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Sleep Apnea Implications

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By Gabe Lediaz Dental hygienist
Jayasri Nanduri, Ying-Jie Peng, Guoxiang Yuan, Ganesh K Kumar, Nanduri R Prabhakar
Systemic hypertension is one of the most prevalent cardiovascular diseases. Sleep-disordered breathing (SDB) with recurrent apnea is a major risk factor for developing essential hypertension. Chronic intermittent hypoxia (CIH) is a hallmark manifestation of recurrent apnea. Rodent models patterned after the O2 profiles seen with SDB patients showed that CIH is the major stimulus for causing systemic hypertension. This article reviews the physiological and molecular basis of CIH-induced hypertension. Physiological studies have identified that augmented carotid body chemosensory reflex and the resulting increase in sympathetic nerve activity are major contributors to CIH-induced hypertension...
May 2015: Journal of Molecular Medicine: Official Organ of the "Gesellschaft Deutscher Naturforscher und Ärzte"
Stephanie A Kielb, Sonia Ancoli-Israel, George W Rebok, Adam P Spira
Obstructive sleep apnea-hypopnea syndrome (OSAS) is characterized by the presence of disordered breathing events that occur during sleep, as well as symptoms such as sleepiness and snoring. OSAS is associated with a number of adverse health consequences, and a growing literature focuses on its cognitive correlates. Although research in this field is mixed, multiple studies indicate that OSAS patients show impairment in attention, memory, and executive function. Continuous positive airway pressure (CPAP) is the most effective and widely used treatment of OSAS, and supplemental medications may supplement CPAP treatment to ameliorate associated symptoms...
September 2012: Neuromolecular Medicine
Sasan Moghimi, Aliasghar Ahmadraji, Hamed Sotoodeh, Khosro Sadeghniat, Maryam Maghsoudipour, Ghasem Fakhraie, Golshan Latifi, Nariman Nassiri, Joann A Giaconi
OBJECTIVE: To investigate the prevalence of glaucoma, visual field abnormalities, as well as changes in retinal nerve fiber layer in patients with obstructive sleep apnea syndrome (OSAS). METHODS: In this cross-sectional study, 51 patients with OSAS were included. Based on apnea hypopnea index (AHI), there were 26, 6 and 19 cases of severe (AHI⩾30), moderate (15⩽AHI<30), and mild (5⩽AHI<15) OSAS, respectively. The control group was matched for age, sex and body mass index...
January 2013: Sleep Medicine
Judette Louis, Dennis Auckley, Branko Miladinovic, Anna Shepherd, Patricia Mencin, Deepak Kumar, Brian Mercer, Susan Redline
OBJECTIVE: To investigate the associations between obstructive sleep apnea (OSA) and maternal and neonatal morbidities in a cohort of obese gravid women. METHODS: Participants were enrolled in a prospective observational study designed to screen for OSA and describe the possible risk factors for and outcomes of OSA among obese (body mass index [BMI, calculated as weight (kg)/[height (m)]2] 30 or higher) pregnant women. Women underwent an overnight sleep study using a portable home monitor...
November 2012: Obstetrics and Gynecology
Georgia Trakada, Paschalis Steiropoulos, Paul Zarogoulidis, Evangelia Nena, Nikolaos Papanas, Efstratios Maltezos, Demosthenes Bouros
PURPOSE: The purpose of this study was to investigate the role of a fatty meal before bedtime, on sleep characteristics and blood pressure in patients with obstructive sleep apnea (OSA). METHODS: Recently diagnosed, by full polysomnography (PSG), patients with OSA (n=19) were included. These underwent PSG for additional two consecutive nights. Two hours before the PSG examination, a ham and cheese sandwich of 360 kcal was served to all patients, at first night, while a fatty meal of 1,800 kcal was served before the second PSG examination...
March 2014: Sleep & Breathing, Schlaf & Atmung
Stephanie M Stahl, H Klar Yaggi, Stanley Taylor, Li Qin, Cristina S Ivan, Charles Austin, Jared Ferguson, Radu Radulescu, Lauren Tobias, Jason Sico, Carlos A Vaz Fragoso, Linda S Williams, Rachel Lampert, Edward J Miech, Marianne S Matthias, John Kapoor, Dawn M Bravata
BACKGROUND: The literature about the relationship between obstructive sleep apnea (OSA) and stroke location is conflicting with some studies finding an association and others demonstrating no relationship. Among acute ischemic stroke patients, we sought to examine the relationship between stroke location and the prevalence of OSA; OSA severity based on apnea-hypopnea index (AHI), arousal frequency, and measure of hypoxia; and number of central and obstructive respiratory events. METHODS: Data were obtained from patients who participated in a randomized controlled trial (NCT01446913) that evaluated the effectiveness of a strategy of diagnosing and treating OSA among patients with acute ischemic stroke and transient ischemic attack...
