> Effects of CPAP on Early Signs of Atherosclerosis in Obstructive Sleep
> Apnea

> Am J Respir Crit Care Med, 7/7/07 -- epub ahead of print

> BACKGROUND: Obstructive sleep apnea (OSA) is associated with adverse
> cardiovascular outcomes, including myocardial infarction and stroke.
> Atherosclerosis is a key mechanism for these cardiovascular events.
> Recent cross-sectional studies showed the presence of early signs of
> atherosclerosis in OSA patients that were free of comorbidities.
> However, the impact of treatment with continuous positive airway
> pressure (CPAP) on atherosclerosis is unknown. METHODS: We randomly
> assigned 24 patients with severe OSA (age: 46+/-6 years) that were
> free of comorbidities to receive no treatment (control; n=12) or CPAP
> (n=12) for 4 months. Carotid intima-media thickness, arterial
> stiffness (evaluated by pulse wave velocity), carotid diameter, 24-
> hour {*filter*} pressure monitoring, C-reactive protein, and catecholamines
> were determined at baseline and after 4 months. RESULTS: At baseline,
> all measurements were similar in both groups and did not change in the
> control group after 4 months. In contrast, a significant decrease
> occurred in carotid intima-media thickness (707+/-105 vs. 645+/-95
> microm; P=0.04), pulse wave velocity (10.4+/-1.0 vs. 9.3+/-0.9 m/s;
> P<0.001), C-reactive protein (3.7+/-1.8 vs. 2.0+/-1.2 mg/L; P=0.001),
> and catecholamines (365+/-125 vs. 205+/-51 ng/mL; P<0.001) after 4
> months of CPAP. Carotid diameter did not change significantly.
> Regarding the whole group, changes in carotid intima-media thickness
> were correlated with changes in catecholamines (r=0.41; P<0.05).
> Changes in pulse wave velocity were correlated with changes in C-
> reactive protein (r=0.58; P<0.01) and catecholamines (r=0.54; P<0.01).
> CONCLUSIONS: The treatment of OSA significantly improves early signs
> of atherosclerosis, supporting the concept that OSA is an independent
> risk factor for atherosclerosis. ClinicalTrials.gov number,NCT00400543
> [ClinicalTrials.gov].

> > Effects of CPAP on Early Signs of Atherosclerosis in Obstructive Sleep
> > Apnea

> > Am J Respir Crit Care Med, 7/7/07 -- epub ahead of print

> > BACKGROUND: Obstructive sleep apnea (OSA) is associated with adverse
> > cardiovascular outcomes, including myocardial infarction and stroke.
> > Atherosclerosis is a key mechanism for these cardiovascular events.
> > Recent cross-sectional studies showed the presence of early signs of
> > atherosclerosis in OSA patients that were free of comorbidities.
> > However, the impact of treatment with continuous positive airway
> > pressure (CPAP) on atherosclerosis is unknown. METHODS: We randomly
> > assigned 24 patients with severe OSA (age: 46+/-6 years) that were
> > free of comorbidities to receive no treatment (control; n=12) or CPAP
> > (n=12) for 4 months. Carotid intima-media thickness, arterial
> > stiffness (evaluated by pulse wave velocity), carotid diameter, 24-
> > hour {*filter*} pressure monitoring, C-reactive protein, and catecholamines
> > were determined at baseline and after 4 months. RESULTS: At baseline,
> > all measurements were similar in both groups and did not change in the
> > control group after 4 months. In contrast, a significant decrease
> > occurred in carotid intima-media thickness (707+/-105 vs. 645+/-95
> > microm; P=0.04), pulse wave velocity (10.4+/-1.0 vs. 9.3+/-0.9 m/s;
> > P<0.001), C-reactive protein (3.7+/-1.8 vs. 2.0+/-1.2 mg/L; P=0.001),
> > and catecholamines (365+/-125 vs. 205+/-51 ng/mL; P<0.001) after 4
> > months of CPAP. Carotid diameter did not change significantly.
> > Regarding the whole group, changes in carotid intima-media thickness
> > were correlated with changes in catecholamines (r=0.41; P<0.05).
> > Changes in pulse wave velocity were correlated with changes in C-
> > reactive protein (r=0.58; P<0.01) and catecholamines (r=0.54; P<0.01).
> > CONCLUSIONS: The treatment of OSA significantly improves early signs
> > of atherosclerosis, supporting the concept that OSA is an independent
> > risk factor for atherosclerosis. ClinicalTrials.gov number,NCT00400543
> > [ClinicalTrials.gov].

