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Pathophysiology of obstructive sleep apnea

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https://www.readbyqxmd.com/read/29241747/pathophysiology-of-the-metabolic-syndrome
#1
Emma McCracken, Monica Monaghan, Shiva Sreenivasan
The metabolic syndrome-otherwise called syndrome X, insulin resistance syndrome, Reaven syndrome, and "the deadly quartet"-is the name given to the aggregate of clinical conditions comprising central and abdominal obesity, systemic hypertension, insulin resistance (or type 2 diabetes mellitus), and atherogenic dyslipidemia. It is a prothrombotic and proinflammatory state characterized by increased inflammatory cytokine activity. In addition to inflammatory dermatoses such as psoriasis, lichen planus, and hidradenitis suppurativa, metabolic syndrome is also commonly associated with accelerated atherosclerotic cardiovascular disease, hyperuricemia/gout, chronic kidney disease, and obstructive sleep apnea...
January 2018: Clinics in Dermatology
https://www.readbyqxmd.com/read/29228393/quantifying-the-arousal-threshold-using-polysomnography-in-obstructive-sleep-apnea
#2
Scott A Sands, Philip I Terrill, Bradley A Edwards, Luigi Taranto Montemurro, Ali Azarbarzin, Melania Marques, Camila M de Melo, Stephen H Loring, James P Butler, David White, Andrew Wellman
Objectives: Precision medicine for obstructive sleep apnea (OSA) requires non-invasive estimates of each patient's pathophysiological "traits". Here we provide the first, automated technique to quantify the respiratory arousal threshold-defined as the level of ventilatory drive triggering arousal from sleep-using diagnostic polysomnographic signals in patients with OSA. Methods: Ventilatory drive preceding clinically-scored arousals was estimated from polysomnographic studies by fitting a respiratory control model (Terrill P et al...
November 9, 2017: Sleep
https://www.readbyqxmd.com/read/29225775/fibromax-based-nonalcoholic-fatty-liver-disease-in-chronic-obstructive-pulmonary-disease-patients-with-obstructive-sleep-apnea-methodological-considerations
#3
Denis Monneret
The relationship between nonalcoholic fatty liver disease (NAFLD) and obstructive sleep apnea (OSA) has been well demonstrated, but remains to be evidenced in chronic obstructive pulmonary disease (COPD). Recently, Viglino et al. (Eur Respir J, 2017) attempted to determine the prevalence of liver fibrosis, steatosis and nonalcoholic steatohepatitis (NASH) in COPD patients, some of whom had OSA, basing the NAFLD diagnostic on three circulating biomarker-based liver scores: the FibroTest, SteatoTest and NashTest, from the Fibromax® panel...
2017: F1000Research
https://www.readbyqxmd.com/read/29223509/neuropeptides-and-breathing-in-health-and-disease
#4
REVIEW
Katarzyna Kaczyńska, Dominika Zając, Piotr Wojciechowski, Ewelina Kogut, Małgorzata Szereda-Przestaszewska
Regulatory neuropeptides control and regulate breathing in physiological and pathophysiological conditions. While they have been identified in the neurons of major respiratory areas, they can be active not only at the central level, but also at the periphery via chemoreceptors, vagal afferents, or locally within lungs and airways. Some neuropeptides, such as leptin or substance P, are respiratory stimulants; others, such as neurotensin, produce variable effects on respiration depending on the site of application...
December 6, 2017: Pulmonary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29214337/sleep-disordered-breathing-in-patients-with-sickle-cell-disease
#5
REVIEW
Vikram M Raghunathan, Peter L Whitesell, Seah H Lim
Sickle cell disease is one of the most common hereditary hemoglobinopathies worldwide, and its vaso-occlusive and hemolytic crises cause considerable patient morbidity. A growing body of evidence has shown that sleep-disordered breathing, and in particular, obstructive sleep apnea, occurs at high frequency in the sickle cell population, and that there is significant overlap in the underlying pathophysiology of these two conditions. Through a variety of mechanisms including nocturnal hypoxemia and increased oxidative stress, production of pro-inflammatory cytokines, and endothelial dysfunction, sickle cell anemia and sleep-disordered breathing potentiate each other's clinical effects and end-organ complications...
December 6, 2017: Annals of Hematology
https://www.readbyqxmd.com/read/29208538/sleep-related-painful-erections-a-meta-analysis-on-the-pathophysiology-and-risks-and-benefits-of-medical-treatments
#6
REVIEW
Sanne Vreugdenhil, Alida Cornelia Weidenaar, Igle Jan de Jong, Mels Frank van Driel
BACKGROUND: Patients with sleep-related painful erections (SRPEs) have frequent awakenings from deep penile pain during nocturnal erections. This results in severe sleep deprivation. AIM: To review the current literature on SRPEs and discuss the pathophysiologic theories and risks and benefits of medical treatments. METHODS: PubMed was searched using the terms sleep-related painful erections, nocturnal priapism, treatment, and sleep-related erections...
