Eating more fruits and veggies could help you sleep better: Study

From counting sheep to white noise and weighted blankets, people have tried innumerable ways to get a good night’s sleep. Sleep disruptions can have far-reaching negative consequences, impacting cardiovascular and metabolic health, memory, learning, productivity, mood regulation, interpersonal relationships and more.

It turns out that an important tool for improving sleep quality may have been hiding in plain sight…in the produce aisle. A new study led by researchers at the University of Chicago Medicine and Columbia University found that eating more fruits and vegetables during the day was associated with sleeping more soundly later that same night.

“Dietary modifications could be a new, natural and cost-effective approach to achieve better sleep,” said co-senior author Esra Tasali, MD, director of the UChicago Sleep Center. “The temporal associations and objectively-measured outcomes in this study represent crucial steps toward filling a gap in important public health knowledge.”

Uncovering the connection between diet and sleep

Studies have shown that inadequate sleep can cause people to gravitate towards unhealthier diets higher in fat and sugar. However, despite the far-reaching effects of sleep on public health and even economic productivity, doctors and scientists know far less about how diet can affect sleep patterns.

In previous observational studies, high fruit and vegetable intakes were associated with better self-reported overall sleep quality, but this new study was the first to draw a temporal connection between a given day’s dietary choices and objectively-measured sleep quality that same night.

Healthy young adults who participated in the study reported their food consumption each day with an app and wore a wrist monitor that allowed the researchers to objectively measure their sleep patterns. The researchers specifically looked at “sleep fragmentation,” an index that reflects how often someone awakens or shifts from deep to light sleep throughout the night.

Promising findings support dietary guidelines

The researchers found that each day’s diet was correlated with meaningful differences in the subsequent night’s sleep. Participants who ate more fruits and vegetables during the day tended to have deeper, more uninterrupted sleep that same night, as did those who consumed more healthy carbohydrates like whole grains.

Based on their findings and statistical modeling, the researchers estimate that people who eat the CDC-recommended five cups of fruits and veggies per day could experience a 16 percent improvement in sleep quality compared to people who consume no fruits or vegetables.

“16 percent is a highly significant difference,” Tasali said. “It’s remarkable that such a meaningful change could be observed within less than 24 hours.”

Future studies will help establish causation, broaden the findings across diverse populations, and examine the underlying mechanisms of digestion, neurology, and metabolism that could explain the positive impact of fruits and vegetables on sleep quality. But based on current data, the experts confidently advise that regularly eating a diet rich in complex carbohydrates, fruits, and vegetables is best for long-term sleep health.

“People are always asking me if there are things they can eat that will help them sleep better,” said co-senior author Marie-Pierre St-Onge, PhD, director of the Center of Excellence for Sleep & Circadian Research at Columbia. “Small changes can impact sleep. That is empowering-better rest is within your control.”

Reference:

Boege, Hedda L. et al., Higher daytime intake of fruits and vegetables predicts less disrupted nighttime sleep in younger adults, Sleep Health, DOI:10.1016/j.sleh.2025.05.003 

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Conservative Oxygen Therapy does not harm chances of survival in Ventilated ICU Patients: JAMA

Reducing supplementary oxygen given to intensive care patients does not deliver any clear and obvious health benefits or harm their chances of survival, according to new research.

Each year, around 184,000 patients are admitted to NHS intensive care units (ICUs) and over 30% need breathing support in the form of oxygen provided through mechanical ventilators.

However, there is insufficient evidence to guide the use of oxygen, with the possibility that administering too much, or too little, oxygen may not deliver the intended benefits and actually end up causing patients additional harm.

That prompted researchers to establish UK-ROX, the largest ever clinical trial of oxygen use in UK ICUs, and they recruited 16,500 patients across almost 100 intensive care units at UK hospitals.

They then sought to establish whether a strategy of conservative oxygen therapy – delivering less oxygen to maintain a person’s oxygen saturation at around 90% – would reduce mortality rates among ICU patients.

The results-published in the JAMA journal-showed there was no statistically significant difference in patient outcomes with 35.4% of patients receiving conservative oxygen therapy having died within 90 days of their admission compared with 34.9% of patients receiving usual oxygen therapy.

