scholarly journals Effects of acetazolamide on control of breathing in sleep apnea patients: Mechanistic insights using meta‐analyses and physiological model simulations

2021 ◽  
Vol 9 (20) ◽  
Author(s):  
Christopher N. Schmickl ◽  
Shane Landry ◽  
Jeremy E. Orr ◽  
Brandon Nokes ◽  
Bradley A. Edwards ◽  
...  
Keyword(s):  
Sleep Apnea ◽  
Physiological Model ◽  
Control Of Breathing ◽  
Model Simulations ◽  
Meta Analyses

Control of Breathing in Obstructive Sleep Apnea

CHEST Journal ◽  
1984 ◽  
Vol 85 (2) ◽  
pp. 174-180 ◽  
Author(s):  
Krishnan R. Rajagopal ◽  
Peter H. Abbrecht ◽  
Claude J. Tellis
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Control Of Breathing ◽  
Obstructive Sleep

Investigating the Association between Wake-Up Stroke and Obstructive Sleep Apnea: A Meta-Analysis

2021 ◽  
pp. 1-10
Author(s):  
Xin Lu ◽  
Wenhong Liu ◽  
Hui Wang
Keyword(s):  
Sleep Apnea ◽  
Sleep Disordered Breathing ◽  
Meta Analysis ◽  
Sleep Apnea Syndrome ◽  
Stroke Patients ◽  
Respiratory Effects ◽  
Respiratory Events ◽  
Obstructive Sleep ◽  
Appropriate Therapy ◽  
Meta Analyses

<b><i>Background:</i></b> Management of wake-up stroke (WUS) is always a challenge as no clear time of onset could be ascertained, and how to choose an appropriate therapy remains unclear. Sleep-disordered breathing (SDB) has been regarded as a potential risk factor to WUS, yet no consensus was achieved. Motivated by the need for a deeper understanding of WUS and its association with sleep apnea, meta-analyses summarizing the available evidence of respiratory events and indices were conducted, and sensitivity analysis was also used for heterogeneity. <b><i>Methods:</i></b> Electronic databases were systematically searched, and cross-checking was done for relevant studies. Collected data included demographic characteristics, and sleep apnea parameters were extracted with stroke patients divided into WUS and NWUS groups. Clinical data of stroke patients accompanied with sleep apnea syndrome (OSA, SAS, and severe SAS) were also extracted for meta-analysis. <b><i>Results:</i></b> A total of 13 studies were included in the analysis. The meta-analysis results showed that OSA, SAS, and severe SAS were significantly higher in WUS patients. A significantly higher AHI (WMD 7.74, 95% CI: 1.38–14.11; <i>p</i> = 0.017) and ODI (WMD of 3.85, 95% CI: 0.261–7.438; <i>p</i> = 0.035) than NWUS patients was also observed in the analysis of respiratory indices. <b><i>Conclusion:</i></b> WUS patients have severer SDB problems compared to NWUS patients suggesting that respiratory events during sleep might be underlying the induction of WUS. Besides, the induction of WUS was significantly associated with men rather than women. Therefore, early diagnosis and management of potential WUS patients should benefit from the detection of SDB status and respiratory effects.

scholarly journals Sleep-disordered breathing is associated with brain vascular reactivity in spinal cord injury

Neurology ◽  
2019 ◽  
Vol 93 (24) ◽  
pp. e2181-e2191
Author(s):  
Jordan W. Squair ◽  
Amanda H.X. Lee ◽  
Zoe K. Sarafis ◽  
Geoff Coombs ◽  
Otto Barak ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Sleep Apnea ◽  
Sleep Disordered Breathing ◽  
Population Level ◽  
Chronic Fatigue ◽  
Severity Of Injury ◽  
Cord Injury ◽  
Meta Analyses ◽  
Disordered Breathing

