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Complex sleep apnea

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https://www.readbyqxmd.com/read/29130961/endothelial-cell-derived-microparticles-from-patients-with-obstructive-sleep-apnea-hypoxia-syndrome-and-coronary-artery-disease-increase-aortic-endothelial-cell-dysfunction
#1
Lixin Jia, Jingyao Fan, Wei Cui, Sa Liu, Na Li, Wayne Bond Lau, Xinliang Ma, Jie Du, Shaoping Nie, Yongxiang Wei
BACKGROUND/AIMS: Obstructive sleep apnea hypoxia syndrome (OSAHS) is an independent risk factor for coronary artery disease (CAD). Treatment of OSAHS improves clinical outcome in some CAD patients, but the relationship between OSAHS and CAD is complex. Microparticles (MPs) are shed by the plasma membrane by either physiologic or pathologic stimulation. In the current study, we investigated the role of MPs in the context of OSAHS. METHODS AND RESULTS: 54 patients with both suspected coronary artery stenosis and OSAHS were recruited and underwent both coronary arteriography and polysomnography...
November 1, 2017: Cellular Physiology and Biochemistry
https://www.readbyqxmd.com/read/29130597/co-occurring-medical-conditions-in-adults-with-down-syndrome-a-systematic-review-toward-the-development-of-health-care-guidelines
#2
REVIEW
George T Capone, Brian Chicoine, Peter Bulova, Mary Stephens, Sarah Hart, Blythe Crissman, Andrea Videlefsky, Katherine Myers, Nancy Roizen, Anna Esbensen, Moya Peterson, Stephanie Santoro, Jason Woodward, Barry Martin, David Smith
Adults with Down syndrome (DS) represent a unique population who are in need of clinical guidelines to address their medical care. The United States Preventive Service Task Force (USPSTF) has developed criteria for prioritizing conditions of public health importance with the potential for providing screening recommendations to improve clinical care. The quality of existing evidence needed to inform clinical guidelines has not been previously reviewed. Using the National Library of Medicine (NLM) database PubMed, we first identified 18 peer reviewed articles that addressed co-occurring medical conditions in adults with DS...
November 12, 2017: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/29129750/k-complex-morphological-features-in-male-obstructive-sleep-apnea-hypopnea-syndrome-patients
#3
Lin Sun, Xiangmin Zhang, Shaoxiong Huang, Jiuxing Liang, Yuxi Luo
This study characterized the differences in K-complex (KC) morphology features between obstructive sleep apnea-hypopnea syndrome (OSAHS) patients and healthy controls and analyzed the effect of respiratory events on KC morphology. We enrolled 42 male subjects (21 OSAHS patients and 21 age-matched healthy controls) who underwent overnight polysomnography. KCs in stage N2 were manually identified. We found that KCs in healthy controls had larger negative and whole amplitudes, longer durations, and smoother positive waves than OSAHS patients but smaller positive amplitudes...
November 9, 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/29121095/the-pedunculopontine-tegmentum-controls-renal-sympathetic-nerve-activity-and-cardiorespiratory-activities-in-nembutal-anesthetized-rats
#4
Anne M Fink, Caron Dean, Mariann R Piano, David W Carley
Elevated renal sympathetic nerve activity (RSNA) accompanies a variety of complex disorders, including obstructive sleep apnea, heart failure, and chronic kidney disease. Understanding pathophysiologic renal mechanisms is important for determining why hypertension is both a common sequelae and a predisposing factor of these disorders. The role of the brainstem in regulating RSNA remains incompletely understood. The pedunculopontine tegmentum (PPT) is known for regulating behaviors including alertness, locomotion, and rapid eye movement sleep...
