0000000000365411
AUTHOR
Jean-louis Pépin
showing 11 related works from this author
Sleep laboratories reopening and COVID-19 : a European perspective
2021
The clinical activities regarding sleep disordered breathing (SDB) have been sharply interrupted during the initial phase of the COVID-19 epidemic throughout Europe. In the last months, activities have gradually restarted, according to epidemiological phase of COVID-19 and National recommendations. The recent increase in cases throughout Europe obliges to reconsider management strategies of SDB accordingly. Diagnosis of SDB and initiation of treatment pose some specific problems to be addressed to preserve safety of the patients and health personnel. This perspective document by a group of European sleep experts aims at summarising some different approaches followed in Europe and United Sta…
Arterial stiffness in obese CPAP-treated obstructive sleep apnea (OSA): A seven years prospective longitudinal study
2017
Introduction: Arterial stiffness measured by carotid-femoral pulse wave velocity (PWV) is elevated in severe OSA. A 1m/s increase in PWV is associated with a 15% increased risk of mortality. There is a paucity of data regarding long term evolution of PWV in CPAP-treated OSA. Aims: To measure PWV evolution in CPAP-treated OSA. Methods: In a prospective obese OSA cohort, we collected PWV, clinical and biological metabolic data, incident cardiovascular events and CPAP adherence at time of diagnosis and after at least 5-year follow-up. Results: 72 OSA (men: 52.8%, median age: 55.8 years and median BMI of 38.5 kg/m2) with a high prevalence of hypertension: 58.3%, Type 2 diabetes: 20.8%, hypercho…
Clusters of sleep apnoea phenotypes: A large pan-European study from the European Sleep Apnoea Database (ESADA)
2021
Background and objective: To personalize OSA management, several studies have attempted to better capture disease heterogeneity by clustering methods. The aim of this study was to conduct a cluster analysis of 23 000 OSA patients at diagnosis using the multinational ESADA. Methods: Data from 34 centres contributing to ESADA were used. An LCA was applied to identify OSA phenotypes in this European population representing broad geographical variations. Many variables, including symptoms, comorbidities and polysomnographic data, were included. Prescribed medications were classified according to the ATC classification and this information was used for comorbidity confirmation. Results: Eight cl…
Long-term variations of arterial stiffness in patients with obesity and obstructive sleep apnea treated with continuous positive airway pressure
2020
BackgroundObstructive sleep apnea (OSA) is associated with cardiovascular co-morbidities and mortality. Arterial stiffness is an independent predictor of cardiovascular risk and mortality, and is influenced by the presence of OSA and related comorbidities. There is a paucity of data regarding long-term evolution of arterial stiffness in CPAP-treated OSA patients. We aimed to prospectively study long term PWV variations and determinants of PWV deterioration.MethodsIn a prospective obese OSA cohort, at time of diagnosis and after several years of follow-up we collected arterial stiffness measured by carotid-femoral pulse wave velocity (PWV), clinical and metabolic parameters, and CPAP adheren…
ARIA digital anamorphosis: Digital transformation of health and care in airway diseases from research to practice: Review
2020
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Evaluation of a multicomponent grading system for obstructive sleep apnoea: the Baveno classification
2021
New findings on pathophysiology, epidemiology, and outcome have raised concerns on the relevance of the apnoea–hypopnoea index (AHI) in the classification of obstructive sleep apnoea (OSA) severity. Recently, a multicomponent grading system decision integrating symptomatology and comorbidities (Baveno classification), was proposed to characterise OSA and to guide therapeutic decisions. We evaluated whether this system reflects the OSA population, whether it translates into differences in outcomes, and whether the addition of AHI improves the scheme. A total of 14 499 OSA patients from the European Sleep Apnoea Database cohort were analysed. The groups were homogeneously distributed and were…
Fixed But Not Autoadjusting Positive Airway Pressure Attenuates the Time-dependent Decline in Glomerular Filtration Rate in Patients With OSA
2018
Abstract: BACKGROUND: The impact of treating OSA on renal function decline is controversial. Previous studies usually included small samples and did not consider specific effects of different CPAP modalities. The aim of this study was to evaluate the respective influence of fixed and autoadjusting CPAP modes on estimated glomerular filtration rate (eGFR) in a large sample of patients derived from the prospective European Sleep Apnea Database cohort. METHODS: In patients of the European Sleep Apnea Database, eGFR prior to and after follow-up was calculated by using the Chronic Kidney Disease-Epidemiology Collaboration equation. Three study groups were investigated: untreated patients (n = 14…
Incident cardiovascular events in severely obese patients treated with continous positive airway pressure (CPAP)/non invasive ventilation (NIV): A 5.…
2015
it is still debated whether CPAP or non-invasive ventilation (NIV) reduces cardiovascular (CV) risk in morbidly obese patients. Obese subjects affected by obstructive sleep apnea (OSA) or obesity hypoventilation syndrome (OHS) (n=210) were recruited between 2007-2010 in the Sleep Center, Univ. of Grenoble; 152 of them were treated with CPAP or NIV, and regularly followed by a home-care provider (Agir a dom). Patients underwent phone interviews to assess incident CV events during 5.6 years (range 4.0-6.5 yrs) of follow-up. One hundred seventeen patients (63 men) responded to questionnaire, 3 OSA patients died, and 32 declined/were lost to follow-up (response rate 77%). All patients at baseli…
Allergic Rhinitis and its Impact on Asthma (ARIA) Phase 4 (2018): Change management in allergic rhinitis and asthma multimorbidity using mobile techn…
2019
Allergic Rhinitis and its Impact on Asthma (ARIA) has evolved from a guideline by using the best approach to integrated care pathways using mobile technology in patients with allergic rhinitis (AR) and asthma multimorbidity. The proposed next phase of ARIA is change management, with the aim of providing an active and healthy life to patients with rhinitis and to those with asthma multimorbidity across the lifecycle irrespective of their sex or socioeconomic status to reduce health and social inequities incurred by the disease. ARIA has followed the 8-step model of Kotter to assess and implement the effect of rhinitis on asthma multimorbidity and to propose multimorbid guidelines. A second c…
Hyperlipidemia Prevalence and Cholesterol Control in OSA: Data from European Sleep Apnea Database (ESADA)
2019
European-Respiratory-Society (ERS) International Congress -- SEP 28-OCT 02, 2019 -- Madrid, SPAIN
Investigation and management of residual sleepiness in CPAP-treated patients with obstructive sleep apnoea: the European view
2022
International audience; Excessive daytime sleepiness (EDS) is a major symptom of obstructive sleep apnoea (OSA), defined as the inability to stay awake during the day. Its clinical descriptors remain elusive, and the pathogenesis is complex, with disorders such as insufficient sleep and depression commonly associated. Subjective EDS can be evaluated using the Epworth Sleepiness Scale, in which the patient reports the probability of dozing in certain situations; however, its reliability has been challenged. Objective tests such as the multiple sleep latency test or the maintenance of wakefulness test are not commonly used in patients with OSA, since they require nocturnal polysomnography, da…