> It is not clear from the abstract that the investigators controlled
> for differences in VAT loss during the 4 months of the study.

> People with the fatigue and daytime somnolence associated with
> untreated OSA tend to eat more than folks with treated OSA because of
> the false belief that eating more will help them overcome their
> symptoms by giving them more energy.

> > > Effects of CPAP on Early Signs of Atherosclerosis in Obstructive Sleep
> > > Apnea

> > > Am J Respir Crit Care Med, 7/7/07 -- epub ahead of print

> > > BACKGROUND: Obstructive sleep apnea (OSA) is associated with adverse
> > > cardiovascular outcomes, including myocardial infarction and stroke.
> > > Atherosclerosis is a key mechanism for these cardiovascular events.
> > > Recent cross-sectional studies showed the presence of early signs of
> > > atherosclerosis in OSA patients that were free of comorbidities.
> > > However, the impact of treatment with continuous positive airway
> > > pressure (CPAP) on atherosclerosis is unknown. METHODS: We randomly
> > > assigned 24 patients with severe OSA (age: 46+/-6 years) that were
> > > free of comorbidities to receive no treatment (control; n=12) or CPAP
> > > (n=12) for 4 months. Carotid intima-media thickness, arterial
> > > stiffness (evaluated by pulse wave velocity), carotid diameter, 24-
> > > hour {*filter*} pressure monitoring, C-reactive protein, and catecholamines
> > > were determined at baseline and after 4 months. RESULTS: At baseline,
> > > all measurements were similar in both groups and did not change in the
> > > control group after 4 months. In contrast, a significant decrease
> > > occurred in carotid intima-media thickness (707+/-105 vs. 645+/-95
> > > microm; P=0.04), pulse wave velocity (10.4+/-1.0 vs. 9.3+/-0.9 m/s;
> > > P<0.001), C-reactive protein (3.7+/-1.8 vs. 2.0+/-1.2 mg/L; P=0.001),
> > > and catecholamines (365+/-125 vs. 205+/-51 ng/mL; P<0.001) after 4
> > > months of CPAP. Carotid diameter did not change significantly.
> > > Regarding the whole group, changes in carotid intima-media thickness
> > > were correlated with changes in catecholamines (r=0.41; P<0.05).
> > > Changes in pulse wave velocity were correlated with changes in C-
> > > reactive protein (r=0.58; P<0.01) and catecholamines (r=0.54; P<0.01).
> > > CONCLUSIONS: The treatment of OSA significantly improves early signs
> > > of atherosclerosis, supporting the concept that OSA is an independent
> > > risk factor for atherosclerosis. ClinicalTrials.gov number,NCT00400543
> > > [ClinicalTrials.gov].

> > It is not clear from the abstract that the investigators controlled
> > for differences in VAT loss during the 4 months of the study.

> > People with the fatigue and daytime somnolence associated with
> > untreated OSA tend to eat more than folks with treated OSA because of
> > the false belief that eating more will help them overcome their
> > symptoms by giving them more energy.

