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Pathophysiology of obstructive sleep apnea

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https://www.readbyqxmd.com/read/29047083/altered-redox-balance-in-the-development-of-chronic-hypoxia-induced-pulmonary-hypertension
#1
Nikki L Jernigan, Thomas C Resta, Laura V Gonzalez Bosc
Normally, the pulmonary circulation is maintained in a low-pressure, low-resistance state with little resting tone. Pulmonary arteries are thin-walled and rely heavily on pulmonary arterial distension and recruitment for reducing pulmonary vascular resistance when cardiac output is elevated. Under pathophysiological conditions, however, active vasoconstriction and vascular remodeling lead to enhanced pulmonary vascular resistance and subsequent pulmonary hypertension (PH). Chronic hypoxia is a critical pathological factor associated with the development of PH resulting from airway obstruction (COPD, sleep apnea), diffusion impairment (interstitial lung disease), developmental lung abnormalities, or high altitude exposure (World Health Organization [WHO]; Group III)...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28978212/overview-of-idiopathic-pulmonary-fibrosis-ipf-and-evidence-based-guidelines
#2
Roozbeh Sharif
Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive form of interstitial lung disease (ILD), characterized by fibrosis and worsening lung function, that primarily occurs in those 50 years and older. Various causes including genetic susceptibility, environmental risk factors, and exposures have been suggested in the literature. All of these cause repetitive micro-injury to the lung tissue and vasculature, which triggers a cascade of inflammatory response and fibrosis. Symptoms are nonspecific and most patients present several years after the initial radiographic changes occur...
July 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28966594/the-role-of-the-autonomic-nervous-system-in-the-pathophysiology-of-obesity
#3
REVIEW
Daniela Guarino, Monica Nannipieri, Giorgio Iervasi, Stefano Taddei, Rosa Maria Bruno
Obesity is reaching epidemic proportions globally and represents a major cause of comorbidities, mostly related to cardiovascular disease. The autonomic nervous system (ANS) dysfunction has a two-way relationship with obesity. Indeed, alterations of the ANS might be involved in the pathogenesis of obesity, acting on different pathways. On the other hand, the excess weight induces ANS dysfunction, which may be involved in the haemodynamic and metabolic alterations that increase the cardiovascular risk of obese individuals, i...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28964643/pathophysiology-evaluation-and-management-of-sleep-disorders-in-the-mucopolysaccharidoses
#4
REVIEW
David M Rapoport, John J Mitchell
The mucopolysaccharidoses (MPS) represent a heterogeneous group of lysosomal storage disorders, each one associated with a deficiency in one of the enzymes involved in glycosaminoglycan degradation. Sleep disorders are a frequent manifestation of all types of MPS. Underlying causes are diverse and comprised of both respiratory and central nervous system (CNS) abnormalities. Sleep disordered breathing such as obstructive sleep apnea and nocturnal hypoventilation can arise in patients with upper airway obstruction and/or with alterations in respiratory mechanics, causing restrictive pulmonary disease...
August 25, 2017: Molecular Genetics and Metabolism
https://www.readbyqxmd.com/read/28942270/tracking-dynamic-tongue-motion-in-ultrasound-images-for-obstructive-sleep-apnea
#5
Chih-Yen Chien, Jeng-Wen Chen, Chun-Hsiang Chang, Chih-Chung Huang
Obstructive sleep apnea (OSA), a breathing disorder characterized by repetitive collapse of the pharyngeal airway during sleep, can cause intermittent hypoxemia and frequent arousal. The evaluation of dynamic tongue motion not only provides the biomechanics and pathophysiology for OSA diagnosis, but also helps doctors to determine treatment strategies for these patients with OSA. The purpose of this study was to develop and verify a dedicated tracking algorithm, called the modified optical flow (OF)-based method, for monitoring the dynamic motion of the tongue base in ultrasound image sequences derived from controls and patients with OSA...
