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Obstructive Sleep Apnoea

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https://www.readbyqxmd.com/read/28544082/a-resource-of-potential-drug-targets-and-strategic-decision-making-for-obstructive-sleep-apnoea-pharmacotherapy
#1
REVIEW
Richard L Horner, Kevin P Grace, Andrew Wellman
There is currently no pharmacotherapy for obstructive sleep apnoea (OSA) but there is no principled a priori reason why there should not be one. This review identifies a rational decision-making strategy with the necessary logical underpinnings that any reasonable approach would be expected to navigate to develop a viable pharmacotherapy for OSA. The process first involves phenotyping an individual to quantify and characterize the critical predisposing factor(s) to their OSA pathogenesis and identify, a priori, if the patient is likely to benefit from a pharmacotherapy that targets those factors...
May 25, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28543355/nurse-versus-physician-led-care-for-obstructive-sleep-apnea-a-systematic-review-and-meta-analysis-of-randomised-trials
#2
REVIEW
Fengqiu Gong, Xiaojun Chen, Yaoye Wu, Dianye Yao, Lihong Xie, Qiuyi Ouyang, Ping Wang, Gang Niu
AIM: To evaluate the effectiveness of nurse-led care for obstructive sleep apnoea compared with physician-led care. BACKGROUND: The incidence of obstructive sleep apnoea is increasing worldwide. There is a need for cost-effective care models to ease off the pressure on tertiary care centres and divert care to the community. DESIGN: Systematic review and meta-analysis. DATA SOURCES: We searched major electronic databases (MEDLINE, EMBASE, AMED, British Nursing Index, CINAHL, HMIC, PsycINFO, Health Business Elite and the Cochrane Central Register of Controlled Trials CENTRAL) from inception till December 2016 using a structured search strategy for all randomised trials evaluating nurse-led treatment interventions for adults with obstructive sleep apnoea compared with physician-led ones...
May 24, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28534455/effect-of-modern-surgical-treatment-on-the-inflammatory-anti-inflammatory-balance-in-patients-with-obstructive-sleep-apnoea
#3
M Binar, T M Akcam, O Karakoc, R I Sagkan, U Musabak, M Gerek
OBJECTIVE: To investigate the inflammatory/anti-inflammatory cytokine balance - T helper 1/T helper 2 ratios - in obstructive sleep apnoea patients, before and after treatment. METHODS: Twenty-eight patients received continuous positive airway pressure treatment and 29 patients who could not tolerate continuous positive airway pressure were scheduled for surgery. Serum levels of interleukins 2, 4 and 10, tumour necrosis factor-alpha, and interferon gamma were analysed by enzyme-linked immunosorbent assays before and three months after treatment...
May 23, 2017: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/28532519/a-case-of-severe-obstructive-sleep-apnoea-in-madelung-s-disease-treated-by-lateral-pharyngoplasty
#4
V Pinto, P G Morselli, D Tassone, O Piccin
BACKGROUND: Madelung's disease is a rare disorder characterised by the presence of multiple, symmetric, non-capsulated fat masses in the face, neck and other areas of upper extremities. In some cases, severe clinical complications such as upper airway compression can occur. CASE REPORT: A 56-year-old man affected by Madelung's disease complained of snoring and severe daytime sleepiness. Polysomnography revealed severe obstructive sleep apnoea. An attempt to treat sleep apnoea by continuous positive airway pressure failed because of poor compliance...
May 23, 2017: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/28531336/loop-gain-predicts-the-response-to-upper-airway-surgery-in-patients-with-obstructive-sleep-apnoea-ventilatory-control-abnormalities-predict-surgical-responsiveness
#5
Simon A Joosten, Paul Leong, Shane A Landry, Scott A Sands, Philip I Terrill, Dwayne Mann, Anthony Turton, Jhanavi Rangaswamy, Christopher Andara, Glen Burgess, Darren Mansfield, Garun S Hamilton, Bradley A Edwards
Study Objectives: Upper airway surgery is often recommended to treat OSA patients who cannot tolerate continuous positive airways pressure (CPAP). However, the response to surgery is variable, potentially because it does not improve the non-anatomical factors (i.e. loop gain and arousal threshold) causing OSA. Measuring these traits clinically might predict responses to surgery. Our primary objective was to test the value of loop gain and arousal threshold to predict surgical success defined as 50% reduction in apnea-hypopnea index (AHI) and AHI <10 events/hr post-surgery...
