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New Treatments of Sleep Apnea

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https://www.readbyqxmd.com/read/28978212/overview-of-idiopathic-pulmonary-fibrosis-ipf-and-evidence-based-guidelines
#1
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
#2
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
#3
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 non-invasive 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 non-inferior to FixedEPAP for the control of obstructive sleep apnea (OSA) during intelligent volume-assured pressure support (iVAPS) treatment of chronic hypoventilation...
August 14, 2017: Sleep
https://www.readbyqxmd.com/read/28941735/barbed-snore-surgery-for-concentric-collapse-at-the-velum-the-alianza-technique
#4
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
#5
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
#6
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
#7
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...
September 14, 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
#8
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
#9
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
#10
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
https://www.readbyqxmd.com/read/28887782/development-of-acrodat-%C3%A2-a-new-software-medical-device-to-assess-disease-activity-in-patients-with-acromegaly
#11
Aart J van der Lely, Roy Gomez, Andreas Pleil, Xavier Badia, Thierry Brue, Michael Buchfelder, Pia Burman, David Clemmons, Ezio Ghigo, Jens Otto Lunde Jørgensen, Anton Luger, Joli van der Lans-Bussemaker, Susan M Webb, Christian J Strasburger
PURPOSE: Despite availability of multimodal treatment options for acromegaly, achievement of long-term disease control is suboptimal in a significant number of patients. Furthermore, disease control as defined by biochemical normalization may not always show concordance with disease-related symptoms or patient's perceived quality of life. We developed and validated a tool to measure disease activity in acromegaly to support decision-making in clinical practice. METHODS: An international expert panel (n = 10) convened to define the most critical indicators of disease activity...
September 8, 2017: Pituitary
https://www.readbyqxmd.com/read/28862662/snorap-a-device-for-the-correction-of-impaired-sleep-health-by-using-tactile-stimulation-for-individuals-with-mild-and-moderate-sleep-disordered-breathing
#12
Mete Yağanoğlu, Murat Kayabekir, Cemal Köse
Sleep physiology and sleep hygiene play significant roles in maintaining the daily lives of individuals given that sleep is an important physiological need to protect the functions of the human brain. Sleep disordered breathing (SDB) is an important disease that disturbs this need. Snoring and Obstructive Sleep Apnea Syndrome (OSAS) are clinical conditions that affect all body organs and systems that intermittently, repeatedly, with at least 10 s or more breathing stops that decrease throughout the night and disturb sleep integrity...
September 1, 2017: Sensors
https://www.readbyqxmd.com/read/28822761/down-regulation-of-vascular-ppar-%C3%AE-contributes-to-endothelial-dysfunction-in-high-fat-diet-induced-obese-mice-exposed-to-chronic-intermittent-hypoxia
#13
Yanan Zhang, Chunlian Zhang, Haiou Li, Jingdong Hou
Obstructive sleep apnea (OSA), characterized by chronic intermittent hypoxia (CIH), is associated with endothelial dysfunction. The prevalence of OSA is linked to an epidemic of obesity. CIH has recently been reported to cause endothelial dysfunction in diet-induced obese animals by exaggerating oxidative stress and inflammation, but the underlying mechanism remains unclear. PPAR-γ, a ligand-inducible transcription factor that exerts anti-oxidant and anti-inflammatory effects, is down-regulated in the peripheral tissues in diet-induce obesity...
October 14, 2017: Biochemical and Biophysical Research Communications
https://www.readbyqxmd.com/read/28820743/sleep-apnea-a-review-of-diagnostic-sensors-algorithms-and-therapies
#14
Mehdi Shokoueinejad, Chris Fernandez, Emily Carroll, Fa Wang, Jake Levin, Sam Rusk, Nick Glattard, Ashley Mulchrone, Xuan Zhang, Ailiang Xie, Mihaela Teodorescu, Jerome Dempsey, John Webster
While public awareness of sleep related disorders is growing, sleep apnea syndrome (SAS) remains a public health and economic challenge. Over the last two decades, extensive controlled epidemiologic research has clarified the incidence, risk factors including the obesity epidemic, and global prevalence of obstructive sleep apnea (OSA), as well as establishing a growing body of literature linking OSA with cardiovascular morbidity, mortality, metabolic dysregulation, and neurocognitive impairment. The US Institute of Medicine Committee on Sleep Medicine estimates that 50-70 million US adults have sleep or wakefulness disorders...
