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apnea effects

Joseph M Blankush, Robbie Freeman, Joy McIlvaine, Trung Tran, Stephen Nassani, I Michael Leitman
Modified Early Warning Scores (MEWS) provide real-time vital sign (VS) trending and reduce ICU admissions in post-operative patients. These early warning calculations classically incorporate oxygen saturation, heart rate, respiratory rate, systolic blood pressure, and temperature but have not previously included end-tidal CO2 (EtCO2), more recently identified as an independent predictor of critical illness. These systems may be subject to failure when physiologic data is incorrectly measured, leading to false alarms and increased workload...
October 20, 2016: Journal of Clinical Monitoring and Computing
Paul Castellanos, Manjunath Mk, Ihab Atallah
The management of tracheobronchomalacia is a very challenging problem with few treatment options. This study aims to evaluate the outcomes of a novel surgical treatment for membranous tracheobronchomalacia. A consecutive series of patients with tracheobronchomalacia were treated with two to three holmium laser scarring surgeries of the hyperdynamic tracheal and bronchial walls for the purpose of stiffening them through fibrosis. Patients filled out a Dyspnea Index questionnaire before and after treatment. Ten patients were treated for their tracheobronchomalacia with a mean age of 54 years...
October 20, 2016: European Archives of Oto-rhino-laryngology
Joanne Avraam, Rosie Bourke, John A Trinder, Christian L Nicholas, Danny Brazzale, Fergal J O'Donoghue, Peter D Rochford, Amy S Jordan
Respiratory magnetometers are increasingly being used in sleep studies to measure changes in end expiratory lung volume (EELV), including in obese obstructive sleep apnea (OSA) patients. Despite this, the accuracy of magnetometers has not been confirmed in obese patients, nor compared between genders. Thus, we compared spirometer-measured and magnetometer-estimated lung volume and tidal volume changes during voluntary end-expiratory lung volume changes of 1.5L, 1L, and 0.5L above, and 0.5L below, functional respiratory capacity (FRC) in supine normal weight (BMI<25kg/m(2)) and healthy obese (BMI>30kg/m(2)) men and women...
October 7, 2016: Journal of Applied Physiology
Roseanne J S Vliegenthart, Christine H Ten Hove, Wes Onland, Anton H L C van Kaam
BACKGROUND: Apnea of prematurity (AOP) is a common complication of preterm birth, for which caffeine is the first treatment of choice. In case of persistent AOP, doxapram has been advocated as an additional therapy. OBJECTIVE: To identify and appraise all existing evidence regarding efficacy and safety of doxapram use for AOP in infants born before 34 weeks of gestational age. METHODS: All studies reporting on doxapram use for AOP were identified by searching electronic databases, references from relevant studies, and abstracts from the Societies for Pediatric Research...
October 20, 2016: Neonatology
Melinda A Ma, Rajesh Kumar, Paul M Macey, Frisca L Yan-Go, Ronald M Harper
INTRODUCTION: Obstructive sleep apnea (OSA) is a male-predominant condition, characterized by repeated upper-airway collapse with continued diaphragmatic efforts during sleep, and is accompanied by severe physiological consequences. Multiple morphological aspects, including epiglottis cross-sectional area (CSA) and oropharyngeal airway length (OPAL), can contribute to airway collapsibility in the condition. This study focused on the effects of OSA severity, sex, and race on OPA dimensions...
2016: Nature and Science of Sleep
Michael G Ziegler, Milos Milic
PURPOSE OF REVIEW: The sympathetic nervous system (SNS) mediates short-term increases in blood pressure. Evidence that psychosocial stress leads to chronic hypertension is mixed. The SNS activation found in obstructive sleep apnea (OSA), caregiving for a severely demented spouse, and obesity more specifically address whether SNS activation might lead to the metabolic syndrome and hypertension. RECENT FINDINGS: Obesity is associated with both increased SNS electrical activity and plasma norepinephrine...
