scholarly journals 0684 Overnight Fluid Shift In Apnea And Stroke: Does Being Physically Active Matter

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A261-A261
Author(s):  
C Frange ◽  
F M Coelho
Keyword(s):  
Physical Inactivity ◽  
Neck Circumference ◽  
Fluid Volume ◽  
Fluid Shift ◽  
Physically Active ◽  
Obstructive Sleep ◽  
Before And After ◽  
Measured Change ◽  
Active Condition ◽  
Climbing Stairs

Abstract Introduction Obstructive sleep apnea (OSA) and physical inactivity are frequent in patients with stroke. Overnight fluid shift may increase the propensity to pharyngeal obstruction and thus predispose to OSA. Also, physical inactivity can lead to consequent edema in the hemiparetic side. Methods In 7 patients at 3 months following post-first-ever ischemic stroke, we measured change in AHI (PSG), neck circumference, and arms and legs fluid volume (bioelectric impedance), before and after PSG in two conditions during the day before PSG: (1) inactive (sitting/lying), and (2) physically active (standing, walking, climbing stairs and mild exercise for 30 mins/hour). Results Being physically active for one day decreased mean AHI (inactive: 17.9/h; active: 12.6/h). Mean neck circumference increased overnight in both conditions (active and inactive) but increased more when the participants were physically active (inactive: 38 to 38.5cm; active: 38.43 to 39.5cm). Mean paretic arm fluid volume increased after inactive condition and did not change after physically active condition (inactive: 1.33L to 1.45L; active: 1.82L). Mean non-paretic arm fluid volume increased after active and inactive conditions (inactive: 1.34L to 1.45L; active: 1.74 to 1.78L). In both conditions and for paretic and non-paretic arms, being physically active for one day increased arm fluid volume between pre- and post-sleep comparisons. Mean paretic leg fluid volume increased after both conditions but increased more when the participants were inactive (inactive: 6.08L to 6.52L; active: 6.12 to 6.24L). Mean non-paretic leg fluid volume increased after inactive condition and decreased after being physically active (inactive: 6.01L to 6.45L; active: 6.15 to 6.06L). Conclusion Being physically active for one day decreased AHI, despite the increased fluid accumulation in the neck, and contributed to leaving no edema in the hemiparetic side. Breaking up inactivity and increasing physical activity in patients following stroke may be a promising intervention to reduce edema and OSA. Support São Paulo Research Foundation (FAPESP, grant #2018/18952-1 to CF).

scholarly journals Obstructive Sleep Apnea Severity and Overnight Body Fluid Shift before and after Hemodialysis

2015 ◽  
Vol 10 (6) ◽  
pp. 1002-1010 ◽  
Author(s):  
Adam Ogna ◽  
Valentina Forni Ogna ◽  
Alexandra Mihalache ◽  
Menno Pruijm ◽  
Georges Halabi ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Body Fluid ◽  
Fluid Shift ◽  
Obstructive Sleep Apnea Severity ◽  
Obstructive Sleep ◽  
Before And After

Overnight Rostral Fluid Shifts Exacerbate Obstructive Sleep Apnea After Stroke

Stroke ◽  
2021 ◽  
Author(s):  
Devin L. Brown ◽  
Azadeh Yadollahi ◽  
Kevin He ◽  
Yuliang Xu ◽  
Bryan Piper ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Ischemic Stroke ◽  
Sleep Apnea ◽  
Population Based ◽  
Hospitalized Patients ◽  
Fluid Volume ◽  
Calf Circumference ◽  
Fluid Shift ◽  
Obstructive Sleep ◽  
Fluid Shifts

Background and Purpose: Overnight shifts of fluid from lower to upper compartments exacerbate obstructive sleep apnea (OSA) in some OSA populations. Given the high prevalence of OSA after stroke, decreased mobility and use of IV fluids among hospitalized patients with stroke, and improvement in OSA in the months after stroke, we hypothesized that overnight fluid shifts occur and are associated with OSA among patients with subacute ischemic stroke. Methods: Within a population-based project, we performed overnight sleep apnea tests (ApneaLink Plus) during ischemic stroke hospitalizations. Before sleep that evening, and the following morning before rising from bed, we assessed neck and calf circumference, and leg fluid volume (bioimpedance spectroscopy). The average per subject overnight change in the 3 fluid shift measurements was calculated and compared with zero. Linear regression was used to test the crude association between each of the 3 fluid shift measurements and the respiratory event index (REI). Results: Among the 292 participants, mean REI was 24 (SD=18). Within individuals, calf circumference decreased on average by 0.66 cm (SD=0.75 cm, P <0.001), leg fluid volume decreased by a mean of 135.6 mL (SD=132.8 mL, P <0.001), and neck circumference increased by 0.20 cm (SD=1.71 cm, P =0.07). In men, when the overnight change of calf circumference was negative, an interquartile range (0.8 cm) decrease in calf circumference overnight was significantly associated with a 25.1% increase in REI ( P =0.02); the association was not significant in women. The relationship between overnight change in leg fluid volume and REI was U shaped. Conclusions: This population-based, multicenter, cross-sectional study showed that in hospitalized patients with ischemic stroke, nocturnal rostral fluid shifts occurred, and 2 of the 3 measures were associated with greater OSA severity. Interventions that limit overnight fluid shifts should be tested as potential treatments for OSA among patients with subacute ischemic stroke.

