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New Treatments of Sleep Apnea

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https://www.readbyqxmd.com/read/28502280/a-feedback-controlled-mandibular-positioner-identifies-individuals-with-sleep-apnea-who-will-respond-to-oral-appliance-therapy
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
https://www.readbyqxmd.com/read/28128977/a-tailored-intervention-for-pap-adherence-the-scip-pa-trial
#17
Amy M Sawyer, Tonya S King, Terri E Weaver, Douglas A Sawyer, Miranda Varrasse, Jamie Franks, Alexa Watach, Ann M Kolanowski, Kathy C Richards
OBJECTIVE/BACKGROUND: Positive airway pressure (PAP) is highly efficacious treatment but nonadherence is prevalent with little improvement over the last 15 years. Tailored interventions show promise for promoting adherence to other treatments. The study objective was to examine feasibility and acceptability of a tailored intervention to promote PAP adherence. PARTICIPANTS: The convenience sample met inclusion criteria: newly diagnosed OSA; treatment-naïve; ≥ 18 years...
January 27, 2017: Behavioral Sleep Medicine
https://www.readbyqxmd.com/read/28118461/screening-for-obstructive-sleep-apnea-in-adults-us-preventive-services-task-force-recommendation-statement
#18
Kirsten Bibbins-Domingo, David C Grossman, Susan J Curry, Karina W Davidson, John W Epling, Francisco A R García, Jessica Herzstein, Alex R Kemper, Alex H Krist, Ann E Kurth, C Seth Landefeld, Carol M Mangione, William R Phillips, Maureen G Phipps, Michael P Pignone, Michael Silverstein, Chien-Wen Tseng
Importance: Based on data from the 1990s, estimated prevalence of obstructive sleep apnea (OSA) in the United States is 10% for mild OSA and 3.8% to 6.5% for moderate to severe OSA; current prevalence may be higher, given the increasing prevalence of obesity. Severe OSA is associated with increased all-cause mortality, cardiovascular disease and cerebrovascular events, diabetes, cognitive impairment, decreased quality of life, and motor vehicle crashes. Objective: To issue a new US Preventive Services Task Force (USPSTF) recommendation on screening for OSA in asymptomatic adults...
January 24, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28075423/effects-of-device%C3%A2-guided-slow-breathing-training-on-exercise-capacity-cardiac-function-and-respiratory-patterns-during-sleep-in-male-and-female-patients-with-chronic-heart-failure
#19
Kalina Kawecka-Jaszcz, Grzegorz Bilo, Tomasz Drożdż, Dorota Dębicka-Dąbrowska, Grzegorz Kiełbasa, Gabriella Malfatto, Katarzyna Styczkiewicz, Carolina Lombardi, Agnieszka Bednarek, Sabrina Salerno, Danuta Czarnecka, Gianfranco Parati
INTRODUCTION Slow breathing training (SBT) has been proposed as a new nonpharmacologic treatment in patients with chronic heart failure (CHF). OBJECTIVES The aim of this study was to assess the effects of SBT on exercise capacity, hemodynamic parameters, and sleep respiratory patterns in a relatively large sample of CHF patients. PATIENTS AND METHODS A crossover open study was conducted. Patients completed, in a random order, 10- to 12‑week SBT, with 2 15‑minute sessions of device‑guided SBT each day, reaching 6 breaths/ min, and a 10- to 12‑week follow‑up under standard care...
January 10, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/28038795/sleep-apnea-and-driving-recommendations-for-interpreting-spanish-regulations-for-drivers
#20
Joaquín Terán-Santos, Carlos Egea Santaolalla, Jose María Montserrat, Fernando Masa Jiménez, Maria Villar Librada Escribano, Enrique Mirabet, Elena Valdés Rodríguez
Road traffic accidents are one of the main causes of death worldwide and are clearly associated with sleepiness. Individuals with undiagnosed sleep apnea-hypopnea syndrome (SAHS) are among the population with a high risk of experiencing sleepiness at the wheel and, consequently, road traffic accidents. Treatment with continuous positive airway pressure (CPAP) has been shown to reduce the risk of accidents among drivers with SAHS. For this reason, the European Union has included this disease in the psychological and physical criteria for obtaining or renewing a driving license...
December 27, 2016: Archivos de Bronconeumología
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