Search results for "Apnea"

Personalized medicine in sleep respiratory disorders; focus on OSA diagnosis and treatment.

2017

In all fields of medicine, major efforts are currently dedicated to improve the clinical, physiological and therapeutic understanding of disease, and obstructive sleep apnoea (OSA) is no exception. The personalised medicine approach is relevant for OSA, given its complex pathophysiology and variable clinical presentation, the interactions with comorbid conditions and its possible contribution to poor outcomes. Treatment with continuous positive airway pressure (CPAP) is effective, but CPAP is poorly tolerated or not accepted in a considerable proportion of OSA patients. This review summarises the available studies on the physiological phenotypes of upper airway response to obstruction durin…

Relationship between mild to moderate renal dysfunction and obstructive sleep apnea: Data from the European sleep apnea database

2013

The relationship between severity of obstructive sleep apnea (OSA) and kidney function was investigated in the European Sleep Apnea Database (ESADA), where clinical, sleep, and biochemical data of patients studied for suspected OSA in 24 sleep centres of 17 European countries are stored. After excluding patients with missing data or extremely high/low creatinine values, data from 8112 subjects (2328 female) with creatinine values ranging between 0.5 and 2.0 mg% were analyzed. Estimated glomerular filtration rate (eGFR) was obtained with the Modified Diet in Renal Disease (MDRD) equation. Patients were subdivided into two groups: group 1 (n = 3709) studied by full polysomnography; group 2 (n…

Neuropsychological Alterations in Children Affected by Obstructive Sleep Apnea Syndrome

2020

Sleep-related breathing disorders are a group of clinical conditions ranging from habitual snoring to obstructive sleep apnea syndrome (OSAS) during the lifespan. In children, other risk factors are represented by adenotonsillar hypertrophy, rhinitis, nasal structure alteration, cleft palate, velopharyngeal flap surgery, pharyngeal masses, craniofacial malformations, genetic syndrome (i.e. Down syndrome, Crouzon syndrome, and Apert syndrome), genetic hypoplasia mandibular (i.e. Pierre Robin syndrome, Treacher Collins syndrome, Shy-Drager syndrome, and Cornelia De Lange syndrome), craniofacial traumas, chronic or seasonal rhinitis, asthma, neuromuscular syndromes, brainstem pathologies (i.e.…

Sezione 17 Apparato Respiratorio. Capitolo 129 Valutazione dell'Apparato Respiratorio, Capitolo 130 Controllo della Respirazione, Capitolo 131 Ostruz…

2012

Cardiovascular disease: pathophysiological mechanisms

2015

OSA is a common disease that affects approximately 10% of the middle-aged population and becomes more prevalent with age. It is caused by intermittent and repetitive collapse of the UA during sleep. The main acute physiological consequences of OSA are oxygen desaturation, intrathoracic pressure changes and arousals. OSA is associated with significant cardiovascular morbidity and mortality and is an independent risk factor for CVD. The pathogenesis of CVD in OSA is not completely understood but is likely to be multifactorial, involving a diverse range of closely interrelated and detrimental intermediate mechanisms that predispose patients to atherosclerosis, including oxidative stress, sympa…

Predisposing factors

2012

Introduction

2010

Excessive Daytime Sleepiness in Obstructive Sleep Apnea Patients Treated With Continuous Positive Airway Pressure: Data From the European Sleep Apnea…

2021

Excessive daytime sleepiness (EDS) is a symptom of obstructive sleep apnea (OSA) that resolves under treatment with continuous positive airway pressure (CPAP). In some patients, sleepiness persists despite CPAP treatment. We retrospectively analyzed data on subjective residual EDS, assessed as an Epworth Sleepiness Scale score (ESS) >10, in patients from the European Sleep Apnea Database (n = 4,853, mean age +/- SD 54.8 +/- 11.8 years, 26.1% females), at baseline and at the first visit (median follow-up: 5 months, interquartile range 3-13). An ESS > 10 occurred in 56% of patients at baseline and in 28.2% of patients at follow-up. Residual EDS was analyzed in 2,190 patients (age: 55.1 +/- 12…

Efectos de la cirugía bariátrica en la apnea obstructiva del sueño

2023

La obesidad se relaciona íntimamente con la apnea obstructiva del sueño (AOS). Se presenta una tesis doctoral en la que se evaluó mediante un estudio prospectivo longitudinal la prevalencia de AOS en pacientes candidatos a cirugía bariátrica y las características de su vía aérea superior, así como cuáles fueron los efectos de la pérdida de peso tras la cirugía bariátrica en la AOS y los cambios en la anatomía de la vía aérea superior. La prevalencia de AOS en este estudio fue de 74,2%. La edad superior a los 48 años fue un factor predictivo independiente de AOS moderada o grave. Los pacientes con AOS moderada y grave presentaron un mayor peso, cuellos más gruesos, paladares más flácidos, ma…

Advances in ventilatory treatment for OSAS

2021

Continuous positive airway pressure (CPAP) is the most widely used treatment for obstructive sleep apnea (OSA), and was established four decades ago. An alternative option is to use bilevel ventilation, in order to improve compliance to treatment especially in patients who need a high therapeutic pressure to prevent nocturnal respiratory events. Automatic CPAP or bilevel ventilation are also established among OSA therapeutic choices, and are generally indicated in cases of highly variable therapeutic pressure. The major advances in the field regard OSAS in the context of uncomplicated obesity hypoventilation syndrome (OHS), in which either CPAP or bilevel ventilation yield comparable result…