October 2015: Sleep Medicine
Ghanshyam Palamaner Subash Shantha, Anita Ashok Kumar, Lawrence J Cheskin, Samir Bipin Pancholy
OBJECTIVE/BACKGROUND: Via this systematic review and meta-analysis, we assessed the associatio between sleep-disordered breathing (SDB)/obstructive sleep apnea (OSA) and cancer incidence. METHOD: Medline, Embase, Cochrane Central, and electronic databases were searched for relevant studies in any language. Studies were included based on the following criteria: (1) those on patients with SDB/OSA, (2) those reporting cancer incidence rates specific to patients with SDB/OSA, and (3) those defining SDB/OSA using sleep-study-based objective measures...
October 2015: Sleep Medicine
Jin-Cherng Chen, Juen-Haur Hwang
INTRODUCTION: Obstructive sleep apnea (OSA) was associated with increased incidence of all cancers. We aimed to determine the risk for primary central nervous system (CNS) cancers in patients with sleep apnea syndrome. METHODS: A total of 23,055 incident cases of newly diagnosed sleep apnea syndrome (sleep apnea group) were identified between 2000 and 2003 in the medical claims database of Taiwan's National Health Institute (NHI) program and were matched by age and gender to patients without OSA (comparison group) in the same period...
July 2014: Sleep Medicine
Hsiu-Ling Chen, Cheng-Hsien Lu, Hsin-Ching Lin, Pei-Chin Chen, Kun-Hsien Chou, Wei-Ming Lin, Nai-Wen Tsai, Yu-Jih Su, Michael Friedman, Ching-Po Lin, Wei-Che Lin
STUDY OBJECTIVES: To evaluate white matter integrity in patients with obstructive sleep apnea (OSA) using diffusion tensor imaging (DTI) and to assess its relationship with systemic inflammation. DESIGN: Cross-sectional study. SETTING: One tertiary medical center research institute. PATIENTS OR PARTICIPANTS: Twenty patients with severe OSA (apnea-hypopnea index [AHI] > 30, 18 men and 2 women) and 14 healthy volunteers (AHI < 5, 11 men and 3 women)...
March 2015: Sleep
Weihong Pan, Abba J Kastin
Both obstructive sleep apnea (OSA) and Alzheimer's disease (AD) are increasing health concerns. The objective of this study is to review systematically the effects of OSA on the development of AD. The search was conducted in PubMed and Cochrane CENTRAL, and followed by a manual search of references of published studies. Cross-sectional, cohorts, and randomized clinical trials were reviewed. Besides clinical studies, we also discuss neuroimaging data, experimental animal evidence, and molecular mechanisms. Although a causal relationship between OSA and AD is not yet established, OSA induces neurodegenerative changes as a result of two major contributing processes: sleep fragmentation and intermittent hypoxia...
November 2014: Neuroscience and Biobehavioral Reviews
Dai Yumino, T Douglas Bradley
Cheyne-Stokes respiration with central sleep apnea (CSR-CSA) is a form of periodic breathing, commonly observed in patients with heart failure (HF), in which central apneas alternate with hyperpneas that have a waxing-waning pattern of tidal volume. Uniform criteria by which to diagnose a clinically significant degree of CSR-CSA have yet to be established. CSR-CSA is caused by respiratory control system instability characterized by a tendency to hyperventilate. Central apnea occurs when Pa(CO(2)) falls below the threshold for apnea during sleep due to ventilatory overshoot...
February 15, 2008: Proceedings of the American Thoracic Society
Robin Germany, Susan Joseph, Kristofer James, Andrew Kao
Central sleep apnea (CSA) occurs primarily in cardiovascular patients and is associated with high morbidity and mortality. The disorder often is unrecognized due to the overlap of symptoms with those of the underlying cardiac disease. CSA can be easily diagnosed with a sleep study. Following optimization of all co-morbidities, the therapeutic approach available currently focuses on mask-based therapies which suffer from poor patient adherence. A new therapy, the remedē® System, has been developed; it utilizes a transvenous, fully implantable system providing phrenic nerve stimulation intended to restore a more normal breathing pattern...
