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https://www.readbyqxmd.com/read/28343217/contribution-of-hyoid-and-tonsillar-procedures-to-outcome-in-multilevel-surgery-for-obstructive-sleep-apnea-syndrome
#1
Nora Tetter, Kurt Tschopp
BACKGROUND/OBJECTIVE: In multilevel surgery for obstructive sleep apnea (OSA), the contribution of distinct operative steps is still unclear. The aim of the present study is to retrospectively compare different combinations of multilevel surgeries in order to estimate the contribution of hyoid and tonsillar procedures to the outcome. METHODS: A total of 45 patients were selected in a retrospectively matched case-control study from a database of patients who underwent surgery for OSA at our institution: group A (n = 15) had hyoid suspension, tonsillectomy, and radiofrequency-assisted uvulopalatoplasty (RAUP); group B (n = 15) had hyoid pharyngoplasty with resection of the hyoid body and preepiglottic fat tissue, tonsillectomy, and RAUP; and group C (n = 15) had hyoid suspension and RAUP but no tonsillectomy, because the tonsils had already been removed...
March 25, 2017: ORL; Journal for Oto-rhino-laryngology and its related Specialties
https://www.readbyqxmd.com/read/28337439/a-brief-review-of-non-invasive-monitoring-of-respiratory-condition-for-extubated-patients-with-or-at-risk-for-obstructive-sleep-apnea-after-surgery
#2
REVIEW
Xuezheng Zhang, Mahmoud Attia Mohamed Kassem, Ying Zhou, Muhammad Shabsigh, Quanguang Wang, Xuzhong Xu
Obstructive sleep apnea (OSA) is one of the important risk factors contributing to postoperative airway complications. OSA alters the respiratory physiology and increases the sensitivity of muscle tone of the upper airway after surgery to residual anesthetic medication. In addition, the prevalence of OSA was reported to be much higher among surgical patients than the general population. Therefore, appropriate monitoring to detect early respiratory impairment in postoperative extubated patients with possible OSA is challenging...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28337282/chronic-intermittent-hypoxia-affects-endogenous-serotonergic-inputs-and-expression-of-synaptic-proteins-in-rat-hypoglossal-nucleus
#3
Xu Wu, Huan Lu, Lijuan Hu, Wankun Gong, Juan Wang, Cuiping Fu, Zilong Liu, Shanqun Li
Evidence has shown that hypoxic episodes elicit hypoglossal neuroplasticity which depends on elevated serotonin (5-HT), in contrast to the rationale of obstructive sleep apnea (OSA) that deficient serotonergic input to HMs fails to keep airway patency. Therefore, understanding of the 5-HT dynamic changes at hypoglossal nucleus (HN) during chronic intermittent hypoxia (CIH) will be essential to central pathogenic mechanism and pharmacological therapy of OSA. Moreover, the effect of CIH on BDNF-TrkB signaling proteins was quantified in an attempt to elucidate cellular cascades/synaptic mechanisms following 5-HT alteration...
2017: American Journal of Translational Research
https://www.readbyqxmd.com/read/28335841/cardiovascular-outcomes-with-minute%C3%A2-ventilation-targeted-adaptive-servo-ventilation-therapy-in-heart-failure-the-cat-hf-trial
#4
Christopher M O'Connor, David J Whellan, Mona Fiuzat, Naresh M Punjabi, Gudaye Tasissa, Kevin J Anstrom, Adam V Benjafield, Holger Woehrle, Amy B Blase, JoAnn Lindenfeld, Olaf Oldenberg
BACKGROUND: Sleep apnea is common in hospitalized heart failure (HF) patients and is associated with increased morbidity and mortality. OBJECTIVES: The CAT-HF (Cardiovascular Improvements With MV-ASV Therapy in Heart Failure) trial investigated whether minute ventilation (MV) adaptive servo-ventilation (ASV) improved cardiovascular outcomes in hospitalized HF patients with moderate-to-severe sleep apnea. METHODS: Eligible patients hospitalized with HF and moderate-to-severe sleep apnea were randomized to ASV plus optimized medical therapy (OMT) or OMT alone (control)...
March 28, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28329220/prolonged-exposures-to-intermittent-hypoxia-promote-visceral-white-adipose-tissue-inflammation-in-a-murine-model-of-severe-sleep-apnea-effect-of-normoxic-recovery
#5
Alex Gileles-Hillel, Isaac Almendros, Abdelnaby Khalyfa, Recep Nigdelioglu, Zhuanhong Qiao, Robert B Hamanaka, Gökhan M Mutlu, Mahzad Akbarpour, David Gozal
Study Objectives: Increased visceral white adipose tissue (vWAT) mass results in infiltration of inflammatory macrophages that drive inflammation and insulin resistance. Patients with obstructive sleep apnea (OSA) suffer from increased prevalence of obesity, insulin resistance and metabolic syndrome. Murine models of intermittent hypoxia (IH) mimicking moderate-severe OSA manifest insulin resistance following short-term IH. We examined in mice the effect of long-term IH on the inflammatory cellular changes within vWAT, and the potential effect of normoxic recovery (IH-R)...
