The Latest Sleep Apnea Journal Articles

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Keep up to date with the latest in sleep apnea. Check out the latest sleep apnea articles from leading medical journals in a single view, helping you discover relevant articles quickly and easily

  • Obstructive Sleep Apnea patients adhering to Continuous positive Airway Pressure: A randomized trial.
    Excessive daytime sleepiness (EDS) in individuals with obstructive sleep apnea syndrome persisting despite good adherence to continuous positive airway pressure (CPAP) is a disabling condition. Pitolisant is a selective histamine H3-receptor antagonist with wake-promoting effects.Is pitolisant efficacious and safe in reducing daytime sleepiness in individuals presenting moderate to severe OSA adhering to CPAP treatment but […]
  • Ansa Cervicalis Stimulation: A New Direction in Neurostimulation for Obstructive Sleep Apnea.
    Hypoglossal nerve stimulation (HNS) is an alternative treatment option for patients with obstructive sleep apnea (OSA) unable to tolerate positive airway pressure, but implant criteria limit treatment candidacy. Prior research indicates that caudal tracheal traction plays an important role in stabilizing upper airway patency.Does contraction of the sternothyroid muscle with ansa cervicalis stimulation (ACS), which […]
  • Effect of Multilevel Upper Airway Surgery vs Medical Management on the Apnea-Hypopnea Index and Patient-Reported Daytime Sleepiness Among Patients With Moderate or Severe Obstructive Sleep Apnea: The SAMS Randomized Clinical Trial.
    Many adults with obstructive sleep apnea (OSA) use device treatments inadequately and remain untreated.To determine whether combined palatal and tongue surgery to enlarge or stabilize the upper airway is an effective treatment for patients with OSA when conventional device treatment failed.Multicenter, parallel-group, open-label randomized clinical trial of upper airway surgery vs ongoing medical management. Adults […]
  • Positive airway pressure for the treatment of obstructive sleep apnea syndrome in infants.
    Positive airway pressure (PAP) is a standard therapy for the treatment of obstructive sleep apnea syndrome (OSAS) in children, but objective data on effectiveness of PAP in infants are sparse. The aim of this study was to compare the effectiveness of PAP in infants <6 months old with school-age children.Compared to school-age children, can PAP […]
  • Central sleep apnea predicts pulmonary complications after cardiac surgery.
    Postoperative major pulmonary complications (MPCs) continue to be a leading cause of increased morbidity and mortality after cardiac surgery. Although various risk factors have been identified, reports on the association between sleep-disordered breathing (SDB) and postoperative MPCs remain inconclusive.The objectives of the present study were to determine the incidence of the composite endpoint postoperative MPCs […]
  • Acetazolamide for Obstructive and Central Sleep Apnea: A Comprehensive Systematic Review and Meta-Analysis.
    Therapy options for obstructive (OSA) and central (CSA) sleep apnea are limited, thus many patients remain untreated. Clinically acetazolamide is sometimes used for central sleep apnea (CSA), but given overlapping pathophysiology of OSA and CSA, we hypothesized that acetazolamide is equally effective for both types. Prior reviews focused on specific subtypes of sleep apnea, study […]
  • Self-reported snoring patterns predict stroke events in high-risk patients with obstructive sleep apnea: post-hoc analyses of the SAVE study.
    The relation of snoring to risks of stroke and other major cardiovascular (CV) events is uncertain.We aimed to determine associations of snoring patterns and major CV events in relation to the obstructive sleep apnea (OSA), among participants of the international Sleep Apnea cardiovascular Endpoints (SAVE) trial.and Methods: Post-hoc analyses of the SAVE trial, which involved […]
  • Low prognostic value of novel nocturnal oxygen saturation metrics in patients with obstructive sleep apnea and high cardiovascular event risk: post-hoc analyses of the SAVE study.
    Traditional methods for quantifying obstructive sleep apnea (OSA) severity may not encapsulate potential relationships between hypoxaemia in OSA and cardiovascular (CV) risk.Do novel nocturnal oxygen saturation metrics have prognostic value in patients with OSA and high cardiovascular event risk?Post-hoc analyses of the Sleep Apnea CV Endpoints (SAVE) trial.In 2687 individuals, Cox proportional hazards models stratified […]
  • Impact of a multimodal telemonitoring intervention on CPAP adherence in symptomatic low-cardiovascular risk sleep apnea: a randomized controlled trial.
