1
|
Suzuki H, Nakayama T, Sawa A, Yagi T, Iwata Y, Takeuchi H, Motoyoshi M, Chow CM, Komiyama O. Mandibular Advancement Device Therapy in Japanese Rugby Athletes with Poor Sleep Quality and Obstructive Sleep Apnea. Life (Basel) 2022; 12:life12091299. [PMID: 36143335 PMCID: PMC9505292 DOI: 10.3390/life12091299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/11/2022] [Accepted: 08/20/2022] [Indexed: 11/30/2022] Open
Abstract
Obstructive sleep apnea (OSA) may contribute to poor sleep quality. This study assessed subjective sleep quality, the Respiratory Event Index (REI), reaction times, and the therapeutic effects of a custom-made mandibular advancement device (MAD) in male Japanese elite rugby athletes. The Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and level III sleep test (REI and minimum oxygen saturation [SpO2 min]) were used to evaluate sleep quality. MAD therapy was used daily for 3 weeks. A telephone-based reaction time test of kinetic vision (the ability to identify moving objects) was recorded within 15 min of waking and over 5 days of pre- and post-MAD therapy. Differences in variables were evaluated using paired t-tests. Of the 42 players (mean age, 26.3 ± 3.7 years; mean body mass index, 28.7 ± 3.2 kg/m2) included in this study, 29 (69.0%) had poor sleep quality (PSQI > 5.5), and 27 were diagnosed with OSA (64.3%) (mild = 16/moderate = 9/severe = 2). Six were treated with MAD therapy, which significantly improved the REI (p < 0.01), SpO2 min (p < 0.001), ESS score (p < 0.001), reaction times (p < 0.01), and sleep quality. A significant reduction in reaction times suggests that OSA treatment can improve kinetic vision. Future studies should systematically evaluate the impact of sleep-disordered breathing on kinetic vision in athletes.
Collapse
Affiliation(s)
- Hiroshi Suzuki
- Department of Oral Function and Fixed Prosthodontics, Nihon University School of Dentistry at Matsudo, Chiba 271-8587, Japan
- Correspondence:
| | - Toshiyuki Nakayama
- Department of Oral Function and Fixed Prosthodontics, Nihon University School of Dentistry at Matsudo, Chiba 271-8587, Japan
| | - Arisa Sawa
- Department of Oral Function and Fixed Prosthodontics, Nihon University School of Dentistry at Matsudo, Chiba 271-8587, Japan
| | - Tatsuo Yagi
- Department of Physical Reaction, Tokai University School of Physical Education, Hiratsuka-shi 259-1292, Japan
| | - Yoshihiro Iwata
- Department of Oral Function and Fixed Prosthodontics, Nihon University School of Dentistry at Matsudo, Chiba 271-8587, Japan
| | - Hiroki Takeuchi
- Department of Oral Function and Fixed Prosthodontics, Nihon University School of Dentistry at Matsudo, Chiba 271-8587, Japan
| | - Miho Motoyoshi
- Department of Oral Function and Fixed Prosthodontics, Nihon University School of Dentistry at Matsudo, Chiba 271-8587, Japan
| | - Chin-Moi Chow
- Sleep Research Group, Charles Perkins Centre, University of Sydney, Sydney 2006, Australia
- Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney 2006, Australia
| | - Osamu Komiyama
- Department of Oral Function and Fixed Prosthodontics, Nihon University School of Dentistry at Matsudo, Chiba 271-8587, Japan
| |
Collapse
|
2
|
Bullock T, Giesbrecht B, Beaudin AE, Goodyear BG, Poulin MJ. Effects of changes in end-tidal PO 2 and PCO 2 on neural responses during rest and sustained attention. Physiol Rep 2021; 9:e15106. [PMID: 34755481 PMCID: PMC8578925 DOI: 10.14814/phy2.15106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 10/08/2021] [Accepted: 10/10/2021] [Indexed: 01/23/2023] Open
Abstract
