Obstructive Sleep Apnea Clinical Trial
Official title:
The Prevalence and Implications of Obstructive Sleep Apnea in the Population of a Wound Center
This study is looking at the prevalence of sleep apnea in a wound center population. It uses both screening surveys and take home devices. Some measures of wound healing ability are being looked at as well.
Patients with chronic non-healing wounds often have major co-morbidities such as diabetes
and cardiovascular diseases [1]. Obstructive Sleep Apnea (OSA) is present in up to 24% of
middle-aged adults [2], and is far more prevalent in patients with existing cardiovascular
disease [3]. Patients with OSA are at increased risk of developing diabetes l [4]. OSA is an
established cause of hypertension[5], and has an estimated prevalence of 40% in all patients
with hypertension [6-8]. Similarly a strong association exists between OSA, coronary artery
disease [6, 7] and stroke [8]. OSA may be present in over 50% of patients with heart failure
[9]. Patients with chronic non-healing wounds stand to benefit from identification and
treatment of severe co-morbidities such as OSA. Such identification and treatment of OSA
will impact the survival of these patients [10, 11], and may also contribute to improved
morbidity via impacting wound healing.
Several unexplored links exist between OSA and wound healing. OSA is a disorder of
intermittent hypoxia and is associated with increased oxidative stress [12]. Humans with OSA
and animal models of intermittent hypoxia developed impaired vascular function and nitric
oxide deficiency. Patients with OSA have impaired endothelial function even in the absence
of clinically apparent cardiovascular disease [13-15]. Increased sympathetic activity and
episodic pressor response are well documented in OSA. Patients with OSA have increased
vascular tone and baseline vasoconstriction [16]. Impaired vascular reactivity to hypoxia
was also demonstrated in animal models exposed to 2 weeks of intermittent hypoxia[17].
Therefore, in patients with chronic non-healing wounds, OSA is likely to further complicate
the healing process.
OSA as a disorder of oxidative stress and vascular impairment is most likely an important
co-morbidity in patients with non-healing wounds. Other potential mechanisms of interaction
are the inflammatory response associated with OSA
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