scholarly journals Help, I Can’t Breathe!

2019 ◽  
pp. 642-653
Author(s):  
Ai Ping Chua ◽  
Loutfi S. Aboussouan
Keyword(s):  
Sleep Apnea ◽  
Sleep Apnea Syndrome ◽  
Central Sleep Apnea ◽  
Apnea Hypopnea Index ◽  
Central Apnea ◽  
Arousal Index ◽  
Cpap Titration ◽  
Obstructive Sleep ◽  
Apnea Syndrome ◽  
Complex Sleep Apnea

This chapter presents a case of treatment-emergent central sleep apnea (TECSA), which is also known as complex sleep apnea syndrome or continuous positive airway pressure (CPAP)–emergent central sleep apnea. In this disorder, central apnea events emerge in patients with obstructive sleep apnea (OSA) after initiation of CPAP treatment. This phenomenon has been identified in up to 20% of patients with OSA who undergo CPAP titration. Polysomnography in those with TECSA usually shows an elevated residual Apnea–Hypopnea Index and arousal index after PAP initiation and occurs primarily during non–rapid-eye-movement sleep. Several mechanisms that have been postulated will be reviewed. The phenomenon is usually self-limiting, and recommended management includes applying the lowest PAP pressure needed to achieve reasonable control and avoiding modalities that exacerbate hypocapnia.

scholarly journals High prevalence of obstructive sleep apnea syndrome in Spain’s Stroke Belt

2021 ◽  
Vol 49 (10) ◽  
pp. 030006052110530
Author(s):  
Ana Domínguez-Mayoral ◽  
Jesús Sánchez-Gómez ◽  
Patricia Guerrero ◽  
Marta Ferrer ◽  
Carmen Gutiérrez ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Apnea Syndrome ◽  
Central Sleep Apnea ◽  
University Hospital ◽  
Apnea Hypopnea Index ◽  
Obstructive Sleep ◽  
High Prevalence ◽  
Apnea Syndrome ◽  
Stroke Belt

Objective Spain’s so-called Stroke Belt is an area with high prevalence of vascular disease. We aimed to determine the prevalence of undetected obstructive sleep apnea–hypopnea syndrome (OSAHS) among patients with acute ischemic stroke (AIS) in southern Spain. Methods We conducted a cross-sectional study at the Virgen Macarena University Hospital Stroke Unit during 2018 to 2019. We included patients <72 hours after AIS with a neuroimaging lesion and performed sleep tests. Results Seventy-two patients were included. The median participant age was 72 years. Mean body mass index was 27.07 kg/m2, and 40.28% were daily alcohol drinkers. Hypertension, atrial fibrillation, ischemic cardiomyopathy, and previous stroke were detected in 63.9%, 11.1%, 15.3%, and 17.6% of patients, respectively. Polygraphy was feasible in 91.38% of patients. The prevalence of OSAHS was 84.72% (apnea–hypopnea index ≥5). Patients with moderate and severe OSAHS were more likely to be obese and to have a larger neck circumference and facial palsy. The diagnostic criteria of central sleep apnea syndrome were met in only 1.38% of patients. Conclusions The high prevalence of OSAHS found in the Spanish Stroke Belt justifies further investigation and development of a screening program as a strategy to identify patients with undetected OSAHS.

scholarly journals Effect of a Graduated Walking Program on the Severity of Obstructive Sleep Apnea Syndrome. A Randomized Clinical Trial

2020 ◽  
Vol 17 (17) ◽  
pp. 6334
Author(s):  
Antonio Jurado-García ◽  
Guillermo Molina-Recio ◽  
Nuria Feu-Collado ◽  
Ana Palomares-Muriana ◽  
Adela María Gómez-González ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Intervention Group ◽  
Exercise Program ◽  
Density Lipoprotein ◽  
Apnea Hypopnea Index ◽  
Obstructive Sleep ◽  
Apnea Syndrome

Background: Obstructive sleep apnea syndrome (OSAS) is a common disease. The objective of this research was to determine the effectiveness of a graduated walking program in reducing the apnea–hypopnea index number in patients with obstructive sleep apnea syndrome (OSAS). Methods: A randomized controlled clinical trial with a two-arm parallel in three tertiary hospitals was carried out with seventy sedentary patients with moderate to severe OSAS. Twenty-nine subjects in each arm were analyzed by protocol. The control group received usual care, while usual care and an exercise program based on progressive walks without direct supervision for 6 months were offered to the intervention group. Results: The apnea–hypopnea index decreased by six points in the intervention group, and improvements in oxygen desaturation index, total cholesterol, and Low-Density Lipoprotein of Cholesterol (LDL-c) were observed. A higher decrease in sleep apnea–hypopnea index (45 ± 20.6 vs. 34 ± 26.3/h; p = 0.002) was found in patients with severe vs. moderate OSAS, as well as in oxygen desaturation index from baseline values (43.3 vs. 34.3/h; p = 0.046). Besides, High-Density Lipoprotein of Cholesterol (HDL-c) values showed a higher increase in the intervention group (45.3 vs. 49.5 mg/dL; p = 0.009) and also, a higher decrease in LDL-c was found in this group (141.2 vs. 127.5 mg/dL; p = 0.038). Conclusion: A home physical exercise program is a useful and viable therapeutic measure for the management of OSAS.

