Abstract
Sleep plays a crucial role in the psychological, and biological health of a person. Sleep failure not only occurs in physiological and psychiatric problems, but it also has the adverse effects of sleep deprivation on the cardiovascular system. Decreased levels of sleep are correlated with lifestyle factors for heart disease, such as hypertension, overweight, sugar levels. The aging population in Pakistan is increasing exponentially, causing rising problems in well-being care. Sleeping illness is one of the many complex disorders involving aging and cardiovascular disease. The present study analyzed 51 patients aged 55 and 88 years old with a CVD indication. Respondents were classified in impaired sleep (N=20) and non-impaired sleep (N=31) classes, further correlated with a measure of inflammatory disease performance in neuropsychological studies on fatigue. Respondents reported slightly higher rates of tiredness during the daytime have both symptoms. This work addresses consequences for the interaction of sleep and CVD.
Key Words
Cardiovascular Disease; Elderly Patients; Psychological performance; Sleep Apnea.
Introduction
Sleep is essential for human health. and wellbeing. Sleep plays a crucial part in the intellectual, psychological, and physical health of a person. Lack of sleep not only causes physiological and psychiatric problems, but also affect the cardiovascular health, as comprehensive research has inspected the adverse results of nap deficiency. (Caples, Sean M;, 2014). Insufficient sleep duration and quality, either due to sleep disturbances or due to lack of sufficient sleep habits, is related with life style factors such as depression, anxiety, obesity, blood sugar levels and metabolic syndrome, especially in older patients (da Silva Paulitsch , F; L, Zhang;, 2018) (Devulapally, Kiran ; Pongonis Jr., Raymond ; Khayat, Rami;, 2008).
Research have found that short sleep periods are linked with a higher chance of contracting or suffering from CVD. While secondary causes of sleep deficiency leading to CVD have been well described such as sleep apnea, here we analyze the literature attributing principal sleep deficiency and deprivation as a purpose for cardiovascular disease through an underlying reality of metabolic abnormalities (Kaditis, Athanasios MD;, 2010).
The current study's purpose and target was to resolve the heightened need for research into factors influencing Pakistan's increasing elderly population. This research had the aim of exploring a new area of early diagnosis of sleeping disorder (sleep apnea). This research focused mainly on heart disease and apnea to sleep. The Heart disease and abnormal nap have been chosen as important factors because of their prominence in the elderly population, their association with each other, and the possible effect each may have on elderly individuals. Major work has been checked into a common sleep complaint, disruptive sleep pattern, and its correlation with heart related problems in ageing. This streak of exploration assisted in elucidating the relationship between heart disease and sleeping disorders (Kaditis, Athanasios MD;, 2010).
Sleep Deprivation and Vascular Disease
Sleep deprivation (Poor sleep is further classified into two subgroups: a) OSA (Obstructive Sleep Apnea) is caused by respiratory block, typically where the lose skin in the posterior of the gullet downfalls in resting position; and b) CSA (Central sleep apnea) varies from OSA when the windpipe is not blocked, but the brain does not allow the muscles to breathe due to weakness in the center of lung function). Heart disease is profoundly related, in respect of both common lifestyle factors and physiological structures. The medical profession has known for some time that lifestyle factors such as weight, blood pressure, especially males and that aging all are the hazard features for disruptive sleep deprivation, thus, poor nap is more severe for people of heart disease. More specifically, work has started to shed light on the physiological processes that underlie this interaction (Devulapally, Kiran ; Pongonis Jr., Raymond ; Khayat, Rami;, 2008) (Kang, Eun-Ju; Bae, W Y;, 2017).
