Obstructive sleep apnea(OSA)is frequently associated with obesity and metabolic syndrome.Also frequently associated with metabolic syndrome is type 2 diabetes mellitus(T2DM).Therefore,it is common to find OSA and T2DM...Obstructive sleep apnea(OSA)is frequently associated with obesity and metabolic syndrome.Also frequently associated with metabolic syndrome is type 2 diabetes mellitus(T2DM).Therefore,it is common to find OSA and T2DM together in individuals with metabolic syndrome.Additionally,both OSA and T2DM have a common pathophysiological link with development of insulin resistance.Individuals with severe insulin resistance are likely to have inadequate glycemic control.Long standing poorly controlled T2DM is associated with debilitating microvascular complications such as retinopathy,nephropathy,neuropathy and macrovascular complications such as coronary artery and cerebrovascular disease.There is extensively published literature exploring the cause-effect relationship between OSA and T2DM.In this article we provide an in-depth review of the complex pathophysiological mechanisms linking OSA to T2DM.Specifically,this review focusses on the effect of OSA on the microvascular complications of T2DM such as retinopathy,nephropathy and neuropathy.Additionally,we review the current literature on the effect of continuous positive airway pressure use in individuals with T2DM and OSA.展开更多
Zolpidem is a sedative-hypnotic drug used to treat in sleep disorders, and it is the most commonly prescribed drug for insomnia. It reduces sleep latency and increases total sleep time. However, some studies have repo...Zolpidem is a sedative-hypnotic drug used to treat in sleep disorders, and it is the most commonly prescribed drug for insomnia. It reduces sleep latency and increases total sleep time. However, some studies have reported that zolpidem might induce sleep related eating disorder (SRED). SRED is characterized by recurrent episodes of compulsive and involuntary eating during night sleep, accompanied by partial consciousness and limited subsequent recall. The pathophysiology of SRED is unknown. Patients with SRED usually suffer from other sleep disorders such as sleepwalking, restless legs syndrome, and obstructive sleep apnea. In this article, we present an overview of case reports on SRED induced by zolpidem.展开更多
Objective To study the relationship between vertebro basilar ischemic attacks (VBI) and sleep related breathing disorders (SRBD). Methods Polysomnographic examinations were performed on 45 VBI patients. The incidence ...Objective To study the relationship between vertebro basilar ischemic attacks (VBI) and sleep related breathing disorders (SRBD). Methods Polysomnographic examinations were performed on 45 VBI patients. The incidence and characteristics of SRBD, and its relationship with various clinical factors were analyzed. Results Eighteen cases (40%) were complicated with SRBD, among which 2/3 was obstructive and 1/3 was central types. They were correlated with obesity and prone to be suffered with cardiovascular disorders.Conclusions Brain stem dysfunction caused by long term repeated ischemias probably is the pathogenesis of SRBD, especially it’s central type, in VBI. The arrhythmia and hypertension secondary to SRBD may aggravate VBI. VBI and SRBD may be reciprocal and form a vicious circle which should draw attention in the prevention and treatment of SRBD in VBI.展开更多
Melatonin and gamma-aminobutyric acid（GABA） have been shown to regulate sleep. The nocturnal concentrations of melatonin, GABA and total antioxidants may relate to insomnia in stroke patients. In this prospective si...Melatonin and gamma-aminobutyric acid（GABA） have been shown to regulate sleep. The nocturnal concentrations of melatonin, GABA and total antioxidants may relate to insomnia in stroke patients. In this prospective single-center non-randomized controlled clinical trial performed in the China Rehabilitation Research Center, we analyzed the relationship of nocturnal concentrations of melatonin, GABA and total antioxidants with insomnia after stroke. Patients during rehabilitation of stroke were recruited and assigned to the insomnia group or non-insomnia group. Simultaneously, persons without stroke or insomnia served as normal controls. Each group contained 25 cases. The primary outcome was nocturnal concentrations of melatonin, GABA and total antioxidants in peripheral blood. The secondary outcomes were Pittsburgh Sleep Quality Index, Insomnia Severity Index, Epworth Sleepiness Scale, Fatigue Severity Scale, Morningness-Eveningness Questionnaire（Chinese version）, and National Institute of Health Stroke Scale. The relationship of nocturnal concentrations of melatonin, GABA and total antioxidants with insomnia after stroke was analyzed and showed that they were lower in the insomnia group than in the non-insomnia group. The severity of stroke was higher in the insomnia group than in the non-insomnia group. Correlation analysis demonstrated that the nocturnal concentrations of melatonin and GABA were associated with insomnia after stroke. This trial was registered at Clinical Trials.gov, identifier： NCT03202121.展开更多
