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Central sleep apnea

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https://www.readbyqxmd.com/read/28543355/nurse-versus-physician-led-care-for-obstructive-sleep-apnea-a-systematic-review-and-meta-analysis-of-randomised-trials
#1
REVIEW
Fengqiu Gong, Xiaojun Chen, Yaoye Wu, Dianye Yao, Lihong Xie, Qiuyi Ouyang, Ping Wang, Gang Niu
AIM: To evaluate the effectiveness of nurse-led care for obstructive sleep apnoea compared with physician-led care. BACKGROUND: The incidence of obstructive sleep apnoea is increasing worldwide. There is a need for cost-effective care models to ease off the pressure on tertiary care centres and divert care to the community. DESIGN: Systematic review and meta-analysis. DATA SOURCES: We searched major electronic databases (MEDLINE, EMBASE, AMED, British Nursing Index, CINAHL, HMIC, PsycINFO, Health Business Elite and the Cochrane Central Register of Controlled Trials CENTRAL) from inception till December 2016 using a structured search strategy for all randomised trials evaluating nurse-led treatment interventions for adults with obstructive sleep apnoea compared with physician-led ones...
May 24, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28542657/-polygraphy-in-hospitalized-children-under-3-months
#2
Daniel Zenteno, Iván Rodríguez-Núñez, Ignacio Molina, Rubén Peña, Carla Rivas, Jaime Tapia, Pablo Brockmann
Apnea and apparently lethal events have great etiological diversity thus complementary tests may help diagnosis. The aim of this study was to describe the results of polygraph studies of children under 3 months hospitalized with suspected apnea. PATIENTS AND METHODS: Retrospective case series. Children under 3 months with suspected apnea were considered and in whom a polygraphy (PG) was performed during hospitalization. General data, the apnea/hypopnea index (AHI), index of central. apnea, obstructive apnea index, average and minimum saturation were recorded...
April 2017: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/28539541/sleep-disordered-breathing-in-heart-failure%C3%A3-a-therapeutic-dilemma
#3
Nobuhiko Haruki, John S Floras
Sleep-disordered breathing (SDB) occurs in approximately 50% of patients with reduced left ventricular ejection fraction receiving contemporary heart failure (HF) therapies. Obstructive (OSA) and central sleep apneas (CSA) interrupt breathing by different mechanisms but impose qualitatively similar autonomic, chemical, mechanical, and inflammatory burdens on the heart and circulation. Because contemporary evidence-based drug and device HF therapies have little or no mitigating effect on the acute or long-term consequences of such stimuli, there is a sound mechanistic rationale for targeting SDB to reduce cardiovascular event rates and prolong life...
May 23, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28536140/angiotensin-converting-enzyme-1-in-the-median-preoptic-nucleus-contributes-to-chronic-intermittent-hypoxia-hypertension
#4
Katelynn E Faulk, T Prashant Nedungadi, J Thomas Cunningham
Obstructive sleep apnea is associated with hypertension and cardiovascular disease. Chronic intermittent hypoxia is used to model the arterial hypoxemia seen in sleep apnea patients and is associated with increased sympathetic nerve activity and a sustained diurnal increase in blood pressure. The renin angiotensin system has been associated with hypertension seen in chronic intermittent hypoxia. Angiotensin converting enzyme 1, which cleaves angiotensin I to the active counterpart angiotensin II, is present within the central nervous system and has been shown to be regulated by AP-1 transcription factors, such as ΔFosB...
May 2017: Physiological Reports
https://www.readbyqxmd.com/read/28530876/research-continuous-surveillance-of-sleep-apnea-patients-in-a-medical-surgical-unit
#5
Dana Supe, Leah Baron, Tom Decker, Kyle Parker, Jeanne Venella, Sarah Williams, Kari Beaton, John Zaleski
This report consists of two separate studies on the use of continuous capnography monitoring conducted in an effort to improve patient safety at Virtua Health System. The desire for improved patient safety is motivating continuous monitoring and improved surveillance in clinical areas not traditionally equipped for such monitoring. We explored the use of remote monitoring of capnography, using enterprise middleware, in patients recovering from surgery in a medical-surgical unit. Continuous monitoring traditionally has been used in higher-acuity settings, such as intensive care units...