As a result, they believe it is safe to allow oxygen levels to be lower in ICU patients but that it may not necessarily be better for them in terms of survival, with the need to develop and evaluate more personalised therapies based on a person’s specific medical conditions.

The UK-ROX trial, funded by the National Institute for Health and Care Research (NIHR), was led by researchers at the University of Plymouth’s Peninsula Medical School and the Intensive Care National Audit & Research Centre (ICNARC).

Professor Daniel Martin OBE, Professor of Perioperative and Intensive Care Medicine at the University of Plymouth and a Consultant at University Hospitals Plymouth NHS Foundation Trust, is co-chief investigator of the UK-ROX trial. He said: “Administering supplemental oxygen through mechanical ventilation is a standard course of treatment for many of those admitted to intensive care. However, there is insufficient evidence to guide us on what oxygen levels deliver the greatest benefits or have the potential to cause harm. The results of this study show that reducing supplementary oxygen results in no overall benefit or harm to the patients, but that doesn’t mean it is not important for intensive care patients. On the contrary, it means that we will have to come up with ways of determining how much oxygen an individual patient needs and deliver it to them in a precise way if we are to improve patient outcomes.”

Paul Mouncey, Co-Director of the Intensive Care National Audit & Research Centre (ICNARC) and the other co-chief investigator of the UK-ROX trial, said: “UK-ROX is the largest individually randomised trial conducted in intensive care in the UK. The study has provided much needed robust evidence to inform clinicians in their day-to-day management of patients. A study of this size was only possible by using routinely collected data held within NHS England and within the Case Mix Programme, the national clinical audit of adult critical care in England, Wales and Northern Ireland. We would like to thank the 97 NHS hospitals and 16,500 patients and their families for taking part in the clinical trial.”

Co-investigator Professor Mike Grocott, Director of the NIHR Southampton Biomedical Research Centre, added: “This landmark study clarifies the safety of administering lower levels of oxygen to critically ill patients. Understanding how to individualise oxygen therapy will be the next step in improving patient care.”

In addition to being published in JAMA, Professor Martin and Mr Mouncey have today presented the results of the UK-ROX trial to delegates at the Critical Care Reviews Meeting 2025 in Belfast.

The study and presentation also include details of how they were able to deliver UK-ROX at a fraction of the usual cost (around £100 per patient) of a randomised control trial, showing that clinical trials can be conducted differently and cost-effectively in an increasingly challenging financial climate.

Reference:

Martin DS, Gould DW, Shahid T, et al. Conservative Oxygen Therapy in Mechanically Ventilated Critically Ill Adult Patients: The UK-ROX Randomized Clinical Trial. JAMA. Published online June 12, 2025. doi:10.1001/jama.2025.9663

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CCR2 Identified as Promising Biomarker for AAA-Associated Aortic Disease: Study

Researchers have found in a new study that CCR2 shows strong potential as a biomarker for diseased aortic tissue in abdominal aortic aneurysm (AAA), supporting its use in future molecular imaging and targeted therapies.

This study evaluated whether C-C Chemokine Receptor 2 (CCR2) is a tissue biomarker of aortic disease severity, particularly in patients with abdominal aortic aneurysm (AAA).

There is an unmet clinical need for tissue biomarkers that can monitor abdominal aortic aneurysm progression and predict rupture risk. Given the key role of inflammation in abdominal aortic aneurysm pathogenesis, we hypothesized that CCR2, involved in the recruitment and activation of immune cells, is upregulated in abdominal aortic aneurysms. They used our human vascular biobank to obtain aortic tissue from 42 individuals with non-ruptured and ruptured abdominal aortic aneurysm (rAAA), aortoiliac occlusive disease (AOD), or normal abdominal aorta (NAA).

