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https://www.readbyqxmd.com/read/29931497/impact-of-pap-therapy-on-hospitalization-rates-in-medicare-beneficiaries-with-copd-and-coexisting-osa
#1
Gurinder Singh, Amitesh Agarwal, Wei Zhang, Yong-Fang Kuo, Rizwana Sultana, Gulshan Sharma
OBJECTIVE: Growing evidence supports that patients with chronic obstructive pulmonary disease (COPD) and coexisting obstructive sleep apnea (OSA) have poor prognosis. This association is described as overlap syndrome. Positive airway pressure (PAP) therapy is now the preferred treatment for OSA. We hypothesized that use of PAP therapy in elderly patients with overlap syndrome would be associated with lower healthcare utilization. METHODS: In this retrospective cohort study, we analyzed data from 5% national sample of fee-for-service Medicare beneficiaries with a diagnosis of COPD who were newly started on PAP therapy in 2011...
June 22, 2018: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/29929990/nocturnal-blood-pressure-is-reduced-by-a-mandibular-advancement-device-for-sleep-apnea-in-women-findings-from-secondary-analyses-of-a-randomized-trial
#2
Helene Rietz, Karl A Franklin, Bo Carlberg, Carin Sahlin, Marie Marklund
BACKGROUND: Obstructive sleep apnea is associated with high blood pressure. The magnitude of blood pressure effects from sleep apnea treatment is unclear. We aimed to determine the effect of mandibular advancement device therapy on ambulatory nighttime and daytime blood pressure in women and men with daytime sleepiness and snoring or mild to moderate sleep apnea (apnea-hypopnea index, <30). METHODS AND RESULTS: In this 4-month, double-blind, randomized controlled trial comprising 96 untreated patients, 27 women and 58 men, aged 31 to 70 years, completed the study...
June 21, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29929840/a-review-of-the-associations-between-obstructive-sleep-apnea-and-hypertensive-disorders-of-pregnancy-and-possible-mechanisms-of-disease
#3
REVIEW
Jennifer E Dominguez, Ashraf S Habib, Andrew D Krystal
Obesity is prevalent among pregnant women in the United States; 15-20% of obese pregnant women have obstructive sleep apnea. The prevalence of obstructive sleep apnea increases along with body mass index, age and in the presence of other co-morbidities. Untreated obstructive sleep apnea in women is associated with a range of cardiovascular, pulmonary and metabolic co-morbidities; recent studies suggest that women with obstructive sleep apnea in pregnancy may be at significantly greater risk of entering pregnancy with chronic hypertension and/or of developing hypertensive disorders of pregnancy: gestational hypertension; preeclampsia; or eclampsia...
May 28, 2018: Sleep Medicine Reviews
https://www.readbyqxmd.com/read/29928235/ampk-%C3%AE-1-or-ampk-%C3%AE-2-deletion-in-smooth-muscles-does-not-affect-the-hypoxic-ventilatory-response-or-systemic-arterial-blood-pressure-regulation-during-hypoxia
#4
Sandy MacMillan, A Mark Evans
The hypoxic ventilatory response (HVR) is markedly attenuated by AMPK-α1 deletion conditional on the expression of Cre-recombinase in tyrosine hydroxylase (TH) expressing cells, precipitating marked increases in apnea frequency and duration. It was concluded that ventilatory dysfunction caused by AMPK deficiency was driven by neurogenic mechanisms. However, TH is transiently expressed in other cell types during development, and it is evident that central respiratory depression can also be triggered by myogenic mechanisms that impact blood supply to the brain...
2018: Frontiers in Physiology
https://www.readbyqxmd.com/read/29927893/physiological-responses-of-a-jaw-repositioning-custom-made-mouthguard-on-airway-and-their-effects-on-athletic-performance
#5
Ricardo Schultz Martins, Patrick Girouard, Evan Elliott, Said Mekary
Martins, RS, Girouard, P, Elliott, E, and Mekary, S. Physiological responses of a jaw repositioning custom-made mouthguard on airway and their effects on athletic performance. J Strength Cond Res XX(X): 000-000, 2018-Advanced dental techniques such as jaw-repositioning have shown to increase lower body muscular power such as vertical jump, but its effects on acceleration and speed have not been studied. Similarly, jaw repositioning is commonly used to increase airways volume and ventilation in a special population (i...
