scholarly journals Does Nasal Obstruction Increase Heart Rate?

2017 ◽  
Vol 25 (3) ◽  
pp. 124-129
Author(s):  
Venkatesha Belur Keshavamurthy ◽  
Munish Kambathatti Shekharappa ◽  
Yogeesha Beesanahalli ◽  
Nagaraj Maradi ◽  
Priya Rani Kori
Keyword(s):  
Heart Rate ◽  
Nasal Obstruction ◽  
Sleep Apnoea ◽  
Cardiovascular Morbidity ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
Obstruction Group ◽  
The Mean ◽  
Mean Heart Rate

Introduction  Nasal obstruction is implicated in the etiopathogenesis of Obstructive Sleep Apnea (OSA). OSA is associated with mean heart rate (HR) variations in wakefulness and in sleep. Early intervention has proven to reduce cardiovascular morbidity in OSA patients. In spite of various confounding factors HR measurement has been utilised as an independent predictor of mortality. The influence of severity of nasal obstruction on HR has not been studied in the literature. This study aims to clarify the influence of severity of nasal obstruction on HR. Materials and Methods We examined 55 patients aged less than 50 years with no previous cardiac complaints, who underwent overnight oxygen saturation and HR monitoring. The patients were divided into Mild, Moderate and Severe Nasal Obstruction group depending on NOSE scale grading. Results There was no statistically significant difference in the Mean HR, Min HR, Max HR, and Max-Min HR in mild, moderate or severe nasal obstruction groups. Discussion The role of nasal obstruction in Obstructive Sleep Apnoea and the importance of HR as predictor of cardiovascular morbidity have been discussed. The studies on the heart rate in nasal obstruction and OSA were reviewed. Conclusion Nasal obstruction does not influence the heart rate.

Modifying effects of the R389G β1-adrenoceptor polymorphism on resting heart rate and blood pressure in patients with obstructive sleep apnoea

2005 ◽  
Vol 110 (1) ◽  
pp. 117-123 ◽  
Author(s):  
Jan Börgel ◽  
Tino Schulz ◽  
Nina K. Bartels ◽  
Jörg T. Epplen ◽  
Nikolaus Büchner ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Obstructive Sleep Apnoea ◽  
Nervous Activity ◽  
Sleep Apnoea ◽  
Cpap Therapy ◽  
Pressure Therapy ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
The Impact

OSA (obstructive sleep apnoea) stimulates sympathetic nervous activity and elevates resting HR (heart rate) and BP (blood pressure). In the present study in a cohort of 309 untreated OSA patients, the resting HR and BP during the daytime were correlated with AHI (apnoea/hypopnea index) and compared with patients with R389R (n=162), R389G (n=125) and G389G (n=22) genotypes of the β1-adrenoreceptor R389G polymorphism. We analysed the impact of the genotype on the decline of HR and BP in a subgroup of 148 patients (R389R, n=86; R389G, n=54; G389G, n=8) during a 6-month follow-up period under CPAP (continuous positive airway pressure) therapy during which cardiovascular medication remained unchanged. In untreated OSA patients, we found an independent relationship between AHI and resting HR (β=0.096, P<0.001), systolic BP (β=0.09, P=0.021) and diastolic BP (β=0.059, P=0.016). The resting HR/BP, however, did not differ among carriers with the R389R, R389G and G389G genotypes. CPAP therapy significantly reduced HR [−2.5 (−1.1 to −4.0) beats/min; values are mean difference (95% confidence intervals)] and diastolic BP [−3.2 (−1.5 to −5.0) mmHg]. The decline in HR was more significantly pronounced in the R389R group compared with the Gly389 carriers [−4.1 (−2.3 to −5.9) beats/min (P<0.001) compared with −0.2 (2.1 to −2.6) beats/min (P=0.854) respectively; Student's t test between groups, P=0.008]. Diastolic BP was decreased significantly (P<0.001) only in Gly389 carriers (R389G or G389G) compared with R389R carriers [−5.0 (−2.3 to −7.6) mmHg compared with −2.0 (0.4 to −4.3) mmHg respectively]. ANOVA revealed a significant difference (P=0.023) in HR reduction between the three genotypes [−4.1 (±8.4) beats/min for R389R, −0.5 (±9.3) beats/min for R389G and +1.9 (±7.2) beats/min for G389G]. In conclusion, although the R389G polymorphism of the β1-adrenoceptor gene did not influence resting HR or BP in untreated OSA patients, it may modify the beneficial effects of CPAP therapy on these parameters.

