Obstructive Sleep Hypopnea Research Articles

Pharmacological and Non-Pharmacological Management of Obstructive Sleep Apnea

Obstructive sleep apnea (O.S.A.), also referred to as obstructive sleep hypopnea – is a sleep disorder that involvescessation or significant decrease in airflow in the presence of breathing effort. It is the most common type of sleep-disorderedbreathing. It is characterized by episodes of total or partial airway collapse and decreased oxygen saturation or sleep arousal. Asa result of this disturbance, sleep is interrupted and non-restorative. It significantly raises morbidity and mortality in both developedand developing countries. This review aims to review relevant studies on obstructive sleep apnea. The method used is acomputerized search method, the pathophysiology, clinical presentation, complications, diagnostic procedures, and therapeuticchoices from the literature. The effects of O.S.A. on cardiovascular health, mental disease, quality of life, and driving safety aresevere. This course of action highlights the interprofessional team's involvement in treating obstructive sleep apnea, itspathophysiology, and its causes.

Anthropometric Measures for the Prognosis of Obstructive Sleep Apnea in Obese.

The objective of this study was to identify, among the different anthropometric indicators, the one that shows higher discriminatory power for the prognosis of Obstructive Sleep Apnea Syndrome (OSAS). Observational cross-sectional study PARTICIPANTS: Obese individuals elective to bariatric surgery METHODS: A study based on data of 758 patients aged ≥ 21 years old, of both sexes, in the pre-operatory stage of the surgical procedure of gastric bypass. Obstructive sleep apnea and obstructive sleep hypopnea were evaluated and classified through the apnea-hypopnea index, which was obtained through the examination of polysomnography. Variables were divided into two groups: individuals with and without OSAS. As predictors, measures of body mass index (BMI), neck circumference (NC), and waist circumference (WC) were used. The area under the ROC curve was used to check the sensitivity and specificity. All evaluated anthropometric indicators showed statistical significance. WC: area of 0.62 (CI 95%: 0.58 - 0.67), NC: area of 0,68 (CI 95%: 0.64 - 0.72) and BMI: area of 0.58 (CI 95%: 0.54 - 0.63). The investigated anthropometric indicators performed as good predictors of OSAS. However, NC seems to be the best anthropometric indicator for the prognosis of OSAS in obese individuals when compared to BMI and WC.

Case Report: Parasomnia Overlap Disorder Induced by Obstructive Sleep Hypopnea Apnea Syndrome: A Case Report and Literature Review.

Obstructive sleep apnea hypopnea syndrome (OSAHS) and parasomnia overlap disorder (POD) are types of sleep disorders. When the symptoms of both conditions coexist, the POD symptoms are most likely caused by OSAHS. In these cases, the symptoms of POD will be relieved when OSAHS is effectively treated. We refer to these cases as symptomatic POD (related to OSAHS), which differs in pathophysiology, complications, and treatment from idiopathic POD. It is important to note that the treatment for idiopathic POD may aggravate the symptoms of OSAHS. In this case, we used video polysomnography (v-PSG) on a POD patient with suspected OSAHS to distinguish idiopathic POD from symptomatic POD, to inform the appropriate treatment course. The video results and clinical features lead us to diagnose symptomatic POD, and we treated the patient with auto-set continuous positive airway pressure to address their OSAHS. This course of treatment resolved all POD-related symptoms. Here, we discuss this case and review the relevant literature. This report highlights the importance of the use of v-PSG in the clinical diagnosis, differential diagnosis, and subsequent treatment of POD.

Comparison of the hemodynamic effects of a loading dose of dexmedetomidine combined with total intravenous anesthesia or inhalation anesthesia on children with obstructive sleep apnea-hypopnea syndrome

Objective To investigate the effects of a loading dose of dexmedetomidine(Dex) on the hemodynamics of children with obstructive sleep apnea-hypopnea syndrome(OSAHS) during total intravenous anesthesia and total inhalation anesthesia. Methods A total of 50 patients scheduled for adenotonsillectomy were enrolled in the study, and randomly divided into a total intravenous anesthesia group (group A) and an inhaled anesthesia group (group B) (n=25). After anesthesia induction, both groups were given a loading dose of Dex (1 μg/kg over 10 min). The systolic blood pressure(SBP), diastolic blood pressure(DBP), mean arterial pressure(MAP) and heart rate were recorded before infusion(T0), 5 min(T5) and 10 min(T10) after administration of Dex. Results Compared with baseline values, group A presented remarkable increases in SBP, DBP and MAP at T5 and T10(P<0.05). Group B demonstrated decreased SBP, DBP and MAP 10 min after infusion(P<0.05). The heart rate in the both groups were significantly decreased after Dex infusion(P<0.05). Conclusions During anesthesia maintenance, a loading dose of Dex can significantly increase arterial blood pressure in OSAHS patients when combined with total intravenous anesthesia, and significantly decrease arterial blood pressure when combined with inhaled anesthesia. Key words: Dexmedetomidine; Hemodynamics; Pediatric; Maintenance of anesthesia; Obstructive sleep hypopnea syndrome

The Obstructive Sleep Apnea Syndrome (OSAS)