    One of the major challenges in treating obstructive sleep apnea (OSA) is to achieve adequate continuous positive airway pressure (CPAP) adherence. Telemonitoring has the potential to provide individualized management and early recognition of problems during treatment.What is the effect of a multimodal telemonitoring intervention on treatment adherence, quality of life and functional status in symptomatic […]
  • Association between nocturnal hypoxemia and cancer incidence in patients investigated for obstructive sleep apnea. Data from a large multicenter French cohort.
    Previous studies have yielded inconsistent findings regarding the association between obstructive sleep apnea (OSA) and cancer in humans.Is there an association between indices of sleep-disordered breathing severity and cancer incidence in patients investigated for suspected OSA?Data from a large multicenter cohort of cancer-free patients investigated for OSA were linked to health administrative data to identify […]
  • Nonoperating room anesthesia for patients with serious comorbidities.
    To provide aids to deal with increasing amount of several comorbidities in nonoperating room anesthesia (NORA).New indexes for assessment of comorbidities are described and guidelines for the care of patients with obesity, obstructive sleep apnea, chronic obstructive pulmonary disease (COPD), diabetes and COVID19 in NORA summarized.In addition to ASA classification, such instruments as Charlson Comorbidity […]
  • Air pollution and systemic inflammation in patients with suspected obstructive sleep apnea living in an urban residential area.
    Air pollution and obstructive sleep apnea (OSA) are independently associated with systemic inflammation, but it is unknown if these exposures interact to influence systemic inflammation.Our objective was to determine the relative importance of these factors and their combined potential to influence systemic inflammation in patients under assessment for sleep complaints.315 patients contributed data including a […]
  • Obstructive Sleep Apnea in Professional Transport Operations: Safety, Regulatory and Economic Impact.
    Obstructive sleep apnea (OSA) is common among commercial vehicle operators (CVOs) in all modes of transportation, including truck, bus, air, rail and maritime operations. OSA is highly prevalent and increases the risk of drowsiness-related crashes in CVOs. Internationally, specific regulations regarding its identification and management vary widely or do not exist; medical examiners and sleep […]
  • CPAP Adherence, Mortality, and Progression-Free Survival in Interstitial Lung Disease and OSA.
    Obstructive sleep apnea (OSA), a common co-morbidity in ILD, could contribute to a worsened course if untreated. It is unclear if adherence to CPAP therapy improves outcomes.We conducted a ten-year retrospective observational multicenter cohort study, assessing adult patients with ILD who had undergone polysomnography. Subjects were categorized based on OSA severity into ‘no/mild OSA’ (AHI […]
  • Comparison of diagnostic sleep studies in hospitalized neurorehabilitation patients with moderate to severe traumatic brain injury.
    Obstructive sleep apnea is prevalent during a time of critical neural repair following traumatic brain injury (TBI). The diagnostic utility of existing sleep studies is needed to inform clinical management during acute recovery from TBI.This study aimed to evaluate the non-inferiority and diagnostic accuracy of a portable Level 3 sleep study relative to Level 1 […]
  • Long-term Noninvasive Ventilation in Obesity Hypoventilation Syndrome without Severe Obstructive Sleep Apnea.
    Noninvasive ventilation (NIV) is an effective form of treatment in obesity hypoventilation syndrome (OHS) with severe obstructive sleep apnea (OSA). However, there is paucity of evidence in OHS patients without severe OSA phenotype.Is NIV effective in OHS without severe OSA phenotype?In this multicenter, open-label parallel group clinical trial performed at 16 sites in Spain, we […]
  • Integrating the STOP-BANG score and clinical data to predict cardiovascular events after infarction: A machine learning study.
    Obstructive sleep apnea (OSA) conveys worse clinical outcomes in coronary artery disease patients. The STOP-BANG score is a simple tool that evaluates the risk of OSA and can be added to the large number of clinical variables and scores obtained during the management of myocardial infarction (MI) patients. Currently, machine learning (ML) is able to […]
  • Defining Extreme Phenotypes of Obstructive Sleep Apnea across International Sleep Centers.