September 20, 2017: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/28935145/determinants-of-obstructive-sleep-apnea-syndrome-pro-inflammatory-state-and-dysfunction-of-high-density-lipoprotein
#6
Yusuf Karadeniz, Altan Onat, Tuğba Akbaş, Barış Şimşek, Hüsniye Yüksel, Günay Can
OBJECTIVE: The goal of this study was to determine variables preceding and predicting incident obstructive sleep apnea syndrome (OSAS) in the population at large. METHODS: Anthropometric, lipid, and non-lipid variables in participants with newly developing OSAS (n = 131) were compared with those of a cohort sample (n = 2615) of the Turkish Adult Risk Factor study. Available values preceding (by a median of 32 mo) the development of OSAS were used in multivariable Cox regression models...
November 2017: Nutrition
https://www.readbyqxmd.com/read/28934520/damage-of-inner-ear-sensory-hair-cells-via-mitochondrial-loss-in-a-murine-model-of-sleep-apnea-with-chronic-intermittent-hypoxia
#7
Young Joon Seo, Hyun Mi Ju, Sun Hee Lee, Sang Hyun Kwak, Min Jung Kang, Joo-Heon Yoon, Chang-Hoon Kim, Hyung-Ju Cho
Study Objectives: Investigating the exact pathophysiology of obstructive sleep apnea syndrome (OSAS)-induced hearing loss is critical. We sought to verify the hypothesis that a correlation exists between mitochondrial dysfunction in inner ear hair cells and the auditory dysfunction induced by chronic intermittent hypoxia (CIH) in a murine model of sleep apnea. Methods: C57BL/6J adult male mice were randomized to 4 weeks of CIH (n = 12) or normoxia (Sham) (n = 12)...
September 1, 2017: Sleep
https://www.readbyqxmd.com/read/28899520/cholinergic-neurotransmission-and-olfactory-function-in-obstructive-sleep-apnea-syndrome-a-tms-study
#8
Viviana Versace, Patrick B Langthaler, Luca Sebastianelli, Stefan Golaszewski, Alexander B Kunz, Francesco Brigo, Leopold Saltuari, Raffaele Nardone
BACKGROUND/OBJECTIVE: Odor identification and discrimination are reduced in subjects with obstructive sleep apnea syndrome (OSAS), but the pathophysiology of the olfactory dysfunction in OSAS is still poorly understood. Experimental evidence suggests that olfactory impairment could be related to central cholinergic dysfunction. Short latency afferent inhibition (SAI) is a paired-pulse transcranial magnetic stimulation (TMS) protocol that gives the opportunity to test an inhibitory cholinergic circuit in the human cerebral motor cortex...
September 2017: Sleep Medicine
https://www.readbyqxmd.com/read/28893610/sex-differences-in-the-respiratory-sympathetic-coupling-in-rats-exposed-to-chronic-intermittent-hypoxia
#9
REVIEW
George Miguel P R Souza, Mateus R Amorim, Davi J A Moraes, Benedito H Machado
Obstructive sleep apnea (OSA) is a complex disease in which humans face episodes of intermittent hypoxia and it affects men and women. Patients with OSA present hypertension and sympathetic overactivity among several other dysfunctions. Therefore, one important question remains: are the autonomic dysfunctions associated with OSA similar in male and female? This is an unresolved question since sex factors are overlooked in most clinical and experimental studies. Epidemiological data indicate that sex exerts an important influence in the prevalence of OSA and associated comorbidities, such as hypertension...
September 8, 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28892548/pediatric-obstructive-sleep-apnea-and-asthma-clinical-implications
#10
Michelle Trivedi, Mai ElMallah, Evan Bailey, Ted Kremer, Lawrence M Rhein
Obstructive sleep apnea (OSA) and asthma are common conditions in children with preventable long-term consequences. There is significant overlap in symptomatology and pathophysiology for pediatric OSA and asthma. Recent evidence supports clear associations between the two diseases; however, causality has not been demonstrated. Regardless, it is important to recognize the overlap and evaluate for the other condition when one is present. For example, in patients with severe OSA, clinical evaluation for asthma should be considered, including history for typical asthma symptoms and spirometry...
