Early Treatment Of Obstructive Sleep Apnea Research Articles

Applying composite physiological characteristics to assess the severity of obstructive sleep apnea

Obstructive Sleep Apnea (OSA) is a common sleep disorder which causes poor sleep quality, daytime drowsiness, memory loss, and lack of attention, and can contribute to accidents. Long-term OSA is associated with cardiovascular disease, high blood pressure, arrhythmia and diabetes. Early discovery and treatment of OSA can significantly reduce the difficulty and cost of treatment. OSA detection uses a scale method which is prone to subjective errors. Polysomnography (PSG) requires long detection times, entails equipment which can be difficult to obtain and high cost, and does not provide immediate diagnosis or the establishment of preventative treatment. Human biosignals have been found to provide a faster and more objective means of sleep apnea diagnosis, allowing for the early treatment of OSA. By identifying key physiological characteristics and observing their change over time, one can assess the severity of the patient’s condition, and appropriate treatment can reduce the likelihood of disease onset or slow its progression. This study applies machine learning techniques to electroencephalography (EEG), electrocardiography (ECG), oxygen saturation (SpO2) and other complex physiological characteristics to establish a model for OSA severity and evaluate the effectiveness of various machine learning methods to detect sleep apnea. In addition, the fuzzy C-mean (FCM) algorithm is used to construct a predictive model for OSA to assist physicians in the early clinical detection of symptoms. The study found that patients with severe sleep apnea have a self-rescue condition which causes wakening due to respiratory arrest. Only relying on SpO2 and the Apnea Hypopnea Index (AHI) will cause severe OSA cases to be misidentified as mild, and this study found that the A5 band brain wave can help detect sleep apnea, reducing the possibility of miscategorization and assisting physicians in accurate clinical diagnosis.

Troubles urinaires et génito-sexuels dans le syndrome d’apnée obstructive du sommeil : revue de la littérature

The objective of this work was to make a review of urinary tract symptoms and erectile dysfunction involved in obstructive sleep apnea (OSA) but also to study their physiopathology and potential treatments. We conducted a literature review in the Pubmed database using PRISMA guidelines and the MeSH terms: sleep apnea, urinary incontinence, erectile dysfunction, sexuality. All French and English articles published up to 2020 were evaluated. The initial evaluation identified 240 articles from which 30 were included. References lists review allowed the inclusion of 26 additional articles. Nocturia, overactive bladder (OAB) and erectile dysfunction (ED) were associated with OSA. Increased levels of natriuretic peptides are behind nocturia. Nocturia is associated with higher Apnea/Hypopnea Index (AHI) (49±11 vs 24±8 episodes/hour with P=0.0001). The severity of nocturia is proportional to the severity of OSA with a positive predictive value of 71%. Intermittent nocturnal hypoxemia causes peripheral axonal damage with subsequent urgency incontinence. There is correlation between severity of OAB and the severity of OSA especially when the latter is moderate or severe. An odds ratio of 0.45 (CI95%: 0.18-0.71) is found for ED in patients who don't have OSA, associating the latter to an increased risk of ED. Intermittent nocturnal hypoxemia, the decrease in the levels of nitric oxide, and the increase in blood pressure and levels of endothelin 1 contribute to the development of ED. An early treatment of OSA with continuous positive airway pressure (CPAP) may allow a partial but significant control of urinary symptoms and erectile dysfunction associated with OSA. OSA is associated with urinary tract symptoms (nocturia and OAB) and erectile dysfunction. The severity of associated symptoms is related to the severity of OSA. Urinary and sexual troubles are reversible after treatment of OSA by CPAP. OSA research is reasonable in case of pathologic nocturia or ED with loss of morning erections.

Cerebrovascular Regulation and Sleep Apnea

The brain relies on a constant blood flow to match nutrient delivery with the local metabolic demands. Cerebral blood flow (CBF) autoregulation is particularly important under hypoxic conditions such as obstructive sleep apnea (OSA) to prevent brain hypoxia. We aim to give a brief overview of cerebral blood flow regulation and evaluate the current evidence for cerebrovascular sensitivity to hypoxia, the capacity of cerebral arteries to respond to reduced oxygen supply during normal sleep and OSA. In clinical conditions such as intermittent hypoxia as well as untreated OSA, cerebrovascular system becomes less reactive to CO2 and impaired autoregulation, and makes the brain more susceptible to ischemic stroke. Results from studies in patients with OSA indicate worse clinical outcome including higher chance of cerebrovascular events, impaired functional capacity and cognition. Early treatment of OSA with continuous positive airway pressure (CPAP), resulting in reversal of cerebral autoregulation.