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Pathophysiology of obstructive sleep apnea

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https://www.readbyqxmd.com/read/28289401/sleep-disorders-is-the-trigemino-cardiac-reflex-a-missing-link
#1
REVIEW
Tumul Chowdhury, Barkha Bindu, Gyaninder Pal Singh, Bernhard Schaller
Trigeminal innervated areas in face, nasolacrimal, and nasal mucosa can produce a wide array of cardiorespiratory manifestations that include apnea, bradypnea, bradycardia, hypotension, and arrhythmias. This reflex is a well-known entity called "trigemino-cardiac reflex" (TCR). The role of TCR is investigated in various pathophysiological conditions especially in neurosurgical, but also skull base surgery procedures. Additionally, its significance in various sleep-related disorders has also been highlighted recently...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28282995/understanding-copd-overlap-syndromes
#2
Tuang Yeow Poh, Micheál Mac Aogáin, Adrian Kwok Wai Chan, Anthony Chau Ang Yii, Valerie Fei Lee Yong, Pei Yee Tiew, Mariko Siyue Koh, Sanjay Haresh Chotirmall
Chronic obstructive pulmonary disease accounts for a large burden of lung disease. It can 'overlap' with other respiratory diseases including bronchiectasis, fibrosis and obstructive sleep apnea (OSA). While COPD alone confers morbidity and mortality, common features with contrasting clinical outcomes can occur in COPD 'overlap syndromes'. Areas covered: Given the large degree of heterogeneity in COPD, individual variation to treatment is adopted based on its observed phenotype, which in turn overlaps with features of other respiratory disease states such as asthma...
March 24, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28268774/distinguishing-obstructive-from-central-sleep-apneas-and-hypopneas-using-linear-svm-and-acoustic-features
#3
Richard Hummel, T Douglas Bradley, Devin Packer, Hisham Alshaer
Sleep Apnea (SA) is a very common but underdiagnosed respiratory disorder. SA has 2 main types, obstructive and central sleep apnea (OSA and CSA, respectively). The distinction between the 2 types is important for proper clinical management. Our aim in this study was to deploy acoustic analysis of breath sounds to distinguish central from obstructive events. We recorded breath sounds from 29 patients from which 45 segments with obstructive only and 40 segments with central only respiratory events were isolated...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28255159/high-intensity-aerobic-exercise-training-improves-chronic-intermittent-hypoxia-induced-insulin-resistance-without-basal-autophagy-modulation
#4
Marion Pauly, Allan Assense, Aurélie Rondon, Amandine Thomas, Hervé Dubouchaud, Damien Freyssenet, Henri Benoit, Josiane Castells, Patrice Flore
Chronic intermittent hypoxia (IH) associated with obstructive sleep apnea (OSA) is a major risk factor for cardiovascular and metabolic diseases (insulin resistance: IR). Autophagy is involved in the pathophysiology of IR and high intensity training (HIT) has recently emerged as a potential therapy. We aimed to confirm IH-induced IR in a tissue-dependent way and to explore the preventive effect of HIT on IR-induced by IH. Thirty Swiss 129 male mice were randomly assigned to Normoxia (N), Intermittent Hypoxia (IH: 21-5% FiO2, 30 s cycle, 8 h/day) or IH associated with high intensity training (IH HIT)...
March 3, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28238099/phenotyping-based-treatment-improves-obstructive-sleep-apnea-symptoms-and-severity-a-pilot-study
#5
Ludovico Messineo, Roberto Magri, Luciano Corda, Laura Pini, Luigi Taranto-Montemurro, Claudio Tantucci
BACKGROUND: Obstructive sleep apnea is a common disorder characterized by multiple pathogenetic roots. Continuous positive airway pressure (CPAP) is almost always prescribed as the first-line treatment to all patients regardless of the heterogeneous pathophysiology, because it mechanically splints the airways open and reduces the collapsibility of the upper airway. Despite its high efficacy, CPAP is burdened by poor adherence and compliance rates. In this pilot study, we treated OSA patients with composite approaches different than CPAP, tailoring the therapeutic choice on OSA phenotypic traits...
February 25, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/28226965/distinguishing-obstructive-from-central-sleep-apneas-and-hypopneas-using-linear-svm-and-acoustic-features
#6
Richard Hummel, T Douglas Bradley, Devin Packer, Hisham Alshaer, Richard Hummel, T Douglas Bradley, Devin Packer, Hisham Alshaer, Devin Packer, T Douglas Bradley, Hisham Alshaer, Richard Hummel
Sleep Apnea (SA) is a very common but underdiagnosed respiratory disorder. SA has 2 main types, obstructive and central sleep apnea (OSA and CSA, respectively). The distinction between the 2 types is important for proper clinical management. Our aim in this study was to deploy acoustic analysis of breath sounds to distinguish central from obstructive events. We recorded breath sounds from 29 patients from which 45 segments with obstructive only and 40 segments with central only respiratory events were isolated...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28218220/establishment-of-a-rabbit-model-of-chronic-obstructive-sleep-apnea-and-application-in-cardiovascular-consequences
#7
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...
February 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28215270/decreased-cerebral-vasomotor-reactivity-in-patients-with-obstructive-sleep-apnea-syndrome
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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