Background Sleep disturbance is common in patients with emphysema. This study aimed to develop a novel model of sleep-related hypoxemia （SRH） in emphysema （SRHIE） with rats, and to explore the inflammatory status ...Background Sleep disturbance is common in patients with emphysema. This study aimed to develop a novel model of sleep-related hypoxemia （SRH） in emphysema （SRHIE） with rats, and to explore the inflammatory status of SRHIE in lung, liver, pancreas, carotid artery and whole blood.Methods Seventy-five male Wistar rats were assigned to 5 groups with 15 per group according to the exposure conditions. The protocols varied with the degree of hypoxia exposure and severity of pre-existing emphysema caused by cigarette smoke exposure： （1） SRH control （SRHCtrl） group, sham smoke exposure （smoke exposure, exposed to smoke of 15 cigarettes twice everyday, 16 weeks） and SRH exposure （12.5% O2, 3 hours, SRH exposure, divide total hypoxia time （1.5 hours or 3 hours） into 4 periods evenly （22.5 minutes or 45 minutes） and distribute these hypoxia periods evenly into physiological sleep time of rats identified by electroencephalogram, week 9 to week 16）; （2） Emphysema control （ECtrl） group, smoke exposure and sham SRH exposure （21% O2, 3 hours）; （3） Short SRH in emphysema （SRHShort） group, smoke exposure and short SRH exposure （12.5% O2, 1.5 hours）; （4） Mild SRH in emphysema （SRHMild） group,smoke exposure and mild SRH exposure （15% O2, 3 hours）; （5） Standard SRH in emphysema （SRHStand） group, smoke exposure and SRH exposure （12.5% O2, 3 hours）. ECtrl, SRHShort, SRHMild and SRHStand groups were groups with emphysematous rats. Two days before the end of exposure, 5 rats in each group were randomly selected for arterial blood gas analysis. In the rest 10 rats in each group, we obtained blood samples and bronchoalveolar lavage fluid （BALF）for routine tests. We also obtained tissue blocks of lung, liver, pancreas, and right carotid artery for pathologic scoring and measurements of liver oxidative stress （measuring hepatic oxidative stress enzymes, superoxide dismutase （SOD） activity, catalase （CAT） activity and malondialdehyde （MDA） conce展开更多
文摘Obstructive sleep apnea(OSA)is frequently associated with obesity and metabolic syndrome.Also frequently associated with metabolic syndrome is type 2 diabetes mellitus(T2DM).Therefore,it is common to find OSA and T2DM together in individuals with metabolic syndrome.Additionally,both OSA and T2DM have a common pathophysiological link with development of insulin resistance.Individuals with severe insulin resistance are likely to have inadequate glycemic control.Long standing poorly controlled T2DM is associated with debilitating microvascular complications such as retinopathy,nephropathy,neuropathy and macrovascular complications such as coronary artery and cerebrovascular disease.There is extensively published literature exploring the cause-effect relationship between OSA and T2DM.In this article we provide an in-depth review of the complex pathophysiological mechanisms linking OSA to T2DM.Specifically,this review focusses on the effect of OSA on the microvascular complications of T2DM such as retinopathy,nephropathy and neuropathy.Additionally,we review the current literature on the effect of continuous positive airway pressure use in individuals with T2DM and OSA.
文摘Zolpidem is a sedative-hypnotic drug used to treat in sleep disorders, and it is the most commonly prescribed drug for insomnia. It reduces sleep latency and increases total sleep time. However, some studies have reported that zolpidem might induce sleep related eating disorder (SRED). SRED is characterized by recurrent episodes of compulsive and involuntary eating during night sleep, accompanied by partial consciousness and limited subsequent recall. The pathophysiology of SRED is unknown. Patients with SRED usually suffer from other sleep disorders such as sleepwalking, restless legs syndrome, and obstructive sleep apnea. In this article, we present an overview of case reports on SRED induced by zolpidem.