High Blood Pressure and Sleep Apnea
Observational studies have repeatedly demonstrated that the incidence of anxiety levels in sufferer with disruptive sleep issues is greater. For example, the research of the Wisconsin Sleep Cluster found a triple raise in the occurrence of anxiety and depression in OSA sufferer for 4 years, independently of the lifestyle factors. As this interaction was further explored, it showed that vascular constriction of the anxiousness (a recognized function in blood related issues) were seen present in sleep-deprived conscious. Specific causative agents causing the association between OSA and anxiety and depression were identified, thus well acknowledged in relations of the consequences of the loss of oxygen at the cellular-level variations contributing to this irrational relation. The inflammatory insulin receptor known as C-reactive protein (CRP) is another common physiological trait of vascular disease or dysfunction, and OSA. Over the last decade, the association between CRP and cardiovascular disease has gained growing interest in the research literature. Reactive protein has been recognized as a hazard factor in relations of recurring heart issues, and in particular recent heart attacks. The liver produces CRP, and it is one of the circulating compounds that stimulates inflammatory response. while it can be determined by rapid blood draining and is correlated with cardiac hypertrophy as well as mortality rates and survival levels, in several situations this was a popular research test (Devulapally, Kiran ; Pongonis Jr., Raymond ; Khayat, Rami;, 2008) (Kaditis, Athanasios MD;, 2010). The link between sensitive protein and deprived resting is even not as much of vibrant, but it has been shown reactive protein has formed in answer to both sleep deficiency and oxygen deprivation (mutually rising in OSA) (Kang, Eun-Ju; Bae, W Y;, 2017) (Lawati, NM Al; Ayas, NT;, 2008) through the mechanism described above.
Material and Methods
Patient
Participation
Respondents in the present research were people who were
registered in a Hearts International Hospital research on aging and
cardiovascular disease. Respondents for this research were recruited via the
Department of Cardiology at the Hearts International Hospital. Enrolment
happened by this researcher, or a qualified research associate, reviewing
medical records. Respondents were approached and asked to know more about
involvement in the study of heart disease and sleep disorders, with the
approval of the prospective respondents’ physician.
Inclusion
and Exclusion
Prospective participants, who showed interest, were
interviewed face to face about specifications for incorporation and omission
and reporting on the study include time commitment, costs, benefits and mutual
intent of response. If a prospective respondent was qualified and showed
interest, a physician at the Hearts International Hospital checked their
medical history to validate the participants' eligibility and health.
Inclusion
Criteria
To qualify for the study, prospective participants had to
be:
-
55 to 90 years old.
-
Doctor providing a diagnosis of
cardiovascular disease.
-
The condition was considered
whether the prospective patient has one or more of the following factors: heart
pains, cardiac infarction, stent and/or peripheral artery dysfunction also
known as muscle growth of the left ventricle.
Exclusion
Criteria
The study's exclusion criteria attempted to minimize
potential possible factors that could in overlay relationships between early
stage CVDs.
Criteria for omission include the following:
-
History of heart surgery (CABG)
-
Background of heart valve
maintenance procedures
-
Cerebrovascular incident in
patients (stroke)
-
Those that have a serious brain
injury history of a lack of consciousness spanning 30 minutes.
-
Patients with a diagnosis of
any brain condition like epilepsy disorders, demyelination disorders and
neurological diseases including Parkinson's disease.
To be
particular to participate for the sleep complaint sub-study, respondents has
obligation to fulfill the above standards and be completely interested in
broader research on aging and vascular disease. Respondents who chose to engage
in the sub-analysis were interviewed face to face and asked if they were drawn
to engage. The protocols for the sub-study were briefly explained, and
additional information on research protocols was gathered from the interested
respondents. Those who wanted to participate at the time of their daily
research visit completed the sub-study materials, where possible.
Medical
Examination of Patients
At
Rawalpindi Hearts International Hospital, both respondents completed an
interview on personal records and a short physical test. A physician or nurse
conducted both interviews and tests to gather basic longitudinal and wellbeing
associated evidence by this study. Data gathered comprised age, the main
educational degree received, current prescriptions, smoking record, history of
alcohol use and prior medical diagnosis. Throughout the medical examination a
physician, nurse, or other trained medical technician obtained heart rhythm and
laboratory values. These tests included full height, mass of the body, pressure
of blood, beat of the heart and fat index of the body.
Respondents have had a blood
check and an echocardiogram (ECG). The plasma extracts were tested to obtain
serum C-reactive protein levels, as well as other essential indicators for the
research lines itself. The respondents were expected to pace for 12 hours, as
well as withhold drugs, before undergoing the blood draw for examination. A
doctor has given medical guidelines and instructions for the removal of drugs.