June 20, 2018: Journal of Strength and Conditioning Research
https://www.readbyqxmd.com/read/29926395/hypoglossal-nerve-stimulation-therapy-on-peripheral-arterial-tonometry-in-obstructive-sleep-apnea-a-pilot-study
#6
Allison K Ikeda, Qiao Li, Arshed A Quyuumi, Raj C Dedhia
PURPOSE: Hypoglossal nerve stimulation (HGNS) is being increasingly utilized in the setting of moderate-severe obstructive sleep apnea (OSA). While moderate-severe OSA confers excess cardiovascular risk, the impact of HGNS on cardiovascular requires further investigation. With the advent of peripheral arterial tonometry (PAT), one can non-invasively study real-time changes to the autonomic nervous system. This study evaluates the effect of HGNS therapy on autonomic output, using PAT-integrated polysomnography...
June 21, 2018: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/29922222/cognitive-deficits-are-attenuated-in-neuroglobin-overexpressing-mice-exposed-to-a-model-of-obstructive-sleep-apnea
#7
Deepti Nair, Vijay Ramesh, David Gozal
Background: Obstructive sleep apnea (OSA) is a highly prevalent disease manifesting as intermittent hypoxia during sleep (IH) and is increasingly recognized as being independently associated with neurobehavioral deficits. These deficits may be due to increased apoptosis in the hippocampus and cerebral cortex, as well as increased oxidative stress and inflammation. It has been reported that neuroglobin (Ngb) is upregulated in response to hypoxia-ischemia insults and exhibits a protective role in ischemia-reperfusion brain injury...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29922183/guinea-pig-as-a-model-to-study-the-carotid-body-mediated-chronic-intermittent-hypoxia-effects
#8
Inmaculada Docio, Elena Olea, Jesus Prieto-LLoret, Teresa Gallego-Martin, Ana Obeso, Angela Gomez-Niño, Asuncion Rocher
Clinical and experimental evidence indicates a positive correlation between chronic intermittent hypoxia (CIH), increased carotid body (CB) chemosensitivity, enhanced sympatho-respiratory coupling and arterial hypertension and cardiovascular disease. Several groups have reported that both the afferent and efferent arms of the CB chemo-reflex are enhanced in CIH animal models through the oscillatory CB activation by recurrent hypoxia/reoxygenation episodes. Accordingly, CB ablation or denervation results in the reduction of these effects...
2018: Frontiers in Physiology
https://www.readbyqxmd.com/read/29921056/-multimodal-analgesic-analgesia-in-patients-with-obstructive-sleep-apnea-hypopnea-syndrome-with-multiple-planar-surgery
#9
J Su, J H Tian, X X Gao, Y F Wu, J M Zu, K F Dong, L G Duan
Objective: To observe the value of multimodal analgesia in patients with OSAHS undergoing multiplanar surgery. Method: A total number of 90 patients with obstructive sleep apnea hypopnea syndrome with tongue hypertrophy or hyperplasia of the root lymphoid tissue were collected. All patients underwent improved uvulatopharyngeal angioplasty (H-UPPP) and tongue root partial resection, or simultaneous tongue ablation at the same time, and they were randomly divided into two groups,45 patients in each group.In multi-modal analgesic group, the parrixibub sodium 40 mg were given intravenously 0...
June 5, 2018: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
https://www.readbyqxmd.com/read/29920337/swallow-breathing-coordination-during-incremental-ascent-to-altitude
#10
Alyssa Huff, Trevor A Day, Mason English, Mitchell D Reed, Shaelynn Zouboules, Gurkarn Saran, Jack K Leacy, Carli Mann, Joel D B Peltonen, Ken D O'Halloran, Mingma T Sherpa, Teresa Pitts
Swallow and breathing are highly coordinated behaviors reliant on shared anatomical space and neural pathways. Incremental ascent to high altitudes results in hypoxia/hypocapnic conditions altering respiratory drive, however it is not known whether these changes also alter swallow. We examined the effect of incremental ascent (1,045 m, 3,440 m and 4,371 m) on swallow motor pattern and swallow-breathing coordination in seven healthy adults. Submental surface electromyograms (sEMG) and spirometry were used to evaluate swallow triggered by saliva and water infusion...
