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Sleep apnea nasal obstruction

Samuel A Mickelson
Obstructive sleep apnea is a common condition, primarily caused by narrowing of the nasal and pharyngeal airway. Treatment with continuous positive airway pressure (CPAP) is considered the first line of therapy, but long-term compliance is only about 40%, often because of nasal obstruction. Any nasal obstruction can worsen CPAP compliance. Treatment of the nasal obstruction with topical nasal steroid sprays or nasal dilators has been shown to improve sleep disordered breathing. Surgical treatment of nasal obstruction, has been shown to improve sleep disordered breathing, as well as CPAP requirement and compliance with CPAP...
October 6, 2016: Otolaryngologic Clinics of North America
Fabiana Yagihara, Geraldo Lorenzi-Filho, Rogerio Santos-Silva
STUDY OBJECTIVES: The aim of this study was to evaluate the effects of nasal dilator strip (NDS) as a placebo intervention compared with continuous positive airway pressure (CPAP) treatment in patients with severe obstructive sleep apnea (OSA). METHODS: Patients were treated with both NDS and nasal CPAP. The sequence was randomized and interposed by 15 days of washout. Polysomnography was performed at baseline and on the first night of intervention with NDS and CPAP (titration)...
September 29, 2016: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Zhijun Li, Tingyu Tang, Wenjuan Wu, Liang Gu, Jianzong Du, Tian Zhao, Xiaoxi Zhou, Haiyan Wu, Guangyue Qin
PURPOSE: This study aimed to test the hypothesis that erectile dysfunction (ED) is common in men with obstructive sleep apnea (OSA). We also assessed the efficacy of continuous positive airway pressure (CPAP) treatment for ED and sex hormone levels in patients with severe OSA and ED. METHODS: A total of 153 OSA patients and 60 healthy controls were enrolled in this study. The International Index of Erectile Dysfunction-5 (IIEF-5) score was obtained, and blood samples were collected for analysis of sex hormones after polysomnography...
October 2016: Respiratory Medicine
Murat Can, Fırat Uygur, Hakan Tanrıverdi, Bilgehan Acıkgoz, Barıs Alper, Berrak Guven
Obstructive sleep apnea syndrome (OSAS) is a common sleep disorder characterized by repeated episodes of apnea and hypopnea during sleep. Continuous positive airway pressure (CPAP) is the most effective method for treating OSAS and alleviating the patients' symptoms. The aim of this study was to assess the effect of 3-month CPAP therapy on serum levels of IL-23 in patients with OSAS. Twenty-three patients with newly diagnosed moderate-to-severe OSAS who had not yet started nasal CPAP treatment were prospectively enrolled...
September 24, 2016: Immunologic Research
Alison Wimms, Sahisha Ketheeswaran, Claus Ziegenbein, Laura Jennings, Holger Woehrle
Aim. Continuous positive airway pressure (CPAP) masks are a key factor in patient compliance. This program assessed the performance of a new nasal pillows mask (NPM) on a variety of new and established obstructive sleep apnea (OSA) patients using CPAP therapy. Methods. Five programs were developed to assess the new NPM [AirFit P10, ResMed] on naïve patients; patients established on another NPM; patients using a nasal mask; patients with low CPAP compliance; and patients who wished to stop using CPAP therapy...
2016: Sleep Disorders
David F Smith, Ting Sa, Matthew Fenchel, Aliza P Cohen, Christine Heubi, Sally R Shott, Christine G Gourin, Stacey L Ishman
OBJECTIVES/HYPOTHESIS: We sought to characterize changes in the patterns of inpatient surgical sleep care over time and ascertain if these changes were consistent with previously reported trends in adult surgical sleep care. STUDY DESIGN: Repeated cross-sectional study. METHODS: Discharge data from the U.S. Nationwide Inpatient Sample for 125,691 nasal, palatal, or hypopharyngeal procedures in children for sleep-disordered breathing or obstructive sleep apnea (OSA) from 1993 to 2010 were analyzed using cross-tabulations and multivariate regression modeling...
September 19, 2016: Laryngoscope
Moussa Riachy, Samer Najem, Mirella Iskandar, Jad Choucair, Ihab Ibrahim, Georges Juvelikian
PURPOSE: Obstructive sleep apnea (OSA) is associated with a range of neurocognitive and cardiovascular complications, leading to a compromised quality of life. Continuous positive airway pressure (CPAP) is the gold standard therapeutic intervention for this disorder, yet patient compliance remains essential to its success. This study aimed at identifying the determinants of short-term and long-term CPAP adherence in a group of Lebanese patients. METHODS: This cross-sectional study, conducted at the Sleep Center of Hôtel-Dieu de France hospital in Lebanon, included patients diagnosed with OSA and treated with CPAP for at least one night between June 2008 and January 2015...
