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OSA treatment

Laszlo Kunos, Zsofia Lazar, Fruzsina Martinovszky, Adam D Tarnoki, David L Tarnoki, Daniel Kovacs, Bianka Forgo, Peter Horvath, Gyorgy Losonczy, Andras Bikov
PURPOSE: Obstructive sleep apnoea (OSA) is a prevalent disorder, characterised by collapse of the upper airways during sleep. The impact of sleep-disordered breathing on pulmonary function indices is however currently not well described. The aim of the study was to evaluate diurnal change in lung function indices in a cohort of patients with OSA and relate pulmonary function changes to disease severity. METHODS: 42 patients with OSA and 73 healthy control subjects participated in the study...
October 21, 2016: Lung
Ari Shechter, Kyle Kovtun, Marie-Pierre St-Onge
Obesity is among the leading risk factors for obstructive sleep apnea (OSA). A reciprocal relationship between obesity and OSA has been proposed, which may be due to excessive food intake. We conducted a pilot study to test the effects of continuous positive airway pressure (CPAP) on energy intake (EI) in OSA patients using a sham-controlled crossover design. In-laboratory total daily EI was assessed after 2mo of active and sham CPAP. Four men were enrolled (age±SEM: 51.8±2.1y; body mass index: 31.5±1.5kg/m(2))...
October 18, 2016: Physiology & Behavior
A Amaddeo, L de Sanctis, J Olmo Arroyo, J-P Giordanella, P-J Monteyrol, B Fauroux
Obesity, along with hypertrophy of the adenoids and the tonsils, represents one of the major risk factors for obstructive sleep apnea (OSA) in children. Obesity is associated with an increase in the prevalence and the severity of OSA and is a major factor in the persistence and aggravation of OSA over time. Neurocognitive dysfunction and abnormal behavior are the most important and frequent end-organ morbidities associated with OSA in children. Other deleterious consequences such as cardiovascular stress and metabolic syndrome are less common in children than in adults with OSA...
October 18, 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Anil Gungor
Pediatric OSAS and craniofacial malformations present challenges that require innovative approaches and comprehensive treatment strategies. Synchronous airway lesions, craniofacial malformations, obstructive anomalies of the tongue base, nasal vault and choanae are commonly addressed by subspecialists from various clinical and surgical academic traditions who practice variable levels of required communication. This is not a mere social requirement but an important requisite for intelligent and effective airway management...
September 28, 2016: American Journal of Otolaryngology
Seong Hwan Kim
Resistant hypertension is defined as blood pressure that remains above 140/90 mmHg in spite of the concurrent use of three antihypertensive agents of different classes at optimal dosing, of which one should be a diuretic. Accordingly, it is not synonymous with uncontrolled hypertension. Among a variety of risk factors, obstructive sleep apnea (OSA), which is a common type of sleep-disordered breathing, has been recognized a well-established risk factor for resistant hypertension. Indeed, both European and American guidelines for the management of arterial hypertension stated that OSA is a modifiable cause of resistant hypertension...
September 2016: Journal of Hypertension
Martin Wolley, Diane Cowley, Ashraf Ahmed, Richard Gordon, Michael Stowasser
OBJECTIVE: Obstructive sleep apnoea (OSA) is known to commonly co-exist with primary aldosteronism (PA), but it is unknown if treatment via mineralocorticoid receptor blockade or adrenalectomy (for aldosterone producing adenoma, APA), improves sleep apnoea parameters in these patients. We therefore aimed to determine if specific medical or surgical treatment of PA improves OSA, as measured by the apnoea hypopnoea index (AHI). DESIGN AND METHOD: Patients undergoing diagnostic workup for PA were recruited if they had symptoms suggestive of OSA...