ObjectiveTo determine the population-level odds of individuals with spinal cord injury (SCI) experiencing fatigue and sleep apnea, to elucidate relationships with level and severity of injury, and to examine associations with abnormal cerebrovascular responsiveness.MethodsWe used population-level data, meta-analyses, and primary physiologic assessments to provide a large-scale integrated assessment of sleep-related complications after SCI. Population-level and meta-analyses included more than 60,000 able-bodied individuals and more than 1,800 individuals with SCI. Physiologic assessments were completed on a homogenous sample of individuals with cervical SCI and matched controls. We examined the prevalence of (1) self-reported chronic fatigue, (2) clinically identified sleep apnea, and 3) cerebrovascular responsiveness to changing CO2.ResultsLogistic regression revealed a 7-fold elevated odds of chronic fatigue after SCI (odds ratio [OR] 7.9, 95% confidence interval [CI] 3.5–16.2), and that fatigue and trouble sleeping are correlated with the level and severity of injury. We further show that those with SCI experience elevated risk of clinically defined sleep-disordered breathing in more than 600 individuals with SCI (pooled OR 3.1, 95% CI 1.3–7.5). We confirmed that individuals with SCI experience a high rate of clinically defined sleep apnea using primary polysomnography assessments. We then provide evidence using syndromic analysis that sleep-disordered breathing is a factor strongly associated with impaired cerebrovascular responsiveness to CO2 in patients with SCI.ConclusionsIndividuals with SCI have an increased prevalence of sleep-disordered breathing, which may partially underpin their increased risk of stroke. There is thus a need to integrate sleep-related breathing examinations into routine care for individuals with SCI.

Abnormal Breathing during Sleep and Chemical Control of Breathing during Wakefulness in Patients with Sleep Apnea Syndrome

1989 ◽  
Vol 139 (1) ◽  
pp. 164-169 ◽  
Author(s):  
Fumio Kunitomo ◽  
Hiroshi Kimura ◽  
Koichiro Tatsumi ◽  
Shinya Okita ◽  
Hirokazu Tojima ◽  
...  
Keyword(s):  
Sleep Apnea ◽  
Chemical Control ◽  
Sleep Apnea Syndrome ◽  
Control Of Breathing ◽  
Abnormal Breathing ◽  
Apnea Syndrome

scholarly journals Meta-analyses of the Association of Sleep Apnea with Insulin Resistance, and the Effects of CPAP on HOMA-IR, Adiponectin, and Visceral Adipose Fat

2015 ◽  
Vol 11 (04) ◽  
pp. 475-485 ◽  
Author(s):  
Imran H. Iftikhar ◽  
Camilla M. Hoyos ◽  
Craig L. Phillips ◽  
Ulysses J. Magalang
Keyword(s):  
Insulin Resistance ◽  
Sleep Apnea ◽  
Meta Analyses ◽  
Visceral Adipose

scholarly journals The Treatment of Central Sleep Apnea Syndromes in Adults: Practice Parameters with an Evidence-Based Literature Review and Meta-Analyses

SLEEP ◽  
2012 ◽  
Vol 35 (1) ◽  
pp. 17-40 ◽  
Author(s):  
R. Nisha Aurora ◽  
Susmita Chowdhuri ◽  
Kannan Ramar ◽  
Sabin R. Bista ◽  
Kenneth R. Casey ◽  
...  
Keyword(s):  
Sleep Apnea ◽  
Literature Review ◽  
Central Sleep Apnea ◽  
Sleep Apnea Syndromes ◽  
Evidence Based ◽  
Practice Parameters ◽  
Meta Analyses

Disordered Control of Breathing in Infants and Children

1993 ◽  
Vol 14 (2) ◽  
pp. 51-65
Author(s):  
John L. Carroll ◽  
Carole L. Marcus ◽  
Gerald M. Loughlin
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Respiratory Control ◽  
Upper Airway ◽  
Control Of Breathing ◽  
Control Mechanisms ◽  
Airway Patency ◽  
Breathing Control ◽  
Airway Control ◽  
Obstructive Sleep