scholarly journals Lateral-Expansion Pharyngoplasty: Combined Technique for the Treatment of Obstructive Sleep Apnea Syndrome

2019 ◽  
Vol 24 (01) ◽  
pp. e107-e111 ◽  
Author(s):  
José Antonio Pinto ◽  
Luciana Balester Mello de Godoy ◽  
Heloisa dos Santos Sobreira Nunes ◽  
Kelly Elia Abdo ◽  
Gabriella Spinola Jahic ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Surgical Techniques ◽  
Upper Airway ◽  
Apnea Hypopnea Index ◽  
Lateral Expansion ◽  
Obstructive Sleep ◽  
Apnea Syndrome

Abstract Introduction Obstructive sleep apnea syndrome (OSAS) is a multifactorial disease characterized by episodes of partial or complete collapse during sleep of different regions of the upper airway. Surgery for OSAS evolved with the introduction of different techniques, considering new surgical concept of reconstruction of the upper airway. Objective To retrospectively evaluate the effectiveness of a new approach aimed at reducing pharyngeal collapse by combining two surgical techniques: lateral and expansion pharyngoplasty. Methods We reviewed the medical records of 38 patients with OSAS undergoing lateral/expansion pharyngoplasty from January 2012 to December 2016. The following data were collected: patient age, gender, and pre- and postoperative body mass index (BMI), Epworth sleepiness scale (ESS) scores, snoring visual analogue scale (VAS) scores, and polysomnography (PSG) results. Results The PSG results showed a significant reduction in the apnea/hypopnea index (AHI) from 22.4 ± 27.3 events/h preoperatively to 13.6 ± 17.9 events/h postoperatively (p = 0.009), with postoperative AHI reduction greater than 50% in 63.2% of the patients. There was also a significant reduction in the microarousal index (19.5 ± 22.6 vs 11.0 ± 13.4 events/h; p = 0.001) and in the minimum oxygen saturation (82.6 ± 10.3 vs 86.9 ± 11.1; p = 0.007). Conclusions Lateral-expansion pharyngoplasty represents a new surgical strategy for the treatment of OSAS in patients with palatal collapse by combining two different techniques: lateral and expansion pharyngoplasty. The two techniques, performed as a one-stage procedure, led to improvements in excessive daytime sleepiness, snoring, and PSG respiratory parameters by acting on lateral and retropalatal collapse, producing favorable results with good applicability in otolaryngology clinical practice.

PORTABLE MONITOR WITH AUTOMATIC CPAP TITRATION FOR OBSTRUCTIVE SLEEP APNEA SYNDROME IN THE INPATIENT SETTING

CHEST Journal ◽  
2008 ◽  
Vol 134 (4) ◽  
pp. 52S
Author(s):  
Haven R. Malish ◽  
Sterling L. Malish ◽  
Kashif Mazhar ◽  
Boyce K. Fish ◽  
Prabhakar Patel ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Inpatient Setting ◽  
Portable Monitor ◽  
Cpap Titration ◽  
Obstructive Sleep ◽  
Apnea Syndrome

scholarly journals Effects of Obstructive Sleep Apnea Syndrome and Medical Comorbidities on Language Abilities

2021 ◽  
Vol 12 ◽  
Author(s):  
Konstantinos Makanikas ◽  
Georgia Andreou ◽  
Panagiotis Simos ◽  
Efstathia Chartomatsidou
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep Apnea Syndrome ◽  
Test Scores ◽  
Sleep Apnea Syndrome ◽  
Apnea Hypopnea Index ◽  
Language Test ◽  
Language Abilities ◽  
Obstructive Sleep ◽  
Apnea Syndrome

Objective: The primary objective of the present cross-sectional study is to evaluate the semantic language abilities of patients with Obstructive Sleep Apnea Syndrome (OSAS) compared to normative data. Secondary objectives are to examine the effects of OSAS comorbidities on language test performance.Method: 118 adult patients suffering from OSAS were assessed using standardized tests (Boston Naming Test, the Peabody Picture Vocabulary Test and the Verbal Fluency Test).Results: Compared to normative standards, the OSAS group (age and education adjusted mean) scored significantly lower on all tests (p &lt; 0.01). The OSAS group also included a significantly higher percentage of persons scoring below the 5th percentile of the normative distribution on the four tests (p &lt; 0.01). The Apnea/Hypopnea Index, O2 Desaturation index, SaO2 &lt;85% (min) and SaO2 &lt;75% (min) were significantly associated with language test scores (p &lt; 0.05). Moreover, higher Apnea–Hypopnea Index score and night-time oxygen desaturation were associated with reduced phonemic and semantic fluency performance only among patients with a history of hypertension and hypercholesterolemia (p &lt; 0.05). The moderating effect of diabetes and cardiovascular disease on the association between OSAS severity indices and test scores did not reach significance (p &gt; 0.6).Conclusions: Results suggest that the severity of semantic language impairments in patients with OSAS is associated with the severity of the disease and intensified by common medical comorbidities (hypertension and hypercholesterolemia).

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