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Mollie McDermott, Devin L Brown, Ronald D Chervin
Stroke is a major cause of disability and death in the United States and across the world, and the incidence and prevalence of stroke are expected to rise significantly due to an aging population. Obstructive sleep apnea, an established independent risk factor for stroke, is a highly prevalent disease that is estimated to double the risk of stroke. It remains uncertain whether non-apnea sleep disorders increase the risk of stroke. Areas covered: This paper reviews the literature describing the association between incident stroke and sleep apnea, REM sleep behavior disorder, restless legs syndrome, periodic limb movements of sleep, insomnia, and shift work...
June 14, 2018: Expert Review of Neurotherapeutics
Laura Ellwein Fix, Joseph Khoury, Russell R Moores, Lauren Linkous, Matthew Brandes, Henry J Rozycki
Non-invasive ventilation is increasingly used for respiratory support in preterm infants, and is associated with a lower risk of chronic lung disease. However, this mode is often not successful in the extremely preterm infant in part due to their markedly increased chest wall compliance that does not provide enough structure against which the forces of inhalation can generate sufficient pressure. To address the continued challenge of studying treatments in this fragile population, we developed a nonlinear lumped-parameter respiratory system mechanics model of the extremely preterm infant that incorporates nonlinear lung and chest wall compliances and lung volume parameters tuned to this population...
2018: PloS One
Toritseju Oluwafunmilayo Sillo, Simon Lloyd-Owen, Emma White, Karen Abolghasemi-Malekabadi, Penny Lock-Pullan, Muhammed Ali, Anthony Perry, Steven John Robinson, Martin Stuart Wadley
OBJECTIVE: Obesity is associated with a high incidence of obstructive sleep apnoea (OSA). Bariatric surgery is postulated to lead to OSA resolution, but there is inconclusive evidence on its efficacy. We used objective measurements to determine the rate of resolution or improvement of OSA in patients who had bariatric procedures in our unit. RESULTS: Data was analysed on all patients with OSA who underwent bariatric procedures [laparoscopic Roux-en-Y gastric bypass (LRYGB) and sleeve gastrectomy (LSG)] between June 2012 and September 2016 in our unit...
June 14, 2018: BMC Research Notes
Kristen D Pitts, Alberto A Arteaga, Elliot T Hardy, Ben P Stevens, Christopher S Spankovich, Andrea F Lewis
BACKGROUND: Nasal congestion and obstruction are reported in the majority of continuous positive airway pressure (CPAP) users and are frequently cited as reasons for noncompliance. To our knowledge, no study has demonstrated a change in objective or subjective nasal patency in patients with obstructive sleep apnea (OSA) after a therapeutic trial of CPAP therapy. METHODS: This prospective nonrandomized trial tested the hypothesis that CPAP therapy would result in both objective and subjective improvements in nasal patency in patients with OSA...
June 13, 2018: International Forum of Allergy & Rhinology
Abdelnaby Khalyfa, David Gozal, Juan F Masa, José Maria Marin, Zhuanghong Qiao, Jaime Corral, Mónica González, Sergi Marti, Leila Kheirandish-Gozal, Carlos Egea, M-Ángeles Sánchez-Quiroga, Francisco J Gómez de Terreros, F Javier Barca
BACKGROUND: Sleep-disordered-breathing (SDB), which is characterized by chronic intermittent hypoxia (IH) and sleep fragmentation (SF), is a prevalent condition that promotes metabolic dysfunction, particularly among patients suffering from obstructive hypoventilation syndrome (OHS). Exosomes are generated ubiquitously, are readily present in the circulation, and their cargo may exert substantial functional cellular alterations in both physiological and pathological conditions. However, the effects of plasma exosomes on adipocyte metabolism in patients with OHS or in mice subjected to IH or SF mimicking SDB are unclear...
June 11, 2018: International Journal of Obesity: Journal of the International Association for the Study of Obesity
Nicholas-Tiberio Economou, Ioannis Ilias, Lemonia Velentza, Yiannis Papachatzakis, Paul Zarogoulidis, Anastasios Kallianos, Georgia Trakada
Patients with Chronic Obstructive Pulmonary Disease (COPD) and / or Obstructive Sleep Apnea (OSA) often complain about sleepiness, fatigue, anxiety and depression. However, common screening questionnaires, like Epworth Sleepiness Scale (ESS), Fatigue Severity Scale (FSS) and Hospital Anxiety and Depression Scale (HADS) have not been previous evaluated in patients with overlap-coexisting COPD and OSA-syndrome versus patients with OSA alone. Our study compared ESS, FSS and HADS between patients with overlap syndrome and patients with OSA, before and after treatment with Continuous Positive Airways Pressure (CPAP)...