    We developed objective definitions of extreme phenotypes of obstructive sleep apnea (OSA) using a multivariate approach, and demonstrate their utility for identifying characteristics that confer predisposition towards or protection against OSA in a new prospective sample.In a large international sample, we calculated race-specific liability scores from a weighted logistic regression including age, gender and body […]
  • The sleep apnea-specific hypoxic burden predicts incident heart failure.
    Heart failure (HF) is a leading cause of morbidity and mortality and while linked to sleep apnea, it is unclear which physiological stressors most strongly associate with incident disease. Here we tested whether Sleep Apnea-Specific Hypoxic Burden (SASHB) predicts incident HF in two independent cohort studies.The samples were derived from two cohort studies: The Sleep […]
  • Continuous Positive Airway Pressure Treatment, Glycemia, and Diabetes Risk in Obstructive Sleep Apnea and Comorbid Cardiovascular Disease.
    Despite evidence of a relationship among obstructive sleep apnea (OSA), metabolic dysregulation, and diabetes, it is uncertain whether OSA treatment can improve metabolic parameters. We sought to determine effects of long-term continuous positive airway pressure (CPAP) treatment on glycemic control and diabetes risk in patients with cardiovascular disease (CVD) and OSA.Blood, medical history, and personal […]
  • Diagnosis and Management of Obstructive Sleep Apnea: A Review.
    Obstructive sleep apnea (OSA) affects 17% of women and 34% of men in the US and has a similar prevalence in other countries. This review provides an update on the diagnosis and treatment of OSA.The most common presenting symptom of OSA is excessive sleepiness, although this symptom is reported by as few as 15% to […]
  • Efficacy of continuous positive airway pressure (CPAP) for improvements in sleepiness, cognition, mood and quality of life in elderly patients with obstructive sleep apnea: Systematic review and meta-analysis of randomized controlled trials.
    Obstructive sleep apnea (OSA) is commonly found in the elderly population (≥ 65 years old), and continuous positive airway pressure (CPAP) improves sleepiness, health-related quality of life (HRQoL) in the middle-aged population; however, data about its efficacy in elderly patients are unclear.To evaluate the efficacy of CPAP for sleepiness, HRQoL, mood, and cognition in elderly […]
  • Diagnosis and Management of Obstructive Sleep Apnea: A Review.
    Obstructive sleep apnea (OSA) affects 17% of women and 34% of men in the US and has a similar prevalence in other countries. This review provides an update on the diagnosis and treatment of OSA.The most common presenting symptom of OSA is excessive sleepiness, although this symptom is reported by as few as 15% to […]
  • The Effect of Venlafaxine on Apnea Hypopnea Index in Patients with Sleep Apnea – a Randomized, Double-Blind Crossover Study.
    One of the key mechanisms underlying obstructive sleep apnea (OSA) is a reduced pharyngeal muscle tone during sleep. Recent data suggest that pharmacological augmentation of central serotonergic/adrenergic tone increases pharyngeal muscle tone.We hypothesized that venlafaxine, a serotonin-norepinephrine reuptake inhibitor, would improve OSA severity.and Methods: In this mechanistic, randomized, double-blind, placebo-controlled crossover trial, 20 OSA patients […]
  • Undiagnosed Obstructive Sleep Apnea May Significantly Impact Outcomes in Adults Admitted for COPD in an Inner-City Hospital.
    Chronic Obstructive Pulmonary Disease (COPD) is the second most common cause of hospital admission in the United States. Obstructive sleep apnea (OSA) is a highly prevalent and underdiagnosed condition which may impact the outcome of COPD. We hypothesized that presence of unrecognized and untreated OSA will increase hospital readmissions in patients admitted for COPD exacerbation.We […]
  • Relation of Age to Survival in Patients with Obstructive Sleep Apnea who Develop an Acute Coronary Event (from the National Inpatient Sample).
    This study was undertaken to investigate whether obstructive sleep apnea (OSA) produces a survival advantage in acute coronary syndrome (ACS), and to evaluate the mechanism of any benefit, including the impact of age and other risk factors. The National Inpatient Sample was queried for all patients who were admitted for ACS during the years 2013 […]
  • Obstructive sleep apnea and neurocognitive impairment in children with congenital heart disease.