> Cite:

> > > > Effects of CPAP on Early Signs of Atherosclerosis in Obstructive Sleep
> > > > Apnea

> > > > Am J Respir Crit Care Med, 7/7/07 -- epub ahead of print

> > > > BACKGROUND: Obstructive sleep apnea (OSA) is associated with adverse
> > > > cardiovascular outcomes, including myocardial infarction and stroke.
> > > > Atherosclerosis is a key mechanism for these cardiovascular events.
> > > > Recent cross-sectional studies showed the presence of early signs of
> > > > atherosclerosis in OSA patients that were free of comorbidities.
> > > > However, the impact of treatment with continuous positive airway
> > > > pressure (CPAP) on atherosclerosis is unknown. METHODS: We randomly
> > > > assigned 24 patients with severe OSA (age: 46+/-6 years) that were
> > > > free of comorbidities to receive no treatment (control; n=12) or CPAP
> > > > (n=12) for 4 months. Carotid intima-media thickness, arterial
> > > > stiffness (evaluated by pulse wave velocity), carotid diameter, 24-
> > > > hour {*filter*} pressure monitoring, C-reactive protein, and catecholamines
> > > > were determined at baseline and after 4 months. RESULTS: At baseline,
> > > > all measurements were similar in both groups and did not change in the
> > > > control group after 4 months. In contrast, a significant decrease
> > > > occurred in carotid intima-media thickness (707+/-105 vs. 645+/-95
> > > > microm; P=0.04), pulse wave velocity (10.4+/-1.0 vs. 9.3+/-0.9 m/s;
> > > > P<0.001), C-reactive protein (3.7+/-1.8 vs. 2.0+/-1.2 mg/L; P=0.001),
> > > > and catecholamines (365+/-125 vs. 205+/-51 ng/mL; P<0.001) after 4
> > > > months of CPAP. Carotid diameter did not change significantly.
> > > > Regarding the whole group, changes in carotid intima-media thickness
> > > > were correlated with changes in catecholamines (r=0.41; P<0.05).
> > > > Changes in pulse wave velocity were correlated with changes in C-
> > > > reactive protein (r=0.58; P<0.01) and catecholamines (r=0.54; P<0.01).
> > > > CONCLUSIONS: The treatment of OSA significantly improves early signs
> > > > of atherosclerosis, supporting the concept that OSA is an independent
> > > > risk factor for atherosclerosis. ClinicalTrials.gov number,NCT00400543
> > > > [ClinicalTrials.gov].

> > > It is not clear from the abstract that the investigators controlled
> > > for differences in VAT loss during the 4 months of the study.

> > > People with the fatigue and daytime somnolence associated with
> > > untreated OSA tend to eat more than folks with treated OSA because of
> > > the false belief that eating more will help them overcome their
> > > symptoms by giving them more energy.

> > Cite:

> 13 years of clinical experience as a practicing physician.

> Truth is simple.

> May GOD bless you in HIS mighty way making you healthier (hungrier)
> than ever.

> Prayerfully in Jesus' awesome love,

> Andrew <><
> --
> Andrew B. Chung, MD/PhD
> Cardiologist

> > > > Effects of CPAP on Early Signs of Atherosclerosis in Obstructive Sleep
> > > > Apnea

> > > > Am J Respir Crit Care Med, 7/7/07 -- epub ahead of print

> > > > BACKGROUND: Obstructive sleep apnea (OSA) is associated with adverse
> > > > cardiovascular outcomes, including myocardial infarction and stroke.
> > > > Atherosclerosis is a key mechanism for these cardiovascular events.
> > > > Recent cross-sectional studies showed the presence of early signs of
> > > > atherosclerosis in OSA patients that were free of comorbidities.
> > > > However, the impact of treatment with continuous positive airway
> > > > pressure (CPAP) on atherosclerosis is unknown. METHODS: We randomly
> > > > assigned 24 patients with severe OSA (age: 46+/-6 years) that were
> > > > free of comorbidities to receive no treatment (control; n=12) or CPAP
> > > > (n=12) for 4 months. Carotid intima-media thickness, arterial
> > > > stiffness (evaluated by pulse wave velocity), carotid diameter, 24-
> > > > hour {*filter*} pressure monitoring, C-reactive protein, and catecholamines
> > > > were determined at baseline and after 4 months. RESULTS: At baseline,
> > > > all measurements were similar in both groups and did not change in the
> > > > control group after 4 months. In contrast, a significant decrease
> > > > occurred in carotid intima-media thickness (707+/-105 vs. 645+/-95
> > > > microm; P=0.04), pulse wave velocity (10.4+/-1.0 vs. 9.3+/-0.9 m/s;
> > > > P<0.001), C-reactive protein (3.7+/-1.8 vs. 2.0+/-1.2 mg/L; P=0.001),
> > > > and catecholamines (365+/-125 vs. 205+/-51 ng/mL; P<0.001) after 4
> > > > months of CPAP. Carotid diameter did not change significantly.
> > > > Regarding the whole group, changes in carotid intima-media thickness
> > > > were correlated with changes in catecholamines (r=0.41; P<0.05).
> > > > Changes in pulse wave velocity were correlated with changes in C-
> > > > reactive protein (r=0.58; P<0.01) and catecholamines (r=0.54; P<0.01).
> > > > CONCLUSIONS: The treatment of OSA significantly improves early signs
> > > > of atherosclerosis, supporting the concept that OSA is an independent
> > > > risk factor for atherosclerosis. ClinicalTrials.gov number,NCT00400543
> > > > [ClinicalTrials.gov].

