Sleep-related breathing disorders: classification and diagnosis

ESC CardioMed ◽  
2018 ◽  
pp. 1062-1065
Author(s):  
Melissa C. Lipford ◽  
Virend K. Somers
Keyword(s):  
Risk Factors ◽  
Clinical Practice ◽  
Sleep Apnoea ◽  
Screening Tools ◽  
Cardiac Patients ◽  
Separate Entity ◽  
Sleep Related Breathing Disorders ◽  
Clinical Screening ◽  
Breathing Disorders ◽  
Obstructive Sleep

Sleep-related breathing disorders encapsulate multiple respiratory abnormalities which occur during sleep. The most common disorders within this category are obstructive sleep apnoea, central sleep apnoea, and sleep-related hypoventilation. This chapter defines each of these conditions as a separate entity; however, in clinical practice there is overlap between the disorders and patients may have combinations of disease. Untreated sleep-related breathing disorders serve as risk factors for cardiovascular and cerebrovascular disease, and these diseases are commonly co-morbid in cardiac patients. Identification and treatment in the cardiac patient population is extremely important; yet many patients remain undiagnosed. This chapter discusses clinical screening tools as well as definitive diagnostic studies for these respiratory disorders. The definitions in this chapter will pertain only to adult patients.

Obstructive Sleep Apnoea, Atrial Fibrillation and Erectile Dysfunction – The OSAFED Syndrome – Is there More than Meets the Eye?

2015 ◽  
Vol 01 (01) ◽  
pp. 19
Author(s):  
Filip M Szymanski ◽  
Anna E Platek ◽  
Krzysztof J Filipiak ◽  
◽  
◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Erectile Dysfunction ◽  
Clinical Practice ◽  
Cardiovascular Risk ◽  
General Population ◽  
Obstructive Sleep Apnoea ◽  
Sleep Apnoea ◽  
Clinical Syndromes ◽  
Obstructive Sleep

Obstructive sleep apnoea, atrial fibrillation and erectile dysfunction (OSAFED) syndrome is a new clinical entity recently introduced into clinical practice. The acronym consists of the first letters of the three clinical entities that comprise the disease, namely obstructive sleep apnoea (OSA), atrial fibrillation (AF) and erectile dysfunction (ED). As with many other clinical syndromes, OSAFED syndrome groups several clinical entities, which seemingly concern various organs and have different symptoms, but are closely associated by sharing risk factors and phenotype, and effecting cardiovascular risk in the same manner. OSA, AF and ED are also highly prevalent in the general population and tend to coexist. OSAFED syndrome was named as such to show how important diagnosis is of all these components in specific groups of patient. It is crucial for clinicians to improve the diagnosis and early treatment of all – OSA, AF and ED – and the incorporation of all these factors into one syndrome might help to facilitate this process.

Day-case tonsillectomy for children in Glasgow: the impact of changing indications and deprivation

2013 ◽  
Vol 127 (4) ◽  
pp. 392-398 ◽  
Author(s):  
W A Clement
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Day Surgery ◽  
Sleep Apnoea ◽  
Day Case ◽  
Sleep Related Breathing Disorders ◽  
Number Of Children ◽  
Breathing Disorders ◽  
Obstructive Sleep ◽  
Same Day Discharge ◽  
The Impact

AbstractObjective:To determine the number of children undergoing tonsillectomy that could have this performed as a day surgery procedure.Methods:This paper reports a prospective cohort study, which entailed a comparison of children's eligibility for day-case surgery between 2001 and 2011 and an assessment of the Scottish Index of Multiple Deprivation scores.Results:In total, 148 children were enrolled. In 2011, 60 children (42 per cent) were eligible for surgery with same day discharge compared with 27 per cent in 2001. The percentage of children undergoing tonsillectomy for sleep-related breathing disorders or obstructive sleep apnoea hypopnoea syndrome increased from 26 per cent to 55 per cent.Conclusion:Eligibility for tonsillectomy with same day discharge has increased. This appears to be related to an increase in the number of children who are able to fulfil the social criteria for same day discharge. The results indicate an association between deprivation and tonsillectomy, particularly surgery carried out for the symptoms of sleep-related breathing disorders or obstructive sleep apnoea hypopnoea syndrome. There has been a significant increase in the percentage of children undergoing tonsillectomy for the indication of sleep-related breathing disorders or obstructive sleep apnoea hypopnoea syndrome.

Sleep-related breathing disorders and pulmonary hypertension

2020 ◽  
Vol 57 (1) ◽  
pp. 2002258
Author(s):  
Yochai Adir ◽  
Marc Humbert ◽  
Ari Chaouat
Keyword(s):  
Pulmonary Hypertension ◽  
Sleep Apnoea ◽  
Sleep Related Breathing Disorders ◽  
Breathing Disorders ◽  
Respiratory Events ◽  
Obstructive Sleep ◽  
Pulmonary Haemodynamics ◽  
Pulmonary Arterial ◽  
Central Apnoea