2017: PloS One
https://www.readbyqxmd.com/read/29109195/sleep-apnea-and-cardiovascular-disease-lessons-from-recent-trials-and-need-for-team-science
#5
REVIEW
Luciano F Drager, R Doug McEvoy, Ferran Barbe, Geraldo Lorenzi-Filho, Susan Redline
Emerging research highlights the complex interrelationships between sleep-disordered breathing and cardiovascular disease, presenting clinical and research opportunities as well as challenges. Patients presenting to cardiology clinics have a high prevalence of obstructive and central sleep apnea associated with Cheyne-Stokes respiration. Multiple mechanisms have been identified by which sleep disturbances adversely affect cardiovascular structure and function. Epidemiological research indicates that obstructive sleep apnea is associated with increases in the incidence and progression of coronary heart disease, heart failure, stroke, and atrial fibrillation...
November 7, 2017: Circulation
https://www.readbyqxmd.com/read/29108893/bariatric-surgery-as-a-treatment-for-heart-failure-review-of-the-literature-and-potential-mechanisms
#6
Tammy L Kindel, Jennifer L Strande
Heart failure due to severe obesity is a complex disease due to multiple mechanisms, including increased body mass, inflammation, and impaired cardiac metabolism that is complicated by obesity-associated co-morbidities, such as type 2 diabetes and obstructive sleep apnea. Bariatric surgery significantly improves cardiac geometry, function, and symptoms related to obesity cardiomyopathy. There is a consistently positive impact of bariatric surgery on diastolic function with the potential to significantly improve systolic function as measured by ejection fraction in patients with advanced heart failure...
October 2, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29080583/prediabetes-beyond-the-borderline
#7
REVIEW
Mara Lynn Wilson
Prediabetes is a complex multifactorial metabolic disorder that extends beyond glucose control. Current studies have found that microvascular disease (neuropathy, nephropathy, and retinopathy), macrovascular disease (stroke, coronary artery disease, and peripheral vascular disease), periodontal disease, cognitive dysfunction, blood pressure changes, obstructive sleep apnea, low testosterone level, fatty liver disease, and cancer are some of conditions that are present with the onset of glycemic dysregulation...
December 2017: Nursing Clinics of North America
https://www.readbyqxmd.com/read/29060714/usefulness-of-discrete-wavelet-transform-in-the-analysis-of-oximetry-signals-to-assist-in-childhood-sleep-apnea-hypopnea-syndrome-diagnosis
#8
Fernando Vaquerizo-Villar, Daniel Alvarez, Gonzalo C Gutierrez-Tobal, Veronica Barroso-Garcia, Leila Kheirandish-Gozal, Andrea Crespo, Felix Del Campo, David Gozal, Roberto Hornero
Sleep apnea hypopnea syndrome (SAHS) is a highly prevalent respiratory disorder that may cause many negative consequences for the health and development of children. The gold standard for diagnosis is the overnight polysomnography (PSG), which is a high cost, complex, intrusive, and time-demanding technique. To improve the early detection of pediatric SAHS, we propose an automated analysis of the SpO2 signal from nocturnal oximetry. A database composed of 298 SpO2 recordings from children ranging from 0 to 13 years old was used for this purpose...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/29029239/what-does-the-sleeping-brain-say-syntax-and-semantics-of-sleep-talking-in-healthy-subjects-and-in-parasomnia-patients
#9
Isabelle Arnulf, Ginevra Uguccioni, Frederick Gay, Etienne Baldayrou, Jean-Louis Golmard, Frederique Gayraud, Alain Devevey
Objectives: Speech is a complex function in humans, but the linguistic characteristics of sleep talking are unknown. We analyzed sleep-associated speech in adults, mostly (92%) during parasomnias. Methods: The utterances recorded during night-time video-polysomnography were analyzed for number of words, propositions and speech episodes, frequency, gaps and pauses (denoting turn-taking in the conversation), lemmatization, verbosity, negative/imperative/interrogative tone, first/second person, politeness and abuse...
October 5, 2017: Sleep
https://www.readbyqxmd.com/read/28984599/sleep-apnea-cognitive-profile-and%C3%A2-vascular-changes-an-intriguing-relationship
#10
Laura Buratti, Giovanna Viticchi, Sara Baldinelli, Lorenzo Falsetti, Simona Luzzi, Alessandra Pulcini, Cristina Petrelli, Leandro Provinciali, Mauro Silvestrini
BACKGROUND: Sleep breathing disorders can affect cognitive performances through complex brain anatomical and functional changes. OBJECTIVE: Our aim was to evaluate the correlations between cognitive performances and obstructive sleep apnea syndrome (OSAS), as well as the possible influence of vascular factors. METHODS: Thirty-four non-demented OSAS patients and 34 controls were submitted to a neuropsychological evaluation and to a vascular screening including the study of cerebrovascular reactivity by means of the breath-holding index (BHI) calculation...
