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@article{Unnur2018,
title = {Obesity modulates the association between sleep apnea treatment and CHI3L1 levels but not CHIT1 activity in moderate to severe OSA: an observational study},
author = {Unnur, Diljá Teitsdóttir and Erna, Sif Arnardóttir and Erla, Björnsdóttir and Þórarinn, Gíslason and Pétur, Henry Petersen},
url = {https://pubmed.ncbi.nlm.nih.gov/30311184/},
year = {2018},
date = {2018-10-11},
abstract = {Purpose: The inflammatory markers chitinase-3-like protein 1 (CHI3L1) and chitotriosidase (CHIT1) have both been associated with cardiovascular complications. The aim of this preliminary observational study was to assess the roles and interaction of obstructive sleep apnea (OSA) severity and body mass index (BMI) with plasma CHI3L1 levels and CHIT1 activity in patients with moderate to severe OSA. The second aim was to assess the roles and interaction of positive airway pressure (PAP) treatment and BMI on the expression of the same proteins.

Methods: The study included 97 OSA patients with an apnea-hypopnea index (AHI) ≥ 15 and full usage of PAP treatment after 4 months. Plasma CHI3L1 levels and CHIT1 activity were measured before and after treatment.

Results: Multiple linear regression analysis demonstrated an independent association of BMI on CHI3L1 levels (p < 0.05) but not on CHIT1 activity. The OSA severity markers (AHI and oxygen desaturation index) did not independently or in interaction with BMI levels associate with CHI3L1 levels or with CHIT1 activity (p > 0.05). A two-way repeated measures ANOVA revealed a significant interaction between PAP treatment effect (before vs. after) and BMI groups (< 35 kg/m2 vs. ≥ 35 kg/m2) on CHI3L1 levels (p = 0.03) but not on CHIT1 activity (p = 0.98).

Conclusions: Obesity independently associated with CHI3L1 levels. Association between OSA severity and CHI3L1 levels or CHIT1 activity (independent of or dependent on obesity level) could not be confirmed. However, decrease was observed in CHI3L1 levels after PAP treatment in severely obese OSA patients but not in those less obese.},
keywords = {Positive airway pressure, Sleep Apnea},
pubstate = {published},
tppubtype = {article}
}

@article{Erla2013,
title = {Symptoms of Insomnia among Patients with Obstructive Sleep Apnea Before and After Two Years of Positive Airway Pressure Treatment.},
author = {Erla, Björnsdóttir and Christer, Janson and Jón, F Sigurðsson and Philip, Gehrman and Michael, Perlis and Sigurður, Júlíusson and Erna, Sif Arnardóttir and Samuel, T Kuna and Allan, I Pack and Þórarinn, Gíslason and Bryndís, Benediktsdóttir},
url = {https://academic.oup.com/sleep/article/36/12/1901/2709415},
year = {2013},
date = {2013-12-01},
abstract = {Study Objectives:
To assess the changes of insomnia symptoms among patients with obstructive sleep apnea (OSA) from starting treatment with positive airway pressure (PAP) to a 2-y follow-up.

Design:
Longitudinal cohort study.

Setting:
Landspitali—The National University Hospital of Iceland.

Participants:
There were 705 adults with OSA who were assessed prior to and 2 y after starting PAP treatment.

Intervention:
PAP treatment for OSA.

Measurements and Results:
All patients underwent a medical examination along with a type 3 sleep study and answered questionnaires on health and sleep before and 2 y after starting PAP treatment. The change in prevalence of insomnia symptoms by subtype was assessed by questionnaire and compared between individuals who were using or not using PAP at follow-up. Symptoms of middle insomnia were most common at baseline and improved signifcantly among patients using PAP (from 59.4% to 30.7%, P < 0.001). Symptoms of initial insomnia tended to persist regardless of PAP treatment, and symptoms of late insomnia were more likely to improve among patients not using PAP. Patients with symptoms of initial and late insomnia at baseline were less likely to adhere to PAP (odds ratio [OR] 0.56, P = 0.007, and OR 0.53, P < 0.001, respectively).

Conclusion:
Positive airway pressure treatment significantly reduced symptoms of middle insomnia. Symptoms of initial and late insomnia, however, tended to persist regardless of positive airway pressure treatment and had a negative effect on adherence. Targeted treatment for insomnia may be beneficial for patients with obstructive sleep apnea comorbid with insomnia and has the potential to positively affect adherence to positive airway pressure.},
keywords = {Insomnia, Positive airway pressure, Sleep Apnea},
pubstate = {published},
tppubtype = {article}
}