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https://www.readbyqxmd.com/read/28550476/stroke-and-other-cardiovascular-events-in-patients-with-obstructive-sleep-apnea-and-the-effect-of-continuous-positive-airway-pressure
#1
Mirjam H Schipper, Korne Jellema, Bregje J W Thomassen, Diego Alvarez-Estevez, Johan Verbraecken, Roselyne M Rijsman
Obstructive sleep apnea (OSA) is a known-risk factor for cardiovascular diseases. There are indications that treatment with continuous positive airway pressure (CPAP) reduces the risk of new cardiovascular events. In this study, we analyzed the incidence of cardiovascular events in patients with OSA and compared for the impact of CPAP therapy. All polysomnographies performed in 2009 and 2010 were selected with an AHI ≥5 and patients older than 18 years. These 1110 patients were approached with a questionnaire about cardiovascular events and CPAP treatment...
May 26, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28549834/obstructive-sleep-apnea-the-effect-of-bariatric-surgery-after-12%C3%A2-months-a-prospective-multicenter-trial
#2
P Peromaa-Haavisto, H Tuomilehto, J Kössi, J Virtanen, M Luostarinen, J Pihlajamäki, P Käkelä, M Victorzon
BACKGROUND: Obstructive sleep apnea (OSA) is a highly prevalent sleep disorder, particularly in bariatric patients. It is known to be tightly linked with metabolic abnormalities and cardiovascular morbidity. Obesity is the most noteworthy individual risk factor for OSA. The aim of this study was to investigate the effect of a laparoscopic Roux-en-Y gastric bypass (LRYGB) on OSA one year after surgery. METHODS: In this prospective multicenter study standard overnight cardiorespiratory recording was conducted 12 months after bariatric surgery in 132 patients who had OSA in the baseline recording prior to the operation...
January 12, 2017: Sleep Medicine
https://www.readbyqxmd.com/read/28545542/recognition-and-treatment-of-sleep-disordered-breathing-an-important-component-of-chronic-disease-management
#3
REVIEW
Peter C Farrell, Glenn Richards
Sleep-disordered breathing (SDB) is a highly prevalent condition, and is associated with many debilitating chronic diseases. The role of untreated obstructive sleep apnea (OSA) in arterial hypertension has been recognized in international guidelines. Treatment with continuous positive airway pressure (CPAP) is associated with clinically-relevant reductions in blood pressure. In heart failure (HF), SDB is associated with worse prognosis and increased mortality. Major HF guidelines recommend that patients should be treated for sleep apnea to improve their HF status...
May 25, 2017: Journal of Translational Medicine
https://www.readbyqxmd.com/read/28545360/melatonin-effects-in-rem-sleep-behavior-disorder-associated-with-obstructive-sleep-apnea-syndrome-a-case-series
#4
Carolin Schaefer, Dieter Kunz, Frederik Bes
OBJECTIVES: REM sleep behavior disorder (RBD), with its main clinical symptoms of nightmares with dream-enacting behavior, is considered as a possible precursor of neurodegenerative disease. Obstructive Sleep Apnea Syndrome (OSAS) is known to be capable of provoking RBD-like symptoms by apneic event related arousals. The two sleep related pathologies must coincide in a relevant number of individuals because of overlapping prevalence in similar age groups. Until now RBD symptoms coexisting with OSAS are rarely described in scientific literature and in fact considered as OSAS mimicking RBD...
May 22, 2017: Current Alzheimer Research
https://www.readbyqxmd.com/read/28544488/obstructive-sleep-apnea-in-down-syndrome-benefits-of-surgery-and-noninvasive-respiratory-support
#5
Benjamin Dudoignon, Alessandro Amaddeo, Annick Frapin, Briac Thierry, Livio de Sanctis, Jorge Olmo Arroyo, Sonia Khirani, Brigitte Fauroux
Children with Down syndrome are at increased risk of obstructive sleep apnea (OSA). The aim of the study was to describe the management of OSA in a large cohort of children with Down syndrome. A retrospective analysis of sleep studies and consequent management was performed for all consecutive Down syndrome patients evaluated between September 2013 and April 2016. The data of 57 patients were analyzed: 51/53 had an interpretable overnight polygraphy and 4 the recording of nocturnal gas exchange. Mean age at baseline sleep study was 6...