We evaluated aortic wall CCR2-positive cellular content and aortic tissue levels of cytokines and CCR2 ligand, monocyte chemoattractant protein 1 (MCP1). Additionally, a single-cell RNA sequencing dataset was analyzed to assess Ccr2 expression in human abdominal aortic aneurysm tissues. Results: Compared with NAA, the aneurysmal aorta (AAA and rAAA) demonstrated significantly higher CCR2-positive cellular content (P<0.05). The number of aortic wall CCR2-positive macrophages was significantly elevated in individuals with abdominal aortic aneurysm (P<0.05), rAAA (P<0.01), and AOD (P<0.01). They also observed higher levels of MCP1 and inflammatory cytokines in diseased aortic tissue. Furthermore, single-cell transcriptomics revealed that in abdominal aortic aneurysm tissue, Ccr2 is predominantly expressed by macrophages (69%), followed by T-cells (22%), and B-cells (8%).

The findings indicate that CCR2 is a promising biomarker for diseased aortic tissue, particularly in the setting of abdominal aortic aneurysm. These findings suggest potential applications for novel molecular imaging and pharmacological targeting.

Reference:

Hafezi, Shahab MD*; Arif, Batool MS*; Ruhel, Rajrani PhD†; Zaghloul, Mohamed MD*; Elizondo-Benedetto, Santiago MD*; Pyeatte, Sophia R. MD*,‡; Joseph, Karan BS*; Zhang, Bo PhD†; Lin, Chieh-Yu MD PhD§; Gropler, Robert J. MD∥; Zayed, Mohamed A. MD PhD MBA*,‡,∥,¶,#,**. C-C Chemokine Receptor 2 is a Tissue Biomarker for Abdominal Aortic Aneurysmal and Occlusive Disease. Annals of Surgery ():10.1097/SLA.0000000000006778, June 11, 2025. | DOI: 10.1097/SLA.0000000000006778

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Combination of exercise and omega-3 reduces the severity of tooth root infections, suggests study

A study published in the journal Scientific Reports indicates that physical exercise combined with omega-3 supplementation considerably improves the immune response and reduces the severity of chronic apical periodontitis.

Inflammation at the apex of the tooth – the tip of the root – and in the surrounding area is primarily caused by caries. If left untreated, the bacteria can reach the root canal and pass through it to the apex, causing apical periodontitis. This condition leads to bone loss in the area.

The study is the first to demonstrate that a combination of moderate physical exercise and omega-3 supplementation significantly improves the inflammatory condition caused by apical periodontitis. This combination limited bacterial progression, reduced bone tissue loss, regulated the release of pro-inflammatory cytokines, and stimulated the activity of fibroblasts, the cells that create and maintain tissue.

If left untreated, the infection can lead to tooth loss. In addition, there is a two-way relationship between apical periodontitis and systemic changes in patients. Diabetes, metabolic syndrome, arteriosclerosis, and kidney disease, among others, can exacerbate apical periodontitis. At the same time, infection in the apex can exacerbate these diseases.

“It’s a condition that patients may not even know they have because of its chronic nature, but which can evolve and lead to bone destruction and tooth mobility. In addition, in specific situations, such as a drop in immunity, it can become acute, so the patient starts to feel pain, pus forms at the site, the face can become swollen,” explains Rogério de Castilho, a professor at the Araçatuba School of Dentistry at São Paulo State University (FOA-UNESP) in Brazil. Castilho supervised the study and is supported by FAPESP.

“In rats, physical exercise alone brought about a systemic improvement, regulating the local immune response. In addition, when combined with supplementation, it further reduced the destructive condition caused by endodontic pathology,” explains Ana Paula Fernandes Ribeiro, the first author of the study, carried out during her doctorate at FOA-UNESP.

Less inflammation

The researchers induced apical periodontitis in 30 rats and divided them into three groups. The first group received no intervention. The second and third groups underwent a 30-day swimming regimen.

The third group also received dietary supplementation of omega-3, a polyunsaturated fatty acid known for its therapeutic effects on chronic inflammatory diseases.

The group that only swam had better outcomes than the untreated control group. However, omega-3 supplementation combined with physical exercise regulated the immune response and infection control even better.

Immunohistochemical analyses, which assess how the immune system responds to infection, revealed varying levels of the cytokines interleukin 17 (IL-17) and tumor necrosis factor alpha (TNF-α), indicating the intensity of the inflammatory response.

While the rats that received no treatment had moderate levels of these cytokines, those that exercised had lower levels, and those that took supplementation had the lowest levels.

