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Pathophysiology of obstructive sleep apnea

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https://www.readbyqxmd.com/read/29685205/may-inflammatory-markers-be-used-for-monitoring-the-continuous-positive-airway-pressure-effect-in-patients-with-obstructive-sleep-apnea-and-arrhythmias
#1
G N Dediu, C C Diaconu, S Dumitrache Rujinski, M A Iancu, L A Balaceanu, I Dina, M Bogdan
INTRODUCTION: Obstructive sleep apnea syndrome (OSAS) is defined by recurrent episodes of significant reduction or absence of the oro-nasal airflow during sleep, in the presence of thorax and abdominal movements and snoring. The pathophysiological consequences of intermittent hypoxia determined by OSAS are represented by systemic inflammation, the release of free oxygen radicals and activation of the sympathetic nervous system. Cardiac arrhythmias are a frequent comorbidity in patients with OSAS...
June 2018: Medical Hypotheses
https://www.readbyqxmd.com/read/29676627/effect-of-world-trade-center-dust-exposure-and-chronic-intermittent-hypoxia-on-macrophage-matrix-metalloproteinase-12-expression-in-mice
#2
Jared Radbel, Oanh Le-Hoang, Kinal N Vayas, Kaiwal Patel, Michael Goedken, Vasanthi R Sunil, Debra Laskin, Jag Sunderram
RATIONALE: The pathophysiologic mechanisms by which World Trade Center (WTC) dust exposure leads to pulmonary disease have not been established. Matrix metalloproteinase-12 (MMP-12) is involved in the development of pulmonary fibrosis and chronic obstructive pulmonary disease. We have previously shown that exposure of mice to WTC dust results in increased expression of matrix metalloproteinase 12 by alveolar macrophages. Matrix metalloproteinase 12 expression is regulated, in part, by oxidative stress, which is also increased after WTC dust exposure...
April 2018: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29659956/polyphenols-have-no-impact-on-endothelial-function-in-patients-with-obstructive-sleep-apnea-a-randomized-controlled-trial
#3
Wojciech Trzepizur, Vanessa Bironneau, Sylvain Recoquillon, Pascaline Priou, Nicole Meslier, Jean-François Hamel, Samir Henni, Astrid Darsonval, Khaled Messaoudi, Maria Carmen Martínez, Ramaroson Andriantsitohaina, Frédéric Gagnadoux
Background: Endothelial dysfunction, a pathophysiologic determinant of atherogenesis, has been found to occur in obstructive sleep apnea syndrome (OSA) and is improved by continuous positive airway pressure (CPAP). However, the efficacy of CPAP therapy is limited by variable adherence. Alternative treatment strategies are needed. The impact of polyphenols on endothelial function has never been evaluated in OSA. Objective: We evaluated the impact of 1-mo supplementation with grape juice polyphenols (GJPs) on the reactive hyperemia index (RHI), a validated measure of endothelial function in patients with severe OSA...
April 1, 2018: Journal of Nutrition
https://www.readbyqxmd.com/read/29617218/computational-model-of-brainstem-circuit-for-state-dependent-control-of-hypoglossal-motoneurons
#4
Mohsen Naji, Maxim Komarov, Giri P Krishnan, Atul Malhotra, Frank L Powell, Irma Rukhadze, Victor B Fenik, Maxim Bazhenov
In patients with obstructive sleep apnea (OSA) the pharyngeal muscles become relaxed during sleep, which leads to a partial or complete closure of upper airway. Experimental studies suggest that withdrawal of noradrenergic and serotonergic drives importantly contribute to depression of hypoglossal motoneurons and, therefore, may contribute to OSA pathophysiology; however, specific cellular and synaptic mechanisms remain unknown. In this new study, we developed a biophysical network model to test the hypothesis that, in order to explain experimental observations, the neuronal network for monoaminergic control of excitability of hypoglossal motoneurons needs to include excitatory and inhibitory perihypoglossal interneurons that mediate noradrenergic and serotonergic drives to hypoglossal motoneurons...
April 4, 2018: Journal of Neurophysiology
https://www.readbyqxmd.com/read/29615922/sensory-processing-and-integration-at-the-carotid-body-tripartite-synapse-neurotransmitter-functions-and-effects-of-chronic-hypoxia
#5
REVIEW
Erin M Leonard, Shaima Salman, Colin A Nurse
Maintenance of homeostasis in the respiratory and cardiovascular systems depends on reflexes that are initiated at specialized peripheral chemoreceptors that sense changes in the chemical composition of arterial blood. In mammals, the bilaterally-paired carotid bodies (CBs) are the main peripheral chemoreceptor organs that are richly vascularized and are strategically located at the carotid bifurcation. The CBs contribute to the maintenance of O2 , CO2 /H+ , and glucose homeostasis and have attracted much clinical interest because hyperactivity in these organs is associated with several pathophysiological conditions including sleep apnea, obstructive lung disease, heart failure, hypertension, and diabetes...
