Clinical Sleep-Related Breathing Disorders

2021 ◽  
pp. 1199-1202
Author(s):  
Vichaya Arunthari ◽  
Brynn K. Dredla
Keyword(s):  
Sleep Apnea ◽  
Respiratory Muscle ◽  
Sleep Apnea Syndrome ◽  
Central Sleep Apnea ◽  
Sleep Apnea Syndromes ◽  
Respiratory Drive ◽  
Sleep Related Breathing Disorders ◽  
Breathing Disorders ◽  
Obstructive Sleep ◽  
Adults And Children

Sleep-related breathing disorders are categorized into obstructive sleep apnea syndromes, central sleep apnea syndrome, and sleep-related hypoventilation or hypoxic syndromes. These disorders can occur in adults and children. Clinical characteristics, diagnosis, and treatment are discussed in this chapter. Sleep apnea occurs when recurrent complete (apnea) or nearly complete (hypopnea) cessation of airflow develops, accompanied by preservation of the respiratory drive manifested as persistent respiratory muscle effort. Apnea is defined as the cessation of airflow for more than 10 seconds, using a valid measure of airflow. Hypopnea is an airflow reduction of at least 30% from baseline that lasts at least 10 seconds and is accompanied by an oxygen desaturation of 4% or more.

scholarly journals Hormonal status and the orexin system in obese patients with obstructive sleep apnea syndrome

2015 ◽  
Vol 12 (2) ◽  
pp. 24-30
Author(s):  
Natalya Viktorovna Strueva ◽  
Galina Afanas'evna Melnichenko ◽  
Mikhail Gur'evich Poluektov ◽  
Larisa Viktorovna Savel'eva ◽  
Gulinara Viktorovna Katsya ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Obese Patients ◽  
Hormone Metabolism ◽  
Sleep Related Breathing Disorders ◽  
Breathing Disorders ◽  
Obstructive Sleep ◽  
Apnea Syndrome

The aim of research was to estimate the influence of hormone metabolism and sleep apnea on patients with obesity. 76 patients (37 males and 39 females) with obesity were included in this study. After night polysomnography all patients were divided in two groups comparableby age, sex ratio and BMI. The first group consisted of 41 patients with obstructive sleep apnea syndrome (OSAS), the second (controls) – 35 patients without breath disorders during sleep. OSAS is accompanied by the increase in urinary cortisol during the night, high levels ofbasal insulin, disturbances of hepatic production of IGF-1, dysfunction of the pituitary-gonadal axis. Our results show that sleep-related breathing disorders render markedly and negatively affect on hormonal parameters of patients with obesity. As a reliable difference of basalsecretion of orexin A in obese patients with and without OSAS was not revealed (42,0 [14; 99,5] vs. 18,0 [14,5; 124,5] pg/ml; р=0,9), we were not able to show the existence that the existence of OSAS is followed by any special changes of activity of the orexin system.

scholarly journals Sleep-related breathing disorders in patients with heart failure: classification, epidemiology and pathophysiology. Part I

2021 ◽  
Vol 26 (2S) ◽  
pp. 4386
Author(s):  
K. S. Krupichka ◽  
M. V. Agaltsov ◽  
R. P. Myasnikov ◽  
O. M. Drapkina
Keyword(s):  
Heart Failure ◽  
Sleep Apnea ◽  
Central Sleep Apnea ◽  
Periodic Breathing ◽  
Healthy Person ◽  
Underlying Disease ◽  
Sleep Related Breathing Disorders ◽  
Breathing Disorders ◽  
Obstructive Sleep ◽  
High Prevalence

The problem of heart failure (HF) is one of the central problems in modern cardiology due to its high prevalence among the population and high mortality. In turn, sleep-related breathing disorders (SRBD) are widespread in patients with HF and are associated with both the progression of the underlying disease and a decrease in the quality of life. For the first time, periodic breathing, as one of the types of sleep breathing disorders, was described in patients with HF.Further study of the issue showed a high prevalence of other types of SRBD among patients with HF The article discusses the physiology of sleep breathing monitoring in a healthy person and the pathophysiology of SRBD. The pathogenesis of central sleep apnea and its relationship with HF are discussed in detail. In addition, the mechanisms of the adverse effect of obstructive sleep apnea and HF are highlighted.

