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Bark B, Nam B, Kim IY. SelANet: decision-assisting selective sleep apnea detection based on confidence score. BMC Med Inform Decis Mak 2023; 23:190. [PMID: 37735681 PMCID: PMC10514955 DOI: 10.1186/s12911-023-02292-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 09/08/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND One of the most common sleep disorders is sleep apnea syndrome. To diagnose sleep apnea syndrome, polysomnography is typically used, but it has limitations in terms of labor, cost, and time. Therefore, studies have been conducted to develop automated detection algorithms using limited biological signals that can be more easily diagnosed. However, the lack of information from limited signals can result in uncertainty from artificial intelligence judgments. Therefore, we performed selective prediction by using estimated respiratory signals from electrocardiogram and oxygen saturation signals based on confidence scores to classify only those sleep apnea occurrence samples with high confidence. In addition, for samples with high uncertainty, this algorithm rejected them, providing a second opinion to the clinician. METHOD Our developed model utilized polysomnography data from 994 subjects obtained from Massachusetts General Hospital. We performed feature extraction from the latent vector using the autoencoder. Then, one dimensional convolutional neural network-long short-term memory (1D CNN-LSTM) was designed and trained to measure confidence scores for input, with an additional selection function. We set a confidence score threshold called the target coverage and performed optimization only on samples with confidence scores higher than the target coverage. As a result, we demonstrated that the empirical coverage trained in the model converged to the target coverage. RESULT To confirm whether the model has been optimized according to the objectives, the coverage violation was used to measure the difference between the target coverage and the empirical coverage. As a result, the value of coverage violation was found to be an average of 0.067. Based on the model, we evaluated the classification performance of sleep apnea and confirmed that it achieved 90.26% accuracy, 91.29% sensitivity, and 89.21% specificity. This represents an improvement of approximately 7.03% in all metrics compared to the performance achieved without using a selective prediction. CONCLUSION This algorithm based on selective prediction utilizes confidence measurement method to minimize the problem caused by limited biological information. Based on this approach, this algorithm is applicable to wearable devices despite low signal quality and can be used as a simple detection method that determine the need for polysomnography or complement it.
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Affiliation(s)
- Beomjun Bark
- Department of Biomedical Engineering, Hanyang University, 222, Wangsimni-Ro, Seongdong-Gu, 04763, Seoul, Republic of Korea
| | - Borum Nam
- Department of Electronic Engineering, Hanyang University, Seoul, Republic of Korea
| | - In Young Kim
- Department of Biomedical Engineering, Hanyang University, 222, Wangsimni-Ro, Seongdong-Gu, 04763, Seoul, Republic of Korea.
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2
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Dakterzada F, Benítez ID, Targa A, Carnes A, Pujol M, Jové M, Mínguez O, Vaca R, Sánchez-de-la-Torre M, Barbé F, Pamplona R, Piñol-Ripoll G. Cerebrospinal fluid lipidomic fingerprint of obstructive sleep apnoea in Alzheimer's disease. Alzheimers Res Ther 2023; 15:134. [PMID: 37550750 PMCID: PMC10408111 DOI: 10.1186/s13195-023-01278-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 07/21/2023] [Indexed: 08/09/2023]
Abstract
BACKGROUND Obstructive sleep apnoea (OSA) has a high prevalence in patients with Alzheimer's disease (AD). Both conditions have been shown to be associated with lipid dysregulation. However, the relationship between OSA severity and alterations in lipid metabolism in the brains of patients with AD has yet to be fully elucidated. In this context, we examined the cerebrospinal fluid (CSF) lipidome of patients with suspected OSA to identify potential diagnostic biomarkers and to provide insights into the pathophysiological mechanisms underlying the effect of OSA on AD. METHODS The study included 91 consecutive AD patients who underwent overnight polysomnography (PSG) to diagnose severe OSA (apnoea-hypopnea index ≥ 30/h). The next morning, CSF samples were collected and analysed by liquid chromatography coupled to mass spectrometry in an LC-ESI-QTOF-MS/MS platform. RESULTS The CSF levels of 11 lipid species were significantly different between AD patients with (N = 38) and without (N = 58) severe OSA. Five lipids (including oxidized triglyceride OxTG(57:2) and four unknown lipids) were significantly correlated with specific PSG measures of OSA severity related to sleep fragmentation and hypoxemia. Our analyses revealed a 4-lipid signature (including oxidized ceramide OxCer(40:6) and three unknown lipids) that provided an accuracy of 0.80 (95% CI: 0.71-0.89) in the detection of severe OSA. These lipids increased the discriminative power of the STOP-Bang questionnaire in terms of the area under the curve (AUC) from 0.61 (0.50-0.74) to 0.85 (0.71-0.93). CONCLUSIONS Our results reveal a CSF lipidomic fingerprint that allows the identification of AD patients with severe OSA. Our findings suggest that an increase in central nervous system lipoxidation may be the principal mechanism underlying the association between OSA and AD.
