American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Dec 2024
Meta AnalysisHypnotics on Obstructive Sleep Apnea Severity and Endotypes: A Systematic Review and Meta-Analysis.
Rationale: Low arousal threshold and poor muscle responsiveness are common determinants of obstructive sleep apnea (OSA). Hypnotics were hypothesized as an alternative OSA treatment via raising the arousal threshold and possibly genioglossus responsiveness. Objectives: To examine the effect of common hypnotics on arousal threshold, OSA severity, and genioglossus responsiveness. ⋯ However, people with very low arousal threshold or those who exhibited a 0-25% arousal threshold increase from placebo experienced the greatest, yet still modest, post-treatment AHI reductions (∼10%). Hypnotics did not affect genioglossus responsiveness (high QoE). Conclusions: Further research testing or clinical use of hypnotics as OSA alternative treatments should be discouraged, unless in the presence of comorbid insomnia or as part of combination therapy in individuals with very low arousal threshold.
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Am. J. Respir. Crit. Care Med. · Dec 2024
Association of Ground Glass Opacities with Systemic Inflammation and Progression of Emphysema.
Rationale: Ground-glass opacities (GGOs) in the absence of interstitial lung disease are understudied. Objectives: To assess the association of GGOs with white blood cells (WBCs) and progression of quantified chest computed tomography emphysema. Methods: We analyzed data of participants in the SPIROMICS study (Subpopulations and Intermediate Outcome Measures in COPD Study). ⋯ We found no association between %GGOAMFM and 1-year FEV1 decline, but %GGOAMFM was associated with exacerbations and all-cause mortality during a median follow-up of 1,544 days (interquartile interval, 1,118-2,059). Among normal spirometry participants, we found similar results, except that %GGOAMFM was associated with progression to COPD at 1-year follow-up. Conclusions: Our findings suggest that GGOAMFM is associated with increased systemic inflammation and emphysema progression.