Introduction to Sleep-Disordered Breathing and Treatment

2021 ◽  
pp. 509-528
Author(s):  
Joanne S. Martires ◽  
Reuben Ram ◽  
Jeanne Wallace
Keyword(s):  
Sleep Apnea ◽  
Airway Pressure ◽  
Sleep Disordered Breathing ◽  
Positive Airway Pressure ◽  
Sleep Apnea Syndrome ◽  
Central Sleep Apnea ◽  
Sleep Related Breathing Disorders ◽  
Adaptive Servo Ventilation ◽  
Breathing Disorders ◽  
Disordered Breathing

Sleep-related breathing disorders encompass a wide range of problems that occur during sleep. The most common sleep-related breathing disorder is obstructive sleep apnea syndrome (OSAS). OSAS is increasingly prevalent, underdiagnosed and can lead to significant daytime sleepiness and disability. Continuous positive airway pressure (CPAP) is the treatment of choice for OSAS but lack of adherence to CPAP is rampant. Supportive care, education, and motivational enhancement programs do show promise in improving compliance. Alternatives to CPAP such as oral appliances, hypoglossal nerve stimulation, and myofunctional therapy have not been proved as efficacious but may provide some benefit. In the future, personalized treatment may be the best way to approach this condition. Central sleep apnea and hypoventilation are other forms of sleep-related breathing disorders. Treatment largely depends on the underlying condition but may require the use of advanced modes of noninvasive ventilation such as adaptive servo-ventilation, bilevel positive airway pressure, and volume-assured pressure support. Treatment of sleep-related breathing disorders is complex and includes seeking patient input, understanding barriers to treatment, and reevaluating patients after treatment is initiated. Successful treatment of sleep-disordered breathing can lead to improvements in daytime function, quality of life, and overall health.

scholarly journals Etiopathogenetic Mechanisms of Pulmonary Hypertension in Sleep-Related Breathing Disorders

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Ayodeji Adegunsoye ◽  
Siva Ramachandran
Keyword(s):  
Obstructive Sleep Apnea ◽  
Pulmonary Hypertension ◽  
Sleep Apnea ◽  
Sleep Disordered Breathing ◽  
Sleep Apnea Syndrome ◽  
Sleep Related Breathing Disorders ◽  
Breathing Disorders ◽  
Obstructive Sleep ◽  
Significant Health ◽  
Disordered Breathing

Obstructive sleep apnea syndrome is a common disorder with significant health consequences and is on the rise in consonance with the obesity pandemic. In view of the association between sleep-disordered breathing and pulmonary hypertension as depicted by multiple studies, current clinical practice guidelines categorize obstructive sleep apnea as a risk factor for pulmonary hypertension and recommend an assessment for sleep disordered breathing in evaluating patients with pulmonary hypertension. The dysregulatory mechanisms associated with hypoxemic episodes observed in sleep related breathing disorders contribute to the onset of pulmonary hypertension and identification of these potentially treatable factors might help in the reduction of overall cardiovascular mortality.

scholarly journals EXPRESS: Hypoxemia during Sleep and Overnight Rostral Fluid Shift in Pulmonary Arterial Hypertension: a pilot study

2021 ◽  
pp. 204589402199693
Author(s):  
Etienne-Marie Jutant ◽  
David Montani ◽  
Caroline Sattler ◽  
Sven Günther ◽  
Olivier Sitbon ◽  
...  
Keyword(s):  
Sleep Apnea ◽  
Pilot Study ◽  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Central Sleep Apnea ◽  
The Body ◽  
Fluid Shift ◽  
Sleep Related Breathing Disorders ◽  
Breathing Disorders ◽  
Pulmonary Arterial

Introduction. Sleep-related breathing disorders, including sleep apnea and hypoxemia during sleep, are common in pulmonary arterial hypertension (PAH), but the underlying mechanisms remain unknown. Overnight fluid shift from the legs to the upper airway and to the lungs promotes obstructive and central sleep apnea, respectively, in fluid retaining states. The main objective was to evaluate if overnight rostral fluid shift from the legs to the upper part of the body is associated with sleep-related breathing disorders in PAH. Methods. In a prospective study, a group of stable patients with idiopathic, heritable, related to drugs, toxins, or treated congenital heart disease PAH underwent a polysomnography and overnight fluid shift measurement by bioelectrical impedance in the month preceding or following a one-day hospitalization according to regular PAH follow-up schedule with a right heart catheterization. Results. Among 15 patients with PAH (women: 87%; median [25th;75th percentiles] age: 40 [32;61] years; mean pulmonary arterial pressure 56 [46;68] mmHg; pulmonary vascular resistance 8.8 [6.4;10.1] Wood units), 2 patients had sleep apnea and 8 (53%) had hypoxemia during sleep without apnea. The overnight rostral fluid shift was 168 [118;263] mL per leg. Patients with hypoxemia during sleep had a greater fluid shift (221 [141; 361] mL) than those without hypoxemia (118 [44; 178] mL, p = 0.045). Conclusion. This pilot study suggests that hypoxemia during sleep is associated with overnight rostral fluid shift in PAH.

