Camilla Hoyos - Academia.edu (original) (raw)

Papers by Camilla Hoyos

Research paper thumbnail of The Link between Obstructive Sleep Apnea and Neurocognitive Impairment: An Official American Thoracic Society Workshop Report

Annals of the American Thoracic Society

There is emerging evidence that obstructive sleep apnea (OSA) is a risk factor for preclinical Al... more There is emerging evidence that obstructive sleep apnea (OSA) is a risk factor for preclinical Alzheimer's disease (AD). An American Thoracic Society workshop was convened that included clinicians, basic scientists, and epidemiologists with expertise in OSA, cognition, and dementia, with the overall objectives of summarizing the state of knowledge in the field, identifying important research gaps, and identifying potential directions for future research. Although currently available cognitive screening tests may allow for identification of cognitive impairment in patients with OSA, they should be interpreted with caution. Neuroimaging in OSA can provide surrogate measures of disease chronicity, but it has methodological limitations. Most data on the impact of OSA treatment on cognition are for continuous positive airway pressure (CPAP), with limited data for other treatments. The cognitive domains improving with CPAP show considerable heterogeneity across studies. OSA can negatively influence risk, manifestations, and possibly progression of AD and other forms of dementia. Sleepdependent memory tasks need greater incorporation into OSA testing, with better delineation of sleep fragmentation versus intermittent hypoxia effects. Plasma biomarkers may prove to be sensitive, feasible, and scalable biomarkers for use in clinical trials. There is strong biological plausibility, but insufficient data, to prove bidirectional causality of the associations between OSA and aging pathology. Engaging, recruiting, and retaining diverse populations in health care and research may help to decrease racial and ethnic disparities in OSA and AD. Key recommendations from the workshop include research aimed at underlying mechanisms; longer-term longitudinal studies with objective assessment of OSA, sensitive cognitive markers, and sleep-dependent cognitive tasks; and pragmatic study designs for interventional studies that control for other factors that may impact cognitive outcomes and use novel biomarkers.

Research paper thumbnail of Effect of omega 3 and omega 6 fatty acid intakes from diet and supplements on plasma fatty acid levels in the first 3 years of life

Asia Pacific Journal of Clinical Nutrition, 2008

The optimal method for conducting omega (n-)3 polyunsaturated fatty acid (PUFA) supplementation t... more The optimal method for conducting omega (n-)3 polyunsaturated fatty acid (PUFA) supplementation trials in children is unknown. To assess the impact of n-3 and n-6 PUFA intake from the background diet on plasma levels of n-3 and n-6 PUFA in children aged 0-3 years, with and without n-3 supplementation. Subjects were randomised antenatally to receive either n-3 PUFA supplements and low n-6 PUFA cooking oils and spreads or a control intervention, designed to maintain usual fatty acid intake. Dietary intake was assessed at 18 months by 3-day weighed food record and at 3 years by food frequency questionnaire. Plasma phospholipids were measured at both time points. Associations were tested by regression. N-3 PUFA intake from background diet did not significantly affect plasma n-3 levels. In contrast, n-6 PUFA intake in background diet was positively related to plasma n-6 levels in both study groups. In addition, n-6 PUFA intake from diet was negatively associated with plasma n-3 levels at...

Research paper thumbnail of Circadian rhythm and sleep alterations in older people with lifetime depression: a case-control study

BMC Psychiatry

Background Depression is common in older people and is associated with underlying brain change in... more Background Depression is common in older people and is associated with underlying brain change increasing the risk of dementia. Sleep disturbance is frequently reported by those with lifetime depression, however whether circadian misalignment also exists is unclear. We aimed to examine circadian rhythms and sleep associations in older patients with and without lifetime depression. Methods Thirty-four older people meeting DSM-IV criteria for lifetime major depression (mean age = 63.9 years), and 30 healthy controls (mean age = 65.7 years) were recruited. Participants underwent 2-weeks of actigraphy followed by a 3-night protocol including dim light melatonin onset (DLMO) assessment and overnight polysomnography (PSG) for sleep architecture. DLMO and phase angle of entrainment were computed. Results Compared to controls, participants with depression had a significantly longer phase angle of entrainment (6.82 h ± 1.45 vs. 5.87 h ± 1.60, p = 0.02, Cohens-d = 0.62). A small to moderate y...

