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New Treatments of Sleep Apnea

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https://www.readbyqxmd.com/read/28633723/validated-measures-of-insomnia-function-sleepiness-and-nasal-obstruction-in-a-cpap-alternatives-clinic-population
#1
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...
June 16, 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
#2
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 16, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28550476/stroke-and-other-cardiovascular-events-in-patients-with-obstructive-sleep-apnea-and-the-effect-of-continuous-positive-airway-pressure
#3
Mirjam H Schipper, Korne Jellema, Bregje J W Thomassen, Diego Alvarez-Estevez, Johan Verbraecken, Roselyne M Rijsman
Obstructive sleep apnea (OSA) is a known-risk factor for cardiovascular diseases. There are indications that treatment with continuous positive airway pressure (CPAP) reduces the risk of new cardiovascular events. In this study, we analyzed the incidence of cardiovascular events in patients with OSA and compared for the impact of CPAP therapy. All polysomnographies performed in 2009 and 2010 were selected with an AHI ≥5 and patients older than 18 years. These 1110 patients were approached with a questionnaire about cardiovascular events and CPAP treatment...
June 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28530153/baseline-sleep-efficiency-and-arousal-index-do-not-predict-who-will-benefit-from-sedatives-in-improving-positive-airway-pressure-adherence-in-sleep-apnea-to-90
#4
R Bart Sangal
Positive airway pressure (PAP) is the preferred treatment for obstructive sleep apnea (OSA), but adherence is low. Educational or ongoing supportive intervention improves the number of PAP adherent patients from the 50% to the 70% range. A common side effect of PAP is increased awakenings. This prospective trial examined baseline polysomnographically derived sleep efficiency and arousal index in PAP adherent and nonadherent patients, and in patients needing sedating medicines to attain PAP adherence versus those who did not need such medicines...
May 1, 2017: Clinical EEG and Neuroscience: Official Journal of the EEG and Clinical Neuroscience Society (ENCS)
https://www.readbyqxmd.com/read/28502280/a-feedback-controlled-mandibular-positioner-identifies-individuals-with-sleep-apnea-who-will-respond-to-oral-appliance-therapy
#5
John E Remmers, Zbigniew Topor, Joshua Grosse, Nikola Vranjes, Erin V Mosca, Rollin Brant, Sabina Bruehlmann, Shouresh Charkhandeh, Seyed Abdolali Zareian Jahromi
STUDY OBJECTIVES: Mandibular protruding oral appliances represent a potentially important therapy for obstructive sleep apnea (OSA). However, their clinical utility is limited by a less-than-ideal efficacy rate and uncertainty regarding an efficacious mandibular position, pointing to the need for a tool to assist in delivery of the therapy. The current study assesses the ability to prospectively identify therapeutic responders and determine an efficacious mandibular position. METHODS: Individuals (n = 202) with OSA participated in a blinded, 2-part investigation...
May 11, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/28482446/-effect-of-mandibular-advancement-device-upon-nuclear-factor-%C3%AE%C2%BAb-and-tumor-necrosis-factor-%C3%AE-interleukin-6-in-genioglossus-of-rabbit-with-obstructive-sleep-apnea-hypopnea-syndrome
#6
S L Zhang, C Y Liu, W Wang, X Qiao, H Y Lu
Objective: To investigate the effects of mandibular advancement device (MAD) upon nuclear factor κB (NF-κB), tumor necrosis factor α (TNF-α) and interleukin 6 (IL-6) in the genioglossus. Methods: Eighteen New Zealand white rabbits (male, six months old), in accordance with the random number table, were equally divided into three groups, the control group, obstructive sleep apnea hypopnea syndrome (OSAHS) group and MAD group. All animals were induced to sleep in supine position for 2 hours every morning in the next 8 weeks...