In addition to having lower levels of these cytokines, the group that exercised had fewer osteoclasts. These are cells that resorb bone tissue, indicating bone loss. The results were even better for the group that consumed omega-3, showing statistically significant differences compared to the animals that received no treatment.

Micro CT scans of the jaws showed that the animals that swam experienced less loss of volume of alveolar bone, which covers the teeth, than those in the control group. The loss was even less in the supplemented group.

For the authors, the study provides new evidence of the benefits of physical activity and omega-3 for the immune system, now with even more obvious repercussions for oral health.

“To know if the same would be true for humans, we’d need a clinical study with a significant number of patients. However, in addition to the many proven benefits of physical exercise and omega-3 consumption, this is yet another important piece of evidence,” Jacinto says.

Reference:

Ribeiro, A.P.F., de Lima Rodrigues, M., Loureiro, C. et al. Physical exercise alone or combined with omega-3 modulates apical periodontitis induced in rats. Sci Rep 15, 8760 (2025). https://doi.org/10.1038/s41598-025-90029-9

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Delayed First Childbirth Linked to Increased Risk of Pelvic Organ Prolapse, Review Finds

USA: As more women worldwide delay childbearing, emerging evidence suggests that having a first baby at an older age could increase the risk of developing pelvic organ prolapse (POP) later in life. A recent review conducted by researchers from the University of Utah, led by Hannah A. Zabriskie, has examined the link between maternal age at first delivery and the likelihood of POP, calling for greater clinical attention and further research on this growing concern.

The findings were published online in the American Journal of Obstetrics and Gynecology in the June 2025 issue.

Pelvic organ prolapse—a condition in which pelvic organs such as the bladder, uterus, or rectum descend from their normal position—has long been associated with vaginal delivery and advancing chronological age. However, the specific contribution of maternal age at the time of first childbirth has received limited investigation until now.

The review emphasizes that aging naturally leads to deterioration in muscle function, including a decline in strength, flexibility, and healing capacity—factors that can compromise the pelvic floor muscles during childbirth. As a result, older first-time mothers may be more vulnerable to pelvic floor injuries during delivery and less able to recover effectively afterward.

Zabriskie and her team analyzed available literature to assess how delayed childbirth influences known mechanisms involved in POP, such as pelvic muscle weakening, levator ani muscle defects, and widening of the genital hiatus. They found consistent evidence that advancing maternal age at first delivery is linked to an increased risk of pelvic floor trauma and subsequent development of prolapse symptoms.

Importantly, the authors highlighted that current human studies are limited in number and scope, especially regarding the underlying cellular and molecular processes. There is a need for more comprehensive research that examines these biological mechanisms, specifically concerning maternal age at first delivery.

The review outlines several key recommendations for future investigations. These include ensuring clearly defined study populations with consistent parity and delivery methods, using appropriate statistical models, and accounting for confounding variables such as the duration of labor. Additionally, the authors noted that older mothers are often more likely to attend postpartum follow-ups, potentially skewing data and underrepresenting younger women. Therefore, greater efforts are needed to engage and retain younger postpartum women in future cohort studies.

Ultimately, the authors advocate for age-specific analyses in future POP research and stress the need to stratify findings based on maternal age at first birth. By better understanding how age affects pelvic floor outcomes, clinicians may be able to more effectively identify women at higher risk and develop targeted therapies to prevent or treat POP.

Reference:

Zabriskie HA, Drummond MJ, Nygaard IE, Swenson CW. Older maternal age at first delivery as a risk factor for pelvic organ prolapse: what we know. Am J Obstet Gynecol. 2025 Jun;232(6):499-505. doi: 10.1016/j.ajog.2025.03.006. Epub 2025 Mar 8. PMID: 40064413.

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FDA Approves Prednisolone Acetate Ophthalmic Suspension for Ocular Inflammation

The FDA has approved preodnisolone acetate ophthalmic suspension, USP 1%, for treating steroid-responsive ocular inflammation. Amneal Pharmaceuticals plans to launch the product in Q3 2025.

Prednisolone acetate ophthalmic suspension, USP 1% is a sterile, topical anti-inflammatory 0agent for ophthalmic use and is indicated for treating steroid-responsive ocular inflammation.