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Affiliation(s)
- Farida Dakterzada
- Unitat Trastorns Cognitius, Cognition and Behaviour Study Group, Santa Maria University Hospital, IRBLleida, Rovira Roure No. 44, Lleida, 25198, Spain
| | - Iván D Benítez
- Group of Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
- Center for Biomedical Research in Respiratory Diseases Network (CIBERES), Madrid, Spain
| | - Adriano Targa
- Group of Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
- Center for Biomedical Research in Respiratory Diseases Network (CIBERES), Madrid, Spain
| | - Anna Carnes
- Unitat Trastorns Cognitius, Cognition and Behaviour Study Group, Santa Maria University Hospital, IRBLleida, Rovira Roure No. 44, Lleida, 25198, Spain
| | - Montse Pujol
- Group of Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
| | - Mariona Jové
- Department of Experimental Medicine, University of Lleida-Biomedical Research Institute of Lleida (UdL-IRBLleida), Lleida, Spain
| | - Olga Mínguez
- Group of Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
| | - Rafi Vaca
- Group of Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
| | - Manuel Sánchez-de-la-Torre
- Department of Nursing and Physiotherapy, Group of Precision Medicine in Chronic Diseases, University Hospital Arnau de Vilanova and Santa María, IRBLleida, Faculty of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
| | - Ferran Barbé
- Group of Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
- Center for Biomedical Research in Respiratory Diseases Network (CIBERES), Madrid, Spain
| | - Reinald Pamplona
- Department of Experimental Medicine, University of Lleida-Biomedical Research Institute of Lleida (UdL-IRBLleida), Lleida, Spain
| | - Gerard Piñol-Ripoll
- Unitat Trastorns Cognitius, Cognition and Behaviour Study Group, Santa Maria University Hospital, IRBLleida, Rovira Roure No. 44, Lleida, 25198, Spain.
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3
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Dakterzada F, Benítez ID, Targa A, Carnes A, Pujol M, Jové M, Mínguez O, Vaca R, Sánchez-de-la-Torre M, Barbé F, Pamplona R, Piñol-Ripoll G. Blood-based lipidomic signature of severe obstructive sleep apnoea in Alzheimer's disease. Alzheimers Res Ther 2022; 14:163. [PMID: 36329512 PMCID: PMC9632042 DOI: 10.1186/s13195-022-01102-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 10/17/2022] [Indexed: 11/06/2022]
Abstract
Background Obstructive sleep apnoea (OSA) is the most frequent form of sleep-disordered breathing in patients with Alzheimer’s disease (AD). Available evidence demonstrates that both conditions are independently associated with alterations in lipid metabolism. However, it is unknown whether the expression of lipids is different between AD patients with and without severe OSA. In this context, we examined the plasma lipidome of patients with suspected OSA, aiming to identify potential diagnostic biomarkers and to provide insights into the pathophysiological mechanisms underlying the disease. Methods The study included 103 consecutive patients from the memory unit of our institution with a diagnosis of AD. The individuals were subjected to overnight polysomnography (PSG) to diagnose severe OSA (apnoea-hypopnea index ≥30/h), and blood was collected the following morning. Untargeted plasma lipidomic profiling was performed using liquid chromatography coupled with mass spectrometry. Results We identified a subset of 44 lipids (mainly phospholipids and glycerolipids) that were expressed differently between patients with AD and severe and nonsevere OSA. Among the lipids in this profile, 30 were significantly correlated with specific PSG measures of OSA severity related to sleep fragmentation and hypoxemia. Machine learning analyses revealed a 4-lipid signature (phosphatidylcholine PC(35:4), cis-8,11,14,17-eicosatetraenoic acid and two oxidized triglycerides (OxTG(58:5) and OxTG(62:12)) that provided an accuracy (95% CI) of 0.78 (0.69–0.86) in the detection of OSA. These same lipids improved the predictive power of the STOP-Bang questionnaire in terms of the area under the curve (AUC) from 0.61 (0.50–0.74) to 0.80 (0.70–0.90). Conclusion Our results show a plasma lipidomic fingerprint that allows the identification of patients with AD and severe OSA, allowing the personalized management of these individuals. The findings suggest that oxidative stress and inflammation are potential prominent mechanisms underlying the association between OSA and AD. Supplementary Information The online version contains supplementary material available at 10.1186/s13195-022-01102-8.