Impairments of cognitive function during alterations in arterial blood gases (e.g., high-altitude hypoxia) may result from the disruption of neurovascular coupling; however, the link between changes in arterial blood gases, cognition, and cerebral blood flow (CBF) is poorly understood. To interrogate this link, we developed a multimodal empirical strategy capable of monitoring neural correlates of cognition and CBF simultaneously. Human participants performed a sustained attention task during hypoxia, hypercapnia, hypocapnia, and normoxia while electroencephalographic (EEG) activity and CBF (middle and posterior cerebral arteries; transcranial Doppler ultrasound) were simultaneously measured. The protocol alternated between rest and engaging in a visual target detection task that required participants to monitor a sequence of brief-duration colored circles and detect infrequent, longer duration circles (targets). The target detection task was overlaid on a large, circular checkerboard that provided robust visual stimulation. Spectral decomposition and event-related potential (ERP) analyses were applied to the EEG data to investigate spontaneous and task-specific fluctuations in neural activity. There were three main sets of findings: (1) spontaneous alpha oscillatory activity was modulated as a function of arterial CO2 (hypocapnia and hypercapnia), (2) task-related neurovascular coupling was disrupted by all arterial blood gas manipulations, and (3) changes in task-related alpha and theta band activity and attenuation of the P3 ERP component amplitude were observed during hypocapnia. Since alpha and theta are linked with suppression of visual processing and executive control and P3 amplitude with task difficulty, these data suggest that transient arterial blood gas changes can modulate multiple stages of cognitive information processing.
Collapse
Affiliation(s)
- Tom Bullock
- Department of Psychological and Brain SciencesUniversity of CaliforniaSanta BarbaraCaliforniaUSA
- Institute for Collaborative BiotechnologiesUniversity of CaliforniaSanta BarbaraCaliforniaUSA
| | - Barry Giesbrecht
- Department of Psychological and Brain SciencesUniversity of CaliforniaSanta BarbaraCaliforniaUSA
- Institute for Collaborative BiotechnologiesUniversity of CaliforniaSanta BarbaraCaliforniaUSA
- Interdepartmental Graduate Program in Dynamical NeuroscienceUniversity of CaliforniaSanta BarbaraCaliforniaUSA
| | - Andrew E. Beaudin
- Department of Physiology & PharmacologyUniversity of CalgaryCalgaryAlbertaCanada
- Hotchkiss Brain InstituteCumming School of MedicineUniversity of CalgaryCalgaryAlbertaCanada
| | - Bradley G. Goodyear
- Hotchkiss Brain InstituteCumming School of MedicineUniversity of CalgaryCalgaryAlbertaCanada
- Department of Clinical NeurosciencesUniversity of CalgaryCalgaryAlbertaCanada
- Department of RadiologyUniversity of CalgaryCalgaryAlbertaCanada
| | - Marc J. Poulin
- Department of Physiology & PharmacologyUniversity of CalgaryCalgaryAlbertaCanada
- Hotchkiss Brain InstituteCumming School of MedicineUniversity of CalgaryCalgaryAlbertaCanada
- Department of Clinical NeurosciencesUniversity of CalgaryCalgaryAlbertaCanada
- O’Brien Institute for Public HealthUniversity of CalgaryCalgaryAlbertaCanada
- Libin Cardiovascular Institute of AlbertaUniversity of CalgaryCalgaryAlbertaCanada
- Faculty of KinesiologyUniversity of CalgaryCalgaryAlbertaCanada
| |
Collapse
|
3
|
Kaur A, Chawla N, Subramanian T. Oropharyngeal muscle strengthening exercises in obstructive sleep apnea. ARCHIVES OF MEDICINE AND HEALTH SCIENCES 2021. [DOI: 10.4103/amhs.amhs_318_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
4
|
An HJ, Baek SH, Kim SW, Kim SJ, Park YG. Clustering-based characterization of clinical phenotypes in obstructive sleep apnoea using severity, obesity, and craniofacial pattern. Eur J Orthod 2020; 42:93-100. [PMID: 31119286 DOI: 10.1093/ejo/cjz041] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To identify and characterize the phenotypes of adult obstructive sleep apnoea (OSA) patients based on clustering using OSA severity, obesity, and craniofacial pattern. MATERIAL AND METHODS The samples consisted of 89 adult OSA patients whose polysomnography and lateral cephalogram were available. With cluster analysis using apneahypopnea index (AHI, events/hour), body mass index (BMI, kg/m2), ANB (degree), and mandibular plane angle (MPA, degree), three clusters were