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Pathophysiology of obstructive sleep apnea

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https://www.readbyqxmd.com/read/29867724/aberrant-interhemispheric-connectivity-in-obstructive-sleep-apnea-hypopnea-syndrome
#1
Yu-Ting Liu, Hui-Xin Zhang, Hui-Jun Li, Ting Chen, Ya-Qing Huang, Lian Zhang, Zhi-Chun Huang, Bin Liu, Ming Yang
Objective: To determine the changes in interhemispheric functional coordination in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) relative to controls, using a recently introduced method of analysis: voxel-mirrored homotopic connectivity (VMHC). Methods: Twenty-nine patients with OSAHS and twenty-six normal sex-, age-, and education-matched controls were recruited and resting-state functional magnetic resonance imaging data were obtained. We employed VMHC to analyze the interhemispheric functional connectivity differences between groups...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29804145/residual-renal-function-affects-severity-of-sleep-apnea-in-peritoneal-dialysis-a-pilot-study
#2
Aviya Lanis, Eric Kerns, Susie L Hu, Margaret H Bublitz, Patricia Risica, Susan Martin, Jeffrey Parker, Richard Millman, Lance D Dworkin, Ghada Bourjeily
PURPOSE: Obstructive sleep apnea is common in patients with end-stage renal disease, and there is increasing evidence that clinical factors specific to end-stage renal disease contribute pathophysiologically to obstructive sleep apnea. It is not known whether circumstances specific to dialysis modality, in this case peritoneal dialysis, affect obstructive sleep apnea. Our study aimed to investigate the prevalence of obstructive sleep apnea in the peritoneal dialysis population and the relevance of dialysis-specific measures and kidney function in assessing this bidirectional relationship...
May 26, 2018: Lung
https://www.readbyqxmd.com/read/29801027/association-of-obstructive-sleep-apnea-with-calvarial-and-skull-base-thinning
#3
Cyrus Rabbani, Mohamad Z Saltagi, Michael J Ye, Janaki M Patel, Shalini Manchanda, Rick F Nelson
Importance: Spontaneous cerebrospinal fluid leaks (sCSF-L) of the temporal bone are associated with obesity, calvarial thinning, and obstructive sleep apnea (OSA), and the incidence has doubled in the past decade. It is currently unknown if OSA is independently associated with skull thinning. Objective: To determine if patients with OSA have thinner skulls than patients without OSA. Design, Setting, and Participants: A retrospective cohort study of patients who underwent a level 1 polysomnogram (PSG) and also had high-resolution computed tomographic (CT) imaging of the head from January 2010 to March 2017 at Indiana University was carried out...
May 3, 2018: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29798363/-an-association-between-obstructive-sleep-apnea-hypopnea-syndrome-and-deep-vein-thrombosis-and-pulmonary-embolism
#4
REVIEW
L Li, G H Jin, J Q Lang, N Cui
OSAHS is a kind of the sleep-related breathing disorder, with lack of oxygen. OSAHS can induce many kinds of cardiovascular system diseases. Deep vein thrombosis and pulmonary embolism (deep vein thrombosis and/or pulmonary embolism, DVT and PE) is caused by deep vein thrombosis embolism pulmonary artery trunk or branch pulmonary disorder, potentially lethal diseases of the cardiovascular system. In recent years, researchers have found that OSAHS may have something to do with DVT-PE. So in this review, the relationship was summarized between OSAHS and DVT-PE in epidemiology, pathophysiology, assessment and treatment measures...
August 5, 2017: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
https://www.readbyqxmd.com/read/29788034/sleep-disorders-including-sleep-apnea-and-hypertension
#5
E M Van Ryswyk, S Mukherjee, C L Chai-Coetzer, A Vakulin, R D McEvoy
There is mounting evidence for an association between sleep disorders and hypertension. In obstructive sleep apnea (OSA) there are plausible biological reasons for the development of hypertension, and treatment of OSA results in modest (2-3 mmHg), adherence-dependent decreases in blood pressure (BP), with larger effects evident in those with resistant hypertension. However, prospective, population-based cohort studies have not yet convincingly demonstrated a link between OSA and incident hypertension, and adequately powered controlled trials of CPAP for the prevention or treatment or hypertension are lacking...
