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Complex sleep apnea

Dominik Linz, R Doug McEvoy, Martin R Cowie, Virend K Somers, Stanley Nattel, Patrick Lévy, Jonathan M Kalman, Prashanthan Sanders
Importance: Obstructive sleep apnea (OSA) is the most common clinically significant breathing abnormality during sleep. It is highly prevalent among patients with atrial fibrillation (AF), and it promotes arrhythmogenesis and impairs treatment efficacy. Observations: The prevalence of OSA ranges from 3% to 49% in population-based studies and from 21% to 74% in patients with AF. Diagnosis and treatment of OSA in patients with AF requires a close interdisciplinary collaboration between electrophysiologists, cardiologists, and sleep specialists...
March 14, 2018: JAMA Cardiology
David Stevens, Rodrigo Tomazini Martins, Sutapa Mukherjee, Andrew Vakulin
Sleep-disordered breathing (SDB), encompassing both obstructive and central sleep apnea, is prevalent in at least 50% of stroke patients. Small studies have shown vast improvements in post-stroke functional recovery outcomes after the treatment of SDB by continuous positive airway pressure. However, compliance to this therapy is very poor in this complex patient group. There are alternative therapy options for SDB that may be more amenable for use in at least some post-stroke patients, including mandibular advancement, supine avoidance, and oxygen therapy...
2018: Frontiers in Surgery
Jiuxing Liang, Xiangmin Zhang, Yuxi Luo, Tingting Wang, Lin Sun, Shaoxiong Huang
Sleep apnea hypopnea syndrome (SAHS) is an independent risk factor for cardiovascular diseases. However, the pathophysiology between them is not yet clear. This paper seeks to understand how respiratory events impact the cardiovascular system by heart rate variability. We compared the differences between successional pathological respiratory events (PR) and pure normal respiration (NR) during sleep. The transitions between normal and pathological respiration (TR) were also analyzed. Thirteen patients who suffered moderate or severe SAHS were enrolled in this study...
March 12, 2018: International Heart Journal
Stacey Gunn, Sreelatha Naik, Matt Travis Bianchi, Robert Joseph Thomas
Study Objectives: Adaptive servo ventilation (ASV) devices provide anti-cyclic pressure support for treatment of central/complex sleep apnea, including in heart failure patients. Variability in responses in the clinic and negative clinical trials motivated assessment of standard and novel signal biomarkers for ASV efficacy. Methods: Multiple clinical databases were queried to assess potential signal biomarkers of ASV effectiveness, including 1) Attended laboratory adaptive ventilation titrations: 108, of which 66 had mainstream ETCO2 measurements...
February 17, 2018: Sleep
Mohamed Ahmed Abd El Salam
Obesity is a highly prevalent non-communicable disease worldwide and is commonly associated with male infertility. Several etiopathological theories have been mentioned in the literature by which obesity affects spermatogenesis, thus affecting the male fertility potential. Mechanisms for explaining the effect of obesity on male infertility include endocrinopathy, increased aromatization activity, associated erectile dysfunction, psychological and thermal effects, obstructive sleep apnea, increased leptin and oxygen free radicals, and associated inflammatory and obstructive elements of epididymitis...
January 2018: Oman Medical Journal
Renata Pecotic, Ivana Pavlinac Dodig, Maja Valic, Tea Galic, Linda Lusic Kalcina, Natalija Ivkovic, Zoran Dogas
STUDY OBJECTIVES: We prospectively investigated the effects of continuous positive airway pressure (CPAP) on long-term cognitive and psychomotor performances, and excessive daytime sleepiness in severe obstructive sleep apnea (OSA) patients. METHODS: A total of 40 patients were recruited and 23 patients with severe OSA fully completed the study protocol to investigate the effects of CPAP therapy on psychomotor performance at 1, 3, and 6 months and 1 year following initiation of the therapy...