December 2, 2017: Journal of Sexual Medicine
https://www.readbyqxmd.com/read/29199167/which-diseases-are-risk-factors-for-developing-gastroesophageal-reflux-disease
#7
Filiz Akyüz, Özlem Mutluay Soyer
Although the pathophysiology of gastroesophageal reflux disease (GERD) remains unclear, it is accepted as a multifactorial disease. It is thought that some of the interventions that might cause alterations in the normal gastrointestinal tract anatomy and diseases that affect the lower esophageal sphincter, esophageal clearance, and stomach motility (gastric emptying) might lay a foundation for GERD development. Moreover, it is common knowledge that GERD might cause various extraesophageal symptoms and complications...
December 2017: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/29173609/effects-of-patent-foramen-ovale-closure-on-obstructive-sleep-apnea-syndrome-pcosa-study
#8
Stephen P Hoole, Jules Hernández-Sánchez, William R Davies, Duncan C McNab, Patrick A Calvert, Bushra S Rana, Leonard M Shapiro, Michael G Davies
BACKGROUND: Previous studies have shown a higher prevalence of patent foramen ovale (PFO) in patients with obstructive sleep apnea syndrome (OSAS). Right to left shunting through a PFO may be encouraged by the respiratory physiology of OSAS, contributing to the disease pathophysiology. We assessed whether PFO closure would improve respiratory polygraphy parameters compared with baseline measurements in patients with OSAS. METHODS: Twenty-six patients with newly diagnosed OSAS and a moderate-large PFO (prevalence, 18% of 143 patients screened) were referred for PFO closure...
December 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29147581/review-of-and-updates-on-hypertension-in-obstructive-sleep-apnea
#9
REVIEW
Masood Ahmad, Devan Makati, Sana Akbar
Obstructive sleep apnea (OSA) is a prevalent sleep disorder as is hypertension (HTN) in the 21st century with the rising incidence of obesity. Numerous studies have shown a strong association of OSA with cardiovascular morbidity and mortality. There is overwhelming evidence supporting the relationship between OSA and hypertension (HTN). The pathophysiology of HTN in OSA is complex and dependent on various factors such as sympathetic tone, renin-angiotensin-aldosterone system, endothelial dysfunction, and altered baroreceptor reflexes...
2017: International Journal of Hypertension
https://www.readbyqxmd.com/read/29142091/physiological-and-pathophysiological-firing-properties-of-single-postganglionic-sympathetic-neurons-in-humans
#10
Vaughan G Macefield, B Gunnar Wallin
It has long been known from microneurographic recordings in human subjects that activity of postganglionic sympathetic axons occurs as spontaneous bursts, with muscle sympathetic nerve activity (MSNA) exhibiting strong cardiac rhythmicity via the baroreflex and skin sympathetic nerve activity (SSNA) showing much weaker cardiac modulation. Here we review the firing properties of single sympathetic neurons, obtained using highly selective microelectrodes. Individual vasoconstrictor neurons supplying muscle or skin, or sudomotor neurones supplying sweat glands, always discharge with a low firing probability (~30%) and at very low frequencies (~0...
November 15, 2017: Journal of Neurophysiology
https://www.readbyqxmd.com/read/29135515/association-between-allergic-and-nonallergic-rhinitis-and-obstructive-sleep-apnea
#11
Ming Zheng, Xiangdong Wang, Luo Zhang
PURPOSE OF REVIEW: Allergic rhinitis and nonallergic rhinitis (NAR) are common disorders, which have been considered as potential risk factors for obstructive sleep apnea (OSA). This review summarizes the proposed underlying pathophysiological mechanisms to provide a better understanding of the relationship between these conditions. RECENT FINDINGS: In adults, allergic rhinitis and NAR may be considered as symptoms potentiating, rather than risk potentiating factors in the pathophysiology of OSA, whereas in children, these are considered to be independent predictors for sleep-disordered breathing (SDB) and failure of adeno-tonsillectomy, the recommended first-line therapy for children with OSA...
November 14, 2017: Current Opinion in Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/29122399/-sleep-apneas-metabolic-syndrome-and-cardiovascular-risk-data-from-the-pays-de-la-loire-sleep-cohort
#12
REVIEW
F Gagnadoux, P Priou, T Urban, N Meslier, W Trzepizur
Obstructive sleep apnea-hypopnea syndrome (OSAHS) is a prevalent disease characterized by recurrent episodes of partial or complete obstruction of upper airway during sleep. Untreated moderate to severe OSAHS is recognized as a cardiovascular (CV) risk factor. Data from the Pays de la Loire sleep cohort and other clinic- or population-based cohorts demonstrate a strong association between OSAHS and the different components of the metabolic syndrome including systemic hypertension, diabetes and impaired lipid metabolism...
