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Pathophysiology of obstructive sleep apnea

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https://www.readbyqxmd.com/read/28218220/establishment-of-a-rabbit-model-of-chronic-obstructive-sleep-apnea-and-application-in-cardiovascular-consequences
#1
Li-Fang Xu, Xiu-Fang Zhou, Ke Hu, Si Tang, Yu-Chuan Luo, Wen Lu
BACKGROUND: Although obstructive sleep apnea (OSA) has been recognized as a major risk factor for cardiovascular complications and its clinical features are well characterized, it is difficult to replicate the OSA hypoxic model in humans. We aimed to establish an experimental rabbit model for chronic OSA and to explore its application to measure blood pressure (BP), myocardial systolic function, and oxidative stress. METHODS: The rabbit model for OSA was established by repeatedly closing the airway and then reopening it...
2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28215270/decreased-cerebral-vasomotor-reactivity-in-patients-with-obstructive-sleep-apnea-syndrome
#2
Oguzhan Oz, Serdar Tasdemir, Hakan Akgun, Murat Erdem, Adem Balikci, Ahmet Cetiz, Mehmet Yucel, Umit Hidir Ulas, Seref Demirkaya, Yasar Kutukcu, Fuat Özgen
OBJECTIVE: In obstructive sleep apnea syndrome (OSAS), any of the activated neural, vascular, hemodynamic, metabolic, inflammatory, and thrombotic mechanisms may be related to increased cerebrovascular disease and risk of death; however, the possible pathophysiological process between obstructive sleep apnea syndrome and stroke has not been clearly explained. We hypothesize that alterations in vasomotor reactivity in patients may be responsible for their altered cerebral blood flow, and may contribute to the increased risk of ischemic stroke...
February 2017: Sleep Medicine
https://www.readbyqxmd.com/read/28213776/the-importance-of-drug-induced-sedation-endoscopy-d-i-s-e-techniques-in-surgical-decision-making-conventional-versus-target-controlled-infusion-techniques-a-prospective-randomized-controlled-study-and-a-retrospective-surgical-outcomes-analysis
#3
Andrea De Vito, Vanni Agnoletti, Gianluca Zani, Ruggero Massimo Corso, Giovanni D'Agostino, Elisabetta Firinu, Chiara Marchi, Ying-Shuo Hsu, Stefano Maitan, Claudio Vicini
Drug-Induced Sedation Endoscopy (DISE) consists of the direct observation of the upper airways during sedative-induced sleep, allowing the identification of the sites of pharyngeal collapse, which is the main pathological event in Obstructive Sleep Apnea (OSA). The Authors have compared Target Controlled Infusion (TCI) sedation endoscopy (TCI-DISE) technique to conventional DISE (CDISE), performed by a manual bolus injection of sedative agent, to recreate accurately and safely snoring and apnea patterns comparable to natural sleep...
February 17, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28169105/current-evidence-on-prevalence-and-clinical-outcomes-of-co-morbid-obstructive-sleep-apnea-and-chronic-obstructive-pulmonary-disease-a-systematic-review
#4
REVIEW
Md Shajedur R Shawon, Jennifer L Perret, Chamara V Senaratna, Caroline Lodge, Garun S Hamilton, Shyamali C Dharmage
The objective of this systematic review is to synthesize the evidence on prevalence, polysomnographic findings and clinical outcomes of co-morbid obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD) - known as the "overlap syndrome". We systematically searched PubMed on 1 December 2015 using appropriate medical subject headings (MeSH) and text words to capture prevalence studies and comparative studies of any observational design examining the clinical outcomes in patients with co-existent COPD and OSA...
April 2017: Sleep Medicine Reviews
https://www.readbyqxmd.com/read/28167000/urine-cysteinyl-leukotriene-levels-in-children-with-sleep-disordered-breathing-before-and-after-adenotonsillectomy
#5
A Satdhabudha, P Sritipsukho, S Manochantr, W Chanvimalueng, U Chaumrattanakul, P Chaumphol
OBJECTIVES: Obstructive sleep apnea (OSA) is a common problem in children and is associated with increased cardiovascular, neurobehavioral and somatic growth consequences. Cysteinyl leukotrienes (CysLTs) play a major role with local and systemic relations to the pathophysiology of OSA. The level of CysLTs in urine, blood, exhaled breath and adenotonsillar tissue of OSA children are increased. However it remains unclear whether inflammatory marker levels are alleviated after adenotonsillectomy...
March 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28154583/renal-denervation-for-chronic-heart-failure-background-and-pathophysiological-rationale
#6
REVIEW
Michael Böhm, Sebastian Ewen, Felix Mahfoud
The activation of the sympathetic nervous system is associated with cardiovascular hospitalizations and death in heart failure. Renal denervation has been shown to effectively reduce sympathetic overdrive in certain patients with uncontrolled hypertension. Pilot trials investigating renal denervation as a potential treatment approach for heart failure were initiated. Heart failure comorbidities like obstructive sleep apnea, metabolic syndrome and arrhythmias could also be targets for renal denervation, because these occurrences are also mediated by the activation of the sympathetic nervous system...