May 9, 2017: Zhonghua Kou Qiang Yi Xue za Zhi, Zhonghua Kouqiang Yixue Zazhi, Chinese Journal of Stomatology
https://www.readbyqxmd.com/read/28414687/disseminated-cryptococcal-disease-with-diffuse-pulmonary-infiltrates-in-a-non-hiv-host
#7
M Hughes, K Trivedi, M Rudrappa
INTRODUCTION: We present a case of disseminated Cryptococcus in a non-HIV host, where the primary manifestation was pulmonary with diffuse pulmonary infiltrates. This patient was on high dose corticosteroids for autoimmune hemolytic anemia. CASE: A 79 year old Caucasian man with a history of autoimmune hemolytic anemia on 100 mg of prednisone daily, coronary artery disease s/p bypass surgery, ischemic cardiomyopathy, chronic obstructive pulmonary disease, sleep apnea, chronic kidney disease, and history of bilateral pulmonary emboli presented to Hematology/Oncology clinic with symptoms of productive cough, worsening shortness of breath, hemoptysis...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28408965/phospholipase-c-related-catalytically-inactive-protein-can-regulate-obesity-a-state-of-peripheral-inflammation
#8
REVIEW
Yosuke Yamawaki, Kana Oue, Satomi Shirawachi, Satoshi Asano, Kae Harada, Takashi Kanematsu
Obesity is defined as abnormal or excessive fat accumulation. Chronic inflammation in fat influences the development of obesity-related diseases. Many reports state that obesity increases the risk of morbidity in many diseases, including hypertension, dyslipidemia, type 2 diabetes, coronary heart disease, stroke, sleep apnea, and breast, prostate and colon cancers, leading to increased mortality. Obesity is also associated with chronic neuropathologic conditions such as depression and Alzheimer's disease. However, there is strong evidence that weight loss reduces these risks, by limiting blood pressure and improving levels of serum triglycerides, total cholesterol, low-density lipoprotein (LDL)-cholesterol, and high-density lipoprotein (HDL)-cholesterol...
February 2017: Japanese Dental Science Review
https://www.readbyqxmd.com/read/28399379/physiology-of-arousal-in-osa-and-potential-impacts-for-sedative-treatment
#9
Amy S Jordan, Fergal J O'Donoghue, Jennifer M Cori, John Trinder
Treatment options for patients with obstructive sleep apnea (OSA) intolerant of continuous positive airway pressure (CPAP) are limited. Thus, new therapies are sought. Recently, there has been interest in using sedatives to delay arousal from sleep, allowing upper airway dilator muscle recruitment sufficient to re-open the airway while maintaining sleep. In this review the rationale for sedative use and prior sedative studies in OSA are presented, along with a description of six factors that may determine sedative treatment success...
April 11, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28376127/the-doc-screen-feasible-and-valid-screening-for-depression-obstructive-sleep-apnea-osa-and-cognitive-impairment-in-stroke-prevention-clinics
#10
Richard H Swartz, Megan L Cayley, Krista L Lanctôt, Brian J Murray, Ashley Cohen, Kevin E Thorpe, Michelle N Sicard, Karen Lien, Demetrios J Sahlas, Nathan Herrmann
BACKGROUND: Post-stroke Depression, Obstructive sleep apnea (OSA) and Cognitive impairment ("DOC") are associated with greater mortality, worse recovery and poorer quality of life. Best practice recommendations endorse routine screening for each condition; yet, all are under-assessed, diagnosed and treated. We seek to determine the feasibility and validity of an integrated tool ("DOC" screen) to identify stroke clinic patients at high-risk of depression, OSA, and cognitive impairment...
