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Upper Airway Resistance Syndrome

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https://www.readbyqxmd.com/read/28572979/complex-effects-of-high-flow-nasal-cannula-therapy-on-hemodynamics-in-the-pediatric-patient-after-cardiac-surgery
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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...
October 17, 2016: 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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
https://www.readbyqxmd.com/read/26830959/systematic-review-the-influence-of-nasal-obstruction-on-sleep-apnea
#16
REVIEW
Debora Petrungaro Migueis, Luiz Claudio Santos Thuler, Lucas Neves de Andrade Lemes, Chirlene Santos Souza Moreira, Lucia Joffily, Maria Helena de Araujo-Melo
INTRODUCTION: Obstructive sleep apnea syndrome (OSAS) is a common disorder that can lead to cardiovascular morbidity and mortality, as well as to metabolic, neurological, and behavioral consequences. It is currently believed that nasal obstruction compromises the quality of sleep when it results in breathing disorders and fragmentation of sleep. However, recent studies have failed to objectively associate sleep quality and nasal obstruction. OBJECTIVE: The aim of this systematic review is to evaluate the influence of nasal obstruction on OSAS and polysomnographic indices associated with respiratory events...
March 2016: Brazilian Journal of Otorhinolaryngology
https://www.readbyqxmd.com/read/26797925/somatic-syndromes-insomnia-anxiety-and-stress-among-sleep-disordered-breathing-patients
#17
Tshering Amdo, Nadia Hasaneen, Morris S Gold, Avram R Gold
OBJECTIVES: We tested the hypothesis that the prevalence of somatic syndromes, anxiety, and insomnia among sleep disordered breathing (SDB) patients is correlated with their levels of somatic arousal, the symptoms of increased sympathetic nervous system tone under conditions of stress. METHODS: We administered the Body Sensation Questionnaire (BSQ; a 17-item questionnaire with increasing levels of somatic arousal scored 17-85) to 152 consecutive upper airway resistance syndrome (UARS) patients and 150 consecutive obstructive sleep apnea/hypopnea (OSA/H) patients...
May 2016: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/26715228/airway-resistance-in-children-with-obstructive-sleep-apnea-syndrome
#18
Ignacio E Tapia, Carole L Marcus, Joseph M McDonough, Ji Young Kim, Mary Anne Cornaglia, Rui Xiao, Julian L Allen
STUDY OBJECTIVES: Enlarged tonsils and adenoids, the main cause of obstructive sleep apnea syndrome (OSAS) in children, results in upper airway (UA) loading. This contributes to the imbalance between structural and neuromotor factors ultimately leading to UA collapse during sleep. However, it is unknown whether this UA loading can cause elevated airway resistance (AR) during wakefulness. We hypothesized that children with OSAS have elevated AR compared to controls and that this improves after OSAS treatment...
April 1, 2016: Sleep
https://www.readbyqxmd.com/read/26691626/myofunctional-therapy-applied-to-upper-airway-resistance-syndrome-a-case-report
#19
Camila de Castro Corrêa, Giédre Berretin-Felix
The literature presents publications on the treatment of patients with obstructive sleep apnea syndrome (OSAS) by myofunctional therapy, but there are no reports of this approach to patients with upper airway resistance syndrome (UARS). The objective was to verify the effect of myofunctional therapy in a case of UARS in relation to morphological and functional aspects of the stomatognathic system, anthropometric data, and quality of sleep. Patient, aged 61 years, diagnosed with UARS, underwent 12 sessions of myofunctional therapy for 3 months with exercises aimed at the suprahyoid, the tongue, and the soft palate muscles...
November 2015: CoDAS
https://www.readbyqxmd.com/read/26672413/upper-airway-dimensions-and-sleep-efficiency-three-dimensional-imaging-analysis-and-assessment-of-the-nasopharyngeal-appliance
#20
RANDOMIZED CONTROLLED TRIAL
R Venkat, M Vasanthakumar, D Balakrishnan, P Deenadayalan
BACKGROUND: Reduction of upper airway (UA) dimensions during sleep is contemplated to cause reduced sleep efficiency (SE) but a definitive association is not affirmed. Efficacy of nasopharyngeal appliance (NPA) in management of UA resistance syndrome (UARS) has not been compared with mandibular repositioning splint (MRS). This study intended to assess relation of UA dimensions to SE and effectiveness of NPA. MATERIALS AND METHODS: Research had two phases: Case-control study to determine association between UA and SE; randomized control trial (with independent concurrent trial groups and double-blind design) to analyze treatment outcome with NPA...
September 2015: Indian Journal of Dental Research: Official Publication of Indian Society for Dental Research
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