October 15, 2016: Current Opinion in Nephrology and Hypertension
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
Anping Cai, Ling Wang, Yingling Zhou, Jiyan Chen, Yingqing Feng, Qi Zhong
OBJECTIVE: Current study sought to evaluate the effects of obstructive sleep apnea (OSA) plus hypertension (HTN) on prevalent cardiovascular diseases (CVD). DESIGN AND METHOD: This was a cross-sectional study and a total of 1889 subjects were enrolled. The apnea-hypopnea index (AHI) was measured by polysomnography and OSA degree was classified as mild (AHI 5-14.9) and moderate-severe (AHI ≥ 15), and AHI < 5 was considered no-OSA. Mean and lowest oxyhemoglobin saturation (SaO2) was detected by pulse oximetry...
September 2016: Journal of Hypertension
Wei-Jei Lee
Obesity is a pan-endemic health problem in both developed and developing countries, in both western and eastern countries. It increases risk for many common diseases, including type 2 diabetes, dyslipidemia, hypertension, obstructive sleep apnea, heart disease, stroke, asthma, osteoarthritis, cancers and depression etc.. Although the incidence of obesity in Asia is relatively low, Asian patients tend to have similar incidence of obesity related metabolic syndrome at lower BMI level comparing to Caucasians because of central obesity...
September 2016: Journal of Hypertension
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
Nancy J Carballo, Cathy A Alessi, Jennifer L Martin, Michael N Mitchell, Ron D Hays, Nananda Col, Emily S Patterson, Stella Jouldjian, Karen Josephson, Constance H Fung
PURPOSE: Obstructive sleep apnea is a prevalent sleep disorder among older adults. Oral appliances are increasingly prescribed as therapy for obstructive sleep apnea. Adherence to oral appliance therapy is highly variable. Based on value-expectancy theory and other social-psychological theories, adherence to oral appliance therapy may be influenced by patients' perceived effectiveness of the therapy, self-efficacy, and availability of social support. We examined these perceptions among older adults with obstructive sleep apnea who were prescribed oral appliance therapy...
October 14, 2016: Clinical Therapeutics
Ilana Borukhov, Denise Rizzolo
Obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD) both cause an infl ammatory response and hypoxia. Patients who have both conditions (overlap syndrome) have increased morbidity and mortality. This article aims to increase awareness of the potential effects that untreated OSA can have on COPD and the importance of treating patients with overlap syndrome.
September 30, 2016: JAAPA: Official Journal of the American Academy of Physician Assistants
Sairam Parthasarathy, Mary A Carskadon, Girardin Jean-Louis, Judith Owens, Adam Bramoweth, Daniel Combs, Lauren Hale, Elizabeth Harrison, Chantelle N Hart, Brant P Hasler, Sarah M Honaker, Elisabeth Hertenstein, Samuel Kuna, Clete Kushida, Jessica C Levenson, Caitlin Murray, Allan I Pack, Vivek Pillai, Kristi Pruiksma, Azizi Seixas, Patrick Strollo, Saurabh S Thosar, Natasha Williams, Daniel Buysse
A wealth of scientific knowledge is being generated in sleep and circadian science. In order for us to realize the return on investment for such scientific knowledge and to improve the health of the nation, we need to disseminate and implement research findings into practice. An implementation gap - termed a "quality chasm" by the Institutes of Medicine - separates the scientific knowledge we possess and the implementation of such knowledge into preventative interventions or healthcare treatments. It is frequently reported that a time lag of 17 years transpires before medical research reaches clinical practice...
October 10, 2016: Sleep
Jianguo Zhuang, Xiuping Gao, Franklin Gao, Fadi Xu
We tested the hypothesis that mu-opioid receptors (MORs) in the caudomedial nucleus tractus solitarius (cmNTS) are important for the ventilatory responses to stimulation of bronchopulmonary C-fibers (PCFs), the carotid body-mediated hypoxia, and hypercapnia independent of the carotid body. First, we used immunohistochemistry to map MORs distribution in the caudal medulla. Then we compared the effects of intra-cmNTS microinjection of DAMGO (a MOR agonist) with or without a combination of CTAP (a MOR antagonist) on the ventilatory responses to: 1) right atrial injection of capsaicin (to stimulation of PCFs) and 2) acute hypoxia (HVR, to stimulate the carotid body) in awake intact rats; and 3) hypercapnia (HCVR) in the carotid body ablated rats...
