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https://www.readbyqxmd.com/read/29045745/long-term-oral-appliance-therapy-improves-daytime-function-and-mood-in-upper-airway-resistance-syndrome-patients
#1
Luciana B M Godoy, Luciana Palombini, Dalva Poyares, Cibele Dal-Fabbro, Thaís Moura Guimarães, Priscila Calixto Klichouvicz, Sergio Tufik, Sonia Maria Togeiro
Objectives: To evaluate the long term effects of an oral appliance on clinical symptoms, respiratory sleep parameters, sleep quality and sustained attention in patients with Upper Airway Resistance Syndrome (UARS) compared with placebo. Methods: This study was a randomized placebo-controlled clinical trial. Thirty UARS patients were randomized in two groups: placebo and mandibular advancement device (MAD) groups. UARS criteria were presence of sleepiness (Epworth Sleepiness Scale ≥ 10) and/or fatigue (Modified Fatigue Impact Scale ≥ 38) associated with an apnea/hypopnea index (AHI) ≤ 5 and a respiratory disturbance index (RDI) > 5 events/hour of sleep, and/or flow limitation in more than 30% of total sleep time...
October 17, 2017: Sleep
https://www.readbyqxmd.com/read/29042891/differential-effects-of-obesity-on-obstructive-sleep-apnea-syndrome-according-to-age
#2
Yu-Jin G Lee, Yu Jin Lee, Do-Un Jeong
OBJECTIVE: To evaluate the effect of obesity on obstructive sleep apnea syndrome (OSAS) by age in relation to anthropometric measurements. METHODS: The medical records of 1,110 participants diagnosed with OSAS were analyzed according to age. All participants underwent nocturnal polysomnography and had their body mass index, waist circumference, neck circumference (NC), and waist-to-hip ratio measured. RESULTS: According to the multiple linear regression analysis model for the natural logarithm of the apnea-hypopnea index treating all four anthropometric measurements and gender as covariates, the final stepwise model accounted for an increasing percentage of the variability in the severity of OSAS as a function of age: 7...
September 2017: Psychiatry Investigation
https://www.readbyqxmd.com/read/29038950/firing-a-loaded-gun-during-sleep-in-an-elderly-man-with-a-perfect-storm-of-risk-factors-including-severe-obstructive-sleep-apnea
#3
Francesca Ingravallo, Carlos H Schenck, Ernesto D'Aloja, Monica Puligheddu
PURPOSE: We report a case of firing a loaded gun during sleep in a geriatric patient with undiagnosed major sleep disorders and multiple risk factors for sleep violence. Polysomnographic findings, diagnostic challenges, and forensic implications in this unprecedented geriatric case are discussed. METHODS: A 75-year-old employed man, married for 32 years, presented to a sleep center reporting to having fired a shot in his bedroom during sleep while his wife was away, without memory of hearing the gunshot...
October 16, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/29038203/effect-of-continuous-positive-airway-pressure-weight-loss-or-continuous-positive-airway-pressure-plus-weight-loss-on-central-hemodynamics-and-arterial-stiffness
#4
Snigdha Jain, Indira Gurubhagavatula, Raymond Townsend, Samuel T Kuna, Karen Teff, Thomas A Wadden, Jesse Chittams, Alexandra L Hanlon, Greg Maislin, Hassam Saif, Preston Broderick, Zeshan Ahmad, Allan I Pack, Julio A Chirinos
Obesity and obstructive sleep apnea tend to coexist. Little is known about the effects of obstructive sleep apnea, obesity, or their treatment on central aortic pressures and large artery stiffness. We randomized 139 adults with obesity (body mass index >30 kg/m(2)) and moderate-to-severe obstructive sleep apnea to (1) continuous positive airway pressure (CPAP) therapy (n=45), (2) weight loss (WL) therapy (n=48), or (3) combined CPAP and WL (n=46) for 24 weeks. We assessed the effect of these interventions on central pressures and carotid-femoral pulse wave velocity (a measure of large artery stiffness), measured with arterial tonometry...
October 16, 2017: Hypertension
https://www.readbyqxmd.com/read/29036393/angiotensin-receptor-expression-and-vascular-endothelial-dysfunction-in-obstructive-sleep-apnea
#5
Rami N Khayat, Saradhadevi Varadharaj, Kyle Porter, Angela Sow, David Jarjoura, Mikhail A Gavrilin, Jay L Zweier
Background: Obstructive sleep apnea (OSA) is associated with vascular endothelial dysfunction (VED) in otherwise healthy patients. The role of renin-angiotensin system (RAS) in the OSA induced VED is not well understood. Methods: Recently diagnosed OSA patients with very low cardiovascular disease (CVD) risk (Framingham score <5%) were studied at diagnosis and after 12 weeks of verified continuous positive airway pressure (CPAP) therapy. Participants underwent biopsy of gluteal subcutaneous tissue at baseline and after CPAP...
