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Pathophysiology of obstructive sleep apnea

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https://www.readbyqxmd.com/read/27908527/-historical-review-on-obstructive-sleep-apnea-in-children
#1
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
#2
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...
November 17, 2016: 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
#3
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
#4
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...
November 5, 2016: Current Heart Failure Reports
https://www.readbyqxmd.com/read/27815038/phenotypes-in-obstructive-sleep-apnea-a-definition-examples-and-evolution-of-approaches
#5
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
#6
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
#7
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
#8
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...
October 20, 2016: Sleep
https://www.readbyqxmd.com/read/27693594/obstructive-sleep-apnea-and-cardiac-arrhythmogenesis-mechanistic-insights
#9
Anna M May, David R Van Wagoner, Reena Mehra
A surge of data has reproducibly identified strong associations of obstructive sleep apnea (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. While 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 and sympathetic surges subsequent to respiratory events which contribute to augmented arrhythmic propensity...
September 29, 2016: Chest
https://www.readbyqxmd.com/read/27655455/obstructive-sleep-apnea-without-obesity-is-common-and-difficult-to-treat-evidence-for-a-distinct-pathophysiological-phenotype
#10
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
#11
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
#12
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
https://www.readbyqxmd.com/read/27567051/sleep-bruxism-associated-with-obstructive-sleep-apnoea-syndrome-a-pilot-study-using-a-new-portable-device
#13
M Winck, M Drummond, P Viana, J C Pinho, J C Winck
Sleep bruxism (SB) and obstructive sleep apnoea syndrome (OSAS) share common pathophysiologic pathways. We aimed to study the presence and relationship of SB in a OSAS population. Patients referred with OSAS suspicion and concomitant SB complains were evaluated using a specific questionnaire, orofacial evaluation and cardio-respiratory polygraphy that could also monitor audio and EMG of the masseter muscles. From 11 patients studied 9 had OSAS. 55.6% were male, mean age was 46.3±11.3 years, and apnea hypopnea index of 11...
August 23, 2016: Revista Portuguesa de Pneumologia
https://www.readbyqxmd.com/read/27489385/zolpidem-induced-sleep-related-eating-and-complex-behaviors-in-a-patient-with-obstructive-sleep-apnea-and-restless-legs-syndrome
#14
Young-Min Park, Hyun-Woo Shin
Zolpidem-induced sleep-related complex behaviors (SRCB) with anterograde amnesia have been reported. We describe herein a case in which the development of zolpidem-induced sleep-related eating disorder (SRED) and SRCB was strongly suspected. A 71-year-old Korean male was admitted to the Department of Psychiatry due to his repetitive SRED and SRCB with anterograde amnesia, which he reported as having occurred since taking zolpidem. The patient also had restless legs syndrome (RLS) and obstructive sleep apnea (OSA)...
August 31, 2016: Clinical Psychopharmacology and Neuroscience: the Official Scientific Journal of the Korean College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/27478683/sleep-disorders-and-cardio-renal-disease-implications-for-minority-populations
#15
Judith Giunta, Moro O Salifu, Samy I McFarlane
Obesity is a major public health problem that is reaching pandemic proportion. Currently two thirds of the American population is either overweight or obese and worldwide, 39% of the population is overweight and 13% are considered obese [1,2]. This rapid rise in obesity is associated with increased in diabetes mellitus type 2 (DM2), hypertension (HTN), chronic kidney disease (CKD) and cardiovascular diseases (CVD), the major killer of adults in the USA. Parallel to this epidemic is the rapid rise of sleep disorders such as Obstructive Sleep Apnea (OSA)...
2016: Epidemiology: Current Research
https://www.readbyqxmd.com/read/27476705/obstructive-sleep-apnea-a-perioperative-risk-factor
#16
Philipp Fassbender, Frank Herbstreit, Matthias Eikermann, Helmut Teschler, Jürgen Peters
BACKGROUND: Obstructive sleep apnea (OSA) is a common disorder of breathing but is probably underappreciated as a perioperative risk factor. METHODS: This review is based on pertinent articles, published up to 15 August 2015, that were retrieved by a selective search in PubMed based on the terms "sleep apnea AND anesthesia" OR "sleep apnea AND pathophysiology." The guidelines of multiple specialty societies were considered as well. RESULTS: OSA is characterized by phases of upper airway obstruction accompanied by apnea/hypoventilation, with hypoxemia, hypercapnia, and recurrent overactivation of the sympathetic nervous system...
