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Central Sleep Apnea

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1. Central sleep apnoea

Central sleep apnoea Central sleep apnoea - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Central sleep apnoea Last reviewed: February 2019 Last updated: March 2018 Summary Characterised by repetitive apnoeas or hypopnoeas with absent or diminished respiratory effort during sleep, occurring more than 5 times per hour. Important to search for underlying disorders such as congestive heart failure (CHF), renal failure (...) , stroke, brainstem lesions, acromegaly, hypothyroidism, or opioid use. Presence portends a poorer prognosis for CHF patients. Management of the underlying disorder may suffice to resolve the condition. Presenting symptoms may be the same as with other sleep-related breathing disorders. The disorder may be asymptomatic, observed by a partner, or detected on testing. A polysomnogram is required for diagnosis. Definition Central sleep apnoea (CSA) syndromes are characterised by repetitive absent

2018 BMJ Best Practice

3. Ambulatory Sleep Study for diagnosing obstructive sleep apnoea

Ambulatory Sleep Study for diagnosing obstructive sleep apnoea '); } else { document.write(' '); } ACE | Ambulatory Sleep Study for diagnosing obstructive sleep apnoea Search > > Ambulatory Sleep Study for diagnosing obstructive sleep apnoea - Ambulatory Sleep Study for diagnosing obstructive sleep apnoea Published on 2 May 2019 Guidance Recommendation The Ministry of Health's MTAC has recommended: Ambulatory sleep study or home sleep test (HST) with a type 2 or type 3 device for diagnosing (...) obstructive sleep apnoea (OSA) in adults aged ≥18 years who fulfil both (A) and (B) . High pre-test probability for moderate-severe OSA, where signs and symptoms indicating a high pre-test probability for moderate-severe OSA include: Excessive daytime sleepiness; and At least two of the following three criteria: (i) habitual loud snoring; (ii) witnessed apnoea, gasping, or choking; and (iii) diagnosed hypertension No complicated conditions that include: Awake hypoventilation or high risk of sleep-related

2019 Appropriate Care Guides, Agency for Care Effectiveness (Singapore)

4. Positional therapy for obstructive sleep apnoea. (Abstract)

Positional therapy for obstructive sleep apnoea. The modalities of therapy for obstructive sleep apnoea (OSA) include behavioural and lifestyle modifications, positional therapy, oral appliances, surgery and continuous positive airway pressure therapy (CPAP). Though CPAP has proven efficacy in treating OSA, adherence with CPAP therapy is suboptimal. Positional therapy (to keep people sleeping on their side) is less invasive and therefore expected to have better adherence. This review considered (...) ) in people with OSA.We identified studies from the Cochrane Airways' Specialised Register (including CENTRAL, MEDLINE, Embase, CINAHL, AHMED and PsycINFO), ClinicalTrials.gov, and the World Health Organization trials portal (ICTRP). It also contains results derived from handsearching of respiratory journals and abstract books of major annual meetings. We searched all databases from their inception to September 2018, with no restrictions on language of publication or publication type.We included

2019 Cochrane

5. Treatment-emergent central sleep apnea with non-positive airway pressure therapies for obstructive sleep apnea

Treatment-emergent central sleep apnea with non-positive airway pressure therapies for obstructive sleep apnea Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any associated files

2020 PROSPERO

6. Does CPAP ameliorate the risk of cardiovascular events in patients with obstructive sleep apnea?

, Vgontzas AN, Lin HM, et al. Prevalence of sleep-disordered breathing in women: effects of gender. Am J Respir Crit Care Med 2001;163:608-613. Basner RC. Continuous positive airway pressure for obstructive sleep apnea. N Engl J Med . 2007;356:1751–8. doi: 10.1056/NEJMct066953. White DP. Pathogenesis of obstructive and central sleep apnea. Am J Respir Crit Care Med 2005;172:1363-1370. Loube DI, Gay PC, Strohl KP, Pack AI, White DP, Collop NA. Indications for positive airway pressure treatment of adult (...) obstructive sleep apnea patients: a consensus statment. Chest 1999;115:863-866. Marin JM, Carrizo SJ, Vicente E, Agusti AGN. Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet 2005;365:1046-1053. Somers VK, Dyken ME, Clary MP, Abboud FM. Sympathetic neural mechanisms in obstructive sleep apnea. J Clin Invest 1995;96:1897-1904. Marin JM, Agusti A, Villar I, et al. Association