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

Pre-eminence of Moderate to Robust Physical Activity in Battling COVID-19: A Narrative Review

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 934-937
Author(s):  
Tasneem M. Lakkadsha ◽  
Kiran Kumar ◽  
Waqar M. Naqvi ◽  
Pratik Phansopkar
Keyword(s):  
Physical Activity ◽  
Mass Media ◽  
Physical Inactivity ◽  
Narrative Review ◽  
The Other ◽  
Physically Active ◽  
Corona Virus ◽  
Media Platform ◽  
Being There ◽  
History Books

In January 2020, we met with COVID-19 (aka SARS-Co-V-2 and/or Corona virus) on our news channels all the way from china. Little did we know that it would shake up our lives in such a manner that we had heard only in a movie or read in history books. Currently we are all in some sort of lockdown, be it in hospital/home or in our minds. Being there, most of us are facing certain kind of misery, be it emotional, mental, physical or social. To be expansive the most common stresses that have been addressed by people on mass media platform are feeling of depression and isolation caused by being away from family and friends, some are complaining of losing their enthusiasm, some of gaining weight, some of losing it and many more. Going through a pandemic is also helping people in some or the other way, one of which is being concerned about their health and habits to keep themselves fit and away from serious comorbidities which can stem out from physical inactivity and heightened stress levels. There are many ways to stay fit at home without any complex gym equipment, but far less is known about it. Thus, an understanding of methods through which one can become physically active with least complexity, easy availability, and appropriate utilization is need of the hour.

scholarly journals BASAN index (Body mass index, Age, Sex, Arterial hypertension and Neck circumference) predicts severe apnoea in adults living at high altitude

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e044228
Author(s):  
Henry Oliveros ◽  
Rafael Lobelo ◽  
Luis Fernando Giraldo-Cadavid ◽  
Alirio Bastidas ◽  
Constanza Ballesteros ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Arterial Hypertension ◽  
High Altitude ◽  
Body Mass ◽  
Sleep Apnoea ◽  
Neck Circumference ◽  
Binary Logistic Regression Model ◽  
Cross Sectional ◽  
Derivation Cohort ◽  
Obstructive Sleep

ObjectivesObstructive sleep apnoea (OSA)/hypopnoea syndrome is associated with serious and major multiorgan morbidities, particularly in its most severe forms. However, no severe OSA screening instruments are available for high altitude residents that enable adequate identification and clinical prioritisation of such patients. We aimed at developing a severe OSA prediction tool based on the clinical characteristics and anthropometric measurements of a clinical referral cohort living at 2640 m.a.s.l.DesignCohort-nested cross-sectional study.SettingSleep laboratory for standard polysomnography (PSG) in Colombia.ParticipantsA predictive model was generated from 8718 participants referred to the PSG laboratory. Results were subsequently validated in a second cohort of 1898 participants.Primary outcomeTo identify clinical and anthropometric variables associated with severe OSA (>30 events/hour) and to include them in a binary logistic regression model.ResultsThe significant variables that were retained with the presence of severe OSA included Body mass index (BMI), Age, Sex, Arterial hypertension and Neck circumference (BASAN). The area under the receiver operating characteristic curvefor the BASAN index was 0.69 (95% CI: 0.68 to 0.70) in the derivation cohort and 0.67 (95% CI: 0.65 to 0.69) in the validation cohort, whereby a BASAN index ≥2 had a sensitivity of 95% and a specificity of 17% to detect severe OSA.ConclusionAn objectively based approach to screen for the presence of severe OSA, the BASAN index, exhibits favourable sensitivity characteristics that should enable its operational use as a screening tool in a Hispanic population with a clinical suspicion of OSA and living at high altitude.

scholarly journals The effect of obstructive sleep apnoea on timing of acute coronary syndrome

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M.H Muhmad Hamidi ◽  
H Sani ◽  
M.A Ibrahim ◽  
K.S Ibrahim ◽  
A.B Md Radzi ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
High Risk ◽  
Systolic Function ◽  
Strong Association ◽  
Multiple Logistic Regression Analysis ◽  
Sleep Apnoea ◽  
Neck Circumference ◽  
Coronary Syndrome ◽  
Obstructive Sleep ◽  
Significant Difference

