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Sleep apnea review

Colin Huntley, Armin Steffen, Karl Doghramji, Benedikt Hofauer, Clemens Heiser, Maurits Boon
OBJECTIVES/HYPOTHESIS: An elevated body mass index (BMI) influences the severity of disease and treatment options utilized for obstructive sleep apnea (OSA). With this study, we aim to evaluate a cohort of patients undergoing upper airway stimulation (UAS) for treatment of OSA and assess the impact of BMI on surgical and quality of life outcomes. METHODS: We designed a case-control, retrospective review, of all patients undergoing UAS at two academic institutions between 2014 and 2017...
August 10, 2018: Laryngoscope
Colin Huntley, Jeniece Cooper, Marlind Stiles, Ritu Grewal, Maurits Boon
STUDY OBJECTIVES: Oral appliance therapy (OAT) can be an effective treatment option for patients with obstructive sleep apnea unable to tolerate continuous positive airway pressure. We hypothesize that drug-induced sleep endoscopy (DISE) can be useful in identifying patients who will benefit from OAT. METHODS: A retrospective review of all patients who underwent DISE (DISE group) between January 2014 and June 2016 was carried out. We included patients if they received OAT based on recommendations made by DISE findings...
August 6, 2018: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Soontharee Congrete, Maythawee Bintvihok, Charat Thongprayoon, Tarun Bathini, Boonphiphop Boonpheng, Konika Sharma, Ronpichai Chokesuwattanaskul, Narat Srivali, Tanyanan Tanawuttiwat, Wisit Cheungpasitporn
BACKGROUND/OBJECTIVES: Patients with obstructive sleep apnea (OSA) have an increased the risk of developing atrial fibrillation (AF). However, it remains unclear if patients with OSA carry a higher risk of recurrent AF after successful catheter ablation. This meta-analysis was conducted (1) to evaluate the association between OSA and recurrent AF after catheter ablation, and (2) to assess the effect of continuous positive airway pressure (CPAP) on the risk of recurrent AF in patients with OSA...
August 8, 2018: Journal of Evidence-based Medicine
Angeliki Vgontzas, Jelena M Pavlović
Migraine shares a complex and poorly understood relationship with sleep. Patients consistently report poor sleep prior to migraine attacks and during them, identifying poor sleep as a migraine trigger. However, anecdotally, sleep is reported to serve a therapeutic role in terminating headache. Are the associations between migraine and sleep simply the result of various bidirectional relationships? A growing body of evidence suggests there may be a common underlying etiology as well. Our objective was to review studies of sleep and migraine from the last 2 decades utilizing validated subjective and objective measures of sleep and to explore potential mechanisms underlying this complex relationship by incorporating recent advances in neuroscience...
August 8, 2018: Headache
Colin Huntley, Adam Vasconcellos, Karl Doghramji, Benedikt Hofauer, Clemens Heiser, Maurits Boon
Upper airway stimulation therapy (UAS) is a new option for treatment of obstructive sleep apnea (OSA) in patients unable to tolerate continuous positive airway pressure (CPAP). We set out to evaluate the effectiveness of UAS in patients who have undergone prior palate surgery. We designed a retrospective review and evaluated patients undergoing UAS at 2 academic centers. We recorded demographic and pre- and postoperative polysomnogram (PSG) data. We compared the cohort of patients who had undergone prior palate surgery, "prior surgery," to the cohort who had not, "no prior surgery...
August 7, 2018: Otolaryngology—Head and Neck Surgery
Robert J Fleck, Sally R Shott, Mohamed Mahmoud, Stacey L Ishman, Raouf S Amin, Lane F Donnelly
Sleep-disordered breathing has a spectrum of severity that spans from snoring and partial airway collapse with increased upper airway resistance, to complete upper airway obstruction with obstructive sleep apnea during sleeping. While snoring occurs in up to 20% of children, obstructive sleep apnea affects approximately 1-5% of children. The obstruction that occurs in obstructive sleep apnea is the result of the airway collapsing during sleep, which causes arousal and impairs restful sleep. Adenotonsillectomy is the first-line treatment of obstructive sleep apnea and is usually effective in otherwise healthy nonsyndromic children...