Research paper thumbnail of The association of insomnia disorder characterised by objective short sleep duration with hypertension, diabetes and body mass index: A systematic review and meta-analysis

Research paper thumbnail of Effects of continuous positive airway pressure on endothelial function and circulating progenitor cells in obstructive sleep apnoea: A randomised sham-controlled study

ABSTRACT OBJECTIVE: Obstructive sleep apnoea (OSA) is characterised by reoccurring apnoeas and hy... more ABSTRACT OBJECTIVE: Obstructive sleep apnoea (OSA) is characterised by reoccurring apnoeas and hypopneas, causing repetitive hypoxia and reoxygenation, and is associated with endothelial dysfunction and reduced levels of circulating progenitor cells (CPCs). The potential to improve endothelial function and CPC levels in people with OSA by preventing hypoxic episodes with Continuous Positive Airway Pressure (CPAP) was investigated in a sham-controlled CPAP study. METHODS: Men with moderate-to-severe OSA (mean±SD: age=49±12y, apnoea hypopnea index (AHI)=37.6±16.4events/h, body mass index=31.5±5.7kg/m2) who were CPAP naïve without diabetes mellitus were randomised in a 12-week double-blind sham-controlled parallel group study to receive either active (n=25) or sham (n=21) CPAP. CPCs, isolated from blood, were measured by flow cytometry and by co-staining cultured cells (7days) with acetylated low-density lipoprotein (acLDL) and lectin. Endothelial function was assessed by peripheral arterial tonometry (PAT). RESULTS: Compared to sham, CPAP significantly decreased AHI (mean between-group difference -36.0events/h; 95%CI, -49.7 to -22.3, p<0.0001) after 12weeks. Despite this improvement in AHI, CPAP had no effect on change in CPC levels (including CD34+/KDR+ (565cells/mL; -977 to 2106, p=0.45), CD34+/KDR+/CD45- (37.0cells/mL; -17.7 to 85.7, p=0.13), acLDL+/lectin+ (-43.1 cells/field, -247 to 161, p=0.67)) or change in endothelial function (0.27; -0.14 to 0.67, p=0.19) compared to sham therapy. CONCLUSIONS: Despite the improvement in OSA parameters and ablation of apnoeic events by CPAP, CPC counts and endothelial function in men with moderate-to-severe OSA were not significantly improved after 12weeks of therapeutic CPAP when compared to sham control.

Research paper thumbnail of Effect of CPAP on Weight and Local Adiposity in Adults with Obstructive Sleep Apnea: A Meta-Analysis

Annals of the American Thoracic Society

RATIONALE Evidence suggests that continuous positive airway pressure (CPAP) treatment promotes we... more RATIONALE Evidence suggests that continuous positive airway pressure (CPAP) treatment promotes weight gain in obstructive sleep apnea (OSA) patients. It is unclear whether weight gain is influenced by CPAP adherence or comorbid disorders. OBJECTIVES To examine the CPAP effects on body mass index (BMI) and local adiposity，and the potential moderators of CPAP effects on BMI in OSA patients. METHODS We searched PubMed/Medline, Embase and Cochrane through to December 2019. Randomized controlled trials (RCTs) of CPAP versus controls with ≥4 weeks treatment were included. RESULTS A total of 39 RCTs with 6954 subjects were included. In intention-to-treat analysis, BMI increased significantly after CPAP treatment compared to controls (WMD=0.148 kg/m2, 95% CI=0.04-0.26, P=0.001). In studies demonstrating an increase in BMI, waist and neck circumferences were also significantly increased. Subgroup-analyses revealed that increased BMI was attributable to CPAP use of ≤5 hours/night (WMD=0.231), but not in those with CPAP use of >5 hours/night (WMD=0.001, between-group P-value=0.049). Furthermore, BMI increased significantly in patients without cardiovascular disease (CVD, WMD=0.200), whereas decreased significantly in those with CVD at baseline (WMD=-0.188, between-group P-value<0.001). Moreover, BMI increased significantly in patients with dysglycemia (WMD=0.499), but not in those without dysglycemia at baseline (WMD=0.100, between-group P-value=0.032). Meta-regression confirmed the subgroup findings. CONCLUSIONS BMI increased significantly in OSA patients after CPAP treatment, especially in those with CPAP use of ≤5 hours/night, without CVD and/or with dysglycemia at baseline. CPAP use of at least 5 hours/night seems to be necessary in mitigating the risk for weight gain in OSA patients.

