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Central sleep apnea

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https://www.readbyqxmd.com/read/28818154/physiology-based-modeling-may-predict-surgical-treatment-outcome-for-obstructive-sleep-apnea
#1
Yanru Li, Jingying Ye, Demin Han, Xin Cao, Xiu Ding, Yuhuan Zhang, Wen Xu, Jeremy Orr, Rachel Jen, Scott Sands, Atul Malhotra, Robert Owens
STUDY OBJECTIVES: To test whether the integration of both anatomical and nonanatomical parameters (ventilatory control, arousal threshold, muscle responsiveness) in a physiology-based model will improve the ability to predict outcomes after upper airway surgery for obstructive sleep apnea (OSA). METHODS: In 31 patients who underwent upper airway surgery for OSA, loop gain and arousal threshold were calculated from preoperative polysomnography (PSG). Three models were compared: (1) a multiple regression based on an extensive list of PSG parameters alone; (2) a multivariate regression using PSG parameters plus PSG-derived estimates of loop gain, arousal threshold, and other trait surrogates; (3) a physiological model incorporating selected variables as surrogates of anatomical and nonanatomical traits important for OSA pathogenesis...
August 14, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/28817421/association-of-stop-bang-questionnaire-as-a-screening-tool-for-sleep-apnea-and-postoperative-complications-a-systematic-review-and-bayesian-meta-analysis-of-prospective-and-retrospective-cohort-studies
#2
Mahesh Nagappa, Jayadeep Patra, Jean Wong, Yamini Subramani, Mandeep Singh, George Ho, David T Wong, Frances Chung
BACKGROUND: The risk of postoperative complications increases with undiagnosed obstructive sleep apnea (OSA). The high-risk OSA (HR-OSA) patients can be easily identified using the STOP-Bang screening tool. The aim of this systematic review and meta-analysis is to determine the association of postoperative complications in patients screened as HR-OSA versus low-risk OSA (LR-OSA). METHODS: The following data bases were searched from January 1, 2008, to October 31, 2016, to identify the eligible articles: Cochrane Central Register of Controlled Trials, MEDLINE, PubMed, Cochrane Databases of Systematic Reviews, Medline-in-Process & other nonindexed citations, Google Scholar, Embase, Web of Sciences and Scopus...
August 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28814632/intermittent-apnea-elicits-inactivity-induced-phrenic-motor-facilitation-via-a-retinoic-acid-and-protein-synthesis-dependent-pathway
#3
Nathan A Baertsch, Tracy L Baker
Respiratory motoneuron pools must provide rhythmic inspiratory drive that is robust and reliable, yet dynamic enough to respond to respiratory challenges. One form of plasticity that is hypothesized to contribute to motor output stability by sensing and responding to inadequate respiratory neural activity is inactivity-induced phrenic motor facilitation (iPMF), an increase in inspiratory output triggered by a reduction in phrenic synaptic inputs. Evidence suggests that mechanisms giving rise to iPMF differ depending on the pattern of reduced respiratory neural activity (i...
August 16, 2017: Journal of Neurophysiology
https://www.readbyqxmd.com/read/28808861/epidemiology-of-sleep-disordered-breathing-and-heart-failure-what-drives-what
#4
REVIEW
Sushma M Dharia, Lee K Brown
PURPOSE OF REVIEW: The bidirectional relationships that have been demonstrated between heart failure (HF) and central sleep apnea (CSA) demand further exploration with respect to the implications that each condition has for the other. This review discusses the body of literature that has accumulated on these relationships and how CSA and its potential treatment may affect outcomes in patients with CSA. RECENT FINDINGS: Obstructive sleep apnea (OSA) can exacerbate hypertension, type 2 diabetes, obesity, and atherosclerosis, which are known predicates of HF...
