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Complex sleep apnea

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https://www.readbyqxmd.com/read/27913972/in-hospital-diagnosis-of-sleep-apnea-in-stroke-patients-using-a-portable-acoustic-device
#1
Clodagh M Ryan, Kelly Wilton, T Douglas Bradley, Hisham Alshaer
PURPOSE: Sleep apnea (SA) is highly prevalent in post-stroke patients. Due to physical disability and relative inaccessibility of polysomnography (PSG) to test for SA, patients with stroke frequently remain undiagnosed and untreated. Portable SA monitoring can facilitate at-home or in-hospital testing for SA. However, portable SA monitoring is not recommended in those with complex medical conditions, such as stroke, due to the lack of validation of portable monitoring in such patients...
December 2, 2016: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/27890604/gender-dimorphism-in-pediatric-osa-is-it-for-real
#2
REVIEW
Pablo E Brockmann, Dorit Koren, Leila Kheirandish-Gozal, David Gozal
In epidemiologic studies focused on adults, obstructive sleep apnea (OSA) has higher prevalence in men than in women. The evidence supporting a gender-related discrepant prevalence of OSA is however much more tenuous in children. Here, we aimed to review the evidence concerning gender- based differences in the prevalence of OSA in children, and if so, to examine the evidence with the intent to identify potential factors that may account for this putative association. Gender-based perception and reporting of clinical manifestations of OSA may be modulated by several social and cultural factors in children...
November 23, 2016: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/27886849/prevalence-and-burden-of-comorbidities-in-chronic-obstructive-pulmonary-disease
#3
REVIEW
Alexandru Corlateanu, Serghei Covantev, Alexander G Mathioudakis, Victor Botnaru, Nikolaos Siafakas
The classical definition of Chronic Obstructive Pulmonary Disease (COPD) as a lung condition characterized by irreversible airway obstruction is outdated. The systemic involvement in patients with COPD, as well as the interactions between COPD and its comorbidities, justify the description of chronic systemic inflammatory syndrome. The pathogenesis of COPD is closely linked with aging, as well as with cardiovascular, endocrine, musculoskeletal, renal, and gastrointestinal pathologies, decreasing the quality of life of patients with COPD and, furthermore, complicating the management of the disease...
November 2016: Respiratory Investigation
https://www.readbyqxmd.com/read/27857512/respiratory-manifestations-in-endocrine-diseases
#4
REVIEW
Codruţa Lencu, Teodora Alexescu, Mirela Petrulea, Monica Lencu
The control mechanisms of respiration as a vital function are complex: voluntary - cortical, and involuntary - metabolic, neural, emotional and endocrine. Hormones and hypothalamic neuropeptides (that act as neurotrasmitters and neuromodulators in the central nervous system) play a role in the regulation of respiration and in bronchopulmonary morphology. This article presents respiratory manifestations in adult endocrine diseases that evolve with hormone deficit or hypersecretion. In hyperthyroidism, patients develop ventilation disorders, obstructive and central sleep apnea, and pleural collection...
2016: Clujul Medical (1957)
https://www.readbyqxmd.com/read/27829262/-upper-airway-stimulation-in-osa
#5
B Bender
Anatomical basis of obstructive sleep apnea (OSA) is the collapse of the pharynx during sleep. It is considered as a result of complex interactions of structural and neuromuscular factors. Depth of sleep and body position have modulating effects. Although different areas of obstruction were identified, studies show that the sleep-mediated obstruction frequently occurs in the base of tongue area.Continuous positive airway pressure (CPAP) is the standard treatment for obstructive sleep apnea syndrome (OSAS) since more than 30 years...
November 2016: Laryngo- Rhino- Otologie
https://www.readbyqxmd.com/read/27818084/obstructive-sleep-apnea-and-energy-balance-regulation-a-systematic-review
#6
REVIEW
Ari Shechter
: Obesity and obstructive sleep apnea (OSA) have a reciprocal relationship. Sleep disruptions characteristic of OSA may promote behavioral, metabolic, and/or hormonal changes favoring weight gain and/or difficulty losing weight. The regulation of energy balance (EB), i.e., the relationship between energy intake (EI) and energy expenditure (EE), is complex and multi-factorial, involving food intake, hormonal regulation of hunger/satiety/appetite, and EE via metabolism and physical activity (PA)...