What role do adrenoreceptor polymorphisms play in modifying cardiovascular responses in obstructive sleep apnoea?

2005 ◽  
Vol 110 (1) ◽  
pp. 89-91 ◽  
Author(s):  
Nigel Mcardle
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Cardiovascular Risk ◽  
Diastolic Blood Pressure ◽  
Obstructive Sleep Apnoea ◽  
Cardiovascular Responses ◽  
Sleep Apnoea ◽  
Cpap Treatment ◽  
Obstructive Sleep

OSA (obstructive sleep apnoea) is a common condition that is strongly associated with cardiovascular disease. It is remains unclear what role OSA plays in determining cardiovascular risk. The immediate physiological changes that occur during upper airway obstruction are potential contributors to cardiovascular risk in OSA. These changes include increased sympathetic activity, which is responsive to treatment of OSA with CPAP (continuous positive airway pressure). In this issue of Clinical Science, the possible role of a common polymorphism in the β1-adrenoreceptor [R389G (Arg389Gly)] has been investigated by Börgel and co-workers. Measurements of heart rate and blood pressure in untreated OSA patients were not related to the R389G polymorphism. There were changes in heart rate and diastolic blood pressure with CPAP treatment that were related to this polymorphism. Reduction in heart rate with CPAP treatment was associated with the R389R genotype. By contrast, a reduction in diastolic blood pressure was associated with the Gly389 carriers. These findings are intriguing, but difficult to fully explain. Further study is needed to determine if there is an important role of the R389G polymorphism in modifying cardiovascular responses among OSA patients.

scholarly journals Application of the paediatric throat disorders outcome test (T-14) for tonsillectomy and adenotonsillectomy

2013 ◽  
Vol 95 (6) ◽  
pp. 410-414 ◽  
Author(s):  
K Konieczny ◽  
TC Biggs ◽  
S Caldera
Keyword(s):  
Patient Reported Outcome ◽  
Sleep Apnoea ◽  
Mean Difference ◽  
Clinical Value ◽  
Recurrent Tonsillitis ◽  
Obstructive Sleep ◽  
Patient Reported ◽  
The Mean ◽  
The Uk

Introduction The T-14 questionnaire is a validated patient reported outcome measure (PROM) used to assess the value of paediatric tonsillectomy from the patient’s perspective. Tonsillectomy is a procedure under threat. As such, this study aimed to provide further evidence supporting the role of tonsillectomy in the management of recurrent tonsillitis and obstructive sleep apnoea. Methods A prospective uncontrolled observational study was undertaken examining 54 paediatric patients undergoing tonsillectomy at our institution. Parents of children having surgery were invited to complete a T-14 questionnaire preoperatively as well as at three and six months postoperatively. Results The questionnaire was completed for 52 of the 54 patients preoperatively as well as at 3 and 6 months postoperatively (96% response rate). The mean difference between the preoperative and six-month T-14 score was 31.8 (p<0.0001). T-14 scores at three months were also significantly improved compared with those taken preoperatively (mean difference: 29.9, p<0.0001). Conclusions This is the first study in the literature to assess T-14 questionnaires at three and six months following paediatric tonsillectomy, providing evidence of the early benefit on PROMs. Tonsillectomy is the most common surgical procedure performed in the UK, and it is regarded highly by patients and otolaryngologists alike. This study provides significant evidence that tonsillectomy improves PROMs, thereby demonstrating its ongoing clinical value as a funded National Health Service procedure.