identified. Cephalometric variables including craniofacial, soft palate, hyoid bone, and pharyngeal space compartments were compared among clusters by one-way analysis of variance or Kruskal-Wallis test. Multivariable linear regression analysis was performed to find contributing factors to OSA severity within each cluster. RESULTS Cluster-1 (obesity type; 49.4 per cent) exhibited moderate OSA, obesity, and normal sagittal and vertical skeletal pattern (AHI, 22.4; BMI, 25.5; ANB, 3.2 degrees; MPA, 26.3 degrees) without significant upper airway abnormality. Cluster-2 (skeletal type; 33.7 per cent) was characterized by moderate OSA, severe skeletal Class II hyperdivergent pattern with narrow pharyngeal airway spaces, without obesity (AHI, 27.9; BMI, 23.5; ANB, 7.5 degrees; MPA, 36.6 degrees). Cluster-3 (complex type; 16.8 per cent) included severe OSA, obesity, skeletal Class II hyperdivergent pattern (AHI, 52.8; BMI, 28.0; ANB, 4.5 degrees; MPA, 32.2 degrees), with posteriorly displaced hyoid and retroclined soft palate. The main contributing factors to AHI were obesity in Cluster-1; hyperdivergent vertical pattern with narrow pharyngeal space in Cluster-2; and hyperdivergent pattern, obesity, displaced hyoid, and soft palate in Cluster-3. CONCLUSION Three OSA phenotypes resulted from this study provide a clinical guideline for differential diagnosis and orthodontic intervention in the interdisciplinary treatment for OSA patients.
Collapse
Affiliation(s)
- Hyun-Joon An
- Department of Orthodontics, Graduate School, Kyung Hee University
| | - Seung-Hak Baek
- Department of Orthodontics, School of Dentistry, Seoul National University
| | - Sung-Wan Kim
- Department of Otorhinolaryngology, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Su-Jung Kim
- Department of Orthodontics, School of Dentistry, Kyung Hee University, Seoul, Republic of Korea
| | - Young-Guk Park
- Department of Orthodontics, School of Dentistry, Kyung Hee University, Seoul, Republic of Korea
| |
Collapse
|
5
|
Welton KL, Gagnier JJ, Urquhart AG. Proportion of Obese Patients Presenting to Orthopedic Total Joint Arthroplasty Clinics. Orthopedics 2016; 39:e127-33. [PMID: 26726980 DOI: 10.3928/01477447-20151222-12] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 06/15/2015] [Indexed: 02/03/2023]
Abstract
The purpose of this study is to demonstrate that the percentage of obese individuals initially presenting to total joint arthroplasty clinics in a public, tertiary hospital is greater than the proportion of obese individuals in the general population. In a retrospective, comparative study of patients seen in total joint replacement clinics at a public, tertiary hospital with an ICD-9 diagnosis of hip or knee osteoarthritis and documented body mass index, the proportion of obese individuals was compared with recent obesity data for the general population from the Centers for Disease Control and Prevention. Patients who had previously undergone hip or knee replacement surgery were excluded. Comorbid conditions, functional comorbidity index (FCI) scores, and Charlson comorbidity index scores were compared between obese and nonobese cohorts. The study included 499 patients aged 20 to 92 years (mean, 64.3 years), 58.9% of whom were female. Fifty-five percent of patients were obese, a significantly greater percentage than in the national (34.9%; P<.0005; odds ratio [OR]=2.23), regional (29.5%; P<.0005; OR=2.85), and state (31.1%; P<.0005; OR=2.64) populations. Obese patients had significantly more comorbid conditions (P<.002) and higher functional comorbidity index scores (P<.0009). The number of comorbidities and having Medicare/Medicaid insurance were predictive of obesity. This study highlights that the majority of patients presenting to orthopedic total joint arthroplasty clinics are obese and that they come with significantly more comorbidities. The total joint surgeon has a unique opportunity to facilitate weight loss in the obese osteoarthritic patient prior to joint replacement.