August 2018: Pediatric Radiology
Gonzalo Labarca, Tomas Reyes, Jorge Jorquera, Jorge Dreyse, Lauren Drake
INTRODUCTION: Obstructive sleep apnea hypopnea syndrome (OSAHS) is a prevalent condition across the world; it co-exists with others metabolic diseases, such as central obesity, dyslipidemia, and arterial hypertension. These associations increase the cardiovascular risk and mortality. Observational studies have reported a strength association between OSA and type 2 Diabetes Mellitus (T2DM) and continuous positive airway pressure (CPAP) is recommended for moderate to severe OSAHS OBJECTIVE: To summarize the evidence of CPAP in T2DM patients with OSAHS...
August 2, 2018: Clinical Respiratory Journal
Himad K Khattak, Faisal Hayat, Salpy V Pamboukian, Harvey S Hahn, Brian P Schwartz, Phyllis K Stein
Obstructive sleep apnea is a sleep-related breathing disorder that has a major impact on cardiovascular function. It has been associated with hypertension, coronary artery disease, cardiac arrhythmias, sudden cardiac death, and heart failure. This review focuses on the relationship between obstructive sleep apnea and heart failure with either reduced or preserved ejection fraction. We discuss the pathophysiology of obstructive sleep apnea, as well as its prevalence, treatment outcomes with continuous positive airway pressure, and prognosis in these 2 distinct types of heart failure...
June 2018: Texas Heart Institute Journal
Vasileios Stavrou, Fotini Bardaka, Eleni Karetsi, Zoe Daniil, Konstantinos I Gourgoulianis
This brief review summarizes the available literature on the intersection of obstructive sleep apnea syndrome (OSAS) and ergospirometry. Ergospirometry provides an assessment of integrative exercise responses involving pulmonary, cardiovascular, neuropsychological, and skeletal muscle systems, which are not adequately reflected through the measurement of individual organ system functions. Sleep disorders, including OSAS, often exacerbate problems in the operation of the autonomic nervous system, heart function, lung mechanics, anxiety, and muscle metabolism...
July 31, 2018: Journal of Clinical Medicine
Stephen A Glazer, Ann L Erickson, Ross D Crosby, Jennifer Kieda, Agata Zawisza, Mervyn Deitel
BACKGROUND: Obstructive sleep apnea (OSA) is extremely common among bariatric surgical candidates. Identifying those at risk for moderate to severe OSA is challenging. Testing all bariatric surgical candidates with a level 1 polysomnographic study is expensive and resource intensive. The aim of this study is to evaluate three standardized screening questionnaires that are utilized to identify high-risk patients for OSA undergoing bariatric surgery. METHODS: A retrospective review of data collected prospectively was undertaken on bariatric surgical patients who have not had a preexisting diagnosis of OSA...
July 31, 2018: Obesity Surgery
Monica Levy Andersen, Paula Araujo, Cristina Frange, Sergio Tufik
Chronic pain has been associated with sleep disturbances in a bidirectional manner, with pain disrupting sleep, and sleep deprivation or disturbance increasing pain. This conventional view began to be reassessed with data from longitudinal and micro-longitudinal studies investigating the causal relationship. In this review, we examine the current thinking on the temporal associations between sleep and pain, focusing on studies that considered whether sleep disturbances could predispose individuals to pain conditions...
July 27, 2018: Chest
Victoria A Eley, Rebecca Christensen, Louis Guy, Benjamin Dodd
Blood pressure monitoring plays a key part in the preoperative, intraoperative, and postoperative care of all patients. In patients with obesity, hypertension indicates increased metabolic and surgical risk and may signal the presence of significant medical comorbidities, including obstructive sleep apnea. Avoidance of hypertension postoperatively is necessary to minimize bleeding risk after surgery. Hypotension in the postoperative period may be the first sign of significant complications that require urgent management...
July 27, 2018: Anesthesia and Analgesia
Boris A Stuck, Madeline J L Ravesloot, Till Eschenhagen, H C W de Vet, J Ulrich Sommer
BACKGROUND: The most commonly performed surgical procedure for obstructive sleep apnea (OSA) is uvulopalatopharyngoplasty with or without tonsillectomy (UPPP ± TE). However, there is currently no review solely focusing on clinically relevant effects of standard UPPP technique with or without tonsillectomy as a monotherapy in patients with OSA. METHODS: A systematic review and meta-analysis were performed to assess the effects of isolated UPPP ± TE in patients with OSA...