September 2016: Journal of Hypertension
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
Gulgun Cetintas Afsar, Ozlem Oruc, Sema Sarac, Özgür Bilgin Topçuoğlu, Cuneyt Salturk, Fatma Merve Tepetam, Ismet Bulut
BACKGROUND: Obstructive sleep apnea (OSA) is the most common sleep disorder affecting 2-4 % of the adult population. In addition to several potential mechanisms, inflammation is one of the suggested etiological factors in OSA. Fractalkine/CX3CL1 which is detected in activated or stressed endothelium, smooth muscle cells, skeletal muscle cells, macrophages, neurons, and hepatocytes is an inflammatory marker and attracts attention of sleep specialists in OSA pathogenesis. In this study, we had two goals...
October 17, 2016: Sleep & Breathing, Schlaf & Atmung
Gang Deng, Zhan-Dong Qiu, Da-Yong Li, Yu Fang, Su-Ming Zhang
Obstructive sleep apnea (OSA) is an independent risk factor for cardiovascular diseases. Aldosterone was reported to be increased in patients with OSA and correlated with OSA severity. Many studies investigated the effect of continuous positive airway pressure (CPAP) therapy on plasma aldosterone concentrations (PAC) in OSA patients. The results, however, were inconsistent. In the present study, we aimed to evaluate the effects of CPAP therapy on PAC by performing a meta-analysis. Literature search was carried out in electronic databases including PubMed/Medline, Cochrane Library, Embase and Web of Science...
October 2016: Journal of Huazhong University of Science and Technology. Medical Sciences
Christophe Colas-Ribas, Isabelle Signolet, Samir Henni, Mathieu Feuillloy, Frédéric Gagnadoux, Pierre Abraham
The prevalence of pulmonary disease in patients with peripheral artery disease (PAD) has not been extensively studied. Recent evidence has shown that ∼20% of the patients have an atypical chest transcutaneous oxygen pressure (TcpO2) pattern during exercise, which suggests walking-induced hypoxemia. The main objectives of this study were to: (1) describe in a retrospective way the characteristics of the patients suffering from claudication, who attended a treadmill testing in our laboratory, (2) assess the prevalence of known or unknown pulmonary disease...
October 2016: Medicine (Baltimore)
Jeffrey Dorrity, Nicholas Wirtz, Oleg Froymovich, David Hamlar
Surgical intervention for obstructive sleep apnea (OSA) is a complex topic. The discussion involves intricate procedures targeting specific areas of the upper airway. Because of the wide variety of physiologic and anatomic causes of this disorder it is important to tailor the treatment to offer the patient the best possible outcome. Genioglossus, hyoid, and tongue base procedures should be considered among theses treatment options.
October 11, 2016: Otolaryngologic Clinics of North America
José Serrano-Pariente, Vicente Plaza, Joan B Soriano, Mercè Mayosc, Antolín López-Viña, César Picado, Laura Vigil
BACKGROUND: Continuous positive airway pressure (CPAP) in asthma patients with concomitant obstructive sleep apnea syndrome (OSAS) seems to have a favorable impact on asthma, but data are inconsistent due to methodological limitations of previous studies METHODS: Prospective, multicenter study. We examined asthma outcomes after six months of CPAP in 99 adult asthma patients (mean age 57 years) with OSAS (respiratory disturbance index ≥20). Asthma control and quality of life were assessed with the Asthma Control Questionnaire (ACQ) and the Mini Asthma Quality of Life Questionnaire (MiniAQLQ), respectively...
October 12, 2016: Allergy
Jae Hoon Cho, Hyun Jun Kim
PURPOSE: The aim of the study was to investigate cardiopulmonary coupling (CPC) as a tool for evaluating the efficacy of continuous positive airway pressure (CPAP) in the treatment of obstructive sleep apnea (OSA). METHOD: The medical records of patients who had undergone either standard polysomnography (PSG-only group, n = 62) or split-night CPAP titration (CPAP titration group, n = 115) due to habitual snoring or sleep apnea were analyzed. RESULT: The apnea-hypopnea index, CPC variables, and sleep stage (%) during the first 2 h of the sleep study did not differ between the PSG-only and CPAP titration groups...
