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Medicina 2018Stroke, one of the main causes of disability and death worldwide, is frequently associated to the obstructive sleep apnea-hypopnea syndrome. This sleep disorder has been... (Review)
Review
Stroke, one of the main causes of disability and death worldwide, is frequently associated to the obstructive sleep apnea-hypopnea syndrome. This sleep disorder has been demonstrated to be an independent risk factor for stroke, and therefore its investigation and treatment has been recommended for patients with stroke. Mechanisms relating these two clinical disorders include: oxidative stress, cerebral blood flow alterations, autonomic dysfunction, and hypercoagulability, as well as patent foramen ovale, blood pressure, and heart rhythm disorders. Increasing amount of evidence supports continuous airway positive pressure therapy in patients with stroke, but further randomized clinical trials are needed to obtain solid conclusions. This work reviews the literature on epidemiology, pathophysiology, clinical assessment, and treatment of apnea-hypopnea syndrome in patients with stroke.
Topics: Continuous Positive Airway Pressure; Humans; Risk Factors; Sleep Apnea, Obstructive; Stroke
PubMed: 30504110
DOI: No ID Found -
The European Respiratory Journal Apr 2022
Topics: Aged; Humans; Sleep Apnea Syndromes; Sleep Apnea, Obstructive
PubMed: 35483717
DOI: 10.1183/13993003.01627-2021 -
British Journal of Hospital Medicine... Feb 2024Paediatric sleep-disordered breathing is a common condition which varies in severity from snoring to obstructive sleep apnoea. Paediatric sleep-disordered breathing is... (Review)
Review
Paediatric sleep-disordered breathing is a common condition which varies in severity from snoring to obstructive sleep apnoea. Paediatric sleep-disordered breathing is usually diagnosed clinically, with investigations such as polysomnography reserved for more complex cases. Management can involve watching and waiting, medical or adjunct treatments and adenotonsillectomy. National working groups have sought to standardise the pathway for surgery and improve the management of surgical and anaesthetic complications. Current guidelines use age, weight and comorbidities to stratify risk for these surgical cases. This article summarises these recommendations and outlines the important factors that indicate cases that may be more suitable for management in secondary and tertiary units. Appropriate case selection will reduce pressure on tertiary units while maintaining training opportunities in district general hospitals.
Topics: Child; Humans; Sleep Apnea Syndromes; Sleep Apnea, Obstructive; Adenoidectomy; Tonsillectomy
PubMed: 38416524
DOI: 10.12968/hmed.2023.0275 -
European Respiratory Review : An... Mar 2016Sleep apnoea is a disorder characterised by repetitive pauses in breathing during sleep caused by airway occlusion (obstructive sleep apnoea) or altered control of... (Review)
Review
Sleep apnoea is a disorder characterised by repetitive pauses in breathing during sleep caused by airway occlusion (obstructive sleep apnoea) or altered control of breathing (central sleep apnoea). In this Clinical Year in Review, we summarise high-impact research from the past year pertaining to management, diagnosis and cardio-metabolic consequences of sleep apnoea.
Topics: Animals; Comorbidity; Humans; Prognosis; Risk Factors; Sleep Apnea, Central; Sleep Apnea, Obstructive
PubMed: 26929416
DOI: 10.1183/16000617.0077-2015 -
European Respiratory Review : An... Jan 2024Obstructive sleep apnoea (OSA) can occur in both rapid eye movement (REM) and non-REM sleep or be limited to REM sleep, when the upper airway is most prone to collapse... (Review)
Review
Obstructive sleep apnoea (OSA) can occur in both rapid eye movement (REM) and non-REM sleep or be limited to REM sleep, when the upper airway is most prone to collapse due to REM sleep atonia. Respiratory events are usually longer and more desaturating in REM than in NREM sleep. The prevalence of REM OSA is higher in women than in men and REM OSA usually occurs in the context of mild-moderate OSA based on the apnoea-hypopnoea index calculated for the entire sleep study. Studies have highlighted some detrimental consequences of REM OSA; for example, its frequent association with systemic hypertension and a degree of excessive daytime sleepiness similar to that found in nonsleep-stage-dependent OSA. Moreover, REM OSA could increase cardiometabolic risk. Continuous positive airway pressure (CPAP) treatment aimed at preventing REM OSA should be longer than the 4 h usually considered as good compliance, since REM sleep occurs mostly during the second half of the night. Unfortunately, patients with REM OSA show poor adherence to CPAP. Alternative non-CPAP treatments might be a good choice for REM OSA, but data are lacking. This review summarises the available data on REM OSA and critically examines the weaknesses and strengths of existing literature.
Topics: Male; Humans; Female; Sleep, REM; Sleep Apnea, Obstructive; Patient Compliance; Continuous Positive Airway Pressure; Polysomnography
PubMed: 38355150
DOI: 10.1183/16000617.0166-2023 -
IEEE Transactions on Bio-medical... May 2021In this work, a detection and classification method for sleep apnea and hypopnea, using photopletysmography (PPG) and peripheral oxygen saturation (SpO ) signals, is...
