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Pathophysiology of obstructive sleep apnea

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https://www.readbyqxmd.com/read/28697968/update-on-pathophysiology-and-treatment-of-childhood-obstructive-sleep-apnea-syndrome
#1
REVIEW
Justin C Brockbank
Obstructive sleep apnea syndrome (OSAS) is common in childhood and is characterized by recurrent upper airway obstructive events during sleep that produce significant neurocognitive and cardiovascular sequelae. The pathophysiology of childhood OSAS is complex and involves mechanical airway obstruction often secondary to adenotonsillar hypertrophy. However, neuromotor abnormalities and instability of central ventilatory control are also implicated. Several surgical and non-surgical treatment options for childhood OSAS are available, and will be discussed...
June 12, 2017: Paediatric Respiratory Reviews
https://www.readbyqxmd.com/read/28670393/chronic-intermittent-hypoxia-decreases-pulmonary-clearance-of-99m-tc-labelled-particulate-matter-in-mice
#2
Cuiping Fu, Huan Lu, Xu Wu, Jie Liu, Chengying Liu, Zilong Liu, Wei Yuan, Jian Zhou, Shanqun Li
BACKGROUND: Obstructive sleep apnea-hypopnea syndrome (OSAHS) could cause systematic inflammation including pulmonary inflammatory response, whereas the influence of OSAHS in pulmonary clearance ability remains unknown. The main pathophysiological feature of OSAHS is chronic intermittent hypoxia (CIH). The goal of this study is to clarify the airway clearance of particulate matter (PM) in CIH mice, and to explore the potential mechanism. METHODS: Balb/c mice were divided into a CIH group and a control group, exposed to intermittent hypoxia and air chamber, respectively...
2017: American Journal of Translational Research
https://www.readbyqxmd.com/read/28667353/the-use-of-handheld-nasal-spirometry-to-predict-the-presence-of-obstructive-sleep-apnea
#3
Judd H Fastenberg, Christina H Fang, Viraj M Patel, Juan Lin, Howard D Stupak
OBJECTIVE: Nasal obstruction and oral breathing may play an important role in the pathophysiology of obstructive sleep apnea (OSA). This study aims to better understand the link between oral breathing, nasal obstruction, and the spectrum of sleep-disordered breathing. STUDY DESIGN: Prospective study. METHODS AND MATERIALS: Prospective study of patients who presented to the Otolaryngology clinic and underwent polysomnogram (PSG) from 2015 to 2016...
June 30, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/28647595/intermittent-hypoxia-caused-cognitive-dysfunction-relate-to-mirnas-dysregulation-in-hippocampus
#4
Huabin Gao, Zhaoli Han, Shan Huang, Ruojing Bai, Xintong Ge, Fanglian Chen, Ping Lei
Intermittent hypoxia (IH) is a characteristic pathophysiological change of obstructive sleep apnea (OSA), a commonly diagnosed chronic sleep disorder. With the process of OSA, patients will suffer from the nervous system damage and appear to multiple cognitive dysfunction. The mechanism that how IH causes cognitive impairment is still unknown. Both control and experimental rats were placed in conditions absence and presence of intermittent hypoxia (IH) for 8h a day for a week, two weeks and four weeks, and then followed by behavioral assessments with Morris Water Maze (MWM) test...
June 21, 2017: Behavioural Brain Research
https://www.readbyqxmd.com/read/28637196/chronological-change-of-right-ventricle-by-chronic-intermittent-hypoxia-in-mice
#5
Hyung-Ju Cho, Woon Heo, Jung Woo Han, Yong Hyuk Lee, Jin Myung Park, Min Jung Kang, Joo-Heon Yoon, Min Goo Lee, Chang-Hoon Kim, Joo Young Kim
Study Objective: No studies have investigated sequential changes in the heart on MRI, along with observation of functional lung phenotypes and genetics, over the duration of chronic intermittent hypoxia (CIH). We investigated chronological changes in heart and lung phenotypes after CIH using a mouse model to provide new insights into the pathophysiology of sleep apnea-induced cardiovascular disease. Methods: C57BL/6J adult male mice were randomized to 4 weeks or 8 weeks of CIH...