August 14, 2017: Current Heart Failure Reports
https://www.readbyqxmd.com/read/28796527/role-of-leptin-in-obstructive-sleep-apnea
#5
Ikuyo Imayama, Bharati Prasad
Leptin is a peptide hormone mainly produced in white adipose tissue. It is known to regulate energy homeostasis, inflammation, metabolism, and sympathetic nerve activity. Increasing evidence suggests it has a role in ventilatory function and upper airway obstruction. Leptin levels correlate positively with measurements of adiposity and can potentially provide important insights into the pathophysiology of diseases associated with obesity. Obesity is a strong risk factor for obstructive sleep apnea, a disease characterized by periodic upper airway occlusion during sleep...
August 10, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28777366/-complex-sleep-apnea-syndrome
#6
A D Palman
Complex sleep apnea syndrome (Comp-SAS) is the term used to describe a specific form of sleep disordered breathing characterized by the arise of central sleep apnea in patient with previous obstructive sleep apnea syndrome (OSAS) treated with continuous positive airway pressure devices (CPAP). The mechanisms of its occurrence are not well understood, but partly it seems to be a consequence of increased carbon dioxide elimination under positive airway pressure treatment and related improvement of pulmonary ventilation...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/28777178/sleep-disordered-breathing
#7
Nancy R Foldvary-Schaefer, Tina E Waters
PURPOSE OF REVIEW: Sleep-disordered breathing encompasses a broad spectrum of sleep-related breathing disorders, including obstructive sleep apnea (OSA), central sleep apnea, as well as sleep-related hypoventilation and hypoxemia. Diagnostic criteria have been updated in the International Classification of Sleep Disorders, Third Edition and the American Academy of Sleep Medicine Manual for Scoring Sleep and Associated Events. Neurologic providers should have basic knowledge and skills to identify at-risk patients, as these disorders are associated with substantial morbidity, the treatment of which is largely reversible...
August 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28777177/chronic-insomnia-disorder
#8
Alon Y Avidan, David N Neubauer
PURPOSE OF REVIEW: Neurologists, along with all health care providers, commonly encounter patients with insomnia, which is a condition that impacts patients' underlying neurologic conditions in a bidirectional manner. While chronic insomnia is one of the most common sleep disturbances, only a small proportion of individuals with this condition discuss their sleep problems with their providers. When insomnia is described, it is more often in relationship to another medical problem, as opposed to an independent condition...
August 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28775068/active-sleep-unmasks-apnea-and-delayed-arousal-in-infant-rat-pups-lacking-central-serotonin
#9
Jacob O Young, Aron M Geurts, Matthew Robert Hodges, Kevin J Cummings
Sudden Infant Death Syndrome (SIDS), occurring during sleep periods, is highly associated with abnormalities within serotonin (5-HT) neurons, including reduced 5-HT. There is evidence that future SIDS cases experience more apnea and have abnormal arousal from sleep. In rodents, a loss of 5-HT neurons is associated with apnea in early life and, in adulthood, delayed arousal. As the activity of 5-HT neurons changes with vigilance state, we hypothesized that the degree of apnea and delayed arousal displayed by rat pups specifically lacking central 5-HT varies with state...
August 3, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28755899/the-serve-hf-safety-notice-in-clinical-practice-experiences-of-a-tertiary-sleep-center
#10
Anne-Kathrin Brill, Jacqueline Pichler Hefti, Thomas Geiser, Sebastian R Ott
BACKGROUND: In May 2015, the results of the SERVE-HF trial - addressing adaptive servoventilation (ASV) in chronic congestive heart failure (CHF) patients with central sleep apnea (CSA) - prompted a field safety notice. It was recommended to identify CHF patients treated with ASV and to advise the discontinuation of the treatment. We aimed to analyze the identification process and effect of ASV discontinuation on affected patients. METHODS: 126 patients treated with ASV on May 13th, 2015 at our institution were retrospectively analyzed...