January 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/28126503/-pathophysiology-of-obstructive-sleep-apnea-syndrome-and-its-cardiometabolic-consequences
#7
Marie Destors, Renaud Tamisier, Louis-Marie Galerneau, Patrick Lévy, Jean-Louis Pepin
Obstructive sleep apnoea syndrome (OSAS) is characterized by recurrent partial or complete pharyngeal collapses during sleep. The pathophysiology of OSAS is complex and multifactorial. Factors influencing upper airway patency include a reduction in upper airway dimensions that can result from both anatomical and functional alterations (obesity, fluid shift or maxillo-facial structural changes), and increased pharyngeal collapsibility owing to reduced neuromuscular compensation and lack of the pharyngeal protective reflex during sleep...
January 23, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28121361/the-role-of-oxidative-stress-in-the-relation-between-fibromyalgia-and-obstructive-sleep-apnea-syndrome
#8
T Yildirim, R Alp
OBJECTIVE: The aim of this study is to examine the involvement of oxidative and antioxidative parameters and to evaluate the relation between fibromyalgia (FMS) and obstructive sleep apnea syndrome (OSAS). PATIENTS AND METHODS: Oxidative stress was determined by measuring the levels of malondialdehyde (MDA) and antioxidative parameters (superoxide dismutase [SOD], catalase [CAT], and glutathione peroxidase [GPx]) in 131 randomly selected patients with OSAS. The control group was composed of 129 subjects with no clinical OSAS symptoms...
January 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28118867/quantifying-airflow-limitation-and-snoring-during-sleep
#9
REVIEW
Erna Sif Arnardottir, Thorarinn Gislason
Traditional techniques to assess respiratory disturbances during sleep allow the accurate diagnosis of moderate and severe cases of obstructive sleep apnea but have serious limitations in mild obstructive sleep apnea and cases with signs of obstructive breathing during sleep without apneas and hypopneas. This article describes advantages and limitations of available techniques to measure obstructive breathing during sleep by measuring flow limitation, respiratory effort, and snoring. Standardization of these techniques is crucial for moving the field further and understanding the pathophysiologic role of obstructive breathing itself, and not solely focusing on the associated outcomes of arousals and oxygen desaturations...
December 2016: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/28076341/risk-factors-for-post-coronary-artery-bypass-graft-atrial-fibrillation-role-of-obstructive-sleep-apnea
#10
Amro Qaddoura, Adrian Baranchuk
In this chapter, we start by discussing coronary artery bypass grafting and the most common complication after surgery – post coronary artery bypass grafting atrial fibrillation (PCAF). We then discuss the major risk factors for PCAF, and subsequently conduct an in-depth discussion of obstructive sleep apnea as a risk factor. In this endeavor, we outline how obstructive sleep apnea is diagnosed, its pathophysiological relationship to PCAF, and recent clinical studies investigating the association between obstructive sleep apnea and PCAF...
December 21, 2016: Medwave
https://www.readbyqxmd.com/read/28068279/identifying-predictors-of-central-sleep-apnea-cheyne-stokes-breathing-in-chronic-heart-failure-a-pathophysiological-approach
#11
Aneliya I Draganova, Kiril V Terziyski, Stefan S Kostianev
Chronic heart failure (CHF) is a major health problem associated with increased mortality, despite modern treatment options. Central sleep apnea (CSA)/Cheyne-Stokes breathing (CSB) is a common and yet largely under-diagnosed co-morbidity, adding significantly to the poor prognosis in CHF because of a number of acute and chronic effects, including intermittent hypoxia, sympathetic overactivation, disturbed sleep architecture and impaired physical tolerance. It is characterized by repetitive periods of crescendo-decrescendo ventilatory pattern, alternating with central apneas and hypopneas...
December 1, 2016: Folia Medica
https://www.readbyqxmd.com/read/28060323/a-model-to-simulate-clinically-relevant-hypoxia-in-humans
#12
Lars Eichhorn, Florian Kessler, Volker Böhnert, Felix Erdfelder, Anja Reckendorf, Rainer Meyer, Richard K Ellerkmann
In case of apnea, arterial partial pressure of oxygen (pO2) decreases, while partial pressure of carbon dioxide (pCO2) increases. To avoid damage to hypoxia sensitive organs such as the brain, compensatory circulatory mechanisms help to maintain an adequate oxygen supply. This is mainly achieved by increased cerebral blood flow. Intermittent hypoxia is a commonly seen phenomenon in patients with obstructive sleep apnea. Acute airway obstruction can also result in hypoxia and hypercapnia. Until now, no adequate model has been established to simulate these dynamics in humans...
December 22, 2016: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28040290/obstructive-sleep-and-atrial-fibrillation-pathophysiological-mechanisms-and-therapeutic-implications
#13
REVIEW
Christos A Goudis, Dimitrios G Ketikoglou
Atrial fibrillation (AF) is the commonest arrhythmia in clinical practice and is associated with increased cardiovascular morbidity and mortality. Obstructive sleep apnea (OSA), a common breathing disorder, is an independent risk factor for AF. Several pathophysiological mechanisms, including apnea-induced hypoxia, intrathoracic pressure shifts, sympathovagal imbalance, atrial remodeling, oxidative stress, inflammation and neurohumoral activation have been implicated in the occurrence of AF in OSA patients...
