scholarly journals Obstructive Sleep Apnea Management in Patients with Cardiovascular Comorbidities

2021 ◽  
Vol 65 ◽  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Cardiovascular Comorbidities ◽  
Obstructive Sleep

Abstract 14965: Atrial Conduction During Obstructive Sleep Apnea: Comparison of Stacked Versus Isolated Apnea Episodes

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Krishan Patel ◽  
Hussain Basrawala ◽  
Pavan Reddy ◽  
Edwin Valladares ◽  
Vincent Grbach ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
P Wave ◽  
Conduction Delay ◽  
Apnea Hypopnea Index ◽  
Peripheral Oxygen Saturation ◽  
Cardiovascular Comorbidities ◽  
Obstructive Sleep ◽  
Cost Efficient ◽  
The Impact

Introduction: Obstructive sleep apnea (OSA) is associated with increased rates of atrial fibrillation (AF). Recent randomized data suggest that traditional scoring of OSA needs to evolve to improve cardiovascular outcomes. Traditional scoring of OSA does not fully reflect pathophysiological links between OSA and AF, particularly regarding OSA-induced prolongation of p-wave duration (PWD), which is the most powerful predictor of AF occurrence. Hypothesis: We hypothesized that OSA episodes that closely follow each other (serially stacked apneas, ssOSA) exert greater effect on PWD compared to isolated OSA (iOSA) episodes. Methods: Sleeping patients (adults with mild-moderate OSA and presence of both iOSA and ssOSA, but without other cardiovascular comorbidities) undergoing diagnostic polysomnography were recorded by continuous 8-lead ECG. iOSA was defined as OSA episodes with no other episode within 30 seconds. ssOSA consisted of ≥3 consecutive apneas with inter-OSA intervals <30 seconds. PWD was defined from onset of p-wave in any ECG lead to termination in any lead (measured by digital calipers, averaged over 3 beats from first half of OSA and 3 beats from second half of OSA). Wilcoxon rank-sum test was used. Results: We analyzed 208 OSA episodes (51.0% iOSA, 49.0% ssOSA) which occurred in 12 patients (7 women; age 63.1±11.5 years; apnea hypopnea index 16.8±5.4). PWD was longer during ssOSA compared to iOSA (median 117.7ms vs 109.6ms; p<0.0001). The following variables did not differ between ssOSA and iOSA: PR interval (p=0.3139), RR interval (p=0.7531), peripheral oxygen saturation (p=0.7776). Conclusions: The impact of OSA on atrial conduction delay is exacerbated by the phenomenon of OSA stacking, which seems independent of oxygen desaturation and heart rate. Stacking of OSA episodes may be an underused and cost-efficient variable in evaluating the severity of OSA and the effectiveness of OSA treatments with the ultimate goal of reducing occurrence of AF.

scholarly journals 0692 Difference In Improvement Of ESS Score After CPAP Use In Patients From Different Workforces

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A264-A264
Author(s):  
T R Mehta ◽  
P Gurung ◽  
L Digala ◽  
Y Nene ◽  
P C Bollu
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
White Collar ◽  
Blue Collar ◽  
University Of Missouri ◽  
Initial Analysis ◽  
Cardiovascular Comorbidities ◽  
Institutional Review ◽  
Obstructive Sleep ◽  
The Difference

Abstract Introduction Obstructive sleep apnea (OSA) is characterized by recurrent occurrences of apnea and hypopnea throughout the night during sleep. Reported to prevail in 23.4% women and 49.7% men aged 40 years or older, OSA is considered to be the most preventable cause of excessive daytime sleepiness. Methods After obtaining approval from the institutional review board (IRB) for this retrospective study, a total of 825 patient records from a prospective registry of obstructive sleep apnea from our sleep lab affiliated with the University of Missouri Hospital were searched for variables including but not limited to age, race, gender, occupation, medications any sleep-related comorbidities, psychiatric comorbidities, cardiovascular comorbidities, pre CPAP ESS score and post CPAP ESS score. The mean improvement score of ESS in both these populations was compared and possible causes for the difference in these groups were analyzed. Results Initial analysis from 22 patients belonging to the white-collar and 22 patients belonging to the blue-collar workforce with a mean age of 49.27 (±14.28) years and a mean BMI of 37.60 (±9.41) showed a mean improvement of -1.27 and 0.63 respectively with no significance statistically. Statistical analysis will be performed after gathering data from a larger sample size. Conclusion Although insignificant, the blue-collar workforce showed more improvement than the white-collar workforce in the initial analysis. Support No support, financial or otherwise was used for this study.

scholarly journals Obstructive Sleep Apnea and Cardiovascular Comorbidities

Medicine ◽  
2014 ◽  
Vol 93 (9) ◽  
pp. e45 ◽  
Author(s):  
Hanna Gilat ◽  
Shlomo Vinker ◽  
Inon Buda ◽  
Ethan Soudry ◽  
Michal Shani ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Cardiovascular Comorbidities ◽  
Obstructive Sleep

scholarly journals Ventricular Arrhythmias in Patients with Obstructive Sleep Apnea

2018 ◽  
Vol 15 (1) ◽  
pp. 64-74 ◽  
Author(s):  
Rita Marinheiro ◽  
Leonor Parreira ◽  
Pedro Amador ◽  
Dinis Mesquita ◽  
José Farinha ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Ventricular Arrhythmias ◽  
Positive Airway Pressure ◽  
Etiologic Factor ◽  
Mortality Benefit ◽  
Cardiovascular Comorbidities ◽  
Obstructive Sleep ◽  
High Incidence ◽  
Electrocardiographic Changes

Obstructive Sleep Apnea (OSA) is a prevalent condition thought to increase in the future. Being mostly undiagnosed, the most serious complications are cardiovascular diseases, among which are arrhythmias. Controversy remains as to whether OSA is a primary etiologic factor for ventricular arrhythmias, because of the high incidence of cardiovascular comorbidities in OSA patients. However, there is mostly a strong evidence of a relation between OSA and ventricular arrhythmias. A few mechanisms have been proposed to be responsible for this association and some electrocardiographic changes have also been demonstrated to be more frequent in OSA patients. Treatment of OSA with Continuous Positive Airway Pressure (CPAP) has the potential to reduce arrhythmias and confer a mortality benefit.

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

Sign in / Sign up

Export Citation Format

Share Document