scholarly journals Zolpidem Increases Sleep Efficiency and the Respiratory Arousal Threshold in Obstructive Sleep Apnea

2020 ◽  
Author(s):  
L. Messineo ◽  
S.G. Carter ◽  
A. Chiang ◽  
J. Carberry ◽  
D.J. Eckert
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Efficiency ◽  
Arousal Threshold ◽  
Obstructive Sleep

scholarly journals O013 The pathogenesis of obstructive sleep apnea in individuals with comorbid insomnia and obstructive sleep apnoea (COMISA)

2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A6-A7
Author(s):  
E Brooker ◽  
L Thomson ◽  
S Landry ◽  
B Edwards ◽  
S Drummond
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Upper Airway ◽  
Severity Index ◽  
Loop Gain ◽  
Comorbid Insomnia ◽  
Arousal Threshold ◽  
Obstructive Sleep ◽  
High Loop ◽  
Insomnia Severity

Abstract Obstructive sleep apnea (OSA) and Insomnia are prevalent sleep disorders which are highly comorbid. This frequent co-occurrence suggests a shared etiology may exist. OSA is caused by the interaction of four pathophysiological traits: a highly collapsible upper airway, elevated loop gain, a low arousal threshold, and poor muscle compensation. No study has ascertained whether these traits are influenced by insomnia. We aimed to quantify the four traits which contribute to OSA in individuals diagnosed with comorbid insomnia and OSA (COMISA). We non-invasively determined these traits in 52 COMISA patients (Age: 56±14 years) with mild-to-severe OSA (AHI=21.2±10.63 events/h) using polysomnography. Our results indicated that 83% of COMISA patients had a low arousal threshold and only 2% of patients exhibited a highly collapsible airway using previously defined thresholds. Multiple linear regression revealed the arousal threshold (b=0.24, 95%CI[0.11, 0.37], β=0.47, p<0.001) and loop gain (b=23.6, 95%CI[7.02, 40.18], β=0.33, p<0.01) were the strongest predictors of OSA severity in our sample. There was no significant relationship between the arousal threshold and insomnia severity measured by the insomnia severity index (ISI). Further work is being performed to compare these findings with a matched sample of OSA only participants. Our preliminary findings demonstrate OSA in COMISA is characterized by a mildly collapsible airway/low arousal threshold phenotype and is largely driven by non-anatomical factors including a low arousal threshold and high loop gain. OSA treatments which are effective in patients with mild anatomical compromise and raise the arousal threshold may provide therapeutic benefit in COMISA patients.

scholarly journals The Effect of Hypopnea Scoring on the Arousal Threshold in Patients with Obstructive Sleep Apnea

2020 ◽  
Vol 202 (9) ◽  
pp. 1308-1311
Author(s):  
Luke D. J. Thomson ◽  
Shane A. Landry ◽  
Rebecca Singleton ◽  
Ai-Ming Wong ◽  
Simon A. Joosten ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Arousal Threshold ◽  
Obstructive Sleep

scholarly journals 0710 Hypoglossal Neurostimulation In Rem- Vs. Nrem-predominant Obstructive Sleep Apnea

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A270-A270
Author(s):  
C I Cabrera ◽  
B Szelestey ◽  
K Strohl ◽  
A Schell
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Univariate Analysis ◽  
Disease Process ◽  
Loop Gain ◽  
Upper Airway Stimulation ◽  
Arousal Threshold ◽  
Obstructive Sleep ◽  
Baseline Characteristics ◽  
Star Trial