September 27, 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/29035296/a-wireless-monitoring-system-using-a-tunneling-sensor-array-in-a-smart-oral-appliance-for-sleep-apnea-treatment
#6
Kun-Ying Yeh, Chao-Chi Yeh, Chun-Chang Wu, Kuan Tang, Jyun-Yi Wu, Yun-Ting Chen, Ming-Xin Xu, Yunn-Jy Chen, Yao-Joe Yang, Shey-Shi Lu
Sleep apnea is a serious sleep disorder, and the most common type is obstructive sleep apnea (OSA). Untreated OSA will cause lots of potential health problems. Oral appliance therapy is an effective and popular approach for OSA treatment, but making a perfect fit for each patient is time-consuming and decreases its efficiency considerably. This paper proposes a System-on-a-Chip (SoC) enabled sleep monitoring system in a smart oral appliance, which is capable of intelligently collecting the physiological data about tongue movement through the whole therapy...
October 16, 2017: Sensors
https://www.readbyqxmd.com/read/29035088/the-last-25-years-of-obstructive-sleep-apnea-epidemiology-and-the-next-25
#7
Paul E Peppard, Erika W Hagen
Considerable new knowledge regarding the epidemiology of obstructive sleep apnea (OSA) in adults arose from large-scale population-based epidemiologic investigations that initiated in the late 1980s to 1990s; these investigations have continued to produce relevant findings in recent years. In this Perspective, we briefly comment on the past 25 years of adult population-based OSA epidemiology and discuss selected ways in which the field can further progress over the coming decades. Population-based studies have shown that OSA is common in both men and women, and that prevalence is increasing...
October 16, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29033621/nonarteritic-anterior-ischemic-optic-neuropathy-cause-effect-and-management
#8
REVIEW
Shauna Berry, Weijie V Lin, Ama Sadaka, Andrew G Lee
Nonarteritic anterior ischemic optic neuropathy (NAION) is the most common form of ischemic optic neuropathy and the second most common optic neuropathy. Patients are generally over the age of 50 years with vasculopathic risk factors (eg, diabetes mellitus, hypertension, and obstructive sleep apnea). The exact mechanism of NAION is not fully understood. In addition, several treatment options have been proposed. This article summarizes the current literature on the diagnosis, treatment, and management of NAION...
2017: Eye and Brain
https://www.readbyqxmd.com/read/29033618/schizophrenia-and-sleep-disorders-links-risks-and-management-challenges
#9
REVIEW
Rachel E Kaskie, Bianca Graziano, Fabio Ferrarelli
Schizophrenia is a major psychiatric disorder that has a massive, long-lasting negative impact on the patients as well as society. While positive symptoms (i.e., delusions and hallucinations), negative symptoms (i.e., anhedonia, social withdrawal), and cognitive impairments are traditionally considered the most prominent features of this disorder, the role of sleep and sleep disturbances has gained increasing prominence in clinical practice. Indeed, the vast majority of patients with schizophrenia report sleep abnormalities, which tend to precede illness onset and can predict an acute exacerbation of psychotic symptoms...
2017: Nature and Science of Sleep
https://www.readbyqxmd.com/read/29031760/impact-of-diagnosing-and-treating-obstructive-sleep-apnea-on-healthcare-utilization
#10
Robert J Walter, Scott I Hagedorn, Christopher J Lettieri
PURPOSE: Obstructive sleep apnea (OSA) contributes to an increased risk for multiple co-morbidities and decreased quality of life. As a result, OSA patients may have higher usage of healthcare resources which can be mitigated with effective treatment. This study evaluates changes in healthcare utilization (HCU) following the initiation of therapy for OSA. METHODS: We conducted a retrospective study of newly diagnosed OSA patients. To assess total HCU, we incorporated the sum total of outpatient clinic encounters, laboratory tests, and medication prescriptions into a composite HCU score...