May 22, 2017: Sleep
https://www.readbyqxmd.com/read/28530254/palatal-surgery-in-a-transoral-robotic-setting-tors-preliminary-results-of-a-retrospective-comparison-between-uvulopalatopharyngoplasty-uppp-expansion-sphincter-pharyngoplasty-esp-and-barbed-repositioning-pharyngoplasty-brp
#6
G Cammaroto, F Montevecchi, G D'Agostino, E Zeccardo, C Bellini, G Meccariello, C Vicini
It has become increasingly clear in the past decade that surgical management of obstructive sleep apnoea hypopnoea syndrome (OSAHS) is most successfully managed with multilevel surgery. We evaluated the outcomes of multilevel interventions comparing three different palatal techniques added to TORS: uvulopalatopharyngoplasty (UPPP), a modified expansion sphincter pharyngoplasty (ESP), inspired by the Pang expansion sphincter pharyngoplasty technique and the latest barbed repositioning pharyngoplasty (BRP). Thirty patients were retrospectively evaluated...
May 22, 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/28526545/obstructive-sleep-apnoea-and-right-ventricular-function-a-combined-assessment-by-speckle-tracking-and-three-dimensional-echocardiography
#7
Agostino Buonauro, Maurizio Galderisi, Ciro Santoro, Angelo Canora, Maria Luisa Bocchino, Francesco Lo Iudice, Maria Lembo, Roberta Esposito, Sabrina Castaldo, Bruno Trimarco, Alessandro Sanduzzi
BACKGROUND: Little is known on right ventricular (RV) involvement in obstructive sleep apnoea (OSA). This study aimed at evaluating early RV dysfunction by standard and advanced echocardiography in OSA. METHODS: Fifty-nine OSA patients without heart failure and 29 age-matched controls underwent standard, speckle tracking and real time 3D echocardiography of right ventricle. OSA patients performed lung function tests and overnight cardio-respiratory monitoring with evaluation of apnea-hypopnea index (AHI)...
May 4, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28522090/hearing-loss-mediates-executive-function-impairment-in-sleep-disordered-breathing
#8
Catherine M Hill, Romola S Bucks, Colin R Kennedy, Dawn Harrison, Annette Carroll, Nicolas Upton, Alexandra M Hogan
BACKGROUND: Sleep-disordered breathing (SDB) is often co-morbid with conductive hearing loss in early childhood due to a shared aetiology of adenotonsillar hypertrophy. Hearing loss is independently associated with impairment of executive function and behavioural difficulties. We hypothesised that these impairments in children with SDB may be mediated through hearing loss. METHODS: Fifty-eight children including 37 snorers awaiting adenotonsillectomy and 21 healthy non-snoring controls, aged 3-5 years, were assessed with pure tone audiometry, Strengths and Difficulties (SDQ), Behaviour Rating of Executive Function (BRIEF-P), and Childhood Middle Ear Disease and Hearing questionnaires...
June 2017: Sleep Medicine
https://www.readbyqxmd.com/read/28516964/barbed-reposition-pharyngoplasty-in-multilevel-robotic-surgery-for-obstructive-sleep-apnoea
#9
C Vicini, G Meccariello, G Cammaroto, M Rashwan, F Montevecchi
The surgical treatment of obstructive sleep apnoea in patients who are non-compliant with continuous positive airway pressure therapy still represents a valid alternative. In recent years, the multilevel approach is becoming more diffuse in routine surgical practice, especially since the introduction of transoral robotic surgery. Barbed reposition pharyngoplasty in multilevel robotic surgery for OSA may represent a valid option to surgically approach the soft palate. Herein, we describe the technique and preliminary results of our experience...
June 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/28504184/lessons-from-healthcare-utilization-in-children-with-obstructive-sleep-apnoea-syndrome
#10
Paz Martinez-Beneyto, Cristina E Soria Checa, Paloma Botella-Rocamora, Inés Rincon-Piedrahita, Francisco J Garcia Callejo, Jaime Marco Algarra
INTRODUCTION AND OBJECTIVES: Paediatric Obstructive Sleep Apnoea-Hypopnoea Syndrome (OSAS) is a multisystemic condition affecting child's health status that may be investigated analyzing demand for healthcare. OBJECTIVE: to quantify the frequency of medical consultations in children with OSAS over a 5-year period, compared to a healthy population. METHODS: A longitudinal, case-control, ambispective study was conducted at a hospital pertaining to the national public health system...
