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"Andersen, Monica"
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Obstructive sleep apnea and objective short sleep duration are independently associated with the risk of serum vitamin D deficiency
by
Tufik, Sergio
,
Hirotsu, Camila
,
Piovezan, Ronaldo D.
in
Adult
,
Apnea
,
Biology and Life Sciences
2017
Studies demonstrate an association between vitamin D (25(OH)D) deficiency and sleep disturbances, such as obstructive sleep apnea (OSA) and short sleep duration. However, to date, no studies have concurrently and objectively evaluated the effect of these factors on 25(OH)D.
To evaluate whether OSA and objective short sleep duration are independently associated with reduced 25(OH)D in an adult population sample.
A cross-sectional study included 657 individuals from the city of Sao Paulo, Brazil, as part of the ERA project. Participants fulfilled questionnaires and underwent clinical evaluation, polysomnography and blood sample collection for 25(OH)D quantification. OSA was classified into three categories (mild, moderate and severe). The risk of 25(OH)D deficiency was considered as levels<30 ng/mL. Short sleep duration was defined as total sleep time<6 hours.
The risk of 25(OH)D deficiency was observed in 59.5% of the sample, affecting more individuals of the female gender, obese, with African American ethnicity, and those that were smokers, sedentary and presented hypertension and diabetes. In the final logistic model adjusted for age, gender, ethnicity, obesity, smoking, hypertension, diabetes, sedentary lifestyle, seasonality and creatinine serum levels, both OSA and short sleep duration showed significant independent associations with the risk of 25(OH)D deficiency (moderate OSA: OR for 25(OH)D<30 = 2.21, 95% CI: 1.35-3.64, p<0.01; severe OSA: OR for 25(OH)D<30 = 1.78, 95% CI: 1.06-3.00, p = 0.03; short sleep duration: OR for 25(OH)D<30 = 1.61, 95% CI: 1.15-2.26, p = 0.01). After a subgroup analysis, similar results were observed only in participants ≥50 years.
OSA and short sleep duration are independently associated with the risk of 25(OH)D deficiency in an adult population. Age-related changes in vitamin D metabolism and the frequency of sleep disorders may be involved in these associations. Future studies exploring whether 25(OH)D levels may modulate OSA and sleep curtailment-related outcomes are needed.
Journal Article
Association Between Uric Acid Levels and Obstructive Sleep Apnea Syndrome in a Large Epidemiological Sample
by
Bittencourt, Lia R.
,
Tufik, Sergio
,
Mazzotti, Diego R.
in
Acids
,
Adenosine
,
Adenosine triphosphatase
2013
Recurrent hypoxia, which is associated with obstructive sleep apnea syndrome (OSAS), leads to an increase in the degradation of adenosine triphosphatase into xanthine, which in turn increases uric acid concentrations.
The current study aimed to determine whether an association exists between OSAS and uric acid levels in the peripheral blood from a representative population of Sao Paulo (Brazil).
A population-based survey adopting a probabilistic 3-stage cluster sample of Sao Paulo was used to represent the population according to gender, age, and socioeconomic class. A total of 1,042 volunteers underwent polysomnography recordings for OSAS diagnosis, blood pressure assessment, and biochemical blood analysis, and answered questionnaires.
Uric acid levels were correlated with most important risk factors for OSAS, such as AHI, desaturation time and index, minimum oxyhemoglobin saturation (SpO2), blood pressure, cholesterol, BMI, triglycerides and arousal, and with OSAS itself. Also, uric acid was increased in OSAS volunteers even after controlling for all confounders. Hyperuricemic volunteers presented lower mean and minimum SpO2 and increased desaturation index. Importantly, minimum SpO2 was a significant predictor of uric acid levels, which in turn was considered an independent predictor for OSAS in the binary logistic model. However, a ROC curve analysis for establishing cut-off points for uric acid levels as a biomarker of OSAS revealed moderate sensitivity and specificity.
A strong association was found between uric acid levels and OSAS in a representative sample of the population of Sao Paulo. Although they do not qualify for a biomarker alone, uric acid levels may be involved in OSAS severity and should be considered in sleep apnea management in the future.
Journal Article
The interplay between X-chromosome functional dosage and circadian regulation in females
by
Tufik, Sergio
,
Andersen, Monica L
,
Moysés-Oliveira, Mariana
in
Bias
,
Circadian rhythm
,
Circadian rhythms
2024
PurposeBiological factors and mechanisms that drive higher prevalence of insomnia in females are poorly understood. This study focused on the neurological consequences of X-chromosome functional imbalances between sexes.MethodsBenefited from publicly available large-scale genetic, transcriptional and epigenomic data, we curated and contrasted different gene lists: (1) X-liked genes, including assignments for X-chromosome inactivation patterns and disease associations; (2) sleep-associated genes; (3) gene expression markers for the suprachiasmatic nucleus.ResultsWe show that X-linked markers for the suprachiasmatic nucleus are significantly enriched for clinically relevant genes in the context of rare genetic syndromes and brain waves modulation.ConclusionConsidering female-specific patterns on brain transcriptional programs becomes essential when designing health care strategies for mental and sleep illnesses with sex bias in prevalence.
Journal Article
Optimising preterm infant nutrition: valuing the potential of melatonin in breast milk
by
de Oliveira, Allan Chiaratti
,
Tufik, Sergio
,
Cavalcante-Silva, Vanessa
in
Breast Feeding
,
Breast milk
,
Breastfeeding & lactation
2025
The impact of synchronising the collection and supply of breast milk produced during the day and night on improving long-term health outcomes for preterm infants is discussed, focusing on breast milk as a valuable source of melatonin, an essential synchroniser of biological rhythms.
