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.

827 Central Sleep Apnea in a patient with Multiple Sclerosis

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A322-A323
Author(s):  
Rahul Dasgupta ◽  
Sonja Schütz ◽  
Tiffany Braley
Keyword(s):  
Multiple Sclerosis ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Disordered Breathing ◽  
Central Sleep Apnea ◽  
Progressive Multiple Sclerosis ◽  
Obstructive Sleep ◽  
Increased Risk ◽  
Demyelinating Lesions ◽  
The Brain

Abstract Introduction Sleep-disordered breathing is common in persons with multiple sclerosis (PwMS), and may contribute to debilitating fatigue and other chronic MS symptoms. The majority of research to date on SDB in MS has focused on the prevalence and consequences of obstructive sleep apnea; however, PwMS may also be at increased risk for central sleep apnea (CSA), and the utility of methods to assess CSA in PwMS warrant further exploration. We present a patient with secondary progressive multiple sclerosis who was found to have severe central sleep apnea on WatchPAT testing. Report of case(s) A 61 year-old female with a past medical history of secondary progressive multiple sclerosis presented with complaints of fragmented sleep. MRI of the brain, cervical spine, and thoracic spine showed numerous demyelinating lesions in the brain, brainstem, cervical, and thoracic spinal cord. Upon presentation, the patient noted snoring, witnessed apneas, and daytime sleepiness. WatchPAT demonstrated severe sleep apnea, with a pAHI of 63.3, and a minimum oxygen saturation of 90%. The majority of the scored events were non-obstructive in nature (73.1% of all scored events), and occurred intermittently in a periodic fashion. Conclusion The differential diagnosis of fatigue in PwMS should include sleep-disordered breathing, including both obstructive and central forms of sleep apnea. Demyelinating lesions in the brainstem (which may contribute to impairment of motor and sensory networks that control airway patency and respiratory drive), and progressive forms of MS, have been linked to both OSA and CSA. The present data illustrate this relationship in a person with progressive MS, and offer support for the WatchPAT as a cost-effective means to evaluate for both OSA and CSA in PwMS, while reducing patient burden. PwMS may be at increased risk for CSA. Careful clinical consideration should be given to ordering appropriate sleep testing to differentiate central from obstructive sleep apnea in PwMS, particularly for patients with demyelinating lesions in the brainstem. Support (if any) 1. Braley TJ, Segal BM, Chervin RD. Obstructive sleep apnea and fatigue in patients with multiple sclerosis. J Clin Sleep Med. 2014 Feb 15;10(2):155–62. doi: 10.5664/jcsm.3442. PMID: 24532998; PMCID: PMC3899317.

scholarly journals Obstructive sleep apnea

2011 ◽  
Vol 3 (3) ◽  
pp. 15 ◽  
Author(s):  
Matthew L. Ho ◽  
Steven D. Brass
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Treatment Options ◽  
Poor Quality ◽  
The Body ◽  
Primary Care Doctor ◽  
Obstructive Sleep ◽  
Headache Diagnosis ◽  
Neurological Conditions ◽  
The Brain

Obstructive sleep apnea (OSA) affects millions of Americans and is estimated to be as prevalent as asthma and diabetes. Given the fact that obesity is a major risk factor for OSA, and given the current global rise in obesity, the prevalence of OSA will increase in the future. Individuals with sleep apnea are often unaware of their sleep disorder. It is usually first recognized as a problem by family members who witness the apneic episodes or is suspected by their primary care doctor because of the individual’s risk factors and symptoms. The vast majority remain undiagnosed and untreated, despite the fact that this serious disorder can have significant consequences. Individuals with untreated OSA can stop breathing hundreds of times a night during their sleep. These apneic events can lead to fragmented sleep that is of poor quality, as the brain arouses briefly in order for the body to resume breathing. Untreated, sleep apnea can have dire health consequences and can increase the risk of hypertension, diabetes, heart disease, and heart failure. OSA management has also become important in a number of comorbid neurological conditions, including epilepsy, stroke, multiple sclerosis, and headache. Diagnosis typically involves use of screening questionnaires, physical exam, and an overnight polysomnography or a portable home study. Treatment options include changes in lifestyle, positive airway pressure, surgery, and dental appliances.

scholarly journals A Review on Complications of Sleep Apnea

2021 ◽  
Vol 11 (6) ◽  
pp. 265-271
Author(s):  
JOHN DAVID ◽  
Cindy Jose ◽  
N Venkateswaramurthy ◽  
R Sambath Kumar
Keyword(s):  
Obstructive Sleep Apnea ◽  
Pulmonary Hypertension ◽  
Sleep Apnea ◽  
Cardiac Arrhythmia ◽  
Central Sleep Apnea ◽  
Upper Airway ◽  
Review Article ◽  
Occupational Disability ◽  
Obstructive Sleep ◽  
The Brain