October 8, 2016: Sleep & Breathing, Schlaf & Atmung
Leila Kheirandish-Gozal, David Gozal
Since the initial report 40 years ago on pediatric obstructive sleep apnea syndrome (OSAS) as a distinct and prevalent clinical entity, substantial advances have occurred in the delineation of diagnostic and treatment approaches. However, despite emerging and compelling evidence that OSAS increases the risk for cognitive, cardiovascular and metabolic end-organ morbidities, routine assessment of such morbidities is seldom conducted in clinical practice. One of the major reasons for such discrepancies resides in the relatively labor-intensive and onerous steps that would be required to detect the presence of any of such morbidities, further adding to the already elevated cost of diagnosing the disorder...
October 6, 2016: Chest
Boris Paskhover
Obstructive sleep apnea (OSA) is a prevalent disease entity that has become commonplace over the past few decades. Its surge in diagnosis can be linked to a better understanding of the process with a concurrent increase in prevalence. The social, economic, and personal impacts are significant; there continues to be a need to improve our treatment modalities for OSA.
October 6, 2016: Otolaryngologic Clinics of North America
Kathleen Yaremchuk
Uvulopalatopharyngoplasty was the first surgical procedure described, other than tracheostomy, for the treatment of obstructive sleep apnea (OSA) in 1981. It was recognized then that there were responders who were cured of OSA with the procedure and others that were not. It took many years for a staging system to be described that categorized patients based on Mallampati score, tonsil size, and body mass index to better predict success rates. It was recognized that individuals with retro-palatal obstruction as the cause of the airway obstruction responded well but that the morbidity associated with the inpatient procedure was often problematic...
October 6, 2016: Otolaryngologic Clinics of North America
José E Barrera
Multilevel surgery has been established as the mainstay of treatment for the surgical management of obstructive sleep apnea (OSA). Combined with uvulopalatopharyngoplasty, tongue-base surgeries, including the genioglossus advancement (GA), sliding genioplasty, and hyoid myotomy and suspension, have been developed to target hypopharyngeal obstruction. Total airway surgery consisting of maxillomandibular advancement (MMA) with/without GA has shown significant success. Skeletal procedures for OSA with or without a palatal procedure is a proven technique for relieving airway obstruction during sleep...
October 6, 2016: Otolaryngologic Clinics of North America
Katherine Koral Green, B Tucker Woodson
Traditional upper airway surgery directly modifies skeletal and soft tissue structures surrounding the airway to treat obstructive sleep apnea (OSA). Upper airway stimulation (UAS) attempts to treat upper airway obstruction and OSA by stimulating the hypoglossal nerve. The Inspire II implant has been approved for clinical UAS. Basic science data support that UAS prevents obstruction and improves airflow. Clinical results demonstrate that UAS improves respiratory sleep metrics and improves both objective and subjective self-reported sleep and quality-of-life outcomes...
October 6, 2016: Otolaryngologic Clinics of North America
Katarzyna Foryś, Mariusz Foryś, Katarzyna Piotrowicz
The obstructive sleep apnea (OSA) is a mortality risk factor of the cardiovascular system diseases. One of the elements of this relationship is the occurrence of nocturnal cardiac arrhythmias. The arrhytmias in question are resistant to drug therapy so it is suggested to consider electrotherapy. However, the coexistence of OSA and thus recurrent episodes of nocturnal hypoxia, may have significant impact on the diagnosis and the treatment applied as shown in the following cases. In some cases, the decision of electrotherapy should be preceded by the use of therapy with continuous positive airway pressure (CPAP)...
2016: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
Fabiana Yagihara, Geraldo Lorenzi-Filho, Rogerio Santos-Silva
STUDY OBJECTIVES: The aim of this study was to evaluate the effects of nasal dilator strip (NDS) as a placebo intervention compared with continuous positive airway pressure (CPAP) treatment in patients with severe obstructive sleep apnea (OSA). METHODS: Patients were treated with both NDS and nasal CPAP. The sequence was randomized and interposed by 15 days of washout. Polysomnography was performed at baseline and on the first night of intervention with NDS and CPAP (titration)...
September 29, 2016: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
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