Sleep-related breathing disorders (SBDs) include obstructive apnoea, central apnoea and sleep-related hypoventilation. These nocturnal events have the potential to increase pulmonary arterial pressure (PAP) during sleep but also in the waking state. “Pure” obstructive sleep apnoea syndrome (OSAS) is responsible for a small increase in PAP whose clinical impact has not been demonstrated. By contrast, in obesity hypoventilation syndrome (OHS) or overlap syndrome (the association of chronic obstructive pulmonary disease (COPD) with obstructive sleep apnoea (OSA)), nocturnal respiratory events contribute to the development of pulmonary hypertension (PH), which is often severe. In the latter circumstances, treatment of SBDs is essential in order to improve pulmonary haemodynamics.Patients with pulmonary arterial hypertension (PAH) or chronic thromboembolic pulmonary hypertension (CTEPH) are at risk of developing SBDs. Obstructive and central apnoea, as well as a worsening of ventilation–perfusion mismatch, can be observed during sleep. There should be a strong suspicion of SBDs in such a patient population; however, the precise indications for sleep studies and the type of recording remain to be specified. The diagnosis of OSAS in patients with PAH or CTEPH should encourage treatment with continuous positive airway pressure (CPAP). The presence of isolated nocturnal hypoxaemia should also prompt the initiation of long-term oxygen therapy. These treatments are likely to avoid worsening of PH; however, it is prudent not to treat central apnoea and Cheyne–Stokes respiration (CSR) with adaptive servo-ventilation in patients with chronic right-heart failure because of a potential risk of serious adverse effects from such treatment.In this review we will consider the current knowledge of the consequences of SBDs on pulmonary haemodynamics in patients with and without chronic respiratory disease (group 3 of the clinical classification of PH) and the effect of treatments of respiratory events during sleep on PH. The prevalence and consequences of SBDs in PAH and CTEPH (groups 1 and 4 of the clinical classification of PH, respectively), as well as therapeutic options, will also be discussed.

scholarly journals The nose, snoring and obstructive sleep apnoea

2011 ◽  
Vol 49 (3) ◽  
pp. 259-263
Author(s):  
B. Kotecha
Keyword(s):  
Nasal Obstruction ◽  
Obstructive Sleep Apnoea ◽  
Upper Airway ◽  
Sleep Apnoea ◽  
Nasal Surgery ◽  
Sleep Related Breathing Disorders ◽  
Breathing Disorders ◽  
Obstructive Sleep ◽  
Nasal Pathology

Snoring and obstructive sleep apnoea are both due to multilevel anatomical obstruction, and the nose and nasal pathology both contribute in many cases. This paper addresses some of the issues surrounding the problem and briefly discusses the role of medication and nasal dilators and in more detail the implication of nasal surgery in various aspects of sleep related breathing disorders (SRBD). Nasal obstruction leads to mouth breathing, which destabilises the upper airway and aggravates SRBD.

Sleep disorders

2018 ◽  
Author(s):  
Lawrence J. Epstein
Keyword(s):  
Sleep Disorders ◽  
Sleep Apnoea ◽  
Behaviour Disorder ◽  
Sleep Wake Disorders ◽  
Sleep Related Breathing Disorders ◽  
Breathing Disorders ◽  
Sleep Behaviour ◽  
Obstructive Sleep ◽  
Broad Array ◽  
The Individual

Over 70 described sleep disorders disrupt the sleep of an estimated 50–70 million Americans. The disorders present with a broad array of symptoms but result in the individual not getting the health, cognitive, and restorative benefits of a good night’s sleep. The disorders have been categorized into the following categories: insomnia, sleep-related breathing disorders, central disorders of hypersomnolence, circadian rhythm sleep–wake disorders, parasomnias, and sleep-related movement disorders. This chapter reviews each category and provides details on the symptoms, pathophysiology, and treatment of the most common disorder in each category, including insomnia, obstructive sleep apnoea, narcolepsy, restless legs syndrome, and REM sleep behaviour disorder. The presenting complaint is the key to diagnosis, directing subsequent evaluation.

Relationship Between Obstructive Sleep Apnoea, Oxygen Desaturation and Cardiovascular Risk

2019 ◽  
Vol 70 (10) ◽  
pp. 3582-3586
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cardiovascular Risk ◽  
Obstructive Sleep Apnoea ◽  
Cardiovascular Events ◽  
Sleep Apnoea ◽  
Oxygen Desaturation ◽  
Obstructive Sleep Apnoea Syndrome ◽  
Obstructive Sleep

Obstructive sleep apnoea syndrome (OSAS) increases the risk cardiovascular events regardless of the presence of previous cardiovascular disease. As both OSAS and coronary heart disease (CHD) have same risk factors it’s often difficult to quantify the proportion of each risk factor in developing cardiac events. The aim of this study was to evaluate the 10-year risk of developing a coronary heart disease (CHD) event or stroke in newly diagnosed OSAS patients. 65 patients diagnosed with OSAS over a period of four months in Oradea Sleep Laboratory were included. Demographic characteristics, anthropometric parameters, clinical and biochemical data, sleep disorder and daytime sleepiness assessment, results of polysomnography were collected in all patients. In 55 selected patients by age range from 34 to 74 years old, cardiovascular risk was assessed using Framingham score calculator. Statistical analysis was performed using SPSS-PC version 7.5 and Stata 10.The estimated 10-years risk of a CHD event was 18.97% (± 9.67) in all cases. It was higher in men (22.17% ± 9.24) compare to women (12.39% ± 6.92) and it was not significantly different by stages of OSAS severity (20.58% ±9.41 in patients with severe OSAS versus 15.4% in mild OSAS), suggesting that apnea hypopnea index is not a major confounding factor. Desaturation of oxygen is a better outcome to define the relation between OSAS and cardiovascular diseases. OSAS and cardiovascular risk factors increased risk for future adverse cardiovascular events related to the severity of oxygen desaturation. Keywords: obstructive sleep apnoea syndrome, cardiovascular events, risk factors, oxygen desaturation

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