May 17, 2018: American Journal of Hypertension
https://www.readbyqxmd.com/read/29759271/drug-therapy-in-obstructive-sleep-apnea
#6
REVIEW
Jan Hedner, Ding Zou
There are several reasons to develop a pharmacologic remedy in obstructive sleep apnea (OSA); but so far, there is no generally effective drug available. Previous attempts to find a drug in OSA therapy were serendipity driven in small pilot trials. There is growing literature on phenotyping pathophysiologic mechanisms of OSA that may be exploited in strategic drug development programs. The current review addresses potential pitfalls encountered in previous studies and highlights several drug candidates under development in the field...
June 2018: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/29741725/ventilatory-control-sensitivity-in-patients-with-obstructive-sleep-apnea-is-sleep-stage-dependent
#7
Shane A Landry, Christopher Andara, Philip I Terrill, Simon A Joosten, Paul Leong, Dwayne L Mann, Scott A Sands, Garun S Hamilton, Bradley A Edwards
Study Objectives: The severity of obstructive sleep apnea (OSA) is known to vary according to sleep stage; however, the pathophysiology responsible for this robust observation is incompletely understood. The objective of the present work was to examine how ventilatory control system sensitivity (i.e. loop gain) varies during sleep in patients with OSA. Methods: Loop gain was estimated using signals collected from standard diagnostic polysomnographic recordings performed in 44 patients with OSA...
May 1, 2018: Sleep
https://www.readbyqxmd.com/read/29725917/pain-headache-and-other-non-motor-symptoms-in-myasthenia-gravis
#8
REVIEW
Olivia Tong, Leslie Delfiner, Steven Herskovitz
PURPOSE OF REVIEW: Myasthenia gravis (MG) is traditionally conceptualized as a disease with purely motor manifestations. This paper reviews the supporting evidence and pathophysiology of non-motor symptoms in MG, including pain, headache, special sense and autonomic dysfunction, sleep disturbance, and cognitive and psychosocial issues. RECENT FINDINGS: Work in this area has been limited. Recent studies have identified bodily pain and headache as common complaints in patients with MG...
May 3, 2018: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/29720305/on-line-breath-metabolomics-in-respiratory-diseases-using-secondary-electrospray-ionization-mass-spectrometry
#9
Martin Thomas Gaugg
Every second we are exhaling hundreds of endogenous and exogenous compounds that originate from blood and lung tissue. Obtaining metabolic information via exhaled breath analysis has been an emerging topic since the 1970s. Secondary electrospray ionization-mass spectrometry is a relatively new technique to detect these metabolites on-line in a highly sensitive and specific fashion. Using this technique, several respiratory diseases, including chronic obstructive pulmonary disease, obstructive sleep apnea, idiopathic pulmonary fibrosis, asthma, and lung cancer have been investigated over the past years...
April 25, 2018: Chimia
https://www.readbyqxmd.com/read/29705781/the-respiratory-overlap-syndrome-efficacy-and-usefulness-of-the-combined-double-bronchodilation
#10
Albino Petrone, Filippo Luca Fimognari, Francesco Mormile, Leonello Fuso, Michela Quartieri, Ludovico Petrone, Francesco Romano
The coexistence of chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea syndrome in a single patient is known as "overlap syndrome," and worsens the prognosis of the affected subjects. A marked bronchodilation may be useful for the treatment of this condition. In fact, as stated in the GOLD 2017 guidelines, the combination of indacaterol/glycopyrronium may exert positive synergistic effects on smooth muscle cell and airway resistance, with a more pronounced efficiency in reducing lung hyperinflation...
2018: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/29705780/a-case-of-ventricular-fibrillation-in-a-frail-patient-with-chronic-obstructive-pulmonary-disease-obstructive-sleep-apnea-syndrome-and-electrolytic-disorder
#11
Nicola Marchitto, Monica Mauti, Simona Andreozzi, Alberto Pannozzi, Serenella G Dalmaso, Gianfranco Raimondi
Chronic obstructive pulmonary disease (COPD) is associated with an increased cardiovascular risk, although the pathophysiological mechanisms responsible for this interdependence are not completely known. For instance, the increased sympathetic activity may be implied. The severity of COPD correlates with various arrhythmic manifestations such as atrial fibrillation, atrial flutter, and either sustained or nonsustained ventricular tachycardia. COPD and obstructive sleep apnea syndrome may increase the overall cardiovascular risk, especially in elderly patients...
2018: Respiration; International Review of Thoracic Diseases
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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 21, 2018: Metabolism: Clinical and Experimental
https://www.readbyqxmd.com/read/29536012/post-stroke-sleep-disordered-breathing-pathophysiology-and-therapy-options
#18
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
#19
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...
May 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
#20
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
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