September 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28853425/obstructive-sleep-apnea-syndrome-osas-and-cardiovascular-system
#11
Carolina Lombardi, Eleonora Tobaldini, Nicola Montano, Anna Losurdo, Gianfranco Parati
There is increasing evidence of a relationship between Obstructive Sleep Apnea (OSA) and cardiovascular diseases. The strong association between OSA and arterial hypertension, in particular in patients with resistant hypertension and/or a non-dipping profile, has been extensively reported. The relationship between OSA and high blood pressure (BP) has been found independent from a number of confounders, but several factors may affect this relationship, including age and sex. It is thus important to better assess pathophysiologic and clinical interactions between OSA and arterial hypertension, also aimed at optimizing treatment approaches in OSA and hypertensive patients with co-morbidities...
August 28, 2017: La Medicina del Lavoro
https://www.readbyqxmd.com/read/28831208/evaluation-of-inflammatory-markers-in-a-large-sample-of-obstructive-sleep-apnea-patients-without-comorbidities
#12
Izolde Bouloukaki, Charalampos Mermigkis, Nikolaos Tzanakis, Eleftherios Kallergis, Violeta Moniaki, Eleni Mauroudi, Sophia E Schiza
Systemic inflammation is important in obstructive sleep apnea (OSA) pathophysiology and its comorbidity. We aimed to assess the levels of inflammatory biomarkers in a large sample of OSA patients and to investigate any correlation between these biomarkers with clinical and polysomnographic (PSG) parameters. This was a cross-sectional study in which 2983 patients who had undergone a polysomnography for OSA diagnosis were recruited. Patients with known comorbidities were excluded. Included patients (n = 1053) were grouped according to apnea-hypopnea index (AHI) as mild, moderate, and severe...
2017: Mediators of Inflammation
https://www.readbyqxmd.com/read/28827237/accuracy-and-reliability-of-the-sensory-test-performed-using-the-laryngopharyngeal-endoscopic-esthesiometer-and-rangefinder-in-patients-with-suspected-obstructive-sleep-apnoea-hypopnoea-protocol-for-a-prospective-double-blinded-randomised-exploratory-study
#13
Luis Fernando Giraldo-Cadavid, Alirio Rodrigo Bastidas, Diana Marcela Padilla-Ortiz, Diana Carolina Concha-Galan, María Angelica Bazurto, Leslie Vargas
INTRODUCTION: Patients with obstructive sleep apnoea hypopnoea syndrome (OSA) might have varying degrees of laryngopharyngeal mechanical hyposensitivity that might impair the brain's capacity to prevent airway collapse during sleep. However, this knowledge about sensory compromises in OSA comes from studies performed using methods with little evidence of their validity. Hence, the purpose of this study is to assess the reliability and accuracy of the measurement of laryngopharyngeal mechanosensitivity in patients with OSA using a recently developed laryngopharyngeal endoscopic esthesiometer and rangefinder (LPEER)...
August 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28826581/uncommon-causes-of-cerebral-microbleeds
#14
REVIEW
Nariman Noorbakhsh-Sabet, Varun Chandi Pulakanti, Ramin Zand
BACKGROUND: Cerebral microbleeds (CMBs) are small and round perivascular hemosiderin depositions detectable by gradient echo sequences or susceptibility-weighted imaging. Cerebral microbleeds are common among patients with hypertension, cerebral ischemia, or cerebral amyloid angiopathy. In this article, we describe uncommon causes of CMBs. METHODS: We searched Pubmed with the keyword CMBs for relevant studies and looked for different uncommon causes of CMBs. RESULTS: CMBs have several uncommon etiologies including posterior reversible encephalopathy syndrome, infective endocarditis, brain radiation therapy, cocaine abuse, thrombotic thrombocytopenic purpura, traumatic brain injury, intravascular lymphomatosis or proliferating angio-endotheliomatosis, moyamoya disease, sickle cell anemia/β-thalassemia, cerebral autosomal dominant arteriopathy subcortical infarcts, and leukoencephalopathy (CADASIL), genetic syndromes, or obstructive sleep apnea...
