scholarly journals RESPIRATORY MANIFESTATIONS IN ENDOCRINE DISEASES

2016 ◽  
Vol 89 (4) ◽  
pp. 459-463 ◽  
Author(s):  
Codruţa Lencu ◽  
Teodora Alexescu ◽  
Mirela Petrulea ◽  
Monica Lencu
Keyword(s):  
Sleep Apnea ◽  
Central Sleep Apnea ◽  
Regulation Of Respiration ◽  
Control Mechanisms ◽  
Upper Airways ◽  
Respiratory Disorders ◽  
Medical Practitioners ◽  
Endocrine Diseases ◽  
The Central Nervous System ◽  
Pulmonary Arterial

The control mechanisms of respiration as a vital function are complex: voluntary – cortical, and involuntary – metabolic, neural, emotional and endocrine. Hormones and hypothalamic neuropeptides (that act as neurotrasmitters and neuromodulators in the central nervous system) play a role in the regulation of respiration and in bronchopulmonary morphology. This article presents respiratory manifestations in adult endocrine diseases that evolve with hormone deficit or hypersecretion. In hyperthyroidism, patients develop ventilation disorders, obstructive and central sleep apnea, and pleural collection. The respiratory abnormalities in hyperthyroidism as a result of the hypermetabolic action of thyroid hormones are hyperventilation, myopathy and cardiovascular involvement; recent studies have reported pulmonary arterial hypertension in Graves’ disease, as a result of the association of several mechanisms. Thyroid hypertrophy can induce through compression of the upper airways dyspnea, stridor, wheezing and cough. The respiratory disorders in acromegaly are ventilatory dysfunction and sleep apnea, which contribute to an unfavorable evolution of the disease. Respiratory changes in parathyroid, adrenal and reproductive system diseases have been described. Respiratory disorders should be recognized, investigated and monitored by medical practitioners of various specialties (family physicians, internists, endocrinologists, pneumologists, cardiologists). They are frequently severe, causing an unfavorable evolution of the associated endocrine and respiratory disease. 

scholarly journals EXPRESS: Hypoxemia during Sleep and Overnight Rostral Fluid Shift in Pulmonary Arterial Hypertension: a pilot study

2021 ◽  
pp. 204589402199693
Author(s):  
Etienne-Marie Jutant ◽  
David Montani ◽  
Caroline Sattler ◽  
Sven Günther ◽  
Olivier Sitbon ◽  
...  
Keyword(s):  
Sleep Apnea ◽  
Pilot Study ◽  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Central Sleep Apnea ◽  
The Body ◽  
Fluid Shift ◽  
Sleep Related Breathing Disorders ◽  
Breathing Disorders ◽  
Pulmonary Arterial

Introduction. Sleep-related breathing disorders, including sleep apnea and hypoxemia during sleep, are common in pulmonary arterial hypertension (PAH), but the underlying mechanisms remain unknown. Overnight fluid shift from the legs to the upper airway and to the lungs promotes obstructive and central sleep apnea, respectively, in fluid retaining states. The main objective was to evaluate if overnight rostral fluid shift from the legs to the upper part of the body is associated with sleep-related breathing disorders in PAH. Methods. In a prospective study, a group of stable patients with idiopathic, heritable, related to drugs, toxins, or treated congenital heart disease PAH underwent a polysomnography and overnight fluid shift measurement by bioelectrical impedance in the month preceding or following a one-day hospitalization according to regular PAH follow-up schedule with a right heart catheterization. Results. Among 15 patients with PAH (women: 87%; median [25th;75th percentiles] age: 40 [32;61] years; mean pulmonary arterial pressure 56 [46;68] mmHg; pulmonary vascular resistance 8.8 [6.4;10.1] Wood units), 2 patients had sleep apnea and 8 (53%) had hypoxemia during sleep without apnea. The overnight rostral fluid shift was 168 [118;263] mL per leg. Patients with hypoxemia during sleep had a greater fluid shift (221 [141; 361] mL) than those without hypoxemia (118 [44; 178] mL, p = 0.045). Conclusion. This pilot study suggests that hypoxemia during sleep is associated with overnight rostral fluid shift in PAH.