May 12, 2017: Acta Otorrinolaringológica Española
https://www.readbyqxmd.com/read/28503259/five-year-outcomes-of-laparoscopic-sleeve-gastrectomy-as-a-primary-procedure-for-morbid-obesity-a-prospective-study
#11
Carlos Hoyuela
AIM: To prospectively evaluate the postoperative morbi-mortality and weight loss evolution of patients who underwent a laparoscopic sleeve gastrectomy (LSG) as a primary bariatric procedure during 5 years of follow-up. METHODS: Since 2006, data from patients undergoing a highly restrictive primary LSG have been prospectively registered in a database and analysed. Preoperative co-morbid conditions, operating time, hospital stay, early and late complications rate and evolution of weight loss after 5 years of follow-up were analysed...
April 27, 2017: World Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28495359/gender-differences-in-obstructive-sleep-apnoea-insomnia-and-restless-legs-syndrome-in-adults-what-do-we-know-a-clinical-update
#12
REVIEW
Jenny Theorell-Haglöw, Christopher B Miller, Delwyn J Bartlett, Brendon J Yee, Hannah D Openshaw, Ronald R Grunstein
Research in sleep medicine over the last decades has involved a broad variety of sleep disorders in both men and women. Gender differences have been identified in sleep physiology as well as in the three most common sleep disorders: obstructive sleep apnoea (OSA), insomnia and restless legs syndrome (RLS). However, research on gender differences in sleep medicine appears limited. This clinical review aims to give an updated overview of gender differences, in relation to prevalence, clinical presentation, treatment and quality of life in OSA, insomnia and RLS...
March 27, 2017: Sleep Medicine Reviews
https://www.readbyqxmd.com/read/28493047/effects-of-cpap-in-patients-with-obstructive-apnoea-is-the-presence-of-allergic-rhinitis-relevant
#13
A Cisternas, F Aguilar, J M Montserrat, M Àvila, M Torres, A Iranzo, J Berenguer, I Vilaseca
PURPOSE: The aim of the study is to compare the effects of continuous positive airway pressure (CPAP) on the nasal cavities of patients with obstructive sleep apnoea (OSA) and with or without allergic rhinitis (AR/nonAR). METHODS: This paper is a prospective, longitudinal study. Thirty-four consecutive CPAP treatment-adherent patients with OSA (17 AR and 17 nonAR) were evaluated before and 2 months after treatment, by means of clinical (otorhinolaryngological symptoms, daytime sleepiness, overall and rhinoconjunctivitis-specific quality of life), anatomical (otorhinolaryngological examination), functional (auditory function, tubal function, nasal airflow, and mucociliary clearance), and biological variables (nasal cytology)...
May 10, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/28487061/the-spectrum-of-ambulatory-electrocardiographic-monitoring
#14
REVIEW
Harry G Mond
Since its introduction as a clinical investigative tool, the 12-lead electrocardiograph (ECG) has been the gold standard for recognition of cardiac arrhythmias. The resting 12-lead ECG, however, gives only a rhythm snapshot in time, whereas arrhythmias maybe short-lived, paroxysmal and even asymptomatic making documentation in many patients very difficult. To overcome this, ambulatory ECG monitoring has been developed as a means of recording the ECG in patients over a set period of time, whether it be short-, medium- or long-term...
April 13, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28485989/non-invasive-positive-airway-pressure-in-obesity-hypoventilation-syndrome-and-chronic-obstructive-pulmonary-disease-present-and-future-perspectives
#15
Victor R Ramírez-Molina, Francisco J Gómez-de-Terreros, Javier Barca-Durán, Juan F Masa
Obesity hypoventilation syndrome (OHS) is a sleep disorder that has acquired great importance worldwide because of its prevalence and association with obesity leading to increased morbidity and mortality with reduced quality of life. The primary feature is insufficient sleep-related ventilation, resulting in abnormally elevated arterial carbon dioxide pressure (PaCO2) during sleep and demonstration of daytime hypoventilation. There are three main mechanisms that can generate diurnal hypoventilation in obese patients: alteration of the respiratory mechanics secondary to obesity; central hypoventilation secondary to leptin resistance and sleep disorder with sleep hypoventilation and obstructive apnoeas, which can be potentially solved with the use of positive airway pressure: non-invasive ventilation (NIV) and continuous positive airway pressure (CPAP)...