2017: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/28978212/overview-of-idiopathic-pulmonary-fibrosis-ipf-and-evidence-based-guidelines
#11
Roozbeh Sharif
Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive form of interstitial lung disease (ILD), characterized by fibrosis and worsening lung function, that primarily occurs in those 50 years and older. Various causes including genetic susceptibility, environmental risk factors, and exposures have been suggested in the literature. All of these cause repetitive micro-injury to the lung tissue and vasculature, which triggers a cascade of inflammatory response and fibrosis. Symptoms are nonspecific and most patients present several years after the initial radiographic changes occur...
July 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28976322/medical-devices-for-paediatric-apnea-monitoring-and-therapy-past-and-new-trends
#12
Salvatore A Pullano, Ifana Mahbub, Maria Giovanna Bianco, Samira Shamsir, Syed K Islam, Mark S Gaylord, Vichien Lorch, Antonino S Fiorillo
Apnea in the paediatric population is associated with increased morbidity and mortality in a large number of developed as well as developing countries. It is even more prominent in preterm newborn infants and is commonly referred to as apnea of prematurity. Its current diagnosis and therapy involve the use of traditional technologies which often result in discomfort to the infants due to the use of invasive devices attached to their sensitive skin, especially in overnight clinical sleep analysis (for over 12- or 24-hour period)...
September 29, 2017: IEEE Reviews in Biomedical Engineering
https://www.readbyqxmd.com/read/28960569/surgical-anatomy-of-the-hypoglossal-nerve-a-new-classification-system-for-selective-upper-airway-stimulation
#13
Clemens Heiser, Andreas Knopf, Benedikt Hofauer
BACKGROUND: Selective upper airway stimulation (UAS) has shown effectiveness in treating patients with obstructive sleep apnea (OSA). The terminating branches of the hypoglossal nerve show a wide complexity, requiring careful discernment of a functional breakpoint between branches for inclusion and exclusion from the stimulation cuff electrode. The purpose of this study was to describe and categorize the topographic phenotypes of these branches. METHODS: Thirty patients who received an implant with selective UAS from July 2015 to June 2016 were included...
September 27, 2017: Head & Neck
https://www.readbyqxmd.com/read/28936176/chronic-intermittent-hypoxia-differentially-impacts-different-states-of-inspiratory-activity-at-the-level-of-the-preb%C3%A3-tzinger-complex
#14
Alfredo J Garcia, Tatiana Dashevskiy, Maggie A Khuu, Jan-Marino Ramirez
The preBötzinger complex (preBötC) is a medullary brainstem network crucially involved in the generation of different inspiratory rhythms. In the isolated brainstem slice, the preBötC reconfigures to produce different rhythms that we refer to as "fictive eupnea" under baseline conditions (i.e., carbogen), and "fictive gasping" in hypoxia. We recently demonstrated that fictive eupnea is irregular following exposure to chronic intermittent hypoxia (CIH). However, it is unknown how CIH impacts fictive gasping...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28915135/otolaryngologic-management-of-down-syndrome-patients-what-is-new
#15
Ethan C Bassett, Mary F Musso
PURPOSE OF REVIEW: The management of children with Down syndrome as it pertains to the otolaryngologist continues to evolve. Obstructive sleep apnea (OSA) has dominated the recent literature, but other topics including hearing loss, swallowing, and perioperative considerations are also reported. RECENT FINDINGS: The prevalence of OSA in children with Down syndrome ranges from 57 to 73% in certain cohorts, and, whereas adentonsillectomy can decrease Apnea-Hypopnea Index, up to 80% may have persistent OSA...
