Search results for "Obstructive"
showing 9 items of 609 documents
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.…
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…
Sleep Disturbances in COPD are Associated with Heterogeneity of Airway Obstruction
2018
Individuals with Chronic Obstructive Pulmonary Disease (COPD) experience sleep disturbances due to the impact of respiratory symptoms on sleep quality. We explored whether sleep disturbances in COPD are linked to heterogeneity of airway constriction.The impact of breathing problems on sleep quality was measured in consecutive COPD outpatients with the COPD and Asthma Sleep Impact Scale (CASIS) questionnaire. Impulse oscillometry technique (IOS) was employed to assess heterogeneity of airway constriction. Subjects with a previous or concomitant diagnosis of asthma or obstructive sleep apnea (OSA) were excluded.Fifty COPD subjects (M/F 40/10; age: 71 +/- 8 yrs, Body Mass Index (BMI): 26.2 +/-…
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…
Absence of Adverse Effects of Tiotropium/Olodaterol Compared with the Monocomponents on Long-Term Heart Rate and Blood Pressure in Patients with Mode…
2020
Stefan Andreas,1,2 Lorcan McGarvey,3 Ulrich Bothner,4 Matthias Trampisch,4 Alberto de la Hoz,4 Matjaz Fležar,5 Roland Buhl,6 Peter Alter7 1Department of Cardiology and Pneumology, University Medical Center Göttingen, Göttingen, Germany; 2LungClinic Immenhausen, Immenhausen, Germany, Member of the German Center for Lung Research (DZL); 3Queen’s University Belfast, Belfast, UK; 4Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany; 5Klinika Golnik, Golnik, Slovenia; 6Pulmonary Department, Johannes Gutenberg University Mainz, Mainz, Germany; 7Department of Medicine, Pulmonary and Critical Care Medicine, Philipps University of Marburg (UMR); Member o…
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…
Monotherapy with indacaterol once daily reduces the rate of exacerbations in patients with moderate-to-severe COPD: Post-hoc pooled analysis of 6 mon…
2014
Summary Background In patients with COPD, exacerbations are associated with poor quality of life and may shorten survival. Prevention of exacerbations is, therefore, a key objective in COPD management. Indacaterol, a once-daily ultra-long-acting β 2 -agonist, has been shown to reduce exacerbations in various studies. This pooled analysis evaluated the effect of indacaterol on exacerbations versus placebo. Methods Six-month data were pooled from three randomized, double-blind, and placebo-controlled studies: indacaterol 300 μg versus placebo (1 year); indacaterol 150 μg and 300 μg versus placebo (6 months); and indacaterol 150 μg versus placebo (6 months). All treatments were administered on…