Obstructive sleep apnea in patients with neuromuscular disorders

2014 ◽  
pp. 310-316
Author(s):  
Fauziya Hassan
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Neuromuscular Disorders ◽  
Obstructive Sleep

Fatigability

2015 ◽  
Author(s):  
Aziz Shaibani
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Chronic Fatigue Syndrome ◽  
Myasthenia Gravis ◽  
Neuromuscular Disorders ◽  
Chronic Fatigue ◽  
Extraocular Muscles ◽  
Sustained Contraction ◽  
Fatigue Syndrome ◽  
Obstructive Sleep

Undue fatigability is common in neuromuscular clinics but non-neuromuscular causes are much more common than neuromuscular causes. Generalized fatigue is commonly caused by anemia, hypothyroidism, obstructive sleep apnea, depression, chronic fatigue syndrome, uremia, COPD, etc. Physiological fatigue is accentuated by neuromuscular disorders. Most strikingly, myasthenia gravis causes undue fatigue of the ocular, chewing, swallowing, and breathing muscles. However, ALS, myopathies, and motor neuropathies are also associated with abnormal fatigue. Myasthenia rarely causes isolated fatigue. Examination for fatigability should be part of neuromuscular evaluation and is conducted by inducing repetitive or sustained contraction of the suspected muscles (typically extraocular muscles) for a minute and reevaluation after 2 minutes of rest of the tested muscles.

scholarly journals Sleep-related breathing disorders and non-invasive ventilation

2015 ◽  
Vol 9 (2) ◽  
pp. 109
Author(s):  
Agata Lax ◽  
Simona Colamartino ◽  
Paolo Banfi ◽  
Antonello Nicolini
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Neuromuscular Disorders ◽  
Invasive Mechanical Ventilation ◽  
Patient Acceptance ◽  
Invasive Ventilation ◽  
Respiratory Impairment ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Obstructive Sleep

Non-invasive mechanical ventilation (NPPV) was originally used in patients with acute respiratory impairment or exacerbations of chronic respiratory diseases, as an alternative to the endotracheal tube. Over the last thirty years NPPV has been also used at night in patients with stable chronic lung disease such as obstructive sleep apnea, the overlap syndrome (chronic obstructive pulmonary disease and obstructive sleep apnea), neuromuscular disorders, obesity-hypoventilation syndrome, and in other conditions such as sleep disorders associated with congestive heart failure (Cheyne-Stokes respiration). In this no-systematic review we discuss the different types of NPPV, the specific conditions in which they can be used and the indications, recommendations and evidence supporting the efficacy of NPPV. Optimizing patient acceptance and adherence to non-invasive ventilation treatment is challenging. The treatment of sleep-related disorders is a life-threatening condition. The optimal level of treatment should be determined in a sleep laboratory. Side effects directly affecting the patient’s adherence to treatment are known. The most common are nasopharyngeal symptoms including increased congestion and rhinorrhea; these effects are related to reduced humidity of inspired gas. Humidification of delivered gas may improve these symptoms.

scholarly journals Application of Dual Mask for Postoperative Respiratory Support in Obstructive Sleep Apnea Patient

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Jahan Porhomayon ◽  
Gino Zadeii ◽  
Nader D. Nader ◽  
George R. Bancroft ◽  
Alireza Yarahamadi
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Neuromuscular Disorders ◽  
Central Sleep Apnea ◽  
Obstructive Sleep Apnea Patient ◽  
Chronic Obstructive ◽  
Bilevel Positive Airway Pressure ◽  
Obstructive Sleep

In some conditions continuous positive airway pressure (CPAP) or bilevel positive airway pressure (BIPAP) therapy alone fails to provide satisfactory oxygenation. In these situations oxygen (O2) is often being added to CPAP/BIPAP mask or hose. Central sleep apnea and obstructive sleep apnea (OSA) are often present along with other chronic conditions, such as chronic obstructive pulmonary disease (COPD), congestive heart failure, pulmonary fibrosis, neuromuscular disorders, chronic narcotic use, or central hypoventilation syndrome. Any of these conditions may lead to the need for supplemental O2administration during the titration process. Maximization of comfort, by delivering O2directly via a nasal cannula through the mask, will provide better oxygenation and ultimately treat the patient with lower CPAP/BIPAP pressure.

Treating Velopharyngeal Inadequacy Using Bilateral Buccal Flap Revision Palatoplasty

2019 ◽  
Vol 4 (5) ◽  
pp. 878-892
Author(s):  
Joseph A. Napoli ◽  
Linda D. Vallino
Keyword(s):  
Systematic Review ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
A Priori ◽  
Sufficient Evidence ◽  
Obstructive Sleep ◽  
Before And After ◽  
Buccal Flap

Purpose The 2 most commonly used operations to treat velopharyngeal inadequacy (VPI) are superiorly based pharyngeal flap and sphincter pharyngoplasty, both of which may result in hyponasal speech and airway obstruction. The purpose of this article is to (a) describe the bilateral buccal flap revision palatoplasty (BBFRP) as an alternative technique to manage VPI while minimizing these risks and (b) conduct a systematic review of the evidence of BBFRP on speech and other clinical outcomes. A report comparing the speech of a child with hypernasality before and after BBFRP is presented. Method A review of databases was conducted for studies of buccal flaps to treat VPI. Using the principles of a systematic review, the articles were read, and data were abstracted for study characteristics that were developed a priori. With respect to the case report, speech and instrumental data from a child with repaired cleft lip and palate and hypernasal speech were collected and analyzed before and after surgery. Results Eight articles were included in the analysis. The results were positive, and the evidence is in favor of BBFRP in improving velopharyngeal function, while minimizing the risk of hyponasal speech and obstructive sleep apnea. Before surgery, the child's speech was characterized by moderate hypernasality, and after surgery, it was judged to be within normal limits. Conclusion Based on clinical experience and results from the systematic review, there is sufficient evidence that the buccal flap is effective in improving resonance and minimizing obstructive sleep apnea. We recommend BBFRP as another approach in selected patients to manage VPI. Supplemental Material https://doi.org/10.23641/asha.9919352

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