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Upper Airway Resistance Syndrome

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https://www.readbyqxmd.com/read/29090123/investigation-of-the-effects-of-miniscrew-assisted-rapid-palatal-expansion-on-airflow-in-the-upper-airway-of-an-adult-patient-with-obstructive-sleep-apnea-syndrome-using-computational-fluid-structure-interaction-analysis
#1
Jae-Sik Hur, Hyoung-Ho Kim, Jin-Young Choi, Sang-Ho Suh, Seung-Hak Baek
OBJECTIVE: The objective of this study was to investigate the effects of miniscrew-assisted rapid palatal expansion (MARPE) on changes in airflow in the upper airway (UA) of an adult patient with obstructive sleep apnea syndrome (OSAS) using computational fluid-structure interaction analysis. METHODS: Three-dimensional UA models fabricated from cone beam computed tomography images obtained before (T0) and after (T1) MARPE in an adult patient with OSAS were used for computational fluid dynamics with fluid-structure interaction analysis...
November 2017: Korean Journal of Orthodontics
https://www.readbyqxmd.com/read/29045745/long-term-oral-appliance-therapy-improves-daytime-function-and-mood-in-upper-airway-resistance-syndrome-patients
#2
Luciana B M Godoy, Luciana Palombini, Dalva Poyares, Cibele Dal-Fabbro, Thaís Moura Guimarães, Priscila Calixto Klichouvicz, Sergio Tufik, Sonia Maria Togeiro
Objectives: To evaluate the long term effects of an oral appliance on clinical symptoms, respiratory sleep parameters, sleep quality and sustained attention in patients with Upper Airway Resistance Syndrome (UARS) compared with placebo. Methods: This study was a randomized placebo-controlled clinical trial. Thirty UARS patients were randomized in two groups: placebo and mandibular advancement device (MAD) groups. UARS criteria were presence of sleepiness (Epworth Sleepiness Scale ≥ 10) and/or fatigue (Modified Fatigue Impact Scale ≥ 38) associated with an apnea/hypopnea index (AHI) ≤ 5 and a respiratory disturbance index (RDI) > 5 events/hour of sleep, and/or flow limitation in more than 30% of total sleep time...
October 17, 2017: Sleep
https://www.readbyqxmd.com/read/29034238/exploring-the-abnormal-modulation-of-the-autonomic-systems-during-nasal-flow-limitation-in-upper-airway-resistance-syndrome-by-hilbert-huang-transform
#3
Chen Lin, Men-Tzung Lo, Christian Guilleminault
Patients with nasal flow limitation and upper airway resistance syndrome (UARS) during sleep can present with low blood pressure and disturbing symptoms associated with hypervagotony. We hypothesized that the dynamic changes of the autonomic system related to inspiratory flow limitation can be quantified by the developed analytic technique applied on beat-to-beat heart rate (RR intervals) and finger photoplethysmography (PPG). METHOD: A breath-by-breath investigation based on the Hilbert-Huang transform was performed to explore autonomic nervous system changes observed during inspiratory flow limitation...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28894286/intermittent-hypoxia-induced-insulin-resistance-is-associated-with-alterations-in-white-fat-distribution
#4
Laureline Poulain, Hervé Mathieu, Amandine Thomas, Anne-Laure Borel, Chantal Remy, Patrick Levy, Claire Arnaud, Maurice Dematteis
Sleep apnea syndrome is characterized by repetitive upper airway collapses during night leading to intermittent hypoxia (IH). The latter is responsible for metabolic disturbances that rely, at least in part, on abdominal white fat inflammation. Besides qualitative alterations, we hypothesized that IH could also modify body fat distribution, a key factor for metabolic complications. C57BL6 mice exposed to IH (21-5% FiO2, 60 s cycle, 8 h/day) or air for 6 weeks were investigated for topographic fat alterations (whole-body MRI)...
September 11, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28805272/clinical-phenotype-of-south-east-asian-temporomandibular-disorder-patients-with-upper-airway-resistance-syndrome
#5
David K L Tay, Kenny P Pang
OBJECTIVE: To document the clinical phenotype of temporomandibular disorder (TMD) patients with concomitant upper airway resistance syndrome (UARS) in a South East Asian population. STUDY DESIGN: A multi-center prospective series of 86 TMD patients (26 men and 60 women / mean age 35.7 years) with UARS. All had excessive daytime sleepiness, high arousal index and apnea-hypopnea index (AHI)<5 RESULTS: The mean body mass index was 20.1, mean arousal index 16.2, mean respiratory disturbance index 19...