Sleep apnea occurs when the upper airway repeatedly becomes blocked during sleep, reducing or entirely blocking airflow. This is referred to as obstructive sleep apnea. If the brain fails to provide the necessary impulses for breathing, the disease is known as central sleep apnea. Sleep apnea and other sleep breathing problems are a leading cause of medical, social, and occupational disability. Sleep apnea is also linked to pulmonary hypertension, cardiac arrhythmia and other neurocognitive effects, majority of individuals with sleep apnea go undetected, putting them at danger during surgery. It is critical to identify these patients so that relevant steps can be implemented as soon as possible. In this review article, we will discuss about sleep apnea issues and their possible causes. Keywords: Sleep apnea, Bradycardia, Tachycardia, Breathing, Hypercapnia

Commonly Encountered Sleep Disorders

2018 ◽  
Author(s):  
Karl Doghramji
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Disorders ◽  
Eye Movement ◽  
Treatment Options ◽  
Sleep Apnea Syndrome ◽  
Central Sleep Apnea ◽  
Periodic Limb Movement Disorder ◽  
Sleep Behavior ◽  
Obstructive Sleep

Complaints related to sleep and wakefulness are some of the most commonly encountered in clinical settings. This chapter reviews specific sleep disorders including insomnia disorder, hypersomnolence disorder, narcolepsy, obstructive sleep apnea hypopnea syndrome, central sleep apnea syndrome and selected parasomnias (nonrapid eye movement sleep arousal disorders and rapid eye movement sleep behavior disorder). These disorders are some of the best characterized and commonly comorbid with other medical and psychiatric disorders. Their defining characteristics, diagnostic modalities, and treatment options are summarized. Topics covered in this chapter include narcolepsy, cataplexy, insomnia, restless legs syndrome, periodic limb movement disorder, obstructive sleep apnea, central sleep apnea, hypersomnolence.

Brainstem Evoked Potentials in Adult Sleep Apnea

1982 ◽  
Vol 91 (6) ◽  
pp. 597-598 ◽  
Author(s):  
Nancy L. Snyderman ◽  
Margareta Møller ◽  
Jonas T. Johnson ◽  
Patricia B. Thearle
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Evoked Potentials ◽  
Central Sleep Apnea ◽  
Obstructive Sleep ◽  
Brainstem Dysfunction ◽  
Brainstem Evoked Potentials

Brainstem evoked potentials (BSEP) were recorded in 23 patients with adult sleep apnea (ASA). These patients were studied with all-night polysomnography prior to our testing. They were categorized as having obstructive, central, or mixed sleep apnea depending on the predominant sleep findings. All patients with central sleep apnea had abnormal BSEP with prolongation of wave V. A majority of the remaining patients with obstructive sleep apnea and mixed sleep apnea had abnormal BSEP, but without specific configurations. These findings substantiate our hypothesis that brainstem dysfunction may play a role in ASA.

393 Comparison of Oxygenation Abnormalities Between Obstructive Sleep Apnea and Central Sleep Apnea

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A156-A157
Author(s):  
Sikawat Thanaviratananich ◽  
Hao Cheng ◽  
Maria Pino ◽  
Krishna Sundar
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Demographic Data ◽  
Central Sleep Apnea ◽  
Nrem Sleep ◽  
Rate Of Change ◽  
Apnea Hypopnea Index ◽  
P Value ◽  
Obstructive Sleep ◽  
Cheyne Stokes Breathing

Abstract Introduction The apnea-hypopnea index (AHI) is used as a generic index to quantify both central sleep apnea (CSA) and obstructive sleep apnea (OSA) syndromes. Patterns of oxygenation abnormalities seen in CSA and OSA may be key to understanding differing clinical impacts of these disorders. Oxygen desaturation and resaturation slopes and durations in OSA and CSA were compared between OSA and CSA patients. Methods Polysomnographic data of patients aged 18 years or older with diagnosis of OSA and CSA, at University of Iowa Hospitals and Clinics, were analyzed and demographic data were collected. Oximetric changes during hypopneas and apneas were studied for desaturation/resaturation durations and desaturation/resaturation slopes. Desaturation and resaturation slopes were calculated as rate of change in oxygen saturation (ΔSpO2/Δtime). Comparison of hypoxemia-based parameters between patients with OSA and CSA was performed using unpaired t-test. Results 32 patients with OSA with median AHI of 15.4 (IQR 5.1 to 30.55) and median ODI of 15.47 (IQR 9.50 to 29.33) were compared to 15 patients with CSA with a median AHI of 20.4 (IQR 12.6 to 47.8) and median ODI of 27.56 (IQR 17.99 to 29.57). The mean number of desaturation and resaturation events was not significantly different between patients with OSA and CSA (OSA - 106.81±87.93; CSA - 130.67±76.88 with a p-value 0.1472). 4/15 CSA patients had Cheyne-Stokes breathing, 2/15 had treatment emergent central sleep apnea, 1/15 had methadone-associated CSA and for 8/15, no etiologies for CSA were found. Mean desaturation durations was significantly longer in OSA (20.84 s ± 5.67) compared to CSA (15.94 s ± 4.54) (p=0.0053) and consequently the desaturation slopes were steeper in CSA than OSA (-0.35%/sec ±0.180 vs. -0.243 ± 0.073; p=0.0064). The resaturation duration was not significantly longer in OSA (9.76 s ± 2.02) than CSA (9.057 s ± 2.17) (p=0.2857). Differences between desaturation duration and slopes between CSA and OSA persisted during REM and NREM sleep, and in supine sleep. Conclusion As compared to OSA, patients with CSA have different patterns of desaturations and resaturations with lesser hypoxic burden with CSA. This may have implications on the clinical outcomes seen between these two disorders. Support (if any):

