Saif Arsan Mashaqi
- Associate Professor, Medicine - (Clinical Scholar Track)
- Krishna J, Mashaqi S (2014). ‘Actigraphy’, in Aminoff M, Daroff R. Encyclopedia of The Neurological Sciences second edition, USA: Academic Press (Elsevier), 36-40.
- Mashaqi S. Q-T Prolongation with the Use of Methadone in Severe and Persistent Restless Legs Syndrome. Neuroscience discovery, Volume 5, Issue 1, 2017. doi.org/10.7243/2052-6946-5-1
- Mashaqi S, Lee M, McClelland C. Obstructive Sleep Apnea in a Patient with Bilateral, Sequential Non-arteritic Anterior Ischemic Optic Neuropathy. J Sleep Disor Treat Care 6:3. 2017. doi: 10.4172/2325-9639.1000199
- Mashaqi S, Johnson K. Severe Obstructive Sleep Apnea in a Patient with Fragile X Syndrome. J Sleep Disor Treat Care Vol 7:1. 2018. doi: 10.4172/2325-9639.1000206
- Mashaqi S, Hennessy J, Eaton M, Erickson J. Obstructive Sleep Apnea in a Patient with Cornelia De Lange Syndrome. Cureus. 2017 Dec 28;9(12): e1993. doi: 10.7759/cureus.1993. PMID: 29507843
- Mashaqi S, Steffen K, Crosby R, Garcia L. The impact of Bariatric Surgery on Sleep Disordered Breathing Parameters from Overnight Polysomnography and Home Sleep Apnea Test. Cureus. 2018 May 8;9(12): e2593. doi: 10.7759/cureus.2593. PMID: 30009105
- Mashaqi S, Mehra R. Cheyne Stokes Respiration in Heart Failure with Low Ejection Fraction: To Treat or Not to Treat - That is the Central Question’, in Foldvary-Schaefer N, Grigg-Damberger M, Mehra R. Sleep disorders: A Case a Week from the Cleveland Clinic, New York:OUP; 2019:
- Mashaqi S. Tailored treatment for excessive daytime sleepiness. In: Auckley D, Hershner S, ed. Case Book of Sleep Medicine. 3rd edition. Darien, IL: American Academy of Sleep Medicine; 2019:266-271
- Mashaqi S, Badr MS. The Impact of OSA and PAP Therapy on Metabolic Peptides Regulating Appetite, Food Intake, Energy Homeostasis and Systemic Inflammation – A Literature Review. J Clin Sleep Med. 2019 Jul 15;15(7):1037-1050.
- Mashaqi S, Gozal D. Obstructive Sleep Apnea and Systemic Hypertension: Gut Dysbiosis as the Mediator – A literature Review. J Clin Sleep Med. 2019 Oct 15;15(10):1517-1527
- Gozal D, Mashaqi S. The Impact of Obstructive Sleep Apnea and PAP Therapy on All-cause and Cardiovascular Mortality Based on Age and Gender – A Literature Review. Respir Investig. 2020 Jan;58(1):7-20. doi: 10.1016
- Berryhill S, Morton CJ, Dean A, Berryhill A, Provencio-Dean N, Patel SI, Estep L, Combs D, Mashaqi S, Gerald LB, Krishnan JA, Parthasarathy S. Effect of Wearables on Sleep in Healthy Individuals: A Randomized Cross-Over Trial and Validation Study. J Clin Sleep Med. 2020 Feb 11. doi: 10.5664
- Pandey A, Mereddy S, Combs D, Shetty S, Patel SI, Mashaqi S, Seixas, Littlewood K2, Jean-Luis G, Parthasarathy S. Socioeconomic Inequities in Adherence to Positive Airway Pressure Therapy in Population-Level Analysis. J Clin Med. 2020 Feb 6;9(2):442. doi: 10.3390
- Mashaqi S, Gozal D. Circadian misalignment and gut microbiome. A bidirectional relationship triggering inflammation and metabolic derangements. Sleep Med. 2020 Mar 30;72: 93-108. doi: 10.1016
- Mashaqi S, Danelle Staebler, Mehra R. Combined nocturnal pulse oximetry and questionnaire-based obstructive sleep apnea screening - A cohort study. Sleep Med; 72:157-163. doi: 10.1016/j.sleep.2020.03.027
- Mashaqi S, Mansour HM, Alameddin H, Combs D, Patel S, Estep L, Parthasarathy S. Matrix metalloproteinase-9 as a messenger in the crosstalk between obstructive sleep apnea and comorbid systemic hypertension, cardiac remodeling, and ischemic stroke - a literature review. J Clin Sleep Med. 2020 Oct 27. doi: 10.5664/jcsm.8928. Online ahead of print.