July 15, 2016: Sleep Medicine Reviews
https://www.readbyqxmd.com/read/27815038/phenotypes-in-obstructive-sleep-apnea-a-definition-examples-and-evolution-of-approaches
#7
REVIEW
Andrey V Zinchuk, Mark J Gentry, John Concato, Henry K Yaggi
Obstructive sleep apnea (OSA) is a complex and heterogeneous disorder and the apnea hypopnea index alone can not capture the diverse spectrum of the condition. Enhanced phenotyping can improve prognostication, patient selection for clinical trials, understanding of mechanisms, and personalized treatments. In OSA, multiple condition characteristics have been termed "phenotypes." To help classify patients into relevant prognostic and therapeutic categories, an OSA phenotype can be operationally defined as: "A category of patients with OSA distinguished from others by a single or combination of disease features, in relation to clinically meaningful attributes (symptoms, response to therapy, health outcomes, quality of life)...
October 12, 2016: Sleep Medicine Reviews
https://www.readbyqxmd.com/read/27789174/-pediatric-obstructive-sleep-apnea-syndrome-treatment-strategy
#8
J Cohen-Lévy, J Potenza, V Couloigner
Pediatric obstructive sleep apnea syndrome (OSAS) has a multifactorial origin. For the child with no dysmorphic disorders or comorbidities, its main etiology is pharyngeal soft tissue hypertrophy, a dimensional reduction of the facial skeletal frame restricting the airway, an anomaly of muscular tone, or a combination of these factors. Consequently, proper diagnosis and treatment planning for these children can require several medical specialties, according to the complexity, severity, and persistence of OSAS: ear-nose-throat specialists (ENT), pneumologists/allergologists, dentofacial orthopedists/orthodontists, and physical therapists/speech therapists...
October 24, 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/27769628/-obesity-and-obstructive-sleep-apnea-in-children
#9
A Amaddeo, L de Sanctis, J Olmo Arroyo, J-P Giordanella, P-J Monteyrol, B Fauroux
Obesity, along with hypertrophy of the adenoids and the tonsils, represents one of the major risk factors for obstructive sleep apnea (OSA) in children. Obesity is associated with an increase in the prevalence and the severity of OSA and is a major factor in the persistence and aggravation of OSA over time. Neurocognitive dysfunction and abnormal behavior are the most important and frequent end-organ morbidities associated with OSA in children. Other deleterious consequences such as cardiovascular stress and metabolic syndrome are less common in children than in adults with OSA...
October 18, 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/27754829/potential-inflammatory-markers-in-obstructive-sleep-apnea-hypopnea-syndrome
#10
Dongmei Lu, Nanfang Li, Xiaoguang Yao, Ling Zhou
Obstructive sleep apnea-hypopnea syndrome (OSAHS) is a complex chronic inflammatory respiratory disease with multiple pathogenic factors and high morbidity and mortality. Serum levels of nuclear factor-κB (NF-κB), hypoxia-inducible factor-1 alpha (HIF-1α), and surfactant protein D (SPD) were investigated in OSAHS patients, to determine their clinical significance and correlation with the pathogenesis. Patients were classified into a mild and moderate OSAHS group (n = 25) and severe OSAHS group (n = 33). Twenty healthy patients served as a control group...
October 18, 2016: Bosnian Journal of Basic Medical Sciences
https://www.readbyqxmd.com/read/27742106/genioglossal-advancement-hyoid-suspension-tongue-base-radiofrequency-and-endoscopic-partial-midline-glossectomy-for-obstructive-sleep-apnea
#11
REVIEW
Jeffrey Dorrity, Nicholas Wirtz, Oleg Froymovich, David Hamlar
Surgical intervention for obstructive sleep apnea (OSA) is a complex topic. The discussion involves intricate procedures targeting specific areas of the upper airway. Because of the wide variety of physiologic and anatomic causes of this disorder it is important to tailor the treatment to offer the patient the best possible outcome. Genioglossus, hyoid, and tongue base procedures should be considered among theses treatment options.