Journal Article
Temporal Analysis of Chronic Musculoskeletal Pain and Sleep in Postmenopausal Women
2019
Study Objectives:
To investigate the temporal association between chronic musculoskeletal pain (CMP) and sleep in women who are postmenopausal in a 10-day actigraphic study. This is a microlongitudinal study in which 52 participants were allocated to 4 groups women who are postmenopausal: control (CTRL, n = 10), chronic musculoskeletal pain (CMP, n = 12), insomnia (INS, n = 15) and chronic musculoskeletal pain+insomnia (CMP+INS, n = 15).
Methods:
All volunteers underwent a clinical interview and completed questionnaires, used an actigraph, and kept sleep diaries for 10 consecutive days.
Results:
Women in the CMP+INS group presented more sleep episodes (mean of 1.02 episodes) and longer sleep latency (8.97 minutes), as well as higher pain intensity during the day compared to the other groups. Sleep duration recorded by actigraphy directly predicted pain intensity the following morning on waking, with a 1-unit increase in pain intensity, for every 6.9 minutes more of sleep. Higher pain intensity at bedtime was a significant predictor of both increased time in bed and sleep duration, meaning that for each 1-unit increase in pain intensity at bedtime, sleep duration increased by an average of 6.7 minutes.
Conclusions:
Data showed that the coexistence of insomnia and CMP results in greater pain intensity and alterations in sleep homeostasis. Collectively, the data indicate that there is a bidirectional and directly proportional relationship between sleep duration and pain intensity in women who are postmenopausal with insomnia. This result strongly suggests that both sleep and pain conditions should be targeted in the treatment of women who are postmenopausal.
Citation:
Frange C, Hachul H, Hirotsu C, Tufik S, Andersen ML. Temporal analysis of chronic musculoskeletal pain and sleep in postmenopausal women.
J Clin Sleep Med
2019;15(2):223–234.
Journal Article
Does obstructive sleep apnea increase the risk of breast cancer in women during and after menopause?
by
Tufik, Sergio
,
Hachul, Helena
,
Ishikura, Isabela Antunes
in
Breast Neoplasms - epidemiology
,
Female
,
Humans
2022
CITATION
Porcacchia AS, Ishikura IA, Hachul H, Andersen ML, Tufik S. Does obstructive sleep apnea increase the risk of breast cancer in women during and after menopause?
J Clin Sleep Med
. 2022;18(3):961–962.
Journal Article
Lipid metabolism and neuromuscular junction as common pathways underlying the genetic basis of erectile dysfunction and obstructive sleep apnea
2024
Erectile dysfunction (ED) incidence is higher in patients with obstructive sleep apnea (OSA). Studies have suggested that ED and OSA may activate similar pathways; however, few have investigated the links between their underlying genotypic profiles. Therefore, we conducted an in-silico analysis to test whether ED and OSA share genetic variants of risk and to identify any molecular, cellular and biological interactions between them. Two gene lists were manually curated through a literature review based on a PUBMED search, which resulted in one gene list associated with ED (total of 205 genes) and the other with OSA (total of 2622 genes). Between those gene sets, 35 were common for both lists (Fisher exact test,
p-
value = 0.027). The Protein–protein interaction (PPI) analysis using the intersect list as input showed that 3 of them had direct interactions (LPL, DGKB and PLCB1). In addition, the biological function of the genes contained in the intersect list suggested that pathways related to lipid metabolism and the neuromuscular junction were commonly found in the genetic basis of ED and OSA. From the shared genes between both conditions, the biological pathways highlighted in this study may serve as preliminary findings for future functional investigations on OSA and ED association.
Journal Article
Nicotine and sleep deprivation: impact on pain sensitivity and immune modulation in rats
by
Berro, Laís Fernanda
,
Tufik, Sergio
,
Pedroni, Matheus Negrao
in
631/378/1385/1815
,
692/617/375/1692
,
96/21
2018
Repeated nicotine administration has been associated with increased paradoxical sleep in rats and antinociceptive properties, whereas paradoxical sleep deprivation (PSD) elicits pronociceptive and inflammatory responses. Thus, we aimed to evaluate the effect of repeated nicotine administration and its withdrawal combined with PSD on pain sensitivity and inflammatory markers. Sixty adult male Wistar rats were subjected to repeated injections of saline (SAL) or nicotine (NIC) for 12 days or 7 days of nicotine followed by acute mecamylamine administration on day 8 to precipitate nicotine abstinence (ABST). On day 9, the animals were submitted to PSD for 72 h or remained in control condition (CTRL); on day 12, thermal pain threshold was assessed by the hot plate test. PSD significantly decreased the latency to paw withdrawal in all groups compared to their respective controls. ABST-PSD animals presented higher levels of interleukin (IL)-6 compared to all groups, except ABST-CTRL. After adjustment for weight loss, IL-6, IL-4 and tumor necrosis factor alpha, ABST-PSD was associated with the lowest pain threshold. Nicotine and IL-4 levels were predictors of higher pain threshold. Hyperalgesia induced by PSD prevailed over the antinociceptive action of nicotine, while the association between PSD and ABST synergistically increased IL-6 concentrations and decreased pain threshold.
Journal Article