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autonomic alteration and OSA

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https://www.readbyqxmd.com/read/29926395/hypoglossal-nerve-stimulation-therapy-on-peripheral-arterial-tonometry-in-obstructive-sleep-apnea-a-pilot-study
#1
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/29883682/regional-brain-tissue-integrity-in-pediatric-obstructive-sleep-apnea
#2
Leila Kheirandish-Gozal, Ashish K Sahib, Paul M Macey, Mona F Philby, David Gozal, Rajesh Kumar
Children with long-standing obstructive sleep apnea (OSA) show evidence of neural injury and functional deficits in behavioral and cognitive regulatory brain regions that are reflected in symptoms of altered cognitive performance and behaviors. While we earlier showed reduced gray matter volume and increased and reduced regional cortical thicknesses, such structural changes give little indication of the underlying pathology. Brain tissue integrity in pediatric OSA subjects can reflect the nature and extent of injury or structural adaptation, and can be assessed by entropy tissue texture, a measure of local changes in signal intensity patterns from high-resolution magnetic resonance images...
June 5, 2018: Neuroscience Letters
https://www.readbyqxmd.com/read/29789952/carotid-body-ablation-a-new-target-to-address-central-autonomic-dysfunction
#3
REVIEW
Rodrigo Iturriaga
PURPOSE OF REVIEW: An abnormal heightened carotid body (CB) chemoreflex, which produces autonomic dysfunction and sympathetic overactivation, is the common hallmark of obstructive sleep apnea (OSA), resistant hypertension, systolic heart failure (HF), and cardiometabolic diseases. Accordingly, it has been proposed that the elimination of the CB chemosensory input to the brainstem may reduce the autonomic and cardiorespiratory alterations in sympathetic-associated diseases in humans. RECENT FINDINGS: A growing body of evidence obtained in preclinical animal models support that an enhanced CB discharge produces sympathetic hyperactivity, baroreflex sensitivity and heart rate variability impairment, breathing instability, hypertension, and insulin resistance...
May 22, 2018: Current Hypertension Reports
https://www.readbyqxmd.com/read/29734980/the-longest-obstructive-apnea-you-have-ever-seen-a-patient-with-new-onset-autonomic-dysfunction
#4
Puneet K Aulakh, David E Westerman, Raj C Dedhia
Autonomic dysfunction (AD) has been associated with both obstructive and central sleep apneas. Several mechanisms have been proposed for the emergence of sleep apnea in AD, which include impaired sensory input, compromised local reflexes, and altered central processing. We present a case of a 70-year-old woman who had experienced cardiac arrest four times related to hypoxic events due to the apparent sudden onset of obstructive sleep apnea (OSA) in the setting of AD. The episodes of OSA were profoundly prolonged and a tracheostomy was ultimately needed due to the inability of positive airway pressure therapy with supplemental oxygen to control events...
May 15, 2018: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/29609720/heart-rate-variability-responses-of-individuals-with-and-without-saline-induced-obstructive-sleep-apnea
#5
Daniel Vena, T Douglas Bradley, Philip J Millar, John S Floras, Jonathan Rubianto, Bojan Gavrilovic, Elisa Perger, Azadeh Yadollahi
STUDY OBJECTIVES: Postoperative development of obstructive sleep apnea (OSA) has been attributed to the fluid overloaded state of patients during the postoperative period. In this context, alterations in cardiac autonomic regulation caused by OSA may explain the increased postoperative risk for adverse cardiovascular events. This study tests the hypothesis that individuals with fluid overload-induced OSA will experience autonomic dysregulation, compared to those without fluid overload-induced OSA...
April 15, 2018: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/29509806/obstructive-sleep-apnea-and-cortical-thickness-in-females-and-males
#6
Paul M Macey, Natasha Haris, Rajesh Kumar, M Albert Thomas, Mary A Woo, Ronald M Harper
INTRODUCTION: Obstructive sleep apnea (OSA) affects approximately 10% of adults, and alters brain gray and white matter. Psychological and physiological symptoms of the disorder are sex-specific, perhaps related to greater injury occurs in female than male patients in white matter. Our objective was to identify influences of OSA separated by sex on cortical gray matter. METHODS: We assessed cortical thickness in 48 mild-severe OSA patients (mean age±std[range] = 46...