December 22, 2016: Sleep
https://www.readbyqxmd.com/read/28329099/effect-of-sleeping-position-on-upper-airway-patency-in-obstructive-sleep-apnea-is-determined-by-the-pharyngeal-structure-causing-collapse
#6
Melania Marques, Pedro R Genta, Scott A Sands, Ali Azarbazin, Camila de Melo, Luigi Taranto-Montemurro, David P White, Andrew Wellman
Objectives: In some patients, obstructive sleep apnea (OSA) can be resolved with improvement in pharyngeal patency by sleeping lateral rather than supine, possibly as gravitational effects on the tongue are relieved. Here we tested the hypothesis that the improvement in pharyngeal patency depends on the anatomical structure causing collapse, with patients with tongue-related obstruction and epiglottic collapse exhibiting preferential improvements. Methods: Twenty-four OSA patients underwent upper airway endoscopy during natural sleep to determine the pharyngeal structure associated with obstruction, with simultaneous recordings of airflow and pharyngeal pressure...
January 31, 2017: Sleep
https://www.readbyqxmd.com/read/28326793/changes-in-habitual-sleep-duration-after-continuous-positive-airway-pressure-for-obstructive-sleep-apnea
#7
Ryo Tachikawa, Takuma Minami, Takeshi Matsumoto, Kimihiko Murase, Kiminobu Tanizawa, Morito Inouchi, Toru Oga, Kazuo Chin
RATIONALE: Obstructive sleep apnea (OSA) can affect not only sleep quality but also sleep duration. Determining the therapeutic effects of continuous positive airway pressure (CPAP) on habitual sleep profiles may shed light on the impact of OSA on sleep duration. OBJECTIVES: To determine whether and how CPAP affects habitual sleep duration in patients with OSA. METHODS: Assessments of sleep duration and sleep quality were performed on 57 newly diagnosed study subjects with OSA (46 men, median 63 years, apnea-hypopnea index >20 h-1) at baseline and 3 months after initiation of CPAP therapy...
March 22, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28325015/estimating-apnea-hypopnea-index-only-from-an-accelerometer-signal-measured-on-the-chest
#8
Yasunobu Yamauchi, Sawa Fuke, Kanako Nakayama, Jun'ya Takakura, Hitoshi Usuniwa, Keiji Koike, Eriko Ouchi, Nagafumi Doi
Sleep apnea syndrome (SAS) is becoming a public concern in the field of preventive medicine because it causes more deleterious diseases. However, the majority of patients are not diagnosed and an easier-to-use, lower-cost device for screening of SAS is needed compared to the existing multimodal devices. In this study, we developed and tested a method to estimate the apnea-hypopnea index (AHI), which is the measure of severity of SAS, only from an accelerometer signal measured on the chest. Simultaneous recordings of overnight sleep polysomnography and accelerometer signal were conducted for 50 participants...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28323671/codeine-and-opioid-metabolism-implications-and-alternatives-for-pediatric-pain-management
#9
Vidya Chidambaran, Senthilkumar Sadhasivam, Mohamed Mahmoud
PURPOSE OF REVIEW: Use of perioperative opioids for surgical pain management of children presents clinical challenges because of concerns of serious adverse effects including life-threatening respiratory depression. This is especially true for children with history of obstructive sleep apnea. This review will explore current knowledge of clinically relevant factors and genetic polymorphisms that affect opioid metabolism and postoperative outcomes in children. RECENT FINDINGS: Within the past several years, an increasing number of case reports have illustrated clinically important respiratory depression, anoxic brain injuries and even death among children receiving appropriate weight-based dosages of codeine and other opioids for analgesia at home setting particularly following tonsillectomy...
March 18, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28320992/right-ventricular-enlargement-and-renal-function-are-associated-with-smooth-introduction-of-adaptive-servo-ventilation-therapy-in-chronic-heart-failure-patients
#10
Toshihiro Iwasaku, Yoshitaka Okuhara, Akiyo Eguchi, Tomotaka Ando, Yoshiro Naito, Tohru Masuyama, Shinichi Hirotani
Although adaptive servo-ventilation (ASV) therapy has beneficial effects on chronic heart failure (CHF), a relatively large number of CHF patients cannot undergo ASV therapy due to general discomfort from the mask and/or positive airway pressure. The present study aimed to clarify baseline patient characteristics which are associated with the smooth introduction of ASV treatment in stable CHF inpatients.Thirty-two consecutive heart failure (HF) inpatients were enrolled (left ventricular ejection fraction (LVEF) < 45%, estimated glomerular filtration rate (eGFR) > 10 mL/minute/1...