June 20, 2017: Sleep
https://www.readbyqxmd.com/read/28635907/-the-problem-of-obstructive-sleep-apnea-syndrome-in-asthmatic-patients
#6
E G Sheludko, D E Naumov, Yu M Perelman, V P Kolosov
Asthma and obstructive sleep apnea syndrome (OSAS) are one of the most common chronic respiratory diseases. These have common risk factors that include obesity, gastroesophageal reflux disease (GERD) and impaired nasal breathing (allergic rhinitis, sinusitis). At the same time, experimental evidence demonstrates common pathophysiological mechanisms of these diseases, such as involvement in the process of the respiratory tract, a systemic inflammatory response, and implementation of neuromechanical reflexes...
2017: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/28620058/intermittent-hypercapnic-hypoxia-during-sleep-does-not-induce-ventilatory-long-term-facilitation-in-healthy-males
#7
Naomi Louise Deacon, Doug R McEvoy, Daniel L Stadler, Peter G Catcheside
Intermittent hypoxia induced ventilatory neuroplasticity is likely important in obstructive sleep apnea pathophysiology. Although concomitant CO2 levels and arousal state critically influence neuroplastic effects of intermittent hypoxia, no studies have investigated intermittent hypercapnic hypoxia effects during sleep in humans. Thus, the purpose of this study was to investigate if intermittent hypercapnic hypoxia during sleep induces neuroplasticity (ventilatory long-term facilitation and increased chemoreflex responsiveness) in humans...
June 15, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28599952/risk-of-developing-obstructive-sleep-apnea-among-women-with-polycystic-ovarian-syndrome-a-nationwide-longitudinal-follow-up-study
#8
Ting-Yang Lin, Pei-Yin Lin, Tung-Ping Su, Cheng-Ta Li, Wei-Chen Lin, Wen-Hang Chang, Tzeng-Ji Chen, Ya-Mei Bai, Mu-Hong Chen
BACKGROUND: Previous cross-sectional studies have suggested a comorbid relationship between polycystic ovarian syndrome (PCOS) and obstructive sleep apnea (OSA). However, the temporal association between these two distinct diseases has not yet been investigated. METHODS: Using the Taiwan National Health Insurance Research Database, 4595 women with PCOS and 4595 (1:1) age-/sex-matched controls were enrolled into the present study between 1998 and 2009, and followed to the end of 2011...
March 10, 2017: Sleep Medicine
https://www.readbyqxmd.com/read/28571821/rhinitis-and-sleep-disorders-the-trigeminocardiac-reflex-link
#9
Barkha Bindu, Gyaninder Pal Singh, Tumul Chowdhury, Bernhard Schaller
Rhinitis, allergic or non-allergic, is an inflammatory condition of the nose. It is associated with a wide range of sleep disorders that are generally attributed to nasal congestion and presence of inflammatory mediators like cytokines and interleukins. However, the pathophysiological mechanisms behind these sleep disorders remain unclear. On the other hand, the trigeminocardiac reflex (TCR) has recently been linked to various sleep disorders like obstructive sleep apnea, sleep bruxism and rapid eye movement (REM) sleep apnea...
June 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28555408/bariatric-surgery-induced-resolution-of-hypertension-and-obstructive-sleep-apnea-impact-of-modulation-of-body-fat-ectopic-fat-autonomic-nervous-activity-inflammatory-and-adipokine-profiles
#10
Audrey Auclair, Laurent Biertho, Simon Marceau, Frédéric-Simon Hould, Simon Biron, Stéfane Lebel, François Julien, Odette Lescelleur, Yves Lacasse, Marie-Eve Piché, Katherine Cianflone, Sebastian Demian Parlee, Kerry Goralski, Julie Martin, Marjorie Bastien, David H St-Pierre, Paul Poirier
BACKGROUND: Obesity-associated systemic hypertension (HTN) and obstructive sleep apnea (OSA) have multiple pathophysiological pathways including ectopic fat deposition, inflammation, altered adipokine profile, and increased sympathetic nervous activity. We characterized these potential mechanisms in severely obese patients with or without HTN and OSA. We also compared changes of these mechanisms at 12 months following biliopancreatic diversion with duodenal switch (BPD-DS) surgery according to HTN and OSA resolution...