August 14, 2017: Journal of Oral Rehabilitation
https://www.readbyqxmd.com/read/28572979/complex-effects-of-high-flow-nasal-cannula-therapy-on-hemodynamics-in-the-pediatric-patient-after-cardiac-surgery
#6
EDITORIAL
Yu Inata, Muneyuki Takeuchi
BACKGROUND: The high-flow nasal cannula (HFNC) system has been widely used for children in various clinical settings. However, the physiological and clinical impact of HFNC therapy on the pediatric patient with respiratory distress after cardiac surgery has not been thoroughly investigated. MAIN BODY OF THE ABSTRACT: It seems logical to use HFNC as a primary therapy for post-extubation respiratory failure after congenital heart surgery, in which low cardiac output syndrome and upper airway obstruction are commonly encountered; the HFNC therapy alleviates the work of breathing and large negative swings of intrathoracic pressure, which in turn helps to decrease the systemic ventricular afterload...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28482650/obesity-and-perioperative-noninvasive-ventilation-in-bariatric-surgery
#7
Michele Carron, Francesco Zarantonello, Giovanna Ieppariello, Carlo Ori
The incidence and prevalence of obesity continues to increase globally. Physicians will therefore provide care for an increasing number of obese patients in their clinical practice. Optimal management of these patients is required to minimize the risk of perioperative complications that increase morbidity and mortality. Obesity affects the respiratory function. It is generally associated with reduced lung volume with increased atelectasis, decreased lung and chest wall compliance, increased airway resistance, and moderate to severe hypoxemia...
June 2017: Minerva Chirurgica
https://www.readbyqxmd.com/read/28355121/airway-resistance-in-patients-with-obstructive-sleep-apnea-syndrome-following-robotic-prostatectomy
#8
Wiebke Köhne, André Börgers, Michael Musch, Darko Kröpfl, Harald Groeben
BACKGROUND: Because minimally invasive surgery can improve postoperative recovery, it became the preferred technique for patients with significant comorbidities. However, steep Trendelenburg position and abdominal CO2-insufflation can lead to a significant increase in upper airway resistance and an alteration of overall lung function. In particular, patients who already suffer from an obstructive airway disease like obstructive sleep apnea syndrome (OSAS) might be at risk for postoperative airway complications...
May 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28331381/retrospective-nonrandomized-controlled-study-on-autoadjusting-dual-pressure-positive-airway-pressure-therapy-for-a-consecutive-series-of-complex-insomnia-disorder-patients
#9
Barry Krakow, Natalia D McIver, Victor A Ulibarri, Michael R Nadorff
PURPOSE: Emerging evidence shows that positive airway pressure (PAP) treatment of obstructive sleep apnea (OSA) and upper airway resistance syndrome (UARS) in chronic insomnia patients (proposed "complex insomnia" disorder) leads to substantial decreases in insomnia severity. Although continuous PAP (CPAP) is the pressure mode most widely researched, intolerance to fixed pressurized air is rarely investigated or described in comorbidity patients. This retrospective study examined dual pressure, autoadjusting PAP modes in chronic, complex insomnia disorder patients...
2017: Nature and Science of Sleep
https://www.readbyqxmd.com/read/28225162/mandibular-position-and-movements-suitability-for-diagnosis-of-sleep-apnoea
#10
Jean-Benoit Martinot, Jean-Christian Borel, Valérie Cuthbert, Hervé Jean-Pierre Guénard, Stéphane Denison, Philip E Silkoff, David Gozal, Jean-Louis Pepin
BACKGROUND AND OBJECTIVE: Mandibular movements (MMs) and position during sleep reflect respiratory efforts related to increases in upper airway resistance and micro-arousals. The study objective was to assess whether MM identifies sleep-disordered breathing (SDB) in patients with moderate to high pre-test probability. METHODS: This was a prospective study of 87 consecutive patients referred for an in-laboratory sleep test. Magnetometer-derived MM signals were incorporated into standard polysomnography (PSG)...
