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Sleep Medicine

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Sleep apnoea may make it hard for you to remember simple things, such as where you parked your car or left your house keys, a small study suggests.

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Researchers believe that disrupted circadian clocks are the reason that shift workers experience higher incidences of type 2 diabetes, obesity and cancer. The body's primary circadian clock, which regulates sleep and eating, is in the brain. But other body tissues also have circadian clocks, including the liver, which regulates blood glucose levels.

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In recent research is has been found that disruption to rapid eye-movement (REM) sleep caused by sleep apnoea, may affect an individual’s capacity to form new spatial memories.

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Office workers with more light exposure at work had longer sleep duration, better sleep quality, more physical activity and better quality of life compared to office workers with less light exposure in the workplace.

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Can you be sleep deprived without knowing it? Sleep is not always prioritised however the implications can be devastating. Even one night sleep deprived can be impacting your body on a variety of different levels; physically and psychologically. The only way to know if you are getting consolidated sleep is to monitor with specialised equipment what is happening when you are asleep.

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In what may be the largest study of sleep problems among individuals with multiple sclerosis (MS), researchers at UC Davis have found that widely undiagnosed sleep disorders may be at the root of the most common and disabling symptom of the disease: fatigue. Study paticipant reports of sleep disorder frequency, sleep patterns and complaints of excessive daytime sleepiness suggest that sleep problems may be a hidden epidemic in the MS population.

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Link between obstructive sleep apnea and increased bone resorption in men

A recent Japanese study is first evidence of a link between obstructive sleep apnoea (OSA) and abnormal bone metabolism, due to the effects of hypoxia, microinflammation and oxidative stress.

osabones1

Obstructive sleep apnea (OSA) is a prevalent disorder and should be considered a systemic illness.

Studies have shown that the pro-inflammatory cytokines interleukin-6 (IL-6) and tumour necrosis factor-alpha (TNFalpha) are elevated in patients with OSA independently of obesity and that visceral fat.

OSA in obese patients is now considered manifestations of the Metabolic Syndrome, include:

  • obesity without OSA is associated with daytime sleepiness;
  • PCOS and diabetes type 2 are independently associated with EDS after controlling for SDB, obesity, and age;
  • increased prevalence of OSA in post-menopausal women, with hormonal replacement therapy associated with a significantly reduced risk for OSA;
  • lack of effect of continuous positive airway pressure (CPAP) in obese patients with apnea on hypercytokinemia and insulin resistance indices; and
  • the prevalence of the metabolic syndrome in the US population from the Third National Health and Nutrition Examination Survey (1988-1994) parallels the prevalence of symptomatic OSA in general random samples. Finally, the beneficial effect of a cytokine antagonist on EDS in obese, male apneics and that of exercise on SDB in a general random sample, supports the hypothesis that cytokines and insulin resistance are mediators of EDS and sleep apnea in humans.

 Hypoxia, micro-inflammation and oxidative stress are also known to affect bone metabolism.

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Model for mediation of effects of E on osteoclast formation and function by cytokines in bone marrow microenvironment.

The bone metabolic abnormalities in patients with OSA were studied, specifically the serum/ urinary levels of bone resorption markers and their attenuation following CPAP therapy in subjects with OSA.

The study was a cross-sectional and prospective study and was conducted in 50 consecutive male subjects visiting a sleep clinic and 15 age-matched control subjects without OSA. Plasma concentrations of IL-1β, IL-6, TNF-alfa, 3-nitrotyrosine, osteocalcin, bone-specific alkaline phosphatase (BAP), and urinary concentrations of cross-linked C-terminal telopeptide of type I collagen (CTX) were examined before and after 3 months' CPAP in subjects with OSA.

 The results showed that the plasma levels of the cytokines as well as the urinary CTX levels were higher in subjects with severe OSA than in those with mild OSA or control subjects. Significant decrease of the urinary excretion of CTX (before: 211±107 vs. after: 128±59 μg/mmol/creatinine; p<0.01) as well as of the plasma levels of the cytokines was observed following 3 months' CPAP.

Overall this study found that increased OSA severity correlates with the serum/ urinary levels of bone resorption markers and there is reversal following CPAP in subjects with OSA.

More information on Bone Metabolism

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