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https://www.readbyqxmd.com/read/27913971/myofunctional-therapy-improves-adherence-to-continuous-positive-airway-pressure-treatment
#1
Giovana Diaféria, Rogerio Santos-Silva, Eveli Truksinas, Fernanda L M Haddad, Renata Santos, Silvana Bommarito, Luiz C Gregório, Sergio Tufik, Lia Bittencourt
PURPOSE: Few studies have investigated myofunctional therapy in patients with obstructive sleep apnea syndrome (OSAS). The objective of this study was to evaluate the effect of myofunctional therapy on continuous positive airway pressure (CPAP) adherence. METHODS: The study was registered at ClinicalTrials.gov (NCT01289405). Male patients with OSAS were randomly divided into four treatment groups: placebo, patients undergoing placebo myofunctional therapy (N = 24); myofunctional therapy, undergoing myofunctional therapy (N = 27); CPAP, undergoing treatment with CPAP (N = 27); and combined, undergoing CPAP therapy and myofunctional therapy (N = 22)...
December 2, 2016: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/27911338/sleepiness-and-sleep-related-breathing-disorders-in-myotonic-dystrophy-and-responses-to-treatment-a-prospective-cohort-study
#2
Sophie D West, Hanns Lochmüller, Joan Hughes, Antonio Atalaia, Chiara Marini-Bettolo, Simon V Baudouin, Kirstie N Anderson
OBJECTIVE: We conducted prospective assessments in people with myotonic dystrophy type 1 (DM1) with daytime sleepiness, provided targeted therapies and assessed response. METHODS: Patients had overnight sleep assessments. Treatment with continuous positive airway pressure (CPAP) for OSA, non-invasive ventilation (NIV) for respiratory failure, modafinil for excessive daytime sleepiness were commenced. RESULTS: 120 people were studied: mean age 46...
November 29, 2016: Journal of Neuromuscular Diseases
https://www.readbyqxmd.com/read/27909488/atrial-fibrillation-and-sleep-apnea-considerations-for-a-dual-epidemic
#3
REVIEW
Patricia Tung Md, Elad Anter Md
Atrial fibrillation (AF) is the most common cardiac arrhythmia and shares many of the same risk factors as another common clinical condition, sleep apnea. The estimated prevalence of sleep apnea has increased over the past decade, and reflects a parallel increase in the most prominent risk factors of obesity and overweight. Both obstructive and central sleep apnea have been associated with AF in multiple studies, with the risk of AF increasing 2-4-fold compared to those without sleep breathing disorder. Continuous positive airway pressure (CPAP) has been shown to reduce the rate of AF recurrence following catheter ablation in patients with sleep apnea...
April 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27905903/immediate-effect-of-cpap-titration-on-perceived-health-related-quality-of-life-a-prospective-observational-study
#4
Serena Iacono Isidoro, Adriana Salvaggio, Anna Lo Bue, Salvatore Romano, Oreste Marrone, Giuseppe Insalaco
BACKGROUND: Perceived Health Related Quality of Life (HRQoL) is impaired in obstructive sleep apnea (OSA). This study examines changes in HRQoL aspects occurring immediately after CPAP titration. Furthermore, we analyzed variations in each gender and in patients undergoing home or laboratory-based CPAP titration pathways. METHODS: Twohundredfive outpatients (151 M) (56.7 ± 10.3 years) were evaluated, before first visit and nocturnal diagnostic examination (T0), and the morning after CPAP titration (T1)...
December 1, 2016: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/27901270/adipose-tissue-inflammation-by-intermittent-hypoxia-mechanistic-link-between-obstructive-sleep-apnoea-and-metabolic-dysfunction
#5
Silke Ryan
Obstructive sleep apnoea (OSA) is a highly prevalent condition and recognized as a major public health burden conveying a significant risk of cardiometabolic diseases and mortality. Type 2 diabetes (T2D), insulin resistance (IR) and glucose tolerance are common in subjects with OSA and this association is at least in part independent of the effects of obesity. Continuous positive airway pressure (CPAP) is the treatment of choice for the majority of patients with OSA but the benefit of CPAP on glycaemic health is uncertain...