Research paper thumbnail of The effect of cannabidiol on simulated car driving performance: A randomised, double‐blind, placebo‐controlled, crossover, dose‐ranging clinical trial protocol

Human Psychopharmacology: Clinical and Experimental

Research paper thumbnail of Effect of Continuous Positive Airway Pressure on Weight and Local Adiposity in Adults with Obstructive Sleep Apnea: A Systematic Review and Meta-Analysis of the Randomized Controlled Trials

Research paper thumbnail of Objective measurement of sleep in mild cognitive impairment: A systematic review and meta-analysis

Research paper thumbnail of Cannabinoid therapies in the management of sleep disorders: A systematic review of preclinical and clinical studies

Research paper thumbnail of Arterial stiffness relates to executive dysfunction in later life

Aging, Neuropsychology, and Cognition

Research paper thumbnail of Editorial: Metabolic Health in Normal and Abnormal Sleep

Frontiers in Endocrinology

Sleep comprises one third of the human lifespan and therefore has a significant impact on metabol... more Sleep comprises one third of the human lifespan and therefore has a significant impact on metabolism. There is a growing recognition that sleep disorders are associated with obesity, metabolic syndrome, and cardiovascular disease. This Research Topic, "Metabolic Health in Normal and Abnormal Sleep" contains a collection of studies that address complex interactions between sleep and metabolic health.

Research paper thumbnail of Nocturnal Hypoxemia Is Associated with Altered Parahippocampal Functional Brain Connectivity in Older Adults at Risk for Dementia

Journal of Alzheimer's Disease

Research paper thumbnail of Cardiopulmonary rehabilitation for obese sleep-disordered breathing: a new treatment frontier?

Research paper thumbnail of Nocturnal Oxygen Desaturation is Associated with Altered Parahippocampal Functional Brain Connectivity in Older Adults at Risk for Dementia

Research paper thumbnail of How Does Sleep-Wake Disturbance Relate to Neuropsychological and Neuroimaging Markers in Older People at Risk for Dementia?

Research paper thumbnail of Magnesium supplementation for the treatment of restless legs syndrome and periodic limb movement disorder: A systematic review

Research paper thumbnail of Diurnal changes in central blood pressure and pulse pressure amplification in patients with obstructive sleep apnoea

International Journal of Cardiology Hypertension

Research paper thumbnail of Is Obstructive Sleep Apnea a Risk Factor for Depression in Coronary Artery Disease?

Annals of the American Thoracic Society

Research paper thumbnail of Impaired Neurobehavioural Performance in Untreated Obstructive Sleep Apnea Patients Using a Novel Standardised Test Battery

Frontiers in surgery, 2018

Although polysomnography (PSG) is the gold-standard measure for assessing disease severity in obs... more Although polysomnography (PSG) is the gold-standard measure for assessing disease severity in obstructive sleep apnea (OSA), it has limited value in identifying individuals experiencing significant neurobehavioural dysfunction. This study used a brief and novel computerised test battery to examine neurobehavioural function in adults with and without OSA. 204 patients with untreated OSA [age 49.3 (12.5) years; body mass index, [BMI] 33.6 (8.0) kg/m; Epworth sleepiness scale 12 (4.9)/24; apnea hypopnea index 33.6 (25.8)/h] and 50 non-OSA participants [age 39.2 (14.0) years; BMI 25.8 (4.2) kg/m, ESS 3.6 (2.3)/24]. All participants completed a computerised neurobehavioural battery during the daytime in the sleep clinic. The OSA group subsequently underwent an overnight PSG. The 30 min test battery assessed cognitive domains of visual spatial scanning and selective attention (Letter Cancellation Test), executive function (Stroop task) and working memory (2- and 3-Back tasks), and a valid...

