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Life Sciences Jan 2019This review analyses the knowledge about the incidence of transient apnoeic spells, induced by substances which activate vagal chemically sensitive afferents. It... (Review)
Review
This review analyses the knowledge about the incidence of transient apnoeic spells, induced by substances which activate vagal chemically sensitive afferents. It considers the specificity and expression of appropriate receptors, and relevant research on pontomedullary circuits contributing to a cessation of respiration. Insight is gained into an excitatory drive of 5-HT serotonin receptors in overcoming opioid-induced respiratory inhibition.
Topics: Animals; Apnea; Humans; Incidence; Neural Pathways; Receptor, Serotonin, 5-HT1A; Receptors, Opioid, mu; Receptors, Serotonin, 5-HT3; Respiration; TRPV Cation Channels; Vagus Nerve
PubMed: 30553870
DOI: 10.1016/j.lfs.2018.12.021 -
Pneumologie (Stuttgart, Germany) Sep 2017In this study, recognition of apnoeas by means of polysomnography (PSG) and nocturnal respiratory sound recordings in patients with obstructive sleep apnoea (OSA) was... (Comparative Study)
Comparative Study
In this study, recognition of apnoeas by means of polysomnography (PSG) and nocturnal respiratory sound recordings in patients with obstructive sleep apnoea (OSA) was analyzed and compared. In 45 patients with OSA requiring treatment (AHI > 15/h), concomitant polysomnographic recordings and long term respiratory sound recordings by means of LEOSound were performed. Patients' average age was 58 ± 12 years (mean ± standard deviation), average BMI was 33 ± 7 kg/m. Audio-visual apnoea detection by LEOSound was compared to polysomnographic apnoea detection. Increased artifact rate due to dislocation of microphones led to rejection of 11 out of 45 recordings for detailed analysis. Comparison of apnea detection by audio-visual analysis and polysomnography yielded a median of 164 apneas for LEOSound recordings and 158 apneas for PSG. Median apnoea index (AI) was calculated to be 20/h for respiratory sounds recording and 21/h for PSG. The correlation of apnea indices from acoustic long term registration and PSG was 0.939 (p < 0.001). Acoustic long term registration of primary and secondary respiratory sounds is also capable to recognize apnoeas. Exact differentiation between apnoeas and hypopnoeas is only possible in a limited fashion.
Topics: Adult; Aged; Female; Humans; Male; Middle Aged; Polysomnography; Predictive Value of Tests; Respiratory Sounds; Sleep Apnea, Obstructive
PubMed: 28759934
DOI: 10.1055/s-0043-112888 -
Schweizerische Medizinische... Apr 1987Apneas during sleep are physiologic events. If they occur with some frequency and cause health problems, the disturbance is called sleep apnea syndrome. Most commonly...
Apneas during sleep are physiologic events. If they occur with some frequency and cause health problems, the disturbance is called sleep apnea syndrome. Most commonly the apneas are mainly obstructive and caused by intermittent upper airway collapse during sleep. The resultant pathophysiologic phenomena and their clinical aspects are the consequences of this. The diagnostic aspects and differential diagnosis of related disorders are discussed, and the various types of treatment are reviewed.
Topics: Barbiturates; Electroencephalography; Humans; Sleep Apnea Syndromes; Sleep, REM; Tracheotomy
PubMed: 3589615
DOI: No ID Found -
Comptes Rendus Des Seances de La... 1989Sleep apnea syndromes have been identified only relatively recently. Their most frequent form is characterized by a sleep-related upper airway obstruction resulting in...
Sleep apnea syndromes have been identified only relatively recently. Their most frequent form is characterized by a sleep-related upper airway obstruction resulting in apneas which may repeat themselves up to several hundred times during a night's sleep. Their mean duration is about 30 to 40 seconds, but some apneas last over one minute. Breathing resumption requires an arousal, which may be clearly identified on the EEG but usually goes unnoticed by the patient. The most immediate consequence are hypoxemia and sleep fragmentation. There may be associated arrhythmias and hemodynamic changes, especially in the pulmonary circulation. The predominant clinical signs are snoring (during the breathing resumption between the apneas) and daytime somnolence due to sleep fragmentation. In addition to the risks of work and traffic accidents, these patients run a long-term risk of cardiovascular accidents. About 20% develop pulmonary hypertension, a contributing factor to right heart failure. About 50% are hypertensive, which combined with a frequently observed polycythemia, makes them vulnerable to ischemic accidents. The treatment is based upon the use of continuous positive airway pressure (CPAP) during sleep. In case of failure, surgical alternatives may be considered.