2019 Clinical Correlations

7. Treatment of Adult Obstructive Sleep Apnea with Positive Airway Pressure

. , , This guideline does not address the initiation and management of PAP in patients with obesity hypoventilation syndrome, sleep-related hypoventilation, or those with concurrent forms of obstructive and central sleep apnea. The efficacy of continuous PAP (CPAP), auto-adjusting PAP (APAP), bilevel PAP (BPAP), and other advanced PAP modalities for central sleep apnea and hypoventilation are addressed in other active AASM guidelines. , Furthermore, several prior recommendations on the management of OSA with PAP (...) in productivity or social functioning, and daytime fatigue. c = comorbidities may include: congestive heart failure, chronic opiate use, significant lung disease such as chronic obstructive pulmonary disease, neuromuscular disease, history of uvulopalatopharyngoplasty, those with known sleep-related oxygen requirements or expected to have nocturnal arterial oxyhemoglobin desaturation due to conditions other than OSA including hypoventilation syndromes and central sleep apnea syndromes. d = alternative

2019 American Academy of Sleep Medicine

8. The Treatment of Central Sleep Apnea Syndromes in Adults: Practice Parameters with an Evidence-Based Literature Review and Meta-Analyses

The Treatment of Central Sleep Apnea Syndromes in Adults: Practice Parameters with an Evidence-Based Literature Review and Meta-Analyses Guideline Update May 2016 The AASM has made an important update to the recommendation regarding use of adaptive servo-ventilation (ASV) for treatment of central sleep apnea syndromes (CSAS) related to chronic heart failure (CHF). This update stems from the May 2015 ResMed Field Safety Notice indicating that patients with symptomatic CHF and reduced left (...) ventricular ejection fraction (LVEF =45%) using ASV for treatment of CSAS are at an increased risk of cardiovascular mortality. The updated recommendation is an essential supplement to the practice parameter document: Aurora RN, Bista SR, Casey KR, Chowdhuri S, Kristo DA, Mallea JM, Ramar K, Rowley JA, Zak RS, Heald JL. Updated adaptive servo-ventilation recommendations for the 2012 AASM guideline: “The Treatment of Central Sleep Apnea Syndromes in Adults: Practice Parameters with an Evidence-Based

2016 American Academy of Sleep Medicine

9. Clinical practice guideline for diagnostic testing for adult obstructive sleep apnea: an American Academy of Sleep Medicine clinical practice guideline.

. ( Strong ) Recommendation 3 : The TF recommends that if a single home sleep apnea test is negative, inconclusive or technically inadequate, polysomnography be performed for the diagnosis of OSA. ( Strong ) Remarks : The following remarks are based on specifications used by studies that support these recommendation statements: An uncomplicated patient is defined by the absence of: Conditions that place the patient at increased risk of non-obstructive sleep-disordered breathing (e.g., central sleep apnea (...) Clinical practice guideline for diagnostic testing for adult obstructive sleep apnea: an American Academy of Sleep Medicine clinical practice guideline. Clinical practice guideline for diagnostic testing for adult obstructive sleep apnea: an American Academy of Sleep Medicine clinical practice guideline. | National Guideline Clearinghouse success fail JUN 09 2017 2018 2019 03 Oct 2017 - 12 Jul 2018 COLLECTED BY Organization: Formed in 2009, the Archive Team (not to be confused