March 6, 2017: Sleep Medicine
https://www.readbyqxmd.com/read/28734941/sleep-chronic-pain-and-opioid-risk-for-apnea
#11
REVIEW
Serguei Marshansky, Pierre Mayer, Dorrie Rizzo, Marc Baltzan, Ronald Denis, Gilles J Lavigne
Pain is an unwelcome sleep partner. Pain tends to erode sleep quality and alter the sleep restorative process in vulnerable patients. It can contribute to next-day sleepiness and fatigue, affecting cognitive function. Chronic pain and the use of opioid medications can also complicate the management of sleep disorders such as insomnia (difficulty falling and/or staying asleep) and sleep-disordered breathing (sleep apnea). Sleep problems can be related to various types of pain, including sleep headache (hypnic headache, cluster headache, migraine) and morning headache (transient tension type secondary to sleep apnea or to sleep bruxism or tooth grinding) as well as periodic limb movements (leg and arm dysesthesia with pain)...
July 19, 2017: Progress in Neuro-psychopharmacology & Biological Psychiatry
https://www.readbyqxmd.com/read/28728251/-progress-of-dopamine-in-obstructive-sleep-apnea-hypopnea-syndrome
#12
Z Y Song, H L Yi
The etiology and pathogenesis of sleep obstructive apnea hypopnea syndrome (OSAHS) is not yet definitive, evidence shows that the dysfunction of pharyngeal nerve and the atonia of the muscle innervated by these nerve could play an important role in the progress of OSAHS. Dopamine is a neurotransmitter in the central nervous system which significantly affects the sleep-awake regulation. So far mounting evidence shows that dopamine has a potential role in the modulation of hypoglossal nucleus. The progress of dopamine in obstructive sleep apnea hypopnea syndrome is reviewed in this article...
July 7, 2017: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
https://www.readbyqxmd.com/read/28711234/sleep-related-breathing-disorders-and-indications-for-polysomnography-in-preterm-infants
#13
Koen Joosten, Robbin de Goederen, Angelique Pijpers, Karel Allegaert
There is a range of breathing problems which occur and may persist in preterm infants, such as central apneas, obstructive apneas and periodic breathing. Preterm infants may also suffer from respiratory distress syndrome and chronic lung disease necessitating prolonged use of oxygen therapy after discharge from the hospital. Due to these persistent breathing pattern abnormalities in preterm infants, there is a higher risk of altered sleep and apparent life threatening events. Polysomnography can be a helpful tool to identify those infants who have abnormalities in their breathing pattern, to identify those infants who have an increased risk to get a sleep related breathing event at home and to decide about the discontinuation of oxygen therapy...
July 12, 2017: Early Human Development
https://www.readbyqxmd.com/read/28702829/severe-obstructive-sleep-apnea-treatment-with-oral-appliance-the-impact-on-obstructive-central-and-mixed-events
#14
Maria de Lourdes Rabelo Guimarães, Ana Paula Hermont, Pedro Guimarães de Azevedo, Poliana Lima Bastos, Millena Teles Portela de Oliveira, Iracema Matos de Melo, Guilherme Salles Ottoboni, Gabriela Vedolin, Jorge Machado Caram
PURPOSE: The aim of this study is to evaluate the effectiveness of two types of oral appliance (OA) in the treatment of severe obstructive sleep apnea syndrome (OSAS) and their impact on the reduction of obstructive, central and mixed apneas. METHODS: Forty-eight patients suffering from severe OSAS with a history of non-adherence to positive airway pressure therapy were treated with OA (lingual orthosis and combined orthosis). Polysomnography exams were performed before and after treatment...
July 12, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/28697968/update-on-pathophysiology-and-treatment-of-childhood-obstructive-sleep-apnea-syndrome
#15
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/28697252/association-of-positive-airway-pressure-with-cardiovascular-events-and-death-in-adults-with-sleep-apnea-a-systematic-review-and-meta-analysis
#16
REVIEW
Jie Yu, Zien Zhou, R Doug McEvoy, Craig S Anderson, Anthony Rodgers, Vlado Perkovic, Bruce Neal
Importance: Sleep apnea (obstructive and central) is associated with adverse cardiovascular risk factors and increased risks of cardiovascular disease. Positive airway pressure (PAP) provides symptomatic relief, whether delivered continuously (CPAP) or as adaptive servo-ventilation (ASV), but the associations with cardiovascular outcomes and death are unclear. Objective: To assess the association of PAP vs control with cardiovascular events and death in patients with sleep apnea...