In this work, a detection and classification method for sleep apnea and hypopnea, using photopletysmography (PPG) and peripheral oxygen saturation (SpO ) signals, is proposed. The detector consists of two parts: one that detects reductions in amplitude fluctuation of PPG (DAP)and one that detects oxygen desaturations. To further differentiate among sleep disordered breathing events (SDBE), the pulse rate variability (PRV) was extracted from the PPG signal, and then used to extract features that enhance the sympatho-vagal arousals during apneas and hypopneas. A classification was performed to discriminate between central and obstructive events, apneas and hypopneas. The algorithms were tested on 96 overnight signals recorded at the UZ Leuven hospital, annotated by clinical experts, and from patients without any kind of co-morbidity. An accuracy of 75.1% for the detection of apneas and hypopneas, in one-minute segments,was reached. The classification of the detected events showed 92.6% accuracy in separating central from obstructive apnea, 83.7% for central apnea and central hypopnea and 82.7% for obstructive apnea and obstructive hypopnea. The low implementation cost showed a potential for the proposed method of being used as screening device, in ambulatory scenarios.
Topics: Arousal; Heart Rate; Humans; Polysomnography; Sleep Apnea Syndromes; Sleep Apnea, Obstructive
PubMed: 32997622
DOI: 10.1109/TBME.2020.3028041 -
European Respiratory Review : An... Jan 2017Sleep disordered breathing, especially obstructive sleep apnoea (OSA), has a high and increasing prevalence. Depending on the apnoea and hypopnoea scoring criteria used,... (Review)
Review
Sleep disordered breathing, especially obstructive sleep apnoea (OSA), has a high and increasing prevalence. Depending on the apnoea and hypopnoea scoring criteria used, and depending on the sex and age of the subjects investigated, prevalence varies between 3% and 49% of the general population. These varying prevalences need to be reflected when considering screening for OSA. OSA is a cardiovascular risk factor and patients are at risk when undergoing medical interventions such as surgery. Screening for OSA before anaesthesia and surgical interventions is increasingly considered. Therefore, methods for screening and the rationale for screening for OSA are reviewed in this study.
Topics: Algorithms; Checklist; Continuous Positive Airway Pressure; Decision Support Techniques; Humans; Lung; Patient Selection; Polysomnography; Postoperative Complications; Predictive Value of Tests; Prevalence; Respiration; Risk Assessment; Risk Factors; Sleep Apnea, Obstructive; Surgical Procedures, Operative; Surveys and Questionnaires; Treatment Outcome; Waiting Lists
PubMed: 28049125
DOI: 10.1183/16000617.0012-2016 -
Current Neurology and Neuroscience... Jul 2022The purpose of this article is to review the recent literature on central apnea. Sleep disordered breathing (SDB) is characterized by apneas (cessation in breathing),... (Review)
Review
PURPOSE
The purpose of this article is to review the recent literature on central apnea. Sleep disordered breathing (SDB) is characterized by apneas (cessation in breathing), and hypopneas (reductions in breathing), that occur during sleep. Central sleep apnea (CSA) is sleep disordered breathing in which there is an absence or diminution of respiratory effort during breathing disturbances while asleep. In obstructive sleep apnea (OSA), on the other hand, there is an absence of flow despite ongoing ventilatory effort.
RECENT FINDINGS
Central sleep apnea is a heterogeneous disease with multiple clinical manifestations. OSA is by far the more common condition; however, CSA is highly prevalent among certain patient groups. Complex sleep apnea (CompSA) is defined as the occurrence/emergence of CSA upon treatment of OSA. Similarly, there is considerable overlap between CSA and OSA in pathogenesis as well as impacts. Thus, understanding sleep disordered breathing is important for many practicing clinicians.
Topics: Humans; Sleep; Sleep Apnea Syndromes; Sleep Apnea, Central; Sleep Apnea, Obstructive
PubMed: 35588042
DOI: 10.1007/s11910-022-01199-2 -
Respirology (Carlton, Vic.) Feb 2022
Topics: Cheyne-Stokes Respiration; Humans; Sleep Apnea, Central
PubMed: 34989085
DOI: 10.1111/resp.14200 -
Journal of Neuroscience Methods Jul 2023Sleep apnea, the most widespread sleep-related breathing disorder (SBD), consists of recurrent episodes of breathing cessation during sleep. This condition can be... (Review)
Review
Sleep apnea, the most widespread sleep-related breathing disorder (SBD), consists of recurrent episodes of breathing cessation during sleep. This condition can be classified as either central (CSA) or obstructive (OSA) sleep apnea, with the latest being the most common and toxic. Due to the complexity of living organisms, animal models and, particularly, mice still represent an essential tool for the study of SBD. In the present review we first discuss the methodological pros and cons in the use of whole-body plethysmography to coupling respiratory and sleep measurements and to characterize CSA and OSA in mice; then, we draw an updated and objective picture of the methods used so far in the study of sleep apnea in mice. Most of the studies present in the literature used intermittent hypoxia to mimic OSA in mice and to investigate consequent pathological correlates. On the contrary, few studies using genetic manipulation or high-fat diets investigated the pathogenesis or potential treatments of sleep apnea. To date, mice lacking orexins, hemeoxygenase-2, monoamine oxidase A, Phox2b or Cdkl5 can be considered validated mouse models of sleep apnea. Moreover, genetically- or diet-induced obese mice, and mice recapitulating Down syndrome were proposed as OSA models. In conclusion, our review shows that despite the growing interest in the field and the need of new therapeutical approaches, technical complexity and inter-study variability strongly limit the availability of validated mouse of sleep apnea, which are essential in biomedical research.
Topics: Humans; Mice; Animals; Sleep Apnea, Obstructive; Sleep Apnea Syndromes; Sleep; Respiration; Disease Models, Animal
PubMed: 37459897
DOI: 10.1016/j.jneumeth.2023.109923