文摘Objective To study the relationship between vertebro basilar ischemic attacks (VBI) and sleep related breathing disorders (SRBD). Methods Polysomnographic examinations were performed on 45 VBI patients. The incidence and characteristics of SRBD, and its relationship with various clinical factors were analyzed. Results Eighteen cases (40%) were complicated with SRBD, among which 2/3 was obstructive and 1/3 was central types. They were correlated with obesity and prone to be suffered with cardiovascular disorders.Conclusions Brain stem dysfunction caused by long term repeated ischemias probably is the pathogenesis of SRBD, especially it’s central type, in VBI. The arrhythmia and hypertension secondary to SRBD may aggravate VBI. VBI and SRBD may be reciprocal and form a vicious circle which should draw attention in the prevention and treatment of SRBD in VBI.
基金supported by the Optional Research Project of China Rehabilitation Research Center,No.2014-7the Sub-Project under National“Twelfth Five-Year”Plan for Science&Technology Support Project,No.2011BAI08B11
文摘Melatonin and gamma-aminobutyric acid（GABA） have been shown to regulate sleep. The nocturnal concentrations of melatonin, GABA and total antioxidants may relate to insomnia in stroke patients. In this prospective single-center non-randomized controlled clinical trial performed in the China Rehabilitation Research Center, we analyzed the relationship of nocturnal concentrations of melatonin, GABA and total antioxidants with insomnia after stroke. Patients during rehabilitation of stroke were recruited and assigned to the insomnia group or non-insomnia group. Simultaneously, persons without stroke or insomnia served as normal controls. Each group contained 25 cases. The primary outcome was nocturnal concentrations of melatonin, GABA and total antioxidants in peripheral blood. The secondary outcomes were Pittsburgh Sleep Quality Index, Insomnia Severity Index, Epworth Sleepiness Scale, Fatigue Severity Scale, Morningness-Eveningness Questionnaire（Chinese version）, and National Institute of Health Stroke Scale. The relationship of nocturnal concentrations of melatonin, GABA and total antioxidants with insomnia after stroke was analyzed and showed that they were lower in the insomnia group than in the non-insomnia group. The severity of stroke was higher in the insomnia group than in the non-insomnia group. Correlation analysis demonstrated that the nocturnal concentrations of melatonin and GABA were associated with insomnia after stroke. This trial was registered at Clinical Trials.gov, identifier： NCT03202121.
基金This study was supported by the grants from the National Natural Science Foundation of China （No. 30800507, 30770934）. None of the authors has a financial relationship with a commercial entity that has an interest in the subject of this manuscript.
文摘Background Sleep disturbance is common in patients with emphysema. This study aimed to develop a novel model of sleep-related hypoxemia （SRH） in emphysema （SRHIE） with rats, and to explore the inflammatory status of SRHIE in lung, liver, pancreas, carotid artery and whole blood.Methods Seventy-five male Wistar rats were assigned to 5 groups with 15 per group according to the exposure conditions. The protocols varied with the degree of hypoxia exposure and severity of pre-existing emphysema caused by cigarette smoke exposure： （1） SRH control （SRHCtrl） group, sham smoke exposure （smoke exposure, exposed to smoke of 15 cigarettes twice everyday, 16 weeks） and SRH exposure （12.5% O2, 3 hours, SRH exposure, divide total hypoxia time （1.5 hours or 3 hours） into 4 periods evenly （22.5 minutes or 45 minutes） and distribute these hypoxia periods evenly into physiological sleep time of rats identified by electroencephalogram, week 9 to week 16）; （2） Emphysema control （ECtrl） group, smoke exposure and sham SRH exposure （21% O2, 3 hours）; （3） Short SRH in emphysema （SRHShort） group, smoke exposure and short SRH exposure （12.5% O2, 1.5 hours）; （4） Mild SRH in emphysema （SRHMild） group,smoke exposure and mild SRH exposure （15% O2, 3 hours）; （5） Standard SRH in emphysema （SRHStand） group, smoke exposure and SRH exposure （12.5% O2, 3 hours）. ECtrl, SRHShort, SRHMild and SRHStand groups were groups with emphysematous rats. Two days before the end of exposure, 5 rats in each group were randomly selected for arterial blood gas analysis. In the rest 10 rats in each group, we obtained blood samples and bronchoalveolar lavage fluid （BALF）for routine tests. We also obtained tissue blocks of lung, liver, pancreas, and right carotid artery for pathologic scoring and measurements of liver oxidative stress （measuring hepatic oxidative stress enzymes, superoxide dismutase （SOD） activity, catalase （CAT） activity and malondialdehyde （MDA） conce