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Affiliation(s)
- Farida Dakterzada
- Unitat Trastorns Cognitius, Clinical Neuroscience Research, IRBLleida-Santa Maria Lleida University Hospital, Rovira Roure n° 44, 25198, Lleida, Spain
| | - Iván D Benítez
- Group of Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain.,Center for Biomedical Research in Respiratory Diseases Network (CIBERES), Madrid, Spain
| | - Adriano Targa
- Group of Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain.,Center for Biomedical Research in Respiratory Diseases Network (CIBERES), Madrid, Spain
| | - Anna Carnes
- Unitat Trastorns Cognitius, Clinical Neuroscience Research, IRBLleida-Santa Maria Lleida University Hospital, Rovira Roure n° 44, 25198, Lleida, Spain
| | - Montse Pujol
- Group of Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
| | - Mariona Jové
- Department of Experimental Medicine, University of Lleida-Biomedical Research Institute of Lleida (UdL-IRBLleida), E25198, Lleida, Spain
| | - Olga Mínguez
- Group of Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
| | - Rafi Vaca
- Group of Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
| | - Manuel Sánchez-de-la-Torre
- Department of Nursing and Physiotherapy, Group of Precision Medicine in Chronic Diseases, University Hospital Arnau de Vilanova and Santa María, IRBLleida, Faculty of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
| | - Ferran Barbé
- Group of Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain.,Center for Biomedical Research in Respiratory Diseases Network (CIBERES), Madrid, Spain
| | - Reinald Pamplona
- Department of Experimental Medicine, University of Lleida-Biomedical Research Institute of Lleida (UdL-IRBLleida), E25198, Lleida, Spain
| | - Gerard Piñol-Ripoll
- Unitat Trastorns Cognitius, Clinical Neuroscience Research, IRBLleida-Santa Maria Lleida University Hospital, Rovira Roure n° 44, 25198, Lleida, Spain.
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4
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Rahman M, Nowakowski S, Agrawal R, Naik A, Sharafkhaneh A, Razjouyan J. Validation of a Natural Language Processing Algorithm for the Extraction of the Sleep Parameters from the Polysomnography Reports. Healthcare (Basel) 2022; 10:healthcare10101837. [PMID: 36292283 PMCID: PMC9602175 DOI: 10.3390/healthcare10101837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 09/14/2022] [Accepted: 09/16/2022] [Indexed: 11/16/2022] Open
Abstract
Background: There is a need to better understand the association between sleep and chronic diseases. In this study we developed a natural language processing (NLP) algorithm to mine polysomnography (PSG) free-text notes from electronic medical records (EMR) and evaluated the performance. Methods: Using the Veterans Health Administration EMR, we identified 46,093 PSG studies using CPT code 95,810 from 1 October 2000−30 September 2019. We randomly selected 200 notes to compare the accuracy of the NLP algorithm in mining sleep parameters including total sleep time (TST), sleep efficiency (SE) and sleep onset latency (SOL), wake after sleep onset (WASO), and apnea-hypopnea index (AHI) compared to visual inspection by raters masked to the NLP output. Results: The NLP performance on the training phase was >0.90 for precision, recall, and F-1 score for TST, SOL, SE, WASO, and AHI. The NLP performance on the test phase was >0.90 for precision, recall, and F-1 score for TST, SOL, SE, WASO, and AHI. Conclusions: This study showed that NLP is an accurate technique to extract sleep parameters from PSG reports in the EMR. Thus, NLP can serve as an effective tool in large health care systems to evaluate and improve patient care.