- Badran M, Mashaqi S, Gozal D. The gut microbiome as a target for adjuvant therapy in obstructive sleep apnea. Expert Opin Ther Targets. 2020 Nov 12. doi: 10.1080/14728222.2020.1841749. Online ahead of print.
- M.D. Critical Care Medicine
- Cleveland Clinic, Cleveland, Ohio, United States
- Critical Care Fellowship
- M.D. Sleep Medicine
- Cleveland Clinic, Cleveland, Ohio, United States
- Sleep Medicine Fellowship
- M.D. Pulmonary Diseases
- Marshall University School of Medicine, Huntington, West Virginia, United States
- Pulmonary Fellowship
- M.D. Internal Medicine
- Marshall University School of Medicine, Huntington, West Virginia, United States
- Internal Medicine residency
- University of Jordan School of Medicine, Amman, Jordan
- University of North Dakota School of Medicine (2018 - 2019)
- University of North Dakota School of Medicine (2015 - 2018)
Licensure & Certification
- The American Board of Pulmonary Diseases, ABIM (2011)
- The American Board of Internal Medicine, ABIM (2009)
- The American Board of Critical Care Medicine, ABIM (2016)
- The American Board of Sleep Medicine, ABIM (2013)
- The role of gut microbiota as a mediator of obstructive sleep apnea associated comorbidities (obesity and systemic hypertension).- The role of gut dysbiosis in circadian rhythm misalignment.- The impact of sleep disordered breathing and positive airway pressure therapy on hormones and metabolites regulating food intake and energy homeostasis.- Screening for obstructive sleep apnea.
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- Mashaqi, S. (2019). Tailored Treatment of Excessive Daytime Sleepiness. In Case Book of Sleep Medicine(pp 266-271). USA: American Academy of Sleep Medicine.
- Mashaqi, S., & Mehra, R. (2019). To Treat or Not to Treat: That Is the Central Question. In Sleep Disorders: A Case a Week from the Cleveland Clinic (Second Edition)(pp Chapter 16). USA: Oxford University Press. doi:10.1093/med/9780190671099.001.0001
- Mashaqi, S., & Krishna, J. (2014). Actigraphy. In Encyclopedia of the Neurological Sciences(pp 36-40). Elsevier.
- Badran, M., Mashaqi, S., & Gozal, D. (2020). The gut microbiome as a target for adjuvant therapy in obstructive sleep apnea. Expert opinion on therapeutic targets, 24(12), 1263-1282.More info: Gut dysbiosis is assumed to play a role in obstructive sleep apnea (OSA)-associated morbidities. Pre- and probiotics, short chain fatty acids (SCFA) and fecal matter transplantation (FMT) may offer potential as novel therapeutic strategies that target this gut dysbiosis. As more mechanisms of OSA-induced dysbiosis are being elucidated, these novel approaches are being tested in preclinical and clinical development. : We examined the evidence linking OSA to gut dysbiosis and discuss the effects of pre- and probiotics on associated cardiometabolic, neurobehavioral and gastrointestinal disorders. The therapeutic potential of SCFA and FMT are also discussed. We reviewed the National Center for Biotechnology Information database, including PubMed and PubMed Central between 2000 - 2020. : To date, there are no clinical trials and only limited evidence from animal studies describing the beneficial effects of pre- and probiotic supplementation on OSA-mediated dysbiosis. Thus, more work is necessary to assess whether prebiotics, probiotics and SCFA are promising future novel strategies for targeting OSA-mediated dysbiosis.