Collapse
|
6
|
Cheung K, Ishman SL, Benke JR, Collop N, Tron L, Moy N, Stierer TL. Prediction of obstructive sleep apnea using visual photographic analysis. J Clin Anesth 2016; 32:40-6. [PMID: 27290943 DOI: 10.1016/j.jclinane.2015.12.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Revised: 08/27/2015] [Accepted: 12/21/2015] [Indexed: 10/22/2022]
Abstract
STUDY OBJECTIVES Obstructive sleep apnea (OSA) has been historically underdiagnosed and may be associated with grave perioperative complications. The ASA and American Academy of Sleep Medicine recommend OSA screening prior to surgery; however, only a minority of patients are screened. The objective of this study was to determine the proficiency of anesthesiologists, otolaryngologists, and internists at predicting the presence of OSA by visual photographic analysis without the use of a computer program to assist, and determine if prediction accuracy varies by provider type. DESIGN Prospective case series SETTING Tertiary care hospital-based academic center PATIENTS Fifty-six consecutive patients presenting to the sleep laboratory undergoing polysomnography had frontal and lateral photographs of the face and torso taken. INTERVENTIONS Not applicable. MEASUREMENTS Polysomnography outcomes and physician ratings. An obstructive apnea hypopnea index (oAHI) ≥15 was considered "positive." Twenty anesthesiologists, 10 otolaryngologists, and 11 internists viewed patient photographs and scored them as OSA "positive" or "negative" before and after being informed of patient comorbidities. MAIN RESULTS Nineteen patients had an oAHI <15, 18 were ≥15 but <30, and 19 were ≥30. The mean oAHI was 28.7 ± 26.7 events/h (range, 0-125.7), and the mean body mass index was 34.1 ± 9.7 kg/m(2) (range, 17.4-63.7). Overall, providers predicted the correct answer with 61.8% accuracy without knowledge of comorbidities and 62.6% with knowledge (P < .0001). There was no difference between provider groups (P = .307). Prediction accuracy was unrelated to patient age (P = .067), gender (P = .306), or race (P = .087), but was related to body mass index (P = .0002). CONCLUSION The ability to predict OSA based on visual inspection of frontal and lateral photographs is marginally superior to chance and did not differ by provider type. Knowledge of comorbidities did not improve prediction accuracy.