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Affiliation(s)
- Mahbubur Rahman
- Houston Veterans Affairs Health Services Research and Development Service, Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veteran Affairs Medical Center, Houston, TX 77030, USA
- Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
- Medical Care Line, Michael E. DeBakey Veteran Affairs Medical Center, Houston, TX 77030, USA
| | - Sara Nowakowski
- Houston Veterans Affairs Health Services Research and Development Service, Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veteran Affairs Medical Center, Houston, TX 77030, USA
- Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
- Veterans Affairs South Central Mental Illness Research, Education and Clinical Center, Houston, TX 77030, USA
| | - Ritwick Agrawal
- Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
- Medical Care Line, Michael E. DeBakey Veteran Affairs Medical Center, Houston, TX 77030, USA
| | - Aanand Naik
- Houston Veterans Affairs Health Services Research and Development Service, Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veteran Affairs Medical Center, Houston, TX 77030, USA
- University of Texas School of Public Health, 1200 Pressler Str., Houston, TX 77030, USA
| | - Amir Sharafkhaneh
- Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
- Veterans Affairs South Central Mental Illness Research, Education and Clinical Center, Houston, TX 77030, USA
| | - Javad Razjouyan
- Houston Veterans Affairs Health Services Research and Development Service, Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veteran Affairs Medical Center, Houston, TX 77030, USA
- Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
- Correspondence:
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5
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Abstract
Amyotrophic lateral sclerosis is a progressive neurodegenerative disease involving upper and lower motor neurons and has limited treatment options. The weakness progresses to involve the diaphragms, resulting in respiratory failure and death. Home noninvasive ventilation has been shown to improve survival and quality of life, especially in those with intact bulbar function. Once initiated, close monitoring with nocturnal oximetry, remote downloads from the home noninvasive ventilation machine, and measurement of serum bicarbonate should be conducted. Additionally, transcutaneous CO2 monitoring can be considered if available. This article discusses the indications, timing, initiation, and management of noninvasive ventilation in amyotrophic lateral sclerosis.
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Affiliation(s)
- Jessica A Cooksey
- Northwestern University, 1475 East Belvidere Road, Suite 185, Grayslake, IL 60030, USA
| | - Amen Sergew
- Division of Pulmonary, Critical Care and Sleep Medicine, Section of Critical Care Medicine, Department of Medicine, National Jewish Health, 1400 Jackson Street, B140, Denver, CO 80207, USA.
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6
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Insomnia is frequent in amyotrophic lateral sclerosis at the time of diagnosis. Sleep Biol Rhythms 2020. [DOI: 10.1007/s41105-020-00296-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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7
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Targa A, Dakterzada F, Benítez ID, de Gonzalo-Calvo D, Moncusí-Moix A, López R, Pujol M, Arias A, de Batlle J, Sánchez-de-la-Torre M, Barbé F, Piñol-Ripoll G. Circulating MicroRNA Profile Associated with Obstructive Sleep Apnea in Alzheimer's Disease. Mol Neurobiol 2020; 57:4363-4372. [PMID: 32720075 DOI: 10.1007/s12035-020-02031-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 07/22/2020] [Indexed: 11/29/2022]
Abstract
The diagnosis of obstructive sleep apnea (OSA) in Alzheimer's disease (AD) by polysomnography (PSG) is challenging due to the required collaboration of the patients. In addition, screening questionnaires have demonstrated limited usefulness with this subpopulation. Considering this, we investigated the circulating microRNA (miRNA) profile associated with OSA in AD patients. This study included a carefully selected cohort of females with mild-moderate AD confirmed by biological evaluation (n = 29). The individuals were submitted to one-night PSG to diagnose OSA (apnea-hypopnea index ≥ 15/h) and the blood was collected in the following morning. The plasma miRNA profile was evaluated using RT-qPCR. The patients had a mean (SD) age of 75.8 (5.99) years old with a body mass index of 28.6 (3.83) kg m-2. We observed a subset of 15 miRNAs differentially expressed between OSA and non-OSA patients, of which 10 were significantly correlated with the severity of OSA. Based on this, we built a prediction model that generated an AUC (95% CI) of 0.95 (0.88-1.00) including 5 of the differentially expressed miRNAs that correlated with OSA severity: miR-26a-5p, miR-30a-3p, miR-374a-5p, miR-377-3p, and miR-545-3p. Our preliminary results suggest a plasma miRNA signature associated with the presence of OSA in AD patients. Further studies will be necessary to validate these findings.
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Affiliation(s)
- A Targa
- Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, IRBLleida, Lleida, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - F Dakterzada
- Unitat Trastorns Cognitius, Clinical Neuroscience Research, Santa Maria University Hospital, IRBLleida, Rovira Roure n° 44, 25198, Lleida, Spain
| | - I D Benítez
- Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, IRBLleida, Lleida, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - D de Gonzalo-Calvo
- Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, IRBLleida, Lleida, Spain
| | - A Moncusí-Moix
- Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, IRBLleida, Lleida, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - R López
- Unitat Trastorns Cognitius, Clinical Neuroscience Research, Santa Maria University Hospital, IRBLleida, Rovira Roure n° 44, 25198, Lleida, Spain
| | - M Pujol
- Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, IRBLleida, Lleida, Spain
| | - A Arias
- Unitat Trastorns Cognitius, Clinical Neuroscience Research, Santa Maria University Hospital, IRBLleida, Rovira Roure n° 44, 25198, Lleida, Spain
| | - J de Batlle
- Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, IRBLleida, Lleida, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - M Sánchez-de-la-Torre
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Group of Precision Medicine in Chronic Diseases, Hospital Universitari Arnau de Vilanova-Santa Maria, IRBLleida, Lleida, Spain
| | - F Barbé
- Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, IRBLleida, Lleida, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Gerard Piñol-Ripoll
- Unitat Trastorns Cognitius, Clinical Neuroscience Research, Santa Maria University Hospital, IRBLleida, Rovira Roure n° 44, 25198, Lleida, Spain.