March 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27994605/the-triad-of-sleep-apnea-hypertension-and-chronic-kidney-disease-a-spectrum-of-common-pathology
#14
REVIEW
Fahad Aziz, Kunal Chaudhary
Obstructive sleep apnea (OSA), hypertension, and chronic kidney disease (CKD) are different entities and are generally managed individually most of the time. However, CKD, OSA, and hypertension share many common risk factors and it is not uncommon to see this complex triad together. In fact, they share similar pathophysiology and have been interlinked with each other. The common pathophysiology includes chronic volume overload, hyperaldosteronism, increased sympathetic activity, endothelial dysfunction, and increased inflammatory markers...
November 2016: Cardiorenal Medicine
https://www.readbyqxmd.com/read/27965894/bariatric-surgery-polycystic-ovary-syndrome-and-infertility
#15
REVIEW
James Butterworth, Jean Deguara, Cynthia-Michelle Borg
Background. Polycystic ovary syndrome (PCOS) is the commonest cause of female infertility. Visceral obesity and insulin resistance are key pathophysiological mechanisms behind PCOS. Women suffering from this syndrome and infertility often seek bariatric surgery hoping that they would be able to conceive postoperatively. Objective. At present, there is no consensus on the role of bariatric surgery in the management of PCOS-associated infertility within the medical community, making it difficult to give specific advice to these women, so a review of the literature was necessary...
2016: Journal of Obesity
https://www.readbyqxmd.com/read/27938623/-personalized-combined-modality-therapy-based-on-pathophysiology-of-obstructive-sleep-apnea-hypopnea-syndrome
#16
Y Q Zhou, J Y Ye
No abstract text is available yet for this article.
November 7, 2016: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
https://www.readbyqxmd.com/read/27931299/association-of-allergy-immunology-and-obstructive-sleep-apnea
#17
Charles J Calais, Brian D Robertson, Douglas E Beakes
Obstructive sleep apnea (OSA) is characterized by repetitive upper airway collapse that results in nonrefreshing sleep, excessive daytime sleepiness, and, ultimately, adverse consequences on quality of life, the cardiovascular system, and neurocognitive performance. OSA has traditionally been linked to body habitus (obesity and increased neck circumference), racial demographics, alcohol, tobacco, and sedative use. Numerous other conditions are linked to OSA, which may have clinical relevance. Specifically, asthma and nasal obstructive syndromes, e...
November 2016: Allergy and Asthma Proceedings:
https://www.readbyqxmd.com/read/27908527/-historical-review-on-obstructive-sleep-apnea-in-children
#18
Y H Chien, C Guilleminault
An historical review on the discoveries on pediatric obstructive sleep apnea syndrome and sleep-disordered breathing is outlined. Starting with the description by Dickens of "Joe" the obese, snoring and sleepy individual, the authors trace more than 50 years of questions and research starting with the lean adult to the child and from the recognition of obstructive sleep apnea syndrome to the outline of upper-airway resistance syndrome. The pathophysiological knowledge on sleep-disordered breathing has evolved over time, as have treatment approaches in children, from tracheostomy to positive-airway-pressure therapy, to adenotonsillectomy with and without orthodontic treatments to oral-facial myofunctional therapy...
November 28, 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/27861433/understanding-phenotypes-of-obstructive-sleep-apnea-applications-in-anesthesia-surgery-and-perioperative-medicine
#19
Yamini Subramani, Mandeep Singh, Jean Wong, Clete A Kushida, Atul Malhotra, Frances Chung
Obstructive sleep apnea (OSA) is a prevalent sleep-disordered breathing with potential long-term major neurocognitive and cardiovascular sequelae. The pathophysiology of OSA varies between individuals and is composed of different underlying mechanisms. Several components including the upper airway anatomy, effectiveness of the upper airway dilator muscles such as the genioglossus, arousal threshold of the individual, and inherent stability of the respiratory control system determine the pathogenesis of OSA...
January 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27857764/dimensional-and-volumetric-analysis-of-the-oropharyngeal-region-in-obstructive-sleep-apnea-patients-a-cone-beam-computed-tomography-study
#20
Tripti Tikku, Rohit Khanna, Kiran Sachan, Akhil Agarwal, Kamna Srivastava, Anubha Lal
BACKGROUND: Obstructive Sleep Apnea (OSA) is a potentially life-threatening condition in which there is a periodic cessation of breathing (for 10 sec or longer) that occurs during sleep in the presence of inspiratory effort. The aim of the study was to assess volumetric and dimensional differences between OSA patients and normal individuals in the upright posture. MATERIAL AND METHOD: The present study was conducted on CBCT scans of 32 patients who were divided into two groups -Group I (control group) and Group II (OSA subjects)...
September 2016: Dental Research Journal
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