scholarly journals Impinging problem of COVID 19 associated to obstructive sleep apnea and relevance of ventilatory strategies: A case report

2020 ◽  
pp. 38-43
Author(s):  
M Louardi, H Ezzouine ◽  
M Simou ◽  
A Khamboubi ◽  
I Mokhtari ◽  
A Raja ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Intensive Care Unit ◽  
Obstructive Sleep Apnea ◽  
Intensive Care ◽  
Sleep Apnea ◽  
Sleep Apnea Syndrome ◽  
Obstructive Sleep ◽  
Apnea Syndrome ◽  
Considerable Morbidity ◽  
Keywords Obstructive Sleep Apnea

Pneumonia due to SARS-CoV-2 has caused considerable morbidity and mortalityworldwide particularly amongst those with comorbidities. The most frequent comorbidities are hypertension, diabetes and cardiovascular disease. until now, few associations between obstructive sleep apnea syndrome (OSAS) and COVID-19 have been reported. So, through the column of this article, Given the limited number of clinical cases reported about obstructive sleep apnea and COVID-19, we would like to report a case and share some experiences. Keywords: Obstructive Sleep Apnea; Obesity; COVID-19; Intensive care unit

Cardiovascular outcomes of CPAP therapy in obstructive sleep apnea syndrome

2007 ◽  
Vol 293 (4) ◽  
pp. R1666-R1670 ◽  
Author(s):  
Walter T. McNicholas
Keyword(s):  
Cardiovascular Disease ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Cpap Therapy ◽  
Obstructive Sleep ◽  
Cardiovascular Morbidity And Mortality ◽  
Apnea Syndrome ◽  
The Impact

Considerable evidence is now available of an independent association between obstructive sleep apnea syndrome (OSAS) and cardiovascular disease. The association is particularly strong for systemic arterial hypertension, but there is growing evidence of an association with ischemic heart disease and stroke. The mechanisms underlying cardiovascular disease in patients with OSAS are still poorly understood. However, the pathogenesis is likely to be a multifactorial process involving a diverse range of mechanisms, including sympathetic overactivity, selective activation of inflammatory molecular pathways, endothelial dysfunction, abnormal coagulation, and metabolic dysregulation, the latter particularly involving insulin resistance and disordered lipid metabolism. Therapy with continuous positive airway pressure (CPAP) has been associated with significant benefits to cardiovascular morbidity and mortality, both in short-term studies addressing specific aspects of morbidity, such as hypertension, and more recently in long-term studies that have evaluated major outcomes of cardiovascular morbidity and mortality. However, there is a clear need for further studies evaluating the impact of CPAP therapy on cardiovascular outcomes. Furthermore, studies on the impact of CPAP therapy have provided useful information concerning the role of basic cell and molecular mechanisms in the pathophysiology of OSAS.

Postoperative treatment of the patient with obstructive sleep apnea

2000 ◽  
Vol 122 (2) ◽  
pp. 233-236 ◽  
Author(s):  
Keith M. Ulnick ◽  
Richard F. Debo
Keyword(s):  
Intensive Care Unit ◽  
Obstructive Sleep Apnea ◽  
Intensive Care ◽  
Sleep Apnea ◽  
Sleep Apnea Syndrome ◽  
Study Groups ◽  
Postoperative Treatment ◽  
Arterial Oxygen ◽  
Obstructive Sleep ◽  
Increased Risk

>OBJECTIVE The postoperative management of patients with obstructive sleep apnea syndrome (OSAS) has been based primarily on the potential loss of the airway. Our hypothesis is that not all patients with OSAS require placement in the intensive care unit after surgery. METHODS We undertook a prospective, nonrandomized study (N = 38). Data included demographics, polysomnograms, body mass index (BMI), and postoperative course, including any complications within 72 hours. RESULTS The average respiratory disturbance index was 66, and the average BMI was 29. The average preoperative and postoperative maximal arterial oxygen desaturation values were 82% and 94%, respectively. Patients with BMIs less than 35 did not have desaturation values below 90%. No complications occurred. DISCUSSION Within the first 72 hours after surgery, no complications were observed in our study groups. Patients with BMIs greater than 35 were at increased risk for postoperative desaturations. The uncomplicated OSAS patient, one without significant comorbid factors, can be treated in a safe and prudent fashion outside of an intensive care unit.

scholarly journals Pathophysiologic Mechanisms of Cardiovascular Disease in Obstructive Sleep Apnea Syndrome

2013 ◽  
Vol 2013 ◽  
pp. 1-16 ◽  
Author(s):  
Carlos Zamarrón ◽  
Luis Valdés Cuadrado ◽  
Rodolfo Álvarez-Sala
Keyword(s):  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Obstructive Sleep Apnea ◽  
Cardiovascular Risk ◽  
Sleep Apnea ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Metabolic Effects ◽  
Obstructive Sleep ◽  
Apnea Syndrome

Obstructive sleep apnea syndrome (OSAS) is a highly prevalent sleep disorder, characterized by repeated disruptions of breathing during sleep. This disease has many potential consequences including excessive daytime sleepiness, neurocognitive deterioration, endocrinologic and metabolic effects, and decreased quality of life. Patients with OSAS experience repetitive episodes of hypoxia and reoxygenation during transient cessation of breathing that provoke systemic effects. Furthermore, there may be increased levels of biomarkers linked to endocrine-metabolic and cardiovascular alterations. Epidemiological studies have identified OSAS as an independent comorbid factor in cardiovascular and cerebrovascular diseases, and physiopathological links may exist with onset and progression of heart failure. In addition, OSAS is associated with other disorders and comorbidities which worsen cardiovascular consequences, such as obesity, diabetes, and metabolic syndrome. Metabolic syndrome is an emerging public health problem that represents a constellation of cardiovascular risk factors. Both OSAS and metabolic syndrome may exert negative synergistic effects on the cardiovascular system through multiple mechanisms (e.g., hypoxemia, sleep disruption, activation of the sympathetic nervous system, and inflammatory activation). It has been found that CPAP therapy for OSAS provides an objective improvement in symptoms and cardiac function, decreases cardiovascular risk, improves insulin sensitivity, and normalises biomarkers. OSAS contributes to the pathogenesis of cardiovascular disease independently and by interaction with comorbidities. The present review focuses on indirect and direct evidence regarding mechanisms implicated in cardiovascular disease among OSAS patients.

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