May 24, 2017: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/28543437/the-adenoid-its-history-and-a-cautionary-tale
#6
Robert J Ruben
The existence of the adenoid first appears to have been noted by Conrad Victor Schneider in 1661. James Yearsley reported in 1842 one case in which he improved hearing by removal of a mucus membrane from behind the uvula, which indicates some appreciation of a relationship of the nasopharynx to ear disease. Hans Wilhelm Meyer, in 1868, was the first to demonstrate the relationship of the adenoid to ear disease and to develop an effective, although somewhat difficult, surgical operation to remove the adenoid...
June 2017: Laryngoscope
https://www.readbyqxmd.com/read/28543355/nurse-versus-physician-led-care-for-obstructive-sleep-apnea-a-systematic-review-and-meta-analysis-of-randomised-trials
#7
REVIEW
Fengqiu Gong, Xiaojun Chen, Yaoye Wu, Dianye Yao, Lihong Xie, Qiuyi Ouyang, Ping Wang, Gang Niu
AIM: To evaluate the effectiveness of nurse-led care for obstructive sleep apnoea compared with physician-led care. BACKGROUND: The incidence of obstructive sleep apnoea is increasing worldwide. There is a need for cost-effective care models to ease off the pressure on tertiary care centres and divert care to the community. DESIGN: Systematic review and meta-analysis. DATA SOURCES: We searched major electronic databases (MEDLINE, EMBASE, AMED, British Nursing Index, CINAHL, HMIC, PsycINFO, Health Business Elite and the Cochrane Central Register of Controlled Trials CENTRAL) from inception till December 2016 using a structured search strategy for all randomised trials evaluating nurse-led treatment interventions for adults with obstructive sleep apnoea compared with physician-led ones...
May 24, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28539541/sleep-disordered-breathing-in-heart-failure%C3%A3-a-therapeutic-dilemma
#8
Nobuhiko Haruki, John S Floras
Sleep-disordered breathing (SDB) occurs in approximately 50% of patients with reduced left ventricular ejection fraction receiving contemporary heart failure (HF) therapies. Obstructive (OSA) and central sleep apneas (CSA) interrupt breathing by different mechanisms but impose qualitatively similar autonomic, chemical, mechanical, and inflammatory burdens on the heart and circulation. Because contemporary evidence-based drug and device HF therapies have little or no mitigating effect on the acute or long-term consequences of such stimuli, there is a sound mechanistic rationale for targeting SDB to reduce cardiovascular event rates and prolong life...
May 23, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28536140/angiotensin-converting-enzyme-1-in-the-median-preoptic-nucleus-contributes-to-chronic-intermittent-hypoxia-hypertension
#9
Katelynn E Faulk, T Prashant Nedungadi, J Thomas Cunningham
Obstructive sleep apnea is associated with hypertension and cardiovascular disease. Chronic intermittent hypoxia is used to model the arterial hypoxemia seen in sleep apnea patients and is associated with increased sympathetic nerve activity and a sustained diurnal increase in blood pressure. The renin angiotensin system has been associated with hypertension seen in chronic intermittent hypoxia. Angiotensin converting enzyme 1, which cleaves angiotensin I to the active counterpart angiotensin II, is present within the central nervous system and has been shown to be regulated by AP-1 transcription factors, such as ΔFosB...
May 2017: Physiological Reports
https://www.readbyqxmd.com/read/28531336/loop-gain-predicts-the-response-to-upper-airway-surgery-in-patients-with-obstructive-sleep-apnoea-ventilatory-control-abnormalities-predict-surgical-responsiveness
#10
Simon A Joosten, Paul Leong, Shane A Landry, Scott A Sands, Philip I Terrill, Dwayne Mann, Anthony Turton, Jhanavi Rangaswamy, Christopher Andara, Glen Burgess, Darren Mansfield, Garun S Hamilton, Bradley A Edwards
Study Objectives: Upper airway surgery is often recommended to treat OSA patients who cannot tolerate continuous positive airways pressure (CPAP). However, the response to surgery is variable, potentially because it does not improve the non-anatomical factors (i.e. loop gain and arousal threshold) causing OSA. Measuring these traits clinically might predict responses to surgery. Our primary objective was to test the value of loop gain and arousal threshold to predict surgical success defined as 50% reduction in apnea-hypopnea index (AHI) and AHI <10 events/hr post-surgery...