Collapse
Affiliation(s)
- Kristin Cheung
- Department of Anesthesia & Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Stacey L Ishman
- Division of Otolaryngology-Head & Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
| | - James R Benke
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Nancy Collop
- Emory Sleep Center, Emory University, Atlanta, GA, USA
| | - Lia Tron
- Department of Anesthesiology, Lankenau Hospital, Wynnewood, PA, USA
| | - Nicole Moy
- Department of Anesthesia & Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Tracey L Stierer
- Department of Anesthesia & Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| |
Collapse
|
7
|
Abstract
Obstructive Sleep Apnea (OSA) is a common sleep disorder characterized by repetitive collapse of the upper airway (UA) during sleep. Treatment options for OSA include mandibular advancement splints (MAS), worn intra-orally to protrude the lower jaw to stabilize the airway. However not all patients will respond to MAS therapy and individual effects on the upper airway are not well understood. Simulations of airway behavior represent a non-invasive means to understand this disorder and treatment responses in individual patients. The aims of this study was to perform analysis of upper airway (UA) occlusion and flow dynamics in OSA using the fluid structure interaction (FSI) method, and secondly to observe changes associated with MAS usage. Magnetic resonance imaging (MRI) scans were obtained with and without mandibular advance splint (MAS) treatment in a patient known to be a treatment responder. Computational models of the anatomically correct UA geometry were reconstructed for both pre-and post-treatment (MAS) conditions. By comparing the simulation results, the treatment success of MAS was demonstrated by smaller UA structure deformation (maximum 2mm) post-treatment relative to the pre-treatment fully collapsed (maximum 6mm) counterpart. The UA collapse was located at the oropharynx and the low oropharyngeal pressure (-51 Pa to-39 Pa) was induced by the velopharyngeal jet flow (maximum 10 m/s). The results support previous OSA computational fluid dynamics (CFD) studies by indicating similar UA pressure drop and maximum velocity values. These findings lay a firm platform for the application of computational models for the study of the biomechanical properties of the upper airway in the pathogenesis and treatment of OSA.
Collapse
|
8
|
Relationship of Chronic Pain and Opioid Use with Respiratory Disturbance during Sleep. Pain Manag Nurs 2012; 13:70-9. [DOI: 10.1016/j.pmn.2010.04.003] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2009] [Revised: 04/23/2010] [Accepted: 04/26/2010] [Indexed: 11/24/2022]
|
9
|
Computational Fluid Dynamics Study of the Inspiratory Upper Airway and Clinical Severity of Obstructive Sleep Apnea. J Craniofac Surg 2012; 23:401-5. [DOI: 10.1097/scs.0b013e318240feed] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
10
|
Dasgupta A, Bagchi A, Nag S, Bardhan S, Bhattacharyya P. Profile of respiratory problems in patients presenting to a referral pulmonary clinic. Lung India 2011; 25:4-7. [PMID: 20390068 PMCID: PMC2851148 DOI: 10.4103/0970-2113.44129] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Analysis of OPD data of 2012 patients in a referral pulmonary clinic at Kolkata was done following a protocol-based approach. Obstructive airway diseases (COPD and asthma) were the most common (43%) problem followed by infective lung diseases (15%) including tuberculosis, bronchogenic carcinoma (8%), ILD (4%), haemopty-sis of undiagnosed etiology (4.5%), chronic cough of undiagnosed etiology (6.5%) and pleural diseases (4.6%). Other diseases like obstructive sleep apnoea, sarcoid-osis, systemic diseases with lung involvements etc., and non respiratory problems formed the rest (14.4%).
Collapse
Affiliation(s)
- Angira Dasgupta
- The Institute of Pulmocare and Research, CB-16, Salt Lake, Sector - I, Kolkata - 700064, India
| | | | | | | | | |
Collapse
|
11
|
Sonsuwan N, Suchachaisri S, Chaloeykitti L. The relationships between cephalometric parameters and severity of obstructive sleep apnea. Auris Nasus Larynx 2010; 38:83-7. [PMID: 20554416 DOI: 10.1016/j.anl.2010.04.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2010] [Revised: 04/12/2010] [Accepted: 04/20/2010] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To verify the relationships between cephalometric parameters and apnea hypopnea index (AHI) in snoring patients in Chiang Mai University Hospital. METHODS Fifty patients who attend ENT snoring clinic, Faculty of Medicine, Chiang Mai University Hospital during 1 October, 2007 to 31 October, 2008 were enrolled. All subsequently underwent overnight polysomnography by SOMNOCHECK(®) V2.04 and lateral cephalometric radiographs. RESULTS Of the 50 patients, 78% were men (n=39) and 22% were women (n=11). Ages ranged from 31 to 65 years. Average apnea hypopnea index (AHI)=18.4 ± 18.2 events/h. Body mass index (BMI)=27.2 ± 3.3 kg/m². The mean sella-nasion-subspinale (SNA)=84.1 ± 4.3°. Sella-nasion-supramental (SNB)=81.8 ± 3.4°. Posterior airway space (PAS)=14.9 ± 4.3mm. Distance between mandibular plane and hyoid (MP-H)=27.7 ± 5.6 mm. Distance between posterior nasal spine and tip of soft palate (PNS-P)=42.5 ± 5.4mm. Using Pearson's correlation analysis of BMI, the cephalometric parameters from all subjects with AHI revealed BMI, PAS and MP-H had significant correlation with AHI; p=0.009, p=0.003, and p=0.005, respectively. BMI, MP-H, and PAS were correlated with AHI. The multiple regression model for the effects of BMI, PAS, and MP-H on AHI is AHI=2.090(BMI)-1.953(PAS)+1.1333(MP-H)-40.54. CONCLUSION The model seems to be useful as a screening tool to assess the severity of obstructive sleep apnea in snoring patients.