December 2016: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/27690206/the-interaction-of-obesity-and-nocturnal-hypoxemia-on-cardiovascular-consequences-in-adults-with-suspected-obstructive-sleep-apnea-a-historical-observational-study
#12
Tetyana Kendzerska, Richard S Leung, Andrea S Gershon, George Tomlinson, Najib Ayas
RATIONALE: The inter-relationships between obstructive sleep apnea (OSA) and obesity are complex and bidirectional; however, the current evidence regarding their combined effect o cardiovascular risk is limited and conflicting. Animal studies suggest that obesity may exacerbate the cardiovascular consequences of intermittent hypoxemia. OBJECTIVES: In this historical observational study, we investigated whether obesity increases the effect of nocturnal hypoxemia on the incidence of cardiovascular events in adults with suspected OSA...
September 30, 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/27634813/relationships-between-smoking-and-sleep-problems-in-black-and-white-adolescents
#13
Anna Bellatorre, Kelvin Choi, Daniel Lewin, Denise Haynie, Bruce Simons-Morton
STUDY OBJECTIVES: The relationship between sleeping and smoking in adolescent remains unclear and is likely complex. We aim to evaluate the longitudinal reciprocal associations between sleep problems, sleep duration, smoking among non-Hispanic white (NHW) and non-Hispanic black (NHB) youth. DESIGN: Prospective cohort study. SETTING: NEXT Generation Health Study. PARTICIPANTS: A national sample (N=1394) of NHB and NHW 10th graders were surveyed annually between 2009 (Wave 1) and 2012 (Wave 3)...
September 9, 2016: Sleep
https://www.readbyqxmd.com/read/27631230/assessment-of-regional-right-ventricular-systolic-function-in-patients-with-obstructive-sleep-apnea-syndrome-using-velocity-vector-imaging
#14
Junfang Li, Zhibing Wang, Yong Li, Yuanyuan Meng, Rong Li, Wugang Wang, Xiuxiu Fu
Obstructive sleep apnea syndrome (OSAS) is the most common type of sleep disorder which is associated with a series of cardiovascular disorders, including right ventricular (RV) dysfunction. However, it is difficult to assess the RV function systematically using a conventional echocardiography because RV has a complex geometrical shape. A case-control study was performed to assess the regional right ventricular potential dysfunction in patients with OSAS using velocity vector imaging (VVI) from March 2014 to October 2015...
September 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27617808/subtypes-of-maxillomandibular-advancement-surgery-for-patients-with-obstructive-sleep-apnea
#15
Won-June Lee, Dong-Hyun Hwang, Stanley Yung-Chuan Liu, Su-Jung Kim
Maxillomandibular advancement (MMA) surgery, which is the most effective treatment modality for patients with moderate-to-severe obstructive sleep apnea with apparent skeletal discrepancies, has been modified in conjunction with segmental osteotomies, counterclockwise rotation of maxillomandibular complex, and other adjunctive procedures. However, any single type of MMA could not treat or cure all the patients with obstructive sleep apnea showing different dentofacial and pharyngeal patterns. We aimed to suggest critical decision factors for the selective application of MMA subtypes, categorized as straight MMA with genioplasty, rotational MMA, segmental MMA, and segmental-rotational MMA, in the surgical treatment objective process: anteroposterior position of maxilla, upper lip projection, overjet, lower incisor inclination as sagittal factors, and upper incisor exposure and occlusal plane angle as vertical factors...
