Abstract: Obstructive sleep apnea (OSA) affects 2-4 % of the pediatric population; allergic rhinitis (AR) has been identified as a risk factor in sleep-disordered-breathing, but no studies evaluating such association […]» Read more
Abstract: Patients with chronic kidney disease have increased morbidity and mortality, mainly due to cardiovascular disease. Compared to the general population, patients with chronic kidney disease have an increased prevalence […]» Read more
Phenotypic sub-types of obstructive sleep apnea: a challenge and opportunity for precision medicine.
Abstract: Current strategies for management of obstructive sleep apnea (OSA) reflect a one-size-fits-all approach. Diagnosis and severity of OSA are based on the apnea hypopnea index and treatment initiated with […]» Read more
Abstract: Polysomnography is central to the diagnosis and management of childhood obstructive sleep apnea (OSA). However, it is not known whether the treatment-related outcomes of OSA are causally associated with […]» Read more
Abstract: Congenital hypopituitarism (CH) is rarely observed in combination with severe joint contractures (arthrogryposis). Schaaf-Yang syndrome (SHFYNG) phenotypically overlaps with Prader-Willi syndrome, with patients also manifesting arthrogryposis. L1 syndrome: a […]» Read more
Abstract: Surgery is curative for the majority of early-stage endometrial cancers. Postoperatively, patients are actually at much higher risk of mortality from obesity-related comorbidities unless they have sustained weight loss.A […]» Read more
Hypothyroidism and its Association with Sleep Apnea Among Adults in The United States: NHANES 2007-2008.
The association between hypothyroidism and sleep apnea (SA) has been previously studied, but results are discrepant and mostly based on small population studies.To determine whether there is a positive association between hypothyroidism and SA in the U.S. population.Cross-sectional study.U.S. National Health and Nutrition Examination Survey (NHANES), 2007-2008.We included all subjects above the age of 18 years who met inclusion criteria. Participants not on antithyroid medication with a thyroid stimulating hormone (TSH) >5.6 mIU/L and those on thyroid hormone replacement regardless of TSH were categorized as hypothyroid. Participants not on thyroid hormone replacement with a TSH<0.34 mIU/L and those on antithyroid medications regardless of TSH were categorized as hyperthyroid. Participants not on thyroid hormone replacement or antithyroid medication who had a TSH?0.34 and ?5.6 mIU/L were categorized as euthyroid. The diagnosis of SA was based on participants' response when asked if they had been diagnosed with SA by their doctors.None.Multivariate logistic regression analyses were performed to determine the association between hypothyroidism and SA.5,515 adults were included for data analysis. The prevalence of hypothyroidism and hyperthyroidism were calculated at 9.47% and 1.19%, respectively. Multivariate logistic regression analysis adjusted for demographics, health care access, body mass index, socioeconomic factor, alcohol use, smoking, and other comorbidities demonstrated a significant association between hypothyroidism and SA (OR=1.88, 95% CI: 1.24-2.84, P<0.01).Hypothyroidism is associated with SA after adjustment for potential confounding variables.» Read more
Upper Airway Stimulation versus Positive Airway Pressure Impact on Blood Pressure and Sleepiness Symptoms in Obstructive Sleep Apnea.
Positive airway pressure (PAP) and upper airway stimulation (UAS) are approved obstructive sleep apnea (OSA) treatment options.. Although the effect of PAP on improvement in blood pressure (BP) and daytime sleepiness (defined by Epworth Sleepiness Scale, ESS) has been established, the impact of UAS on BP remains unclear. We hypothesize that PAP and UAS will confer improvements in BP and daytime sleepiness.Clinic-based BP and ESS were compared between 517 OSA (apnea hypopnea index (AHI), 15-65) patients with body mass index <35 kg/m2 initiating PAP therapy (2010-2014) at Cleveland Clinic and 320 patients with UAS implantation (2015-2017) via an international registry with 2-6 month follow-up. Mixed-effect models were used to compare outcomes in 201 patients in each arm after propensity matching.PAP showed greater improvement in diastolic BP (mean difference of change between groups 3.7 mmHg, p <0.001) and mean arterial pressure (mean difference of change between groups 2.8 mmHg, p=0.008) compared to UAS.UAS showed greater improvement in ESS versus PAP (mean difference of change between PAP and UAS groups -0.8, p=0.046). UAS therapy usage was 6.2 hours/week greater than PAP patients (95% CI = 3.3 to 9.0). Results were consistent after adjusting for therapy adherence.PAP showed greater improvement in BP, potentially reflecting enhanced ability of PAP to exert beneficial mechanical intrathoracic cardiac and vascular influences. BP measurement error in the UAS group may also have accounted for findings. Greater improvement in sleepiness symptoms were noted in UAS compared to PAP.» Read more
Abstract: Oronasal mask is frequently used to treat OSA. In contrast to nasal CPAP, the effectiveness of oronasal CPAP varies for unknown mechanisms. We hypothesized that oral breathing and pressure […]» Read more
The role of CPAP treatment in elderly patients with moderate obstructive sleep apnea. A Multicenter Randomised Controlled Trial.
Abstract: The efficacy of continuous positive airway pressure (CPAP) treatment in elderly patients with non-severe obstructive sleep apnea (OSA) is controversial.The objective of this study was to assess the effect […]» Read more