May 2017: Biomedical Instrumentation & Technology
https://www.readbyqxmd.com/read/28528846/the-multi-level-impact-of-chronic-intermittent-hypoxia-on-central-auditory-processing
#6
Eddie Wong, Bin Yang, Lida Du, Wai Hong Ho, Condon Lau, Ya Ke, Ying Shing Chan, Wing Ho Yung, Ed X Wu
During hypoxia, the tissues do not obtain adequate oxygen. Chronic hypoxia can lead to many health problems. A relatively common cause of chronic hypoxia is sleep apnea. Sleep apnea is a sleep breathing disorder that affects 3-7% of the population. During sleep, the patient's breathing starts and stops. This can lead to hypertension, attention deficits, and hearing disorders. In this study, we apply an established chronic intermittent hypoxemia (CIH) model of sleep apnea to study its impact on auditory processing...
May 19, 2017: NeuroImage
https://www.readbyqxmd.com/read/28527878/obstructive-sleep-apnea-and-diabetes-a-state-of-the-art-review
#7
REVIEW
Sirimon Reutrakul, Babak Mokhlesi
Obstructive sleep apnea (OSA) is a chronic treatable sleep disorder and a frequent comorbidity in patients with type 2 diabetes. Cardinal features of OSA, including intermittent hypoxemia and sleep fragmentation, have been linked to abnormal glucose metabolism in laboratory-based experiments. OSA has also been linked to the development of incident type 2 diabetes. The relationship between OSA and type 2 diabetes may be bidirectional in nature given that diabetic neuropathy can affect central control of respiration and upper airway neural reflexes promoting sleep-disordered breathing...
May 17, 2017: Chest
https://www.readbyqxmd.com/read/28522081/natural-course-and-potential-prognostic-factors-for-sleep-disordered-breathing-in-multiple-system-atrophy
#8
Yasuyoshi Ohshima, Hideaki Nakayama, Naho Matsuyama, Satoshi Hokari, Takuro Sakagami, Tomoe Sato, Toshiyuki Koya, Tetsuya Takahashi, Toshiaki Kikuchi, Masatoyo Nishizawa, Takayoshi Shimohata
OBJECTIVE/BACKGROUND: Multiple system atrophy (MSA) frequently results in the development of sleep-disordered breathing (SDB). Few reports have described the natural course of this phenomenon. The aim of the present study was to determine the natural course of SDB and prognostic factors associated with such conditions in MSA. PATIENTS/METHODS: Twenty-four consecutive patients were recruited with probable MSA, who had not been treated with continuous positive airway pressure (CPAP) and had undergone overnight polysomnography (PSG) more than once following the development of snoring or stridor...
June 2017: Sleep Medicine
https://www.readbyqxmd.com/read/28507531/noradrenergic-activation-of-hypoglossal-nucleus-modulates-the-central-regulation-of-genioglossus-in-chronic-intermittent-hypoxic-rats
#9
Xinshi Nie, Ling Zhou, Aidi Wang, Hongyu Jin, Zheng Qin, Jian Pang, Wei Wang, Jian Kang
Neuromuscular compensation of the genioglossus muscle can be induced by chronic intermittent hypoxia (CIH) in obstructive sleep apnea to maintain upper airway stability. Noradrenergic activation of hypoglossal nucleus plays a critical role in the central control of the genioglossus. However, it remains unknown whether norepinephrine takes part in the central regulation of the genioglossus during CIH. Adult male Wistar rats (n = 32) were studied to explore the influence of noradrenergic activation of hypoglossal nucleus on the central control of the genioglossus at different stages of CIH...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28506292/normobaric-hypoxia-overnight-impairs-cognitive-reaction-time
#10
Stephan Pramsohler, Stefan Wimmer, Martin Kopp, Hannes Gatterer, Martin Faulhaber, Martin Burtscher, Nikolaus Cristoph Netzer
BACKGROUND: Impaired reaction time in patients suffering from hypoxia during sleep, caused by sleep breathing disorders, is a well-described phenomenon. High altitude sleep is known to induce periodic breathing with central apneas and oxygen desaturations, even in perfectly healthy subjects. However, deficits in reaction time in mountaineers or workers after just some nights of hypoxia exposure are not sufficiently explored. Therefore, we aimed to investigate the impact of sleep in a normobaric hypoxic environment on reaction time divided by its cognitive and motoric components...
