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central AND airway obstruction

Christian M Horvath, Stephan Zbinden, Sebastian R Ott, Anne-Kathrin Brill
A 43-year-old man was referred to our tertiary sleep center for the initiation of sleep apnea treatment. A prior diagnostic overnight polysomnography (Fig 1) had revealed an apnea-hypopnea index (AHI) of 22/h of sleep. The apneas were predominantly central (central AHI, 18.2/h; obstructive AHI, 3.8/h), more pronounced in the supine position (AHI supine, 36.6/h; AHI nonsupine, 11/h) and during non-rapid eye movement (non-REM) sleep (REM, 15.8/h; non-REM, 23.5/h). A continuous positive airway pressure (CPAP) trial in an outpatient setting had failed, as the fixed CPAP of 11 cm H2O was not tolerated by the patient because of a feeling of lightheadedness when wearing the mask...
October 2016: Chest
Fernando R Carvalho, Débora A Lentini-Oliveira, Lucila Bf Prado, Gilmar F Prado, Luciane Bc Carvalho
BACKGROUND: Apnoea is a breathing disorder marked by the absence of airflow at the nose or mouth. In children, risk factors include adenotonsillar hypertrophy, obesity, neuromuscular disorders and craniofacial anomalies. The most common treatment for obstructive sleep apnoea syndrome (OSAS) in childhood is adeno-tonsillectomy. This approach is limited by its surgical risks, mostly in children with comorbidities and, in some patients, by recurrence that can be associated with craniofacial problems...
October 5, 2016: Cochrane Database of Systematic Reviews
Liliana Fernandez, Luz F Sua, Mauricio Velasquez, Leidys Gutiérrez
No abstract text is available yet for this article.
October 2016: Journal of Thoracic Oncology
Leidys Gutiérrez, Liliana Fernandez, Luz F Sua
No abstract text is available yet for this article.
October 2016: Journal of Thoracic Oncology
Hongwu Wang, Nan Zhang, Dongmei Li, Hang Zou, Jieli Zhang, Yunzhi Zhou, Xiuyun Bai
BACKGROUND: Pulmonary sarcoma is a rare malignant tumor in soft tissues. Resection is the preferred option to treat this tumor. The aim of this study is to explore the effect of interventional bronchoscopies in the treatment of pulmonary sarcoma if the patient is inoperable. METHODS: Sixteen cases with pulmonary sarcoma were retrospectively reviewed in our hospital from November 2008 to July 2014. The mean age was (53.1±5.4) years old. Rigid bronchoscopy was applied for the first procedure with general anesthesia, and electronic bronchoscopy was used for the second procedure or slight patients...
September 20, 2016: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
Craig Anderson, Doug McEvoy, Jiguang Wang
OBJECTIVE: There is uncertainty over whether treatment of obstructive sleep apnea (OSA) can prevent serious cardiovascular (CV) events. DESIGN AND METHOD: SAVE (NCT00738179; ACTRN12608000409370) was designed to determine whether treatment of OSA with CPAP reduces the risk of serious CV events in patients with established CV disease. Participants were centrally randomised to CPAP treatment or usual care between 2008 and 2013,with follow-up completed late 2015 and the results will be announced in August 2016...
September 2016: Journal of Hypertension
Benedict Griffiths, Geraint Lee, Andrew Durward
Central airway obstruction (trachea and major bronchi) in neonates can be caused by malacia, stenosis, or compression by masses or vascular structures. These abnormalities may be present in the neonatal period but are typically not detected until at least 6 months of age. We present four patients (1.6-4.1 kg, 32-41 weeks gestation) with nonspecific symptoms (e.g., poor weight gain, difficulty weaning from CPAP) who underwent bronchoscopy in the neonatal period. Critical airway obstruction (>90%) was identified in these relatively asymptomatic neonates...
September 18, 2016: Pediatric Pulmonology
Martin R Cowie
The majority of patients with heart failure have sleep-disordered breathing (SDB)-with central (rather than obstructive) sleep apnoea becoming the predominant form in those with more severe disease. Cyclical apnoeas and hypopnoeas are associated with sleep disturbance, hypoxaemia, haemodynamic changes, and sympathetic activation. Such 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 partially normalise the sleep and respiratory physiology, but recent randomised trials of cardiovascular outcomes in central sleep apnoea have been neutral or suggested the possibility of harm, likely from increased sudden death...