July 11, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28681964/a-shared-comparison-of-diabetes-mellitus-and-neurodegenerative-disorders
#17
Mahmoud Morsi, Ahmed Maher, Ahmed Metwally, Omnia Abo-Elmagd, Dina Johar, Larry Bernstein
Diabetes Mellitus (DM) is one of the most common diseases in the world population, associated with obesity, pancreatic endocrine changes, cardiovascular disease, renal glomerular disease, cerebrovascular disease, peripheral neuropathy, neurodegenerative disease, retinal disease, sleep apnea, some of which are bundled into the metabolic syndrome. The main characteristic of this disease is hyperglycemia, and often with albuminuria. Nevertheless, the classic features, with ketoacidosis in the extreme, are only a first layer of description of this condition...
July 6, 2017: Journal of Cellular Biochemistry
https://www.readbyqxmd.com/read/28673378/newly-diagnosed-obstructive-sleep-apnoea-and-type-2-diabetes-mellitus
#18
Anne Roed Jacobsen, Freja Eriksen, Line Thorup, Lykke Bennedsen Skødeberg, Jonas Peter Yde Holm, Klavs Wörgler Hansen
INTRODUCTION: Obstructive sleep apnoea (OSA) is frequent in type 2 diabetes mellitus (DM) and is seen in 12-30% of patients with newly diagnosed OSA according to previous studies. Our aim was to determine the referral pattern and prevalence of patients with self-reported type 2 DM in a Danish cohort of patients with newly diagnosed OSA. Furthermore, we compared clinical data related to the sleep disorder in patients with and without type 2 DM and different OSA severities. METHODS: This retrospective observational study was based on data from a cohort including all patients offered continuous positive airway pressure therapy in the course of a 14-month period after being referred to a sleep disorders clinic...
July 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28669116/validation-of-apnealink%C3%A2-plus-for-the-diagnosis-of-sleep-apnea
#19
Jae Hoon Cho, Hyun Jun Kim
PURPOSE: The aim of this study is to evaluate the validation of ApneaLink™ Plus (ALP) based on a large number of subjects in a prospective design. METHOD: We recommended enrolling of 200 consecutive patients who had been referred because of habitual snoring or witnessed apnea during sleep. If consent was obtained, patients underwent standard polysomnography (PSG) and ALP evaluation simultaneously at the hospital (ALPlab), and repeated ALP at home (ALPhome) within 1 month...
July 1, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/28668820/obstructive-and-central-sleep-apnea-and-the-risk-of-incident-atrial-fibrillation-in-a-community-cohort-of-men-and-women
#20
Patricia Tung, Yamini S Levitzky, Rui Wang, Jia Weng, Stuart F Quan, Daniel J Gottlieb, Michael Rueschman, Naresh M Punjabi, Reena Mehra, Suzie Bertisch, Emelia J Benjamin, Susan Redline
BACKGROUND: Previous studies have documented a high prevalence of atrial fibrillation (AF) in individuals with obstructive sleep apnea (OSA). Central sleep apnea (CSA) has been associated with AF in patients with heart failure. However, data from prospective cohorts are sparse and few studies have distinguished the associations of obstructive sleep apnea from CSA with AF in population studies. METHODS AND RESULTS: We assessed the association of obstructive sleep apnea and CSA with incident AF among 2912 individuals without a history of AF in the SHHS (Sleep Heart Health Study), a prospective, community-based study of existing ("parent") cohort studies designed to evaluate the cardiovascular consequences of sleep disordered breathing...
July 1, 2017: Journal of the American Heart Association
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