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New Treatments of Sleep Apnea

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https://www.readbyqxmd.com/read/29222619/improvement-in-obstructive-sleep-apnea-after-a-tailored-behavioural-sleep%C3%A2-medicine-intervention-targeting-healthy-eating-and-physical-activity-a-randomised-controlled-trial
#1
Helena Igelström, Pernilla Åsenlöf, Margareta Emtner, Eva Lindberg
PURPOSE: The aim of the present single-centre randomised controlled trial was to assess the effect of a behavioural sleep medicine (BSM) intervention on obstructive sleep apnea (OSA) severity in patients who have been referred for new treatment with continuous positive airway pressure (CPAP). METHODS: After baseline assessment including ventilatory and anthropometric parameters, and physical activity monitoring, 86 patients who were overweight (BMI ≥ 25) and had moderate-severe OSA with apnea-hypopnea index (AHI) ≥ 15 were randomised into a control group (CG; CPAP and advice about weight loss) or an experimental group (ExpG; CPAP and BSM intervention targeting physical activity and eating behaviour)...
December 8, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/29206695/drug-induced-sleep-endoscopy-from-obscure-technique-to-diagnostic-tool-for-assessment-of-obstructive-sleep-apnea-for-surgical-interventions
#2
Joshua H Atkins, Jeff E Mandel
PURPOSE OF REVIEW: Provide a practical update on drug-induced sleep endoscopy (DISE) for anesthesia providers, which can also serve as a reference for those preparing to establish a DISE program. RECENT FINDINGS: New developments in surgical approaches to OSA and the growing global incidence of the condition have stimulated increased interest and demand for drug-induced sleep endoscopy. New techniques include transoral robotic surgery and hypoglossal nerve stimulation...
December 4, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29198305/comparing-the-efficacy-mask-leak-patient-adherence-and-patient-preference-of-three-different-cpap-interfaces-to-treat-moderate-severe-obstructive-sleep-apnea
#3
Sharn Rowland, Vinod Aiyappan, Cathy Hennessy, Peter Catcheside, Ching Li Chai-Coezter, R Doug McEvoy, Nick A Antic
STUDY OBJECTIVES: To determine if the type of continuous positive airway pressure (CPAP) mask interface influences CPAP treatment efficacy, adherence, side effects, comfort and sleep quality in patients with moderate-severe obstructive sleep apnea (OSA). METHODS: This took place in a hospital-based tertiary sleep disorders unit. It is a prospective, randomized, crossover trial comparing three CPAP interfaces: nasal mask (NM), nasal mask plus chinstrap (NM-CS) and oronasal mask (ONM) each tried in random order, for 4 weeks...
November 29, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/29177130/sleep-disordered-breathing-and-spinal-cord-injury-challenges-and-opportunities
#4
Abdulghani Sankari, Jennifer L Martin, M Safwan Badr
Purpose of review: This paper focuses on the sleep disorders in patients with spinal cord injury (SCI/D), particularly mechanism of sleep disordered breathing (SDB) and challenges in diagnosis and management. Based on a review of recent literatures and studies the paper summarizes some main challenges with respect to management of SDB in patients with SCI; and what are the responsible mechanisms of disease? What are the barriers in diagnosing and treating SDB using standard treatment such as positive airway pressure (CPAP)?...
December 2017: Current Sleep Medicine Reports
https://www.readbyqxmd.com/read/29154970/patient-engagement-using-new-technology-to-improve-adherence-to-positive-airway-pressure-therapy-a-retrospective-analysis
#5
Atul Malhotra, Maureen E Crocker, Leslee Willes, Colleen Kelly, Sue Lynch, Adam V Benjafield
BACKGROUND: Sleep apnea has major neurocognitive and cardiovascular and metabolic risks. Treatment of sleep apnea is sub-optimal because of variable adherence to existing therapies. METHODS: This trial compared PAP adherence among patients who were provided active patient engagement (APE) technology versus those who received usual care monitoring (UCM). The primary outcome was defined by the U.S. Medicare definition of adherence. PARTICIPANTS: Adherence data from two cloud-based databases (AirView™ and myAir™) were analyzed for patients with sleep apnea...