Percussion
for Sleep Disorder Sub-studies
The respondents
who decided to engage in the ongoing study of sleep disturbance and were
voluntarily involved in the overall study of ageing, vascular disease and
parent cognition performed both of the aforementioned assessments and an extra
assessment of exhaustion and sleep interruption. During the research on sleep
disorder, medical record of all patients at Hearts International Hospital was
carefully checked to ascertain the lack or existence of a diagnosis of sleeping
disorder. A respondent was found as having poor resting pattern if the health
graph confined an analysis of a poor resting made by a physician. If the
diagnostic report included a diagnosis of a sleep disorder provided by a
doctor, a person was listed as sleep disordered. Diagnosis may have been made
for the purposes of the present research either through a detailed background
and symptom analysis, or through a systematic sleep examination. If the
analysis of sleep disturbance was made outside Hearts International Hospital,
it was confirmed either by the actual practitioner of the subject or by the
existence of screened external documents.
The Berlin Questionnaire
examined personality-reports of sleep disturbance and the related effects. This
test used questions taken from the literature on sleep disorders that
accurately predicted the existence of sleep disordered respiration in the
studies
Table 1. Inclusion
criteria for a sleep disorder, no-sleep disorder, and omitted clusters.
|
Variables |
Sleep Disorder |
Non-Sleep Disorder |
Excluded |
|
Diagnosed Status |
Primary treatment of a suspected
sleep condition is self-sufficient and recorded in medical charts, if
confirmed by doctor |
The existence of sleep disturbance is
self-reported, but the diagnostic chart provides no text. Undiagnosed by any
doctor |
Obstructive sleep apnea, dreaming
person |
|
No Sleep Disturbance Self-Report.
Sleep condition diagnosis and adequately reported by a health care provider |
No self-sufficient rest disorder
diagnosis reported in the health panel AND no doctor's therapy |
Disruptive sleep apnea which was
historically diagnosed in psychiatric graphs |
Statistical
Analysis
The statistical analysis was done on Windows using SPSS
15.0. Variance analysis or individual sample T-tests have been used to assess
classes with any of the following study hypotheses:
- Those
suffering from diagnosed sleep disorders and CVD should show higher rates of
everyday exhaustion than those with CVD alone
- For
quantitative neuropsychological research subjects with reported sleep
disturbances and CVD would do slightly poorer than subjects with CVD alone.
- Anyone
afflicted with sleep disturbances and CVD may have elevated biochemical markers
of inflammatory pathways, as determined by C-reactive protein serum levels. Yet
again, the two classes will be measured using a separate T-test analyses for
the immune marker blood levels.
Results
Patient
Participation
Respondents in the present research were people who were
registered in a Hearts International Hospital research on aging and
cardiovascular disease. Respondents for this research were recruited via the
Department of Cardiology at the Hearts International Hospital. Enrolment
happened by this researcher, or a qualified research associate, reviewing
medical records. Respondents were approached and asked to know more about
involvement in the study of heart disease and sleep disorders, with the
approval of the prospective respondents’ physician.
Inclusion
and Exclusion
Prospective participants, who showed interest, were
interviewed face to face about specifications for incorporation and omission
and reporting on the study include time commitment, costs, benefits and mutual
intent of response. If a prospective respondent was qualified and showed
interest, a physician at the Hearts International Hospital checked their
medical history to validate the participants' eligibility and health.
Inclusion
Criteria
To qualify for the study, prospective participants had to
be:
-
55 to 90 years old.
-
Doctor providing a diagnosis of
cardiovascular disease.
-
The condition was considered
whether the prospective patient has one or more of the following factors: heart
pains, cardiac infarction, stent and/or peripheral artery dysfunction also
known as muscle growth of the left ventricle.
Exclusion
Criteria
The study's exclusion criteria attempted to minimize
potential possible factors that could in overlay relationships between early
stage CVDs.
Criteria for omission include the following:
-
History of heart surgery (CABG)
-
Background of heart valve
maintenance procedures
-
Cerebrovascular incident in
patients (stroke)
-
Those that have a serious brain
injury history of a lack of consciousness spanning 30 minutes.
-
Patients with a diagnosis of
any brain condition like epilepsy disorders, demyelination disorders and
neurological diseases including Parkinson's disease.