2018: PloS One
https://www.readbyqxmd.com/read/29424572/atrial-arrhythmias-and-autonomic-dysfunction-in-rats-exposed-to-chronic-intermittent-hypoxia
#7
Sara L Bober, John Ciriello, Douglas L Jones
Obstructive sleep apnea (OSA), which involves chronic, intermittent hypoxia (CIH), is a major risk factor for developing atrial fibrillation (AF). Whether or not CIH alone alters cardiac mechanisms to support AF is unknown. This study investigated the effects of CIH on atrial electrophysiology and arrhythmia vulnerability, and evaluated the role of autonomics in CIH promotion of AF. Adult male Sprague-Dawley rats were exposed to 8h/day of CIH or normoxia for 7 days. Following exposure, rats were anesthetized for intracardiac electrophysiological studies...
February 9, 2018: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/29114876/translating-carotid-body-function-into-clinical-medicine
#8
Rodrigo Iturriaga
The carotid body (CB) is considered the main O2 chemoreceptor, which contributes to the cardiorespiratory homeostasis and ventilatory acclimatization. In clinical medicine, the most common pathology associated with the CB are tumours. However, a growing body of evidences supports the novel idea that an enhanced CB chemosensory discharge contributes to the autonomic dysfunction and pathological consequences in obstructive sleep apnoea (OSA), hypertension, systolic heart failure (HF) and cardiometabolic diseases...
November 8, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/28853425/obstructive-sleep-apnea-syndrome-osas-and-cardiovascular-system
#9
Carolina Lombardi, Eleonora Tobaldini, Nicola Montano, Anna Losurdo, Gianfranco Parati
There is increasing evidence of a relationship between Obstructive Sleep Apnea (OSA) and cardiovascular diseases. The strong association between OSA and arterial hypertension, in particular in patients with resistant hypertension and/or a non-dipping profile, has been extensively reported. The relationship between OSA and high blood pressure (BP) has been found independent from a number of confounders, but several factors may affect this relationship, including age and sex. It is thus important to better assess pathophysiologic and clinical interactions between OSA and arterial hypertension, also aimed at optimizing treatment approaches in OSA and hypertensive patients with co-morbidities...
August 28, 2017: La Medicina del Lavoro
https://www.readbyqxmd.com/read/28555408/bariatric-surgery-induced-resolution-of-hypertension-and-obstructive-sleep-apnea-impact-of-modulation-of-body-fat-ectopic-fat-autonomic-nervous-activity-inflammatory-and-adipokine-profiles
#10
Audrey Auclair, Laurent Biertho, Simon Marceau, Frédéric-Simon Hould, Simon Biron, Stéfane Lebel, François Julien, Odette Lescelleur, Yves Lacasse, Marie-Eve Piché, Katherine Cianflone, Sebastian Demian Parlee, Kerry Goralski, Julie Martin, Marjorie Bastien, David H St-Pierre, Paul Poirier
BACKGROUND: Obesity-associated systemic hypertension (HTN) and obstructive sleep apnea (OSA) have multiple pathophysiological pathways including ectopic fat deposition, inflammation, altered adipokine profile, and increased sympathetic nervous activity. We characterized these potential mechanisms in severely obese patients with or without HTN and OSA. We also compared changes of these mechanisms at 12 months following biliopancreatic diversion with duodenal switch (BPD-DS) surgery according to HTN and OSA resolution...