June 2014: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Ryan L Grayburn, Yaquta Kaka, W H Wilson Tang
Central sleep apnea (CSA) is a common and under-diagnosed condition commonly associated with Cheyne-Stokes respiration. It is particularly prevalent in the heart failure population affecting up to 40 % of all patients with heart failure. The pathophysiology associated with CSA is based on the underlying effects of hypoventilation and hyperventilation, with neurologic dysregulation of respiratory control as the primary defect. However, therapeutic options are limited because of the prevailing perception that CSA is a consequence, rather than cause of morbidity and mortality...
July 2014: Current Treatment Options in Cardiovascular Medicine
Matthias Held, Sebastian Meintz, Stefan Baron, Christine Roth, Heinrike Wilkens, Hans Joachim Schäfers, Berthold Jany
No abstract text is available yet for this article.
August 1, 2013: American Journal of Respiratory and Critical Care Medicine
Atul Malhotra, Robert L Owens
Central sleep apnea (CSA) describes a group of conditions in which cessations in air flow occur without respiratory effort. In contrast, obstructive sleep apnea patients have ongoing respiratory effort during respiratory events. However, considerable overlap exists in the pathogenesis and clinical presentation of obstructive sleep apnea and CSA. A good working knowledge of the mechanisms underlying CSA is important for optimal clinical care. In general, CSA can be classified into those with excessive drive (eg, Cheyne-Stokes breathing) versus those with inadequate drive (eg, sleep hypoventilation syndrome)...
September 2010: Respiratory Care
Reena Mehra, Daniel J Gottlieb
No abstract text is available yet for this article.
October 2015: Chest
Arturo Garcia-Touchard, Virend K Somers, Lyle J Olson, Sean M Caples
Congestive heart failure (HF), an exceedingly common and costly disease, is frequently seen in association with central sleep apnea (CSA), which often manifests as a periodic breathing rhythm referred to as Cheyne-Stokes respiration. CSA has historically been considered to be a marker of heart disease, since improvement in cardiac status is often associated with the attenuation of CSA. However, this mirroring of HF and CSA may suggest bidirectional importance to their relationship. In fact, observational data suggest that CSA, associated with repetitive oxyhemoglobin desaturations and surges in sympathetic neural activity, may be of pathophysiologic significance in HF outcomes...
June 2008: Chest
S Javaheri
Central apnea is caused by temporary failure in the pontomedullary pacemaker generating breathing rhythm, which results in the loss of ventilatory effort, and if it lasts 10 seconds or more it is defined as central apnea. This article reviews current knowledge on central sleep apnea.
June 2010: Clinics in Chest Medicine
R Nisha Aurora, Susmita Chowdhuri, Kannan Ramar, Sabin R Bista, Kenneth R Casey, Carin I Lamm, David A Kristo, Jorge M Mallea, James A Rowley, Rochelle S Zak, Sharon L Tracy
The International Classification of Sleep Disorders, Second Edition (ICSD-2) distinguishes 5 subtypes of central sleep apnea syndromes (CSAS) in adults. Review of the literature suggests that there are two basic mechanisms that trigger central respiratory events: (1) post-hyperventilation central apnea, which may be triggered by a variety of clinical conditions, and (2) central apnea secondary to hypoventilation, which has been described with opioid use. The preponderance of evidence on the treatment of CSAS supports the use of continuous positive airway pressure (CPAP)...
January 2012: Sleep
Shahrokh Javaheri, Mark G Goetting, Rami Khayat, Paul E Wylie, James L Goodwin, Sairam Parthasarathy
INTRODUCTION: This study was conducted to evaluate the therapeutic performance of a new auto Servo Ventilation device (Philips Respironics autoSV Advanced) for the treatment of complex central sleep apnea (CompSA). The features of autoSV Advanced include an automatic expiratory pressure (EPAP) adjustment, an advanced algorithm for distinguishing open versus obstructed airway apnea, a modified auto backup rate which is proportional to subject's baseline breathing rate, and a variable inspiratory support...
December 2011: Sleep
2015-11-21 09:22:23
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