November 29, 2016: Journal of Physiology
https://www.readbyqxmd.com/read/27899105/non-invasive-mechanical-ventilation-after-heart-surgery-in-children
#6
Sarah Fernández Lafever, Blanca Toledo, Miguel Leiva, Maite Padrón, Marina Balseiro, Angel Carrillo, Jesús López-Herce
BACKGROUND: The purpose of the study was to analyze the characteristics and evolution of non-invasive mechanical ventilation (NIV) in the postoperative period of heart surgery in children. METHODS: Retrospective observational study including all children requiring NIV after heart surgery in a single center pediatric intensive care unit (PICU) between 2001 and 2012. Demographic characteristics, ventilation parameters and outcomes were registered, comparing the first 6 years of the study with the last 6 years...
November 29, 2016: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/27895847/efficacy-of-a-low-cost-bubble-cpap-system-in-treatment-of-respiratory-distress-in-a-neonatal-ward-in-malawi
#7
Kondwani Kawaza, Heather E Machen, Jocelyn Brown, Zondiwe Mwanza, Suzanne Iniguez, Al Gest, E O'Brian Smith, Maria Oden, Rebecca R Richards-Kortum, Elizabeth Molyneux
BACKGROUND: Respiratory failure is a leading cause of neonatal mortality in the developing world. Bubble continuous positive airway pressure (bCPAP) is a safe, effective intervention for infants with respiratory distress and is widely used in developed countries. Because of its high cost, bCPAP is not widely utilized in low-resource settings. We evaluated the performance of a new bCPAP system to treat severe respiratory distress in a low resource setting, comparing it to nasal oxygen therapy, the current standard of care...
September 2016: Malawi Medical Journal: the Journal of Medical Association of Malawi
https://www.readbyqxmd.com/read/27887730/reducing-upper-airway-collapse-at-lower-continuous-positive-airway-titration-pressure
#8
Sherif Ashaat, Ahmed M Al-Jumaily
During respiration, upper airway (UA) collapse occurs when the forces generated from the negative UA pressures exceed the forces produced by the UA muscles; which leads to loose soft tissue at the back of the mouth. At predetermined titration pressure, the Continuous Positive Airway Pressure (CPAP) normally provides a continuous pressurized and humidified air to prevent airway collapse. However, high titration pressures are not always tolerated by patients and may lead to damaging effects including stroke symptoms for cardiovascular disease patients...
November 9, 2016: Journal of Biomechanics
https://www.readbyqxmd.com/read/27887724/facial-deformations-during-nasal-continuous-positive-airway-pressure-therapy
#9
Andrew Sims, Anne Simmons, Mark Hoffman, Klaus Schindhelm
Obstructive Sleep Apnoea (OSA), characterised by repeated collapse of the pharyngeal airway during sleep, causes cessation of breathing followed by arousal, restoring normality. Continuous Positive Airway Pressure (CPAP) is a non-invasive, effective treatment for OSA where positive pressure is applied to the airway through a mask, maintaining patency. Nasal masks are commonly used, contacting the face across the upper lip, sides of the nose and the nasal bridge. Despite health benefits, therapy compliance is sub-optimal, often due to poor mask fit and discomfort...
October 22, 2016: Journal of Biomechanics
https://www.readbyqxmd.com/read/27886561/the-stop-bang-questionnaire-improves-the-detection-of-epilepsy-patients-at-risk-for-obstructive-sleep-apnea
#10
Anumeha Sharma, Jennifer Molano, Brian D Moseley
Patients with epilepsy and obstructive sleep apnea (OSA) are at risk for worsened seizure control and quality of life. We performed a quality improvement project, evaluating for improvements in the screening of OSA in epilepsy patients using the STOP-BANG questionnaire. The electronic medical records of patients seen in our epilepsy clinic were screened for 4 months prior to the intervention. We subsequently implemented the STOP-BANG questionnaire for 3 months. Only 22/664 patients (3.3%) had their sleeping habits explored during the pre-intervention period; 11 (1...