scholarly journals Obstructive sleep apnea syndrome and cognitive impairment: effects of CPAP

2011 ◽  
Vol 2 (4) ◽  
pp. 209
Author(s):  
Alessandra Giordano ◽  
Alessandro Cicolin ◽  
Roberto Mutani
Keyword(s):  
Obstructive Sleep Apnea ◽  
Cognitive Impairment ◽  
Sleep Apnea ◽  
Executive Functions ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Muscular Activity ◽  
Upper Airways ◽  
Obstructive Sleep ◽  
Apnea Syndrome

Obstructive Sleep Apnea Syndrome (OSAS) is a sleep disorder characterised by repetitive episodes of upper airway obstruction (apnea) or reduced airflow (hypopnoea) despite persistent respiratory effort. Apnea is defined as the cessation of breathing for at least 10 seconds during sleep, while hypopnoea is defined as at least 30% reduction in airflow for 10 seconds associated with oxygen desaturation and sleep fragmentation. The presence in the general population is about 4%. The principal symptoms are: excessive daytime sleepiness (EDS), snoring, dry throat, morning headache, night sweats, gastro-esophageal reflux, and increased blood pressure.Long term complications can be: increased cardio-cerebrovascular risk and cognitive impairment such as deficiency in attention, vigilance, visual abilities, thought, speech, perception and short term memory.Continuous Positive Airway Pressure (CPAP) is currently the best non-invasive therapy for OSAS.CPAP guarantees the opening of upper airways using pulmonary reflexive mechanisms increasing lung volume during exhalation and resistance reduction, decreasing electromyografical muscular activity around airways.The causes of cognitive impairments and their possible reversibility after CPAP treatment have been analysed in numerous studies. The findings, albeit controversial, show that memory, attention and executive functions are the most compromised cognitive functions.The necessity of increasing the patient compliance with ventilotherapy is evident, in order to prevent cognitive deterioration and, when possible, rehabilitate the compromised functions, a difficult task for executive functions.

The Association between Obstructive Sleep Apnea and Allergic Rhinitis: Current Literature Review

2021 ◽  
Vol 17 ◽  
Author(s):  
Shi Nee Tan ◽  
Baharudin Abdullah
Keyword(s):  
Obstructive Sleep Apnea ◽  
Allergic Rhinitis ◽  
Sleep Apnea ◽  
Central Sleep Apnea ◽  
Sleep Apnea Syndromes ◽  
T Helper 2 ◽  
Obstructive Sleep ◽  
Common Clinical Practice ◽  
High Level ◽  
Chemical Mediators

: Sleep-disordered breathing (SDB) is now a significant health problem in today's culture. It ranges from a spectrum of abnormal conditions during sleep from the primary snorer to mild, moderate, or severe obstructive sleep apnea (OSA). SDB also comprises other conditions, such as sleep-related hypoventilation, sleep-related hypoxemia, and central sleep apnea syndromes. One of the components of the pathophysiology of OSA that remain unclear is the association of allergic rhinitis (AR) in the evolution of OSA. Several studies relate OSA and AR's co-existence in the common clinical practice, but its correlation was not clear. This review article aimed to review the relationship between OSA and AR in terms of the role of chemical mediators and pathophysiological and the effect of AR treatment in support of OSA. The symptoms of AR further accelerate the clinical progression to OSA development. Inflammatory mediators such as histamine, cysteinyl leukotrienes, and interleukins are found at a high level in AR, which can aggravate AR symptoms such as nasal obstruction, rhinorrhea, and itchiness, which can then lead to sleep disruption in OSA patients. In addition, OSA patients also have increased chemical mediators such as tumor necrosis factor, interleukin 6, and 1, which would activate the T helper 2 phenotypes that can aggravate AR symptoms. This vicious cycle can potentiate each other and worsen the condition. Few studies have shown that treatment of AR can improve OSA, especially the use of intranasal steroid and leukotriene receptor antagonists. A detailed evaluation of rhinitis symptoms should be made for those OSA patients so that they can benefit not only from the improvement of AR but also the good sleep quality.

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