2018: PloS One
Luis Perez-Baena, Martí Pons-Òdena
Altough the literature data and meta-analysis reported that NIV strategies, nasal intermittent positive pressure ventilation (N-IPPV) and Bi-level-NCPAP (BiPAP), has a better respiratory outcome than n-CPAP in neonatal respiratory distress syndrome, it is possible that the interpretation is not entirely accurate. Salvo et al. found that the incidence of NIV failure was significantly higher in the N-CPAP group versus N-SIPPV/BiPAP groups in infants with RDS. Nevertheless MAP was significantly higher in N-SIPPV group when compared to N-CPAP and BiPAP group (p < 0,05 in both) and MAP in the BiPAP group was significantly higher than N-CPAP group (p < 0,05)...
June 11, 2018: Journal of Maternal-fetal & Neonatal Medicine
Neidin Bussmann, Colm Breatnach, Philip T Levy, Naomi McCallion, Orla Franklin, Afif El-Khuffash
OBJECTIVE: To test if diastolic dysfunction measured on day one of age is associated with the need for invasive ventilation in preterm infants. STUDY DESIGN: We conducted a retrospective observational tissue Doppler echocardiographic study over the first 12 h of age for infants born <32 weeks who were invasively ventilated, and infants on continuous positive pressure ventilation (CPAP). RESULTS: One hundred and eighty-three infants were included (27 ± 2 weeks and 999 ± 296 g)...
June 11, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
X R Yang, R Ren, X Li, J M He, X F Xue, Y Zhang, F Lei, X D Tang, L H Yang
Objective: To investigate the effects of continuous positive airway pressure (CPAP) on periodic limb movements during sleep (PLMS) in patients with obstructive sleep apnea (OSA). Methods: The polysomnography (PSG) data of 828 consecutive OSA outpatients from January 2015 to January 2017 who had undergone overnight CPAP titration were analyzed retrospectively. On the basis of changes in periodic limb movements index (PLMI) values (cut off level≥15/h) from baseline PSG (BPSG) to CPAP titration PSG, patients were assigned to one of the following four groups: persistent, CPAP-emergent, CPAP-disappeared, and non-PLMS...
May 29, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Esther Sapiña, Gerard Torres, Ferran Barbé, Manuel Sánchez-de-la-Torre
PURPOSE OF REVIEW: The significant prevalence of resistant hypertension (RH) and the high cardiovascular risk of the population of patients with RH have indicated the necessity to identify its main causes. Among these, obstructive sleep apnea (OSA) is considered the most well-established cause. RECENT FINDINGS: In recent years, several studies have shown a beneficial effect of continuous positive airway pressure (CPAP) treatment on blood pressure (BP), but this effect exhibits great variability...
June 8, 2018: Current Hypertension Reports
Virend Somers, Michael Arzt, T Douglas Bradley, Winfried Randerath, Renaud Tamisier, Christine Won
As seen in this CME online activity (available at, central sleep apnea (CSA) is associated with increased mortality in patients with heart failure (HF), and it has been thought that treatment of CSA may improve underlying HF. Positive airway pressure therapy, specifically auto-servoventilation (ASV), can not only suppress abnormal breathing patterns but has been reported to improve cardiac function in HF patients with CSA. In patients with HF and with CSA unsuppressed with CPAP, newer ASV use has been associated with significant CSA improvement; in addition, several studies have reported efficacy of ASV in the treatment of underlying cardiac dysfunction in HF patients with CSA...
June 2018: Chest
Ludovico Messineo, Luigi Taranto-Montemurro, Ali Azarbarzin, Melania D Oliveira Marques, Nicole Calianese, David P White, Andrew Wellman, Scott A Sands
Background Increased "loop gain" of the ventilatory control system promotes obstructive sleep apnea (OSA) in some patients and offers an avenue for more personalized treatment, yet diagnostic tools for directly measuring loop gain in the clinical setting are lacking. Here we test the hypothesis that elevated loop gain during sleep can be recognized using voluntary breath-hold maneuvers during wakefulness. Methods Twenty individuals (10 OSA, 10 controls) participated in a single overnight study with voluntary breath-holding maneuvers performed during wakefulness...
June 7, 2018: Journal of Physiology
Alessandro Perri, Riccardo Riccardi, Rossella Iannotta, Domenico V Di Molfetta, Roberta Arena, Giovanni Vento, Enrico Zecca
OBJECTIVES: We aim to verify the diagnostic accuracy of a lung ultrasonography (LUS) score to early predict the need for surfactant therapy in newborns with respiratory distress syndrome (RDS), and to compare it with a chest X-ray score. METHODS: In this prospective diagnostic accuracy study we included all newborns admitted for respiratory distress and initially treated with nasal CPAP. LUS was performed within 2 h from nasal CPAP positioning and in any case before surfactant administration...
