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Pathophysiology of obstructive sleep apnea

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https://www.readbyqxmd.com/read/28076341/risk-factors-for-post-coronary-artery-bypass-graft-atrial-fibrillation-role-of-obstructive-sleep-apnea
#1
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
#2
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
#3
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
#4
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...
December 22, 2016: 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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
https://www.readbyqxmd.com/read/27817003/obstructive-ventilatory-disorder-in-heart-failure-caused-by-the-heart-or-the-lung
#12
REVIEW
Sergio Caravita, Jean-Luc Vachiéry
Heart failure (HF) is a clinical syndrome frequently associated with airway obstruction, either as a respiratory comorbidity or as a direct consequence of HF pathophysiology. Recognizing the relative contribution of an underlying airway disease as opposed to airway obstruction due to volume overload and left atrial pressure elevation is of importance for the appropriate management of patients affected by HF. This review focuses on "les liaisons dangereuses" between the heart and the lungs, outlying recent advances linking in a vicious circle of chronic obstructive lung disease (COPD) and obstructive sleep apnea (OSA) on one side and HF on the other side...
December 2016: Current Heart Failure Reports
https://www.readbyqxmd.com/read/27815038/phenotypes-in-obstructive-sleep-apnea-a-definition-examples-and-evolution-of-approaches
#13
REVIEW
Andrey V Zinchuk, Mark J Gentry, John Concato, Henry K Yaggi
Obstructive sleep apnea (OSA) is a complex and heterogeneous disorder and the apnea hypopnea index alone can not capture the diverse spectrum of the condition. Enhanced phenotyping can improve prognostication, patient selection for clinical trials, understanding of mechanisms, and personalized treatments. In OSA, multiple condition characteristics have been termed "phenotypes." To help classify patients into relevant prognostic and therapeutic categories, an OSA phenotype can be operationally defined as: "A category of patients with OSA distinguished from others by a single or combination of disease features, in relation to clinically meaningful attributes (symptoms, response to therapy, health outcomes, quality of life)...
October 12, 2016: Sleep Medicine Reviews
https://www.readbyqxmd.com/read/27810186/cortical-afferent-inhibition-reflects-cognitive-impairment-in-obstructive-sleep-apnea-syndrome-a-tms-study
#14
Raffaele Nardone, Jürgen Bergmann, Francesco Brigo, Yvonne Höller, Kerstin Schwenker, Cristina Florea, Alexander B Kunz, Stefan Golaszewski, Eugen Trinka
OBJECTIVES: Patients with obstructive sleep apnea syndrome (OSAS) show neurocognitive impairment, but the exact mechanisms that cause cognitive dysfunctions remain unknown. The cholinergic system is known to play a key role in all attentional processes and cognitive functions. A transcranial magnetic stimulation (TMS) protocol may give direct information about the function of some cholinergic circuits in the human brain; this technique relies on short latency afferent inhibition (SAI) of the motor cortex...
August 2016: Sleep Medicine
https://www.readbyqxmd.com/read/27800512/chronic-intermittent-hypoxia-and-obstructive-sleep-apnea-an-experimental-and-clinical-approach
#15
REVIEW
Emilia Sforza, Fréderic Roche
Obstructive sleep apnea (OSA) is a prevalent sleep disorder considered as an independent risk factor for cardiovascular consequences, such as systemic arterial hypertension, ischemic heart disease, cardiac arrhythmias, metabolic disorders, and cognitive dysfunction. The pathogenesis of OSA-related consequence is assumed to be chronic intermittent hypoxia (IH) inducing alterations at the molecular level, oxidative stress, persistent systemic inflammation, oxygen sensor activation, and increase of sympathetic activity...