To be
particular to participate for the sleep complaint sub-study, respondents has
obligation to fulfill the above standards and be completely interested in
broader research on aging and vascular disease. Respondents who chose to engage
in the sub-analysis were interviewed face to face and asked if they were drawn
to engage. The protocols for the sub-study were briefly explained, and
additional information on research protocols was gathered from the interested
respondents. Those who wanted to participate at the time of their daily
research visit completed the sub-study materials, where possible.
Medical
Examination of Patients
At
Rawalpindi Hearts International Hospital, both respondents completed an
interview on personal records and a short physical test. A physician or nurse
conducted both interviews and tests to gather basic longitudinal and wellbeing
associated evidence by this study. Data gathered comprised age, the main
educational degree received, current prescriptions, smoking record, history of
alcohol use and prior medical diagnosis. Throughout the medical examination a
physician, nurse, or other trained medical technician obtained heart rhythm and
laboratory values. These tests included full height, mass of the body, pressure
of blood, beat of the heart and fat index of the body.
Respondents have had a blood
check and an echocardiogram (ECG). The plasma extracts were tested to obtain
serum C-reactive protein levels, as well as other essential indicators for the
research lines itself. The respondents were expected to pace for 12 hours, as
well as withhold drugs, before undergoing the blood draw for examination. A
doctor has given medical guidelines and instructions for the removal of drugs.
Percussion
for Sleep Disorder Sub-studies
The respondents
who decided to engage in the ongoing study of sleep disturbance and were
voluntarily involved in the overall study of ageing, vascular disease and
parent cognition performed both of the aforementioned assessments and an extra
assessment of exhaustion and sleep interruption. During the research on sleep
disorder, medical record of all patients at Hearts International Hospital was
carefully checked to ascertain the lack or existence of a diagnosis of sleeping
disorder. A respondent was found as having poor resting pattern if the health
graph confined an analysis of a poor resting made by a physician. If the
diagnostic report included a diagnosis of a sleep disorder provided by a
doctor, a person was listed as sleep disordered. Diagnosis may have been made
for the purposes of the present research either through a detailed background
and symptom analysis, or through a systematic sleep examination. If the
analysis of sleep disturbance was made outside Hearts International Hospital,
it was confirmed either by the actual practitioner of the subject or by the
existence of screened external documents.
The Berlin Questionnaire
examined personality-reports of sleep disturbance and the related effects. This
test used questions taken from the literature on sleep disorders that
accurately predicted the existence of sleep disordered respiration in the
studies
Table 1. Inclusion
criteria for a sleep disorder, no-sleep disorder, and omitted clusters.
|
Variables |
Sleep Disorder |
Non-Sleep Disorder |
Excluded |
|
Diagnosed Status |
Primary treatment of a suspected
sleep condition is self-sufficient and recorded in medical charts, if
confirmed by doctor |
The existence of sleep disturbance is
self-reported, but the diagnostic chart provides no text. Undiagnosed by any
doctor |
Obstructive sleep apnea, dreaming
person |
|
No Sleep Disturbance Self-Report.
Sleep condition diagnosis and adequately reported by a health care provider |
No self-sufficient rest disorder
diagnosis reported in the health panel AND no doctor's therapy |
Disruptive sleep apnea which was
historically diagnosed in psychiatric graphs |
Statistical
Analysis
The statistical analysis was done on Windows using SPSS
15.0. Variance analysis or individual sample T-tests have been used to assess
classes with any of the following study hypotheses:
- Those
suffering from diagnosed sleep disorders and CVD should show higher rates of
everyday exhaustion than those with CVD alone
- For
quantitative neuropsychological research subjects with reported sleep
disturbances and CVD would do slightly poorer than subjects with CVD alone.
- Anyone
afflicted with sleep disturbances and CVD may have elevated biochemical markers
of inflammatory pathways, as determined by C-reactive protein serum levels. Yet
again, the two classes will be measured using a separate T-test analyses for
the immune marker blood levels.
Discussion
The findings of the present research suggest that sleep-deprived and non-sleep-deprived people vary substantially in relations of everyday exhaustion, while psychiatric instability or inflammation symptoms did not display any substantial variations.