November 6, 2017: Revue de Pneumologie Clinique
https://www.readbyqxmd.com/read/29121095/the-pedunculopontine-tegmentum-controls-renal-sympathetic-nerve-activity-and-cardiorespiratory-activities-in-nembutal-anesthetized-rats
#13
Anne M Fink, Caron Dean, Mariann R Piano, David W Carley
Elevated renal sympathetic nerve activity (RSNA) accompanies a variety of complex disorders, including obstructive sleep apnea, heart failure, and chronic kidney disease. Understanding pathophysiologic renal mechanisms is important for determining why hypertension is both a common sequelae and a predisposing factor of these disorders. The role of the brainstem in regulating RSNA remains incompletely understood. The pedunculopontine tegmentum (PPT) is known for regulating behaviors including alertness, locomotion, and rapid eye movement sleep...
2017: PloS One
https://www.readbyqxmd.com/read/29107469/diseases-of-the-retina-and-the-optic-nerve-associated-with-obstructive-sleep-apnea
#14
REVIEW
Marielle Mentek, Florent Aptel, Diane Godin-Ribuot, Renaud Tamisier, Jean-Louis Pepin, Christophe Chiquet
Many associations between ocular disorders and obstructive sleep apnea (OSA) have been studied, such as nonarteritic anterior ischemic optic neuropathy, glaucoma, papilledema, retinal vein occlusion, eyelid hyperlaxity, lower-eyelid ectropion and recurrent corneal erosions. The objective of this review is to synthetize the possible vascular disorders of the retina and the optic nerve associated with sleep apnea patients and to discuss the underlying pathophysiological hypotheses. Main mechanisms involved in the ocular complications of OSA are related to intermittent hypoxia, sympathetic system activation, oxidant stress, and deleterious effects of endothelin 1...
May 29, 2017: Sleep Medicine Reviews
https://www.readbyqxmd.com/read/29077507/multi-ethnic-meta-analysis-identifies-rai1-as-a-possible-obstructive-sleep-apnea-related-quantitative-trait-locus-in-men
#15
Han Chen, Brian E Cade, Kevin J Gleason, Andrew C Bjonnes, Adrienne M Stilp, Tamar Sofer, Matthew P Conomos, Sonia Ancoli-Israel, Raanan Arens, Ali Azarbarzin, Graeme I Bell, Jennifer E Below, Sung Chun, Daniel S Evans, Ralf Ewert, Alexis C Frazier-Wood, Sina A Gharib, José Haba-Rubio, Erika W Hagen, Raphael Heinzer, David R Hillman, W Craig Johnson, Zoltan Kutalik, Jacqueline M Lane, Emma K Larkin, Seung Ku Lee, Jingjing Liang, Jose S Loredo, Sutapa Mukherjee, Lyle J Palmer, George J Papanicolaou, Thomas Penzel, Paul E Peppard, Wendy S Post, Alberto R Ramos, Ken Rice, Jerome I Rotter, Scott A Sands, Neomi A Shah, Chol Shin, Katie L Stone, Beate Stubbe, Jae-Hoon Sul, Mehdi Tafti, Kent D Taylor, Alexander Teumer, Timothy A Thornton, Gregory J Tranah, Chaolong Wang, Heming Wang, Simon C Warby, D Andrew Wellman, Phyllis C Zee, Craig L Hanis, Cathy C Laurie, Daniel J Gottlieb, Sanjay R Patel, Xiaofeng Zhu, Shamil R Sunyaev, Richa Saxena, Xihong Lin, Susan Redline
Obstructive sleep apnea (OSA) is a common heritable disorder displaying marked sexual dimorphism in disease prevalence and progression. Previous genetic association studies have identified a few genetic loci associated with OSA and related quantitative traits, but they have only focused on single ethnic groups and a large proportion of the heritability remains unexplained. The apnea hypopnea index (AHI) is a commonly used quantitative measure characterizing OSA severity. Since OSA differs by sex, and the pathophysiology of obstructive events differ in rapid eye movement (REM) and non-REM (NREM) sleep, we hypothesized that additional genetic association signals would be identified by analyzing the NREM/REM-specific AHI and by conducting sex-specific analyses in multi-ethnic samples...
October 27, 2017: American Journal of Respiratory Cell and Molecular Biology
https://www.readbyqxmd.com/read/29068938/pediatric-obstructive-sleep-apnea-consensus-controversy-and-craniofacial-considerations
#16
REVIEW
Ravi K Garg, Ahmed M Afifi, Catharine B Garland, Ruston Sanchez, Delora L Mount
Pediatric obstructive sleep apnea, characterized by partial or complete obstruction of the upper airway during sleep, is associated with multiple adverse neurodevelopmental and cardiometabolic consequences. It is common in healthy children and occurs with a higher incidence among infants and children with craniofacial anomalies. Although soft-tissue hypertrophy is the most common cause, interplay between soft tissue and bone structure in children with craniofacial differences may also contribute to upper airway obstruction...
November 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29047083/altered-redox-balance-in-the-development-of-chronic-hypoxia-induced-pulmonary-hypertension
#17
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
#18
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
#19
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
#20
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
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