2017 National Guideline Clearinghouse (partial archive)

10. Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline

sleep-disordered breathing (SDB) encompasses a range of disorders, with most falling into the categories of OSA, central sleep apnea (CSA) or sleep-related hypoventilation. This paper focuses on diagnostic issues related to the diagnosis of OSA, a breathing disorder characterized by narrowing of the upper airway that impairs normal ventilation during sleep. Recent reviews on the evaluation and management of CSA and sleep-related hypoventilation have been published separately by the AASM (...) Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline JCSM - Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline Search article archive here ADVERTISEMENT Current Issue: Volume: 15 Number: 03 Issue Navigator Volume 13 No. 03 .361-362 Reena Mehra, MD, MS .363-364 Andreas Lutterotti, MD .365-367

2017 American Academy of Sleep Medicine

11. Association of serious adverse events with Cheyne-Stokes respiration characteristics in patients with systolic heart failure and central sleep apnoea: A SERVE-Heart Failure substudy analysis. Full Text available with Trip Pro

Association of serious adverse events with Cheyne-Stokes respiration characteristics in patients with systolic heart failure and central sleep apnoea: A SERVE-Heart Failure substudy analysis. Increases in Cheyne-Stokes respiration (CSR) cycle length (CL), lung-to-periphery circulation time (LPCT) and time to peak flow (TTPF) may reflect impaired cardiac function. This retrospective analysis used an automatic algorithm to evaluate baseline CSR-related features and then determined whether (...) these could be used to identify patients with systolic heart failure (HF) who experienced serious adverse events in the Treatment of Sleep-Disordered Breathing with Predominant Central Sleep Apnea by Adaptive Servo Ventilation in Patients with Heart Failure (SERVE-HF) substudy.A total of 280 patients had overnight diagnostic polysomnography data available; an automated algorithm was applied to quantify CSR-related features.Median baseline CL, LPCT and TTPF were similar in the control (n = 152

2019 Respirology

12. Adaptive Servoventilation as Treatment for Central Sleep Apnea Due to High-Altitude Periodic Breathing in Nonacclimatized Healthy Individuals. Full Text available with Trip Pro

Adaptive Servoventilation as Treatment for Central Sleep Apnea Due to High-Altitude Periodic Breathing in Nonacclimatized Healthy Individuals. Orr, Jeremy E., Erica C. Heinrich, Matea Djokic, Dillon Gilbertson, Pamela N. Deyoung, Cecilia Anza-Ramirez, Francisco C. Villafuerte, Frank L. Powell, Atul Malhotra, and Tatum Simonson. Adaptive servoventilation as treatment for central sleep apnea due to high-altitude periodic breathing in nonacclimatized healthy individuals. High Alt Med Biol. 19:178 (...) -184, 2018.Central sleep apnea (CSA) is common at high altitude, leading to desaturation and sleep disruption. We hypothesized that noninvasive ventilation using adaptive servoventilation (ASV) would be effective at stabilizing CSA at altitude. Supplemental oxygen was evaluated for comparison.Healthy subjects were brought from sea level to 3800 m and underwent polysomnography on three consecutive nights. Subjects underwent each condition-No treatment, ASV, and supplemental oxygen-in random order

2019 High altitude medicine & biology Controlled trial quality: uncertain

13. The Role of Weight Management in the Treatment of Adult Obstructive Sleep Apnea Guideline

The Role of Weight Management in the Treatment of Adult Obstructive Sleep Apnea Guideline AMERICANTHORACICSOCIETY DOCUMENTS TheRoleofWeightManagementintheTreatmentofAdultObstructive Sleep Apnea An Of?cial American Thoracic Society Clinical Practice Guideline David W. Hudgel, Sanjay R. Patel, Amy M. Ahasic, Susan J. Bartlett, Daniel H. Bessesen, Melisa A. Coaker, P. Michelle Fiander, Ronald R. Grunstein, Indira Gurubhagavatula, Vishesh K. Kapur, Christopher J. Lettieri, Matthew T. Naughton (...) ,areassociatedwithimprovementsinOSA severity,cardiometaboliccomorbidities,andqualityoflife.The AmericanThoracicSocietyrecommendsthatcliniciansregularly assessweightandincorporateweightmanagementstrategiesthatare tailoredtoindividualpatientpreferencesintotheroutinetreatment ofadultpatientswithOSAwhoareoverweightorobese. Keywords: obstructive sleep apnea; obesity; comprehensive lifestyle intervention; weight-loss medications; bariatric surgery Contents Overview Summary of Recommendations Introduction Methods Panel Composition

