Sleep Science Friday: Sleep-disordered breathing
Sleep Science Friday (3 Sept 2020)
Happy Friday everyone! Grab a coffee/tea/drink to end your week with a quick recap of Sleep Science News following last Friday’s ESRS updates.
As we learn more about COVID-19, certain underlying health conditions are shown to be associated with increased susceptibility and worse outcomes. Specifically, respiratory disorders, including sleep-disordered breathing (on the susceptibility side of COVID-19), along with a long road to recovery requiring lung rehabilitation in some patients (on the convalescence side).
Sleep-disordered breathing (such as obstructive sleep apnea) are characterized by intermittent hypoxia (low levels of oxygen) during sleep, sleep fragmentation, and hypercapnia (abnormally elevated blood CO2), which can activate multiple inflammatory pathways, alter lipid metabolism, and increase oxidative stress. When you struggle to adequately breathe when sleeping, you are at increased risks for cardiovascular, metabolic, and neurocognitive dysfunctions, as well as non-alcoholic fatty liver diseases and certain cancers.
In obstructive sleep apnea—a common (approx. 20-30% of men and 10-15% of women) and serious sleep disorder—the airway is repeatedly blocked as tissues at the back of the throat collapse when muscles in the upper airway relax during sleep. This causes you to stop breathing, limits the amount of air reaching your lungs, and deprives your body and brain of oxygen.
Some may wake up a few times a night, while others with severe cases can wake up hundreds of times—leaving you with daytime sleepiness and fatigue. Those with mild sleep apnea may remain undiagnosed, with long-term consequences on health accumulating over time. Furthermore, up to 70% of stroke patients may have sleep-disordered breathing—underlining the importance of diagnosing sleep disorders to more effectively treat co-morbid health conditions.
A sleep medicine physician can diagnosis sleep-disordered breathing either with an in-lab sleep study (polysomnography) or home sleep apnea test. Treatments include continuous positive airway pressure (CPAP) therapy, oral devices, or in some cases, surgery. Exercise also lowers sleep apnea risk, such as walking 20 minutes a day, or even vigorous activity for just 8 minutes a day. General physical activity can also reduce the severity of sleep apnea, with other studies recommending singing, or any activity that exercises your throat, tongue, soft palate, and jaw.
As sleep-disordered breathing increases the risk of other health conditions (particularly affecting metabolic and cardiovascular systems), it may also increase risks from coronavirus. Obstructive sleep apnea is often co-morbid with obesity—as higher BMIs and larger neck sizes are both major factors in developing sleep apnea—with both of these factors linked to higher risks of viral infection and worse outcomes.
A recent study suggests that obstructive sleep apnea may “contribute to worsening hypoxemia and the cytokine storm that occurs in COVID patients”—although the direct mechanisms still needs to be identified. However, in the early phases of the pandemic, sleep medicine services were reduced by nearly 80%. Given that sleep-disordered breathing shares underlying conditions that may aggravate coronavirus infections, continuing to pursue sleep medicine services and interventions may prove critical alongside mitigating the effects of the COVID-19 pandemic.
Want to know more about sleep and respiratory disorders? Check out last Friday’s ESRS updates for a list of #ESRS2020 talks on sleep and respiratory disorders (see our full #ESRS2020 program for poster sessions and other sleep and sleep-related presentations), including keynote lecture by Dr. David Gozal.
For additional reading, here are some recent scientific publications:
- Duarte et al. (2020) Perception of sleep duration in adult patients with suspected obstructive sleep apnea
- Giannadaki et al. (2020) Small airways function in Obstructive Sleep Apnea-Hypopnea Syndrome
- Gunduz et al. (2020) Long-term positive airway pressure therapy is associated with reduced total cholesterol levels in patients with obstructive sleep apnea: data from the European Sleep Apnea Database (ESADA)
- Insalaco et al. (2020) Sleep Breathing Disorders in the COVID-19 Era: Italian Thoracic Society Organizational Models for a Correct Approach to Diagnosis and Treatment
- Koutsourelakis et al. (2020) The role of sleep endoscopy in oral appliance therapy for obstructive sleep apnea
- Kuna et al. (2020) Effects of Weight Loss on Obstructive Sleep Apnea Severity: 10-year Resultsof the Sleep AHEAD Study
- Peruzzo et al. (2020) Sleep, sleep apneas, and headache in general population
- Rey et al. (2020) Intrahepatic Expression of Fatty Acid Translocase CD36 Is Increased in Obstructive Sleep Apnea
- Schipper et al. (2020) Sleep-related leg movements in obstructive sleep apnea: definitions, determinants, and clinical consequences
- Šiarnik et al. (2020) Pulse oximetric routine examination of sleep apnea in acute stroke
- Soares et al. (2020) Association between the intensity of obstructive sleep apnea and skeletal alterations in the face and hyoid bone
- Tufik et al. (2020) Does obstructive sleep apnea lead to increased risk of COVID-19 infection and severity?
And other general articles:
- “Autopsy Data Show Extensive Lung Damage From COVID-19” (26 May 2020)
- “Controversy Over Smokers’ COVID-19 Risk Among Topics at ERS” (27 Aug 2020)
For August, our featured ESRS Early Career Researcher Network (ECRN) member of the month is Cassiana Silva*
- Neelapu et al. (2017) Craniofacial and upper airway morphology in adult obstructive sleep apnea patients: A systematic review and meta-analysis of cephalometric studies
- Gouveris et al. (2020) The Apnea–Hypopnea Index Underestimates Systemic Inflammation in Women with Sleep-Disordered Breathing
Finally, are you interested in sleep and sleep-related research and medicine?
Due to COVID-19, the 25th Congress of the ESRS goes Virtual (22 – 24 Sept 2020)—so you can attend (even in your pajamas) from anywhere worldwide.
For Spanish speakers, #ESRS2020 will be a joint congress with the Spanish Sleep Society. Both meetings are coordinated in parallel; attendants can participate in both meetings with only one registration. Keynote speakers from #ESRS2020 will have Spanish translations. We will also have poster sessions, teaching courses, networking lounges, and a stream for early career researchers.
Check out our full #ESRS2020 Scientific Program on our website. Abstracts will be published on 8 Sept 2020.
All ESRS members are invited to participate in the ESRS Business Meeting and without registration for the ESRS Congress. Although, we still encourage members to partake in the full Virtual Congress (Sept 22-24), as fees are reduced at 50% of the normal cost this year. The invitation and agenda for the Business Meeting was sent to ESRS members (please get in contact if you have not received an invitation and are an ESRS member).
Not a member yet? Apply here and see our wide range of benefits, including a yearly online subscription to the Journal of Sleep Research, automatic membership to the Federation of European Neuroscience Societies (FENS), support for early career researchers via the ECRN, the ESRS Newsletter, and more.
Just published an article? Want your research to be featured? Saw something interesting? Contact: doris.wu [ at ] esrs.eu.