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Intermittent Hypoxia and Hypercapnia, a Hallmark of ObstructiveSleepApnea, Alters the Gut Microbiome and Metabolome Obstructivesleepapnea (OSA) is a common disorder characterized by episodic obstruction to breathing due to upper airway collapse during sleep. Because of the episodic airway obstruction, intermittently low O2 (hypoxia) and high CO2 (hypercapnia) ensue. OSA has been associated with adverse cardiovascular and metabolic outcomes, although data regarding potential causal pathways (...) are still evolving. As changes in inspired O2 and CO2 can affect the ecology of the gut microbiota and the microbiota has been shown to contribute to various cardiometabolic disorders, we hypothesized that OSA alters the gut ecosystem, which, in turn, exacerbates the downstream physiological consequences. Here, we model human OSA and its cardiovascular consequence using Ldlr-/- mice fed a high-fat diet and exposed to intermittent hypoxia and hypercapnia (IHH). The gut microbiome and metabolome were
Diagnostic accuracy of a two-stage model for detecting obstructivesleepapnoea in chronic tetraplegia Obstructivesleepapnoea (OSA) is highly prevalent in people with spinal cord injury (SCI). Polysomnography (PSG) is the gold-standard diagnostic test for OSA, however PSG is expensive and frequently inaccessible, especially in SCI. A two-stage model, incorporating a questionnaire followed by oximetry, has been found to accurately detect moderate to severe OSA (MS-OSA) in a non-disabled (...) thresholds for diagnosing MS-OSA. The accuracy of both models in diagnosing MS-OSA was prospectively evaluated in 100 participants with chronic tetraplegia across four international SCI units.Injury completeness, sleepiness, self-reported snoring and apnoeas were included in the modified questionnaire, which was highly predictive of MS-OSA (ROC area under the curve 0.87 (95% CI 0.79 to 0.95)). The 3% oxygen desaturation index was also highly predictive (0.93 (0.87-0.98)). The two-stage model
Cost-effectiveness of cognitiveâ€“behavioural therapy for sleepdisorder added to usual care in patients with schizophrenia: the BEST study Sleep problems are pervasive in people with schizophrenia, but there are no clinical guidelines for their treatment. The Better Sleep Trial (BEST) concluded that suitably adapted cognitive-behavioural therapy (CBT) is likely to be highly effective, although its cost-effectiveness is unknown.To assess the potential cost-effectiveness of CBT for sleep (...) needs, as well as very high rates of depression, suicidal ideation and poor physical health. The results of this study showed that treating pervasive sleep problems in this patient group with cognitive-behavioural therapy (CBT) is very likely to improve patient quality of life in the short term. Clinicians most commonly use hypnotic medication to treat sleepingdisorders. This study indicates that CBT may be an effective and cost-effective intervention in this patient group. This alternative would
Therapeutic Approaches of ObstructiveSleepApnea in China 29607299 2019 01 28 2450-131X 6 1 2018 Mar Journal of translational internal medicine J Transl Int Med Therapeutic Approaches of ObstructiveSleepApnea in China. 16-20 10.2478/jtim-2018-0004 Li Wen-Yang WY Institute of Respiratory Disease, The First Hospital of China Medical University, Shenyang, China. Wang Wei W Institute of Respiratory Disease, The First Hospital of China Medical University, Shenyang, China. eng Journal Article 2018 (...) 23589584 J Clin Sleep Med. 2015 Jul 15;11(7):773-827 26094920 SleepBreath. 2015 Mar;19(1):281-9 24859614 Eur Respir J. 2011 May;37(5):1000-28 21406515 J Appl Physiol (1985). 2017 Jul 1;123(1):116-125 28408696 Int J Oral Maxillofac Surg. 2015 Feb;44(2):189-94 25305697 Laryngoscope. 2008 May;118(5):902-8 18300704 Respir Care. 2013 May;58(5):810-5 23051618 Ann Intern Med. 2013 Oct 1;159(7):471-83 24061345 BMJ. 2006 Feb 4;332(7536):266-70 16377643 SleepBreath. 2013 May;17(2):705-12 22821223 Thorax. 2010