Fatigue
The discovery that, as expected, a slightly higher degree of everyday exhaustion has been recorded by the sleep-disordered community is a rather predictable outcome but necessary to investigate because of the population being examined. Fatigue in the literature is generally linked to disturbed sleep, an inclusion in older adults (Monahan, K; Redline, S;, 2011), but there's always been a clear association among heart disease and elevated rates of fatigue (Lawati, NM Al; Ayas, NT;, 2008) (Monahan, K; Redline, S;, 2011). In the present analysis, a substantial differential in recorded exhaustion was found between the two clusters as both collections had a documented history of heart disease, supporting the belief that there is a clear correlation between disturbed resting time and hours of daylight exhaustion in a heart issues population, and that as a function of the participants' health status, fatigue rates did not exceed a ceiling. The definition under review in the present research was an overarching explanation of deprived sleep, described by hypothesis with the ones that reported sleep deprivations experience a type of interrupted wake routine with resulting less peaceful rest and in turn also had fatigue in daytime.
Whereas a distinction has recently started to be made in some literature (Pack, Allan I; Gislason, T;, 2009) related to lack of sleep and interruption of sleep as distinct types of disordered sleep. Sleep deficit is distinguished by an increase in wake-up time and a decrease in average sleep time, whereas sleep variability refers to moderate, intermittent arousal muscle spasms that occur during sleep that do not contribute to full waking. Sleep deficiency is considered to be more characteristic of depression, while sleep dysfunction is known to be associated with conditions such as restless legs and sleep apnea (Peters, Robert W;, 2005). The theory under review in this study was an underlying interpretation of disturbed sleep, defined by the hypothesis that those with documented sleep disturbances experience a form of disturbance of the sleep-wake process with consequent loss of restful sleep and decreased daytime exhaustion. The current research looks at the more perplexed idea of sleep which is generally understood by itself. Nevertheless, a possible future direction in the study of sleep and fatigue may include exploring hunger and separation as distinct structures, either through sleep trials or by clinical distinction and assessing their differences.
Mental and emotional dysfunction
With respect to their scores on a psychiatric and emotional distress test, the two groups in the present study were all in the non-medicinal or normal range and were not significantly different from each other as predicted. For many reasons, the result is significant. Firstly, older adults with a chronic condition can experience elevated depression levels. When directly evaluating older people with cardiovascular disease, evidence shows that 15-22 percent meet major depression guidelines (St. Sauver, Jennifer L; Jacobson, Debra J; Nehra, Ajay; Brant , A;, 2009). This is compounded by an investigation into chronically troubled sleep, which was often linked with depressed mood and increased psychological distress (Caples, Sean M;, 2014) (Tamanna, Sadeka ; Iftekhar Ullah, M;, 2016). As a consequence, it was necessary to analyze the levels of anxiety in both groups to assess whether the sleep-disordered group had a longitudinal effect, or in which both clusters have raised mental illness rates as a function of their well-being.
In this case, as predicted, the two respondents did not distinguish in terms of their level of mental illness, and in general both fell within the normal or non-clinical spectrum of total illness. This is particularly important because of the possible impact of psychological trauma on the other factors that are being studied. Levels of psychological depression can affect exhaustion. Since the two groups do not differ in their levels of anxiety, we should have a fair degree of confidence that the discrepancies found in certain fields are not due to psychological anxiety (Tasci, I;, 2011) (Teramoto, S; Matsuse, O; Ouchi, Y;, 1999). One potential explanation for the lack of disparity between the two classes of psychological distress could be linked to sample characteristics. The group of the present research consisted of people with reasonably high educational performance and decent access to health care (Teramoto, S; Matsuse, O; Ouchi, Y;, 1999).
Conclusion
The findings of the current research confirmed the hypothesis that, in the absence of increased rates of psychiatric discomfort, sleep disordered subjects will show higher rates of exhaustion and do worse on cognitive tests. Contrary to the initial theory, patients with sleep-disorder didn't have substantially elevated stages of C-reactive protein, an indicator of inflammation. The present work has important strengths in terms of collecting accurate knowledge, using the findings of self-report accurately, and the methods used for psychological evaluation. Present drawbacks of the study included relatively limited and diverse sample sizes, and current findings indicated other potential grounds for analysis and follow-up. Which include sleep apnea group study, more detailed evaluation of facets of executive control, and other physiological factors being studied. Addressing these shortcomings and addressing these new issues will improve this significant study line and help to illuminate the functions of neuropsychological processing in sleep, aging and heart disease.