October 2017: Sleep Medicine
https://www.readbyqxmd.com/read/29029984/sleep-sleep-apnea-and-atrial-fibrillation-questions-and-answers
#11
REVIEW
Younghoon Kwon, Ryan J Koene, Alan D Johnson, Gen-Min Lin, John D Ferguson
Sleep apnea (SA) is a common sleep disorder increasingly recognized as a risk for cardiovascular disease. Atrial fibrillation (AF) is the most common cardiac arrhythmia and is associated with significant morbidity and mortality. An increasing number of investigations in recent years have linked SA to AF. In this review, we aim to provide a critical overview of the existing evidence in a question and answer format by addressing the following: What is the prevalent association between the two conditions (separating nocturnally detected AF episodes from AF as a prevalent condition)? Is SA a risk factor for incident AF? Is SA a risk factor for recurrence of AF following cardioversion/catheter-based ablation? What is the association between SA and AF in patients with heart failure? Are there signature electrocardiographic markers of AF found in patients with SA? Are there electrophysiology-based studies supporting the link between SA and AF? What other sleep characteristics (beyond SA) are found in patients with AF? What is the impact of SA treatment on AF? What is the effect of AF treatment on sleep? Finally, we address unsolved questions and suggest future directions to enhance our understanding of the AF-SA relationship...
September 4, 2017: Sleep Medicine Reviews
https://www.readbyqxmd.com/read/29029253/breathing-disturbances-without-hypoxia-are-associated-with-objective-sleepiness-in-sleep-apnea
#12
Henriette Koch, Logan Douglas Schneider, Laurel A Finn, Eileen B Leary, Paul E Peppard, Erika Hagen, Helge Bjarup Dissing Sorensen, Poul Jennum, Emmanuel Mignot
Study Objectives: Determine if defining two subtypes of sleep-disordered breathing (SDB) events - with or without hypoxia - results in measures that are more strongly associated with hypertension and sleepiness. Methods: A total of 1,022 subjects with 2,112 nocturnal polysomnograms (PSGs) from the Wisconsin Sleep Cohort were analyzed with our automated algorithm, developed to detect breathing disturbances and desaturations. Breathing events were time-locked to desaturations, resulting in 2 indices - desaturating (H-BDI) and non-desaturating (NH-BDI) events - regardless of arousals...
September 26, 2017: Sleep
https://www.readbyqxmd.com/read/29029237/cpap-does-not-reduce-inflammatory-biomarkers-in-patients-with-coronary-artery-disease-and-nonsleepy-obstructive-sleep-apnea-a-randomized-controlled-trial
#13
Erik Thunström, Helena Glantz, Tülay Yucel-Lindberg, Kristin Lindberg, Mustafa Saygin, Yüksel Peker
Objectives: Obstructive sleep apnea (OSA) and enhanced vascular inflammation coexist in patients with coronary artery disease (CAD). Continuous positive airway pressure (CPAP) is first-line treatment for OSA with daytime sleepiness. This analysis of data from the RICCADSA trial investigated the effects of CPAP on inflammatory markers in patients with CAD and nonsleepy OSA. Methods: This single-center, randomized, controlled, open-label trial enrolled consecutive revascularized patients with nonsleepy OSA (apnea-hypopnea index >15/h; Epworth Sleepiness Scale score <10)...
October 5, 2017: Sleep
https://www.readbyqxmd.com/read/29024553/obesity-risk-factors-complications-and-strategies-for-sustainable-long-term-weight-management
#14
Sharon M Fruh
BACKGROUND AND PURPOSE: The aims of this article are to review the effects of obesity on health and well-being and the evidence indicating they can be ameliorated by weight loss, and consider weight-management strategies that may help patients achieve and maintain weight loss. METHODS: Narrative review based on literature searches of PubMed up to May 2016 with no date limits imposed. Search included terms such as "obesity," "overweight," "weight loss," "comorbidity," "diabetes," cardiovascular," "cancer," "depression," "management," and "intervention...
October 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/29021511/overcoming-sleep-disordered-breathing-and-ensuring-sufficient-good-sleep-time-for-a-healthy-life-expectancy
#15
Kazuo Chin
Recent advances in basic and clinical medicine have resulted in major improvements in human health. Currently sleep has been considered an essential factor in maintaining and promoting a healthy life expectancy. Sleep disorders include more than 60 diseases. Sleep disordered breathings (SDB) have 17 disorders, including sleep apnea. SDB usually induces hypoxemia and hypercapnia, which would have significant effects on cells, organs, and the whole body. We have investigated SDB for nearly 35 years. We found that SDB has significant associations with humoral factors, including coagulation systems, the body's protective factors against diseases, and metabolic and organ diseases...