December 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28167915/the-role-of-acute-intermittent-hypoxia-in-neutrophil-generated-superoxide-sympathovagal-balance-and-vascular-function-in-healthy-subjects
#11
Germana P L Almeida, Ivani C Trombetta, Felipe X Cepeda, Elaine Hatanaka, Rui Curi, Cristiano Mostarda, Maria C Irigoyen, José A S Barreto-Filho, Eduardo M Krieger, Fernanda M Consolim-Colombo
Introduction: Recurrent hypoxia (HPX), a hallmark of the obstructive sleep apnea (OSA), impairs autonomic balance, and increases arterial blood pressure (BP). Oxidative stress is one of the mechanisms involved in these alterations. The cumulative effect of acute intermittent HPX and the chronicity may determine whether the response crosses the threshold from having protective value to pathology. However, the impact of acute intermittent HPX-reoxygenation on markers of oxidative stress in healthy individuals remains to be fully understood...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/27596614/accelerated-echo-planer-j-resolved-spectroscopic-imaging-of-putamen-and-thalamus-in-obstructive-sleep-apnea
#12
Manoj K Sarma, Paul M Macey, Rajakumar Nagarajan, Ravi Aysola, Ronald M Harper, M Albert Thomas
UNLABELLED: Obstructive sleep apnea syndrome (OSAS) leads to neurocognitive and autonomic deficits that are partially mediated by thalamic and putamen pathology. We examined the underlying neurochemistry of those structures using compressed sensing-based 4D echo-planar J-resolved spectroscopic imaging (JRESI), and quantified values with prior knowledge fitting. Bilaterally increased thalamic mI/Cr, putamen Glx/Cr, and Glu/Cr, and bilaterally decreased thalamic and putamen tCho/Cr and GABA/Cr occurred in OSAS vs healthy subjects (p < 0...
September 6, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27397854/sleep-sleep-deprivation-autonomic-nervous-system-and-cardiovascular-diseases
#13
REVIEW
Eleonora Tobaldini, Giorgio Costantino, Monica Solbiati, Chiara Cogliati, Tomas Kara, Lino Nobili, Nicola Montano
Sleep deprivation (SD) has become a relevant health problem in modern societies. We can be sleep deprived due to lifestyle habits or due to sleep disorders, such as insomnia, obstructive sleep apnea (OSA) and neurological disorders. One of the common element of sleep disorders is the condition of chronic SD, which has complex biological consequences. SD is capable of inducing different biological effects, such as neural autonomic control changes, increased oxidative stress, altered inflammatory and coagulatory responses and accelerated atherosclerosis...
March 2017: Neuroscience and Biobehavioral Reviews
https://www.readbyqxmd.com/read/27166298/positive-airway-pressure-induced-conversion-of-atrial-fibrillation-to-normal-sinus-rhythm-in-severe-obstructive-sleep-apnea
#14
Harneet K Walia, Mina K Chung, Sally Ibrahim, Reena Mehra
Accumulating data implicate obstructive sleep apnea (OSA) as a predisposing factor to the development of atrial fibrillation (AF), the latter representing the most common sustained cardiac arrhythmia. The postulated mechanisms leading to atrial arrhythmogenesis in OSA include alterations in intrathoracic pressures, intermittent hypoxemia, and autonomic nervous system fluctuations. Although these OSA-related pathophysiologic pathways may result in atrial structural and electrical remodeling, thereby predisposing to AF, there are data to suggest that the immediate influences of respiratory events may trigger arrhythmic events...
September 15, 2016: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/27099802/disrupted-functional-brain-network-organization-in-patients-with-obstructive-sleep-apnea
#15
Bumhee Park, Jose A Palomares, Mary A Woo, Daniel W Kang, Paul M Macey, Frisca L Yan-Go, Ronald M Harper, Rajesh Kumar
INTRODUCTION: Obstructive sleep apnea (OSA) subjects show impaired autonomic, affective, executive, sensorimotor, and cognitive functions. Brain injury in OSA subjects appears in multiple sites regulating these functions, but the integrity of functional networks within the regulatory sites remains unclear. Our aim was to examine the functional interactions and the complex network organization of these interactions across the whole brain in OSA, using regional functional connectivity (FC) and brain network topological properties...