References
- Caples, Sean M. (2014). Central Sleep Apnea and Cardiovascular Disease. Sleep Medicines Clinics, 27-35. doi:10.1016/j.jsmc.2013.10.007
- da Silva Paulitsch , F; L, Zhang;. (2018). Continuous positive airway pressure for adults with obstructive sleep apnea and cardiovascular disease: a meta-analysis of randomized trials. Sleep Medicine, 28-34. doi:10.1016/j.sleep.2018.09.030.
- Devulapally, Kiran ; Pongonis Jr., Raymond ; Khayat, Rami;. (2008). OSA: the new cardiovascular disease. Heart Failure Review, 155-164. doi:10.1007/s10741-008-9101-2
- Kaditis, Athanasios MD;. (2010). From Obstructive Sleep Apnea in Childhood to Cardiovascular Disease in Adulthood: What is the Evidence? Sleep, 1279-1280. doi: doi.org/10.1093/sleep/33.10.1279
- Kang, Eun-Ju Bae, W Y;. (2017). Additional value of airway CT in patient with obstructive sleep apnea: quantitative analysis of carotid arterial calcification for predictor of cardiovascular disease. Sleep Medicine, e152-e153. doi: 10.1016/j.sleep.2017.11.447
- Lawati, NM Al; Ayas, NT;. (2008). To sleep, perchance to dip: obstructive sleep apnea, blood pressure, and cardiovascular disease. Sleep, 772-773. doi:10.1093/sleep/31.6.772
- Loffler, K; Heeley, E; Freed, R; Anderson, C; Woodman, R; Hanly, P; McEvoy, R;. (2017). Effect of obstructive sleep apnea treatment on renal function in patients with cardiovascular disease. Sleep Research, 25-28. doi: doi.org/10.1111/jsr.31_12618
- Monahan, K; Redline, S;. (2011). Role of obstructive sleep apnea in cardiovascular disease. Current Opinion in Cardiology, 541-547. doi:10.1097/HCO.0b013e32834b806a.
- Pack, Allan I; Gislason, T;. (2009). Obstructive Sleep Apnea and Cardiovascular Disease: A Perspective and Future Directions. Progress in Cardiovascular Diseases, 434-451. doi.org/10.1016/j.pcad.2009.01.002
- Peters, Robert W;. (2005). Obstructive Sleep Apnea and Cardiovascular Disease. Chest, 1-3. doi: https://doi.org/10.1378/chest.127.1.1
- St. Sauver, Jennifer L; Jacobson, Debra J; Nehra, Ajay; Brant , A;. (2009). Obstructive Sleep Apnea Associated With Erectile Dysfunction and Cardiovascular Disease-Reply-I. MayoClinic Proceedings, 562. doi:// doi.org/10.4065/84.6.562-a
- Tamanna, Sadeka ; Iftekhar Ullah, M;. (2016). Sleep Apnea and Cardiovascular Disease. Cardiovascular Disease, 143-148. doi:10.3329/cardio.v8i2.26818
- Tasci, I;. (2011). Oxidative stress, obstructive sleep apnea and cardiovascular disease. Sleep and Breathing. doi: https://doi.org/10.1007/s11325-011-0553-6
- Teramoto, S; Matsuse, O; Ouchi, Y;. (1999). Does the altered cardiovascular variability associated with obstructive sleep apnea contribute to development of cardiovascular disease in patients with obstructive sleep apnea syndrome? Circulation, 136-137. doi: 10.1161/01.cir.100.25.e136
- Caples, Sean M. (2014). Central Sleep Apnea and Cardiovascular Disease. Sleep Medicines Clinics, 27-35. doi:10.1016/j.jsmc.2013.10.007
- da Silva Paulitsch , F; L, Zhang;. (2018). Continuous positive airway pressure for adults with obstructive sleep apnea and cardiovascular disease: a meta-analysis of randomized trials. Sleep Medicine, 28-34. doi:10.1016/j.sleep.2018.09.030.