May 15, 2017: BMC Neuroscience
https://www.readbyqxmd.com/read/28493179/where-to-position-osteotomies-in-genioglossal-advancement-surgery-based-on-locations-of-the-mental-foramen-canine-lateral-incisor-central-incisor-and-genial-tubercle
#11
Joshua S Park, Christopher Lee, Jason M Rogers, Ho-Hyun Sun, Yuan F Liu, Jeffrey A Elo, Jared C Inman
PURPOSE: The study aimed to provide precise measurements of anterior mandibular structural anatomy and to explore potential osteotomies for genioglossal advancement. METHODS: Cone beam computed tomography was used to analyze 33 randomly selected patients undergoing surgery for obstructive sleep apnea (OSA) between 2014 and 2016 at an academic surgical hospital. The locations of relevant mandibular structures were measured and statistical modeling was performed. RESULTS: Mean horizontal distances from midline to the mental foramina and the roots of the canine, lateral incisor, and central incisor were 22...
May 11, 2017: Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28488317/impact-of-sleep-disordered-breathing-in-patients-with-acute-myocardial-infarction-a-retrospective-analysis
#12
Verena Gessner, Thomas Bitter, Dieter Horstkotte, Olaf Oldenburg, Henrik Fox
Sleep-disordered breathing (SDB) is associated with an increased risk of cardiovascular events. Previous studies showed that severe SDB has a negative impact on myocardial salvage and progression of left ventricular dysfunction after acute myocardial infarction (AMI). This study investigated the frequency of SDB and the effects of SDB on left ventricular function after AMI. This retrospective study enrolled all patients with AMI who had undergone cardiorespiratory polygraphy for SDB diagnosis. The apnea-hypopnea index was used as a standard metric of SDB severity...
May 10, 2017: Journal of Sleep Research
https://www.readbyqxmd.com/read/28483860/rapid-eye-movement-sleep-predominant-central-sleep-apnea-relieved-by-positive-airway-pressure-a-case-report
#13
Noah P Jouett, Michael L Smith, Donald E Watenpaugh, Maryam Siddiqui, Maleeha Ahmad, Farrukh Siddiqui
Central Sleep Apnea (CSA) is characterized by intermittent apneas and hypopneas during sleep that result from absent central respiratory drive. CSA occurs almost exclusively during non-rapid-eye-movement (NREM) sleep due to enhanced neuronal ventilatory drive during REM sleep that makes central apneas highly unlikely to form. A 45-year-old obese African American female presented with co-existing Obstructive Sleep Apnea (OSA) and CSA, not in the form of mixed or complex sleep apnea. Peculiarly, her CSA occurred only during rapid-eye-movement (REM) sleep, which is exceedingly rare...
May 2017: Physiological Reports
https://www.readbyqxmd.com/read/28480154/congenital-tracheobronchomegaly-mounier-kuhn-syndrome-in-a-woman-with-human-immunodeficiency-virus-a-case-report
#14
Amanda Fletcher, Justin Stowell, Socrates Jamoulis
Congenital tracheobronchomegaly (Mounier-Kuhn Syndrome, MKS) is a rare idiopathic disorder characterized by dilation of the central airways, including the trachea and first through fourth order bronchi. MKS disproportionately affects men and results in chronic respiratory tract infections. The diagnosis is made through the synthesis of clinical and radiological data. Here we report a unique case of MKS in a patient with human immunodeficiency virus (HIV) infection. A 45-year-old African American woman with a past medical history of HIV, tobacco and recreational drug abuse, chronic obstructive pulmonary disease, sleep apnea, and a 15-year history of recurrent respiratory infections presented with dyspnea, wheezing, a productive cough, increased yellow-green sputum production, and subjective fevers...