May 22, 2017: Sleep
https://www.readbyqxmd.com/read/28530315/-syndrome-of-obstructive-sleep-apnea-in-the-elderly-population-prevalence-clinical-characteristics-and-treatment-strategy
#11
REVIEW
Boris Punchik, Yan Press, Aviv Goldbart
Obstructive sleep apnea syndrome - a common problem among old people, reduces the quality of life and is accompanied by increased morbidity and mortality. There are tests that enable early detection and diagnosis of this condition and there are effective treatments. This review will focus on the following topics: • The importance of the problem • Review of diagnostic tools • Treatment guidelines • How to improve adherence of patients to treatment.
January 2017: Harefuah
https://www.readbyqxmd.com/read/28530153/baseline-sleep-efficiency-and-arousal-index-do-not-predict-who-will-benefit-from-sedatives-in-improving-positive-airway-pressure-adherence-in-sleep-apnea-to-90
#12
R Bart Sangal
Positive airway pressure (PAP) is the preferred treatment for obstructive sleep apnea (OSA), but adherence is low. Educational or ongoing supportive intervention improves the number of PAP adherent patients from the 50% to the 70% range. A common side effect of PAP is increased awakenings. This prospective trial examined baseline polysomnographically derived sleep efficiency and arousal index in PAP adherent and nonadherent patients, and in patients needing sedating medicines to attain PAP adherence versus those who did not need such medicines...
May 1, 2017: Clinical EEG and Neuroscience: Official Journal of the EEG and Clinical Neuroscience Society (ENCS)
https://www.readbyqxmd.com/read/28528369/effect-of-physical-stress-on-drug-induced-sleep-endoscopy-for-obstructive-sleep-apnea
#13
Sang Min Park, Dong-Kyu Kim
Drug-induced sleep endoscopy (DISE) is a reliable upper airway evaluation tool, widely used to improve surgical results in patients with obstructive sleep apnea (OSA). Several factors, including sleeping position and depth of sedation, affect DISE findings. This study aimed to evaluate the impact of physical stress on DISE findings. Eighty-five patients with OSA underwent two DISE examinations at the same level of sedation. The "first DISE" (control group) was performed after polysomnography, while the "second DISE" (test group) performed immediately after a treadmill stress test...
May 20, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28528348/effect-of-home-noninvasive-ventilation-with-oxygen-therapy-vs-oxygen-therapy-alone-on-hospital-readmission-or-death-after-an-acute-copd-exacerbation-a-randomized-clinical-trial
#14
Patrick B Murphy, Sunita Rehal, Gill Arbane, Stephen Bourke, Peter M A Calverley, Angela M Crook, Lee Dowson, Nicholas Duffy, G John Gibson, Philip D Hughes, John R Hurst, Keir E Lewis, Rahul Mukherjee, Annabel Nickol, Nicholas Oscroft, Maxime Patout, Justin Pepperell, Ian Smith, John R Stradling, Jadwiga A Wedzicha, Michael I Polkey, Mark W Elliott, Nicholas Hart
Importance: Outcomes after exacerbations of chronic obstructive pulmonary disease (COPD) requiring acute noninvasive ventilation (NIV) are poor and there are few treatments to prevent hospital readmission and death. Objective: To investigate the effect of home NIV plus oxygen on time to readmission or death in patients with persistent hypercapnia after an acute COPD exacerbation. Design, Setting, and Participants: A randomized clinical trial of patients with persistent hypercapnia (Paco2 >53 mm Hg) 2 weeks to 4 weeks after resolution of respiratory acidemia, who were recruited from 13 UK centers between 2010 and 2015...
May 21, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28527878/obstructive-sleep-apnea-and-diabetes-a-state-of-the-art-review
#15
REVIEW
Sirimon Reutrakul, Babak Mokhlesi
Obstructive sleep apnea (OSA) is a chronic treatable sleep disorder and a frequent comorbidity in patients with type 2 diabetes. Cardinal features of OSA, including intermittent hypoxemia and sleep fragmentation, have been linked to abnormal glucose metabolism in laboratory-based experiments. OSA has also been linked to the development of incident type 2 diabetes. The relationship between OSA and type 2 diabetes may be bidirectional in nature given that diabetic neuropathy can affect central control of respiration and upper airway neural reflexes promoting sleep-disordered breathing...
