determined. There was a significant increase in the number of arousals in patients of both groups relative to the controls. Moreover, significant between-group differences were found. CONCLUSION: The short duration of OSAS symptoms causes a restructuring of the physiological system of sleep homeostasis to a different level of functioning with compensatory hyperfunction of the structures responsible for REM sleep and a decrease (economization) in the activity of anabolic processes during sleep due to a decrease in SWS, which is a characteristic feature of long-term adaptation. Severe course of OSAS leads to the appearance of specific phenomena of gross structural disorganization of sleep - «alpha-delta sleep¼ and disruption of its segmental organization, which shows the depletion and disruption of compensatory-adaptive mechanisms in the system of sleep homeostasis, disintegration and transformation of functional physiological system in the pathological condition.

Heat Shock Protein HSP70 in Oxidative Stress in Apnea Patients.

We studied the level of heat shock protein HSP70 under conditions of oxidative stress in 47 patients with apnea. The control group included 13 healthy subjects without verified apnea. Blood serum, plasma, and erythrocyte hemolysate were used to determine LPO and anti-oxidant protection components by spectrophotometrical and spectrofluorometrical methods. HSP70 was assayed by ELISA. A direct relationship was established between the intensity of oxidative stress and HSP70 expression in patients with apnea. Quantitative determination of HSP70 can be used as a molecular marker in the early diagnosis and prognosis of the development of various pathological conditions in hypoxia.

[Expression of heat shock proteins HSP70 under oxidative stress.]

Developing oxidative stress inevitably causes damage to cell proteins in need of timely refolding. Synthesis of a group of heat shock proteins is the most ancient and effective mechanism of cell protection. In the course of the whole life of the cell adaptation to a huge number of cytotoxic factors, both xenobiotic and natural origin provide heat shock proteins with polyfunctionality and in terms of the implementation of programmed death acting as either anti - or proapoptogenic factors, or as regulators of the activity of these factors. Studies show the important role of heat shock proteins in adaptation, inflammation, and immune response. Various experimental and clinical studies prove the important role of heat shock proteins in the development of pathophysiological phenomena of oxidative stress, aging, tumor formation, immune reactions. Presented in the review data of domestic and foreign studies on the physiological significance of heat shock proteins, their role in the mechanisms of cell and body stability in General are relevant to modern medicine and biology.

[The role of melatonin as a component of the antioxidant defense system in perimenopausal women with insomnia]. / Rol' melatonina kak komponenta antioksidantnoi zashchity pri insomnii v perimenopauze.

AIM: To determine the ethnic features of the functioning of the 'lipid peroxidation-antioxidants' system and to evaluate the role of melatonin as one of the antioxidant defense system components in Caucasian and Asian perimenopausal women with insomnia. MATERIAL AND METHODS: One hundred and ten perimenopausal women divided into Caucasian (Russian ethnic group (n=60)) and Asian (Buryat ethnic group (n=50)) were studied. All women underwent clinical-anamnestic examination. Diagnoses of insomnia and obstructive sleep apnea syndrome (OSAS) were made according to the results of specialized somnological questionnaires and polysomnographic monitoring. A multidimensional discriminant analysis was used to reveal the most informative parameters among the hormonal and metabolic parameters studied (melatonin 06.00-07.00h; 12.00-13.00h; 18.00-19.00h; 23.00-00.00h; lipid profile, lipid peroxidation and antioxidant defense system). RESULTS: The most informative indicators of the metabolic system in Caucasians with insomnia are morning, evening, night melatonin, ketodienes and conjugated trienes, oxidized glutathione (GSSG); with insomnia and OSAS: morning, day, night melatonin, substrates with conjugated double bonds, total cholesterol; in Asian women with insomnia: evening, night melatonin, superoxide dismutase activity (SOD), diene conjugates, active products of thiobarbituric acid, cholesterol of very low density lipoproteins; in women with insomnia and OSAS: morning, day melatonin, SOD, GSSG. The recalculation of the informativeness of each attribute as a percentage showed the prevalence of the influence of the antioxidant protection system parameters over those of lipid peroxidation processes. The contribution of melatonin to the total share of the antioxidant protection system components is more than 60%. CONCLUSION: Both in Caucasian and Asian women with sleep disorders, there is stress in the antioxidant defense system, where melatonin is the largest contributor.