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8
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Baxter SK, Johnson M, Clowes M, O’Brien D, Norman P, Stavroulakis T, Bianchi S, Elliott M, McDermott C, Hobson E. Optimizing the noninvasive ventilation pathway for patients with amyotrophic lateral sclerosis/motor neuron disease: a systematic review. Amyotroph Lateral Scler Frontotemporal Degener 2019; 20:461-472. [DOI: 10.1080/21678421.2019.1627372] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
| | | | | | | | | | | | - Stephen Bianchi
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK, and
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9
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Aboussouan LS, Mireles-Cabodevila E. Sleep in Amyotrophic Lateral Sclerosis. CURRENT SLEEP MEDICINE REPORTS 2017. [DOI: 10.1007/s40675-017-0094-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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10
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Ahmed RM, Newcombe REA, Piper AJ, Lewis SJ, Yee BJ, Kiernan MC, Grunstein RR. Sleep disorders and respiratory function in amyotrophic lateral sclerosis. Sleep Med Rev 2015; 26:33-42. [PMID: 26166297 DOI: 10.1016/j.smrv.2015.05.007] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 05/07/2015] [Accepted: 05/20/2015] [Indexed: 12/11/2022]
Abstract
Sleep disorders in amyotrophic lateral sclerosis (ALS) present a significant challenge to the management of patients. Issues include the maintenance of adequate ventilatory status through techniques such as non-invasive ventilation, which has the ability to modulate survival and improve patient quality of life. Here, a multidisciplinary approach to the management of these disorders is reviewed, from concepts about the underlying neurobiological basis, through to current management approaches and future directions for research.
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Affiliation(s)
- Rebekah M Ahmed
- Brain and Mind Research Institute and Department of Neurology Royal Prince Alfred Hospital, University of Sydney, Sydney, New South Wales, Australia.
| | - Rowena E A Newcombe
- NHMRC Centre for Integrated Research and Understanding of Sleep (CIRUS), Woolcock Institute of Medical Research and NeuroSleep NHMRC Centre for Research Excellence, Australia
| | - Amanda J Piper
- NHMRC Centre for Integrated Research and Understanding of Sleep (CIRUS), Woolcock Institute of Medical Research and NeuroSleep NHMRC Centre for Research Excellence, Australia; Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Sydney Local Health District, Australia
| | - Simon J Lewis
- Brain and Mind Research Institute and Department of Neurology Royal Prince Alfred Hospital, University of Sydney, Sydney, New South Wales, Australia; NHMRC Centre for Integrated Research and Understanding of Sleep (CIRUS), Woolcock Institute of Medical Research and NeuroSleep NHMRC Centre for Research Excellence, Australia
| | - Brendon J Yee
- NHMRC Centre for Integrated Research and Understanding of Sleep (CIRUS), Woolcock Institute of Medical Research and NeuroSleep NHMRC Centre for Research Excellence, Australia; Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Sydney Local Health District, Australia
| | - Matthew C Kiernan
- Brain and Mind Research Institute and Department of Neurology Royal Prince Alfred Hospital, University of Sydney, Sydney, New South Wales, Australia
| | - Ron R Grunstein
- NHMRC Centre for Integrated Research and Understanding of Sleep (CIRUS), Woolcock Institute of Medical Research and NeuroSleep NHMRC Centre for Research Excellence, Australia; Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Sydney Local Health District, Australia
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11
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Fanfulla F, Carratù P. And the patient said: "let me be able to breathe and dream". J Clin Sleep Med 2015; 11:511-2. [PMID: 25845894 DOI: 10.5664/jcsm.4690] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 03/24/2015] [Indexed: 12/12/2022]
Affiliation(s)
- Francesco Fanfulla
- Sleep Medicine Unit, S. Maugeri Foundation IRCCS, Scientific Institute of Pavia, Italy
| | - Pierluigi Carratù
- Institute of Respiratory Diseases, University of Medicine, Bari, Italy
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