Termination off Central Sleep Apnea Episodes by Upper Airway Stimulation Using Intermittent Positive Pressure Ventilation

CHEST Journal ◽  
1991 ◽  
Vol 99 (6) ◽  
pp. 1527-1529 ◽  
Author(s):  
George Thommi ◽  
Kenneth Nugent ◽  
George M. Bell ◽  
Jing Liu
Keyword(s):  
Sleep Apnea ◽  
Positive Pressure Ventilation ◽  
Central Sleep Apnea ◽  
Upper Airway ◽  
Intermittent Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Upper Airway Stimulation

Central sleep apnea and hypoventilation syndromes

2017 ◽  
Author(s):  
Mithri R. Junna ◽  
Bernardo J. Selim ◽  
Timothy I. Morgenthaler
Keyword(s):  
Sleep Apnea ◽  
Airway Obstruction ◽  
Noninvasive Positive Pressure Ventilation ◽  
Central Sleep Apnea ◽  
Upper Airway ◽  
Upper Airway Obstruction ◽  
Positive Pressure ◽  
Adaptive Servo Ventilation ◽  
Obstructive Sleep ◽  
Alveolar Hypoventilation

Sleep disordered breathing (SDB) may occur in a variety of ways. While obstructive sleep apnea is the most common of these, this chapter reviews the most common types of SDB that occur independently of upper airway obstruction. In many cases, there is concurrent upper airway obstruction and neurological respiratory dysregulation. Thus, along with attempts to correct the underlying etiologies (when present), stabilization of the upper airway is most often combined with flow generators (noninvasive positive pressure ventilation devices) that modulate the inadequate ventilatory pattern. Among these devices, when continuous positive airway pressure (CPAP) alone does not allow correction of SDB, adaptive servo-ventilation (ASV) is increasingly used for non-hypercapnic types of central sleep apnea (CSA), while bilevel PAP in spontaneous-timed mode (BPAP-ST) is more often reserved for hypercapnic CSA/alveolar hypoventilation syndromes. Coordination of care among neurologists, cardiologists, and sleep specialists will often benefit such patients.

scholarly journals Mechanisms of active laryngeal closure during noninvasive intermittent positive pressure ventilation in nonsedated lambs

2008 ◽  
Vol 105 (5) ◽  
pp. 1406-1412 ◽  
Author(s):  
Bianca Roy ◽  
Nathalie Samson ◽  
François Moreau-Bussière ◽  
Alain Ouimet ◽  
Dominique Dorion ◽  
...  
Keyword(s):  
Positive Pressure Ventilation ◽  
Thoracoscopic Surgery ◽  
Upper Airway ◽  
Progressive Increase ◽  
Intermittent Positive Pressure Ventilation ◽  
Control Mode ◽  
Volume Control ◽  
Positive Pressure ◽  
Upper Airways ◽  
Bilateral Vagotomy

The present study stems from our recent demonstration (Moreau-Bussiere F, Samson N, St-Hilaire M, Reix P, Lafond JR, Nsegbe E, Praud JP. J Appl Physiol 102: 2149–2157, 2007) that a progressive increase in nasal intermittent positive pressure ventilation (nIPPV) leads to active glottal closure in nonsedated, newborn lambs. The aim of the study was to determine whether the mechanisms involved in this glottal narrowing during nIPPV originate from upper airway receptors and/or from bronchopulmonary receptors. Two groups of newborn lambs were chronically instrumented for polysomnographic recording: the first group of five lambs underwent a two-step bilateral thoracic vagotomy using video-assisted thoracoscopic surgery (bilateral vagotomy group), while the second group, composed of six lambs, underwent chronic laryngotracheal separation (isolated upper airway group). A few days later, polysomnographic recordings were performed to assess glottal muscle electromyography during step increases in nIPPV (volume control mode). Results show that active glottal narrowing does not develop when nIPPV is applied on the upper airways only, and that this narrowing is prevented by bilateral vagotomy when nIPPV is applied on intact airways. In conclusion, active glottal narrowing in response to increasing nIPPV originates from bronchopulmonary receptors.

Nasal Intermittent Positive Pressure Ventilation versus Continuous Positive Airway Pressure and Apnea of Prematurity: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Bayane Sabsabi ◽  
Ava Harrison ◽  
Laura Banfield ◽  
Amit Mukerji
Keyword(s):  
Systematic Review ◽  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Primary Outcome ◽  
Positive Pressure Ventilation ◽  
Positive Airway Pressure ◽  
Meta Analysis ◽  
Intermittent Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Apnea Of Prematurity

Objective The study aimed to systematically review and analyze the impact of nasal intermittent positive pressure ventilation (NIPPV) versus continuous positive airway pressure (CPAP) on apnea of prematurity (AOP) in preterm neonates. Study Design In this systematic review and meta-analysis, experimental studies enrolling preterm infants comparing NIPPV (synchronized, nonsynchronized, and bi-level) and CPAP (all types) were searched in multiple databases and screened for the assessment of AOP. Primary outcome was AOP frequency per hour (as defined by authors of included studies). Results Out of 4,980 articles identified, 18 studies were included with eight studies contributing to the primary outcome. All studies had a high risk of bias, with significant heterogeneity in definition and measurement of AOP. There was no difference in AOPs per hour between NIPPV versus CPAP (weighted mean difference = −0.19; 95% confidence interval [CI]: −0.76 to 0.37; eight studies, 456 patients). However, in a post hoc analysis evaluating the presence of any AOP (over varying time periods), the pooled odds ratio (OR) was lower with NIPPV (OR: 0.46; 95% CI: 0.32–0.67; 10 studies, 872 patients). Conclusion NIPPV was not associated with decrease in AOP frequency, although demonstrated lower odds of developing any AOP. However, definite recommendations cannot be made based on the quality of the published evidence. Key Points

Sleep and Violence*

1984 ◽  
Vol 29 (2) ◽  
pp. 132-134 ◽  
Author(s):  
L.B. Raschka
Keyword(s):  
Differential Diagnosis ◽  
Sleep Apnea ◽  
Central Sleep Apnea ◽  
Upper Airway ◽  
Violent Behaviour ◽  
Car Accidents ◽  
Prevention And Treatment ◽  
Respiratory Pathology ◽  
The Brain

Most violence connected with sleep disorder is assumed to be related to sleep walking. It is less well known that other sleep disorders can also give rise to violence. The role of narcolepsy in car accidents is mentioned. Sleep drunkenness can lead to confusion resulting in violent behaviour especially on forced awakening. This condition is associated to sleep apnea. Primary or central sleep apnea is caused by disorders of the brain stem affecting the respiratory center. Secondary or upper airway sleep apnea can be caused by virtually any condition that results in cessation of the airflow due to occlusion of the upper airway. The author describes one patient who engaged in assaultive behaviour on forced awakening following earlier alcohol consumption. The pathomechanism of violent behaviour generated by a combination of sleep apnea and respiratory pathology is described. The differential diagnosis, prevention and treatment is outlined. The use of polysomnography in diagnosis and the potentially dangerous effects of drugs with respiratory depressing effects is highlighted.

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