Respiratory disorders are a big issue that affects around 60% of the population all over the world. It varies from simple snoring up to severe stridor which appears mainly during sleep. The cause of all respiratory disorders depends on obstruction, vibration or both. We can also find respiratory disorders in some rare cases like Obesity Hypoventilation Syndrome or Multisystem Disease. The respiratory events start with simple snoring without symptoms of dyspnea or hypopnea. It may extend to arousals due to respiratory efforts (RERAs Syndrome). With more and more distress, the hypopnea (decrease in Oxygen) appears till complete apnea occurs with awakened stridor. The most common sequence of events in sleep respiratory disorders can be summarized into the following; simple snoring which leads to the increase in upper airway resistance and finally ending in a group of syndromes like OSAS (Apnea, Hypopnea, RERAs). In another sequence, snoring leads to Uvular Oedema which feels like morning Obstructive Sleep Hypopnea Apnea Syndrome (ObSHAS). This leads to increase in Arterial Hypertension which causes daytime sleepiness. There are a lot of complications in OSAS which maybe local complications in mouse, nose and chest, or CVS complications like Erythema or Hypertension or psychological problems like dizziness or loss of consciousness or daytime sleepiness. One of the most common problems is how to exactly detect the size and site of the obstruction of air flow. There are several methods like full history of the patient and the partner, full clinical examination, full radiological examination or fiber-optic endoscopic examination. The treatment is either medical or surgical according to the case.

Characterization of pharyngeal resistance during sleep in a spectrum of sleep-disordered breathing

Aims of the study were 1) to compare Hudgel's hyperbolic with Rohrer's polynomial model in describing the pressure-flow relationship, 2) to use this pressure-flow relationship to describe these resistances and to evaluate the effects of sleep stages on pharyngeal resistances, and 3) to compare these resistances to the pressure-to-flow ratio (DeltaP/V). We studied 12 patients: three with upper airway resistance syndrome (UARS), four with obstructive sleep hypopnea syndrome (OSHS), three with obstructive sleep apnea syndrome (OSAS), and two with simple snoring (SS). Transpharyngeal pressures were calculated between choanae and epiglottis. Flow was measured by use of a pneumotachometer. The pressure-flow relationship was established by using nonlinear regression and was appreciated by the Pearson's square (r(2)). Mean resistance at peak pressure (Rmax) was calculated according to the hyperbolic model during stable respiration. In 78% of the cases, the value of r(2) was greater when the hyperbolic model was used. We demonstrated that Rmax was in excellent agreement with P/V. UARS patients exhibited higher awake mean Rmax than normal subjects and other subgroups and a larger increase from wakefulness to slow-wave sleep than subjects with OSAS, OSHS, and SS. Analysis of breath-by-breath changes in Rmax was also a sensitive method to detect episodes of high resistance during sleep.

What Actually is an Obstructive Sleep Hypopnea?

What Actually is an Obstructive Sleep Hypopnea?

Blood Flow of the Middle Cerebral Artery With Sleep-Disordered Breathing: Correlation With Obstructive Hypopneas

To the Editor: Netzer et al1 recently reported that obstructive sleep hypopnea and apnea are associated with reductions in middle cerebral artery (MCA) blood flow compared with central sleep apnea. This study may explain the increased incidence of ischemic stroke in obstructive sleep disorders,2 3 4 although it is important to remember that other mechanisms independent of cerebral hemodynamics have also been proposed.5 6 Transcranial Doppler blood flow measurements of the MCA are assumed to reflect total brain flow, but it should be noted that this technique does not evaluate regional cerebral blood flow (CBF). Several lines of evidence suggest that localized disturbances in CBF may be important in patients who sustain cerebrovascular events in association with sleep disorders. Non-REM sleep in normal subjects is associated with a global reduction in brain blood flow (measured by stable xenon computed tomography) and global glucose hypometabolism (measured by positron emission tomography). Against this global fall in CBF are important regional variations, with some brain regions (frontal cortex, basal ganglia, thalamus, pons, cerebellum) affected to a greater degree while others (temporal cortex) are relatively unaffected.7 8 During REM sleep there is increased CBF to the associated visual area, presumably reflecting the activation involved in processing visual dream experiences, with a reduction in inferior frontal cortical flow.9 Preliminary observations in sleep apnea syndromes indicate the presence of focal cortical perfusion abnormalities in the awake or apneic state that are …

The Pharyngeal Critical Pressure: The Whys and Hows of Using Nasal Continuous Positive Airway Pressure Diagnostically

The Pharyngeal Critical Pressure: The Whys and Hows of Using Nasal Continuous Positive Airway Pressure Diagnostically

Obstructive Sleep Hypopnea Syndrome in a Patient with Marfan Syndrome Treated with Oxygen Therapy

A patient with Marfan's syndrome and obstructive sleep hypopnea syndrome is reported. She had complained about insomnia, tiredness and hypersomnolence lasting 2 years. A complete nightly polysomnography revealed 94 obstructive hypopneas (the hypopnea index was 12.85) and no obstructive apneas. Presumably an increased laxity of the pharyngeal wall was responsible for the phenomenon. A therapy with CPAP was started, but was not tolerated by the patient. Oxygen therapy on the other hand turned out to be effective and well tolerated.