June 16, 2018: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/29911300/confounding-factors-in-ecg-based-detection-of-sleep-disordered-breathing
#11
Christoph Maier, Hartmut Dickhaus
OBJECTIVES: To assess the relevance of various potential confounding factors (comorbidities, obesity, body position, ECG lead, respiratory event type and sleep stage) on the detectability of sleep-related breathing disorders from the ECG. METHODS: A set of 140 simultaneous recordings of polysomnograms and 8-channel Holter ECGs taken from 121 patients with suspected sleep related breathing disorders is stratified with respect to the named factors. Minute-by-minute apnea detection performance is assessed using separate receiver operating characteristics curves for each of the subgroups...
May 2018: Methods of Information in Medicine
https://www.readbyqxmd.com/read/29911008/hemodynamic-effects-of-noninvasive-positive-pressure-ventilation-assessed-using-transthoracic-echocardiography
#12
Shek Yin Au, Cheuk Ling Lau, Ka King Chen, Adrian Piers Cheong, Ying Ting Tong, Lip Kiong Chan
Aims: The aim of this study is to measure the effect of positive-pressure ventilation on heart chamber dimensions, left ventricular (LV) systolic function, LV diastolic function, right ventricular (RV) systolic function, and RV pressure using transthoracic echocardiography. Settings and Design: This is a prospective study in a single secondary health-care center. Materials and Methods: A total of 107 patients with obstructive sleep apnea on continuous positive airway pressure (CPAP) therapy were recruited as participants between April and September 2016...
April 2018: Journal of Cardiovascular Echography
https://www.readbyqxmd.com/read/29910107/maternal-sleep-during-pregnancy-and-poor-fetal-outcomes-a-scoping-review-of-the-literature-with-meta-analysis
#13
REVIEW
Jane Warland, Jillian Dorrian, Janna L Morrison, Louise M O'Brien
There is a wealth of evidence to say that sleep impacts maternal health during pregnancy, however, little has been published on fetal health and maternal sleep. This scoping review summarises current literature on maternal sleep including sleep disordered breathing, sleep quality, sleep duration and supine sleep position, as these relate to fetal outcomes specifically birth weight, growth, preterm birth and stillbirth. An overall interpretation of the studies evaluated shows that events occurring during maternal sleep such as obstructive sleep apnea, sleep disruption and sleep position may have a negative effect on the fetus resulting in altered growth, gestational length and even death...
March 27, 2018: Sleep Medicine Reviews
https://www.readbyqxmd.com/read/29907796/a-recurrent-de-novo-missense-pathogenic-variant-in-smarcb1-causes-severe-intellectual-disability-and-choroid-plexus-hyperplasia-with-resultant-hydrocephalus
#14
Illja J Diets, Trine Prescott, Neena L Champaigne, Grazia M S Mancini, Bård Krossnes, Radek Frič, Kristina Kocsis, Marjolijn C J Jongmans, Tjitske Kleefstra
PURPOSE: SMARCB1 encodes a subunit of the SWI/SNF complex involved in chromatin remodeling. Pathogenic variants (PV) in this gene can give rise to three conditions. Heterozygous loss-of-function germline PV cause rhabdoid tumor predisposition syndrome and schwannomatosis. Missense PV and small in-frame deletions in exons 8 and 9 result in Coffin-Siris syndrome, which is characterized by intellectual disability (ID), coarse facial features, and fifth digit anomalies. METHODS: By a gene matching approach, individuals with a similar SMARCB1 PV were identified...
June 15, 2018: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/29905617/impact-of-clinical-guidelines-on-revisits-after-ambulatory-pediatric-adenotonsillectomy
#15
Helen H Lee, Nicholas M Dalesio, Anthony T Lo Sasso, William C Van Cleve
BACKGROUND: Pediatric adenotonsillectomies are common and carry known risks of potentially severe complications. Complications that require a revisit, to either the emergency department or hospital readmission, increase costs and may be tied to lower reimbursements by federal programs. In 2011 and 2012, recommendations by pediatric and surgical organizations regarding selection of candidates for ambulatory procedures were issued. We hypothesized that guideline-associated changes in practice patterns would lower the odds of revisits...