scholarly journals Pulmonary Arterial Hypertension

2019 ◽  
pp. 884-896
Author(s):  
Hugo Paz y Mar ◽  
Neal F. Chaisson
Keyword(s):  
Pulmonary Hypertension ◽  
Sleep Apnea ◽  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Central Sleep Apnea ◽  
Chronic Obstructive ◽  
Sleep Related Breathing Disorders ◽  
Obstructive Pulmonary Disease ◽  
Breathing Disorders ◽  
Pulmonary Arterial

The high prevalence of pulmonary arterial hypertension (PAH) in patients with obstructive sleep apnea (OSA) and the putative pathophysiologic connections have been extensively documented. Conversely, patients with established PAH are at risk for sleep-related ventilatory instability, including OSA, central sleep apnea, and nocturnal desaturations. This chapter reviews the prevalence and pathophysiologic interactions of these conditions, the interplay with associated disorders, and the effects of continuous positive airway pressure therapy on pulmonary hemodynamics. In patients with OSA, chronic effects of repetitive hypoxia as well as comorbidities, including chronic obstructive pulmonary disease and left-sided heart dysfunction, play a role in promoting pulmonary hypertension. Sleep disordered breathing, representing a spectrum of sleep-related breathing disorders inclusive of OSA, is highly prevalent among patients with established pulmonary hypertension. Obstructive events, central sleep apnea, and nocturnal hypoxia are within the spectrum of sleep-related breathing disorders in pulmonary hypertension. The mechanisms for these associations remain speculative.

scholarly journals Central sleep apnea – a case report

2014 ◽  
Vol 27 (1) ◽  
pp. 14-16
Author(s):  
Andrzej Dybala ◽  
Monika Dyczko ◽  
Boguslaw Makaruk ◽  
Pawel Kicinski ◽  
Elzbieta Bartoszek ◽  
...  
Keyword(s):  
Heart Failure ◽  
Central Nervous System ◽  
Congestive Heart Failure ◽  
Nervous System ◽  
Sleep Apnea ◽  
Central Sleep Apnea ◽  
Respiratory Muscles ◽  
Pathological Changes ◽  
The Central Nervous System ◽  
Central Apneas

Abstract Central sleep apnea (CSA) is a disease characterized by repetitive episodes of the socalled central apneas during sleep. The disease has a very complex etiology. In clinical practice, the most important causes of CSA are disorders of the central nervous system, congestive heart failure or certain pathological changes of the respiratory muscles. We present a case of a 43-year-old male with severe CSA, who was successfully treated with BiPAP ST equipment.

scholarly journals Our Baby Can’t Eat, Can’t Breathe, and Can’t Sleep!

2019 ◽  
pp. 686-704
Author(s):  
Elizabeth A. Blasberg ◽  
Tania L. Kraai ◽  
Madeleine Grigg-Damberger
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Central Sleep Apnea ◽  
Pediatric Intensive Care ◽  
Failure To Thrive ◽  
Regulation Of Respiration ◽  
Inspiratory Stridor ◽  
Feeding Difficulties ◽  
Obstructive Sleep ◽  
Overnight Polysomnography

An infant with severe congenital laryngomalacia presented with inspiratory stridor when feeding, crying, or supine, relieved by prone or upright repositioning. Suprasternal retractions, hypoxemia, feeding difficulties, and failure to thrive prompted admission to the pediatric intensive care unit. Symptoms of sleep disordered breathing contributed to the severity of her laryngomalacia. Overnight polysomnography confirmed severe obstructive sleep apnea and sleep-related hypoxemia. The patient underwent supraglottoplasty with resolution of the wake hypoxemia but with residual stridor and apnea. Revision supraglottoplasty led to remission of the stridor and obstructive sleep apnea but emergence of central sleep apnea. This case discusses the clinical features, diagnostic evaluation, and management of congenital laryngomalacia. Supraglottoplasty, reserved for infants with moderate or severe laryngomalacia, is the treatment of choice. Obstructive sleep apnea improves but usually does not fully remit after supraglottoplasty. Central sleep apnea is not uncommon in infants with laryngomalacia and may reflect immature or abnormal brainstem nuclei regulating regulation of respiration during sleep.

