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New Treatments of Sleep Apnea

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https://www.readbyqxmd.com/read/29469928/obstructive-sleep-apnea-and-neurocognitive-dysfunction-in-edentulous-patients
#1
Soumyojeet Bagchi, Arvind Tripathi, Suryakant Tripathi, Sushil Kar, Sarvada Chandra Tiwari, Juhi Singh
PURPOSE: To record the incidence of cognitive dysfunction in edentulous patients suffering from obstructive sleep apnea (OSA) and establish a plausible hypothesis to explain the correlation of cognitive dysfunction and OSA. MATERIALS AND METHODS: In this study, 315 edentulous patients (aged 60 to 65 years) visiting the outpatient department at Saraswati Dental College, Lucknow were recruited from January 2013 to October 2015. Prosthodontic Diagnostic Index (PDI) classification was used to assess the intraoral condition to relate it with the span of edentulousness...
February 22, 2018: Journal of Prosthodontics: Official Journal of the American College of Prosthodontists
https://www.readbyqxmd.com/read/29460195/high-risk-for-obstructive-sleep-apnea-hypopnea-syndrome-predicts-new-onset-atrial-fibrillation-after-cardiac-surgery-a-retrospective-analysis
#2
Samir V Patel, Harmeet Gill, Diwas Shahi, Ajai Rajabalan, Palak Patel, Rajesh Sonani, Parth Bhatt, Rafael David Rodriguez, Manuel Bautista, Abhishek Deshmukh, Juan Viles Gonzalez, Sanjay Patel
PURPOSE: Obstructive sleep apnea hypopnea syndrome (OSAHS) is highly prevalent in patients undergoing coronary artery bypass surgery (CABG). OSAHS is a risk factor for the development of atrial fibrillation (AF), but the risk of AF in patients who are high risk for OSAHS is unclear. METHODS: A retrospective study was conducted on consecutive patients undergoing CABG from 2013 to 2015 without AF pre-operatively. Patients were categorized as low risk for OSAHS, high risk for OSAHS, or diagnosed OSAHS based on medical records review...
February 19, 2018: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/29429026/modulation-of-renal-sympathetic-innervation-recent-insights-beyond-blood-pressure-control
#3
REVIEW
Dominik Linz, Mathias Hohl, Adrian D Elliott, Dennis H Lau, Felix Mahfoud, Murray D Esler, Prashanthan Sanders, Michael Böhm
Renal afferent and efferent sympathetic nerves are involved in the regulation of blood pressure and have a pathophysiological role in hypertension. Additionally, several conditions that frequently coexist with hypertension, such as heart failure, obstructive sleep apnea, atrial fibrillation, renal dysfunction, and metabolic syndrome, demonstrate enhanced sympathetic activity. Renal denervation (RDN) is an approach to reduce renal and whole body sympathetic activation. Experimental models indicate that RDN has the potential to lower blood pressure and prevent cardio-renal remodeling in chronic diseases associated with enhanced sympathetic activation...
February 10, 2018: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
https://www.readbyqxmd.com/read/29425382/the-beneficial-effect-of-weight-reduction-on-adverse-cardiovascular-outcomes-following-bariatric-surgery-is-attenuated-in-patients-with-obstructive-sleep-apnea
#4
Ahmed Dalmar, Maharaj Singh, Bennet Pandey, Christopher Stoming, Zoe Heis, Khawaja Afzal Ammar, M Fuad Jan, Indrajit Choudhuri, Thomas Y Chua, Jasbir Sra, A Jamil Tajik, Arshad Jahangir
Weight loss after bariatric surgery is associated with reduction in adverse cardiovascular outcomes; however, the impact of obstructive sleep apnea (OSA) on reduction of cardiovascular outcomes after bariatric surgery in morbidly obese patients is not known. We retrospectively assessed differences in cardiovascular events after laparoscopic adjustable gastric banding (LAGB)-induced weight loss in patients with and without OSA before and after propensity score matching for age, sex, body mass index (BMI), and major comorbidities between the two groups and determined predictors of poor outcomes...
February 7, 2018: Sleep
https://www.readbyqxmd.com/read/29352093/excessive-daytime-sleepiness-independently-predicts-increased-cardiovascular-risk-after-myocardial-infarction
#5
Jiang Xie, Fatima H Sert Kuniyoshi, Naima Covassin, Prachi Singh, Apoor S Gami, C Anwar A Chahal, Virend K Somers
BACKGROUND: Excessive daytime sleepiness (EDS), a common symptom among patients with sleep-disordered breathing, is closely associated with the development of cardiovascular diseases, but its long-term prognostic value is not completely understood. The aim of this study was to investigate whether EDS would be an independent prognostic factor after myocardial infarction. METHODS AND RESULTS: We prospectively recruited 112 post-myocardial infarction patients. The Epworth Sleepiness Scale was completed before polysomnography, and EDS was defined as a score ≥11...
January 19, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29276665/insights-since-fda-approval-of-hypoglossal-nerve-stimulation-for-the-treatment-of-obstructive-sleep-apnea
#6
Madeleine M Strohl, Motoo Yamauchi, Zhe Peng, Kingman P Strohl
Purpose: The literature on hypoglossal nerve stimulation (HNS) for the treatment of moderate-to-severe obstructive sleep apnea (OSA) was reviewed from 2014, the time of FDA approval for the Inspire Systems device, to 2017 for themes that might be useful conceptually and practically in the consideration of this new non-anatomic surgical therapy. Recent Findings: there are now further follow-up articles since the 12-month results for Apnea Reduction (STAR) trial of the Inspire device, and post-approval publications which report similar and/0r improved AHI outcomes...
September 2017: Current Sleep Medicine Reports
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
#7
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
#8
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...
February 2018: 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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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