> > > It is not clear from the abstract that the investigators controlled
> > > for differences in VAT loss during the 4 months of the study.

> > > People with the fatigue and daytime somnolence associated with
> > > untreated OSA tend to eat more than folks with treated OSA because of
> > > the false belief that eating more will help them overcome their
> > > symptoms by giving them more energy.

> > Cite:

> 13 years of clinical experience as a practicing physician.

> > > > > Effects of CPAP on Early Signs of Atherosclerosis in Obstructive Sleep
> > > > > Apnea

> > > > > Am J Respir Crit Care Med, 7/7/07 -- epub ahead of print

> > > > > BACKGROUND: Obstructive sleep apnea (OSA) is associated with adverse
> > > > > cardiovascular outcomes, including myocardial infarction and stroke.
> > > > > Atherosclerosis is a key mechanism for these cardiovascular events.
> > > > > Recent cross-sectional studies showed the presence of early signs of
> > > > > atherosclerosis in OSA patients that were free of comorbidities.
> > > > > However, the impact of treatment with continuous positive airway
> > > > > pressure (CPAP) on atherosclerosis is unknown. METHODS: We randomly
> > > > > assigned 24 patients with severe OSA (age: 46+/-6 years) that were
> > > > > free of comorbidities to receive no treatment (control; n=12) or CPAP
> > > > > (n=12) for 4 months. Carotid intima-media thickness, arterial
> > > > > stiffness (evaluated by pulse wave velocity), carotid diameter, 24-
> > > > > hour {*filter*} pressure monitoring, C-reactive protein, and catecholamines
> > > > > were determined at baseline and after 4 months. RESULTS: At baseline,
> > > > > all measurements were similar in both groups and did not change in the
> > > > > control group after 4 months. In contrast, a significant decrease
> > > > > occurred in carotid intima-media thickness (707+/-105 vs. 645+/-95
> > > > > microm; P=0.04), pulse wave velocity (10.4+/-1.0 vs. 9.3+/-0.9 m/s;
> > > > > P<0.001), C-reactive protein (3.7+/-1.8 vs. 2.0+/-1.2 mg/L; P=0.001),
> > > > > and catecholamines (365+/-125 vs. 205+/-51 ng/mL; P<0.001) after 4
> > > > > months of CPAP. Carotid diameter did not change significantly.
> > > > > Regarding the whole group, changes in carotid intima-media thickness
> > > > > were correlated with changes in catecholamines (r=0.41; P<0.05).
> > > > > Changes in pulse wave velocity were correlated with changes in C-
> > > > > reactive protein (r=0.58; P<0.01) and catecholamines (r=0.54; P<0.01).
> > > > > CONCLUSIONS: The treatment of OSA significantly improves early signs
> > > > > of atherosclerosis, supporting the concept that OSA is an independent
> > > > > risk factor for atherosclerosis. ClinicalTrials.gov number,NCT00400543
> > > > > [ClinicalTrials.gov].

> > > > It is not clear from the abstract that the investigators controlled
> > > > for differences in VAT loss during the 4 months of the study.