    Children with congenital heart disease (CHD) have an increased risk of neurocognitive impairment. No prior studies have evaluated the role of obstructive sleep apnea (OSA), which is associated with neurocognitive impairment in children without CHD.Is OSA is associated with neurocognitive impairment in children with CHD?Children age 6-17 years with corrected moderate-complex CHD without syndromes that […]
  • Randomized trial on the effects of high-dose zopiclone on OSA severity, upper airway physiology and alertness.
    Recent studies indicate that standard doses of hypnotics reduce or do not change the apnea-hypopnea index (AHI) or pharyngeal muscle activity. A 1-month trial of nightly zopiclone (7.5mg) modestly reduced the AHI versus baseline without changing other sleep parameters or next-day sleepiness.This study aimed to determine the effects of high-dose zopiclone (15mg) on AHI, arousal […]
  • Update on Persistent Excessive Daytime Sleepiness in Obstructive Sleep Apnea.
    Obstructive sleep apnea (OSA) is a highly prevalent sleep disorder and subjective excessive daytime sleepiness (EDS) is the cardinal symptom for which many individuals seek medical advice. Positive airway pressure (PAP) devices, first line treatment for OSA, eliminates EDS in most patients. However, a subset of patients suffers from persistent EDS despite adherence to therapy. […]
  • Who May Benefit from Diuretics in OSA? A Propensity Score-Match Observational Study.
    Diuretics have been reported as effective for reducing obstructive sleep apnea (OSA) severity by preventing fluid retention and reducing rostral fluid shift. The benefit of diuretics might vary depending upon the OSA clinical phenotype and comorbidities. To test this hypothesis, we conducted a propensity score-matched cohort analysis of data from the French national sleep apnea […]
  • Obstructive sleep apnoea treatment and blood pressure: which phenotypes predict a response? A systematic review and meta-analysis.
    The treatment for obstructive sleep apnea (OSA) with continuous positive airway pressure (CPAP) or mandibular advancement devices (MAD) is associated with blood pressure (BP) reduction however, the overall effect is modest. The aim of this systematic review and meta-analysis of RCTs comparing the effect of such treatments on BP was to identify subgroups of patients […]
  • Variability and Misclassification of Sleep Apnea Severity Based on Multi-Night Testing.
    Portable monitoring is a convenient means for diagnosing sleep apnea. However, data on whether one night of a monitoring is sufficiently precise for the diagnosis of sleep apnea are limited.How variability and misclassification of sleep apnea severity is there, as assessed by multi-night testing?A sample of 10,340 adults referred for sleep apnea testing was assessed. […]
  • Palatal Sensory Function Worsens in Untreated Snorers but not in CPAP-treated Sleep Apnea Patients, indicating Vibration-induced Nervous Lesions.
    snoring per se may damage all upper airway neurons over time, thereby causing progression to manifest sleep apnea. To test this, non-snoring subjects, untreated snorers and CPAP-treated patients underwent repeated sensory testing in the soft palate in a prospective long-term study.Cold detection threshold (CDT) testing at soft palate and lip with a thermode and nocturnal […]
  • Severe desaturations increase PVT-based median reaction time and number of lapses in OSA patients.
    Current diagnostic parameters estimating obstructive sleep apnea (OSA) severity have a poor connection to the psychomotor vigilance of OSA patients. Thus, we aimed to investigate how the severity of apneas, hypopneas, and intermittent hypoxemia is associated with impaired vigilance.We retrospectively examined Type I polysomnography data and corresponding PVTs of 743 consecutive OSA patients (apnea-hypopnea index […]
  • Clinical Evaluation of Deployed Military Personnel with Chronic Respiratory Symptoms: STAMPEDE (Study of Active Duty Military for Pulmonary Disease Related to Environmental Deployment Exposures) III.
    Chronic respiratory symptoms are frequently reported after southwest Asia deployment in support of combat operations. The full spectrum of clinical lung diseases related to these deployments is not well characterized.Military personnel with chronic symptoms, primarily exertional dyspnea, underwent a standardized cardiopulmonary evaluation at two tertiary medical centers. Pulmonary function testing consisted of spirometry, lung volumes, […]
  • Effects of the Combination of Atomoxetine and Oxybutynin on Obstructive Sleep Apnea Endotypic Traits.