May 17, 2017: Chest
https://www.readbyqxmd.com/read/28527784/phrenic-and-hypoglossal-nerve-activity-during-respiratory-response-to-hypoxia-in-6-ohda-unilateral-model-of-parkinson-s-disease
#16
Kryspin Andrzejewski, Krystyna Budzińska, Katarzyna Kaczyńska
AIMS: Parkinson's disease (PD) patients apart from motor dysfunctions exhibit respiratory disturbances. Their mechanism is still unknown and requires investigation. Our research was designed to examine the activity of phrenic (PHR) and hypoglossal (HG) nerves activity during a hypoxic respiratory response in the 6-hydroxydopamine (6-OHDA) model of PD. MAIN METHODS: Male adult Wistar rats were injected unilaterally with 6-OHDA (20μg) or the vehicle into the right medial forebrain bundle (MFB)...
May 17, 2017: Life Sciences
https://www.readbyqxmd.com/read/28526655/digital-morphometrics-a-new-upper-airway-phenotyping-paradigm-in-obstructive-sleep-apnea
#17
Richard J Schwab, Sarah E Leinwand, Cary B Bearn, Greg Maislin, Ramya Bhat Rao, Adithya Nagaraja, Stephen Wang, Brendan T Keenan
BACKGROUND: Obstructive sleep apnea (OSA) is associated with changes in pharyngeal anatomy. The goal of this study was to objectively and reproducibly quantify pharyngeal anatomy using digital morphometrics based on a laser ruler, and to assess differences between apneics and controls and associations with AHI (apnea-hypopnea index). This is the first study to use digital morphometrics to quantify intraoral risk factors for OSA. METHODS: Digital photographs were obtained using an intraoral laser ruler and digital camera in 311 controls (mean AHI=4...
May 16, 2017: Chest
https://www.readbyqxmd.com/read/28522094/continuous-positive-air-pressure-improves-orthonasal-olfactory-function-of-patients-with-obstructive-sleep-apnea
#18
Ute Walliczek-Dworschak, Werner Cassel, Luisa Mittendorf, Robert Pellegrino, Ulrich Koehler, Christian Güldner, Philipp Otto Georg Dworschak, Olaf Hildebrandt, Hanna Daniel, Thomas Günzel, Afshin Teymoortash, Thomas Hummel
OBJECTIVE: Recent studies have suggested that patients with obstructive sleep apnea (OSA) might be affected by olfactory impairment. However, more evidence is needed on the effect that OSA has on the chemical senses (olfaction and gustatory) of these patients, and whether continuous positive airway pressure (CPAP) treatment might help to reverse possible impairment. METHODS: A prospective study was conducted with 44 OSA patients (17 female and 27 male, mean age 54 ± 9...
June 2017: Sleep Medicine
https://www.readbyqxmd.com/read/28522085/blood-pressure-after-modified-uvulopalatopharyngoplasty-results-from-the-skup-3-randomized-controlled-trial
#19
Johan Fehrm, Danielle Friberg, Johan Bring, Nanna Browaldh
OBJECTIVE: Obstructive sleep apnea (OSA) is a risk factor for hypertension. The SKUP(3) study showed that modified uvulopalatopharyngoplasty (UPPP) significantly improved nocturnal respiration, sleepiness, and quality of life. The aim of this study was to evaluate the impact of surgery on blood pressure in patients with OSA. METHODS: We used a single-center randomized controlled trial to compare modified UPPP with controls at baseline and after six months. The controls received delayed surgery with an additional six-month follow-up...
June 2017: Sleep Medicine
https://www.readbyqxmd.com/read/28522078/a-randomized-controlled-trial-of-positional-therapy-versus-oral-appliance-therapy-for-position-dependent-sleep-apnea
#20
Linda Benoist, Maurits de Ruiter, Jan de Lange, Nico de Vries
OBJECTIVE: To compare the effectiveness of positional therapy (PT) with the sleep position trainer (SPT) to oral appliance therapy (OAT) in patients with mild-to-moderate positional obstructive sleep apnea (POSA). METHODS: Multicenter, prospective, randomized, controlled trial. Patients with mild-to-moderate POSA (apnea-hypopnea index (AHI) ≥5 ≤ 30/hour sleep) were randomized for PT or OAT. Polysomnography was repeated after 3 months. Efficacy, adherence, mean disease alleviation (MDA), quality of life, dropouts and adverse events were evaluated...
June 2017: Sleep Medicine
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