2018: Frontiers in Physiology
https://www.readbyqxmd.com/read/29572132/sleep-biology-updates-hemodynamic-and-autonomic-control-in-sleep-disorders
#6
REVIEW
Renaud Tamisier, J Woodrow Weiss, Jean Louis Pépin
Sleep disorders like obstructive sleep apnea syndrome, periodic limb movements in sleep syndrome, insomnia and narcolepsy-cataplexy are all associated with an increased risk of cardiovascular diseases. These disorders share an impaired autonomic nervous system regulation that leads to increased cardiovascular sympathetic tone. This increased cardiovascular sympathetic tone is, in turn, likely to play a major role in the increased risk of cardiovascular disease. Different stimuli, such as intermittent hypoxia, sleep fragmentation, decrease in sleep duration, increased respiratory effort, and transient hypercapnia may all initiate the pathophysiological cascade leading to sympathetic overactivity and some or all of these are encountered in these different sleep disorders...
March 20, 2018: Metabolism: Clinical and Experimental
https://www.readbyqxmd.com/read/29536012/post-stroke-sleep-disordered-breathing-pathophysiology-and-therapy-options
#7
REVIEW
David Stevens, Rodrigo Tomazini Martins, Sutapa Mukherjee, Andrew Vakulin
Sleep-disordered breathing (SDB), encompassing both obstructive and central sleep apnea, is prevalent in at least 50% of stroke patients. Small studies have shown vast improvements in post-stroke functional recovery outcomes after the treatment of SDB by continuous positive airway pressure. However, compliance to this therapy is very poor in this complex patient group. There are alternative therapy options for SDB that may be more amenable for use in at least some post-stroke patients, including mandibular advancement, supine avoidance, and oxygen therapy...
2018: Frontiers in Surgery
https://www.readbyqxmd.com/read/29525140/neuromuscular-function-of-the-soft-palate-and-uvula-in-snoring-and-obstructive-sleep-apnea-a-systematic-review
#8
REVIEW
Jagatkumar A Patel, Bryan J Ray, Camilo Fernandez-Salvador, Christopher Gouveia, Soroush Zaghi, Macario Camacho
OBJECTIVE: A collapsible upper airway is a common cause of obstructive sleep apnea. The exact pathophysiology leading to a more collapsible airway is not well understood. A progressive neuropathy of the soft palate and pharyngeal dilators may be associated with the progression of snoring to OSA. The purpose of this study is to systematically review the international literature investigating the neurophysiologic changes in the soft palate and uvula that contribute to progression from snoring to OSA...
March 5, 2018: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/29506719/elevations-in-neutrophils-with-obstructive-sleep-apnea-the-multi-ethnic-study-of-atherosclerosis-mesa
#9
Glaucylara Reis Geovanini, Rui Wang, Jia Weng, Russell Tracy, Nancy S Jenny, Ary L Goldberger, Madalena D Costa, Yongmei Liu, Peter Libby, Susan Redline
BACKGROUND: Obstructive sleep apnea (OSA) associates with increased risk of cardiovascular diseases (CVD). Immune abnormalities and surges in sympathetic activity accompany OSA and CVD. We hypothesized that OSA associates with leukocytosis partially by abnormalities in autonomic nervous system (ANS) function that would suggest a pathway linking OSA and CVD. METHODS: Participants from the Multi-Ethnic Study of Atherosclerosis (MESA), a prospective cohort of individuals initially without overt CVD, underwent polysomnography and assays for white blood cells (WBC) and subsets...
April 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29493044/an-overview-of-sleep-and-circadian-dysfunction-in-parkinson-s-disease
#10
REVIEW
Susanna Mantovani, Simon S Smith, Richard Gordon, John D O'Sullivan
Sleep and circadian alterations are amongst the very first symptoms experienced in Parkinson's disease, and sleep alterations are present in the majority of patients with overt clinical manifestation of Parkinson's disease. However, the magnitude of sleep and circadian dysfunction in Parkinson's disease, and its influence on the pathophysiology of Parkinson's disease remains often unclear and a matter of debate. In particular, the confounding influences of dopaminergic therapy on sleep and circadian dysfunction are a major challenge, and need to be more carefully addressed in clinical studies...