    We recently showed that the administration of the combination of the noradrenergic drug atomoxetine plus the antimuscarinic oxybutynin (ato-oxy) before sleep greatly reduced obstructive sleep apnea (OSA) severity, likely by increasing upper airway dilator muscle activity during sleep.In patients with OSA who performed the ato-oxy trial with an esophageal pressure catheter to estimate ventilatory drive, […]
  • Update on Apneas of Heart Failure with Reduced Ejection Fraction: Emphasis on the Physiology of Treatment Part 2: Central Sleep Apnea.
    Central sleep apnea/Hunter-Cheyne-Stokes Breathing (CSA/HCSB), is prevalent in patients with heart failure with reduced ejection fraction (HFrEF). The acute pathobiological consequences of CSA/HSCB eventually lead to sustained sympathetic over-activity, repeated hospitalization, and premature mortality. Few small randomized controlled trials (RCTs) have shown statistically significant and clinically important reduction in sympathetic activity when CSA/HCSB is attenuated […]
  • CHEST Submission: Contemporary Reviews in Sleep Medicine The Physical and Social Environment Relationship with Sleep Health and Disorders.
    Sleep health is a multidimensional construct that includes adequate duration, quality and appropriately timed sleep, that may be influenced by environmental factors. In this review, we focus on how an individual’s living and sleeping environment, both the surrounding neighborhood physical and social features and the atmosphere around them, may impact their sleep health. We explore […]
  • Effects of suboptimal adherence of CPAP-therapy on symptoms of obstructive sleep apnea: a randomised, double-blind, controlled trial.
    Continuous positive airway pressure (CPAP) is currently the treatment of choice for sleepiness in patients with obstructive sleep apnea (OSA), however, adherence is often thought to be suboptimal. We investigated the effects of suboptimal CPAP-usage on objective and subjective sleepiness parameters in patients with OSA.In this 2-week, parallel, double-blind, randomised controlled trial we enrolled moderate-to-severe […]
  • Prevalence of obstructive sleep apnea in Alzheimer’s disease patients.
    To assess the prevalence of obstructive sleep apnea (OSA) in patients with mild-moderate Alzheimer’s Disease (AD) and to evaluate cognitive characteristics according to the severity of OSA.Patients with mild-moderate AD, recruited prospectively from a cognitive impairment unit, underwent overnight polysomnography. OSA was defined as an apnea-hypopnea index > 5/h. AD severity was assessed using the Mini-Mental State […]
  • Responsiveness of Patient Reported Outcomes to Treatment among Patients with Type 2 Diabetes Mellitus and Obstructive Sleep Apnea.
    The Patient Reported Outcomes Information System (PROMIS) includes two instruments to quantify sleep symptoms (sleep disturbance, SDA; sleep-related impairment, SRI) in diverse populations across a wide symptom spectrum. However, the responsiveness of PROMIS measures to treatment of sleep disorders is unknown. We examined the responsiveness of the PROMIS sleep scales to the treatment of obstructive […]
  • Obstructive Sleep Apnea in Acromegaly and the Effect of Treatment: A Systematic Review and Meta-Analysis.
    Obstructive Sleep Apnea (OSA) is a common disorder characterized by upper airway collapse requiring nocturnal ventilatory assistance. Multiple studies have investigated the relationship between acromegaly and OSA reporting discordant results.To conduct a meta-analysis on the risk for OSA in acromegaly, in particular to assess the role of disease activity and the effect of treatments.and studies […]
  • Circulating Plasma Exosomes in Obstructive Sleep Apnea and Reverse-Dipping Blood Pressure.
    Obstructive Sleep Apnea (OSA) increases the risk of abnormal non-dipping 24-hour blood pressure profile, an independent risk factor for cardiovascular disease (CVD). We examined differential exosomal miRNA expression in untreated OSA patients with normal dipping blood pressure (NDBP) and reverse dipping blood pressure (RDBP; an extreme form of non-dipping) to understand the mechanisms underlying non-dipping […]
  • Redesigning Care for Obstructive Sleep Apnea.
    Abstract: Constrained by a limited supply of specialized personnel, health systems face a challenge in caring for the large number of patients with obstructive sleep apnea (OSA). The complexity of this challenge is heightened by the varied clinical presentations of OSA and the diversity of treatment approaches. Innovations such as simplified home-based care models and […]
  • The course of obstructive sleep apnea syndrome in patients with acromegaly during treatment.