March 21, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28320866/adenotonsillotomy-versus-adenotonsillectomy-in-pediatric-obstructive-sleep-apnea-an-rct
#11
Anna Borgström, Pia Nerfeldt, Danielle Friberg
BACKGROUND: Adenotonsillectomy (ATE) is a well-established and effective treatment of pediatric obstructive sleep apnea (OSA). In recent years, a more conservative method, adenotonsillotomy (ATT), has gained popularity because it is associated with less postoperative morbidity. Yet no previous randomized study has compared these 2 methods regarding their effectiveness in treating pediatric OSA in terms of polysomnographic data, which was the primary aim of this study. The hypothesis was that ATT is noninferior to ATE after 1 year...
March 20, 2017: Pediatrics
https://www.readbyqxmd.com/read/28320844/the-effects-of-obstructive-sleep-apnea-syndrome-on-the-dentate-gyrus-and-learning-and-memory-in-children
#12
Jiook Cha, Johanna A Zea-Hernandez, Sanghun Sin, Katharina Graw-Panzer, Keivan Shifteh, Carmen R Isasi, Mark E Wagshul, Eileen E Moran, Jonathan Posner, Molly E Zimmerman, Raanan Arens
Obstructive sleep apnea syndrome (OSAS) is associated with intermittent hypoxia and sleep loss. In children, impairments of cognitive function are important manifestations, but underlying pathology is unknown. We hypothesized that OSAS would affect the dentate gyrus, a hippocampal subdivision essential to neurogenesis and cognition, and that this impact would further affect cognitive function in children. In children with OSAS (n=11) and control subjects (n=12; age and sex-matched), we performed diffusion tensor imaging and structural MRI, polysomnography, and neuropsychological assessments...
March 20, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/28319673/the-effect-of-montelukast-on-mild-persistent-osa-after-adenotonsillectomy-in-children-a-preliminary-study
#13
Bing Wang, Jia Liang
This study sought to evaluate the treatment effect of montelukast in children with obstructive sleep apnea (OSA) after tonsillectomy and/or adenoidectomy (T&A). Fifty-eight children with persistent OSA after T&A were included and randomly divided into 2 groups: one group was administered montelukast for 12 weeks, and the other received no treatment. Clinical information, such as the apnea-hypopnea index (AHI) and nadir oxyhemoglobin saturation (nadir SpO2), was recorded. Symptoms of OSA were evaluated using the validated Pediatric Sleep Questionnaire (PSQ)...
March 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28318060/integrating-postural-and-vestibular-dimensions-to-depict-impairment-in-moderate-to-severe-obstructive-sleep-apnea-syndrome-patients
#14
Alessandro Micarelli, Claudio Liguori, Andrea Viziano, Francesca Izzi, Fabio Placidi, Marco Alessandrini
Vestibular dysfunction was linked to moderate-to-severe obstructive sleep apnea syndrome (OSAS) patients in literature. However, due to a lack of knowledge among valid and recent implementations conceived to study postural control on static posturography (SP) and vestibulo-ocular reflex (VOR) gain under physiological conditions (video Head Impulse Test; vHIT), the aim of this work was to integrate (i) VOR changes via vHIT implementation, (ii) postural arrangement by studying both classical parameters and frequency spectra (PS) and (iii) correlation between these findings, polygraphic (PG) and subjective scores along Dizziness Handicap Inventory (DHI) and Epworth Sleepiness Scale (ESS)...
March 20, 2017: Journal of Sleep Research
https://www.readbyqxmd.com/read/28315149/can-myofunctional-therapy-increase-tongue-tone-and-reduce-symptoms-in-children-with-sleep-disordered-breathing
#15
Maria Pia Villa, Melania Evangelisti, Susy Martella, Mario Barreto, Marco Del Pozzo
PURPOSE: Data in the literature suggest that myofunctional therapy (MT) may be able to play a role in the treatment of children with sleep-disordered breathing (SDB). Our study investigated the effectiveness of MT in reducing respiratory symptoms in children with SDB by modifying tongue tone. METHODS: Polysomnographic recordings were performed at baseline to assess obstructive sleep apnea (OSA) severity in 54 children (mean age 7.1 ± 2.5 years, 29 male) with SDB...