September 9, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27584711/sleep-disorders-in-machado-joseph-disease
#16
José Luiz Pedroso, Pedro Braga-Neto, Alberto R M Martinez, Carlos R Martins, Flávio M Rezende Filho, Manoel A Sobreira-Neto, Lucila B F Prado, Gilmar F do Prado, Marcondes C França, Orlando G P Barsottini
PURPOSE OF REVIEW: This article provides a description on clinical features and pathophysiology of the main sleep disorders observed in Machado-Joseph disease (MJD). RECENT FINDINGS: Pathological studies have clearly demonstrated that degenerative process in MJD is widespread in the nervous system, and not restricted to the cerebellum. Nonmotor manifestations are frequent and may include pain, cramps, dysautonomia, cognitive deficits, psychiatric manifestations, olfactory deficits, fatigue, nutritional issues, and sleep disorders...
November 2016: Current Opinion in Psychiatry
https://www.readbyqxmd.com/read/27572119/updates-of-operative-techniques-for-upper-airway-stimulation
#17
REVIEW
Clemens Heiser, Erica Thaler, Maurits Boon, Ryan J Soose, B Tucker Woodson
Selective upper airway stimulation has been established as an additional treatment for obstructive sleep apnea (OSA). Essential for the treatment is the precise placement of the cuff electrode for select branches of the hypoglossal nerve, which innervate the protrusors and stiffeners of the tongue. A direct approach to the distal hypoglossal nerve has been established to achieve this goal. For surgeons, detailed knowledge of this anatomy is vital. Another decisive step is the placement of the sensing lead between the intercostal muscles...
September 2016: Laryngoscope
https://www.readbyqxmd.com/read/27567116/plasma-leptin-concentration-is-associated-with-fatigue-severity-in-patients-with-cardiovascular-risk-factors-hscaa-study
#18
Masafumi Kurajoh, Manabu Kadoya, Akiko Morimoto, Mariko Naka, Akio Miyoshi, Akinori Kanzaki, Miki Kakutani-Hatayama, Kae Hamamoto, Takuhito Shoji, Yuji Moriwaki, Tetsuya Yamamoto, Masaaki Inaba, Mitsuyoshi Namba, Hidenori Koyama
Fatigue induced by complex dysfunctions of the central nervous system is frequently complained by patients with cardiovascular risk factors. Although leptin is considered to regulate the central nervous system, there are no reports regarding its association with fatigue in those patients. This cross-sectional study included 347 patients with cardiovascular risk factors. Fatigue score and plasma leptin concentration were measured. In addition, abdominal fat accumulation, systemic inflammation, sleep condition, and functions of hypothalamus-pituitary axis and autonomic system were estimated...
August 16, 2016: Psychoneuroendocrinology
https://www.readbyqxmd.com/read/27555802/clinical-predictors-of-central-sleep-apnea-evoked-by-positive-airway-pressure-titration
#19
Marilyn Moro, Karen Gannon, Kathy Lovell, Margaret Merlino, James Mojica, Matt T Bianchi
PURPOSE: Treatment-emergent central sleep apnea (TECSA), also called complex apnea, occurs in 5%-15% of sleep apnea patients during positive airway pressure (PAP) therapy, but the clinical predictors are not well understood. The goal of this study was to explore possible predictors in a clinical sleep laboratory cohort, which may highlight those at risk during clinical management. METHODS: We retrospectively analyzed 728 patients who underwent PAP titration (n=422 split-night; n=306 two-night)...
2016: Nature and Science of Sleep
https://www.readbyqxmd.com/read/27543782/an-algorithm-for-sleep-apnea-detection-from-single-lead-ecg-using-hermite-basis-functions
#20
Hemant Sharma, K K Sharma
This paper introduces a methodology for the detection of sleep apnea based on single-lead electrocardiogram (ECG) of the patient. In the proposed technique, each QRS complex of the ECG signal is approximated using a linear combination of the lower order Hermite basis functions. The coefficients of the Hermite expansion are then used to discriminate the apnea and normal segments along with three features based on R-R time series (mean of R-R intervals, the standard deviation of R-R intervals) and energy in the error of the QRS approximation...
October 1, 2016: Computers in Biology and Medicine
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