September 17, 2016: Current Heart Failure Reports
J N Bangiyev, H Traboulsi, I Abdulhamid, A Rozzelle, P J Thottam
INTRODUCTION: Pierre-Robin Sequence (PRS), a triad of micro/retrognathia, glossoptosis, and upper airway obstruction, usually in conjunction with a cleft palate is frequently associated with significant morbidity. Mandibular distraction osteogenesis (MDO) is an effective treatment modality to address retroglossal upper airway obstruction by increasing the anterior-posterior diameter of the infant airway. Although MDO has been shown to improve the apnea-hypopnea index (AHI) in children with PRS, the consequences of MDO on other aspects of infant sleep, including hypercapnea, hypoxia, the REM to Non-REM ratio, as well as its effect on central and mixed apneas has not been investigated with an adequate sample size...
October 2016: International Journal of Pediatric Otorhinolaryngology
Tore Amundsen, Sveinung Sørhaug, Håkon Olav Leira, Stig Sverre Tyvold, Thomas Langø, Tommy Hammer, Frode Manstad-Hulaas, Erney Mattsson
BACKGROUND: Malignant airway obstruction is a feared complication and will most probably occur more frequently in the future because of increasing cancer incidence and increased life expectancy in cancer patients. Minimal invasive treatment using airway stents represents a meaningful and life-saving palliation. We present a new removable airway stent for improved individualised treatment. METHODS: To our knowledge, the new airway stent is the world's first knitted and uncovered self-expanding metal stent, which can unravel and be completely removed...
2016: European Clinical Respiratory Journal
Vitaliano Nicola Quaranta, Pierluigi Carratù, Mario Francesco Damiani, Silvano Dragonieri, Alberto Capozzolo, Anna Cassano, Onofrio Resta
BACKGROUND/OBJECTIVE: Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease characterized by the progressive loss of central and peripheral motor neurons. Some studies have found discordant data in the presence of sleep apnea in ALS patients. An obstructive component also occurs with upper airways hypotonia and muscle weakness that may result in an excessive reduction of airway lumen, leading to obstructive sleep apnea (OSA). The aim of this study was to assess the role of obstructive apneic events at disease onset in the ALS prognosis...
September 6, 2016: Neuro-degenerative Diseases
Denis E O'Donnell, Amany F Elbehairy, Azmy Faisal, Katherine A Webb, J Alberto Neder, Donald A Mahler
Activity-related dyspnoea is often the most distressing symptom experienced by patients with chronic obstructive pulmonary disease (COPD) and can persist despite comprehensive medical management. It is now clear that dyspnoea during physical activity occurs across the spectrum of disease severity, even in those with mild airway obstruction. Our understanding of the nature and source of dyspnoea is incomplete, but current aetiological concepts emphasise the importance of increased central neural drive to breathe in the setting of a reduced ability of the respiratory system to appropriately respond...
September 2016: European Respiratory Review: An Official Journal of the European Respiratory Society
Wouter H van Geffen, W R Douma, Dirk Jan Slebos, Huib A M Kerstjens
BACKGROUND: Bronchodilators are a central component for treating exacerbations of chronic obstructive pulmonary disease (COPD) all over the world. Clinicians often use nebulisers as a mode of delivery, especially in the acute setting, and many patients seem to benefit from them. However, evidence supporting this choice from systematic analysis is sparse, and available data are frequently biased by the inclusion of asthma patients. Therefore, there is little or no formal guidance regarding the mode of delivery, which has led to a wide variation in practice between and within countries and even among doctors in the same hospital...
2016: Cochrane Database of Systematic Reviews
Chloé Kastoer, Marijke Dieltjens, Eline Oorts, Evert Hamans, Marc J Braem, Paul H Van de Heyning, Olivier M Vanderveken
STUDY OBJECTIVES: To perform a review of the current evidence regarding the use of a remotely controlled mandibular positioner (RCMP) and to analyze the efficacy of RCMP as a predictive selection tool in the treatment of obstructive sleep apnea (OSA) with oral appliances that protrude the mandible (OAm), exclusively relying on single-night RCMP titration. METHODS: An extensive literature search is performed through, (CENTRAL only), Embase...