February 16, 2018: Sleep & Breathing, Schlaf & Atmung
Renae C Fernandez, Vivienne M Moore, Emer M Van Ryswyk, Tamara J Varcoe, Raymond J Rodgers, Wendy A March, Lisa J Moran, Jodie C Avery, R Doug McEvoy, Michael J Davies
Polycystic ovary syndrome (PCOS) is a complex endocrine disorder affecting the reproductive, metabolic and psychological health of women. Clinic-based studies indicate that sleep disturbances and disorders including obstructive sleep apnea and excessive daytime sleepiness occur more frequently among women with PCOS compared to comparison groups without the syndrome. Evidence from the few available population-based studies is supportive. Women with PCOS tend to be overweight/obese, but this only partly accounts for their sleep problems as associations are generally upheld after adjustment for body mass index; sleep problems also occur in women with PCOS of normal weight...
2018: Nature and Science of Sleep
Richard Ngo, Elaina Pullano, Zachary S Peacock, Edward T Lahey, Meredith August
PURPOSE: Obstructive sleep apnea (OSA) patients with retrognathia and measurable anatomic airway determinants may represent a subset of OSA patients and have distinct comorbidity profiles. Our aim was to compare the medical comorbidities of OSA patients managed surgically with maxillomandibular advancement with those of nonsurgical patients. PATIENTS AND METHODS: In this cross-sectional retrospective study, patients for both cohorts were identified through the Massachusetts General Hospital oral and maxillofacial surgery data registry and the Massachusetts General Hospital Research Patient Data Registry...
January 31, 2018: Journal of Oral and Maxillofacial Surgery
Peder Wolkoff
There is a long-standing dispute about indoor air humidity and perceived indoor air quality (IAQ) and associated health effects. Complaints about sensory irritation in eyes and upper airways are generally among top-two symptoms together with the perception "dry air" in office environments. This calls for an integrated analysis of indoor air humidity and eye and airway health effects. This overview has reviewed the literature about the effects of extended exposure to low humidity on perceived IAQ, sensory irritation symptoms in eyes and airways, work performance, sleep quality, virus survival, and voice disruption...
January 31, 2018: International Journal of Hygiene and Environmental Health
Nataliya I Biskup, Brian S Pan, Haithem Elhadi-Babiker, Ronald R Hathaway, John van Aalst, Christopher B Gordon
BACKGROUND: Treacher Collins syndrome is a rare disorder (1/50,000 live births) with features that include hypoplastic orbitozygomatic complex with downward slanting eyes, and maxillary/mandibular retrusion. Obstructive sleep apnea and tracheostomy-dependence are common. This study presents the outcomes of skeletal distraction on avoidance of tracheostomy and decannulation in this patient population. METHODS: The authors reviewed charts of all patients with Treacher Collins syndrome who underwent craniofacial reconstruction from 2003 to 2016...
January 29, 2018: Journal of Craniofacial Surgery
Justin S Smith, Christopher I Shaffrey, Han Jo Kim, Peter Passias, Themistocles Protopsaltis, Renaud Lafage, Gregory M Mundis, Eric Klineberg, Virginie Lafage, Frank J Schwab, Justin K Scheer, Emily Miller, Michael Kelly, D Kojo Hamilton, Munish Gupta, Vedat Deviren, Richard Hostin, Todd Albert, K Daniel Riew, Robert Hart, Doug Burton, Shay Bess, Christopher P Ames
BACKGROUND: Surgical treatments for adult cervical spinal deformity (ACSD) are often complex and have high complication rates. OBJECTIVE: To assess all-cause mortality following ACSD surgery. METHODS: ACSD patients presenting for surgical treatment were identified from a prospectively collected multicenter database. Clinical and surgical parameters and all-cause mortality were assessed. RESULTS: Of 123 ACSD patients, 120 (98%) had complete baseline data (mean age, 60...