November 15, 2017: Chest
https://www.readbyqxmd.com/read/29142787/sleep-apnea-symptoms-and-cardiovascular-disease-risks-among-haitian-medical-students
#6
Diana M Rosenthal, Donaldson F Conserve, Dodley Severe, Michaele A Gedeon, Ferdinand Zizi, Georges Casimir, Samy I McFarlane, Girardin Jean Louis
Sleep apnea is a prevalent sleep disorder that disproportionately affects blacks and has been previously studied among Caribbean-born blacks in Brooklyn, New York, but there has been negligible research in the Caribbean, specifically Haiti, and developing countries on this pressing health issue. A total of 373 medical students (mean age=20.6 years ± 2.3 years) from a medical school in Haiti participated in this study. Participants were administered a questionnaire assessing their sleep health and cardiovascular outcomes...
April 2017: Journal of Sleep Disorders & Therapy
https://www.readbyqxmd.com/read/29109195/sleep-apnea-and-cardiovascular-disease-lessons-from-recent-trials-and-need-for-team-science
#7
REVIEW
Luciano F Drager, R Doug McEvoy, Ferran Barbe, Geraldo Lorenzi-Filho, Susan Redline
Emerging research highlights the complex interrelationships between sleep-disordered breathing and cardiovascular disease, presenting clinical and research opportunities as well as challenges. Patients presenting to cardiology clinics have a high prevalence of obstructive and central sleep apnea associated with Cheyne-Stokes respiration. Multiple mechanisms have been identified by which sleep disturbances adversely affect cardiovascular structure and function. Epidemiological research indicates that obstructive sleep apnea is associated with increases in the incidence and progression of coronary heart disease, heart failure, stroke, and atrial fibrillation...
November 7, 2017: Circulation
https://www.readbyqxmd.com/read/29097705/metoprolol-prevents-chronic-obstructive-sleep-apnea-induced-atrial-fibrillation-by-inhibiting-structural-sympathetic-nervous-and-metabolic-remodeling-of-the-atria
#8
Li Sun, Sen Yan, Xiaoyu Wang, Shiqi Zhao, Hui Li, Yike Wang, Shuang Lu, Xinwen Dong, Jing Zhao, Shengzhu Yu, Minghui Li, Yue Li
Chronic obstructive sleep apnea (OSA) may promote the development of atrial fibrillation (AF) by inducing atrial electrical and structural remodeling as well as autonomic nerve hyperinnervation. Here, we investigated the roles of metoprolol in regulation of atrial remodeling induced by chronic OSA. A canine model of chronic OSA was established by stopping the ventilator and closing the airway for 4 h/day every other day for 12 weeks, while metoprolol (5 mg·kg-1·day-1) was continuously administered. Using that model, we observed that increases in sympathetic sprouting and atrial structural remodeling were sharply inhibited by metoprolol...
November 2, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29090478/reliability-of-an-adherence-monitoring-sensor-embedded-in-an-oral-appliance-used-for-treatment-of-obstructive-sleep-apnea
#9
K Gjerde, S Lehmann, I F Naterstad, M E Berge, A Johansson
The aim of this study was to test if digitally registered use of a Mandibular Advancement Device (MAD) by a built-in thermal sensor was reliable compared to a self-reported diary of MAD use. Eighty consecutive patients referred to a specialist outpatient sleep medicine clinic (HUS) were recruited. Patients of both genders aged from 25 to 70 years with a diagnosis of mild to moderate or severe OSA, were included. All participants signed a written informed consent when they received the MAD. For the purpose of this reliability study, we found it sufficient to include the first 30 nights of MAD use in the reliability analysis...
