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OSAS treatment

Maurits Boon, Colin Huntley, Armin Steffen, Joachim T Maurer, J Ulrich Sommer, Richard Schwab, Erica Thaler, Ryan Soose, Courtney Chou, Patrick Strollo, Eric J Kezirian, Stanley Chia, Kirk Withrow, Mark Weidenbecher, Kingman Strohl, Karl Doghramji, Benedikt Hofauer, Clemens Heiser
Objective Upper airway stimulation (UAS) is an alternative treatment option for patients unable to tolerate continuous positive airway pressure (CPAP) for the treatment of obstructive sleep apnea (OSA). Studies support the safety and efficacy of this therapy. The aim of this registry is to collect retrospective and prospective objective and subjective outcome measures across multiple institutions in the United States and Germany. To date, it represents the largest cohort of patients studied with this therapy...
March 1, 2018: Otolaryngology—Head and Neck Surgery
Ruifang Dong, Zhiling Dong, Hongmei Liu, Fangkun Shi, Junfeng Du
BACKGROUND: Obstructive sleep apnea (OSA) is known to increase the risk of cerebrovascular disease (CVD), and patients with CVD have high incidence of OSA. The study aimed to systematically evaluate the prevalence of OSA in patients with CVD. MATERIALS AND METHODS: Medline, Embase, Science Citation Index, Wanfang, CNKI, and Wiley Online Library were thoroughly searched to identify relevant studies. Random-effects models were used to calculate the pooled rate estimates...
March 16, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Charlene E Gamaldo, Alyssa A Gamaldo, Laurence T Hou, Aadi Kalloo, Daniel Hexter, Brian Salter, Molly Price, Maya Carter, Rachel Marie E Salas
OBJECTIVE: To investigate the feasibility and utility of a private community neurology practice-initiated home sleep apnea testing (HSAT) program. METHODS: A private community neurology practice conducted HSAT on patients clinically identified as high risk for obstructive sleep apnea (OSA). An academic board-certified sleep specialist performed all study interpretations. The presence and severity of OSA and its association with patient demographics (eg, sex, age) and comorbid health conditions relevant to OSA were evaluated...
April 2018: Sleep Health
Süheyl Haytoğlu, Osman Kürşat Arikan, Nuray Bayar Muluk, Birgül Tuhanioğlu, Mustafa Çörtük
We prospectively compared the efficacy of anterior palatoplasty and the uvulopalatal flap procedure for the treatment of patients with mild and moderate obstructive sleep apnea syndrome (OSAS). Our study group was made up of 45 patients who had been randomly assigned to undergo one of the two procedures. Palatoplasty was performed on 22 patients-12 men and 10 women, aged 28 to 49 years (mean: 39.2)-and the flap procedure was performed on 23 patients-14 men and 9 women, aged 28 to 56 years (mean: 41.3). Our primary outcomes measure was the difference in pre- and postoperative apnea-hypopnea index (AHI) as determined by polysomnography at 6 months after surgery...
March 2018: Ear, Nose, & Throat Journal
Fu-Chao Yu, Chu-Xiao Yuan, Jia-Yi Tong, Guang-Hao Zhang, Fang-Ping Zhou, Fang Yang
Intermittent hypoxia (IH) induced by obstructive sleep apnea (OSA) is the key factor in oxidative stress and the concomitant inflammation of endothelial cells (ECs). In recent years, the lipid sphingosine-1-phosphate (S1P) has been reported to probably play a central role in inflammatory diseases. However, its role in IH-induced endothelial injury remains uncertain. In this study, we investigated the IH-induced ECs inflammation and apoptosis, as well as the role of S1P in both. First, human umbilical vein endothelial cells (HUVECs) were treated with IH to explore the mechanism of S1P and S1P microbubbles (S1P-MBs) in HUVECs with altered function...
March 16, 2018: Biochemical and Biophysical Research Communications
J O Frimpong, E S K Ofori, S Yeboah, D Marri, B K Offei, F Apaatah, J O Sintim, E Ofori-Ayeh, M Osae
This study evaluated three herbicides active ingredients: Paraquat, Glyphosate and 2,4-D Amine in commercial formulations as Frankoquat, Roundup and Agriherb respectively under field conditions to determine their influence on soil dwelling macrobes and the physical state of soil. Herbicides were serially diluted to three treatment concentrations for each plus three controls. Herbicide concentrations were applied to the demarcated field on three consecutive occasions in splits. Macrobes extraction from soil was done under a stereo microscope at 20 × magnification...
March 15, 2018: Ecotoxicology and Environmental Safety
Ayako Fukui, Meiho Nakayama, Naoko Sakamoto, Sachie Arima, Shintaro Sato, Motohiko Suzuki, Shingo Murakami
OBJECTIVE: This was a first cross-sectional single-center study to research the relation between globus pharyngeus, OSA and GERD. Since previous clinical studies have demonstrated a relationship between globus phayrngeus and GERD, however, no reported study on the relation between globus pharyngeus, sleep disorders including OSA, and GERD. METHODS: Seventeen patients underwent general and otorhinolaryngological examinations and responded to several questionnaires (ESS, PSQI, HADS, and Globus pharyngeus VAS score) at their first visit, and underwent a gastroesophageal test for 24-h pH monitoring and in-laboratory PSG one to two months later...