- Berryhill, S., Morton, C. J., Dean, A., Berryhill, A., Provencio-Dean, N., Patel, S. I., Estep, L., Combs, D., Mashaqi, S., Gerald, L. B., Krishnan, J. A., & Parthasarathy, S. (2020). Effect of wearables on sleep in healthy individuals: a randomized crossover trial and validation study. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 16(5), 775-783.More infoThe purpose of this study was to determine whether a wearable sleep-tracker improves perceived sleep quality in healthy participants and to test whether wearables reliably measure sleep quantity and quality compared with polysomnography.
- Combs, D., Hsu, C. H., Bailey, O., Patel, S. I., Mashaqi, S., Estep, L., Provencio-Dean, N., Lopez, S., & Parthasarathy, S. (2020). Differences in sleep timing and related effects between African Americans and non-Hispanic Whites. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine.More infoPrior studies have shown a morning chronotype for African Americans compared to non-Hispanic Whites, yet self-reported sleep timing is delayed in African Americans compared to Whites.
- Mashaqi, S., & Gozal, D. (2020). "Circadian misalignment and the gut microbiome. A bidirectional relationship triggering inflammation and metabolic disorders"- a literature review. Sleep medicine, 72, 93-108.More infoOver the last decade, emerging studies have related the gut microbiome and gut dysbiosis to sleep and sleep disorders. For example, intermittent hypoxia associated with obstructive sleep apnea was shown to reproducibly alter the gut microbiome. Circadian rhythm disorders (CRD) (eg, shift work disorders, delayed sleep phase syndrome, and advanced sleep phase syndrome) constitute another group of conditions that might be influenced by gut dysbiosis. Indeed, both central and peripheral clocks can affect and be affected by gut microbiota and their metabolites. In addition, the tight rhythmic regulation of almost all metabolic pathways involved in the anabolism and catabolism of carbohydrates, protein, and lipids in addition to detoxification processes that take place in specific cells could be ultimately linked to changes in the microbiota. Since there are no studies to date examining the impact of gut dysbiosis on delayed sleep phase and advanced sleep phase syndrome, and considering the ever-increasing number of people engaging in shift work, more accurate and informed delineation of the association between gut dysbiosis and shift work can provide guidance and opportunities for new avenues of treating circadian rhythm disorders and preventing the metabolic complications of shiftwork via restoration of gut dysbiosis. In this review, the potential bidirectional relationships between gut dysbiosis and circadian rhythm misalignment, their impact on different metabolic pathways, and the potential development of metabolic and systemic disorders, especially in shift work models are critically assessed.
- Mashaqi, S., & Gozal, D. (2020). The impact of obstructive sleep apnea and PAP therapy on all-cause and cardiovascular mortality based on age and gender - a literature review. Respiratory investigation, 58(1), 7-20.More infoObstructive sleep apnea (OSA) is a common sleep disorder which negatively impacts different body systems, especially the cardiovascular system. The correlation between sleep related breathing disorders and cardiovascular diseases has been well studied. However, the impact of OSA on cardiovascular related mortality and the role of positive airway pressure therapy in decreasing mortality is unclear. We reviewed studies investigating the impact of OSA on all-cause and cardiovascular related mortality in both genders, and in different age groups.
