ArticleJournal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine2021
Association of sleep-disordered breathing and wound healing in patients with diabetic foot ulcers.
Article in Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 15 citations in OpenAlex.
- The impact of obstructive sleep apnea on skin wound healing - from preclinical perspective to clinical evidence: A narrative review.Sleep & breathing = Schlaf & Atmung · 2026Review
- The relationship between obstructive sleep apnea and insulin resistance in patients with type 2 diabetes mellitus: a cross-sectional observational study.Journal of thoracic disease · 2026Article
- Obstructive sleep apnea risk and its association with diabetic foot ulcer in patients with type 2 diabetes.Frontiers in endocrinology · 2026Observational
- Sleep and Athletic Performance: A Multidimensional Review of Physiological and Molecular Mechanisms.Journal of clinical medicine · 2025Review
- Wound management, healing, and early prosthetic rehabilitation: Part 3 - A scoping review of chemical biomarkers.Canadian prosthetics & orthotics journal · 2025Review
- Wound management, healing, and early prosthetic rehabilitation: Part 1 - A scoping review of healing and non-healing definitions.Canadian prosthetics & orthotics journal · 2024Review
- Wound management, healing, and early prosthetic rehabilitation: Part 2 - A scoping review of physical biomarkers.Canadian prosthetics & orthotics journal · 2024Review
- Clarifying sleep characteristics and analyzing risk factors of sleep disorders to promote a predictive, preventive, and personalized medicine in patients with burn scars.The EPMA journal · 2023Article
- Obesity and Obstructive Sleep Apnea.Handbook of experimental pharmacology · 2022Article
- Severe Intermittent Hypoxia Modulates the Macrophage Phenotype and Impairs Wound Healing Through Downregulation of HIF-2α.Nature and science of sleep · 2022Article
- Lifestyle Medicine Approach to Wound Management.American journal of lifestyle medicineArticle
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Authors and funding
11 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
STUDY
objectivesSleep-disordered breathing (SDB) is prevalent and associated with an increased risk of morbidity and mortality. However, whether SDB has an adverse impact on wound healing in patients with diabetic foot ulcers (DFUs) is uncertain. The purpose of this study was to investigate the association of SDB with wound healing in patients with DFUs.
methodsA total of 167 patients with DFUs were enrolled between July 2013 and June 2019 at West China Hospital (Chengdu, China) to assess the association of SDB with wound healing, ulcer recurrence, and all-cause mortality.
resultsWhereas there was no significant association between apnea-hypopnea index (AHI) and wound healing, total sleep time (per hour: hazard ratio [HR], 1.15; 95% confidence interval [CI], 1.01-1.30; P = .029), sleep efficiency (per 10%: HR, 1.20; 95% CI, 1.04-1.37; P = .012), and wakefulness after sleep onset (per 30 minutes: HR, 0.89; 95% CI, 0.82-0.97; P = .008) were associated with wound healing. Total sleep time (per hour: odds ratio, 0.71; 95% CI, 0.51-0.97; P = .035) and sleep efficiency (per 10%: odds ratio, 0.68; 95% CI, 0.47-0.97; P = .033) were also associated with ulcer recurrence. Mean oxygen saturation (per 3%: HR, 0.68; 95% CI, 0.49-0.94; P = .021) and percentage of sleep time with oxygen saturation < 90% (per 10%: HR, 1.25; 95% CI, 1.03-1.53; P = .026) were significantly associated with mortality.
conclusionsSDB is highly prevalent in patients with DFUs but its severity, as conventionally measured by AHI, is not associated with wound healing. Sleep fragmentation and hypoxemia are stronger predictors of poor wound healing, high ulcer recurrence, and increased risk of death in patients with DFUs.
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