March 2016: Brain and Behavior
https://www.readbyqxmd.com/read/26943471/aberrant-insular-functional-network-integrity-in-patients-with-obstructive-sleep-apnea
#16
Bumhee Park, Jose A Palomares, Mary A Woo, Daniel W Kang, Paul M Macey, Frisca L Yan-Go, Ronald M Harper, Rajesh Kumar
STUDY OBJECTIVES: Obstructive sleep apnea (OSA) is accompanied by tissue injury to the insular cortices, areas that regulate autonomic pain, dyspnea, and mood, all of which are affected in the syndrome. Presumably, the dysregulation of insular-related functions are mediated by aberrant functional connections with other brain regions; however, the integrity of the functional connectivity (FC) to other sites is undescribed. Our aim was to examine resting-state FC of the insular cortices to other brain areas in OSA, relative to control subjects...
May 1, 2016: Sleep
https://www.readbyqxmd.com/read/26904265/the-sympathetic-nervous-system-and-catecholamines-metabolism-in-obstructive-sleep-apnoea
#17
REVIEW
Valeria Bisogni, Martino F Pengo, Giuseppe Maiolino, Gian Paolo Rossi
Obstructive sleep apnoea (OSA) is the most common sleep disorder of breathing in middle-aged and overweight subjects. It features recurrent episodes of upper airway total (apnoea) o partial (hypopnea) collapse during sleep, which are associated with a reduction in blood oxygen saturation and with arousal from sleep to re-establish airway patency. An association of OSA with dysregulation of the autonomous nervous system (ANS) and altered catecholamines (CAs) metabolism has been contended for years. However, the pathophysiology mechanisms underlying these alterations remain to be fully clarified...
February 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/26843332/obstructive-sleep-apnea-is-associated-with-low-gaba-and-high-glutamate-in-the-insular-cortex
#18
Paul M Macey, Manoj K Sarma, Rajakumar Nagarajan, Ravi Aysola, Jerome M Siegel, Ronald M Harper, M Albert Thomas
The insular cortex is injured in obstructive sleep apnea (OSA) and responds inappropriately to autonomic challenges, suggesting neural reorganization. The objective of this study was to assess whether the neural changes might result from γ-aminobutyric acid (GABA) and glutamate alterations. We studied 14 OSA patients [mean age ± standard deviation (SD): 47.5 ± 10.5 years; nine male; apnea-hypopnea index (AHI): 29.5 ± 15.6 events h(-1) ] and 22 healthy participants (47.5 ± 10.1 years; 11 male), using magnetic resonance spectroscopy to detect GABA and glutamate levels in insular cortices...
August 2016: Journal of Sleep Research
https://www.readbyqxmd.com/read/26621402/near-infrared-spectroscopy-investigations-in-neurovascular-diseases
#19
Henrik Winther Schytz
The purpose of this thesis was to explore and develop methods, where continuous wave near infrared spectroscopy (CW-NIRS) can be applied in different neurovascular diseases, in order to find biological markers that are useful in clinical neurology. To develop a new method to detect changes in cerebral blood flow (CBF), the first study investigated a multi-source detector separation configuration and indocyanine green (ICG) as a tracer to calculate a corrected blood flow index (BFI) value. The study showed no correlation between CBF changes measured by 133Xenon single photon emission computer tomography (133Xe-SPECT) and the corrected BFI value...
December 2015: Danish Medical Journal
https://www.readbyqxmd.com/read/26429743/pupillometric-findings-in-children-with-obstructive-sleep-apnea
#20
Mona F Philby, Secil Aydinoz, David Gozal, Selim Kilic, Rakesh Bhattacharjee, Hari P Bandla, Leila Kheirandish-Gozal
BACKGROUND: Obstructive sleep apnea (OSA) leads to intermittent hypoxia, activation of the sympathetic nervous system, and eventually cardiovascular morbidity. Alterations in autonomic nervous system (ANS) tone and reflexes are likely to play major roles in OSA-associated morbidities, and have been identified in a subset of children with OSA. OBJECTIVES: To evaluate whether pupillometry, a noninvasive and rapid bedside test for the assessment of autonomic nervous system dysfunction (ANS), would detect abnormal ANS function in children with OSA...
October 2015: Sleep Medicine
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