- Mashaqi, S., Mansour, H. M., Alameddin, H., Combs, D., Patel, S., Estep, L., & Parthasarathy, S. (2020). Matrix metalloproteinase-9 as a messenger in the crosstalk between obstructive sleep apnea and comorbid systemic hypertension, cardiac remodeling, and ischemic stroke: a literature review. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine.More infoObstructive sleep apnea is a common sleep disorder. There is a strong link between sleep related breathing disorders and cardiovascular and cerebrovascular diseases. Matrix metalloproteinase-9 (MMP-9) is a biological marker for extracellular matrix degradation which plays a significant role systemic hypertension, myocardial infarction and post-MI heart failure, and ischemic stroke. This manuscript reviews MMP-9 as an inflammatory mediator and a potential messenger between OSA and OSA-induced comorbidities.
- Mashaqi, S., Staebler, D., & Mehra, R. (2020). Combined nocturnal pulse oximetry and questionnaire-based obstructive sleep apnea screening - A cohort study. Sleep medicine, 72, 157-163.More infoScreening for obstructive sleep apnea (OSA) in both inpatient and outpatient settings to pursue diagnostic testing is becoming increasingly relevant, particularly given the estimates of 85-90% of patients with OSA remaining undiagnosed. Although many questionnaires are available for OSA screening, the STOP-BANG questionnaire is becoming increasingly used due to ease of use and positive performance characteristics. The utility of nocturnal oximetry, in conjunction with standard questionnaire-based strategies to enhance OSA screening in adults, has yet to be systematically examined.
- Pandey, A., Mereddy, S., Combs, D., Shetty, S., Patel, S. I., Mashaq, S., Seixas, A., Littlewood, K., Jean-Luis, G., & Parthasarathy, S. (2020). Socioeconomic Inequities in Adherence to Positive Airway Pressure Therapy in Population-Level Analysis. Journal of clinical medicine, 9(2).More info(a) Background: In patients with sleep apnea, poor adherence to positive airway pressure (PAP) therapy has been associated with mortality. Regional studies have suggested that lower socioeconomic status is associated with worse PAP adherence but population-level data is lacking. (b) Methods: De-identified data from a nationally representative database of PAP devices was geo-linked to sociodemographic information. (c) Results: In 170,641 patients, those in the lowest quartile of median household income had lower PAP adherence (4.1 + 2.6 hrs/night; 39.6% adherent by Medicare criteria) than those in neighborhoods with highest quartile median household income (4.5 + 2.5 hrs/night; 47% adherent by Medicare criteria; < 0.0001). In multivariate regression, individuals in neighborhoods with the highest income quartile were more adherent to PAP therapy than those in the lowest income quartile after adjusting for various confounders (adjusted Odds Ratio (adjOR) 1.18; 95% confidence interval (CI) 1.14, 1.21; < 0.0001). Over the past decade, PAP adherence improved over time (adjOR 1.96; 95%CI 1.94, 2.01), but health inequities in PAP adherence remained even after the Affordable Care Act was passed. (d) Conclusion: In a nationally representative population, disparities in PAP adherence persist despite Medicaid expansion. Interventions aimed at promoting health equity in sleep apnea need to be undertaken.
- Mashaqi, S., & Badr, M. S. (2019). The Impact of Obstructive Sleep Apnea and Positive Airway Pressure Therapy on Metabolic Peptides Regulating Appetite, Food Intake, Energy Homeostasis, and Systemic Inflammation: A Literature Review. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 15(7), 1037-1050.More infoSleep-related breathing disorders are very common and highly associated with many comorbid diseases. They have many metabolic consequences that impact appetite, energy expenditure, and systemic inflammation. These consequences are mediated through peptides (eg, ghrelin, leptin, adiponectin, resistin, apelin, obestatin, and neuropeptide Y).
- Mashaqi, S., & Gozal, D. (2019). Obstructive Sleep Apnea and Systemic Hypertension: Gut Dysbiosis as the Mediator?. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 15(10), 1517-1527.More infoObstructive sleep apnea (OSA) and systemic hypertension (SH) are common and interrelated diseases. It is estimated that approximately 75% of treatment-resistant hypertension cases have an underlying OSA. Exploration of the gut microbiome is a new advance in medicine that has been linked to many comorbid illnesses, including SH and OSA. Here, we will review the literature in SH and gut dysbiosis, OSA and gut dysbiosis, and whether gut dysbiosis is common in both conditions.