“Our Affordable Medicines portfolio continues to grow with a strong and diverse pipeline that supports broader access to high-quality treatments across the U.S. healthcare system,” said Andy Boyer, Executive Vice President and Chief Commercial Officer, Affordable Medicines. “The approval of prednisolone acetate ophthalmic suspension-a complex product to develop and manufacture-highlights the depth of our R&D capabilities and the strength of our manufacturing and supply operations.”

The most commonly reported adverse reactions for prednisolone acetate ophthalmic suspension in clinical studies were elevation of intraocular pressure (IOP) with possible development of glaucoma and infrequent optic nerve damage, posterior subcapsular cataract formation, and delayed wound healing. For prescribing information, see package insert here.

According to IQVIA® U.S. annual sales for prednisolone acetate ophthalmic suspension for the 12 months ended April 2025 were approximately $201 million.

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COVID-19 Infection Linked to Higher Miscarriage Risk in Early Pregnancy: Study

A new study published in the journal of BMC Medicine showed women infected with COVID-19 before or during pregnancy faced a two to three times higher risk of miscarriage before 20 weeks of gestation. 

It is yet unclear how SARS-CoV-2 infection prior to or during pregnancy affects the course of the pregnancy. COVID-19 in late pregnancy or the peripartum period was associated with higher incidence of problems, including hypertensive disorders of pregnancy, preterm delivery, and maternal death, during the early waves of the pandemic (pre-Delta).

There is probably a complicated physiological link between maternal and newborn outcomes and SARS-CoV-2 infection at various periods of pregnancy or even before conception. Micaela Sandoval and colleagues therefore developed a tailored electronic health record (EHR)-based cohort of COVID-19 patients who experienced at least one pregnancy episode between 2019 and 2023 in order to investigate the association between COVID-19 and miscarriage.

Using a large, retrospective, electronic health record (EHR)-based cohort, this study investigated the association between COVID-19 and unfavorable pregnancy outcomes, like spontaneous abortion, ectopic pregnancy, and premature birth, between 2019 and 2023. Using generalized estimating equation modeling, risk variables for unfavorable pregnancy outcomes were determined. The following exposures were included in the study: age, race/ethnicity, comorbidity load, neighborhood-level social vulnerability, COVID-19 before pregnancy, and COVID-19 during pregnancy.

The risk of miscarriage was 6.3% among pregnancy episodes with a miscarriage, livebirth, or delivery result in the Southeast Texas Pregnancy and COVID Cohort (26,783 pregnancy episodes) (1514/ 24,119). A history of mild or moderate to severe COVID-19 before to pregnancy was linked to miscarriage in multivariable modeling (adjusted odds ratio (aOR) 2.48, CI 2.21–2.78 and aOR 2.81, CI 1.8–4.38, respectively).

Furthermore, miscarriage was linked to both mild and moderate to severe COVID-19 in the first trimester in the same model. Overall, COVID-19 was found to be a risk factor for spontaneous abortion both before and during pregnancy. These results emphasize how crucial COVID prevention is for expectant mothers and those preparing to become pregnant. 

Source:

Sandoval, M. N., Klawans, M. R., Bach, M. A., Mikhail, J., Graviss, E. A., Cao, T., Parchem, J. G., Husain, J., & Boerwinkle, E. (2025). COVID-19 infection history as a risk factor for early pregnancy loss: results from the electronic health record-based Southeast Texas COVID and Pregnancy Cohort Study. BMC Medicine, 23(1), 274. https://doi.org/10.1186/s12916-025-04094-y

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ASH and ISTH publish revised clinical practice guidelines for pediatric venous thromboembolism

The American Society of Hematology (ASH) and the International Society on Thrombosis and Haemostasis (ISTH) released new and updated clinical practice guidelines for the treatment of pediatric venous thromboembolism (VTE).

The guidelines, published in ASH’s peer-reviewed journal Blood Advances, were developed by an expert panel following a rigorous review process. They aim to improve health outcomes by providing evidence-based recommendations for managing VTE in children.