March 1, 2018: Journal of Sleep Research
https://www.readbyqxmd.com/read/29493039/complement-system-activation-in-obstructive-sleep-apnea
#11
Peter Horvath, David L Tarnoki, Adam D Tarnoki, Kinga Karlinger, Zsofia Lazar, Gyorgy Losonczy, Laszlo Kunos, Andras Bikov
The complement system may play a role in the systemic inflammation characterising obstructive sleep apnea; however, this has not been investigated before. We aimed to study the involvement of effector complement elements in obstructive sleep apnea, namely C3a, C5a and SC5b-9. Venous blood was collected in 50 patients with obstructive sleep apnea and 26 control subjects in the evening and the following morning. Plasma complement proteins were analysed with ELISA. Complement factor levels were compared between the two groups and correlated with clinical variables...
March 1, 2018: Journal of Sleep Research
https://www.readbyqxmd.com/read/29482817/elevated-tau-and-interleukin-6-concentrations-in-adults-with-obstructive-sleep-apnea
#12
Vida Motamedi, Rebekah Kanefsky, Panagiotis Matsangas, Sara Mithani, Andreas Jeromin, Matthew S Brock, Vincent Mysliwiec, Jessica Gill
Obstructive sleep apnea (OSA) is characterized by apneas and hypopneas that result in hypoxia, cerebral hypoperfusion, endothelial dysfunction, inflammation, and oxidative stress. These pathophysiologic processes likely contribute to neuronal damage. Tau is a protein that stabilizes microtubules and, along with amyloid beta (Aβ), is associated with neurodegenerative processes. We sought to determine if tau and other biomarkers of inflammation were related to OSA severity. Concentrations of tau, Aβ40, Aβ42, c-reactive protein (CRP), TNF-α, interleukin (IL)-6, and IL-10 were measured in blood and compared between participants with moderate-severe OSA (n = 28), those with mild OSA (n = 22), and healthy controls (n = 24)...
March 2018: Sleep Medicine
https://www.readbyqxmd.com/read/29440941/sleep-disturbances-in-women-with-polycystic-ovary-syndrome-prevalence-pathophysiology-impact-and-management-strategies
#13
REVIEW
Renae C Fernandez, Vivienne M Moore, Emer M Van Ryswyk, Tamara J Varcoe, Raymond J Rodgers, Wendy A March, Lisa J Moran, Jodie C Avery, R Doug McEvoy, Michael J Davies
Polycystic ovary syndrome (PCOS) is a complex endocrine disorder affecting the reproductive, metabolic and psychological health of women. Clinic-based studies indicate that sleep disturbances and disorders including obstructive sleep apnea and excessive daytime sleepiness occur more frequently among women with PCOS compared to comparison groups without the syndrome. Evidence from the few available population-based studies is supportive. Women with PCOS tend to be overweight/obese, but this only partly accounts for their sleep problems as associations are generally upheld after adjustment for body mass index; sleep problems also occur in women with PCOS of normal weight...
2018: Nature and Science of Sleep
https://www.readbyqxmd.com/read/29429026/modulation-of-renal-sympathetic-innervation-recent-insights-beyond-blood-pressure-control
#14
REVIEW
Dominik Linz, Mathias Hohl, Adrian D Elliott, Dennis H Lau, Felix Mahfoud, Murray D Esler, Prashanthan Sanders, Michael Böhm
Renal afferent and efferent sympathetic nerves are involved in the regulation of blood pressure and have a pathophysiological role in hypertension. Additionally, several conditions that frequently coexist with hypertension, such as heart failure, obstructive sleep apnea, atrial fibrillation, renal dysfunction, and metabolic syndrome, demonstrate enhanced sympathetic activity. Renal denervation (RDN) is an approach to reduce renal and whole body sympathetic activation. Experimental models indicate that RDN has the potential to lower blood pressure and prevent cardio-renal remodeling in chronic diseases associated with enhanced sympathetic activation...
February 10, 2018: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
https://www.readbyqxmd.com/read/29416383/obstructive-sleep-apnea-current-perspectives
#15
REVIEW
Amal M Osman, Sophie G Carter, Jayne C Carberry, Danny J Eckert
The prevalence of obstructive sleep apnea (OSA) continues to rise. So too do the health, safety, and economic consequences. On an individual level, the causes and consequences of OSA can vary substantially between patients. In recent years, four key contributors to OSA pathogenesis or "phenotypes" have been characterized. These include a narrow, crowded, or collapsible upper airway "anatomical compromise" and "non-anatomical" contributors such as ineffective pharyngeal dilator muscle function during sleep, a low threshold for arousal to airway narrowing during sleep, and unstable control of breathing (high loop gain)...