Abstract Introduction Obstructive sleep apnea (OSA) is a chronic condition that requires appropriate treatment strategies to optimize outcomes while minimizing risk. In addition to anatomy, physiologic factors such as arousal threshold and loop gain (i.e. “endotypes”) play a known role in the disease process. Because loop gain tends to be higher and arousal threshold lower in NREM sleep, we hypothesize that patients with NREM-predominance may achieve less success with anatomical therapy such as upper airway stimulation (UAS). Our study aims to evaluate baseline characteristics and objective results related to NREM-predominance in patients treated with UAS. Methods Using data from the STAR trial, we identified patients (n=103) with at least 20 minutes of REM on baseline testing and complete demographic and disease data at baseline and month 18. Baseline NREM-predominant disease (percent NREM events > 50) was defined as a binary variable. We created two cohorts: 1) patients with REM-predominant disease and 2) those with NREM-predominant disease. ODI and AHI were evaluated at month 18. Results Overall 62% (n=64) of patients had NREM-predominant disease at baseline. Other baseline characteristics were similar between both groups. In univariate analysis, age was significantly associated with lower AHI in the NREM-predominant population (p<0.05) but not in the REM-predominant group (p>0.05). Results were similar for ODI. For both groups, increasing age was correlated negatively with increasing AHI; this correlation was stronger in the NREM-predominant group Conclusion A majority of patients in the STAR trial had NREM-predominant OSA at baseline. There appears to be an interaction between NREM-predominance and age as predictors of UAS outcomes. Support  

scholarly journals 0879 Outcomes of Adenotonsillectomy in Children with Down Syndrome and Obstructive Sleep Apnea

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A335-A335
Author(s):  
A Morello Gearhart ◽  
B Gunaratnam ◽  
E Senthilvel
Keyword(s):  
Obstructive Sleep Apnea ◽  
Down Syndrome ◽  
Sleep Apnea ◽  
Sleep Onset ◽  
Sleep Efficiency ◽  
Apnea Hypopnea Index ◽  
P Value ◽  
Children With Down Syndrome ◽  
Arousal Index ◽  
Obstructive Sleep

Abstract Introduction Obstructive sleep apnea (OSA) is highly prevalent in children with Down Syndrome (DS). The aim of this study was to assess the effectiveness of adenotonsillectomy (T&A) on polysomnographic parameters of children with DS. Methods Retrospective chart review of children with DS who underwent T&A between 2012-2019 was performed. Preoperative OSA severity was categorized by obstructive apnea-hypopnea index (OAHI): mild = 1-4.9 events/h; moderate = 5-9.9 events/h; severe ≥ 10 events/h. Results We identified 43 DS children with pre and post T&A polysomnographic data in a population of 162 DS patients. A total of 25 were male, mean age 5.1 years (± 3.8 years) and 56% Caucasians. Preoperative data showed 19% mild OSA, 30% moderate and 51% severe. Postoperatively, apnea-hypopnea index (AHI) normalized in 9.3%, 37.2% had mild OSA, 18.6% moderate and 34.9% severe. Overall, T&A resulted in significant improvement (p-value <0.05) in mean AHI, (18.51 ± 28.05 vs 11.72 ± 16.43), SaO2 nadir (80.00 ± 14.82 vs 85.51 ± 5.94), sleep efficiency (81.97 ± 11.15 vs 85.9 ± 8.28), arousal index (16.14 ± 10.23 vs 14.45 ± 12.34), and wake after sleep onset (67.19 ± 46.89 vs 50.55 ± 40.83) and no statistical difference (p-value >0.05) in end-tidal carbon dioxide (43.86 ± 9.56 vs 44.17 ± 3.78), Rapid Eye Movement (REM)% (15.86 ± 7.75 vs 15.92 ± 7.41), sleep latency (24.03 ± 34.39 vs 22.55 ± 21.11), and central apnea index (0.86 ± 1.38 vs 0.66 ± 0.82) in pre and post T&A data. There was no statistically significant difference in pre and post T&A polysomnographic parameters between 17 DS and 17 age and gender-matched non-DS control subjects. Conclusion Adenotonsillectomy resulted in improvement in AHI, oxygen desaturation nadir, sleep efficiency, arousal index and wake after sleep onset. However, a significant portion of children with DS continued to have moderate to severe OSA after T&A. Support None.

scholarly journals Quantifying the Arousal Threshold Using Polysomnography in Obstructive Sleep Apnea

SLEEP ◽  
2017 ◽  
Vol 41 (1) ◽  
Author(s):  
Scott A Sands ◽  
Philip I Terrill ◽  
Bradley A Edwards ◽  
Luigi Taranto Montemurro ◽  
Ali Azarbarzin ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Arousal Threshold ◽  
Obstructive Sleep