Research paper thumbnail of The Link between Obstructive Sleep Apnea and Neurocognitive Impairment: An Official American Thoracic Society Workshop Report

Annals of the American Thoracic Society

There is emerging evidence that obstructive sleep apnea (OSA) is a risk factor for preclinical Al... more There is emerging evidence that obstructive sleep apnea (OSA) is a risk factor for preclinical Alzheimer's disease (AD). An American Thoracic Society workshop was convened that included clinicians, basic scientists, and epidemiologists with expertise in OSA, cognition, and dementia, with the overall objectives of summarizing the state of knowledge in the field, identifying important research gaps, and identifying potential directions for future research. Although currently available cognitive screening tests may allow for identification of cognitive impairment in patients with OSA, they should be interpreted with caution. Neuroimaging in OSA can provide surrogate measures of disease chronicity, but it has methodological limitations. Most data on the impact of OSA treatment on cognition are for continuous positive airway pressure (CPAP), with limited data for other treatments. The cognitive domains improving with CPAP show considerable heterogeneity across studies. OSA can negatively influence risk, manifestations, and possibly progression of AD and other forms of dementia. Sleepdependent memory tasks need greater incorporation into OSA testing, with better delineation of sleep fragmentation versus intermittent hypoxia effects. Plasma biomarkers may prove to be sensitive, feasible, and scalable biomarkers for use in clinical trials. There is strong biological plausibility, but insufficient data, to prove bidirectional causality of the associations between OSA and aging pathology. Engaging, recruiting, and retaining diverse populations in health care and research may help to decrease racial and ethnic disparities in OSA and AD. Key recommendations from the workshop include research aimed at underlying mechanisms; longer-term longitudinal studies with objective assessment of OSA, sensitive cognitive markers, and sleep-dependent cognitive tasks; and pragmatic study designs for interventional studies that control for other factors that may impact cognitive outcomes and use novel biomarkers.

Research paper thumbnail of Effect of omega 3 and omega 6 fatty acid intakes from diet and supplements on plasma fatty acid levels in the first 3 years of life

Asia Pacific Journal of Clinical Nutrition, 2008

The optimal method for conducting omega (n-)3 polyunsaturated fatty acid (PUFA) supplementation t... more The optimal method for conducting omega (n-)3 polyunsaturated fatty acid (PUFA) supplementation trials in children is unknown. To assess the impact of n-3 and n-6 PUFA intake from the background diet on plasma levels of n-3 and n-6 PUFA in children aged 0-3 years, with and without n-3 supplementation. Subjects were randomised antenatally to receive either n-3 PUFA supplements and low n-6 PUFA cooking oils and spreads or a control intervention, designed to maintain usual fatty acid intake. Dietary intake was assessed at 18 months by 3-day weighed food record and at 3 years by food frequency questionnaire. Plasma phospholipids were measured at both time points. Associations were tested by regression. N-3 PUFA intake from background diet did not significantly affect plasma n-3 levels. In contrast, n-6 PUFA intake in background diet was positively related to plasma n-6 levels in both study groups. In addition, n-6 PUFA intake from diet was negatively associated with plasma n-3 levels at...

Research paper thumbnail of Circadian rhythm and sleep alterations in older people with lifetime depression: a case-control study

BMC Psychiatry

Background Depression is common in older people and is associated with underlying brain change in... more Background Depression is common in older people and is associated with underlying brain change increasing the risk of dementia. Sleep disturbance is frequently reported by those with lifetime depression, however whether circadian misalignment also exists is unclear. We aimed to examine circadian rhythms and sleep associations in older patients with and without lifetime depression. Methods Thirty-four older people meeting DSM-IV criteria for lifetime major depression (mean age = 63.9 years), and 30 healthy controls (mean age = 65.7 years) were recruited. Participants underwent 2-weeks of actigraphy followed by a 3-night protocol including dim light melatonin onset (DLMO) assessment and overnight polysomnography (PSG) for sleep architecture. DLMO and phase angle of entrainment were computed. Results Compared to controls, participants with depression had a significantly longer phase angle of entrainment (6.82 h ± 1.45 vs. 5.87 h ± 1.60, p = 0.02, Cohens-d = 0.62). A small to moderate y...