> > > > People with the fatigue and daytime somnolence associated with
> > > > untreated OSA tend to eat more than folks with treated OSA because of
> > > > the false belief that eating more will help them overcome their
> > > > symptoms by giving them more energy.

> > > Cite:

> > 13 years of clinical experience as a practicing physician.

> Uh huh.

> > > > > > Effects of CPAP on Early Signs of Atherosclerosis in Obstructive Sleep
> > > > > > Apnea

> > > > > > Am J Respir Crit Care Med, 7/7/07 -- epub ahead of print

> > > > > > BACKGROUND: Obstructive sleep apnea (OSA) is associated with adverse
> > > > > > cardiovascular outcomes, including myocardial infarction and stroke.
> > > > > > Atherosclerosis is a key mechanism for these cardiovascular events.
> > > > > > Recent cross-sectional studies showed the presence of early signs of
> > > > > > atherosclerosis in OSA patients that were free of comorbidities.
> > > > > > However, the impact of treatment with continuous positive airway
> > > > > > pressure (CPAP) on atherosclerosis is unknown. METHODS: We randomly
> > > > > > assigned 24 patients with severe OSA (age: 46+/-6 years) that were
> > > > > > free of comorbidities to receive no treatment (control; n=12) or CPAP
> > > > > > (n=12) for 4 months. Carotid intima-media thickness, arterial
> > > > > > stiffness (evaluated by pulse wave velocity), carotid diameter, 24-
> > > > > > hour {*filter*} pressure monitoring, C-reactive protein, and catecholamines
> > > > > > were determined at baseline and after 4 months. RESULTS: At baseline,
> > > > > > all measurements were similar in both groups and did not change in the
> > > > > > control group after 4 months. In contrast, a significant decrease
> > > > > > occurred in carotid intima-media thickness (707+/-105 vs. 645+/-95
> > > > > > microm; P=0.04), pulse wave velocity (10.4+/-1.0 vs. 9.3+/-0.9 m/s;
> > > > > > P<0.001), C-reactive protein (3.7+/-1.8 vs. 2.0+/-1.2 mg/L; P=0.001),
> > > > > > and catecholamines (365+/-125 vs. 205+/-51 ng/mL; P<0.001) after 4
> > > > > > months of CPAP. Carotid diameter did not change significantly.
> > > > > > Regarding the whole group, changes in carotid intima-media thickness
> > > > > > were correlated with changes in catecholamines (r=0.41; P<0.05).
> > > > > > Changes in pulse wave velocity were correlated with changes in C-
> > > > > > reactive protein (r=0.58; P<0.01) and catecholamines (r=0.54; P<0.01).
> > > > > > CONCLUSIONS: The treatment of OSA significantly improves early signs
> > > > > > of atherosclerosis, supporting the concept that OSA is an independent
> > > > > > risk factor for atherosclerosis. ClinicalTrials.gov number,NCT00400543
> > > > > > [ClinicalTrials.gov].

> > > > > It is not clear from the abstract that the investigators controlled
> > > > > for differences in VAT loss during the 4 months of the study.

> > > > > People with the fatigue and daytime somnolence associated with
> > > > > untreated OSA tend to eat more than folks with treated OSA because of
> > > > > the false belief that eating more will help them overcome their
> > > > > symptoms by giving them more energy.

> > > > Cite:

> > > 13 years of clinical experience as a practicing physician.

> > Uh huh.

> Yes.

> > And how many people have come to you complaining
> > of sleep apnea in the course of your ongoing practice?

> Obstructive sleep apnea (OSA) is a diagnosis and not a symptom.

> It logically follows from this understanding that people don't
> complain about OSA but about the symptoms (daytime somnolence,
> fatigue, and morning headaches) associated with OSA.

> During my 13 years of ongoing practice in medicine/cardiology, I have
> personally made the initial diagnosis of suspected OSA that was later
> confirmed to be OSA by sleep study in at least 3000 patients.