Introduction Breathing must be tightly regulated so that the amount of oxygen inhaled and carbon dioxide exhaled matches precisely the metabolic needs of the body. Acute malfunction of breathing control mechanisms, even for a few seconds, may lead rapidly to serious physiologic derangements, with death as the final outcome if the system fails to recover. Chronic malfunction of breathing control mechanisms may lead to chronically abnormal blood gases (eg, hypoxemia), with such consequent complications as developmental delay or cor pulmonale. Because the upper airway is shared for breathing, eating, drinking, and talking, control of breathing also encompasses coordination of these actions in such a way that all are carried out effectively. The upper airway also must be actively held open during sleep or it will collapse during the inspiratory phase of breathing. Tone and activity of the muscles that maintain upper airway patency are controlled, in part, by the respiratory control systems. Malfunction of upper airway control mechanisms may play a role in obstructive sleep apnea. Thus, respiratory control not only refers to the control of gas exchange, but encompasses breathing pattern, apnea, respiratory protective reflexes, and upper airway control—specifically, maintenance of upper airway patency. This review will cover infant apnea and home cardiorespiratory monitoring, apparent life-threatening events (ALTEs) and home monitoring, obstructive sleep apnea syndrome (OSAS) in children, central hypoventilation syndromes, and hyperventilation syndromes.

003 Treatment of Sleep Disordered Breathing with Leptin Loaded Exosomes

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A1-A2
Author(s):  
Carla Freire ◽  
Huy Pho ◽  
Jacob Ramsey ◽  
Stone Streeter ◽  
Ryo Kojima ◽  
...  
Keyword(s):  
Sleep Apnea ◽  
Sleep Disordered Breathing ◽  
Imaging System ◽  
Minute Ventilation ◽  
Upper Airway ◽  
Control Of Breathing ◽  
Obstructive Sleep ◽  
Hypoventilation Syndrome ◽  
Disordered Breathing

Abstract Introduction Obstructive sleep apnea (OSA) is characterized by recurrent periods of upper airway obstruction. The prevalence of OSA exceeds 50% in obese individuals and in 10–20% of obese patients OSA coexists with obesity hypoventilation syndrome (OHS) defined as daytime hypercapnia and hypoventilation during sleep attributed to the depressed control of breathing. There is no effective pharmacotherapy for OSA and OHS. Leptin is a potent respiratory stimulant and a potential therapeutic candidate. However, diet-induced obesity (DIO) results in reduced permeability of the blood-brain barrier (BBB) for leptin. Previous studies have shown that the BBB can be penetrated by exosomes, natural nanoparticles that can be used as drug delivery vehicles. In this study, we aimed to determine if exosomes overcome the BBB and treat OSA and OHS in DIO mice. Methods o examine the ability of exosomes to cross the BBB, male, lean (n=5) and DIO (n=5) C57BL/6J mice were injected with fluorescent exosomes or saline into the lateral tail vein. After 4h fluorescent exosomes biodistribution was evaluated by an in vitro imaging system (IVIS). Saline injected mice images were used for background adjustment. A separate subgroup of male, DIO (n=10) and lean (n=10) mice were headmounted with EEG and nuchal EMG leads. Sleep studies were performed in a plethysmography chamber and mice received saline, empty exosomes, free leptin, or leptin-loaded exosomes in a crossover manner. Results Exosomes were successfully delivered to the brain and the transport across the BBB was more efficient in DIO mice with 2-times greater relative fluorescence units measured in DIO when compared to lean mice (p&lt;0.005). In DIO mice, exosomal leptin induced dramatic 1.7-2.2-fold increases in minute ventilation and 1.5-2.0-fold increases in maximal inspiratory flow during both flow-limited (upper airway/sleep apnea) and non-flow limited breathing (control of breathing) (p&lt;0.05). In contrast, free leptin had no effect. Lean mice did not present significant sleep disordered breathing and no differences were observed between groups. Conclusion We demonstrated that exosomes overcome the BBB and that leptin-loaded exosomes treat OSA and OHS in DIO mice. Support (if any) R01HL 128970, R01HL 138932, R61 HL156240, U18 DA052301, FAPESP 2018/08758-3

scholarly journals Auto-titrating versus fixed continuous positive airway pressure for the treatment of obstructive sleep apnea: a systematic review with meta-analyses

2012 ◽  
Vol 1 (1) ◽  
Author(s):  
Stanley Ip ◽  
Carolyn D'Ambrosio ◽  
Kamal Patel ◽  
Ndidiamaka Obadan ◽  
Georgios D Kitsios ◽  
...  
Keyword(s):  
Systematic Review ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Obstructive Sleep ◽  
Meta Analyses
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