Topics: Electroencephalography; Humans; Positive-Pressure Respiration; Sleep Apnea Syndromes
PubMed: 2534741
DOI: No ID Found -
Electroencephalography and Clinical... Oct 1976A sleep apnea syndrome has been diagnosed in eight children (age range 5-14). Before undertaking therapeutic trials, sleep and respiration were extensively studied....
A sleep apnea syndrome has been diagnosed in eight children (age range 5-14). Before undertaking therapeutic trials, sleep and respiration were extensively studied. Sleep and respiration were again analyzed 3 months after tonsillectomy and adenoidectomy (6 cases) or tracheostomy with insertion of valve (2 cases). Sleep induced apneic apisodes in these children who had normal respiration during wakefulness. Three types of apnea (central, upper airway, and mixed) were recorded in each case. The minimum number of apneas recorded during a single night was 75; the maximum was 816. Polygraphic monitoring demonstrated greatly disturbed sleep. Sleep changes were quantitative as well as qualitative. REM sleep percent was decreased, but stages 3 and 4 NREM sleep were also impaired. A relationship between stages 3-4 NREM sleep and respiration was noted: stages 3-4 sleep disappeared when apneic episodes were numerous; no apnea was recorded during stage 4 sleep. Follow-up nocturnal recordings of two tracheostomized children with valve open, then closed, confirmed this "stage 4/no apnea" relationship. Apneas were also noted to induce marked sinus arrhythmia during sleep.
Topics: Adolescent; Apnea; Arrhythmia, Sinus; Child; Child, Preschool; Electroencephalography; Female; Humans; Male; Respiration; Sleep Stages; Sleep Wake Disorders; Syndrome; Wakefulness
PubMed: 60223
DOI: 10.1016/0013-4694(76)90099-7 -
Respiratory Physiology & Neurobiology Apr 2014Chronic hypoxia increases the hypoxic ventilatory response (HVR). Augmented HVR contributes to central apneas seen in heart failure and complex sleep apnea. Endothelin...
Chronic hypoxia increases the hypoxic ventilatory response (HVR). Augmented HVR contributes to central apneas seen in heart failure and complex sleep apnea. Endothelin receptor (ETR) antagonism decreases carotid body afferent activity following chronic intermittent hypoxia (CIH). We speculated ETR antagonism would reduce HVR and apneas following CIH. HVR and apneas were measured after exposure to CIH and room air sham (SHAM). ETR blocker Ambrisentan was administered via the chow of CIH-exposed animals from days 1 to 12 of CIH (CIH/AMB). A separate crossover group was exposed to CIH and fed normal chow (placebo) days 1-6, and Ambrisentan days 7-12 (CIH/PLA-AMB). SHAM and CIH/PLA animals were fed placebo days 1-12. The CIH/AMB and CIH/PLA-AMB rats had reduced HVR compared to CIH/PLA, similar HVR compared to sham exposed animals, and reduced apnea frequency compared to CIH/PLA animals. The reduced HVR and post-hypoxic apneas resulting from Ambrisentan administration suggests ETR antagonists may have utility in reducing central apneas following CIH.
Topics: Animals; Apnea; Chronic Disease; Cross-Over Studies; Endothelin A Receptor Antagonists; Hypoxia; Male; Phenylpropionates; Pyridazines; Rats; Rats, Sprague-Dawley; Receptor, Endothelin A; Respiration; Respiratory System Agents; Rest
PubMed: 24468467
DOI: 10.1016/j.resp.2014.01.015 -
European Journal of Heart Failure Nov 2016
Topics: Heart Failure; Humans; Sleep Apnea, Central; Sleep Apnea, Obstructive
PubMed: 27634624
DOI: 10.1002/ejhf.635 -
Pediatric Pulmonology. Supplement 1999This paper summarizes current knowledge on laryngeal dynamics during neonatal apneas, including mechanisms potentially involved in mixed/obstructive apneas at the... (Review)
Review
This paper summarizes current knowledge on laryngeal dynamics during neonatal apneas, including mechanisms potentially involved in mixed/obstructive apneas at the laryngeal level, and recent personal data on active glottic closure throughout spontaneous central apneas (either isolated or in periodic breathing) observed in preterm lambs. It is suggested that this is reminiscent of the basic respiratory pattern in vertebrates alternating periods of lung ventilation with periods of breath-holding with the exchanger full of gas. Moreover, this unique ovine model of spontaneous neonatal apneas and periodic breathing offers new opportunity for studying candidate treatments of neonatal apneas.
