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Understanding the pathophysiological mechanisms of cardiometabolic complications in obstructive sleep apnoea: towards personalised treatment approaches

Silke Ryan, Eoin P. Cummins, Ramon Farre, Alex Gileles-Hillel, Jonathan C. Jun, Henrik Oster, Jean-Louis Pepin, David W. Ray, Sirimon Reutrakul, Manuel Sanchez-de-la-Torre, Renaud Tamisier, Isaac Almendros
European Respiratory Journal 2020 56: 1902295; DOI: 10.1183/13993003.02295-2019
Silke Ryan
1Pulmonary and Sleep Disorders Unit, St Vincent's University Hospital, Dublin, Ireland
2School of Medicine, Conway Institute, University College Dublin, Dublin, Ireland
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  • For correspondence: silke.ryan@ucd.ie
Eoin P. Cummins
2School of Medicine, Conway Institute, University College Dublin, Dublin, Ireland
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Ramon Farre
3Unitat de Biofísica i Bioenginyeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona-IDIBAPS, and CIBER Enfermedades Respiratorias, Barcelona, Spain
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Alex Gileles-Hillel
4Pediatric Pulmonology and Sleep Unit, Dept of Pediatrics, and The Wohl Institute for Translational Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
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Jonathan C. Jun
5Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
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Henrik Oster
6Institute of Neurobiology, University of Lübeck, Lübeck, Germany
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Jean-Louis Pepin
7HP2 INSERM U1042, Université Grenoble Alpes, Grenoble, France
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David W. Ray
8NIHR Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford, UK
9Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK
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Sirimon Reutrakul
10Division of Endocrinology, Diabetes, and Metabolism, Dept of Medicine, University of Illinois at Chicago, Chicago, IL, USA
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Manuel Sanchez-de-la-Torre
11Group of Precision Medicine in Chronic Diseases, Hospital Arnau de Vilanova-Santa Maria, IRBLleida, Lleida, Spain
12Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
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Renaud Tamisier
7HP2 INSERM U1042, Université Grenoble Alpes, Grenoble, France
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Isaac Almendros
3Unitat de Biofísica i Bioenginyeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona-IDIBAPS, and CIBER Enfermedades Respiratorias, Barcelona, Spain
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Abstract

In January 2019, a European Respiratory Society research seminar entitled “Targeting the detrimental effects of sleep disturbances and disorders” was held in Dublin, Ireland. It provided the opportunity to critically review the current evidence of pathophysiological responses of sleep disturbances, such as sleep deprivation, sleep fragmentation or circadian misalignment and of abnormalities in physiological gases such as oxygen and carbon dioxide, which occur frequently in respiratory conditions during sleep. A specific emphasis of the seminar was placed on the evaluation of the current state of knowledge of the pathophysiology of cardiovascular and metabolic diseases in obstructive sleep apnoea (OSA). Identification of the detailed mechanisms of these processes is of major importance to the field and this seminar offered an ideal platform to exchange knowledge, and to discuss pitfalls of current models and the design of future collaborative studies. In addition, we debated the limitations of current treatment strategies for cardiometabolic complications in OSA and discussed potentially valuable alternative approaches.

Abstract

The pathogenesis of cardiometabolic complications in obstructive sleep apnoea is poorly understood and this perspective summarises the key learning points of an ERS research seminar discussing the interaction of potential pathophysiological triggers http://bit.ly/2vANqBi

Footnotes

  • This article has supplementary material available from erj.ersjournals.com

  • Conflict of interest: S. Ryan has nothing to disclose.

  • Conflict of interest: E.P. Cummins has nothing to disclose.

  • Conflict of interest: R. Farre has nothing to disclose.

  • Conflict of interest: A. Gileles-Hillel has nothing to disclose.

  • Conflict of interest: J.C. Jun has nothing to disclose.

  • Conflict of interest: H. Oster has nothing to disclose.

  • Conflict of interest: J-L. Pepin has nothing to disclose.

  • Conflict of interest: D.W. Ray has nothing to disclose.

  • Conflict of interest: S. Reutrakul reports grants from Merck Sharp and Dohme, personal fees from Medtronic and Sanofi Aventis, outside the submitted work.

  • Conflict of interest: M. Sanchez-de-la-Torre has nothing to disclose.

  • Conflict of interest: R. Tamisier reports travel grants from Agiradom, grants from Resmed, personal fees for lectures from Resmed, Philips and Elivie, personal fees for consultancy from Navigant, Inspire, Jazz Pharmaceutical and Resmed, outside the submitted work.

  • Conflict of interest: I. Isaac Almendros has nothing to disclose.

  • Received November 27, 2019.
  • Accepted March 15, 2020.
  • Copyright ©ERS 2020
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Understanding the pathophysiological mechanisms of cardiometabolic complications in obstructive sleep apnoea: towards personalised treatment approaches
Silke Ryan, Eoin P. Cummins, Ramon Farre, Alex Gileles-Hillel, Jonathan C. Jun, Henrik Oster, Jean-Louis Pepin, David W. Ray, Sirimon Reutrakul, Manuel Sanchez-de-la-Torre, Renaud Tamisier, Isaac Almendros
European Respiratory Journal Aug 2020, 56 (2) 1902295; DOI: 10.1183/13993003.02295-2019

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Understanding the pathophysiological mechanisms of cardiometabolic complications in obstructive sleep apnoea: towards personalised treatment approaches
Silke Ryan, Eoin P. Cummins, Ramon Farre, Alex Gileles-Hillel, Jonathan C. Jun, Henrik Oster, Jean-Louis Pepin, David W. Ray, Sirimon Reutrakul, Manuel Sanchez-de-la-Torre, Renaud Tamisier, Isaac Almendros
European Respiratory Journal Aug 2020, 56 (2) 1902295; DOI: 10.1183/13993003.02295-2019
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