May 29, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28522758/regulation-of-erythropoiesis-after-normoxic-return-from-chronic-sustained-and-intermittent-hypoxia
#11
Jihyun Song, Krishna Sundar, Radhika Gangaraju, Josef T Prchal
Hypoxia increases erythropoiesis mediated by hypoxia-inducible transcription factors (HIF) which regulate erythropoietin (EPO) transcription. Neocytolysis is a physiological mechanism that corrects polycythemia from chronic sustained hypoxemia (CSH) by transient, preferential destruction of young RBCs after normoxia is restored. We showed that neocytolysis is caused by excessive mitochondrial-derived reactive oxygen species (ROS) in reticulocytes mediated by down-regulation of HIF-controlled BNIP3L regulated mitophagy and a decrease in RBC antioxidant catalase (CAT) in hypoxia-produced erythrocytes...
May 18, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28489776/is-c-reactive-protein-a-marker-of-obstructive-sleep-apnea-a-meta-analysis
#12
REVIEW
Kun Li, Peng Wei, Yanwen Qin, Yongxiang Wei
BACKGROUND: Obstructive sleep apnea (OSA) is a common disease, distinguished by recurrent episodes of upper airway obstruction during sleep, with an inflammatory component. C-reactive protein (CRP) and high-sensitivity C-reactive protein (hs-CRP) are markers of systemic inflammation and may serve as biomarkers of OSA. METHODS: Scientific studies published from January 1, 2006, to January 1, 2016 were obtained via searches of PubMed, Embase, SCI, and China National Knowledge Internet (CNKI) using relevant terms...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28474128/-chronic-hypoxia-and-cardiovascular-risk-clinical-significance-of-different-forms-of-hypoxia
#13
REVIEW
U Koehler, O Hildebrandt, J Krönig, W Grimm, J Otto, W Hildebrandt, R Kinscherf
It is of fundamental importance to differentiate whether chronic hypoxia occurs intermittently or persistently. While chronic intermittent hypoxia (CIH) is found typically in patients with obstructive sleep apnea (OAS), chronic persistent hypoxia (CPH) is typically diagnosed in patients with chronic lung disease. Cardiovascular risk is markedly increased in patients with CIH compared to patients with CPH. The frequent change between oxygen desaturation and reoxygenation in patients with CIH is associated with increased hypoxic stress, increased systemic inflammation, and enhanced adrenergic activation followed by endothelial dysfunction and increased arteriosclerosis...
May 4, 2017: Herz
https://www.readbyqxmd.com/read/28465478/chronic-obstructive-sleep-apnea-promotes-aortic-remodeling-in-canines-through-mir-145-smad3-signaling-pathway
#14
Chengyuan Yu, Yang Liu, Li Sun, Dingyu Wang, Yike Wang, Shiqi Zhao, Hui Dai, Jing Zhao, Song Zhang, Minghui Li, Yu Han, Shuang Lu, Xinwen Dong, Guangzhong Liu, Shengzhu Yu, Yue Li
Obstructive sleep apnea (OSA) is a causal pathogenetic factor of many cardiovascular diseases, however, its role in aortic diseases remains unknown. Therefore, this study was performed to explore the potential effects and pathophysiological mechanisms of chronic OSA on aortic remodeling in a canine model. After chronic OSA, the morphological changes of ascending aorta were characterized by thinner cells with pycnotic nuclei and swollen mitochondria, and obvious hyperplasia of collagenous fiber in the matrix...
June 6, 2017: Oncotarget
https://www.readbyqxmd.com/read/28450367/atrial-fibrillation-epidemiology-pathophysiology-and-clinical-outcomes
#15
REVIEW
Laila Staerk, Jason A Sherer, Darae Ko, Emelia J Benjamin, Robert H Helm
The past 3 decades have been characterized by an exponential growth in knowledge and advances in the clinical treatment of atrial fibrillation (AF). It is now known that AF genesis requires a vulnerable atrial substrate and that the formation and composition of this substrate may vary depending on comorbid conditions, genetics, sex, and other factors. Population-based studies have identified numerous factors that modify the atrial substrate and increase AF susceptibility. To date, genetic studies have reported 17 independent signals for AF at 14 genomic regions...