September 16, 2016: Sleep & Breathing, Schlaf & Atmung
İsa Yuvacı, Emine Pangal, Nurettin Bayram, Sevgi Arık Yüksel, Bedirhan Alabay, Alperen Ağadayı, Ender Sırakaya, Ahmet Gülhan
PURPOSE: Evaluation of the nerve fiber thicknesses of the macula, choroid, and retina using the apnea-hypopnea index in individuals with obstructive sleep apnea syndrome (OSAS) without systemic components. METHODS: Prospective, controlled study. The central macular, choroidal, and retinal nerve fiber layer (RNFL) thicknesses were evaluated using enhanced depth imaging-spectral domain optical coherence tomography in individuals with OSAS. In people with severe OSAS who had received treatment, posterior ocular structures were examined over 3 months (4th and 12th weeks), and changes were evaluated...
July 2016: Arquivos Brasileiros de Oftalmologia
Ulla Anttalainen, Mirja Tenhunen, Ville Rimpilä, Olli Polo, Esa Rauhala, Sari-Leena Himanen, Tarja Saaresranta
Obstructive sleep apnea syndrome (OSAS) is a well-recognized disorder conventionally diagnosed with an elevated apnea-hypopnea index. Prolonged partial upper airway obstruction is a common phenotype of sleep-disordered breathing (SDB), which however is still largely underreported. The major reasons for this are that cyclic breathing pattern coupled with arousals and arterial oxyhemoglobin saturation are easy to detect and considered more important than prolonged episodes of increased respiratory effort with increased levels of carbon dioxide in the absence of cycling breathing pattern and repetitive arousals...
2016: European Clinical Respiratory Journal
Rafaela Garcia Santos Andrade, Fernanda Madeiro, Pedro Rodrigues Genta, Geraldo Lorenzi-Filho
PURPOSE OF REVIEW: Continuous positive airway pressure (CPAP) delivered by nasal mask is the gold standard treatment for obstructive sleep apnea (OSA). However, oral and oronasal masks are also available. We considered experimental evidence and reviewed clinical trials that evaluated the impact of oral and oronasal mask on OSA treatment. RECENT FINDINGS: One recent study in 18 OSA patients that slept with a customized oronasal mask with two sealed compartments showed that the change of CPAP flow from nasal to oronasal and oral caused upper airway obstruction because of posterior displacement of the tongue demonstrated by nasoendoscopy...
November 2016: Current Opinion in Pulmonary Medicine
Guillermo Gutierrez, Jeffrey Williams, Ghadah A Alrehaili, Anna McLean, Ramin Pirouz, Richard Amdur, Vivek Jain, Jalil Ahari, Amandeep Bawa, Shawn Kimbro
Characterizing respiratory rate variability (RRV) in humans during sleep is challenging, since it requires the analysis of respiratory signals over a period of several hours. These signals are easily distorted by movement and volitional inputs. We applied the method of spectral analysis to the nasal pressure transducer signal in 38 adults with no obstructive sleep apnea, defined by an apnea-hypopnea index <5, who underwent all-night polysomnography (PSG). Our aim was to detect and quantitate RRV during the various sleep stages, including wakefulness...
September 2016: Physiological Reports
Vitaliano Nicola Quaranta, Pierluigi Carratù, Mario Francesco Damiani, Silvano Dragonieri, Alberto Capozzolo, Anna Cassano, Onofrio Resta
BACKGROUND/OBJECTIVE: Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease characterized by the progressive loss of central and peripheral motor neurons. Some studies have found discordant data in the presence of sleep apnea in ALS patients. An obstructive component also occurs with upper airways hypotonia and muscle weakness that may result in an excessive reduction of airway lumen, leading to obstructive sleep apnea (OSA). The aim of this study was to assess the role of obstructive apneic events at disease onset in the ALS prognosis...
September 6, 2016: Neuro-degenerative Diseases
M H S Moxness, V Bugten, W M Thorstensen, S Nordgård, G Bruskeland
BACKGROUND: The differences in nasal geometry and function between OSA patients and healthy individuals are not known. Our aim was to evaluate the differences in nasal geometry and function using acoustic rhinometry (AR) and peak nasal inspiratory flow (PNIF) between an OSA population and healthy controls. METHODOLOGY: The study was designed as a prospective case-control study. Ninety-three OSA patients and 92 controls were enrolled from 2010 to 2015. The minimal cross-sectional area (MCA) and the nasal cavity volume (NCV) in two parts of the nose (MCA0-3/NCV0-3 and MCA3-5...