[Ethnic features of sleep disorders in climacteric women]. / Étnicheskie osobennosti narushenii sna u zhenshchin klimaktericheskogo perioda.

AIM: To evaluate the features of sleep disorders in Caucasian and Asian menopausal women. MATERIAL AND METHODS: Five hundreds and forty-two menopausal women, aged 45 to 60 years, were divided into Caucasians (Russians (n=342)) and Asians (Buryats (n=200)). All women were examined by an obstetrician-gynecologist. Also, a general clinical examination and an analysis of medical documentation were conducted. Diagnoses of insomnia and obstructive sleep apnea syndrome (OSAS) were made according to the results of specialized somnological questionnaires and polysomnographic monitoring. RESULTS: The frequency of sleep disorders in Caucasian women in perimenopause was 61.2%, in postmenopause 65.5%; in Asian women it was 63.5% in perimenopause, 72.9% in postmenopause. Difficulties in falling asleep (69.4%) and difficulties in morning awakenings (63.5%) were found in perimenopausal Caucasian women and frequent nightly awakenings (83.5%) and OSAS (48.9%) were found in postmenopausal ones. There were no differences in the structure of sleep disorders depending on the menopause phase in Asian women. The most common complaints were frequent nighttime awakenings (69.5% in perimenopause, 76.9% in postmenopause). Ethnic differences in the sleep complaints were found only in the perimenopause. The decrease in sleep efficacy and changes in the rapid eye movement sleep were found in Asian women as compared to Caucasians. Moreover, apnea-hypopnea index was higher and oxygen saturation was lower in Asian women compared to Caucasians. CONCLUSION: The formation of sleep disorders in menopausal women has ethnogenetic features.

[Lipid status and oxidative stress in menopausal women with obstructive apnea syndrome].

AIM: to assess lipid profile, lipid peroxidation and antioxidant system parameters in peri - and postmenopausal women with obstructive sleep apnea syndrome (OSAS). MATERIALS AND METHODS: 37 perimenopausal women and 43 postmenopausal ones were examined. OSAS diagnosis was made on the basis of the clinical picture and the polysomnography results. In perimenopause, the main group consisted of 18 women, in postmenopausal women - 17. All comparison groups are comparable by age and body mass index. Lipid profile, lipid peroxidation and antioxidant system parameters by spectrophotometric methods were determined. Non - parametric criteria were used to analyze the group differences for the independent samples. RESULTS AND DISCUSSION: The increase of total cholesterol (TC) and low - density lipoprotein cholesterol (LDL-C) levels were observed in perimenopausal women with OSAS as compared to control. The increase of TC, triacylglycerol (TG), LDL-C, very - low - density lipoprotein cholesterol (VLDL-C) levels and decrease of high - density lipoprotein cholesterol (HDL-D) level were found in postmenopausal women with OSAS as compared to control. Accumulation of ketodienes and conjugated trienes in perimenopausal women with OSAS and thiobarbituric acid reactants with a decrease of total antioxidant activity of blood serum in postmenopausal women with OSAS as compared to control was observed. Moreover, postmenopausal women with OSAS have a higher lipid peroxidation substrates and diene conjugates levels with a lower α-tocopherol level and total antioxidant activity compared with perimenopausal patients.The integral indicator of oxidative stress assessment indicates an imbalance in the lipid peroxidation and antioxidant system in menopausal women with OSAS. CONCLUSION: The results obtained indicate a violation of lipid metabolism and the development of oxidative stress in patients with OSAS. This is most pronounced in the postmenopause due to the aggravation of the pathological condition.