Research paper thumbnail of The association of insomnia disorder characterised by objective short sleep duration with hypertension, diabetes and body mass index: A systematic review and meta-analysis

Research paper thumbnail of Effects of continuous positive airway pressure on endothelial function and circulating progenitor cells in obstructive sleep apnoea: A randomised sham-controlled study

ABSTRACT OBJECTIVE: Obstructive sleep apnoea (OSA) is characterised by reoccurring apnoeas and hy... more ABSTRACT OBJECTIVE: Obstructive sleep apnoea (OSA) is characterised by reoccurring apnoeas and hypopneas, causing repetitive hypoxia and reoxygenation, and is associated with endothelial dysfunction and reduced levels of circulating progenitor cells (CPCs). The potential to improve endothelial function and CPC levels in people with OSA by preventing hypoxic episodes with Continuous Positive Airway Pressure (CPAP) was investigated in a sham-controlled CPAP study. METHODS: Men with moderate-to-severe OSA (mean±SD: age=49±12y, apnoea hypopnea index (AHI)=37.6±16.4events/h, body mass index=31.5±5.7kg/m2) who were CPAP naïve without diabetes mellitus were randomised in a 12-week double-blind sham-controlled parallel group study to receive either active (n=25) or sham (n=21) CPAP. CPCs, isolated from blood, were measured by flow cytometry and by co-staining cultured cells (7days) with acetylated low-density lipoprotein (acLDL) and lectin. Endothelial function was assessed by peripheral arterial tonometry (PAT). RESULTS: Compared to sham, CPAP significantly decreased AHI (mean between-group difference -36.0events/h; 95%CI, -49.7 to -22.3, p&lt;0.0001) after 12weeks. Despite this improvement in AHI, CPAP had no effect on change in CPC levels (including CD34+/KDR+ (565cells/mL; -977 to 2106, p=0.45), CD34+/KDR+/CD45- (37.0cells/mL; -17.7 to 85.7, p=0.13), acLDL+/lectin+ (-43.1 cells/field, -247 to 161, p=0.67)) or change in endothelial function (0.27; -0.14 to 0.67, p=0.19) compared to sham therapy. CONCLUSIONS: Despite the improvement in OSA parameters and ablation of apnoeic events by CPAP, CPC counts and endothelial function in men with moderate-to-severe OSA were not significantly improved after 12weeks of therapeutic CPAP when compared to sham control.

Research paper thumbnail of Effect of CPAP on Weight and Local Adiposity in Adults with Obstructive Sleep Apnea: A Meta-Analysis

Annals of the American Thoracic Society

RATIONALE Evidence suggests that continuous positive airway pressure (CPAP) treatment promotes we... more RATIONALE Evidence suggests that continuous positive airway pressure (CPAP) treatment promotes weight gain in obstructive sleep apnea (OSA) patients. It is unclear whether weight gain is influenced by CPAP adherence or comorbid disorders. OBJECTIVES To examine the CPAP effects on body mass index (BMI) and local adiposity，and the potential moderators of CPAP effects on BMI in OSA patients. METHODS We searched PubMed/Medline, Embase and Cochrane through to December 2019. Randomized controlled trials (RCTs) of CPAP versus controls with ≥4 weeks treatment were included. RESULTS A total of 39 RCTs with 6954 subjects were included. In intention-to-treat analysis, BMI increased significantly after CPAP treatment compared to controls (WMD=0.148 kg/m2, 95% CI=0.04-0.26, P=0.001). In studies demonstrating an increase in BMI, waist and neck circumferences were also significantly increased. Subgroup-analyses revealed that increased BMI was attributable to CPAP use of ≤5 hours/night (WMD=0.231), but not in those with CPAP use of >5 hours/night (WMD=0.001, between-group P-value=0.049). Furthermore, BMI increased significantly in patients without cardiovascular disease (CVD, WMD=0.200), whereas decreased significantly in those with CVD at baseline (WMD=-0.188, between-group P-value<0.001). Moreover, BMI increased significantly in patients with dysglycemia (WMD=0.499), but not in those without dysglycemia at baseline (WMD=0.100, between-group P-value=0.032). Meta-regression confirmed the subgroup findings. CONCLUSIONS BMI increased significantly in OSA patients after CPAP treatment, especially in those with CPAP use of ≤5 hours/night, without CVD and/or with dysglycemia at baseline. CPAP use of at least 5 hours/night seems to be necessary in mitigating the risk for weight gain in OSA patients.