November 1, 2017: Journal of Oral Rehabilitation
https://www.readbyqxmd.com/read/29081358/spinal-activation-of-protein-kinase-c-elicits-phrenic-motor-facilitation
#10
Michael J Devinney, Gordon S Mitchell
The protein kinase C family regulates many cellular functions, including multiple forms of neuroplasticity. The novel PKCθ and atypical PKCζ isoforms have been implicated in distinct forms of spinal, respiratory motor plasticity, including phrenic motor facilitation (pMF) following acute intermittent hypoxia or inactivity, respectively. Although these PKC isoforms are critical in regulating spinal motor plasticity, other isoforms may be important for phrenic motor plasticity. We tested the impact of conventional/novel PKC activator, phorbol 12-myristate 13-acetate (PMA) on pMF...
November 2, 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28978212/overview-of-idiopathic-pulmonary-fibrosis-ipf-and-evidence-based-guidelines
#11
Roozbeh Sharif
Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive form of interstitial lung disease (ILD), characterized by fibrosis and worsening lung function, that primarily occurs in those 50 years and older. Various causes including genetic susceptibility, environmental risk factors, and exposures have been suggested in the literature. All of these cause repetitive micro-injury to the lung tissue and vasculature, which triggers a cascade of inflammatory response and fibrosis. Symptoms are nonspecific and most patients present several years after the initial radiographic changes occur...
July 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28966342/evaluation-of-mih-scoring-system-in-diagnosis-of-obstructive-sleep-apnea-syndrome
#12
Qinxing Xu, Junwei Du, Xiaobo Ling, Yangfei Lu
BACKGROUND The objective of the present study was to investigate whether the analysis of magnesium (Mg), high-sensitivity C-reactive protein (hsCRP), and ischemia-modified albumin (IMA) concentrations can be used as a non-invasive and convenient method for diagnosing obstructive sleep apnea syndrome (OSAS). MATERIAL AND METHODS After polysomnography, venous blood was collected from 33 patients with OSAS and 30 control individuals. Serum levels of Mg, hsCRP, and IMA were investigated. The relationship between these factors and apnea-hypopnea index (AHI) was analyzed using the Pearson correlation coefficient...
October 2, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28958052/treating-chronic-hypoventilation-with-automatic-adjustable-versus-fixed-epap-intelligent-volume-assured-positive-airway-pressure-support-ivaps-a-randomized-controlled-trial
#13
Nigel McArdle, Clare Rea, Stuart King, Kathleen Maddison, Dinesh Ramanan, Sahisha Ketheeswaran, Lisa Erikli, Vanessa Baker, Jeff Armitstead, Glenn Richards, Bhajan Singh, David Hillman, Peter Eastwood
Objectives: New noninvasive ventilation (NIV) modes can automatically adjust pressure support settings to deliver effective ventilation in response to varying ventilation demands. It is recommended that fixed expiratory positive airway pressure (FixedEPAP) is determined by attended laboratory polysomnographic (PSG) titration. This study investigated whether automatically determined EPAP (AutoEPAP) was noninferior to FixedEPAP for the control of obstructive sleep apnea (OSA) during intelligent volume-assured pressure support (iVAPS) treatment of chronic hypoventilation...
October 1, 2017: Sleep
https://www.readbyqxmd.com/read/28941735/barbed-snore-surgery-for-concentric-collapse-at-the-velum-the-alianza-technique
#14
Mario Mantovani, Daniela Carioli, Sara Torretta, Vittorio Rinaldi, Tullio Ibba, Lorenzo Pignataro
Recently, new conservative and non-resective surgical techniques, including palatopharyngeal surgical lifting and suspension (the 'Roman blinds technique') and modular barbed snore surgery (MBSS), have been successfully introduced for the treatment of obstructive sleep apnea syndrome (OSAS). This pilot longitudinal study describes our preliminary experience with the 'Alianza technique' (the simultaneous use of Roman blinds and MBSS) in mild to moderate OSAS patients with concentric pharyngeal collapse at the velum, previously documented by means of drug-induced sleep endoscopy...