June 5, 2018: Pediatric Pulmonology
Marie Joyeux-Faure, Jean-Philippe Baguet, Gilles Barone-Rochette, Patrice Faure, Philippe Sosner, Claire Mounier-Vehier, Patrick Lévy, Renaud Tamisier, Jean-Louis Pépin
Objective: Most patients with resistant hypertension (RH) have obstructive sleep apnea (OSA). We aimed to determine the impact of OSA and continuous positive airway pressure (CPAP) treatment on the leptin profile and blood pressure (BP) in patients with RH. Methods: After an initial case-control study (RH with and without OSA), we performed a randomized, single blind study in OSA + RH patients receiving either sham CPAP (3 months) followed by active CPAP (6 months) or 6 months of active CPAP...
2018: Frontiers in Neurology
Dominik Roth, Johannes Mayer, Wolfgang Schreiber, Harald Herkner, Anton N Laggner
Carbon monoxide (CO) is a leading cause of morbidity and mortality. Treatment focuses on the rapid elimination of CO and management of hypoxia. Oxygen is the cornerstone of therapy, and usually applied via a reservoir face mask. Hyperbaric oxygen therapy eliminates CO faster, but requires extensive equipment and expertise. Non-invasive continuous positive airway pressure (CPAP) ventilation using a tight mask provides a higher inspired fraction of oxygen (FiO2 ) compared to a reservoir face mask, and increases gas exchange...
May 29, 2018: American Journal of Emergency Medicine
Padmanabhan Ramnarayan, Paula Lister, Troy Dominguez, Parviz Habibi, Naomi Edmonds, Ruth R Canter, Jerome Wulff, David A Harrison, Paul M Mouncey, Mark J Peters
BACKGROUND: Although high-flow nasal cannula therapy (HFNC) has become a popular mode of non-invasive respiratory support (NRS) in critically ill children, there are no randomised controlled trials (RCTs) comparing it with continuous positive airway pressure (CPAP). We performed a pilot RCT to explore the feasibility, and inform the design and conduct, of a future large pragmatic RCT comparing HFNC and CPAP in paediatric critical care. METHODS: In this multi-centre pilot RCT, eligible patients were recruited to either Group A (step-up NRS) or Group B (step-down NRS)...
June 4, 2018: Critical Care: the Official Journal of the Critical Care Forum
Marius Lebret, Nathalie Arnol, Jean-Benoît Martinot, Renaud Tamisier, Chrystèle Deschaux, Jean-Louis Pépin, Jean-Christian Borel
Nasal obstruction is frequently reported by patients with sleep apnea and complicates the choice of a nasal or oronasal mask for continuous positive airway pressure (CPAP) therapy. However, the type of interface used for the delivery of CPAP is crucial to ensure tolerance and compliance. The aim of this prospective pilot study was to identify whether the validated Nasal Obstruction Symptom Evaluation (NOSE) score rated at CPAP initiation was associated with the type of mask used after 4 months of treatment...
June 1, 2018: Otolaryngology—Head and Neck Surgery
Maisi Muniz Cabral David, Evelim Leal de Freitas Dantas Gomes, Maryjose Carvalho Mello, Dirceu Costa
BACKGROUND: Asthma is characterized by hyperresponsiveness of the airways, and exercise-induced bronchospasm (EIB) is a symptom that limits a large proportion of asthmatic patients, especially children. Continuous positive airway pressure (CPAP) leads to a reduction in the reactivity of the airways. The aim of this study was to evaluate the effect of outpatient treatment with CPAP and bilevel pressure combined with respiratory physical therapy for children and adolescents with asthma following bronchial hyperresponsiveness caused by an exercise bronchoprovocation test...
January 2018: Therapeutic Advances in Respiratory Disease
Montaha Al-Iede, Radhagini Kumaran, Karen Waters
OBJECTIVES: A number of reports exist regarding the use of continuous positive airway pressure (CPAP) to manage obstructive sleep apnoea (OSA) in children, which we term 'conventional CPAP'. In contrast, there are few reports of home CPAP use for other indications, which we have grouped under the term 'cardiopulmonary'. The aims of this study were to (1) document cardiopulmonary indications for CPAP use in a cohort of infants and children, and (2) evaluate its effectiveness in this group...
April 30, 2018: Sleep Medicine
Sandeep Narayan Lal, Jacob M Puliyel
No abstract text is available yet for this article.
May 15, 2018: Indian Pediatrics
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