November 18, 2016: Epilepsy Research
https://www.readbyqxmd.com/read/27882399/-circadian-rhythm-influence-on-epworth-sleepiness-scale-score
#11
M Herzog, A Bedorf, C Rohrmeier, T Kühnel, B Herzog, T Bremert, S Plontke, S Plößl
BACKGROUND: The Epworth Sleepiness Scale (ESS) is frequently used to determine daytime sleepiness in patients with sleep-disordered breathing. It is still unclear whether different levels of alertness induced by the circadian rhythm influence ESS score. OBJECTIVE: The aim of this study is to investigate the influence of circadian rhythm-dependent alertness on ESS performance. MATERIALS AND METHODS: In a monocentric prospective noninterventional observation study, 97 patients with suspected sleep-disordered breathing were investigated with respect to daytime sleepiness in temporal relationship to polysomnographic examination and treatment...
November 23, 2016: HNO
https://www.readbyqxmd.com/read/27879382/veteran-preferences-regarding-wireless-management-of-positive-airway-pressure-for-obstructive-sleep-apnea-at-a-tertiary-health-care-system
#12
Ken He, Brian N Palen, Elizabeth A Mattox, Elizabeth C Parsons
BACKGROUND: Timely monitoring of obstructive sleep apnea (OSA) therapy can be a challenge amid conflicting pressures of rising patient volume and shortage of sleep medicine providers. Positive airway pressure (PAP) devices with wireless modem technology have the potential to improve patient access to care and streamline work load, yet little is known about patient attitudes toward telehealth integration among veterans with sleep apnea. As part of a larger quality improvement initiative at the Veterans Affairs (VA) Puget Sound Health Care System, we elicited veterans' preferences toward modem versus traditional PAP data download, including patient attitudes and factors affecting those preferences...
November 22, 2016: Respiratory Care
https://www.readbyqxmd.com/read/27878543/a-new-predictive-model-for-continuous-positive-airway-pressure-in-the-treatment-of-obstructive-sleep-apnea
#13
Matthew R Ebben, Mariya Narizhnaya, Ana C Krieger
BACKGROUND: Numerous mathematical formulas have been developed to determine continuous positive airway pressure (CPAP) without an in-laboratory titration study. Recent studies have shown that style of CPAP mask can affect the optimal pressure requirement. However, none of the current models take mask style into account. Therefore, the goal of this study was to develop new predictive models of CPAP that take into account the style of mask interface. METHODS: Data from 200 subjects with attended CPAP titrations during overnight polysomnograms using nasal masks and 132 subjects using oronasal masks were randomized and split into either a model development or validation group...
November 22, 2016: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/27871083/work-of-breathing-in-fixed-and-pressure-relief-continuous-positive-airway-pressure-c-flex%C3%A2-a-post-hoc-analysis
#14
Lukas Jerrentrup, Sebastian Canisius, Susanne Wilhelm, Karl Kesper, Thomas Ploch, Claus Vogelmeier, Timm Greulich, Heinrich F Becker
BACKGROUND: Expiratory pressure relief continuous positive airway pressure (pressure relief CPAP; C-Flex™) causes increases in inspiratory duty cycle and shortening of expiratory time. It has been suggested that these changes are caused by an increase in work of breathing. OBJECTIVES: We studied the effects of C-Flex on work of breathing and intrinsic positive end-expiratory pressure as compared to fixed CPAP. METHODS: Work of breathing was analyzed in 24 patients with obstructive sleep apnea during treatment with fixed CPAP and C-Flex with 3 different pressure relief settings in a randomized order during rapid-eye-movement (REM) and non-REM sleep...
November 22, 2016: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/27867577/when-continuous-positive-airway-pressure-cpap-fails
#15
REVIEW
Jagdeep S Virk, Bhik Kotecha
Obstructive sleep apnoea (OSA) is increasingly prevalent, particularly in the context of the obesity epidemic, and is associated with a significant social, health and economic impact. The gold standard of treatment for moderate to severe OSA is continuous positive airway pressure (CPAP). However compliance rates can be low. Methodology to improve patient tolerance to CPAP alongside with alternative, non-surgical and surgical, management strategies are discussed. All patients that fail CPAP therapy would benefit from formal upper airway evaluation by the otolaryngologist to identify any obvious causes and consider site-specific surgical therapies...