2018 American Thoracic Society

14. Perioperative Management of Obstructive Sleep Apnea and Obesity Hypoventilation Syndrome: A Workshop Report

respiratory effects of opioids in patients with OSA (61–64), where both harmful (62) and bene?cial (63) effects on apnea severity during sleep have been demonstrated. Characteristically, in a randomized, placebo- controlled trial, Bernards and colleagues (64) have shown a dramatic increase of central apnea (from 0.8 to 43 events/h) in only 4 out of 10 patients with moderate OSA who received an opioid infusion during PSG, emphasizing the existing variability in the respiratory response to opioids (...) of central apnea in CPAP-naive patients (66). Inthediscussion,thefollowingquestions were also raised. Could pharmacotherapy or other therapies to stimulate the respiratory system be useful (e.g., ampakines [67], phrenic nerve stimulation [68, 69], and elevated body position [70]), especially given that CPAP use is challenging in the perioperative setting? Do other comorbidities, such as congestive heart failure (71, 72) or diabetes (73), affect opioid sensitivity and the development of sleep- disordered

2018 American Thoracic Society

15. Central sleep apnea during continuous positive airway pressure therapy in obstructive sleep apnea patients: from the compliance to adaptation, maladaptation and reflexes Full Text available with Trip Pro

Central sleep apnea during continuous positive airway pressure therapy in obstructive sleep apnea patients: from the compliance to adaptation, maladaptation and reflexes 29268457 2018 11 13 2072-1439 9 11 2017 Nov Journal of thoracic disease J Thorac Dis Central sleep apnea during continuous positive airway pressure therapy in obstructive sleep apnea patients: from the compliance to adaptation, maladaptation and reflexes. 4152-4156 10.21037/jtd.2017.09.116 Lombardi Carolina C Sleep Disorders (...) Center, San Luca Hospital, IRCCS Istituto Auxologico Italiano, Milan, Italy. Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy. Caravita Sergio S Department of Cardiovascular, Neural and Metabolic Sciences, San Luca Hospital, IRCCS Istituto Auxologico Italiano, Milan, Italy. Parati Gianfranco G Sleep Disorders Center, San Luca Hospital, IRCCS Istituto Auxologico Italiano, Milan, Italy. Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy

2017 Journal of thoracic disease

16. Sleep Complaints and Sleep Architecture in Children With Idiopathic Central Sleep Apnea Full Text available with Trip Pro

Sleep Complaints and Sleep Architecture in Children With Idiopathic Central Sleep Apnea Idiopathic central sleep apnea (ICSA) is categorized as a type of nonhypercapnic central sleep apnea (CSA). Recurrent cessation and resumption of respiration leads to sleep fragmentation, which causes excessive daytime sleepiness, frequent nocturnal awakenings, or both. ICSA has been described in the adult population but there is limited information in children. The purpose of this study was to describe (...) was significantly lower in patients with ICSA (P < .05).Similar to adult patients, children with ICSA present with complaints of insomnia, daytime sleepiness, and symptoms of obstructive sleep apnea. Analysis of polysomnograms reveals prolonged sleep latency, increased stage 2 sleep, and decreased slow wave sleep. Further studies are needed to assess mechanisms and the role of hypercapnic response in the pathogenesis of children with ICSA.© 2017 American Academy of Sleep Medicine