June 12, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29905566/-evaluation-of-neuroprotective-activity-of-complex-impact-of-magnesium-of-sulfate-lamotrygine-and-n-acetylcysteine-under-conditions-of-combined-normobaric-hypoxia-with-ligation-of-right-carotid-artery-in-rats
#16
M Samsonia, M Kandelaki, N Baratashvili
Cerebrovascular diseases of ischemic origin still remain the leading cause of death and disability of the population. In acute cerebral discirculation conditions, anaerobic glycolysis is activated, ATP formation rate decreases, the ion pumps work is disrupted and superoxide radicals are formed. Eventually, ionic asymmetry leads to the cytotoxic and vasogenic brain edema. Therefore, it is extremely important to induce simultaneous (complex) effect of medications on the key mechanisms of neuronal damage in process of survival of brain cells during acute ischemic stroke...
May 2018: Georgian Medical News
https://www.readbyqxmd.com/read/29902844/-the-impact-of-arousal-on-sleep-related-deglutition-in-patients-with-obstructive-sleep-apnea-hypopnea-syndrome
#17
Y R Li, X Ding, C Y Wang, D M Han
Objective: To investigate the sleep-related deglutition in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and its correlation with sleep stage and cortical arousals. Methods: From December 2015 to September 2017, simultaneous polysomnography and pharyngeal pressure monitoring were performed in 23 adult patients with OSAHS, Mann-Whitney U test were employed to analyze the following parameters: (1) the relationship between arousal and deglutition; (2) the effect of sleep stage on deglutition; (3) The relationship between the frequency of deglutition and the severity of OSAHS...
June 7, 2018: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
https://www.readbyqxmd.com/read/29901715/dental-and-skeletal-long-term-side-effects-of-mandibular-advancement-devices-in-obstructive-sleep-apnea-patients-a-systematic-review-with-meta-regression-analysis
#18
Maria Lavinia Bartolucci, Francesco Bortolotti, Stefano Martina, Giulia Corazza, Ambra Michelotti, Giulio Alessandri-Bonetti
Background: Mandibular advancement devices (MAD) are effective in reducing apnea episodes and they are frequently used as first-line therapy in obstructive sleep apnea (OSA) patients. Objectives: The MAD must be used every night for a lifetime and since it performs its function discharging the forces on dental elements the aim of this systematic review was to identify the dental and skeletal long-term side effects of MAD therapy and to evaluate the influence of time on them in OSA or snoring patients...
June 13, 2018: European Journal of Orthodontics
https://www.readbyqxmd.com/read/29897663/the-effect-of-continuous-positive-airway-pressure-therapy-on-nasal-patency
#19
Kristen D Pitts, Alberto A Arteaga, Elliot T Hardy, Ben P Stevens, Christopher S Spankovich, Andrea F Lewis
BACKGROUND: Nasal congestion and obstruction are reported in the majority of continuous positive airway pressure (CPAP) users and are frequently cited as reasons for noncompliance. To our knowledge, no study has demonstrated a change in objective or subjective nasal patency in patients with obstructive sleep apnea (OSA) after a therapeutic trial of CPAP therapy. METHODS: This prospective nonrandomized trial tested the hypothesis that CPAP therapy would result in both objective and subjective improvements in nasal patency in patients with OSA...
June 13, 2018: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29896566/intermittent-hypoxia-and-hypercapnia-a-hallmark-of-obstructive-sleep-apnea-alters-the-gut-microbiome-and-metabolome
#20
Anupriya Tripathi, Alexey V Melnik, Jin Xue, Orit Poulsen, Michael J Meehan, Gregory Humphrey, Lingjing Jiang, Gail Ackermann, Daniel McDonald, Dan Zhou, Rob Knight, Pieter C Dorrestein, Gabriel G Haddad
Obstructive sleep apnea (OSA) is a common disorder characterized by episodic obstruction to breathing due to upper airway collapse during sleep. Because of the episodic airway obstruction, intermittently low O2 (hypoxia) and high CO2 (hypercapnia) ensue. OSA has been associated with adverse cardiovascular and metabolic outcomes, although data regarding potential causal pathways are still evolving. As changes in inspired O2 and CO2 can affect the ecology of the gut microbiota and the microbiota has been shown to contribute to various cardiometabolic disorders, we hypothesized that OSA alters the gut ecosystem, which, in turn, exacerbates the downstream physiological consequences...
May 2018: MSystems
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