April 4, 2017: Curēus
https://www.readbyqxmd.com/read/28474653/raising-awareness-about-sleep-disorders
#15
REVIEW
Stuti J Jaiswal, Robert L Owens, Atul Malhotra
Sleep disorders affect a substantial number of people worldwide and may be increasing in prevalence. Unfortunately, many of these disorders can go unrecognized and untreated in clinical practice. Although physicians understand that good sleep is essential to patient health, approaching the issue is often glossed over in the primary care setting. Importantly, recent data also suggest that sleep disorders are becoming increasingly recognized in developing nations. Here, we review the pertinent features and treatment of some of the major sleep disorders, including obstructive sleep apnea, central sleep apnea, insomnia, and others, that affect patient health...
May 2017: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/28467884/impairment-of-pulmonary-diffusion-correlates-with-hypoxemic-burden-in-central-sleep-apnea-heart-failure-patients
#16
Henrik Fox, Britta Koerber, Thomas Bitter, Dieter Horstkotte, Olaf Oldenburg
PURPOSE: Central sleep apnea (CSA) and Cheyne-Stokes respiration (CSR) are highly prevalent in heart failure (HF) and are linked to increased mortality. Impaired pulmonary diffusion capacity [DLCO] and [KCO]) have been suggested to play a key role in CSA-CSR pathophysiology. This study investigated the relationship between HF, CSR, DLCO and KCO in well-characterized HF patients. METHODS: This prospective study included HF patients with CSR, all patients underwent full overnight polysomnography (PSG) and lung function testing...
April 30, 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28454596/opioids-cause-central-and-complex-sleep-apnea-in-humans-and-reversal-with-discontinuation-a-plea-for-detoxification
#17
Shahrokh Javaheri, Sanjiv Patel
No abstract text is available yet for this article.
April 25, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/28453783/sleep-related-breathing-disorders-in-chiari-malformation-type-1-a-prospective-study-of-90-patients
#18
Álex Ferré, Maria A Poca, Maria D de la Calzada, Dulce Moncho, Odile Romero, Gabriel Sampol, Juan Sahuquillo
Study objective: The aim of the present study is to describe the prevalence of sleep disorders in a large group of patients with Chiari malformation type 1 (CM-1) and determine the presence of risk factors associated with these abnormalities. Methods: Prospective study with consecutive patient selection. We included 90 adult patients with CM-1, defined by the presence of a cerebellar tonsillar descent (TD) ≥3mm. Clinical, neuroradiological studies and nocturnal polysomnography (PSG) was carried out...
April 27, 2017: Sleep
https://www.readbyqxmd.com/read/28433385/perioperative-risks-of-narcolepsy-in-patients-undergoing-general-anesthesia-a-case-control-study
#19
Alexandre N Cavalcante, Ryan E Hofer, Maja Tippmann-Peikert, Juraj Sprung, Toby N Weingarten
STUDY OBJECTIVE: To compare the perioperative outcomes between patients with narcolepsy and matched controls undergoing anesthetic management. DESIGN: Retrospective 2:1 matched study design. SETTING: Large tertiary medical center. PATIENTS: Narcoleptic patients who underwent general anesthesia from January 1, 2011, through September 30, 2015, were matched with controls by age, sex, and type and year of surgery. MEASUREMENTS: Medical records were reviewed for episodes of respiratory depression during phase I recovery and for other meaningful perioperative outcomes...
April 19, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28432036/increased-inflammation-from-childhood-to-adolescence-predicts-sleep-apnea-in-boys-a-preliminary-study
#20
Jordan Gaines, Alexandros N Vgontzas, Julio Fernandez-Mendoza, Fan He, Susan L Calhoun, Duanping Liao, Edward O Bixler
While chronic systemic inflammation in obstructive sleep apnea (OSA) has been traditionally considered a consequence of intermittent hypoxia, several treatment studies targeting inflammation suggest that this process may precede the development of the disorder. A recent cross-sectional study in the Penn State Child Cohort (PSCC) revealed that inflammation largely mediates the association between visceral adiposity and OSA in adolescence. The purpose of this study was to examine for the first time whether, longitudinally, inflammation precedes OSA during this developmental period...
April 18, 2017: Brain, Behavior, and Immunity
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