Sleep apnea and hypertension: Pathophysiologic mechanisms

2002 ◽  
Vol 22 (1) ◽  
pp. 71-77 ◽  
Author(s):  
Allen Richert ◽  
Kahlil Ansarin ◽  
Alp Sinan Baran
Keyword(s):  
Sleep Apnea ◽  
Pathophysiologic Mechanisms

Neurobiology of Obstructive Sleep Apnea

2021 ◽  
Author(s):  
Steven Holfinger ◽  
M. Melanie Lyons ◽  
Nitin Bhatt ◽  
Ulysses Magalang
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Current Treatment ◽  
Treatment Modalities ◽  
Sleep Stages ◽  
Critical Importance ◽  
Obstructive Sleep ◽  
The Impact ◽  
Underlying Risk ◽  
Pathophysiologic Mechanisms

Obstructive sleep apnea is recognized as a heterogeneous disease presenting with varying underlying risk factors, phenotypes, and responses to therapy. This clinical variance is in part due to the complex pathophysiology of sleep apnea. While multiple anatomical issues can predispose to the development of sleep apnea, factors that control the airway musculature also contribute via different pathophysiologic mechanisms. As sleep apnea does not occur during wakefulness, the impact of sleep stages on respiration is of critical importance. Altogether, understanding sleep apnea pathophysiology helps to guide current treatment modalities and helps identify potential targets for future therapies.

The microbiome in obstructive sleep apnea

SLEEP ◽  
2021 ◽  
Author(s):  
Yi Cai ◽  
Hailey M Juszczak ◽  
Emily K Cope ◽  
Andrew N Goldberg
Keyword(s):  
Animal Model ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Intermittent Hypoxia ◽  
Microbiota Composition ◽  
Disease States ◽  
Obstructive Sleep ◽  
Bidirectional Relationship ◽  
Model Evidence ◽  
Pathophysiologic Mechanisms

Abstract Recent evidence has highlighted important associations between obstructive sleep apnea and the microbiome. Although the intricacies of the pathophysiologic mechanisms are not well understood, available evidence suggests a bidirectional relationship between obstructive sleep apnea and microbiota composition. Sleep fragmentation, intermittent hypoxia, and intermittent hypercapnia all play significant roles in altering the microbiome, and initial evidence has shown that alterations of the microbiota affect sleep patterns. Animal model evidence strongly supports the idea that the microbiome mediates disease states associated with obstructive sleep apnea including hypertension, atherosclerosis, and obesity. While evidence is limited, several studies suggest there may be a role for treatment of obstructive sleep apnea and obstructive sleep apnea-related comorbidities through alteration of the microbiome with probiotics, prebiotics, and microbiota transplantation.

scholarly journals Obstructive Sleep Apnea Syndrome: The Effect of Acute and Chronic Responses of Exercise

2021 ◽  
Vol 8 ◽  
Author(s):  
Vasileios T. Stavrou ◽  
Kyriaki Astara ◽  
Konstantinos N. Tourlakopoulos ◽  
Eirini Papayianni ◽  
Stylianos Boutlas ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Exercise Program ◽  
Obstructive Sleep ◽  
High Prevalence ◽  
Apnea Syndrome ◽  
Pathophysiologic Mechanisms

Obstructive Sleep Apnea Syndrome (OSAS) is a sleep disorder with high prevalence in general population, but alarmingly low in clinicians' differential diagnosis. We reviewed the literature on PubMed and Scopus from June 1980–2021 in order to describe the altered systematic pathophysiologic mechanisms in OSAS patients as well as to propose an exercise program for these patients. Exercise prevents a dysregulation of both daytime and nighttime cardiovascular autonomic function, reduces body weight, halts the onset and progress of insulin resistance, while it ameliorates excessive daytime sleepiness, cognitive decline, and mood disturbances, contributing to an overall greater sleep quality and quality of life.

scholarly journals The Associations of Obstructive Sleep Apnea and Eye Disorders: Potential Insights into Pathogenesis and Treatment

2021 ◽  
Author(s):  
Jeeyun Ahn ◽  
Michael B. Gorin
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
The Body ◽  
Current Evidence ◽  
Ocular Diseases ◽  
Therapeutic Approaches ◽  
Obstructive Sleep ◽  
The Common ◽  
Osa Treatment ◽  
Pathophysiologic Mechanisms

Abstract Purpose of Review Obstructive sleep apnea (OSA) patients are at significantly increased risks for cardiovascular and cerebrovascular morbidities. Recently, there has been heightened interest in the association of OSA with numerous ocular diseases and possible improvement of these conditions with the initiation of OSA treatment. We reviewed the current evidence with an emphasis on the overlapping pathogeneses of both diseases. Recent Findings Currently available literature points to a substantial association of OSA with ocular diseases, ranging from those involving the eyelid to optic neuropathies and retinal vascular diseases. Since the retina is one of the highest oxygen-consuming tissues in the body, the intermittent hypoxia and hypercapnia ensuing in OSA can have deleterious effects on ocular function and health. Tissue hypoxia, autonomic dysfunction, microvascular dysfunction, and inflammation all play important roles in the pathogenesis of both OSA and ocular diseases. Whether OSA treatment is capable of reversing the course of associated ocular diseases remains to be determined. It is anticipated that future therapeutic approaches will target the common underlying pathophysiologic mechanisms and promote favorable effects on the treatment of known associated ocular diseases. Summary Emerging evidence supports the association of ocular diseases with untreated OSA. Future studies focusing on whether therapeutic approaches targeting the common pathophysiologic mechanisms will be beneficial for the course of both diseases are warranted.

scholarly journals Obstructive Sleep Apnea and Asthma: More Than Chance?

2021 ◽  
Author(s):  
Donna L. Pepito ◽  
Jamal M. Mohammed ◽  
Kimberly A. Hardin
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Severe Asthma ◽  
Positive Airway Pressure ◽  
Current Evidence ◽  
Esophageal Reflux ◽  
Cellular Processes ◽  
Obstructive Sleep ◽  
Pathophysiologic Mechanisms ◽  
New Onset

Abstract Purpose of Review To discuss the current evidence regarding the association and mechanistic interaction between asthma and obstructive sleep apnea (OSA). Recent Findings The co-existence of OSA is highly prevalent in asthmatics and significantly associated with increased severity, decreased control, more frequent exacerbations, and hospitalizations despite medical management. Pre-existing asthma may also be a risk factor for new onset OSA. Rhinitis, obesity, and gastro-esophageal reflux are risk factors in both conditions. The obese asthmatic with OSA may present a unique phenotype. Positive airway pressure in severe asthma improves outcomes. Summary Pathophysiologic mechanisms and co-morbidities overlap between OSA and asthma, but the exact link has yet to be confirmed. Screening for OSA is recommended in those with severe asthma. Further investigations are needed to delineate the cellular processes with therapeutic targets. Similarly, prospective investigations are needed to evaluate the longitudinal relationship in pre-existing asthma and the development of OSA.

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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