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New Treatments of Sleep Apnea

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https://www.readbyqxmd.com/read/29667019/what-is-new-in-heart-failure-management-in-2017-update-on-acc-aha-heart-failure-guidelines
#1
REVIEW
Biykem Bozkurt
PURPOSE OF REVIEW: The goal of this paper is to provide a summary of the new recommendations in the most recent 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. The intent is to provide the background and the supporting evidence for the recommendations and to provide practical guidance for management strategies in treatment of heart failure patients...
April 17, 2018: Current Cardiology Reports
https://www.readbyqxmd.com/read/29617218/computational-model-of-brainstem-circuit-for-state-dependent-control-of-hypoglossal-motoneurons
#2
Mohsen Naji, Maxim Komarov, Giri P Krishnan, Atul Malhotra, Frank L Powell, Irma Rukhadze, Victor B Fenik, Maxim Bazhenov
In patients with obstructive sleep apnea (OSA) the pharyngeal muscles become relaxed during sleep, which leads to a partial or complete closure of upper airway. Experimental studies suggest that withdrawal of noradrenergic and serotonergic drives importantly contribute to depression of hypoglossal motoneurons and, therefore, may contribute to OSA pathophysiology; however, specific cellular and synaptic mechanisms remain unknown. In this new study, we developed a biophysical network model to test the hypothesis that, in order to explain experimental observations, the neuronal network for monoaminergic control of excitability of hypoglossal motoneurons needs to include excitatory and inhibitory perihypoglossal interneurons that mediate noradrenergic and serotonergic drives to hypoglossal motoneurons...
April 4, 2018: Journal of Neurophysiology
https://www.readbyqxmd.com/read/29609704/role-of-positive-airway-pressure-therapy-for-obstructive-sleep-apnea-in-patients-with-stroke-a-randomized-controlled-trial
#3
Anupama Gupta, Garima Shukla, Mohammed Afsar, Shivani Poornima, Ravindra M Pandey, Vinay Goyal, Achal Srivastava, Deepti Vibha, Madhuri Behari
STUDY OBJECTIVES: Obstructive sleep apnea (OSA) is an independent risk factor for stroke. The objective of this study was to assess the effect of continuous positive airway pressure (CPAP) treatment on prevention of new vascular events among patients with stroke and OSA. METHODS: Consecutive conscious patients presenting with first imaging-confirmed arterial stroke were included, 6 weeks or more after ictus. All patients underwent clinical and polysomnography (PSG) testing...
March 30, 2018: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/29602992/updated-panel-report-best-practices-for-the-surgical-treatment-of-obesity
#4
Dana A Telem, Daniel B Jones, Philip R Schauer, Stacy A Brethauer, Raul J Rosenthal, David Provost, Stephanie B Jones
BACKGROUND: During the 2004 annual meeting of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), a panel of experts convened to provide updated information on best practices in bariatric surgery. The rapid evolution of endoluminal technologies, surgical indications, and training in bariatric surgery since 2004 has led to new questions and concerns about optimal treatment algorithms, patient selection, and the preparation of our current and future bariatric workforce...
March 30, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29555137/when-a-private-community-neurology-practice-executes-home-sleep-apnea-testing-benefits-identified-and-lessons-learned-in-a-retrospective-observational-study
#5
Charlene E Gamaldo, Alyssa A Gamaldo, Laurence T Hou, Aadi Kalloo, Daniel Hexter, Brian Salter, Molly Price, Maya Carter, Rachel Marie E Salas
OBJECTIVE: To investigate the feasibility and utility of a private community neurology practice-initiated home sleep apnea testing (HSAT) program. METHODS: A private community neurology practice conducted HSAT on patients clinically identified as high risk for obstructive sleep apnea (OSA). An academic board-certified sleep specialist performed all study interpretations. The presence and severity of OSA and its association with patient demographics (eg, sex, age) and comorbid health conditions relevant to OSA were evaluated...