March 12, 2018: Auris, Nasus, Larynx
Dominik Linz, R Doug McEvoy, Martin R Cowie, Virend K Somers, Stanley Nattel, Patrick Lévy, Jonathan M Kalman, Prashanthan Sanders
Importance: Obstructive sleep apnea (OSA) is the most common clinically significant breathing abnormality during sleep. It is highly prevalent among patients with atrial fibrillation (AF), and it promotes arrhythmogenesis and impairs treatment efficacy. Observations: The prevalence of OSA ranges from 3% to 49% in population-based studies and from 21% to 74% in patients with AF. Diagnosis and treatment of OSA in patients with AF requires a close interdisciplinary collaboration between electrophysiologists, cardiologists, and sleep specialists...
March 14, 2018: JAMA Cardiology
Janki Shah, Jonathon O Russell, Tina Waters, Alan H Kominsky, Douglas Trask
OBJECTIVES: Hypoglossal nerve stimulation (HNS) therapy is an emerging surgical treatment for select patients with obstructive sleep apnea (OSA). This study aims to compare outcomes in patients with moderate to severe OSA who underwent HNS surgery (Inspire Medical Systems) and those who underwent traditional airway reconstructive surgery, specifically uvulopalatopharyngoplasty (UPPP). METHODS: Patients who underwent HNS implantation (n = 20), all with moderate to severe OSA, inability to adhere to positive pressure therapy, and compliant with previously published inclusion criteria, were compared to a historical cohort that were intolerant of CPAP with similar inclusion criteria who all underwent UPPP (n = 20) with some also undergoing additional procedures such as septoplasty/turbinate reduction...
March 2, 2018: American Journal of Otolaryngology
Clara Gregori-Pla, Gianluca Cotta, Igor Blanco, Peyman Zirak, Martina Giovannella, Anna Mola, Ana Fortuna, Turgut Durduran, Mercedes Mayos
MOTIVATION: Obstructive sleep apnea (OSA) can impair cerebral vasoreactivity and is associated with an increased risk of cerebrovascular disease. Unfortunately, an easy-to-use, non-invasive, portable monitor of cerebral vasoreactivity does not exist. Therefore, we have evaluated the use of near-infrared diffuse correlation spectroscopy to measure the microvascular cerebral blood flow (CBF) response to a mild head-of-bed position change as a biomarker for the evaluation of cerebral vasoreactivity alteration due to chronic OSA...
2018: PloS One
Glaucia Carneiro, Maria T Zanella
OBJECTIVE: To analyze metabolic and hormonal disorders resulting from the association between obesity and obstructive sleep apnea (OSA) syndrome that predispose to cardiovascular diseases and investigate the clinical benefits obtained from treatment approaches for both conditions. METHODS: A literature review between 1997 and 2017 was conducted in the PubMed search database. RESULTS: Obesity is the most important risk factor for OSA, and the progressive increase in its prevalence also affects OSA incidence...
March 10, 2018: Metabolism: Clinical and Experimental
P E Vonk, A M E H Beelen, N de Vries
PURPOSE: To evaluate the effect of different passive maneuvers on upper airway patency during drug-induced sleep endoscopy (DISE) compared to recent literature on treatment outcomes of positional therapy (PT), oral appliance therapy (OAT), and combined treatment in obstructive sleep apnea (OSA) patients. METHODS: A retrospective, single-center cohort study including a consecutive series of 200 OSA patients. All patients underwent DISE with and without manually performed jaw thrust and lateral head rotation by using the VOTE classification...
March 9, 2018: Sleep & Breathing, Schlaf & Atmung
You-Ning Gao, Yun-Chun Wu, Shih-Ying Lin, Jenny Zwei-Chieng Chang, Yu-Kang Tu
Many treatments have been proposed for adult obstructive sleep apnea (OSA), but no comprehensive comparison of all interventions has been performed. We aimed to compare and rank the effectiveness of all minimally invasive treatments for adult OSA in a systematic review and network meta-analysis. Literature was searched within Ovid MedLine, EMBASE Classic+Embase, Cochrane library, and Cochrane Database of Systematic Reviews from inception to Aug 9th, 2016 for randomized controlled trials comparing minimally invasive treatments for adult OSA...
March 6, 2018: Journal of the Formosan Medical Association, Taiwan Yi Zhi
Sylvan S Mintz, Reka Kovacs
PURPOSE: In 2005, the American Academy of Sleep Medicine stated, "Oral appliances are indicated for use in patients with mild to moderate obstructive sleep apnea (OSA) who prefer them to CPAP therapy, or who do not respond to, are not appropriate candidates for, or who fail treatment attempts with CPAP." However, this recommendation is based upon variable results from only six studies with more than 100 participants. These studies have assessed the effectiveness of mandibular advancement devices (MADs) in specific groups (military populations, academic institutions, or hospital settings) with no large study conducted in a fee-for-service private practice where the majority of patients receive MADs for OSA...