August 22, 2016: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
M Bullone, P Hélie, P Joubert, J-P Lavoie
BACKGROUND: Remodeling of the peripheral airways persists during the asymptomatic phase of heaves. Assessing the histology of large bronchi could facilitate the diagnosis of heaves during remission of the disease. HYPOTHESIS: Airway inflammation and remodeling in endobronchial biopsy (EBB) specimens differentiate horses with heaves from controls, independently of their clinical status (exacerbation or remission). ANIMALS: Fourteen healthy horses and 24 horses with heaves...
September 2016: Journal of Veterinary Internal Medicine
Terufumi Shimoda, Yasushi Obase, Yukio Nagasaka, Reiko Kishikawa, Hiroshi Mukae, Tomoaki Iwanaga
BACKGROUND: Computer-aided lung sound analysis (LSA) has been reported to be useful for evaluating airway inflammation and obstruction in asthma patients. We investigated the relation between LSA and impulse oscillometry with the evaluation of peripheral airway obstruction. METHODS: A total of 49 inhaled corticosteroid-naive bronchial asthma patients underwent LSA, spirometry, impulse oscillometry, and airway hyperresponsiveness testing. The data were analyzed to assess correlations between the expiration: inspiration lung sound power ratio (dB) at low frequencies between 100 and 195 Hz (E/I LF) and various parameters...
August 8, 2016: Allergology International: Official Journal of the Japanese Society of Allergology
J Drew Prosser, Sally R Shott, Oscar Rodriguez, Narong Simakajornboon, Jareen Meinzen-Derr, Stacey L Ishman
OBJECTIVES/HYPOTHESIS: Lingual tonsil hypertrophy is a common cause of persistent airway obstruction in patients with Down syndrome (DS) following adenotonsillectomy (T&A); however, little is known about the effect of lingual tonsillectomy (LT) on polysomnographic outcomes in these patients. Our objective was to describe changes in sleep-related respiratory outcomes following LT in children with DS and persistent obstructive sleep apnea (OSA) following T&A. STUDY DESIGN: Retrospective case series...
August 12, 2016: Laryngoscope
Gaurav Nigam, Charu Pathak, Muhammad Riaz
INTRODUCTION: Treatment-emergent central sleep apnea (TECSA) is the appearance of central apneas and hypopneas after significant resolution of the obstructive events has been attained using positive airway pressure (PAP) therapy. The aim of the study was to determine the prevalence of TECSA and to understand what factors are associated with its development. METHODS: PubMed, MEDLINE, Scopus, Web of Science and Cochran Library databases were searched with Mesh headings to locate studies linking TECSA and obstructive sleep apnea (OSA)...
July 2016: Annals of Thoracic Medicine
Ola Drange Røksund, John-Helge Heimdal, Hege Clemm, Maria Vollsæter, Thomas Halvorsen
Obstruction of the central airways is an important cause of exercise-induced inspiratory symptoms (EIIS) in young and otherwise healthy individuals. This is a large, heterogeneous and vastly understudied group of patients. The symptoms are too often confused with those of asthma. Laryngoscopy performed as symptoms evolve during increasing exercise is pivotal, since the larynx plays an important role in symptomatology for the majority. Abnormalities vary between patients, and laryngoscopic findings are important for correct treatment and handling...
July 18, 2016: Paediatric Respiratory Reviews
Dirk M Hermann, Claudio L Bassetti
BACKGROUND: Sleep-disordered breathing (SDB) and sleep-wake disturbances (SWD) are highly prevalent in stroke patients. Recent studies suggest that they represent both a risk factor and a consequence of stroke and affect stroke recovery, outcome, and recurrence. METHODS: Review of literature. RESULTS: Several studies have proven SDB to represent an independent risk factor for stroke. Sleep studies in TIA and stroke patients are recommended in view of the very high prevalence (>50%) of SDB (Class IIb, level of evidence B)...
September 27, 2016: Neurology
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