January 17, 2018: Neurosurgery
Mayand Vakil, Steven Park, Anna Broder
Obstructive sleep apnea is known to be associated with diseases such as hypertension, metabolic disorder, and cancer. A more controversial and less understood association is that of sleep apneas and the development and worsening of autoimmune and rheumatologic disorders. Through the main pathways of intermittent hypoxia and sleep deprivation, we hypothesize that obstructive sleep apnea creates a chronic inflammatory state that worsens or incites autoimmune disorders. This thorough review of the available literature highlights our current understanding of the relationship between these disease processes in order to demonstrate the importance of diagnosis and appropriate management of sleep disorders in patients suffering from rheumatologic diseases...
January 2018: Medical Hypotheses
Muna Irfan, Carlos H Schenck
We report a case of problematic spontaneous orgasms during sleep in a 57-year-old woman who also complained of hypnic jerks and symptoms of exploding head syndrome. To our knowledge, this is the first case report in the English language literature of problematic spontaneous orgasms during sleep. She had a complex medical and psychiatric history, and was taking oxycontin, venlafaxine, amitriptyline, and lurasidone. Prolonged video electroencephalogram monitoring did not record any ictal or interictal electroencephalogram discharges, and nocturnal video polysomnography monitoring did not record any behavioral or orgasmic event...
January 15, 2018: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Congcong Sun, Wen Xia, Ying Liu, Guoyong Jia, Cuilan Wang, Chuanzhu Yan, Yi Li
RATIONALE: Fatal familial insomnia (FFI) linked to a D178N/129M haplotype mutation in the PRNP gene is the most common genetic prion disease in the Han Chinese population. Here, we describe a Han Chinese patient with FFI who exhibited agrypnia excitata and obstructive apnea. PATIENT CONCERNS: A 46-year-old man displayed involuntary movements during sleep time, snoring, autonomic nervous system dysfunction, cognitive deficit, brainstem symptoms, myoclonus and ataxia in order within 8 months...
December 2017: Medicine (Baltimore)
Reshma Amin, Theresa Holler, Indra Narang, Sharon L Cushing, Evan J Propst, Suhail Al-Saleh
Objective To estimate the prevalence of persistent obstructive sleep apnea postadenotonsillectomy in children with complex chronic conditions. Study Design A retrospective cohort study. Setting The Hospital for Sick Children Sleep laboratory. Subjects Children ≤18 years of age who had moderate to severe obstructive sleep apnea and had polysomnography pre- and postadenotonsillectomy. Methods Medical and polysomnographic data were reviewed. The prevalence of persistent obstructive sleep apnea postadenotonsillectomy was determined for the following groups: no complex chronic conditions, single-system complex chronic conditions, and multisystem complex chronic conditions...
December 1, 2017: Otolaryngology—Head and Neck Surgery
Katerina Baou, Charalampos Mermigkis, Aliki Minaritzoglou, Emmanouil Vagiakis
PURPOSE: Treatment-emergent central sleep apnea (TE-CSA) is defined as the emergence or persistence of central respiratory events during the initiation of positive airway pressure (PAP) without a back-up rate in obstructive sleep apnea (OSA) patients and after significant resolution of obstructive events. Previous studies have estimated a prevalence from 0.56 to 20.3%. The aim of this study was to establish the prevalence of TE-CSA in a Greek adult population. METHODS: One thousand fifty nine patients with newly diagnosed OSA, who were referred to the Sleep Disorders Center of Evangelismos Hospital of Athens over an 18-month period, were included in this study...
December 8, 2017: Sleep & Breathing, Schlaf & Atmung
Masood Ahmad, Devan Makati, Sana Akbar
Obstructive sleep apnea (OSA) is a prevalent sleep disorder as is hypertension (HTN) in the 21st century with the rising incidence of obesity. Numerous studies have shown a strong association of OSA with cardiovascular morbidity and mortality. There is overwhelming evidence supporting the relationship between OSA and hypertension (HTN). The pathophysiology of HTN in OSA is complex and dependent on various factors such as sympathetic tone, renin-angiotensin-aldosterone system, endothelial dysfunction, and altered baroreceptor reflexes...
2017: International Journal of Hypertension
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
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...
January 2018: American Journal of Medical Genetics. Part A
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...
January 2018: Respiratory Physiology & Neurobiology
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