Obstructive sleep apnoea and cognitive decline in mild-to-moderate Alzheimer's disease

2020 ◽  
Vol 56 (5) ◽  
pp. 2000523
Author(s):  
Carmen Jorge ◽  
Adriano Targa ◽  
Iván David Benítez ◽  
Faride Dakterzada ◽  
Gerard Torres ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Decline ◽  
Obstructive Sleep Apnoea ◽  
Sleep Apnoea ◽  
Disease Assessment ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
Single Centre Study ◽  
The Mean

We evaluated the influence of untreated obstructive sleep apnoea (OSA) on the magnitude of cognitive decline and on several cognitive subdomains in patients with mild-to-moderate Alzheimer's disease.In this single-centre study, 144 patients were recruited prospectively from a cognitive impairment unit and underwent overnight polysomnography.The mean±sd change in the Alzheimer's Disease Assessment Scale cognitive subscale (ADAS-cog) score at 12 months was 3.19±5.61 in the non-OSA group and 0.08±5.62 in the OSA group, with an intergroup difference of −3.36 (95% CI 0.19–0.16; p=0.002). We did not observe a significant difference in any cognitive subdomains at 12 months. Regarding Mini-Mental State Examination scores at 36 months, the mean change was 1.69 (95% CI −1.26–4.64; p=0.445). No significant differences were found among different OSA severity groups.We observed that ADAS-cog scores were better in the OSA group than in the non-OSA group by a statistically but not clinically significant margin. We did not find differences in the different cognitive subdomains after 1 year or in global cognition after 3 years of follow-up.

scholarly journals Osteopathic Manipulation of the Sphenopalatine Ganglia Versus Sham Manipulation, in Obstructive Sleep Apnoea Syndrom: A Randomised Controlled Trial

2021 ◽  
Vol 11 (1) ◽  
pp. 99
Author(s):  
Valérie Attali ◽  
Olivier Jacq ◽  
Karine Martin ◽  
Isabelle Arnulf ◽  
Thomas Similowski
Keyword(s):  
Adverse Events ◽  
Nasal Obstruction ◽  
Obstructive Sleep Apnoea ◽  
Sleep Apnoea ◽  
Obstructive Sleep Apnoea Syndrome ◽  
Upper Airways ◽  
Osteopathic Manipulation ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
Randomised Controlled

(1) Background: osteopathic manipulation of the sphenopalatine ganglia (SPG) blocks the action of postganglionic sensory fibres. This neuromodulation can reduce nasal obstruction and enhance upper airway stability. We investigated the manipulation of the SPG in 31 patients with obstructive sleep apnoea syndrome (OSAS); (2) Methods: Randomised, controlled, double-blind, crossover study. Participants received active (AM), then sham manipulation (SM), or vice versa. The primary endpoint was apnoea-hypopnoea index (AHI). Secondary endpoints were variation of nasal obstruction evaluated by peak nasal inspiratory flow (PNIF) and upper airways stability evaluated by awake critical closing pressure [awake Pcrit]), at 30 min and 24 h. Schirmer’s test and pain were assessed immediately post-manipulation. Tactile/gustatory/olfactory/auditory/nociceptive/visual sensations were recorded. Adverse events were collected throughout. (3) Results: SPG manipulation did not reduce AHI (p = 0.670). PNIF increased post-AM but not post-SM at 30 min (AM-SM: 18 [10; 38] L/min, p = 0.0001) and 24 h (23 [10; 30] L/min, p = 0.001). There was no significant difference on awake Pcrit (AM-SM) at 30 min or 24 h). Sensations were more commonly reported post-AM (100% of patients) than post-SM (37%). Few adverse events and no serious adverse events were reported. (4) Conclusions: SPG manipulation is not supported as a treatment for OSAS but reduced nasal obstruction. This effect remains to be confirmed in a larger sample before using this approach to reduce nasal congestion in CPAP-treated patients or in mild OSAS.

scholarly journals A Non-Framework Multilevel Surgery May Reduce Mean Heart Rate in Patients with Very Severe Obstructive Apnea Having Confined Retroglossal Space and Framework

2020 ◽  
Vol 10 (22) ◽  
pp. 8094
Author(s):  
Ethan I. Huang ◽  
Shu-Yi Huang ◽  
Yu-Ching Lin ◽  
Chieh-Mo Lin ◽  
Chin-Kuo Lin ◽  
...  
Keyword(s):  
Heart Rate ◽  
Cardiovascular Diseases ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Multilevel Surgery ◽  
Risk Of Mortality ◽  
Obstructive Sleep ◽  
The Mean ◽  
Cpap Devices ◽  
Mean Heart Rate