2017: Proceedings of the Japan Academy. Series B, Physical and Biological Sciences
https://www.readbyqxmd.com/read/29016682/effects-of-mandibular-setback-with-or-without-maxillary-advancement-osteotomies-on-pharyngeal-airways-an-overview-of-systematic-reviews
#16
Su Keng Tan, Wai Keung Leung, Alexander Tin Hong Tang, Roger A Zwahlen
BACKGROUND: Mandibular setback osteotomies potentially lead to narrowing of the pharyngeal airways, subsequently resulting in post-surgical obstructive sleep apnea (OSA). OBJECTIVE: To summarize current evidence from systematic reviews that has evaluated pharyngeal airway changes after mandibular setback with or without concomitant upper jaw osteotomies. METHODOLOGY: PubMed, EMBASE, Web of Science, and Cochrane Library databases were searched with no restriction of language or date...
2017: PloS One
https://www.readbyqxmd.com/read/28993211/global-cognitive-profile-and-different-components-of-reaction-times-in-obstructive-sleep-apnea-syndrome-effects-of-continuous-positive-airway-pressure-over-time
#17
Maria Devita, Andrea Zangrossi, Maurizio Marvisi, Paola Merlo, Maria Luisa Rusconi, Sara Mondini
Obstructive sleep apnea syndrome (OSAS) has been recurrently associated with cognitive and psychomotor impairments. However, the occurrence and possible reversibility of these deficits are still extremely controversial, also as a result of different methodologies adopted used by scholars. The aim of the present study was to compare over time the global cognitive profile of patients with OSAS undergoing the continuous positive airway pressure treatment (CPAP; N=23) with that of patients with OSAS who were not (N=10)...
October 6, 2017: International Journal of Psychophysiology
https://www.readbyqxmd.com/read/28988235/readmissions-and-emergency-department-visits-after-bariatric-surgery-at-saudi-arabian-hospital-the-rates-reasons-and-risk-factors
#18
Anwar Ahmed, Doaa AlBuraikan, Bashayr ALMuqbil, Wijdan AlJohi, Wala Alanazi, Budor AlRasheed
BACKGROUND: Saudi Arabian hospital readmissions and emergency department (ED) visits following bariatric surgery and discharge have never been investigated. This study aimed to evaluate the rates and reasons of hospital readmissions and ED visits related to surgical weight loss interventions at the King Abdulaziz Medical City - Riyadh. METHODS: We conducted a retrospective cohort study on 301 patients who underwent bariatric surgery between January 2011 and July 2016...
October 7, 2017: Obesity Facts
https://www.readbyqxmd.com/read/28986091/the-role-of-adenotonsillectomy-in-the-treatment-of-primary-nocturnal-enuresis-in-children-a-systematic-review
#19
Kyle Jeffrey Lehmann, Ralph Nelson, Dawn MacLellan, Peter Anderson, Rodrigo L P Romao
INTRODUCTION: Primary nocturnal enuresis (PNE) is a challenging condition for physicians, patients and families. Although the etiology remains unclear, sleep-disordered breathing (SDB) and sleep apnea have been suggested to play an important role. Recent research has suggested a potential therapeutic benefit of adenotonsillectomy (T&A) and surgical management of upper airway obstruction in the treatment of PNE. OBJECTIVE: The aim was to conduct a systematic review of relevant literature to determine the effectiveness of T&A in treating children aged 2-19 years with PNE...
September 6, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28983236/development-of-a-clinical-pathway-and-technical-aspects-of-upper-airway-stimulation-therapy-for-obstructive-sleep-apnea
#20
REVIEW
Olivier M Vanderveken, Jolien Beyers, Sara Op de Beeck, Marijke Dieltjens, Marc Willemen, Johan A Verbraecken, Wilfried A De Backer, Paul H Van de Heyning
Obstructive sleep apnea (OSA) is a common disease with high morbidity and related mortality. Narrowing and collapse of the pharyngeal airway during sleep characterize the disease, resulting in a decrease (hypopnea) or a complete cessation (apnea) of oronasal airflow. Upper airway stimulation (UAS), using electrical neurostimulation of the hypoglossal nerve (n. XII) synchronized with ventilation, is a novel, evolving treatment option. UAS was found to be an effective treatment in CPAP-intolerant patients. The treatment success is partly due to the strict selection of the patients, based on previous findings...
2017: Frontiers in Neuroscience
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