2017 Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine

17. Pitolisant for Daytime Sleepiness in Patients with Obstructive Sleep Apnea Who Refuse Continuous Positive Airway Pressure Treatment. A Randomized Trial Full Text available with Trip Pro

flowchart. Causes of noneligibility were as follows: 10 due to patient decision... Figure 2. Study flowchart. Causes of noneligibility were as follows: 10 due to patient decision and 20 due to exclusion criteria (6 significant cardiovascular disease or abnormality, 3 Epworth Sleepiness Scale score 16], 1 substance abuse [opioids], 1 significant periodic limb movement disorder and central sleep apnea, 1 age Figure 3. 5 Changes in Epworth Sleepiness Scale... Figure 3. 13 Changes in Epworth Sleepiness (...) Pitolisant for Daytime Sleepiness in Patients with Obstructive Sleep Apnea Who Refuse Continuous Positive Airway Pressure Treatment. A Randomized Trial Pitolisant for Daytime Sleepiness in Patients With Obstructive Sleep Apnea Who Refuse Continuous Positive Airway Pressure Treatment. A Randomized Trial - PubMed This site needs JavaScript to work properly. Please enable it to take advantage of the complete set of features! Clipboard, Search History, and several other advanced features

2020 EvidenceUpdates

18. Increasing cerebral blood flow reduces the severity of central sleep apnea at high altitude. Full Text available with Trip Pro

Increasing cerebral blood flow reduces the severity of central sleep apnea at high altitude. Earlier studies have indicated an important role for cerebral blood flow in the pathophysiology of central sleep apnea (CSA) at high altitude, but were not decisive. To test the hypothesis that pharmacologically altering cerebral blood flow (CBF) without altering arterial blood gas (ABGs) values would alter the severity of CSA at high altitude, we studied 11 healthy volunteers (8M, 3F; 31 ± 7 yr (...) night) to 48 ± 37 events/h of sleep ( P < 0.001). Oral Indo had no significant effect on CSA. We conclude that increasing cerebral blood flow reduced the severity of CSA at high altitude; the likely mechanism is via a reduction in the background stimulation of central chemoreceptors. NEW & NOTEWORTHY This work is significant because it shows convincingly for the first time in healthy volunteers that increasing cerebral blood flow will reduce the severity of central sleep apnea in a high-altitude

2018 Journal of applied physiology (Bethesda, Md. : 1985) Controlled trial quality: uncertain

19. Phrenic nerve stimulation to treat patients with central sleep apnoea and heart failure. Full Text available with Trip Pro

Phrenic nerve stimulation to treat patients with central sleep apnoea and heart failure. The presence of central sleep apnoea (CSA) is associated with poor prognosis in patients with heart failure (HF). The aim of this analysis was to evaluate if using phrenic nerve stimulation to treat CSA in patients with CSA and HF was associated with changes in HF-specific metrics.All patients randomized in the remedē System Pivotal Trial and identified at baseline with HF were included (n = 96 (...) ). Effectiveness data from treatment and former control groups were pooled based on months since therapy activation. Changes from baseline to 6 and 12 months in sleep metrics, Epworth Sleepiness Scale, patient global assessment health-related quality of life, Minnesota Living with Heart Failure Questionnaire (MLHFQ), and echocardiographic parameters are reported. HF hospitalization, cardiovascular death, and the composite of HF hospitalization or cardiovascular death within 6 months are reported

2018 European Journal of Heart Failure Controlled trial quality: uncertain

20. Identification and Treatment of Central Sleep Apnoea: Beyond SERVE-HF Full Text available with Trip Pro

Identification and Treatment of Central Sleep Apnoea: Beyond SERVE-HF Central sleep apnoea (CSA) occurs in a large proportion of HF patients. CSA has clear detrimental effects, resulting in intermittent hypoxia and sympathetic activation, and is associated with significant morbidity and mortality. Treatment options are limited following the results of a recent trial in which adaptive servo-ventilation resulted in an increase in cardiovascular mortality. Ongoing studies utilising other forms

2018 Cardiac Failure Review

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