2016: Hypoxia
https://www.readbyqxmd.com/read/27784404/arousal-intensity-is-a-distinct-pathophysiological-trait-in-obstructive-sleep-apnea
#16
Jason Amatoury, Ali Azarbarzin, Magdy Younes, Amy S Jordan, Andrew Wellman, Danny J Eckert
STUDY OBJECTIVES: Arousals from sleep vary in duration and intensity. Accordingly, the physiological consequences of different types of arousals may also vary. Factors that influence arousal intensity are only partly understood. This study aimed to determine if arousal intensity is mediated by the strength of the preceding respiratory stimulus, and investigate other factors mediating arousal intensity and its role on post-arousal ventilatory and pharyngeal muscle responses. METHODS: Data were acquired in 71 adults (17 controls, 54 obstructive sleep apnea patients) instrumented with polysomnography equipment plus genioglossus and tensor palatini electromyography (EMG), a nasal mask and pneumotachograph, and an epiglottic pressure sensor...
December 1, 2016: Sleep
https://www.readbyqxmd.com/read/27693594/osa-and-cardiac-arrhythmogenesis-mechanistic-insights
#17
REVIEW
Anna M May, David R Van Wagoner, Reena Mehra
A surge of data has reproducibly identified strong associations of OSA with cardiac arrhythmias. As an extension of epidemiologic and clinic-based findings, experimental investigations have made strides in advancing our understanding of the putative OSA and cardiac arrhythmogenesis mechanistic underpinnings. Although most studies have focused on the links between OSA and atrial fibrillation (AF), relationships with ventricular arrhythmias have also been characterized. Key findings implicate OSA-related autonomic nervous system fluctuations typified by enhanced parasympathetic activation during respiratory events and sympathetic surges subsequent to respiratory events, which contribute to augmented arrhythmic propensity...
January 2017: Chest
https://www.readbyqxmd.com/read/27655455/obstructive-sleep-apnea-without-obesity-is-common-and-difficult-to-treat-evidence-for-a-distinct-pathophysiological-phenotype
#18
Emma L Gray, David K McKenzie, Danny J Eckert
STUDY OBJECTIVES: To determine the proportion and physiological characteristics of nonobese patients with obstructive sleep apnea (OSA) and their response to prescribed therapy. METHODS: Data from 163 consecutive in-laboratory diagnostic sleep studies for participants referred to an academic teaching-hospital sleep clinic for suspected OSA were assessed. Sleep and anthropometric parameters at baseline and follow-up (up to 22 mo) were examined and compared between obese and nonobese patients with a diagnosis of OSA (apnea-hypopnea index >5 events/h sleep)...
September 13, 2016: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/27602807/pressure-monitoring-of-the-mueller-maneuver-our-experience-in-twenty-five-obstructive-sleep-apnea-hypopnoea-syndrome-patients-with-oropharyngeal-obstruction
#19
Jacopo Cambi, Paola Staffa, Maria Carla Spinosi
Obstructive Sleep Apnea Hypopnoea Syndrome (OSAHS) is a common disorder characterized by partial (hypopnoea) or total (apnea) closure of the upper airways during sleep. It is associated with hypertension, stroke, car accidents, diabetes, metabolic syndrome and depression. Although this disease is related to major morbidity and mortality(1) , the prevalence of OSAHS is underestimated. The physiopathology of OSAHS is multifactorial and not yet fully understood. Numerous pathophysiological risk factors have been recognized: anatomical abnormalities, impaired upper airway dilators, unstable respiratory control and diminished arousal threshold...
September 7, 2016: Clinical Otolaryngology
https://www.readbyqxmd.com/read/27581116/how-does-serum-brain-natriuretic-peptide-level-change-under-nasal-continuous-positive-airway-pressure-in-obstructive-sleep-apnea-hypopnea-syndrome
#20
Sameh Msaad, Rim Marrakchi, Malek Grati, Rahma Gargouri, Samy Kammoun, Kamel Jammoussi, Ilhem Yangui
BACKGROUND: Obstructive sleep apnea-hypopnea syndrome (OSAHS) is associated with cardiovascular morbidity and mortality, which can be improved by using continuous positive airway pressure (CPAP) therapy. However, the pathophysiological links between the two kinds of disease and the mechanism of the CPAP effect remain incompletely understood. We aimed to inquire into the myocardial involvement in this relationship. We suggested that serum brain natriuretic peptide (BNP) is sensitive enough to detect myocardial stress caused by OSAHS...
2016: Libyan Journal of Medicine
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