2018: Nature and Science of Sleep
https://www.readbyqxmd.com/read/29388824/research-priorities-in-pathophysiology-for-sleep-disordered-breathing-in-patients-with-chronic-obstructive-pulmonary-disease-an-official-american-thoracic-society-research-statement
#16
Atul Malhotra, Alan R Schwartz, Hartmut Schneider, Robert L Owens, Pamela DeYoung, MeiLan K Han, Jadwiga A Wedzicha, Nadia N Hansel, Michelle R Zeidler, Kevin C Wilson, M Safwan Badr
BACKGROUND: Obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD) are common conditions; the co-occurrence of these diseases, called the overlap syndrome (OVS), has been associated with poor health outcomes. PURPOSE: The purpose of this Official American Thoracic Society Research Statement is to describe pathophysiology, epidemiology, outcomes, diagnostic metrics, and treatment of OVS, as well as to identify important gaps in knowledge and make recommendations for future research...
February 1, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29387467/sleep-disordered-breathing-during-congestive-heart-failure-to-intervene-or-not-to-intervene
#17
Ali Valika, Maria Rosa Costanzo
Sleep-disordered breathing is common in heart failure patients and is associated with increased morbidity and mortality. Central sleep apnea occurs more commonly in heart failure-reduced ejection fraction, and obstructive sleep apnea occurs more frequently in heart failure with preserved ejection fraction. Although the two types of sleep-disordered breathing have distinct pathophysiologic mechanisms, both contribute to abnormal cardiovascular consequences. Treatment with continuous positive airway pressure for obstructive sleep apnea in heart failure has been well defined, whereas treatment strategies for central sleep apnea in heart failure continue to evolve...
November 2017: Cardiac failure review
https://www.readbyqxmd.com/read/29368899/-obesity-hypoventilation-syndrome-and-pulmonary-hypertension-an-association-little-known-in-mexico
#18
Ernesto Díaz-Domínguez, Martín Rosas-Peralta, Luis Efrén Santos-Martínez, Nielzer Armando Rodríguez-Almendros, José Antonio Magaña-Serrano, Gilberto Pérez-Rodríguez
The obesity hypoventilation syndrome (OHS) refers to the combination of obesity, daytime hypercapnia and sleep-disordered breathing. Obesity has risen to epidemic proportions in the last three decades in the United States, Mexico and Europe. The OHS is associated with obstructive sleep apnea syndrome in 30%. Without treatment, mortality is 46% at 50 months. So in this paper we analyze the OHS, obesity and pulmonary hypertension, the pathophysiology, clinical presentation and diagnosis as well as the treatment, which is aimed at the correction of sleep-disordered breathing and hypoxemia; although there is little experience with the use of specific pulmonary vasodilator drugs...
January 2018: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/29365388/-neuromuscular-properties-of-genioglossus-activity-in-healthy-adults-and-obstructive-sleep-apnea-patients
#19
Y Q Zhou, J Y Ye
Upper airway patency closely contact with neuromuscular airway regulation during respiratory, especially the activity of the pharyngeal dilators. The genioglossus is the largest pharyngeal dilators with its contraction playing the most important role in keeping the pharyngeal airway open. In healthy individuals, genioglossus activation shows a negative correlation with pharyngeal collapsibility and upper airway resistance. Negative pressure during inspiration can stimulate airway mechanoreceptors to produce a muscle reflex activity...
January 7, 2018: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
https://www.readbyqxmd.com/read/29359806/the-role-of-hypoxia-inducible-factors-in-carotid-body-patho-physiology
#20
Gregg L Semenza, Nanduri R Prabhakar
Hypoxia-inducible factors mediate adaptive responses to reduced O2 availability. In patients with obstructive sleep apnoea, repeated episodes of hypoxaemia and reoxygenation (intermittent hypoxia) are sensed by the carotid body (CB). The ensuing CB chemosensory reflex activates the sympathetic nervous system and increased secretion of catecholamines by the adrenal medulla, resulting in hypertension and breathing abnormalities. In the CB, intermittent hypoxia induces the formation of reactive oxygen species (ROS) and increased intracellular Ca2+ levels, which drive increased expression of hypoxia-inducible factor (HIF) 1α and a decrease in the levels of HIF-2α...
January 23, 2018: Journal of Physiology
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