The new and updated pediatric VTE clinical guidelines incorporate the latest research in the field and mark the first update to the guidelines since their publication in 2018. In total, 16 recommendations were updated and four were added. One of the most notable changes is the new recommendation for direct oral anticoagulants over standard-of-care anticoagulants. Specifically, this recommendation advises clinicians to consider dabigatran or rivaroxaban over therapies such as low molecular weight heparin and vitamin k antagonist.

“These evidence-based guidelines are a key resource for clinicians to improve the quality of care for this vulnerable population,” said Belinda R. Avalos, MD, ASH president. “The recommendations are updated to incorporate the latest science, and we are glad to have collaborated with the ISTH on this project.”

“Collaborating with ASH on these updated pediatric VTE guidelines reflects the ISTH’s commitment to ensuring that children affected by VTE receive the most effective, evidence-based care,” said Pantep Angchaisuksiri, MD, ISTH president. “It’s critical that we continue advancing research and education in this area to support better outcomes for young patients worldwide.”

VTE sometimes manifests as deep vein thrombosis, when a blood clot forms in the deep veins, or pulmonary embolism, when a blood clot blocks an artery in the lung. Although the incidence of VTE in children at a population level is very low, it is higher in children who are hospitalized and can be life-threatening.

“Thrombosis in children is an increasingly common complication in children with complex illnesses and conditions and, if not managed well, can impact long-term outcomes for these patients,” said Paul Monagle, MD, MBBS, MSc, a pediatric hematologist and professor of pediatrics at the University of Melbourne and chair of the ASH ISTH Guidelines on Treatment of Pediatric VTE. “The care of children is important, and parents should know that there is a body of evidence that supports their child’s treatment options.”

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Sleep apnea more common than previously known in female athletes, suggests research

According to a new study, presented at the American College of Cardiology (ACC) Care of the Athletic Heart 2025 conference, sleep apnea may be more prevalent in younger female athletes than previously believed, especially among female athletes with higher levels of training. While obstructive sleep apnea has been observed in younger male athletes, the prevalence in female athletes and the association with cardiovascular risk is largely unknown.

Obstructive sleep apnea (OSA) is the most common sleep-related breathing disorder, impacting about 18 million Americans, and is prevalent in both men and women. It occurs when the throat muscles relax and block the airway, causing patients with OSA to repeatedly stop and start breathing when sleeping. Symptoms include excessive daytime sleepiness, loud snoring, waking during the night and gasping or choking. OSA increases the risk of high blood pressure and other cardiovascular issues, including arrhythmias, heart attack, heart failure and stroke.

“There is a lot of overlap in symptoms of sleep apnea and sleep deprivation, which is unsurprisingly quite common among these athletes. Some symptoms that might clue in an athletic trainer, coach or clinician that an athlete may be experiencing or at risk for sleep apnea include not feeling well-rested despite a full night of sleep, snoring very loudly, gasping or choking while sleeping,” said Austin Rim, MD, a cardiology fellow at Emory University in Atlanta and the study’s lead author. “There may be more subtle signs too, including difficulty concentrating or irritability. Accurately diagnosing sleep apnea is important, as a range of treatment options-such as CPAP, mandibular advancement devices, or even surgery-can significantly improve quality of life and, depending on disease severity, potentially reduce long-term cardiovascular risk.”

The study included 68 female collegiate athletes at two universities in the United States. Softball players made up the largest proportion of female athletes, followed by volleyball and basketball. According to the researchers, about 6 in 10 self-identified as White, a quarter as Black and the rest as Hispanic/Latino, Asian or another race/ethnicity. The average age of participants was 19 years old.

“We found in this cohort that sleep health, not even considering sleep apnea, was poor among athletes, with 36% reporting poor sleep quality and 22% reporting that they had trouble staying awake at least once in the past month while eating or engaging in social activities,” Rim said. “Ensuring good sleep hygiene among these athletes is low-hanging fruit for improving overall health in this population,”

The study recorded anthropometrics (the systematic measurements of the human body to define a person’s size and form), blood pressure and pulse wave velocity—a measurement that quantifies arterial stiffness, a precursor to hypertension. Participants also completed home sleep tests, which can detect abnormalities such as pauses in breathing during sleep. The primary outcomes were apnea-hypopnea index (AHI), systolic and diastolic blood pressure and pulse wave velocity.