August 18, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28738371/robotic-obstructive-sleep-apnea-surgery
#15
Song Tar Toh, Pon Poh Hsu
Since the first report of the use of the da Vinci robotic system (Intuitive Surgical, Sunnyvale, CA, USA) in transoral robotic tongue base reduction for obstructive sleep apnea (OSA) was published in 2010, this surgical tool and technique has been used worldwide for the resection of tongue base tissue in the multilevel surgical treatment of OSA. The combined knowledge of the published literature on its use has enlightened sleep surgeons worldwide on this new yet evolving surgical tool. Here we will discuss the use of the da Vinci robotic system in the treatment of OSA, the pertinent surgical anatomy for a safe surgical procedure, the primary and secondary outcomes to expect in the multilevel and primary use of this technology in treating the tongue base, the predictors for success or failure, and the complications associated with this technique...
2017: Advances in Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28684143/what-s-new-in-clinical-obstetric-anesthesia-in-2015
#16
REVIEW
P E Hess
Each calendar year the Society for Obstetric Anesthesia and Perinatology invites an individual to conduct a review of the medical literature, identifying clinically relevant publications of interest to the obstetric anesthesia provider. This report of that effort covers the publications from 2015 and includes the categories of anesthesia and analgesia, complications of neuraxial procedures, and the effects of anesthesia on the fetus. Neuraxial procedures represent the foundation of obstetric anesthesia; advances in anesthesia and analgesia include novel modes of administration, and refinements in care of the medically complex patient...
November 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28675824/a-new-type-of-swaddling-clothing-improved-development-of-preterm-infants-in-neonatal-intensive-care-units
#17
Yuma Kitase, Yoshiaki Sato, Hirokazu Takahashi, Misaki Shimizu, Chie Ishikawa, Hikaru Yamamoto, Masahiro Hayakawa
BACKGROUND: Preterm infants undergo stress owing to essential treatments and exposure to the extrauterine environment in neonatal intensive care units. AIMS: The aim of this study was to enable preterm infants to maintain adequate positioning with a newly developed swaddling clothing, in order to improve low muscle tone and sleep quality, and to confirm the safety of the clothing. STUDY DESIGN: This prospective clinical trial included an intervention group (preterm infants wearing bag-shaped clothing, allowing only exposure of the head, n=27), and a control group (preterm infants managed only with conventional swaddling, n=12)...
July 1, 2017: Early Human Development
https://www.readbyqxmd.com/read/28647143/a-tertiary-center-experience-with-velopharyngeal-surgical-techniques-for-treatment-of-snoring-and-obstructive-sleep-apnea
#18
Omer Karakoc, Murat Binar, Umit Aydin, Hakan Genc, Timur Akcam, Mustafa Gerek
OBJECTIVES: The aim of this study was to assess the outcomes of patients who treated with the relatively new surgical procedures; anterior palatoplasty (AP), Cahali lateral pharyngoplasty (CLP), and expansion sphincter pharyngoplasty (ESP) for habitual snoring or obstructive sleep apnea (OSA). METHODS: Prospective series of 93 patients were evaluated. The performed surgical techniques, polysomnographic outcomes, pre- and postoperative clinical parameters, and complication rates were assessed...
June 21, 2017: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/28633723/validated-measures-of-insomnia-function-sleepiness-and-nasal-obstruction-in-a-cpap-alternatives-clinic-population
#19
Austin S Lam, Nancy A Collop, Donald L Bliwise, Raj C Dedhia
STUDY OBJECTIVES: Although efficacious in the treatment of obstructive sleep apnea (OSA), continuous positive airway pressure (CPAP) can be difficult to tolerate, with long-term adherence rates approaching 50%. CPAP alternatives clinics specialize in the evaluation and treatment of CPAP-intolerant patients; yet this population has not been studied in the literature. To better understand these patients, we sought to assess insomnia, sleep-related functional status, sleepiness, and nasal obstruction, utilizing data from validated instruments...
August 15, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/28621155/the-role-of-telemedicine-in-obstructive-sleep-apnea-management
#20
Vera Lugo, Jair Asir Villanueva, Onintza Garmendia, Josep M Montserrat
Obstructive sleep apnea (OSA) is a common disease that leads in notorious symptoms and comorbidities. Although general measures are important, continuous positive airway pressure (CPAP) is the best treatment option. However, compliance can be suboptimal and telemedicine may play a role to improve it. Areas covered: Review authors searched EMBASE, PubMed and Cochrane data bases using the following keywords: continuous positive airway pressure, Obstructive sleep apnea, telemedicine, respiratory telemedicine, information and communication technology...
June 29, 2017: Expert Review of Respiratory Medicine
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