October 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27867549/continuous-positive-airway-pressure-therapy-in-non-sleepy-patients-with-obstructive-sleep-apnea-results-of-a-meta-analysis
#16
Dongmei Zhang, Jinmei Luo, Yixian Qiao, Yi Xiao
BACKGROUND: Although continuous positive airway pressure (CPAP) has become the first line of therapy for obstructive sleep apnea (OSA), it remains controversial whether non-sleepy patients could benefit from CPAP treatment. METHODS: We searched the online databases Medline, Embase, the Cochrane library and the Cochrane Central Registry of Controlled Trials to select eligible control trials, including non-sleepy OSA patients and those patients treated by CPAP or either sham CPAP or no CPAP...
October 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27861433/understanding-phenotypes-of-obstructive-sleep-apnea-applications-in-anesthesia-surgery-and-perioperative-medicine
#17
Yamini Subramani, Mandeep Singh, Jean Wong, Clete A Kushida, Atul Malhotra, Frances Chung
Obstructive sleep apnea (OSA) is a prevalent sleep-disordered breathing with potential long-term major neurocognitive and cardiovascular sequelae. The pathophysiology of OSA varies between individuals and is composed of different underlying mechanisms. Several components including the upper airway anatomy, effectiveness of the upper airway dilator muscles such as the genioglossus, arousal threshold of the individual, and inherent stability of the respiratory control system determine the pathogenesis of OSA...
November 17, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27861349/therapeutic-outcomes-of-mandibular-advancement-devices-as-an-initial-treatment-modality-for-obstructive-sleep-apnea
#18
Pona Park, Hyoung Won Jeon, Doo Hee Han, Tae-Bin Won, Dong-Young Kim, Chae-Seo Rhee, Hyun Jik Kim
Although continuous positive airway pressure (CPAP) is a highly efficacious treatment for obstructive sleep apnea (OSA), there is a need for alternative treatment options, such as sleep surgeries and mandibular advancement devices (MADs), to overcome the limitations of CPAP.This study aimed to analyze the therapeutic outcomes of OSA subjects who were treated with a MAD, and to estimate the clinical impact of MAD as a first-line treatment for OSA.Forty-seven patients diagnosed with OSA received an adjustable MAD as an initial treatment...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27860160/effect-of-one-week-of-cpap-treatment-of-obstructive-sleep-apnoea-on-24-h-profiles-of-glucose-insulin-and-counter-regulatory-hormones-in-type-2-diabetes
#19
Babak Mokhlesi, Daniela Grimaldi, Guglielmo Beccuti, Eve Van Cauter
Studies examining the impact of CPAP treatment on glycaemic control have yielded conflicting results. We examined the 24-h profiles of glucose, insulin and counter-regulatory hormones in twelve subjects with type 2 diabetes and OSA before and after one week of effective in-laboratory CPAP therapy over an entire 8-h night. Blood samples were collected every 15-30 minutes for 24 hours under controlled conditions. The 24-h mean glucose decreased from 153.2 ± 33.0 to 139.7 ± 24.2 mg/dL with CPAP (-13...
November 17, 2016: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/27860068/effect-of-osa-on-hypoxic-and-inflammatory-markers-during-cpap-withdrawal-further-evidence-from-three-randomized-control-trials
#20
Chris D Turnbull, Valentina A Rossi, Peter Santer, Esther I Schwarz, John R Stradling, Nayia Petousi, Malcolm Kohler
BACKGROUND AND OBJECTIVE: Obstructive sleep apnoea (OSA) is associated with cardiovascular disease. Intermittent hypoxia, endothelial dysfunction and adipose tissue-mediated inflammation have all been linked to cardiovascular disease in OSA. We therefore explored the effect of OSA on relevant associated blood markers: adrenomedullin (ADM), endocan, endothelin-1 (ET-1), resistin and vascular endothelial growth factor (VEGF). METHODS: Patients with OSA, established on and compliant with continuous positive airways pressure (CPAP) therapy for >1 year were included from three randomized controlled trials, conducted at two centres...
November 18, 2016: Respirology: Official Journal of the Asian Pacific Society of Respirology
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