April 2018: Sleep Health
https://www.readbyqxmd.com/read/29523641/cpap-as-treatment-of-sleep-apnea-after-stroke-a-meta-analysis-of-randomized-trials
#6
Anne-Kathrin Brill, Thomas Horvath, Andrea Seiler, Millene Camilo, Alan G Haynes, Sebastian R Ott, Matthias Egger, Claudio L Bassetti
OBJECTIVE: To perform a systematic review and meta-analysis of randomized controlled trials (RCTs) examining the effectiveness of continuous positive airway pressure (CPAP) in stroke patients with sleep disordered breathing (SDB). METHODS: In a systematic literature search of electronic databases (MEDLINE, Embase, and the Cochrane Library) from 1980 to November 2016, we identified RCTs that assessed CPAP compared to standard care or sham CPAP in adult patients with stroke or TIA with SDB...
March 9, 2018: Neurology
https://www.readbyqxmd.com/read/29523262/predictors-of-sleep-disordered-breathing-in-pregnancy
#7
Judette M Louis, Matthew A Koch, Uma M Reddy, Robert M Silver, Corette B Parker, Francesca L Facco, Susan Redline, Chia-Ling Nhan-Chang, Judith H Chung, Grace W Pien, Robert C Basner, William A Grobman, Deborah A Wing, Hyagriv N Simhan, David M Haas, Brian M Mercer, Samuel Parry, Daniel Mobley, Benjamin Carper, George R Saade, Frank P Schubert, Phyllis C Zee
BACKGROUND: Sleep-disordered breathing (SDB) is common in pregnancy, but there are limited data on predictors. OBJECTIVES: The objective of this study was to develop predictive models of sleep-disordered breathing during pregnancy. STUDY DESIGN: Nulliparous women completed validated questionnaires to assess for symptoms related to snoring, fatigue, excessive daytime sleepiness, insomnia, and restless leg syndrome. The questionnaires included questions regarding the timing of sleep and sleep duration, work schedules (eg, shift work, night work), sleep positions, and previously diagnosed sleep disorders...
February 2, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29509180/cns-drug-development-lessons-learned-part-5-how-preclinical-and-human-safety-studies-inform-the-approval-and-subsequent-use-of-a-new-drug-suvorexant-as-an-example
#8
Sheldon H Preskorn
This column is the fifth in a series examining the advances being made in central nervous system drug development because of advances in molecular pharmacology and an improved understanding of the neurobiology underlying disturbances in brain function including psychiatric illnesses. This column covers the special animal and human studies conducted as part of the development of suvorexant, which is the first in the class of dual orexin 1 and 2 receptor antagonists to be approved; it has an indication for the treatment of disturbances in sleep onset and maintenance...
March 2018: Journal of Psychiatric Practice
https://www.readbyqxmd.com/read/29477718/prevalence-and-characteristics-of-urinary-incontinence-in-a-treatment-seeking-male-prospective-cohort-results-from-the-lurn-study
#9
Brian T Helfand, Abigail R Smith, H Henry Lai, Claire C Yang, John L Gore, Brad A Erickson, Karl J Kreder, Anne P Cameron, Kevin P Weinfurt, James W Griffith, Aaron Lentz, Pooja Talaty, Victor P Andreev, Ziya Kirkali
PURPOSE: Male urinary incontinence (UI) is thought to be infrequent. We sought to describe the prevalence of UI in a male treatment-seeking cohort enrolled in the Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN). MATERIALS AND METHODS: The inclusion/exclusion criteria, including men with prostate cancer or a neurogenic bladder, have been previously reported. LURN participants prospectively completed questionnaires regarding lower urinary tract symptoms (LUTS) and other clinical variables...
February 22, 2018: Journal of Urology
https://www.readbyqxmd.com/read/29469928/obstructive-sleep-apnea-and-neurocognitive-dysfunction-in-edentulous-patients
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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-medicine-intervention-targeting-healthy-eating-and-physical-activity-a-randomised-controlled-trial
#16
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
#17
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
#18
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...
January 15, 2018: 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
#19
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
#20
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 suboptimal because of variable adherence to existing therapies. METHODS: This trial compared positive airway pressure adherence among patients who were provided active patient engagement (APE) technology vs those who received usual care monitoring (UCM). The primary outcome was expressed by using the US Medicare definition of adherence. Adherence data from two cloud-based databases (AirView and myAir) were analyzed for patients with sleep apnea...
November 15, 2017: Chest
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