An elevated mean heart rate in untreated patients of obstructive sleep apnea (OSA) may lead to a higher risk of mortality and the development of various cardiovascular diseases. The elevation may positively relate to the severity of OSA and present in both wakefulness and sleep. A reduction in heart rate has been presented in reports of treating OSA patients with continuous positive airway pressure (CPAP). However, patients with very severe OSA may refuse use of CPAP devices and advocated surgeries, such as direct skeletal surgery or tracheostomy. It is unclear whether the non-framework multilevel surgery we reported previously can overcome the unfavorable anatomy and reduce mean heart rate, which serves as a risk factor of mortality. Here, we show that multilevel surgery reduced the mean heart rate from 68.6 to 62.7 with a mean reduction of 5.9 beats/min. The results suggest that the surgery may reduce the risk of consequences and mortality associated with an elevated mean heart rate, such as various cardiovascular diseases. We disclose these findings, along with the variations and possible risks to our future patients with very severe OSA who refuse or cannot use a CPAP device or reject direct skeletal surgery.

scholarly journals The nose, snoring and obstructive sleep apnoea

2011 ◽  
Vol 49 (3) ◽  
pp. 259-263
Author(s):  
B. Kotecha
Keyword(s):  
Nasal Obstruction ◽  
Obstructive Sleep Apnoea ◽  
Upper Airway ◽  
Sleep Apnoea ◽  
Nasal Surgery ◽  
Sleep Related Breathing Disorders ◽  
Breathing Disorders ◽  
Obstructive Sleep ◽  
Nasal Pathology

Snoring and obstructive sleep apnoea are both due to multilevel anatomical obstruction, and the nose and nasal pathology both contribute in many cases. This paper addresses some of the issues surrounding the problem and briefly discusses the role of medication and nasal dilators and in more detail the implication of nasal surgery in various aspects of sleep related breathing disorders (SRBD). Nasal obstruction leads to mouth breathing, which destabilises the upper airway and aggravates SRBD.

scholarly journals Ergonomic-Based Redesign of Broomsticks Reduces the Physiological Burdens of Street Sweepers in Denpasar City, Indonesia

2020 ◽  
Vol 6 (2) ◽  
pp. 113
Author(s):  
Richard Andreas Palilingan ◽  
Ketut Tirtayasa ◽  
I Wayan Surata
Keyword(s):  
Heart Rate ◽  
Control Group ◽  
Musculoskeletal Complaints ◽  
Musculoskeletal Complaint ◽  
Significance Level ◽  
Treatment Groups ◽  
Significant Difference ◽  
The Mean ◽  
Working Heart ◽  
Mean Heart Rate

The equipment, such as broomsticks used by street sweepers are not appropriate based on anthropometric aspects, with a potency to induce inconvenience among them. Working with equipment that is not ergonomics, in addition to non-physiological work posture can cause fatigue, musculoskeletal disorders, and increased workload. This study aims to determine whether redesign an ergonomic-based broomstick may reduce the physiological burden of street sweepers in Denpasar city, Indonesia. This research is a pure experiment using a cross-design (two-period crossover design). The sample was 16 female street sweepers, divided into two groups: 8 as the control group and 8 treatment groups. Data analysis were performed using a paired t-test with significance level of 5%. The results showed significant difference (p <0.05) on the variables of workload, musculoskeletal complaints, and fatigue. In the first period, the mean of the street sweeper working heart rate was 118.96 ± 2.26 beats per minutes (bpm), the mean musculoskeletal complaint score was 91.63 ± 2.70 and the average fatigue was 77.69 ± 2.96. In Period II, the mean heart rate was 98.49 ± 2.22 bpm, the mean musculoskeletal complaint score was 63.56 ± 2.73 and the average fatigue was 57.56 ± 2.94. Redesigned stem brooms turned out to reduce workload, musculoskeletal complaints, and fatigue by 17.21%, 30.6%, and 25.91%, respectively. It can be concluded that the redesign of an ergonomic-based broomstick can reduce workload, musculoskeletal complaints, and fatigue.