Collapse
|
12
|
Li NF, Yao XG, Zhu J, Yang J, Liu KJ, Wang YC, Wang XL, Zu FY. Higher levels of plasma TNF-alpha and neuropeptide Y in hypertensive patients with obstructive sleep apnea syndrome. Clin Exp Hypertens 2010; 32:54-60. [PMID: 20144074 DOI: 10.3109/10641960902993087] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Resistant hypertension is always fount to be accompanied with obstructive sleep apnea syndrome (OSAS). Previous studies assumed inflammation participated in OSAS and hypertension. The fact that tumor necrosis factor a (TNF-alpha) was related to OSAS, while neuropeptide Y (NPY) was related to hypertension, was widely reported separately. To investigate the involvement of TNF-alpha and NPY simultaneously in hypertension accompanied with OSAS, 417 subjects who underwent the polymonograph and blood pressure measurement were consecutively selected. Plasma TNF-alpha and NPY levels were determined in normotensive with OSAS (n = 113), hypertensive without OSAS (n = 73), hypertensive with OSAS (n = 134), and those of controls (n = 97), respectively. A significant increase of plasma TNF-alpha and NPY were both observed in hypertensive subjects with or without OSAS, the highest level of TNF-alpha and NPY were in hypertension with the OSAS group. TNK-alpha, NPY, and neck circumference contributed to OSAS and hypertension as risk factors in the logistic regression model. Neck circumference was impacted by apnea/hyponea index, mean diastolic blood pressure, and TNF-alpha level, which was indicated via the multiple linear model. The present study indicated a positive interplay between plasma TNF-alpha, NPY, hypertension, and OSAS in the Han population of Xinjiang. Although there is evidence that inflammation plays a role in the pathophysiology of hypertension and OSAS, clear evidence is still lacking, and raises the dilemma of the hen and the egg. Further studies are needed to clarify the role of inflammation in the pathogenesis of hypertension with OSAS, in which neck size should be considered as a linked independent factor.
Collapse
Affiliation(s)
- Nan-Fang Li
- The Center of Diagnosis, Treatment and Research of Hypertension, Xinjiang, China.
| | | | | | | | | | | | | | | |
Collapse
|
13
|
Computational Fluid Dynamic Study on Obstructive Sleep Apnea Syndrome Treated With Maxillomandibular Advancement. J Craniofac Surg 2009; 20:426-30. [DOI: 10.1097/scs.0b013e31819b9671] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
14
|
Patel MR, Davidson TM. Home Sleep Testing in the Diagnosis and Treatment of Sleep Disordered Breathing. Otolaryngol Clin North Am 2007; 40:761-84. [PMID: 17606022 DOI: 10.1016/j.otc.2007.04.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Sleep-disordered breathing is a growing public health concern and an integral part of head and neck surgery. Multichannel home sleep testing is a cost-effective, patient-friendly, scientifically valid technique of evaluating patients who present with symptoms of sleep-disordered breathing, typically snoring or daytime sleepiness. Home sleep tests can be dispensed from the physician's office. They have a 95% successful recording rate. Scoring can be autoscore or manual score. There are several protocols that can be followed based on diagnostic outcomes.