Topics: Apnea; Humans; Infant, Newborn; Larynx
PubMed: 10093140
DOI: No ID Found -
La Pediatria Medica E Chirurgica :... 1986Apneas in the different sleep states are commonly observed in the full-term healthy newborn infant. Central and short apneas prevail whilst apneas greater than 15 sec....
Apneas in the different sleep states are commonly observed in the full-term healthy newborn infant. Central and short apneas prevail whilst apneas greater than 15 sec. are rare; a marked incidence of short apneas (less than 10 sec.) was observed in active sleep, even though apneas are not exclusive of active sleep. There is a strong inter-individual variability of apnea incidence. Apnea incidence in a state is not positively correlated to apnea incidence in different behavioural states: on the contrary there seems to be an opposite correlation between incidence in AS and QS. Apnea occurrence is positively correlated, in individuals, to the periodic breathing percentage. Apneas number and their duration is markedly lowered already in the second month of life. Periodic breathing must be considered a feature of immaturity. Obstructive apneas are less frequent than central apneas: their survey requires sophisticated technics with the aid of simultaneous recording of several breathing parameters. Relationship between central apneas/ obstructive apneas and mixed apneas is not known. Certainly obstructive and mixed apneas occurrence has been underestimated because of technical difficulties deriving from their survey. The meaning of an incidence of short apneas markedly higher than normal in full-term newborn infants is controversial and not clear, individuals with long apneas and subjects with short apneas in excess have been considered infants at SIDS risk. It is not clear whether periodic breathing and apneas depend on a common pathogenesis; the correlation between high incidence of periodic breathing in postnatal period and SIDS risk is still controversial. Few Authors suggest to treat newborn infants with extended apneas in sleep and considerable percentage of periodic breathing with aminophylline. The relation between gastro-oesophageal reflux and apnea has been recently evidenced. Central apneas and obstructive apneas during breast and bottle feeding have also been documented. Differently from pre-term infant apneas, bradycardia, although not exceptional, is not frequent during apneas in full-term newborn infants.
Topics: Age Factors; Apnea; Electroencephalography; Humans; Infant, Newborn; Risk; Sleep Apnea Syndromes; Sudden Infant Death; Wakefulness
PubMed: 3601711
DOI: No ID Found -
Archives Des Maladies Du Coeur Et Des... Jan 2002The sleep apnoea syndrome is the best known apnoeic syndrome. It is observed in 4% of men and 2% of women. Nasal ventilation with continuous positive pressure is the... (Review)
Review
The sleep apnoea syndrome is the best known apnoeic syndrome. It is observed in 4% of men and 2% of women. Nasal ventilation with continuous positive pressure is the best treatment for most patients. To date, electrical stimulation has a limited role in its treatment as it is used only when the apnoea requires ventilation by tracheotomy. This electrogenic ventilation requires so-called diaphragmatic stimulators. Although severe bradycardia may occur during sleep apnoea, there is usually no indication for cardiac pacing. However, recent publications have reported an anti-apnoeic effect of permanent atrial pacing. The modes of action remain unclear but these results support other recently reported data concerning the value of pacing in cardiac failure, the high incidence of sleep apnoea in cardiac failure patients and the possibility of diagnosing and monitoring apnoea by minute ventilation sensors. Therefore, there appears to be a field of research for cardiac pacing in apnoea syndromes. The authors review the principal reported data on the indications and possibilities of extra-cardiac and cardiac stimulation in apnoeic syndromes.
Topics: Electric Stimulation; Humans; Sleep Apnea Syndromes
PubMed: 11901890
DOI: No ID Found