2017: PloS One
https://www.readbyqxmd.com/read/28374832/a-randomized-controlled-trial-of-an-ambulatory-approach-versus-the-hospital-based-approach-in-managing-suspected-obstructive-sleep-apnea-syndrome
#11
David S Hui, Susanna S Ng, Kin-Wang To, Fanny W Ko, Jenny Ngai, Ken K P Chan, Wing-Ho Yip, Tat-On Chan, Karen Yiu, Wilson W S Tam
Comparisons of home-based versus hospital-based approach in managing patients with suspected obstructive sleep apnoea syndrome(OSAS). A prospective, controlled CPAP parallel study of new referrals with suspected OSAS randomized into group A) home-based or B) hospital-based approach. Following detection of AHI ≥ 15/hr by Embletta sleep study (group A) or polysomnography (group B), patients received CPAP for 3 months after an overnight autoCPAP titration at home or in hospital respectively. Modified intention-to-treat analysis of those with AHI ≥ 15/hr on CPAP (n = 86 vs 86) showed no difference in Epworth sleepiness score, the primary endpoint, but greater improvement in Sleep-Apnoea-Quality-of-Life-Index[difference 0...
April 4, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28364416/periodic-limb-movements-during-sleep-mimicking-rem-sleep-behavior-disorder-a-new-form-of-periodic-limb-movement-disorder
#12
Carles Gaig, Alex Iranzo, Montserrat Pujol, Hernando Perez, Joan Santamaria
Study Objectives: To describe a group of patients referred because of abnormal sleep behaviors that were suggestive of rapid eye movement (REM) sleep behavior disorder (RBD) in whom video-polysomnography ruled out RBD and showed the reported behaviors associated with vigorous periodic limb movements during sleep (PLMS). Aims and Methods: Clinical history and video-polysomnography review of patients identified during routine visits in a sleep center. Results: Patients were 15 men and 2 women with a median age of 66 (range: 48-77) years...
March 1, 2017: Sleep
https://www.readbyqxmd.com/read/28279632/drug-induced-sleep-endoscopy-a-new-gold-standard-for-evaluating-osas-part-ii-results
#13
M Blumen, E Bequignon, F Chabolle
Surgical results in obstructive sleep apnea syndrome (OSAS) vary greatly, whatever the surgical technique or site. Most authors agree that rigorous patient selection is logical and mandatory. Drug-induced sleep endoscopy (DISE) was introduced in 1991 and has been rediscovered and used extensively since the 2000s. It attempts to mimic natural sleep in order to observe the upper airway on flexible endoscopy in a situation in which obstruction may occur. A review of the DISE literature was performed, and is reported in two parts...
March 6, 2017: European Annals of Otorhinolaryngology, Head and Neck Diseases
https://www.readbyqxmd.com/read/28279153/the-association-between-biochemical-control-and-cardiovascular-risk-factors-in-acromegaly
#14
John D Carmichael, Michael S Broder, Dasha Cherepanov, Eunice Chang, Adam Mamelak, Qayyim Said, Maureen P Neary, Vivien Bonert
BACKGROUND: The study aim was to estimate the proportion of acromegaly patients with various comorbidities and to determine if biochemical control was associated with reduced proportion of cardiovascular risk factors. METHODS: Data were from a single-center acromegaly registry. Study patients were followed for ≥12 months after initial treatment. Study period was from first to last insulin-like growth factor-I and growth hormone tests. RESULTS: Of 121 patients, 55% were female...
March 9, 2017: BMC Endocrine Disorders
https://www.readbyqxmd.com/read/28240944/a-brief-tool-to-differentiate-factors-contributing-to-insomnia-complaints
#15
Donald Townsend, Louis Kazaglis, Kay Savik, Adam Smerud, Conrad Iber
OBJECTIVE: A complaint of insomnia may have many causes. A brief tool examining contributing factors may be useful for nonsleep specialists. This study describes the development of the Insomnia Symptoms Assessment (ISA) for examining insomnia complaints. METHOD: ISA questions were designed to identify symptoms that may represent 1 of 8 possible factors contributing to insomnia symptoms, including delayed sleep phase syndrome (DSPS), shift work sleep disorder (SWSD), obstructive sleep apnea (OSA), mental health, chronic pain, restless leg syndrome (RLS), poor sleep hygiene, and psychophysiological insomnia (PI)...