    Abstract: Obstructive sleep apnea syndrome (OSAS) is common in active acromegaly and negatively influences quality of life, morbidity and mortality. This prospective study with three predetermined timepoints and a standardized treatment protocol investigates changes in sleep parameters during the first 2.5 years of acromegaly treatment.Before initiation of acromegaly treatment (medical pretreatment followed by surgery), polysomnography […]
  • Utility of Pacemaker With Sleep Apnea Monitor to Predict Left Ventricular Overload and Acute Decompensated Heart Failure.
    Abstract: Pacemakers with sleep apnea monitor (SAM) provide an easy tool to assess obstructive sleep apnea over long periods of time. The link between respiratory disturbances at night and the incidence of acute decompensated heart failure (ADHF) is not well established. We aimed at (1) determining the ability of SAM pacemakers to evaluate the extent […]
  • Utility of Pacemaker With Sleep Apnea Monitor to Predict Left Ventricular Overload and Acute Decompensated Heart Failure.
    Abstract: Pacemakers with sleep apnea monitor (SAM) provide an easy tool to assess obstructive sleep apnea over long periods of time. The link between respiratory disturbances at night and the incidence of acute decompensated heart failure (ADHF) is not well established. We aimed at (1) determining the ability of SAM pacemakers to evaluate the extent […]
  • Bilateral Hypoglossal Nerve Stimulation for Treatment of Adult Obstructive Sleep Apnea.
    Abstract: Hypoglossal Nerve Stimulation (HNS) decreases Obstructive Sleep Apnea (OSA) severity via genioglossus muscle activation and decreased upper airway collapsibility. This study assessed the safety and effectiveness at 6 months post-implantation of a novel device delivering bilateral HNS via a small implanted electrode activated by a unit worn externally, to treat OSA: the Genio™ system.This prospective, […]
  • Bilateral Hypoglossal Nerve Stimulation for Treatment of Adult Obstructive Sleep Apnea.
    Abstract: Hypoglossal Nerve Stimulation (HNS) decreases Obstructive Sleep Apnea (OSA) severity via genioglossus muscle activation and decreased upper airway collapsibility. This study assessed the safety and effectiveness at 6 months post-implantation of a novel device delivering bilateral HNS via a small implanted electrode activated by a unit worn externally, to treat OSA: the Genio™ system.This prospective, […]
  • Allergic Rhinitis and Obstructive Sleep Apnea in Children Residing at High-Altitude.
    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 have been conducted in high altitude environments. We aimed to assess whether the severity of AR is associated with the severity of OSA in children […]
  • Sleep Apnea and Chronic Kidney Disease – A State of the Art Review.
    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 of both obstructive and central sleep apnea, and the presence of sleep apnea in this population has been associated with an increased risk of cardiovascular […]
  • 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 continuous positive airway pressure (CPAP), followed by trials of alternatives, such as oral appliances, if CPAP “fails.” This approach does not consider heterogeneity of individuals […]
  • Polysomnography and Treatment-Related Outcomes of Childhood Sleep Apnea.
    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 its resolution or changes in severity as determined by polysomnography.Polysomnographic, cognitive, behavioral, quality-of life, and health outcomes at baseline and at 7 months were obtained […]
  • Mutations in MAGEL2 and L1CAM are associated with congenital hypopituitarism and arthrogryposis.
    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 group of X-linked disorders including hydrocephalus and lower limb spasticity, also rarely presents with arthrogryposis.We investigated the molecular basis underlying the combination of CH and […]
  • Minimally Invasive Hysterectomy and Bariatric Surgery to Improve Endometrial Cancer Survivorship.
    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 54-year-old woman with class III obesity, type II diabetes mellitus complicated by neuropathy and retinopathy, hypertension, sleep apnea, and fatty liver disease was diagnosed with […]
  • 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.
  • 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.
  • Transmission of oral pressure compromises oronasal CPAP efficacy to treat Obstructive Sleep Apnea.
    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 transmission through the mouth compromises oronasal CPAP efficacy.Thirteen OSA patients, well adapted to oronasal CPAP, were monitored by full polysomnography, pharyngeal pressure catheter and nasoendoscope. […]
  • 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 of CPAP treatment in elderly patients with moderate OSA on clinical, quality of life and neurocognitive spheres.Open-label, randomised, multicenter clinical trial in 143 elderly (?70?years […]