March 8, 2018: Sleep & Breathing, Schlaf & Atmung
Davoud Eskandari, Ding Zou, Ludger Grote, Erik Hoff, Jan Hedner
STUDY OBJECTIVES: The carbonic anhydrase inhibitor acetazolamide (AZT) modulates blood pressure at high altitude and reduces sleep-disordered breathing in patients with obstructive sleep apnea (OSA). We aimed to investigate the treatment effect of AZT and in combination with continuous positive airway pressure (CPAP) on blood pressure in patients with hypertension and OSA. METHODS: In a prospective, randomized, three-way crossover study, 13 male patients with hypertension and moderate to severe OSA (age 64 ± 7 years, body mass index 29 ± 4 kg/m2, and mean apnea-hypopnea index 37 ± 23 events/h) received AZT, CPAP, or AZT plus CPAP for 2-week periods...
February 27, 2018: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Vaishnavi Kundel, Maria Giovanna Trivieri, Nicolas A Karakatsanis, Phillip M Robson, Venkatesh Mani, Jorge R Kizer, Robert Kaplan, Zahi Fayad, Neomi Shah
PURPOSE: Evidence suggests that the inflammatory state of an atherosclerotic plaque is important in predicting future risk of plaque rupture. This study aims to investigate the feasibility of measuring plaque inflammation in patients with obstructive sleep apnea (OSA) utilizing advanced vascular imaging - hybrid positron-emission tomography/magnetic resonance imaging (PET/MRI) with fluorodeoxyglucose (FDG) tracer-before and after continuous positive airway pressure (CPAP). METHODS: Patients with newly diagnosed moderate to severe OSA underwent baseline PET/MRI for assessment of vascular inflammation of the carotid arteries and thoracic aorta prior to initiation of CPAP...
March 5, 2018: Sleep & Breathing, Schlaf & Atmung
Piyush Das, Rahul Kashyap, Suresh Kotagal
Treatment options may be limited for infants with obstructive sleep apnea when there is no surgically correctable upper airway lesion. We therefore evaluated, retrospectively, the efficacy of low-flow oxygen as a therapeutic option for infant obstructive sleep apnea. We reviewed the medical charts of 23 infants who had undergone a therapeutic trial of low-flow oxygen during polysomnography. Split-night polysomnography was used in 21/23 subjects while 2/23 had undergone two separate, full-night polysomnography sleep architecture and respiratory findings on the baseline polysomnogram segment that was obtained in room air were compared with the segment on low-flow oxygen (0...
March 2, 2018: Children
G W Kershaw, K Dissanayake, V M Chen, T-L Khoo
INTRODUCTION: Chromogenic substrate assays (CSA) to measure Factor IX (FIX) have recently become commercially available. However, information on their performance characteristics and use in diagnostic haemostasis laboratories remains limited. AIM: To evaluate the Hyphen Biomed (Hyphen) and Rossix FIX CSAs on fully automated coagulation analysers and compare them to the FIX one-stage assay (OSA). This study was conducted in a tertiary referral haemostasis laboratory associated with a haemophilia treatment centre...
February 28, 2018: Haemophilia: the Official Journal of the World Federation of Hemophilia
Francesco Baratta, Daniele Pastori, Tommaso Bucci, Mario Fabiani, Valerio Fabiani, Marco Brunori, Lorenzo Loffredo, Rossella Lillo, Gaetano Pannitteri, Francesco Angelico, Maria Del Ben
BACKGROUND: Continuous positive airway pressure (CPAP) therapy is a highly effective treatment for obstructive sleep apnea syndrome (OSAS). However, poor adherence is a limiting factor, and a significant proportion of patients are unable to tolerate CPAP. The aim of this study was to determine predictors of long-term non-compliance with CPAP. METHODS: CPAP treatment was prescribed to all consecutive patients with moderate or severe OSAS (AHI ≥15 events/h) (n = 295) who underwent a full-night CPAP titration study at home between February 1, 2002 and December 1, 2016...
March 2018: Sleep Medicine
Seo Yun Jo, Sung Min Lee, Kang Hyun Lee, Dong-Kyu Kim
PURPOSE: Oral appliance therapy is an alternative treatment modality for obstructive sleep apnea (OSA). However, there have been no studies to determine whether changes in the obstructive pattern occur following long-term use of oral devices. Therefore, we examined whether the obstructive pattern changes in patients with OSA who undergo long-term oral appliance therapy using drug-induced sleep endoscopy (DISE). METHODS: We investigated 156 consecutive patients diagnosed with OSA...
February 26, 2018: European Archives of Oto-rhino-laryngology
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