April 28, 2017: Circulation Research
https://www.readbyqxmd.com/read/28412967/factors-associated-with-lingual-tonsil-hypertrophy-in-canadian-adults
#16
Matthew S Harris, Brian W Rotenberg, Kathryn Roth, Leigh J Sowerby
BACKGROUND: Hypertrophy of the lingual tonsil tissue in the adult patient is thought to contribute to the pathophysiology of obstructive sleep apnea. The underlying etiology of lingual tonsil hypertrophy (LTH) in the adult patient is unclear and likely multifactorial. Previous studies have suggested that the lingual tonsils may undergo compensatory hyperplasia post-tonsillectomy in children, although it is unknown if this occurs or persists into adulthood. The purpose of this study was to determine what factors are associated with LTH in a population of Canadian adults...
April 17, 2017: Journal of Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28408696/assessment-of-tongue-mechanical-properties-using-different-contraction-tasks
#17
Wen-Yang Li, Simon Gakwaya, Didier Saey, Frédéric Sériès
Inadequate UA dilator muscle function may play an important role in the pathophysiology of obstructive sleep apnea (OSA). To date, tongue mechanical properties have been mainly assessed using protrusion protocol with conflicting results, while performance during elevation task among patients with OSA remains unknown. This study was aimed to assess tongue muscle strength, strength stability, endurance time, fatigue indices and muscle total work, using elevation and protrusion tasks with repetitive isometric fatiguing contractions during awake in 12 normal+mild, 17 moderate and 11 severe patients with OSA, and to assess the influence of BMI and age...
April 13, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28401379/kidney-lung-pathophysiological-crosstalk-its-characteristics-and-importance
#18
REVIEW
Pilar Domenech, Tomas Perez, Agustina Saldarini, Pedro Uad, Carlos G Musso
Crosstalk between the lung and the kidney is based on the similarities that these organs share. This is why different diseases that affect one organ can have repercussions on the other. Patients with acute kidney injury can present complications such as pulmonary edema and require mechanical ventilation in respiratory failure. This interaction occurs due to the increase in systemic immune mediators that cause inflammatory reactions, oxidative stress, and an increase in vascular permeability in the lung. With regard to lung-induced renal damage, the kidney can also be affected by chemical mediators, which are translocated into the bloodstream...
July 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28394772/obstructive-sleep-apnea-increases-systolic-and-diastolic-blood-pressure-variability-in-hypertensive-patients
#19
Jing Shi, Jingyan Piao, Bin Liu, Yujiao Pan, Yongtai Gong, Xianzhu Deng, Weiyan Sun, Shuang Lu, Yue Li
OBJECTIVE: Obstructive sleep apnea (OSA) has been identified as the most common secondary contributing factor for the development and worsening of hypertension. However, the underlying relationships between blood pressure variability (BPV) and OSA are still not very clear. Therefore, we investigated the influences of OSA on BPV in hypertensive patients and explored the potential pathophysiologic mechanisms. PARTICIPANTS AND METHODS: Ambulatory blood pressure (BP) monitoring was carried out and polysomnography was performed to detect sleep apnea...
August 2017: Blood Pressure Monitoring
https://www.readbyqxmd.com/read/28390595/obstructive-sleep-apnea-in-a-5-month-old-with-tonsillar-hypertrophy-secondary-to-congenital-neutropenia-case-report-and-literature-review
#20
REVIEW
O G Ahmed, E M Lambert
Tonsillectomy and adenoidectomy (T&A) is the primary surgical treatment for obstructive sleep apnea (OSA) in children with tonsillar and adenoid hypertrophy (TAH). We present the case of a 5-month old male with congenital neutropenia who developed severe TAH during treatment with granulocyte colony-stimulating factor (G-CSF). He had severe OSA, decreased oral intake, and failure to thrive (FTT) which all improved after undergoing a successful intracapsular T&A. We describe a successful procedure to help alleviate symptoms of OSA and FTT in this young infant with congenital neutropenia who developed TAH during treatment with G-CSF...
May 2017: International Journal of Pediatric Otorhinolaryngology
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