October 12, 2016: Respiratory Physiology & Neurobiology
Mark A D'Agostino
The standard treatment for patients with obstructive sleep apnea syndrome is positive airway pressure (PAP) therapy. However when PAP therapy fails, surgery maybe an option to alleviate the obstruction. The base of tongue plays an important role in this obstruction, and addressing the tongue base surgically can be a challenge for the head and neck surgeon. Transoral robotic surgery (TORS) using the da Vinci Surgical System provides a safe and effective way to approach and manage the base of tongue and supraglottis...
October 11, 2016: Otolaryngologic Clinics of North America
Mulalibieke Heizhati, Nanfang Li, Liang Shao, Xiaoguang Yao, Yingchun Wang, Jing Hong, Ling Zhou, Delian Zhang, Guijuan Chang, Suofeiya Abulikemu
PURPOSE: Sleep architecture can be affected by alteration in circulating lipopolysaccaride and cytokines. However, still unknown are the effects of lipopolysaccaride-binding protein (LBP) on sleep architecture. Therefore, potential relationship between alteration in serum LBP concentrations and sleep architecture was analyzed. METHODS: This is a cross-sectional study. Consecutive 54 hypertensive males, aged 30-65 years. and with no obstructive sleep apnea via polysomnography, were recruited...
October 13, 2016: Sleep & Breathing, Schlaf & Atmung
I Tuleta, F Stöckigt, U R Juergens, C Pizarro, J W Schrickel, G Kristiansen, G Nickenig, D Skowasch
INTRODUCTION: Intermittent hypoxia as a surrogate of obstructive sleep apnea is associated with different cardiovascular complications. However, the effects of intermittent hypoxia on the lung tissue are less known. Therefore, the aim of our present study was to investigate if intermittent hypoxia may influence oxidative stress, inflammation, and protease/antiprotease system in the lung. Additionally, potential protective properties of anti-inflammatory and anti-oxidative drugs have been evaluated...
October 13, 2016: Lung
Graciela E Silva, James L Goodwin, Kimberly D Vana, Stuart F Quan
INTRODUCTION: The impact of sleep on quality of life (QoL) has been well documented; however, there is a great need for reliable QoL measures for persons with obstructive sleep apnea (OSA). We compared the QoL scores between the 36-Item Short Form of the Medical Outcomes Survey (SF-36), Calgary Sleep Apnea Quality of Life Index (SAQLI), and Functional Outcomes Sleep Questionnaire (FOSQ) in persons with OSA. METHODS: A total of 884 participants from the Sleep Heart Health Study second examination, who completed the SF-36, FOSQ, and SAQLI, and in-home polysomnograms, were included...
2016: Southwest Journal of Pulmonary & Critical Care
E Sh Bairambekov, A V Pevzner, A Yu Litvin, O A Fomicheva
The case history of a 46-year-old patient with obstructive sleep apnea syndrome was analyzed. The examination revealed fourth-degree obesity, prior myocardial infarction, persistent atrial fibrillation with nocturnal asystoles lasting as long as 14.3 sec. During selected drug therapy and regular application of secondary ventilation (continuous positive airway pressure (CPAP) therapy) used to correct breathing problems, there was a reduction in the signs of circulatory deficiency, cessation of cardiac pauses, and recovery of sinus rhythm...
2016: Terapevticheskiĭ Arkhiv
I M Madaeva, O N Berdina, N V Semenova, L A Grebenkina, V V Madaev, L I Kolesnikova
AIM: To reveal gender characteristics of the sleep structure in obstructive sleep apnea syndrome (OSAS) during polysomnographic monitoring (PSGM). SUBJECTS AND METHODS: According to the results of a pre-survey using an apnea screening questionnaire, the investigation included 58 women (body mass index (BMI), 38.2±2.1 kg/m2) and 75 men (BMI, 34.2±1.8 kg/m2), aged 50-55 years, who complained about snoring, sleep apnea, and daytime hypersomnia. Copy-pair groups were formed and compared after objectively confirming the diagnosis by PSGM made at a specialized sleep laboratory, by applying the GRASS-TELEFACTOR Twin PSG system (Comet) with an integrated SPM-1 sleep module (USA) in accordance with the standard procedure...
2016: Terapevticheskiĭ Arkhiv
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