AHI is a key metric to diagnose and assess the severity of sleep apnea by determining how many apneas and hypopneas occur per hour. An apnea is a complete pause of breathing lasting more than 10 seconds, and a hypopnea is a partial reduction in airflow lasting more than 10 seconds. OSA is diagnosed either by an AHI greater than five events per hour accompanied with associated symptoms like daytime sleepiness or unrefreshing sleep or an AHI score greater than 15 events per hour regardless of symptoms. According to Rim, between five events and 15 events per hour is “mild,” 15 to 30 is “moderate,” and anything over 30 is “severe.”

In this study participants ranged from 2.1 events to 7.7 events per hour and 25% were considered to have mild sleep apnea. No athletes had a measured AHI over 15 events per hour. Pulse wave velocity was higher in athletes with mild sleep apnea and was associated with higher AHI. The study found greater age and lean mass were independent predictors of sleep apnea, which the researchers said suggests sleep apnea may become more prevalent with higher levels of training in female athletes.

According to the researchers, while this is the largest study of sleep apnea among female athletes, it is limited in its generalizability given the small sample size. Future studies are needed to confirm the findings.

“Ideally, a future study would include multi-campus projects that track athletes over several seasons, compare men and women directly, and evaluate whether treating mild apnea reduces these early measures of cardiovascular risk. Treatment of OSA in older trials through CPAP haven’t always been shown to mitigate risk, so it would be helpful to see if treatment at a younger age could improve on this,” Rim said.

Reference:

Sleep apnea more common than previously known in female athletes, American College of Cardiology, Meeting: ACC Care of the Athletic Heart.

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Early Preemptive Kidney Transplants fail to Lower Mortality Risk in ESKD: Study

A new study published in the journal of Transplantation Proceedings showed that in individuals with end-stage kidney disease (ESKD), early preventive kidney transplants do not lower the chance of death.

Among other things, diabetes and high blood pressure can lead to end-stage kidney disease, sometimes referred to as renal or kidney failure. When starting dialysis, or even before, a patient with kidney failure needs a transplant. It is widely accepted that people with ESKD would fare better if they received a kidney transplant beforehand, before beginning dialysis, because dialysis strains the body and impairs immunity. With an emphasis on the mortality benefit of early preemptive transplants, Abhishek Kumar and colleagues therefore carried out this study to assess the present status of preemptive kidney transplants in the United States.

This research investigated patterns in preemptive kidney transplantation among first-time adult patients using the United Network of Organ Sharing database. Based on the estimated glomerular filtration rate [eGFR] at the time of transplant, they divided the population into 4 groups: ≥ 20 mL/min/1.73 m2, 10 to < 15 mL/min/1.73 m2, 15 to < 20 mL/min/1.73 m2, and < 10 mL/min/1.73 m2. The risk of ESKD was compared between the groups using the cumulative incidence competing risk (CICR) approach, and the difference in mortality was evaluated using multivariable Cox regression.

About 18% of all kidney transplants are still preventive (33% from dead donors and 67% from current donors). Preemptive kidney transplants were more likely to be given to white individuals with private insurance and greater educational attainment. The four eGFR groups did not vary in terms of mortality. Again, there was no difference in mortality between the four groups in a subgroup analysis that focused solely on recipients of preemptive kidney transplants from live donors.

Overall, the findings of study shows that even though the “Kidney First Initiative” was started more than ten years ago, the rates of preventive kidney transplants have been clinically unchanged over the past 20 years. 24% of recipients of preemptive LDKTs, where the transplant date can be somewhat controlled, have an eGFR ≥ 15 mL/min/1.73 m2, which is overly early given that there was no survival advantage and that patients were exposed to the dangers of immunosuppression and lifestyle changes.

Reference:

Kumar, A., Bonnell, L., & Kuppachi, S. (2025). Early pre-emptive kidney transplant does not offer any mortality benefits: A study of trends in pre-emptive kidney transplantation over the last two decades. Transplantation Proceedings, 57(4), 538–543. https://doi.org/10.1016/j.transproceed.2025.02.032

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