Variability And Reproducibility Of The Respiratory Arousal Threshold In Untreated Obstructive Sleep Apnea Patients

2010 ◽  
Author(s):  
Geoff Kehlmann ◽  
Robert L. Owens ◽  
Andrew Wellman ◽  
Amy S. Jordan ◽  
Shilpa Rahangdale ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Arousal Threshold ◽  
Obstructive Sleep

scholarly journals Intermittent Fasting and Sleep: A Review of Human Trials

Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3489
Author(s):  
Mara McStay ◽  
Kelsey Gabel ◽  
Sofia Cienfuegos ◽  
Mark Ezpeleta ◽  
Shuhao Lin ◽  
...  
Keyword(s):  
Weight Loss ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Quality ◽  
Sleep Duration ◽  
Sleep Latency ◽  
Sleep Efficiency ◽  
Intermittent Fasting ◽  
Obstructive Sleep ◽  
Insomnia Severity

This review examines the effects of two popular intermittent fasting regimens on sleep in adults with overweight and obesity. Specifically, the effects of time restricted eating (TRE; eating all food within a 4–10 h window) and alternate day fasting (ADF; 600 kcal fast day alternated with ad libitum feast day) on sleep quality, sleep duration, sleep latency, sleep efficiency, insomnia severity, and risk of obstructive sleep apnea, will be summarized. The role of weight loss will also be discussed. Results from our review reveal that the majority of these trials produced weight loss in the range of 1–6% from baseline. Sleep quality and sleep duration remained unaltered with TRE and ADF, as assessed by the Pittsburgh Sleep Quality Index (PSQI). The effects of intermittent fasting on sleep latency and sleep efficiency are mixed, with one study showing worsening of these parameters, and others showing no effect. Insomnia severity and the risk of obstructive sleep apnea remained unchanged in the trials assessing these metrics. Taken together, these preliminary findings suggest that TRE and ADF produce mild to moderate weight loss (1–6%) but their effects on sleep remain unclear. Solid conclusions are difficult to establish since participants in the studies had healthy sleep durations and no clinical insomnia at baseline, leaving little room for improvement in these metrics. Moreover, none of the trials were adequately powered to detect statistically significant changes in any measure of sleep. Future well-powered trials, conducted in individuals with diagnosed sleep disturbances, will be necessary to elucidate the effect of these popular diets on sleep.

scholarly journals Characteristics of Obstructive Sleep Apnea Patients With Hypertension and Factors Associated With Autotitration Acceptance

2022 ◽  
Vol 12 ◽  
Author(s):  
Xuan Zhang ◽  
Ning Zhang ◽  
Yang Yang ◽  
Shuo Wang ◽  
Ping Yu ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Eye Movement ◽  
Total Sleep Time ◽  
Sleep Time ◽  
Sleep Efficiency ◽  
Apnea Hypopnea Index ◽  
Rapid Eye Movement ◽  
Obstructive Sleep ◽  
Severe Group

In order to explore the characteristics and treatment status of obstructive sleep apnea (OSA) patients with hypertension, a retrospective study was conducted on 306 patients admitted from October 2018 to December 2019. According to the apnea hypopnea index (AHI), OSA patients with hypertension were divided into three groups. 69 cases were mild OSA (5 ≤ AHI < 15), 86 cases were moderate (15 ≤ AHI < 30), and 151 cases were severe (AHI ≥ 30). Compared with patients in the mild and moderate groups, the severe group had more male patients, with higher body mass index (BMI) and non-rapid eye movement stage 1 accounted for total sleep time (N1%), and lower non-rapid eye movement stage 2 accounted for total sleep time (N2%), average and minimum blood oxygen. Among all the patients, those who underwent the titration test accounted for 20.6% (63/306). Multivariate analysis showed that sleep efficiency (p < 0.001) and AHI (p < 0.001) were independent factors for patients to accept titration test. OSA patients with hypertension had a low acceptance of titration therapy. These people with higher sleep efficiency and AHI were more likely to receive autotitration.

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