Search results for " apnea"
showing 10 items of 261 documents
Decrease in blood pressure during continuous positive airway pressure treatment for obstructive sleep apnoea: still searching for predictive factors
2019
High blood pressure (BP) and non-dipping 24-hour BP profile may help to predict BP decrease after obstructive sleep apnoea treatment by CPAP. However, specific, highly reproducible traits associated with BP responsiveness to CPAP must still be identified.http://bit.ly/2LbS4uV
Sleep Apnea and the Kidney
2020
Abstract Purpose of Review There are some uncertainties about the interactions between obstructive sleep apnea (OSA) and chronic kidney disease (CKD). We critically reviewed recent studies on this topic with a focus on experimental and clinical evidence of bidirectional influences between OSA and CKD, as well as the effects of treatment of either disease. Recent Findings Experimental intermittent hypoxia endangers the kidneys, possibly through activation of inflammatory pathways and increased blood pressure. In humans, severe OSA can independently decrease kidney function. Treatment of OSA by CPAP tends to blunt kidney function decline over time, although its effect may vary. OSA may increa…
European Respiratory Society statement on sleep apnoea, sleepiness and driving risk
2021
Obstructive sleep apnoea (OSA) is highly prevalent and is a recognised risk factor for motor vehicle accidents (MVA). Effective treatment with continuous positive airway pressure has been associated with a normalisation of this increased accident risk. Thus, many jurisdictions have introduced regulations restricting the ability of OSA patients from driving until effectively treated. However, uncertainty prevails regarding the relative importance of OSA severity determined by the apnoea–hypopnoea frequency per hour and the degree of sleepiness in determining accident risk. Furthermore, the identification of subjects at risk of OSA and/or accident risk remains elusive. The introduction of off…
Sleep apnoea as an independent risk factor for cardiovascular disease: current evidence, basic mechanisms and research priorities
2007
Considerable evidence is available in support of an independent association between obstructive sleep apnoea syndrome (OSAS) and cardiovascular disease, which is particularly strong for systemic arterial hypertension and growing for ischaemic heart disease, stroke, heart failure, atrial fibrillation and cardiac sudden death. The pathogenesis of cardiovascular disease in OSAS is not completely understood but likely to be multifactorial, involving a diverse range of mechanisms including sympathetic nervous system overactivity, selective activation of inflammatory molecular pathways, endothelial dysfunction, abnormal coagulation and metabolic dysregulation, the latter particularly involving in…
Obstructive sleep apnea and comorbidities: a dangerous liaison
2018
Obstructive sleep apnea (OSA) is a highly prevalent disease, and is traditionally associated with increased cardiovascular risk. The role of comorbidities in OSA patients has emerged recently, and new conditions significantly associated with OSA are increasingly reported. A high comorbidity burden worsens prognosis, but some data suggest that CPAP might be protective especially in patients with comorbidities. Aim of this narrative review is to provide an update on recent studies, with special attention to cardiovascular and cerebrovascular comorbidities, the metabolic syndrome and type 2 diabetes, asthma, COPD and cancer. Better phenotypic characterization of OSA patients, including comorbi…
Mild obstructive sleep apnea increases hypertension risk, challenging traditional severity classification
2020
STUDY OBJECTIVES: The association of mild obstructive sleep apnea (OSA) with important clinical outcomes remains unclear. We aimed to investigate the association between mild OSA and systemic arterial hypertension (SAH) in the European Sleep Apnea Database cohort. METHODS: In a multicenter sample of 4,732 participants, we analyzed the risk of mild OSA (subclassified into 2 groups: mild(AHI 5-<11/h) (apnea-hypopnea index [AHI], 5 to <11 events/h) and mild(AHI 11-<15/h) (AHI, ≥11 to <15 events/h) compared with nonapneic snorers for prevalent SAH after adjustment for relevant confounding factors including sex, age, smoking, obesity, daytime sleepiness, dyslipidemia, chronic obstructive pulmona…
Comment to the Editorial by KS Park and EW Kang “Is only fixed positive airway pressure a robust tool for kidney protection in patients with obstruct…
2019
We thank doctors Park and Kang for their editorial that well summarized our article. Our common belief is that one of the possible consequences of untreated obstructive sleep apnea (OSA) is an accelerated deterioration of kidney function, and that more knowledge would be necessary on the possible protective effects of OSA treatments. To our knowledge, so far the only OSA therapy whose effects on renal function have been tested is continuous positive airway pressure (CPAP), and most , although not all studies, have demonstrated its benefits. Our own study, while confirming benefits of fixed CPAP, has demonstrated little effect of auto-adjusting CPAP (APAP). This finding may be of relevance a…
Challenges and perspectives in obstructive sleep apnoea: Report by an ad hoc working group of the Sleep Disordered Breathing Group of the European Re…
2018
Obstructive sleep apnoea (OSA) is a major challenge for physicians and healthcare systems throughout the world. The high prevalence and the impact on daily life of OSA oblige clinicians to offer effective and acceptable treatment options. However, recent evidence has raised questions about the benefits of positive airway pressure therapy in ameliorating comorbidities.An international expert group considered the current state of knowledge based on the most relevant publications in the previous 5 years, discussed the current challenges in the field, and proposed topics for future research on epidemiology, phenotyping, underlying mechanisms, prognostic implications and optimal treatment of pat…
EAN/ERS/ESO/ESRS statement on the impact of sleep disorders on risk and outcome of stroke.
2020
BACKGROUND Sleep disorders are highly prevalent in the general population and may be linked in a bidirectional fashion to stroke, which is one of the leading causes of morbidity and mortality. AIM Four major scientific societies established a task force of experts in neurology, stroke, respiratory medicine, sleep medicine and methodology to critically evaluate the evidence regarding potential links and the impact of therapy. MATERIALS AND METHODS Thirteen research questions were evaluated in a systematic literature search using a stepwise hierarchical approach: first, systematic reviews and meta-analyses; second, primary studies post-dating the systematic reviews/meta-analyses. A total of 4…
Reliability of automatic detection of AHI during positive airway pressure treatment in obstructive sleep apnea patients: A “real-life study”
2021
Introduction: Automatic event detection (AED) of residual apnea-hypopnea index (AHI) by ventilators is a current practice in sleep and mechanical ventilation Units but this methodology has not been validated in an unselected population of OSA patients. Aim of the present study was to assess in a “real-life” condition the reliability of AED during PAP therapy by the in-built software compared to full polysomnography during follow-up. Methods: We enrolled 300 OSA patients (105 F; AHI 45.3 ± 27.8) already on Positive airway pressure (PAP) therapy: 53% of the patients were on CPAP while other modalities were used in the rest of the sample. Results: Overall, the built-in software identified resi…