scholarly journals Nocturnal oxyhemoglobin desaturation during sleep in congestive heart failure patients

2016 ◽  
Vol 29 (3) ◽  
pp. 597-606
Author(s):  
Jéssica Julioti Urbano ◽  
Lilian Nanami Uchiyama ◽  
Anderson Soares Silva ◽  
Roger André Oliveira Peixoto ◽  
Sergio Roberto Nacif ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Sleep Apnea ◽  
Pulse Oximetry ◽  
Arterial Oxygen Saturation ◽  
Central Sleep Apnea ◽  
Arterial Oxygen ◽  
Sleep Breathing Disorders ◽  
Breathing Disorders ◽  
Obstructive Sleep

Abstract Introduction: Sleep breathing disorders occur in 45% of patients with heart failure, with 36%-50% manifesting Cheyne-Stokes respiration with central sleep apnea and 12% exhibiting obstructive sleep apnea. Several studies have shown that sleep pathophysiology may negatively affect the cardiovascular system and that cardiac dysfunction alters sleep and respiration. Objective: The aim of this study was to examine oxyhemoglobin desaturation during sleep in patients with congestive heart failure (CHF) using overnight pulse oximetry. Methods: Overnight pulse oximetry was conducted in the patients' homes with wrist pulse oximeters and finger probes that were placed around the forefingers of 15 patients with CHF and ejection fractions less than 50%, who were classified as New York Heart Association functional classes II and III. Results: The patients were divided into two groups. The first group consisted of seven patients with oxyhemoglobin desaturation indices of over 5 events/h, and the second group contained eight patients with oxyhemoglobin desaturation indices of 5 or less events/h. Student's t-tests did not show any significant differences between the groups. The patients' body mass indices correlated positively with the total desaturation episodes and desaturation time less than 90% and correlated negatively with the arterial oxygen saturation nadir. Conclusion: Pulse oximetry monitoring during sleep can be used to detect sleep breathing disorders in stable patients with CHF.

scholarly journals Interrelationship Between Obstructive Sleep Apnea Syndrome and Severe Asthma: From Endo-Phenotype to Clinical Aspects

2021 ◽  
Vol 8 ◽  
Author(s):  
Beatrice Ragnoli ◽  
Patrizia Pochetti ◽  
Alberto Raie ◽  
Mario Malerba
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Severe Asthma ◽  
Daytime Sleepiness ◽  
Sleep Apnea Syndrome ◽  
Future Research ◽  
Clinical Aspects ◽  
Poor Sleep ◽  
Sleep Related Breathing Disorders ◽  
Obstructive Sleep

Sleep-related breathing disorders (SBDs) are characterized by abnormal respiration during sleep. Obstructive sleep apnea (OSA), a common SBD increasingly recognized by physicians, is characterized by recurrent episodes of partial or complete closure of the upper airway resulting in disturbed breathing during sleep. OSA syndrome (OSAS) is associated with decreased patients' quality of life (QoL) and the presence of significant comorbidities, such as daytime sleepiness. Similarly to what seen for OSAS, the prevalence of asthma has been steadily rising in recent years. Interestingly, severe asthma (SA) patients are also affected by poor sleep quality—often attributed to nocturnal worsening of their asthma—and increased daytime sleepiness and snoring compared to the general population. The fact that such symptoms are also found in OSAS, and that these two conditions share common risk factors, such as obesity, rhinitis, and gastroesophageal reflux, has led many to postulate an association between these two conditions. Specifically, it has been proposed a bidirectional correlation between SA and OSAS, with a mutual negative effect in term of disease severity. According to this model, OSAS not only acts as an independent risk factor of asthma exacerbations, but its co-existence can also worsen asthma symptoms, and the same is true for asthma with respect to OSAS. In this comprehensive review, we summarize past and present studies on the interrelationship between OSAS and SA, from endo-phenotype to clinical aspects, highlighting possible implications for clinical practice and future research directions.