- Mashaqi, S., & Johnson, K. (2018). Severe Obstructive Sleep Apnea in a Patient with Fragile X Syndrome. Journal of Sleep Disorders - Treatment and Care, 7(1). doi:10.4172/2325-9639.1000206
- Mashaqi, S., Steffen, K., Crosby, R., & Garcia, L. (2018). The Impact of Bariatric Surgery on Sleep Disordered Breathing Parameters From Overnight Polysomnography and Home Sleep Apnea Test. Cureus, 10(5), e2593.More infoBackground Obstructive sleep apnea (OSA) is a common sleep disorder, especially in patients with obesity. Bariatric surgery is an effective tool to reduce weight and treat co-morbid diseases in patients with morbid obesity. One of these disorders is OSA. The most common bariatric procedures currently performed are Roux-en-Y gastric bypass (RYGB) and laparoscopic sleeve gastrectomy (LSG). Objectives Our study demonstrates that bariatric surgery is a very effective tool to reduce the severity of OSA, if not resolve it. Methods The medical charts of nine patients who had OSA and underwent bariatric surgery (LSG or RYGB) were reviewed and the apnea-hypopnea index (AHI) was compared before and after surgery. The study was conducted at the Sanford sleep center which is affiliated with the University of North Dakota School of Medicine. Results One patient was excluded from the statistical analysis since he was the only male patient, the remaining nine female patients had a significant reduction in AHI after surgery. The mean AHI before surgery was 40 events per hour and seven events per hour after surgery (P 0.004). The mean follow-up with sleep study after surgery was 16 months. The mean reduction in AHI was 80%. There was also an improvement in oxygen saturation (SpO2) before and after surgery (90% and 94% respectively, P 0.008). Conclusion The study confirms the significant reduction in AHI after bariatric surgery in female patients with OSA especially short term (one to two years postoperatively).
- Mashaqi, S., Hennessy, J., Eaton, M., & Erickson, J. (2017). Obstructive Sleep Apnea in a Patient with Cornelia de Lange Syndrome. Cureus, 9(12), e1993.More infoCornelia de Lange syndrome (CdLS) is a rare genetic disorder that is characterized by specific facial, skeletal, and behavioral features associated with variable degrees of intellectual disabilities. Sleep disturbances have been reported in patients with CdLS including insomnia, sleep-disordered breathing, intrinsic sleep disorders, and circadian rhythm disorders. The prevalence of sleep-related breathing disorders, in particular, obstructive sleep apnea (OSA), was conducted using validated questionnaires. We report the first case of CdLS that confirmed a moderate to severe degree of OSA using overnight polysomnography, which is the gold standard diagnostic test for OSA.
- Mashaqi, S., McClelland, C., & Lee, M. (2017). Obstructive Sleep Apnea in a Patient with Bilateral, Sequential Non-arteritic Anterior Ischemic Optic Neuropathy. Journal of Sleep Disorders -Treatment and Care, 6(3). doi:10.4172/2325-9639.1000199
- Parthasarathy, S., Lopez, S., Provencio-Dean, N., Estep, L., Mashaqi, S., Patel, S. I., & Combs, D. (2020, June). Objective differences in sleep timing between African Americans and Non-Hispanic Whites. 2020 meeting of the Associated Professional Sleep Societies. Philadelphia, PA.
- Combs, D., Patel, S. I., Mashaqi, S., Estep, L., Provencio-Dean, N., Lopez, S., & Parthasarathy, S. (2020, June). Objective differences in sleep timing between African Americans and Non-Hispanic Whites. 2020 meeting of the Associated Professional Sleep Societies. Philadelphia, PA.