December 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28915133/complications-and-unplanned-admissions-in-nonoperating-room-procedures
#16
Kate Leslie, Benjamin Kave
PURPOSE OF REVIEW: The purpose of this article is to review complications and unplanned hospital admissions in patients presenting for ambulatory procedures requiring anesthesia care in the gastrointestinal endoscopy, bronchoscopy, and radiology suites. RECENT FINDINGS: The range of ambulatory diagnostic and therapeutic procedures being undertaken in the gastrointestinal endoscopy, bronchoscopy, and radiology suites is expanding rapidly. Recent observational studies in gastrointestinal endoscopy confirm low incidences of complications and unplanned admissions...
September 14, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28902606/an-evaluation-of-patient-risk-factors-to-determine-eligibility-to-undergo-orthopaedic-surgery-in-a-freestanding-ambulatory-center-a-survey-of-4-242-consecutive-patients
#17
Matthew Siow, Germaine Cuff, Jovan Popovic, Joseph Bosco
INTRODUCTION: The value proposition of surgery at freestanding ambulatory surgery centers (FSASCs) in terms of efficiency, safety, and patient satisfaction is well established and has led to increased FSASC utilization. However, there are comorbid conditions that disqualify certain patients from surgery at FSASCs. Understanding the percentage of patients whose comorbid conditions exclude them from FSASCs is important for the proper planning and utilization of operating room assets. We aim to understand the percentage of excluded patients, and we predict that certain procedures have higher rates of disqualification due to the types of patients who undergo them...
May 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/28893610/sex-differences-in-the-respiratory-sympathetic-coupling-in-rats-exposed-to-chronic-intermittent-hypoxia
#18
REVIEW
George Miguel P R Souza, Mateus R Amorim, Davi J A Moraes, Benedito H Machado
Obstructive sleep apnea (OSA) is a complex disease in which humans face episodes of intermittent hypoxia and it affects men and women. Patients with OSA present hypertension and sympathetic overactivity among several other dysfunctions. Therefore, one important question remains: are the autonomic dysfunctions associated with OSA similar in male and female? This is an unresolved question since sex factors are overlooked in most clinical and experimental studies. Epidemiological data indicate that sex exerts an important influence in the prevalence of OSA and associated comorbidities, such as hypertension...
September 8, 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28863405/phantom-study-evaluating-detection-of-simulated-upper-airway-occlusion-using-piezoelectric-ultrasound-transducers
#19
Mohammad Al-Abed, Peter Antich, Donald E Watenpaugh, Khosrow Behbehani
Obstructive sleep apnea/hypopnea syndrome (OSAHS) is characterized by repetitive narrowing or full collapse of the upper airway concomitant with continued respiratory effort during sleep lasting 10s or more. OSAHS is the most prevalent form of sleep-disordered breathing, affecting more than 17% of the middle-aged U.S. POPULATION: Hence, many individuals need to be tested for having OSAHS. Currently, detection of airway occlusion due to OSAHS is achieved by indirect measurements, often requiring multiple sensor types, such as a flow transducer combined with chest and abdomen plethysmography...
August 24, 2017: Computers in Biology and Medicine
https://www.readbyqxmd.com/read/28829519/looking-both-ways-before-crossing-the-street-assessing-the-benefits-and-risk-of-opioids-in-treating-patients-at-risk-of-sleep-disordered-breathing-for-pain-and-dyspnea
#20
Mellar P Davis, Bertrand Behm, Diwakar Balachandran
Opioids adversely influence respiration in five distinct ways. Opioids reduce the respiratory rate, tidal volume, amplitude, reflex responses to hypercapnia and hypoxia, and arousability related necessary for respiratory adaptive responses. Opioids cause impairment of upper pharyngeal dilator muscles leading to obstructive apnea. Opioids cause complex sleep disordered breathing (SDB) consisting of central sleep apnea and obstructive sleep apnea. Clinically opioids worsen pre-existing SDB. Recent studies have shown increased morbidity and mortality in patients receiving opioids for chronic noncancer pain and chronic obstructive pulmonary disease, which appear to be related to cardiovascular events, not overdose...
May 2017: Journal of Opioid Management
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