April 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/27924661/sleep-disordered-breathing-in-pregnancy-the-maternal-and-fetal-implications
#11
REVIEW
Shanthi Carnelio, Adam Morton, H David McIntyre
Sleep disordered breathing (SDB) which includes obstructive sleep apnoea (OSA) and upper airway resistance syndrome (UARS), has emerged as a risk factor for adverse maternal-foetal outcomes in pregnancy. Physiological changes of pregnancy predispose a woman 'at risk' towards developing SDB. The increasing incidence of OSA in pregnancy closely correlates with the population trends of obesity. Common screening tools validated in non-pregnant subjects including Epworth Sleepiness Scale (ESS) and Berlin Questionnaire (BQ) are poor predictors of SDB in pregnancy...
February 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/27908527/-historical-review-on-obstructive-sleep-apnea-in-children
#12
REVIEW
Y H Chien, C Guilleminault
An historical review on the discoveries on pediatric obstructive sleep apnea syndrome and sleep-disordered breathing is outlined. Starting with the description by Dickens of "Joe" the obese, snoring and sleepy individual, the authors trace more than 50 years of questions and research starting with the lean adult to the child and from the recognition of obstructive sleep apnea syndrome to the outline of upper-airway resistance syndrome. The pathophysiological knowledge on sleep-disordered breathing has evolved over time, as have treatment approaches in children, from tracheostomy to positive-airway-pressure therapy, to adenotonsillectomy with and without orthodontic treatments to oral-facial myofunctional therapy...
February 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/27807016/coexistence-of-osa-may-compensate-for-sleep-related-reduction-in-neural-respiratory-drive-in-patients-with-copd
#13
Bai-Ting He, Gan Lu, Si-Chang Xiao, Rui Chen, Joerg Steier, John Moxham, Michael I Polkey, Yuan-Ming Luo
BACKGROUND: The mechanisms underlying sleep-related hypoventilation in patients with coexisting COPD and obstructive sleep apnoea (OSA), an overlap syndrome, are incompletely understood. We compared neural respiratory drive expressed as diaphragm electromyogram (EMGdi) and ventilation during stage 2 sleep in patients with COPD alone and patients with overlap syndrome. METHODS: EMGdi and airflow were recorded during full polysomnography in 14 healthy subjects, 14 patients with OSA and 39 consecutive patients with COPD...
March 2017: Thorax
https://www.readbyqxmd.com/read/27749021/is-impaired-glucose-metabolism-the-missing-piece-in-the-obesity-asthma-puzzle
#14
EDITORIAL
Tarig Ali-Dinar, Jason E Lang
Obesity is a major risk factor for several conditions including atherosclerotic disease, metabolic syndrome, and upper airway dysfunction. However, the purported link between obesity and asthma has remained more difficult to define, in part due to limitations in past epidemiologic studies and the inherent challenge in accurately defining asthma in children. It is possible that obesity leads to asthma only in the presence of a mediating variable such as an obesity-related conditions such as esophageal reflux or insulin resistance...
February 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/27549623/receiver-operating-characteristics-of-impulse-oscillometry-parameters-for-predicting-obstructive-sleep-apnea-in-preobese-and-obese-snorers
#15
Arikin Abdeyrim, Liang Tang, Arzugl Muhamat, Kelimu Abudeyrim, YongPing Zhang, NanFang Li, Yinchun Wang, Minghua Zhao
BACKGROUND: Inability to maintain upper-airway patency during sleep is a cause of obstructive sleep apnea (OSA) and its sequelae. The associated syndrome (OSAS) is common in obese populations, currently, nocturnal polysomnography is the gold standard for diagnosing this conditions, but the diagnostic procedures are expensive and time-consuming. Therefore, identification of new markers of OSAS would be useful. This study aims to examine the receiver operating characteristics of impulse oscillometry (IOS) parameters for the prediction of OSAS in preobese and obese snoring patients...