Research paper thumbnail of The effect of cannabidiol on simulated car driving performance: A randomised, double‐blind, placebo‐controlled, crossover, dose‐ranging clinical trial protocol

Human Psychopharmacology: Clinical and Experimental

Research paper thumbnail of Effect of Continuous Positive Airway Pressure on Weight and Local Adiposity in Adults with Obstructive Sleep Apnea: A Systematic Review and Meta-Analysis of the Randomized Controlled Trials

Research paper thumbnail of Objective measurement of sleep in mild cognitive impairment: A systematic review and meta-analysis

Research paper thumbnail of Cannabinoid therapies in the management of sleep disorders: A systematic review of preclinical and clinical studies

Research paper thumbnail of Arterial stiffness relates to executive dysfunction in later life

Aging, Neuropsychology, and Cognition

Research paper thumbnail of Editorial: Metabolic Health in Normal and Abnormal Sleep

Frontiers in Endocrinology

Sleep comprises one third of the human lifespan and therefore has a significant impact on metabol... more Sleep comprises one third of the human lifespan and therefore has a significant impact on metabolism. There is a growing recognition that sleep disorders are associated with obesity, metabolic syndrome, and cardiovascular disease. This Research Topic, "Metabolic Health in Normal and Abnormal Sleep" contains a collection of studies that address complex interactions between sleep and metabolic health.

Research paper thumbnail of Nocturnal Hypoxemia Is Associated with Altered Parahippocampal Functional Brain Connectivity in Older Adults at Risk for Dementia

Journal of Alzheimer's Disease

Research paper thumbnail of Cardiopulmonary rehabilitation for obese sleep-disordered breathing: a new treatment frontier?

Research paper thumbnail of Nocturnal Oxygen Desaturation is Associated with Altered Parahippocampal Functional Brain Connectivity in Older Adults at Risk for Dementia

Research paper thumbnail of How Does Sleep-Wake Disturbance Relate to Neuropsychological and Neuroimaging Markers in Older People at Risk for Dementia?

Research paper thumbnail of Magnesium supplementation for the treatment of restless legs syndrome and periodic limb movement disorder: A systematic review

Research paper thumbnail of Diurnal changes in central blood pressure and pulse pressure amplification in patients with obstructive sleep apnoea

International Journal of Cardiology Hypertension

Research paper thumbnail of Is Obstructive Sleep Apnea a Risk Factor for Depression in Coronary Artery Disease?

Annals of the American Thoracic Society

Research paper thumbnail of Impaired Neurobehavioural Performance in Untreated Obstructive Sleep Apnea Patients Using a Novel Standardised Test Battery

Frontiers in surgery, 2018

Although polysomnography (PSG) is the gold-standard measure for assessing disease severity in obs... more Although polysomnography (PSG) is the gold-standard measure for assessing disease severity in obstructive sleep apnea (OSA), it has limited value in identifying individuals experiencing significant neurobehavioural dysfunction. This study used a brief and novel computerised test battery to examine neurobehavioural function in adults with and without OSA. 204 patients with untreated OSA [age 49.3 (12.5) years; body mass index, [BMI] 33.6 (8.0) kg/m; Epworth sleepiness scale 12 (4.9)/24; apnea hypopnea index 33.6 (25.8)/h] and 50 non-OSA participants [age 39.2 (14.0) years; BMI 25.8 (4.2) kg/m, ESS 3.6 (2.3)/24]. All participants completed a computerised neurobehavioural battery during the daytime in the sleep clinic. The OSA group subsequently underwent an overnight PSG. The 30 min test battery assessed cognitive domains of visual spatial scanning and selective attention (Letter Cancellation Test), executive function (Stroop task) and working memory (2- and 3-Back tasks), and a valid...