- Devulapally, Kiran ; Pongonis Jr., Raymond ; Khayat, Rami;. (2008). OSA: the new cardiovascular disease. Heart Failure Review, 155-164. doi:10.1007/s10741-008-9101-2
- Kaditis, Athanasios MD;. (2010). From Obstructive Sleep Apnea in Childhood to Cardiovascular Disease in Adulthood: What is the Evidence? Sleep, 1279-1280. doi: doi.org/10.1093/sleep/33.10.1279
- Kang, Eun-Ju Bae, W Y;. (2017). Additional value of airway CT in patient with obstructive sleep apnea: quantitative analysis of carotid arterial calcification for predictor of cardiovascular disease. Sleep Medicine, e152-e153. doi: 10.1016/j.sleep.2017.11.447
- Lawati, NM Al; Ayas, NT;. (2008). To sleep, perchance to dip: obstructive sleep apnea, blood pressure, and cardiovascular disease. Sleep, 772-773. doi:10.1093/sleep/31.6.772
- Loffler, K; Heeley, E; Freed, R; Anderson, C; Woodman, R; Hanly, P; McEvoy, R;. (2017). Effect of obstructive sleep apnea treatment on renal function in patients with cardiovascular disease. Sleep Research, 25-28. doi: doi.org/10.1111/jsr.31_12618
- Monahan, K; Redline, S;. (2011). Role of obstructive sleep apnea in cardiovascular disease. Current Opinion in Cardiology, 541-547. doi:10.1097/HCO.0b013e32834b806a.
- Pack, Allan I; Gislason, T;. (2009). Obstructive Sleep Apnea and Cardiovascular Disease: A Perspective and Future Directions. Progress in Cardiovascular Diseases, 434-451. doi.org/10.1016/j.pcad.2009.01.002
- Peters, Robert W;. (2005). Obstructive Sleep Apnea and Cardiovascular Disease. Chest, 1-3. doi: https://doi.org/10.1378/chest.127.1.1
- St. Sauver, Jennifer L; Jacobson, Debra J; Nehra, Ajay; Brant , A;. (2009). Obstructive Sleep Apnea Associated With Erectile Dysfunction and Cardiovascular Disease-Reply-I. MayoClinic Proceedings, 562. doi:// doi.org/10.4065/84.6.562-a
- Tamanna, Sadeka ; Iftekhar Ullah, M;. (2016). Sleep Apnea and Cardiovascular Disease. Cardiovascular Disease, 143-148. doi:10.3329/cardio.v8i2.26818
- Tasci, I;. (2011). Oxidative stress, obstructive sleep apnea and cardiovascular disease. Sleep and Breathing. doi: https://doi.org/10.1007/s11325-011-0553-6
- Teramoto, S; Matsuse, O; Ouchi, Y;. (1999). Does the altered cardiovascular variability associated with obstructive sleep apnea contribute to development of cardiovascular disease in patients with obstructive sleep apnea syndrome? Circulation, 136-137. doi: 10.1161/01.cir.100.25.e136
Cite this article
-
APA : Shafqat, Q. u. A. (2018). The Role of Sleep Apnea Linked with Cardiovascular Illness in Old Age Patients. Global Sociological Review, III(I), 18-25. https://doi.org/10.31703/gsr.2018(III-I).03
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CHICAGO : Shafqat, Qurat ul Ain. 2018. "The Role of Sleep Apnea Linked with Cardiovascular Illness in Old Age Patients." Global Sociological Review, III (I): 18-25 doi: 10.31703/gsr.2018(III-I).03
-
HARVARD : SHAFQAT, Q. U. A. 2018. The Role of Sleep Apnea Linked with Cardiovascular Illness in Old Age Patients. Global Sociological Review, III, 18-25.
-
MHRA : Shafqat, Qurat ul Ain. 2018. "The Role of Sleep Apnea Linked with Cardiovascular Illness in Old Age Patients." Global Sociological Review, III: 18-25
-
MLA : Shafqat, Qurat ul Ain. "The Role of Sleep Apnea Linked with Cardiovascular Illness in Old Age Patients." Global Sociological Review, III.I (2018): 18-25 Print.
-
OXFORD : Shafqat, Qurat ul Ain (2018), "The Role of Sleep Apnea Linked with Cardiovascular Illness in Old Age Patients", Global Sociological Review, III (I), 18-25
-
TURABIAN : Shafqat, Qurat ul Ain. "The Role of Sleep Apnea Linked with Cardiovascular Illness in Old Age Patients." Global Sociological Review III, no. I (2018): 18-25. https://doi.org/10.31703/gsr.2018(III-I).03