August 22, 2016: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/27445297/computational-fluid-dynamics-upper-airway-effective-compliance-critical-closing-pressure-and-obstructive-sleep-apnea-severity-in-obese-adolescent-girls
#16
David M Wootton, Sanghun Sin, Haiyan Luo, Alireza Yazdani, Joseph M McDonough, Mark E Wagshul, Carmen R Isasi, Raanan Arens
Obstructive sleep apnea syndrome (OSAS) is associated with anatomical abnormalities restricting upper airway size and functional factors decreasing pharyngeal dilator activity in sleep. In this study we hypothesized that OSAS is also associated with altered pharyngeal mechanical compliance during wakefulness. Five OSAS and six control obese girls between 14 and 18 years of age were studied. All underwent polysomnography, critical closing pressure (Pcrit) studies, and dynamic MRI of the upper airway during awake tidal breathing...
October 1, 2016: Journal of Applied Physiology
https://www.readbyqxmd.com/read/27228081/upper-airway-resistance-syndrome-patients-have-worse-sleep-quality-compared-to-mild-obstructive-sleep-apnea
#17
COMPARATIVE STUDY
Luciana Balester Mello de Godoy, Gabriela Pontes Luz, Luciana Oliveira Palombini, Luciana Oliveira E Silva, Wilson Hoshino, Thaís Moura Guimarães, Sergio Tufik, Lia Bittencourt, Sonia Maria Togeiro
PURPOSE: To compare sleep quality and sustained attention of patients with Upper Airway Resistance Syndrome (UARS), mild Obstructive Sleep Apnea (OSA) and normal individuals. METHODS: UARS criteria were presence of excessive daytime sleepiness (Epworth Sleepiness Scale-ESS-≥ 10) and/or fatigue (Modified Fatigue Impact Scale-MFIS-≥ 38) associated to Apnea/hypopnea index (AHI) ≤ 5 and Respiratory Disturbance Index (RDI) > 5 events/hour of sleep or more than 30% of total sleep time with flow limitation...
2016: PloS One
https://www.readbyqxmd.com/read/27217898/obstructive-sleep-apnea-presenting-as-pseudopheochromocytoma
#18
Hela Marmouch, Sondes Arfa, Sameh Graja, Tensim Slim, Ines Khochtali
A 52-year-old female with a history of poorly controlled resistant hypertension was admitted to our hospital with severe hypertension. She had a history of fatigue and intermittent episodes of palpitations. Laboratory evaluation was significant for elevated 24-h urinary catecholamine levels (3,5 times the upper normal levels). This case was presenting with a clinical and biochemical picture indistinguishable from that of pheochromocytoma. However, neither computed tomography nor meta-iodo-benzyl-guanidine scintigraphy detected any catecholamine-producing tumor in or outside the adrenal glands...
2016: Pan African Medical Journal
https://www.readbyqxmd.com/read/27095515/assessment-of-change-in-palatal-sensation-in-obstructive-sleep-apnea-patients-by-using-two-point-palatal-discrimination
#19
Kyung-Hwa Jeong, Youngsoo Yang, Hye Rang Choi, Jae Hoon Cho, Gee-Tae Kim, Jin Kook Kim
OBJECTIVES: Patients with obstructive sleep apnea syndrome (OSAS) have impaired responses to inspiratory resistive loading during sleep. This may be due, in part, to a change in the upper airway sensation. Therefore, we hypothesized that patients with OSAS have diminished upper airway sensation due to snoring. METHODS: A total of 53 participants were selected based on clinical evaluation and polysomnography. Two-point discrimination was measured with modified calipers in the tongue and soft palate...
September 2016: Clinical and Experimental Otorhinolaryngology
https://www.readbyqxmd.com/read/27048669/computational-modeling-of-airway-obstruction-in-sleep-apnea-in-down-syndrome-a-feasibility-study
#20
Goutham Mylavarapu, Dhananjay Subramaniam, Raghuvir Jonnagiri, Ephraim J Gutmark, Robert J Fleck, Raouf S Amin, Mohamed Mahmoud, Stacey L Ishman, Sally R Shott
Current treatment options are successful in 40% to 60% of children with persistent obstructive sleep apnea after adenotonsillectomy. Residual obstruction assessments are largely subjective and do not clearly define multilevel obstruction. We endeavor to use computational fluid dynamics to perform virtual surgery and assess airflow changes in patients with Down syndrome and persistent obstructive sleep apnea. Three-dimensional airway models were reconstructed from respiratory-gated computed tomography and magnetic resonance imaging...
July 2016: Otolaryngology—Head and Neck Surgery
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