Multisensory feedback in gymnastics education: a kinematic study on skill acquisition in youth athletes.

Obesity is a significant risk factor for the development and progression of obstructive sleep apnea (OSA). According to Peppard et al. [], a 10% weight gain is associated with a 32% increase in the apnea-hypopnea index (AHI) and a six-fold risk of developing moderate-to-severe OSA. Meta-analysis showed an AHI reduction effect of glucagon-like peptide-1 (GLP-1) receptor agonist []. In the SURMOUNT-OSA trial [], tirzepatide, which is a long-acting glucose-dependent insulinotropic polypeptide receptor agonist and glucagon-like peptide-1 receptor agonist, reduced the AHI by 25.3 h and body weight by 17.7% at week 52, with more than 70% of individuals experiencing an improvement greater than 50% in AHI. In this case report, we examined the endotypic trait changes for an individual participating in the SURMOUNT-OSA trial, aiming at providing insights into the possible mechanism of tirzepatide for OSA improvement. This case report was prepared in accordance with the CARE guidelines. The completed CARE checklist is provided as supplementary material (for all online suppl. material, see ). A 35-year-old man with poorly controlled hypertension presented to our sleep center with complaints of loud snoring and nasal obstruction. Physical examination revealed a redundant soft palate and elongated uvula, without evidence of tonsillar hypertrophy. Airway patency was preserved. Allergic rhinitis was diagnosed with findings of bilateral nasal mucosal congestion and turbinate hypertrophy. Anthropometric measurements showed a body mass index (BMI) of 31.0 kg/m. A diagnostic polysomnography performed in December 2022 revealed an AHI of 54.8 h. No sleep-related hypoventilation was detected, as evidenced by maximum transcutaneous carbon dioxide of 48.5 mm Hg. The patient was given 15 mg tirzepatide between January 2023 and January 2024, with no adverse events reported, and had two follow-up in-laboratory polysomnographic studies: at 6 months (June 2023) and 12 months (January 2024). Over the 12 months of treatment, his BMI declined to 24.9 kg/m, and waist circumference declined to 93.3 cm. The patient’s blood pressure also decreased without any antihypertensive medication. shows significant reductions in AHI (from 56.3 to 4.4 events·h) and hypoxic burden (from 113.1 to 20.6 min%·h) after 12 months of treatment. Sleep architecture also improved, with increases in both slow-wave sleep and sleep efficiency. Endotypic traits were derived during NREM sleep using the Phenotyping Using Polysomnography method [, ]. Arousal threshold decreased from 135.7 %eupnea to 113.5 %eupnea, and loop gain from 0.51 to 0.30. V increased from 70.6 %eupnea to 95.3 %eupnea, indicating improved upper airway patency. Compensation shifted markedly from −33.5 %eupnea to 10.7 %eupnea. Interestingly, event duration was prolonged following treatment.