Collapse
Affiliation(s)
- Minal R Patel
- University of California, San Diego, San Diego, CA, USA
| | | |
Collapse
|
15
|
Abstract
PURPOSE OF REVIEW Obstructive sleep apnea continues to be a significant public health problem. A variety of imaging modalities have been used recently to gain insight into the pathogenesis of this disease, as well as to identify therapeutic options. RECENT FINDINGS Data from more recent imaging studies have highlighted key findings regarding the anatomic sites of collapse and local tissue factors promoting upper airway compromise. The role of genetics, aging, gender and ethnicity in the development of sleep apnea and the identification of predictors for successful treatment outcomes for sleep-disordered breathing are also reviewed. SUMMARY As our understanding of obstructive sleep apnea evolves, newer imaging techniques and computerized models may be able to further enhance our understanding of the pathogenesis and treatment of this disease.
Collapse
Affiliation(s)
- Murtuza M Ahmed
- Division of Pulmonary, Allergy and Critical Care Medicine, Division of Sleep Medicine, Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
| | | |
Collapse
|
16
|
Foster GE, Poulin MJ, Hanly PJ. Intermittent hypoxia and vascular function: implications for obstructive sleep apnoea. Exp Physiol 2006; 92:51-65. [PMID: 17124276 DOI: 10.1113/expphysiol.2006.035204] [Citation(s) in RCA: 126] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Obstructive sleep apnoea (OSA) has been implicated as a risk factor for the development of hypertension, stroke and myocardial infarction. The main cause of cardiovascular and cerebrovascular disease in OSA is thought to be exposure to intermittent hypoxia, which can lead to oxidative stress, inflammation, atherosclerosis, endothelial dysfunction and hypertension. These proposed mechanisms have been drawn from basic research in animal and human models of intermittent hypoxia in addition to clinical investigation of patients with OSA. This review outlines the association between OSA and vascular disease, describes basic mechanisms that may be responsible for this association and compares the results from studies of OSA subjects with those in experimental models of intermittent hypoxia.
Collapse
Affiliation(s)
- Glen E Foster
- Department of Medicine, Faculty of Medicine, University of Calgary, Health Sciences Center, Room 1421, 3330 Hospital Drive NW, Calgary, Alberta, Canada
| | | | | |
Collapse
|
17
|
Philipsen A, Hornyak M, Riemann D. Sleep and sleep disorders in adults with attention deficit/hyperactivity disorder. Sleep Med Rev 2006; 10:399-405. [PMID: 17084648 DOI: 10.1016/j.smrv.2006.05.002] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Attention deficit/hyperactivity disorder (ADHD) is a frequent disorder that often persists in adulthood. Persistent ADHD is known to be a serious risk factor for other disorders in adulthood, and adults with ADHD often report on sleep disorders. Despite this, only few studies have investigated the subjective and objective quality of sleep in adults suffering from ADHD. Previous studies have revealed seriously impaired subjective sleep quality and increased nocturnal motor activity in spite of essentially normal standard polysomnographic parameters in this patient group. However, primary sleep disorders such as sleep apnea syndrome or restless legs syndrome (RLS) may be misdiagnosed as ADHD. Moreover, ADHD and primary sleep disorders may occur as comorbidities. In particular, RLS was suggested to be highly associated with ADHD, indicating a probable common central nervous dopaminergic dysfunction. To date, larger studies with adequate sample sizes that compare sleep in adult patients with ADHD, healthy control groups and patients with other primary sleep disorders are still lacking.
Collapse
Affiliation(s)
- Alexandra Philipsen
- Department of Psychiatry and Psychotherapy, University of Freiburg Medical School, Haupt-strasse 5, 79104 Freiburg, Germany.
| | | | | |
Collapse
|