The Association between Obstructive Sleep Apnea and Allergic Rhinitis: Current Literature Review

2021 ◽  
Vol 17 ◽  
Author(s):  
Shi Nee Tan ◽  
Baharudin Abdullah
Keyword(s):  
Obstructive Sleep Apnea ◽  
Allergic Rhinitis ◽  
Sleep Apnea ◽  
Central Sleep Apnea ◽  
Sleep Apnea Syndromes ◽  
T Helper 2 ◽  
Obstructive Sleep ◽  
Common Clinical Practice ◽  
High Level ◽  
Chemical Mediators

: Sleep-disordered breathing (SDB) is now a significant health problem in today's culture. It ranges from a spectrum of abnormal conditions during sleep from the primary snorer to mild, moderate, or severe obstructive sleep apnea (OSA). SDB also comprises other conditions, such as sleep-related hypoventilation, sleep-related hypoxemia, and central sleep apnea syndromes. One of the components of the pathophysiology of OSA that remain unclear is the association of allergic rhinitis (AR) in the evolution of OSA. Several studies relate OSA and AR's co-existence in the common clinical practice, but its correlation was not clear. This review article aimed to review the relationship between OSA and AR in terms of the role of chemical mediators and pathophysiological and the effect of AR treatment in support of OSA. The symptoms of AR further accelerate the clinical progression to OSA development. Inflammatory mediators such as histamine, cysteinyl leukotrienes, and interleukins are found at a high level in AR, which can aggravate AR symptoms such as nasal obstruction, rhinorrhea, and itchiness, which can then lead to sleep disruption in OSA patients. In addition, OSA patients also have increased chemical mediators such as tumor necrosis factor, interleukin 6, and 1, which would activate the T helper 2 phenotypes that can aggravate AR symptoms. This vicious cycle can potentiate each other and worsen the condition. Few studies have shown that treatment of AR can improve OSA, especially the use of intranasal steroid and leukotriene receptor antagonists. A detailed evaluation of rhinitis symptoms should be made for those OSA patients so that they can benefit not only from the improvement of AR but also the good sleep quality.

scholarly journals Prevalence of Sleep-Related Disordered Breathing among Acromegaly Patients and its Correlation to Cephalometric Parameters: An Indian Perspective

2020 ◽  
Vol 56 (01) ◽  
pp. 09-14
Author(s):  
Sreejith M. ◽  
Mohd Ashraf Ganie ◽  
Ravinder Goswami ◽  
Nikhil Tandon ◽  
Randeep Guleria ◽  
...  
Keyword(s):  
Sleep Apnea ◽  
Soft Tissues ◽  
Central Sleep Apnea ◽  
Human Growth ◽  
Apnea Hypopnea Index ◽  
Sleep Related Breathing Disorders ◽  
Obstructive Sleep ◽  
Long Term Follow Up ◽  
Treatment Naïve ◽  
Magnetic Resonance Imaging Mri

Abstract Introduction Sleep-related breathing disorders (SRBDs) including obstructive sleep apnea (OSA) and central sleep apnea (CSA) are quite common and are the leading causes of mortality in acromegaly. OSA in acromegaly is generally attributed to changes in oropharyngeal soft tissues. Data on OSA in Indian acromegaly are scant, especially cephalometric findings. The aim of this study is to evaluate the burden of SRBDs in acromegaly and its correlation to cephalometric parameters. Materials and Methods A total of 32 subjects (20 men and 12 women), diagnosed with acromegaly on the basis of standard clinical, biochemical, and hormonal measurements were recruited. In addition to the above parameters, polysomnography and magnetic resonance imaging (MRI) of the pharynx were performed in all subjects. Results The mean age of the subjects was 42.66 ± 11.13 years (range = 26–66) and mean duration of study after first presentation was 7.6 ± 6.3 years (range = 0.25–32). A total of 28 of 32 (93.3%) subjects had sellar MRI documented macroadenomas while 20 (62.5%) patients were treatment naive at the time of assessment. Twenty-nine (90.6%) patients had evidence of SRBD and all of them had OSA subtype. The Apnea–Hypopnea Index (AHI) indicating severity of OSA (mild 21.8%, moderate 34.4%, and severe 34.4%) correlated positively with tongue length, uvula length, and uvula thickness on MRI. However, AHI had no correlation with the severity of GH excess or disease activity or individual parameters such as weight, body mass index, blood pressure, hemoglobin A1c, serum human growth hormone, and insulin-like growth factor-1 level. Conclusion SRBD, the generally overlooked comorbidity, is highly prevalent in subjects with acromegaly and is almost always due to OSA, the severity of which correlates positively with tongue and uvula size. Well-designed, long-term follow-up study on a large cohort of acromegalic patients is required to improve our understanding on the subject.

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