May 9, 2017: COPD
https://www.readbyqxmd.com/read/28484904/is-obstructive-sleep-apnoea-related-to-neuropsychological-function-in-healthy-older-adults-a-systematic-review-and-meta-analysis
#16
REVIEW
Nathan Cross, Amit Lampit, Jonathon Pye, Ronald R Grunstein, Nathaniel Marshall, Sharon L Naismith
Previous systematic reviews and meta-analyses have identified cognitive deficits in adults with obstructive sleep apnoea (OSA). However, quantitative analysis of the association between OSA and neuropsychological performance has not been conducted specifically in older adults, for whom there is a greater risk of cognitive decline. We searched Medline, Embase and PsycINFO through August 2016 for studies describing associations between OSA and neuropsychological outcomes in people aged>50 years. Meta-analyses were performed on these studies for overall cognition and within cognitive domains...
May 8, 2017: Neuropsychology Review
https://www.readbyqxmd.com/read/28477347/p4-medicine-approach-to-obstructive-sleep-apnoea
#17
REVIEW
Diane C Lim, Kate Sutherland, Peter A Cistulli, Allan I Pack
P4 medicine is an evolving approach to personalized medicine. The four Ps offer a means to: Predict who will develop disease and co-morbidities; Prevent rather than react to disease; Personalize diagnosis and treatment; have patients Participate in their own care. P4 medicine is very applicable to obstructive sleep apnoea (OSA) because each OSA patient has a different pathway to disease and its consequences. OSA has both structural and physiological mechanisms with different clinical subgroups, different molecular profiles and different consequences...
May 5, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28477245/systematic-review-and-meta-analysis-of-outcomes-after-revisional-bariatric-surgery-following-a-failed-adjustable-gastric-band
#18
Alistair J Sharples, Vasileios Charalampakis, Markos Daskalakis, Abd A Tahrani, Rishi Singhal
INTRODUCTION: Laparoscopic adjustable gastric band (LAGB)-related complications have been reported in significant numbers of patients often leading to band removal. Increasingly revisional bariatric surgery (RBS) is offered, most commonly either band to Roux-en-Y gastric bypass (B-RYGB) or band to sleeve gastrectomy (B-SG). OBJECTIVES: We conducted a systematic review and meta-analysis of studies to evaluate the efficacy of RBS following failed LAGB. METHODS: Medline, Embase, The Cochrane Library and NHS Evidence were searched for English language studies assessing patients who had undergone LAGB and who subsequently underwent either B-RYGB or B-SG...
May 6, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28474248/a-potential-role-for-staphylococcal-and-streptococcal-superantigens-in-driving-skewing-of-tcr-v%C3%AE-subsets-in-tonsillar-hyperplasia
#19
Fiona J Radcliff, Fiona Clow, Murali Mahadevan, James Johnston, Thomas Proft, Richard G Douglas, John D Fraser
The TCR Vβ repertoire from patients with recurrent tonsillitis and/or tonsillar hyperplasia was examined to determine whether the TCR Vβ composition is suggestive of local superantigen activity and if so, whether it is associated with the presence of superantigen producing bacteria. Tonsil specimens were cultured aerobically to allow identification and isolation of the bacterial pathogens Staphylococcus aureus and Group A Streptococcus. TCR Vβ subset analysis of tonsil leucocytes was performed by flow cytometry...
May 4, 2017: Medical Microbiology and Immunology
https://www.readbyqxmd.com/read/28449886/a-novel-postal-based-approach-to-diagnosing-obstructive-sleep-apnoea-in-a-high-risk-population
#20
Benjamin Prudon, Joan Hughes, Sophie West
OBJECTIVE: More than 50% of patients with diabetic macular oedema (DMO) have obstructive sleep apnoea (OSA), but the majority remain undiagnosed. We used a four-channel device (ApneaLink [AL], ResMed, UK) to establish a remote postal-based diagnostic service for patients with DMO. Here we describe our experience. METHODS: Patients with DMO were invited to participate. Interested patients returned a free-post reply slip to the study team, who posted an AL with pictorial and written instructions to them...
May 2017: Sleep Medicine
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