March 2017: Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association
https://www.readbyqxmd.com/read/28212691/efficacy-of-the-new-generation-of-devices-for-positional-therapy-for-patients-with-positional-obstructive-sleep-apnea-a-systematic-review-of-the-literature-and-meta-analysis
#16
Madeline J L Ravesloot, David White, Raphael Heinzer, Arie Oksenberg, Jean-Louis Pépin
STUDY OBJECTIVES: In approximately 56% to 75% of patients with obstructive sleep apnea (OSA), the frequency and duration of apneas are influenced by body position. This is referred to as position-dependent OSA or POSA. Patients with POSA can be treated with a small device attached to either the neck or chest. These devices-a new generation of devices for positional therapy (PT)-provide a subtle vibrating stimulus that prevents patients adopting the supine position. The objectives of this study were to determine whether PT is effective in improving sleep study variables and sleepiness, and to assess compliance...
February 15, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/28188451/patients-with-cheyne-stokes-respiration-and-heart-failure-patient-tolerance-after-three-month-discontinuation-of-treatment-with-adaptive-servo-ventilation
#17
Arild Hetland, Tøri Vigeland Lerum, Kristina H Haugaa, Thor Edvardsen
The recent SERVE HF study concluded that patients with chronic heart failure (CHF) and Cheyne-Stokes respiration (CSR) have increased mortality when treated with adaptive servo-ventilation (ASV). We, therefore, wanted to explore if these patients tolerated discontinuation of ASV treatment. The study was a prospective post-ASV treatment observational design with a 3-month follow-up period. 14 patients from our outpatient clinic, all male, were originally diagnosed with CHF and Cheyne-Stokes respiration, which is a clinical form of central sleep apnea...
February 11, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28185772/impact-of-weight-loss-management-in-osa
#18
REVIEW
Simon A Joosten, Garun S Hamilton, Matthew T Naughton
The interaction between obesity and obstructive sleep apnea (OSA) is complex. Whilst it is often assumed that obesity is the major cause of OSA, and that treatment of the OSA might mitigate further weight gain, new evidence is emerging that suggest these statements may not be the case. Obesity explains about 60% of the variance of the apnea hypopnea index definition of OSA, mainly in those < 50 years and less so in the elderly. Moreover, long term treatment of OSA with continuous positive airway pressure is associated with small but significant weight gain...
February 6, 2017: Chest
https://www.readbyqxmd.com/read/28168335/at-home-pulse-oximetry-in-children-undergoing-adenotonsillectomy-for-obstructive-sleep-apnea
#19
Martino Pavone, Nicola Ullmann, Elisabetta Verrillo, Giancarlo De Vincentiis, Emanuela Sitzia, Renato Cutrera
Nocturnal pulse oximetry has a high positive predictive value for polysomnographically diagnosed obstructive sleep apnoea (OSA) in children. When significant adenotonsillar hypertrophy is diagnosed, adenotonsillectomy (T&A) represents a common treatment for OSA in children. We investigated the role of pulse oximetry in predicting those patients, referred for suspected OSA, who subsequently needed T&A. At-home nocturnal pulse oximetry was performed on 380 children (65.7% males), median age 4.1(IRQ 3.0-5.6) years, referred for suspected OSA, and data were retrospectively analysed...
February 6, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28144275/serum-of-obstructive-sleep-apnea-patients-impairs-human-coronary-endothelial-cell-migration
#20
Michał Hoffmann, Jacek Wolf, Anna Szyndler, Prachi Singh, Virend K Somers, Krzysztof Narkiewicz
INTRODUCTION: Endothelial cell migration and proliferation play an important role in the growth and development of new blood vessels and endothelium healing. This process occurs in response to injury, inflammation and immune reactions. Dysfunction of the endothelium may play a significant role in development and progression of cardiovascular disease related to sleep-disordered breathing. The aim of our study was to evaluate the chemo-attractant activity of serum from obstructive sleep apnea (OSA) and normal subjects on coronary artery endothelial cell migration...
February 1, 2017: Archives of Medical Science: AMS
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