March 18, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/28314626/cerebral-hemodynamic-effects-of-cheyne-stokes-respiration-in-a-patient-with-stroke
#16
R C Nogueira, R B Panerai, M J Teixeira, T G Robinson, E Bor-Seng-Shu
INTRODUCTION: Cheyne-Stokes respiration (CSR) and central sleep apnea (CSA) are common in patients with heart failure and/or stroke. We aim to describe the cerebrovascular effects of CSR during the acute phase of stroke in a heart failure patient. CASE REPORT: A 74-year-old male with previous dilated cardiomyopathy had sudden onset of right hemiparesis and aphasia. A transcranial Doppler was performed with continuous measurement of blood pressure (BP) (Finometer) and end-tidal CO2 (nasal capnography)...
March 14, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28306607/orexin-a-aggravates-the-impairment-of-hippocampal-neurons-caused-by-intermittent-hypoxemia-by-the-oxr-plc%C3%AE-1-erk1-2-pathway
#17
Guohua Li, Shi Tang, Heng Chi, Weiwei Huang, Shanshan Lu, Xin Lv, Xiaomin Liu, Yan Li, Yanpeng Wang, Jiyou Tang
Obstructive sleep apnea is a highly prevalent but under-recognized disorder that causes neurocognitive deficits such as spatial memory and learning deficits. These deficits are frequently accompanied by an increase in orexin-A, which has been shown to be involved in learning and memory as well as in neuronal apoptosis in brain areas involved in cognition, such as the hippocampus. The aim of this work was to study the possible harmful effects of orexin-A on intermittent hypoxemia-induced hippocampal neuronal damage and to investigate the potential underlying molecular mechanisms and signaling pathways in vitro...
March 16, 2017: Neuroreport
https://www.readbyqxmd.com/read/28306414/cross-sectional-comparison-of-sleep-disordered-breathing-in-native-peruvian-highlanders-and-lowlanders
#18
Luu V Pham, Christopher Meinzen, Rafael S Arias, Noah G Schwartz, Adi Rattner, Catherine H Miele, Philip L Smith, Hartmut Schneider, J Jaime Miranda, Robert H Gilman, Vsevolod Y Polotsky, William Checkley, Alan R Schwartz
Pham, Luu V., Christopher Meinzen, Rafael S. Arias, Noah G. Schwartz, Adi Rattner, Catherine H. Miele, Philip L. Smith, Hartmut Schneider, J. Jaime Miranda, Robert H. Gilman, Vsevolod Y. Polotsky, William Checkley, and Alan R. Schwartz. Cross-sectional comparison of sleep-disordered breathing in native Peruvian highlanders and lowlanders. High Alt Med Biol. 18:11-19, 2017. BACKGROUND: Altitude can accentuate sleep disordered breathing (SDB), which has been linked to cardiovascular and metabolic diseases...
March 2017: High Altitude Medicine & Biology
https://www.readbyqxmd.com/read/28303674/simultaneous-recording-of-ultrasound-and-polysomnography-during-natural-sleep-in-patients-with-obstructive-sleep-apnea-a-pilot-study
#19
Jeng-Wen Chen, Chih-Chung Huang, Chi-Kai Weng, Chun-Hsiang Chang, Shou-Jen Wang
Tongue base deformation may play a critical role in the phenomenon of obstructive sleep apnea, but polysomnography provides limited information regarding the effect of tongue motion during natural sleep. We reported on preliminary results of combining a novel ultrasound system and polysomnography for simultaneous recordings during natural sleep in volunteers and patients with obstructive sleep apnea. All participants underwent time-synchronized polysomnography and submental transcutaneous ultrasound examinations...
March 17, 2017: Journal of Sleep Research
https://www.readbyqxmd.com/read/28300569/obesity-as-an-effect-modifier-in-sleep-disordered-breathing-and-post-cardiac-surgery-atrial-fibrillation
#20
Roop Kaw, Samer El Zarif, Lu Wang, James Bena, Eugene Blackstone, Reena Mehra
INTRODUCTION: As the inter-relationships of objectively-ascertained sleep disordered breathing (SDB), post-cardiac surgery atrial fibrillation (PCSAF) and obesity remain unclear; we aimed to further investigate in a clinic-based cohort. METHODS: Patients with polysomnography (PSG) and cardiac surgery (coronary artery bypass surgery and/or valvular surgery) within 3 years, from January 2009 to January 2014 were identified excluding those with pre-existing AF. Logistic models were used to determine the association of SDB (apnea hypopnea index (AHI) per 5 unit increase) and secondary predictors [central sleep apnea (CSA) (central apnea index>5) and oxygen desaturation index (ODI)] with PCSAF...
March 11, 2017: Chest
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