May 12, 2018: Sleep Medicine
Habib G Zalzal, Michele Carr, William Kohler, Steven W Coutras
OBJECTIVE: To establish how assessment of adenoid size is correlated between drug-induced sleep endoscopy (DISE) with indirect mirror nasopharyngoscopy (IMN). STUDY DESIGN: Retrospective chart review. SETTING: Tertiary care academic hospital. METHODS: Over a 6-year period, 154 pediatric patients underwent DISE for obstructive sleep apnea and had IMN. DISE videos were assessed by one reviewer, blinded to results of mirror exams...
September 2018: International Journal of Pediatric Otorhinolaryngology
María P Oyarce, Rodrigo Iturriaga
Chronic intermittent hypoxia (CIH), the hallmark of obstructive sleep apnea, is the main risk factor to develop systemic hypertension. Oxidative stress, inflammation, and sympathetic overflow have been proposed as possible mechanisms underlying the CIH-induced hypertension. CIH potentiates the carotid body (CB) chemosensory discharge leading to sympathetic overflow, autonomic dysfunction, and hypertension. Oxidative stress and pro-inflammatory molecules are involved in neurogenic models of hypertension, acting on brainstem and hypothalamic nuclei related to the cardiorespiratory control, such as the nucleus of the solitary tract, which is the primary site for the afferent inputs from the CB...
2018: Frontiers in Physiology
Dominik Linz, Mathias Baumert, Peter Catcheside, John Floras, Prashanthan Sanders, Patrick Lévy, Martin R Cowie, R Doug McEvoy
Sleep disordered breathing (SDB) is highly prevalent in patients with atrial fibrillation, heart failure and hypertension and is associated with increased risk of mortality, cardiovascular (CV) events and arrhythmias. Current assessment of the severity of SDB is mainly based on the apnea-hypopnea index (AHI) representing the number of hypopneas and apneas per hour of sleep. However, this event-based parameter alone may not sufficiently reflect the complex pathophysiological mechanisms underlying SDB potentially contributing to CV outcome risk...
July 23, 2018: International Journal of Cardiology
Veronique Latreille, Erik K St Louis, Milena Pavlova
Co-morbid sleep disorders, including sleep apnea, insomnia, restless legs syndrome, and the parasomnias, occur frequently in people with epilepsy. This article reviews the cardinal presenting symptoms and diagnostic features of each of these disorders to enable epileptologists to readily screen and identify sleep co-morbidities in their patients. It summarizes current evidence concerning the reciprocal relationship between sleep disturbances and epilepsy and available treatment options for common sleep disorders in people with epilepsy...
July 17, 2018: Epilepsy Research
Diego Mazzotti, Diane Lim, Kate Sutherland, Lia Bittencourt, Jesse Mindel, Ulysses Magalang, Allan Pack, Philip de Chazal, Thomas Penzel
Obstructive Sleep Apnea (OSA) is a heterogeneous sleep disorder with many pathophysiological pathways to disease. Currently, the diagnosis and classification of OSA is based on the apnea-hypopnea index, which poorly correlates to underlying pathology and clinical consequences. A large number of in-laboratory sleep studies are performed around the world every year, already collecting an enormous amount of physiological data within an individual. Clinically, we have not yet fully taken advantage of this data, but combined with existing analytical approaches, we have the potential to transform the way OSA is managed within an individual patient...
July 26, 2018: Physiological Measurement
Anisha Gohil, Tamara S Hannon
Poor sleep and obesity are both extraordinarily common in the US adolescent population and often occur simultaneously. This review explores the links between obesity and sleep, outlining what is known about the relationships between sleep characteristics, obesity, and cardiometabolic risk factors in youth. Sleep duration is less than optimal in teens, and decreases as age increases. This is detrimental to overall well-being and is associated with obesity in children, adolescents, and young adults. Accordingly, inadequate sleep duration is associated with poor diet quality, decreased insulin sensitivity, hyperglycemia, and prevalent cardiometabolic risk factors...
2018: Frontiers in Endocrinology
Paloma Millan-Billi, Candela Serra, Ana Alonso Leon, Diego Castillo
Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive and fatal disease. The treatment is challenging and nowadays a comprehensive approach based not only in pharmacological strategies is necessary. Identification and control of comorbidities, non-pharmacological treatment, prevention and management of exacerbations as well as other areas of care (social, psychological) are fundamental for a holistic management of IPF. Gastroesophageal reflux, pulmonary hypertension, obstructive sleep apnea, combined with emphysema, lung cancer and cardiovascular involvement are the main comorbidities associated with IPF...
July 24, 2018: Medical Sciences: Open Access Journal
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