September 4, 2016: Rhinology
Shelagh A Cofer, Becky Baas, Edythe Strand, Cara C Cockerill
OBJECTIVES/HYPOTHESIS: To evaluate the effectiveness, durability, and safety of a tissue filler (dextranomer and hyaluronic acid copolymer) when injected submucosally in the nasopharynx to treat velopharyngeal insufficiency (VPI) in pediatric patients. STUDY DESIGN: Retrospective case series. METHODS: Charts were reviewed for all patients treated with injectable filler at a tertiary children's center for VPI from April 2010 through September 2013...
September 1, 2016: Laryngoscope
Sameh Msaad, Rim Marrakchi, Malek Grati, Rahma Gargouri, Samy Kammoun, Kamel Jammoussi, Ilhem Yangui
BACKGROUND: Obstructive sleep apnea-hypopnea syndrome (OSAHS) is associated with cardiovascular morbidity and mortality, which can be improved by using continuous positive airway pressure (CPAP) therapy. However, the pathophysiological links between the two kinds of disease and the mechanism of the CPAP effect remain incompletely understood. We aimed to inquire into the myocardial involvement in this relationship. We suggested that serum brain natriuretic peptide (BNP) is sensitive enough to detect myocardial stress caused by OSAHS...
2016: Libyan Journal of Medicine
Laura Gainche, David J Berlowitz, Mariannick LeGuen, Warren R Ruehland, Fergal J O'Donoghue, John Trinder, Marnie Graco, Rachel Schembri, Danny J Eckert, Peter D Rochford, Amy S Jordan
STUDY OBJECTIVE: Obstructive sleep apnea (OSA) is common in individuals with tetraplegia and associated with adverse health outcomes. The causes of the high prevalence of OSA in this population are unknown, but it is important to understand as standard treatments are poorly tolerated in tetraplegia. Nasal congestion is common in tetraplegia, possibly because of unopposed parasympathetic activity. Further, nasal obstruction can induce OSA in healthy individuals. We therefore aimed to compare nasal resistance before and after topical administration of a sympathomimetic between 10 individuals with tetraplegia (T) and 9 able-bodied (AB) controls matched for OSA severity, gender, and age...
August 22, 2016: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Stefanie Aeschbacher, Matthias Bossard, Tobias Schoen, Delia Schmidlin, Christoph Muff, Anna Maseli, Jörg D Leuppi, David Miedinger, Nicole M Probst-Hensch, Arno Schmidt-Trucksäss, Martin Risch, Lorenz Risch, David Conen
Obstructive sleep apnea seems to have an important influence on the autonomic nervous system. In this study, we assessed the relations of sleep apnea-related parameters with 24-hour heart rate variability (HRV) in a large population of young and healthy adults. Participants aged 25 to 41 years with a body mass index <35 kg/m(2) and without known obstructive sleep apnea were included in a prospective population-based cohort study. HRV was assessed using 24-hour electrocardiographic monitoring. The SD of all normal RR intervals (SDNN) was used as the main HRV variable...
September 15, 2016: American Journal of Cardiology
Stuart G MacKay, Lyndon Chan
Surgery in adult obstructive sleep apnea (OSA) has undergone significant advancement in recent years and continues to evolve. It is a modality of treatment used in the context of failed device use, specifically, failed continuous positive airway pressure or mandibular advancement splint. In this context, the role of surgery is either as salvage therapy or to facilitate better tolerance of device use. Other treatments such as weight loss, adjuvant nasal therapy (medical ± prephase nasal surgery) and positional devices may be combined with airway surgery...
September 2016: Sleep Medicine Clinics
Medine Kara, Halil Erdoğan, Oğuz Güçlü, Hasan Sahin, Fevzi Sefa Dereköy
OBJECTIVE: To investigate the effect of nasal septum deviation, without obstructive sleep apnea, on sleep quality. METHODS: The present case-controlled study enrolled patients older than 16 years with nasal septum deviation who attended the Otorhinolaryngology Clinic between December 2013 and July 2014. The control group was selected from patients attending the clinic for another complaint. Sleep quality was evaluated via the Pittsburgh Sleep Quality Index, and differences between the groups were compared using the Mann-Whitney U test...
October 2016: Journal of Craniofacial Surgery
Chin-Man Wang, Hsueh-Yu Li, Li- Ang Lee, Wann-Yun Shieh, Shih-Wei Lin
The objectives of this study are to investigate swallowing and its coordination with respiration in patients with obstructive sleep apnea (OSA). This is a prospective cohort study conducted in a tertiary referred Medical Center. A non-invasive method of assessing swallowing was used to detect the oropharyngeal swallowing parameters and the coordination with respiration during swallowing. The system used to assess swallowing detected: (1) movement of the larynx using a force-sensing resistor; (2) submental muscle activity using surface electromyography; and (3) coordination with respiration by measuring nasal airflow...
August 12, 2016: Dysphagia
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