August 14, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28933033/sleep-disturbance-after-tbi
#15
REVIEW
Surendra Barshikar, Kathleen R Bell
PURPOSE OF REVIEW: Present relevant literature to update knowledge on sleep science, identify common sleep disturbances seen in TBI, discuss evidence for available treatment options, and illuminate future areas for research. RECENT FINDINGS: Sleep disturbances, including insomnia, circadian rhythm disturbances, and sleep apnea, are prevalent for all severities of traumatic brain injury (TBI), can be chronic, and affect both rehabilitation and recovery from the TBI...
September 20, 2017: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/28923778/links-between-lower-urinary-tract-symptoms-intermittent-hypoxia-and-diabetes-causes-or-cures
#16
REVIEW
Lisa L Abler, Chad M Vezina
Bothersome lower urinary tract symptoms (LUTS) manifest as urinary frequency, urgency, incontinence and incomplete bladder emptying. Existing treatments ameliorate but do not eliminate most symptoms, leading to financial and personal burdens attributable to sustained medical therapies that may last a lifetime. The purpose of this review is to highlight evidence of causal associations between LUTS and several common comorbidities, including intermittent hypoxia (IH) concomitant with obstructive sleep apnea (OSA), obesity, metabolic syndrome and type 2 diabetes...
September 15, 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28915135/otolaryngologic-management-of-down-syndrome-patients-what-is-new
#17
Ethan C Bassett, Mary F Musso
PURPOSE OF REVIEW: The management of children with Down syndrome as it pertains to the otolaryngologist continues to evolve. Obstructive sleep apnea (OSA) has dominated the recent literature, but other topics including hearing loss, swallowing, and perioperative considerations are also reported. RECENT FINDINGS: The prevalence of OSA in children with Down syndrome ranges from 57 to 73% in certain cohorts, and, whereas adentonsillectomy can decrease Apnea-Hypopnea Index, up to 80% may have persistent OSA...
December 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28913630/durability-of-treatment-effects-of-the-sleep-position-trainer-versus-oral-appliance-therapy-in-positional-osa-12-month-follow-up-of-a-randomized-controlled-trial
#18
Maurits H T de Ruiter, Linda B L Benoist, Nico de Vries, Jan de Lange
PURPOSE: The Sleep Position Trainer (SPT) is a new option for treating patients with positional obstructive sleep apnea (POSA). This study investigated long-term efficacy, adherence, and quality of life during use of the SPT device compared with oral appliance therapy (OAT) in patients with POSA. METHODS: This prospective, multicenter trial randomized patients with mild to moderate POSA (apnea-hypopnea index [AHI] 5-30/h) to SPT or OAT. Polysomnography was performed at baseline and after 3 and 12 months' follow-up...
September 15, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/28899524/adherence-to-continuous-positive-airway-pressure-improves-attention-psychomotor-function-and-sleepiness-a-bias-reduction-method-with-further-assessment-of-apples
#19
Tyson H Holmes, Clete A Kushida
OBJECTIVE/BACKGROUND: Variable adherence to prescribed therapies for sleep disorders is commonplace. This study was designed to integrate three available statistical technologies (instrumental variables, residual inclusion, and shrinkage) to allow sleep investigators to employ data on variable adherence in the estimation of the causal effect of treatment as received on clinical outcomes. PATIENTS/METHODS: Using data from the Apnea Positive Pressure Long-term Efficacy Study (APPLES), regression adjustment for observed and unobserved confounders was applied to two primary neurocognitive outcomes, plus two measures of sleepiness...
September 2017: Sleep Medicine
https://www.readbyqxmd.com/read/28888522/sleep-disordered-breathing-and-heart%C3%A2-failure-what-does-the-future-hold
#20
REVIEW
Martin R Cowie, Angela M Gallagher
Most patients with heart failure (HF) have sleep-disordered breathing (SDB), with central (rather than obstructive) sleep apnea becoming the predominant form in patients with more severe disease. Cyclical apnea and hypopneas are associated with sleep disturbance, hypoxemia, hemodynamic changes, and sympathetic activation. These patients have a worse prognosis than those without SDB. Mask-based therapies of positive airway pressure targeted at SDB can improve measures of sleep quality and can partially normalize the sleep and respiratory physiology...
October 2017: JACC. Heart Failure
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