Aerodynamics Analysis of the Impact of Nasal Surgery on Patients with Obstructive Sleep Apnea and Nasal Obstruction

ORL ◽  
2021 ◽  
pp. 1-8
Author(s):  
Lifeng Li ◽  
Demin Han ◽  
Hongrui Zang ◽  
Nyall R. London
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Nasal Obstruction ◽  
Upper Airway ◽  
Apnea Hypopnea Index ◽  
Nasal Surgery ◽  
Subjective Sleep Quality ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
The Impact

<b><i>Objective:</i></b> The purpose of this study was to evaluate the effects of nasal surgery on airflow characteristics in patients with obstructive sleep apnea (OSA) by comparing the alterations of airflow characteristics within the nasal and palatopharyngeal cavities. <b><i>Methods:</i></b> Thirty patients with OSA and nasal obstruction who underwent nasal surgery were enrolled. A pre- and postoperative 3-dimensional model was constructed, and alterations of airflow characteristics were assessed using the method of computational fluid dynamics. The other subjective and objective clinical indices were also assessed. <b><i>Results:</i></b> By comparison with the preoperative value, all postoperative subjective symptoms statistically improved (<i>p</i> &#x3c; 0.05), while the Apnea-Hypopnea Index (AHI) changed little (<i>p</i> = 0.492); the postoperative airflow velocity and pressure in both nasal and palatopharyngeal cavities, nasal and palatopharyngeal pressure differences, and total upper airway resistance statistically decreased (all <i>p</i> &#x3c; 0.01). A significant difference was derived for correlation between the alteration of simulation metrics with subjective improvements (<i>p</i> &#x3c; 0.05), except with the AHI (<i>p</i> &#x3e; 0.05). <b><i>Conclusion:</i></b> Nasal surgery can decrease the total resistance of the upper airway and increase the nasal airflow volume and subjective sleep quality in patients with OSA and nasal obstruction. The altered airflow characteristics might contribute to the postoperative reduction of pharyngeal collapse in a subset of OSA patients.

scholarly journals The effect of obstructive sleep apnoea on timing of acute coronary syndrome

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M.H Muhmad Hamidi ◽  
H Sani ◽  
M.A Ibrahim ◽  
K.S Ibrahim ◽  
A.B Md Radzi ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
High Risk ◽  
Systolic Function ◽  
Strong Association ◽  
Multiple Logistic Regression Analysis ◽  
Sleep Apnoea ◽  
Neck Circumference ◽  
Coronary Syndrome ◽  
Obstructive Sleep ◽  
Significant Difference

Abstract Background and objective Acute coronary syndrome (ACS) remains the principal cause of death in Malaysia. It is estimated about 20% of ACS occurs at nighttime during sleep between 12am to 6am. Factors associated with nocturnal ACS are unknown. Acute nocturnal pathophysiological response to obstructive sleep apnea (OSA) may increase risk of nocturnal ACS. We hypothesized that OSA risk is associated with timing of ACS onset. Methodology This study included 200 patients with ACS who underwent coronary angiogram for which the time of chest pain onset was clearly identified and divided into 2 groups; nocturnal ACS (12am-5.59am) and non-nocturnal ACS (6am–11.59pm). Two validated questionnaires, STOP-BANG and Epworth Sleepiness Scale (ESS) were self-administered by subjects to determine OSA risk. All subjects timing of ACS onset, OSA risk, demography, anthropometric measurements, comorbidities and echocardiographic characteristics were analyzed. Results Acute coronary syndrome occurs nocturnally in 19% of ACS patients. The prevalence of high risk OSA individuals among ACS patients is 43%. There is significantly higher prevalence of high risk OSA individuals in nocturnal ACS group of 95% compared to 30% of high risk OSA individuals in non-nocturnal ACS group (p=0.001). Nocturnal ACS patients was significantly younger (50.1±8.7yrs, p=0.001), had higher BMI (33.9±4.3kg/m2, p=0.005), waist circumference (106.7±10.3cm, p=0.003) and larger neck circumference (44.6±3.3cm, p=0.001) compared to non-nocturnal ACS group. These groups had similar prevalence of other comorbidities for ACS and showed no significant difference between left and right ventricular systolic function. In multiple logistic regression analysis, the most significant predictors for nocturnal ACS are OSA risk, neck circumference and age. Conclusion There is a strong association between high risk OSA individuals and nocturnal ACS onset. Patient with nocturnal ACS onset should be screened for OSA and prioritized for polysomnography. OSA prevalence according to ACS onset Funding Acknowledgement Type of funding source: None

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