> > (assuming that number was greater than zero, I hope you
> > were more accurate regarding them than you were with
> > your hilariously wrong-headed "diagnoses" of my
> > "incontinence" and my "anorexia")

> (incontinence and anorexia are both symptoms and not diagnoses)

> > > > > > > Effects of CPAP on Early Signs of Atherosclerosis in Obstructive Sleep
> > > > > > > Apnea

> > > > > > > Am J Respir Crit Care Med, 7/7/07 -- epub ahead of print

> > > > > > > BACKGROUND: Obstructive sleep apnea (OSA) is associated with adverse
> > > > > > > cardiovascular outcomes, including myocardial infarction and stroke.
> > > > > > > Atherosclerosis is a key mechanism for these cardiovascular events.
> > > > > > > Recent cross-sectional studies showed the presence of early signs of
> > > > > > > atherosclerosis in OSA patients that were free of comorbidities.
> > > > > > > However, the impact of treatment with continuous positive airway
> > > > > > > pressure (CPAP) on atherosclerosis is unknown. METHODS: We randomly
> > > > > > > assigned 24 patients with severe OSA (age: 46+/-6 years) that were
> > > > > > > free of comorbidities to receive no treatment (control; n=12) or CPAP
> > > > > > > (n=12) for 4 months. Carotid intima-media thickness, arterial
> > > > > > > stiffness (evaluated by pulse wave velocity), carotid diameter, 24-
> > > > > > > hour {*filter*} pressure monitoring, C-reactive protein, and catecholamines
> > > > > > > were determined at baseline and after 4 months. RESULTS: At baseline,
> > > > > > > all measurements were similar in both groups and did not change in the
> > > > > > > control group after 4 months. In contrast, a significant decrease
> > > > > > > occurred in carotid intima-media thickness (707+/-105 vs. 645+/-95
> > > > > > > microm; P=0.04), pulse wave velocity (10.4+/-1.0 vs. 9.3+/-0.9 m/s;
> > > > > > > P<0.001), C-reactive protein (3.7+/-1.8 vs. 2.0+/-1.2 mg/L; P=0.001),
> > > > > > > and catecholamines (365+/-125 vs. 205+/-51 ng/mL; P<0.001) after 4
> > > > > > > months of CPAP. Carotid diameter did not change significantly.
> > > > > > > Regarding the whole group, changes in carotid intima-media thickness
> > > > > > > were correlated with changes in catecholamines (r=0.41; P<0.05).
> > > > > > > Changes in pulse wave velocity were correlated with changes in C-
> > > > > > > reactive protein (r=0.58; P<0.01) and catecholamines (r=0.54; P<0.01).
> > > > > > > CONCLUSIONS: The treatment of OSA significantly improves early signs
> > > > > > > of atherosclerosis, supporting the concept that OSA is an independent
> > > > > > > risk factor for atherosclerosis. ClinicalTrials.gov number,NCT00400543
> > > > > > > [ClinicalTrials.gov].

> > > > > > It is not clear from the abstract that the investigators controlled
> > > > > > for differences in VAT loss during the 4 months of the study.

> > > > > > People with the fatigue and daytime somnolence associated with
> > > > > > untreated OSA tend to eat more than folks with treated OSA because of
> > > > > > the false belief that eating more will help them overcome their
> > > > > > symptoms by giving them more energy.

> > > > > Cite:

> > > > 13 years of clinical experience as a practicing physician.

> > > Uh huh.

> > Yes.

> > > And how many people have come to you complaining
> > > of sleep apnea in the course of your ongoing practice?

> > Obstructive sleep apnea (OSA) is a diagnosis and not a symptom.

> > It logically follows from this understanding that people don't
> > complain about OSA but about the symptoms (daytime somnolence,
> > fatigue, and morning headaches) associated with OSA.

> On the contrary, I have myself heard someone complain quite
> specifically that they thought they might be developing
> sleep apnea.

> > During my 13 years of ongoing practice in medicine/cardiology, I have
> > personally made the initial diagnosis of suspected OSA that was later
> > confirmed to be OSA by sleep study in at least 3000 patients.

> So, assuming five days a week --

> > (incontinence and anorexia are both symptoms and not diagnoses)

> No one here is mislead by your continuing evasiveness.