July 11, 2016: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/27470682/evaluation-of-adiponectin-profile-in-italian-patients-affected-by-obstructive-sleep-apnea-syndrome
#17
Donato Lacedonia, Ersilia Nigro, Maria Gabriella Matera, Olga Scudiero, Maria Ludovica Monaco, Rita Polito, Giovanna Elisiana Carpagnano, Maria Pia Foschino Barbaro, Gennaro Mazzarella, Andrea Bianco, Aurora Daniele
Obstructive sleep apnea syndrome (OSAS) is a common breathing disorder; obesity represents a major risk factor for the development and progression of OSAS although obese patients do not necessarily suffer from OSAS. Adipose tissue communicates with lung in both physiologic and pathologic conditions through the production of adipokines, hormones active in metabolic and inflammatory processes. To explore the extent to which Acrp30 impacts on pathophysiology of OSAS and whether these proteins could be considered as targets for both diagnosis and therapy through enzyme-linked immunosorbent assay, western blotting analysis and fast protein liquid chromatography we have analyzed total levels as well as oligomer distribution in OSAS patients...
October 2016: Pulmonary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/27442715/the-effect-of-donepezil-on-arousal-threshold-and-apnea-hypopnea-index-a-randomized-double-blind-cross-over-study
#18
Yanru Li, Robert L Owens, Scott Sands, Jeremy Orr, Walter Moraes, Pamela DeYoung, Erik Smales, Rachel Jen, Atul Malhotra
RATIONALE: Obstructive sleep apnea (OSA) has multiple pathophysiological causes. A low respiratory arousal threshold (ArTh) and a high loop gain (unstable ventilatory control) can contribute to recurrent respiratory events in patients with OSA. Prior small studies have shown that donepezil, an acetylcholinesterase inhibitor, might improve OSA, but the mechanism is unknown. OBJECTIVES: To determine whether a single dose of donepezil lowers the apnea hypopnea index (AHI) by modulating the ArTh or loop gain...
July 21, 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/27373092/-the-clinical-significance-and-changes-of-serum-tumor-necrosis-factor-and-plasma-endothelium-in-patients-with-osahs-associated-type-2-diabetes-mellites
#19
Peilin Hui, Shuangbao Jia, Wei Ma, Lijun Zhao, Jinfeng Wang, Xiaoquan Wei, Liya Zhou, Manke Dai, Wenjuan Zhang, Yuping Xie
OBJECTIVE: To investigate the significance of tumor necrosis factor-alpha (TNF-α) and plasma endothelium (ET) in pathophysiologic process of patients with obstructive sleep apnea hypopnea syndrome(OSAHS) with type 2 diabetes mellitus (T2DM). METHOD: All observed subjects were divided into 4 groups. A number of 80 patients with OSAHS, 65 cases of OSAHS with T2DM patients, 20 patients with T2DM, and 32 cases of healthy control group were observed in this study. The serum levels of TNF-α and ET were detected by double antibody sandwich ELISA, the content of TNF-α and ET were compared between OSAHS group and OSAHS + T2DM group...
February 2016: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
https://www.readbyqxmd.com/read/27372597/pediatric-sleep-apnea-syndrome-an-update
#20
REVIEW
Zhenhong Li, Jocelyn Celestin, Richard F Lockey
Obstructive sleep apnea syndrome (OSAS) may be central neurologic (<5%) or obstructive (>95%) in origin and is a relatively prevalent condition in children. It affects 1%-5% of children aged 2-8 years and is caused by a variety of different pathophysiologic abnormalities. Cardiovascular, metabolic, and neurocognitive comorbidities can occur in both children and adults when left untreated. It also can cause severe behavioral problems in children. The American Academy of Pediatrics recommends that all children be screened with an appropriate history and physical examination for symptoms and signs suggestive of OSAS...
September 2016: Journal of Allergy and Clinical Immunology in Practice
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