scholarly journals Obstructive Sleep Apnea (OSA), Overview and Treatment Options: A Review

2021 ◽  
pp. 63-69
Author(s):  
Najeeb Ullah Ansari ◽  
Kaneez Fatima ◽  
Suresh Kumar ◽  
Waheed Ahmed Arain ◽  
Shahnawaz Sarwari ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Soft Tissues ◽  
Treatment Options ◽  
Central Sleep Apnea ◽  
Respiratory Muscles ◽  
Upper Airways ◽  
Obstructive Sleep ◽  
The Brain

There are different forms of sleep apnea, each with different causes. Fortunately, they are all treatable. 1] Obstructive sleep apnea (OSA) occurs when the muscles and soft tissues in the upper airways relax and become blocked during sleep. It is often accompanied by loud snoring or snorting. OSA is the most common form of sleep apnea, 2] Central sleep apnea (CSA) occurs when the brain stops sending signals to the respiratory muscles while sleeping. Although the airways remain open, breathing stops. CSA is less common than OSA, 3] Mixed sleep apnea is a combination of central and obstructive sleep apnea, and Common to all of these disorders is the occurrence of apneas and hypopneas. Apnea is when the muscles and soft tissues in the upper airways slacken and collapse to the point that they are completely blocked for 10 seconds or more. Hypopnea is a partial blockage of the airways that decreases airflow by more than 50% for 10 seconds or more.

scholarly journals 0723 Associations Between Opioids, Non-Opioids and Central Sleep Apnea: A Case-Control Study

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A275-A275
Author(s):  
R Gavidia ◽  
A L Meng ◽  
A Emenike ◽  
S Hershner ◽  
E Jansen ◽  
...  
Keyword(s):  
Sleep Apnea ◽  
Medication Use ◽  
Central Sleep Apnea ◽  
Opioid Use ◽  
The Central Nervous System ◽  
Opioid Medications ◽  
The University ◽  
Study Participants

Abstract Introduction Opioids are known to contribute to central sleep apnea (CSA), as they depress responsiveness to carbon dioxide and hypoxia. However, the role of non-opioid medications (antihistamines, myorelaxants, neuroleptics, antidepressants, and hypnotics) in CSA remains unclear. Given the hypothesized impact of non-opioids on the central nervous system, we examined associations between opioid and non-opioid medications and CSA. Methods Among all adults who underwent polysomnography testing at the University of Michigan’s Sleep Center between 2013-2018 (n=10,479), we identified 105 cases of CSA. Of these patients, we randomly selected 300 controls. Demographic and health characteristics, use of medications were obtained from medical charts. We classified study participants into three categories based on medication use: non-opioids only, opioids alone or in combination with non-opioids, and none. CSA was defined as a binary outcome using polysomnographic criteria as per the International Classification of Sleep Disorders-Third Edition. We used logistic regression to examine associations between medication use and CSA. Results Among participants, male:female ratio was 1:1 with a mean age of 49 (±14.3 SD) years. Opioid use alone was rare (4%), but more common in combination with non-opioids (17%), while the exclusive use of non-opioids was found among 38%. In adjusted analyses for age and sex, those who used non-opioid alone were less likely to have a CSA diagnosis (OR=0.88, (95% CI 0.5-1.6); however, the use of opioids (alone or in combination with non-opioids) was associated with a 4-fold higher odds of CSA. Conclusion These data suggest that non-opioids have a protective influence on CSA. Conversely, opioids, alone, or in combination with non-opioids, were associated with increased CSA risk, that may be attributed to opioids alone, or to opioids and non-opioids interactions. However, as opioids were mostly co-prescribed with non-opioids, the sole effect of opioids from the synergistic effect with non-opioids are difficult to disentangle. Support Dr. Gavidia was supported by a T32 Post-Doctoral Fellowship in Neuroscience NIH/NINDS T32 NS 007222

Central Sleep Apnea in Heart Failure

2009 ◽  
Vol 6 (2) ◽  
pp. 72-78 ◽  
Author(s):  
Rami Khayat ◽  
Andrew Pederzoli ◽  
William Abraham ◽  
◽  
◽  
...  
Keyword(s):  
Heart Failure ◽  
Sleep Apnea ◽  
Central Sleep Apnea

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