August 17, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28818154/physiology-based-modeling-may-predict-surgical-treatment-outcome-for-obstructive-sleep-apnea
#15
Yanru Li, Jingying Ye, Demin Han, Xin Cao, Xiu Ding, Yuhuan Zhang, Wen Xu, Jeremy Orr, Rachel Jen, Scott Sands, Atul Malhotra, Robert Owens
STUDY OBJECTIVES: To test whether the integration of both anatomical and nonanatomical parameters (ventilatory control, arousal threshold, muscle responsiveness) in a physiology-based model will improve the ability to predict outcomes after upper airway surgery for obstructive sleep apnea (OSA). METHODS: In 31 patients who underwent upper airway surgery for OSA, loop gain and arousal threshold were calculated from preoperative polysomnography (PSG). Three models were compared: (1) a multiple regression based on an extensive list of PSG parameters alone; (2) a multivariate regression using PSG parameters plus PSG-derived estimates of loop gain, arousal threshold, and other trait surrogates; (3) a physiological model incorporating selected variables as surrogates of anatomical and nonanatomical traits important for OSA pathogenesis...
September 15, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/28796527/role-of-leptin-in-obstructive-sleep-apnea
#16
Ikuyo Imayama, Bharati Prasad
Leptin is a peptide hormone mainly produced in white adipose tissue. It is known to regulate energy homeostasis, inflammation, metabolism, and sympathetic nerve activity. Increasing evidence suggests it has a role in ventilatory function and upper airway obstruction. Leptin levels correlate positively with measurements of adiposity and can potentially provide important insights into the pathophysiology of diseases associated with obesity. Obesity is a strong risk factor for obstructive sleep apnea, a disease characterized by periodic upper airway occlusion during sleep...
August 10, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28777180/sleep-wake-disorders-of-childhood
#17
Suresh Kotagal
PURPOSE OF REVIEW: Sleep-wake disorders occur in 10% to 28% of children and differ somewhat in pathophysiology and management from sleep-wake disorders in adults. This article discusses the diagnosis and management of key childhood sleep disorders. RECENT FINDINGS: The role of sleep in memory consolidation and in the facilitation of learning has been increasingly recognized, even at the toddler stage. Cataplexy, a key feature of narcolepsy type 1, may be subtle in childhood and characterized by transient muscle weakness isolated to the face...
August 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28774636/sleep-as-a-new-target-for-improving-outcomes-in-idiopathic-pulmonary-fibrosis
#18
REVIEW
Charalampos Mermigkis, Izolde Bouloukaki, Sophia E Schiza
Idiopathic pulmonary fibrosis (IPF) is the most common type of interstitial pneumonia but remains a disease with a poor outcome. Two drugs, pirfenidone and nintedanib, have shown promising results at stalling disease progression; however, the interplay of sleep disruption or sleep disorders overall and in relation to medication effectiveness remains understudied. In the past, there was limited interest in the role of sleep in patients with IPF. Treating physicians tended to address only the daily disabling symptoms while disregarding the possible significant role of sleep alterations or coexisting sleep disorders...
August 1, 2017: Chest
https://www.readbyqxmd.com/read/28767909/association-of-subclinical-inflammation-glycated-hemoglobin-and-risk-for-obstructive-sleep-apnea-syndrome
#19
Carolina Vicaria Rodrigues D'Aurea, Bruno Gion de Andrade Cerazi, Antonio Gabriele Laurinavicius, Carolina Castro Porto Silva Janovsky, Raquel Dilguerian de Oliveira Conceição, Raul D Santos, Márcio Sommer Bittencourt
Objective: To investigate the inter-relation between high sensitivity C-reactive protein and glycated hemoglobin in prediction of risk of obstructive sleep apnea. Methods: We included all individuals participating in a check-up program at the Preventive Medicine Center of Hospital Israelita Albert Einstein in 2014. The Berlin questionnaire for risk of obstructive sleep apnea was used, and the high sensitivity C-reactive protein and glycated hemoglobin levels were evaluated...
April 2017: Einstein
https://www.readbyqxmd.com/read/28738382/advanced-concepts-in-the-pathophysiology-of-obstructive-sleep-apnea
#20
David P White
The primary pathological event in the disorder obstructive sleep apnea (OSA) is the partial or complete closure of the pharyngeal airway during sleep in an individual with a widely patent airway during wakefulness. This yields an apnea or hypopnea with resulting hypoxia and hypercapnia, and most often requires an arousal to terminate the event. These events occur in a repetitive manner during sleep, yielding intermittent hypoxia and sleep fragmentation with their associated adverse effects on the health and quality of life of the afflicted individual...
2017: Advances in Oto-rhino-laryngology
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