Abstract Background and objective Acute coronary syndrome (ACS) remains the principal cause of death in Malaysia. It is estimated about 20% of ACS occurs at nighttime during sleep between 12am to 6am. Factors associated with nocturnal ACS are unknown. Acute nocturnal pathophysiological response to obstructive sleep apnea (OSA) may increase risk of nocturnal ACS. We hypothesized that OSA risk is associated with timing of ACS onset. Methodology This study included 200 patients with ACS who underwent coronary angiogram for which the time of chest pain onset was clearly identified and divided into 2 groups; nocturnal ACS (12am-5.59am) and non-nocturnal ACS (6am–11.59pm). Two validated questionnaires, STOP-BANG and Epworth Sleepiness Scale (ESS) were self-administered by subjects to determine OSA risk. All subjects timing of ACS onset, OSA risk, demography, anthropometric measurements, comorbidities and echocardiographic characteristics were analyzed. Results Acute coronary syndrome occurs nocturnally in 19% of ACS patients. The prevalence of high risk OSA individuals among ACS patients is 43%. There is significantly higher prevalence of high risk OSA individuals in nocturnal ACS group of 95% compared to 30% of high risk OSA individuals in non-nocturnal ACS group (p=0.001). Nocturnal ACS patients was significantly younger (50.1±8.7yrs, p=0.001), had higher BMI (33.9±4.3kg/m2, p=0.005), waist circumference (106.7±10.3cm, p=0.003) and larger neck circumference (44.6±3.3cm, p=0.001) compared to non-nocturnal ACS group. These groups had similar prevalence of other comorbidities for ACS and showed no significant difference between left and right ventricular systolic function. In multiple logistic regression analysis, the most significant predictors for nocturnal ACS are OSA risk, neck circumference and age. Conclusion There is a strong association between high risk OSA individuals and nocturnal ACS onset. Patient with nocturnal ACS onset should be screened for OSA and prioritized for polysomnography. OSA prevalence according to ACS onset Funding Acknowledgement Type of funding source: None

scholarly journals Changes of Walking Activity During the First Cycle Phases of COVID-19 Pandemic: A Case Study of Seoul, Korea

2021 ◽  
pp. 193758672110265
Author(s):  
Youngjun Park ◽  
Haekwon Chung ◽  
Sohyun Park
Keyword(s):  
Public Health ◽  
Physical Inactivity ◽  
Voluntary Participation ◽  
Walking Activity ◽  
Significant Difference ◽  
Before And After ◽  
Acceleration And Deceleration ◽  
Preliminary Study ◽  
The Government

Aim: This study explores the changes in regular walking activities during the phases of the pandemic. Background: With the spread of COVID-19 transmission, people are refraining from going out, reducing their physical activity. In South Korea, COVID-19 broke out in the 4th week of 2020 and experienced the first cycle phases of the pandemic, such as outbreak, widespread, and decline. In response to the pandemic, the government encouraged voluntary participation in social distancing campaigns, and people reduced their outside activities. Methods: This article examines the decrease and increase of the Prevalence of Regular Walking (≥30 min of moderate walking a day, on ≥5 days a week) by the COVID-19 phases. This study is based on weekly walking data for 15 weeks in 2020, via the smartphone healthcare app, which is managed by 25 public health offices of the Seoul government. Results: According to the findings, the level of prevalence of regular walking (PRW) has a significant difference before and after the outbreak, and every interval of the four-stage COVID-19 phases, that is, pre-pandemic, initiation, acceleration, and deceleration. The level of PRW sharply decreased during initiation and acceleration intervals. In the deceleration interval of COVID-19, the PRW kept increasing, but it has not yet reached the same level as the previous year when the COVID-19 did not exist. Conclusions: As a preliminary study, this study explains empirically how COVID-19 changed PRW in Seoul. It would be helpful to enhance our understanding of the changes in physical inactivity in the pandemic period.

scholarly journals Effects of Feeding Time on Markers of Muscle Metabolic Flexibility Following Acute Aerobic Exercise in Trained Mice Undergoing Time Restricted Feeding

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1717
Author(s):  
Aaron Persinger ◽  
Matthew Butawan ◽  
Martina Faietti ◽  
Ashley Pryke ◽  
Kyley Rose ◽  
...  
Keyword(s):  
Exercise Training ◽  
Performance Outcomes ◽  
Metabolic Flexibility ◽  
Feeding Time ◽  
Restricted Feeding ◽  
Physically Active ◽  
Impact Performance ◽  
Before And After ◽  
And Performance ◽  
Access To Food

Time-restricted feeding (TRF) is becoming a popular way of eating in physically active populations, despite a lack of research on metabolic and performance outcomes as they relate to the timing of food consumption in relation to the time of exercise. The purpose of this study was to determine if the timing of feeding/fasting after exercise training differently affects muscle metabolic flexibility and response to an acute bout of exercise. Male C57BL/6 mice were randomized to one of three groups for 8 weeks. The control had ad libitum access to food before and after exercise training. TRF-immediate had immediate access to food for 6 h following exercise training and the TRF-delayed group had access to food 5-h post exercise for 6 h. The timing of fasting did not impact performance in a run to fatigue despite TRF groups having lower hindlimb muscle mass. TRF-delayed had lower levels of muscle HSL mRNA expression and lower levels of PGC-1α expression but displayed no changes in electron transport chain enzymes. These results suggest that in young populations consuming a healthy diet and exercising, the timing of fasting may not substantially impact metabolic flexibility and running performance.

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