The REM Sleep Behavior Disorder Screening Questionnaire is not Valid in De Novo Parkinson's Disease Rapid eye movement (REM) sleep behavior disorder (RBD) is one of the most specific prodromal indicators for Parkinson's disease (PD).To test the validity of the RBD-Screening Questionnaire (RBDSQ) in assessing RBD in early PD.The RBDSQ was completed before video-supported polysomnography (vPSG) by 134 de novo PD patients, 109 matched controls without neurological disorder (CTR) and 30 subjects
Ventilatory support or respiratory muscle training as adjuncts to exercise in obese CPAP-treated patients with obstructivesleepapnoea: a randomised controlled trial Obstructivesleepapnoea (OSA) and obesity are interdependent chronic diseases sharing reduced exercise tolerance and high cardiovascular risk.A 3-month intervention with innovative training modalities would further improve functional capacity and cardiovascular health than usual cycle exercise training in already continuous (...) positive airway pressure (CPAP)-treated obese patients with OSA.Fifty three patients (35sleep quality were evaluated.All training modalities increased 6 min walking
Simulation of the upper airways in patients with obstructivesleepapnea and nasal obstruction: A novel finite element method To evaluate the biomechanical properties of the soft palate and velopharynx in patients with obstructivesleepapnea (OSA) and nasal obstruction.Prospective experimental study.Two finite element (FE) models of the soft palate were created in six patients undergoing nasal surgery, one homogeneous model based on CT images, and one layered model based on soft tissue (...) . The obstruction occurs mainly at the level of the lateral attachments to the pharyngeal wall, and the width of the soft palate is an indicator of the degree of critical closing pressure. A less negative closing pressure corresponds to small total transverse strain. The effect of nasal surgery on OSA is most likely not explained by change in soft palate biomechanics.NA.
Effect of ObstructiveSleepApnea Treatment on Renal Function in Patients with Cardiovascular Disease Obstructivesleepapnea (OSA) is associated with impaired renal function, but uncertainty exists over whether OSA treatment can influence renal outcomes.To determine the effects of continuous positive airway pressure (CPAP) on renal function in subjects with coexisting OSA and cardiovascular disease.This was a substudy of the international SAVE (SleepApnea Cardiovascular Endpoints) trial
specialist is essential to evaluate and treat less common sleep problems associated with mTBI, such as sleep-related breathingdisorder (e.g., obstructivesleepapnea), circadian rhythm shift, restless leg syndrome, periodic limb movement disorder, and REM sleep behaviour disorder. Some benefits of melatonin have been documented for insomnia, daytime alertness, or circadian rhythm difficulties after mTBI, 2,16,23 however recent guidelines for the treatment of insomnia 24 do not encourage use of melatonin (...) Guideline for concussion/mild traumatic brain injury & persistent symptoms - Sleep-Wake Disturbances Sleep-Wake Disturbances // Brain Injury Guidelines Toggle navigation NAVIGATION > > > > > > > > > > > > > > > > > > Guideline For Concussion/Mild Traumatic Brain Injury & Persistent Symptoms 3rd Edition, for Adults over 18 years of age Sleep-Wake Disturbances More than 50% of patients report sleep disturbances following mTBI, specifically insomnia, hypersomnia, obstructivesleepapnea, poor
Interventions for InsomniaDisorder Interventions for InsomniaDisorder | CADTH.ca Find the information you need Interventions for InsomniaDisorder Interventions for InsomniaDisorder Last updated: December 10, 2018 Project Number: HT0003-OP0527 Product Line: Result type: Report Insomnia is a sleepdisorder affecting approximately 13% of the Canadian population. People with insomnia often have difficulty falling asleep or difficulty remaining asleep. They may also wake up frequently (...) , experience early awakening, have a limited amount of sleep, or have a poor quality of sleep. Insomnia may be acute, meaning it generally starts suddenly and lasts for less than three months, or it may be chronic, meaning it lasts for a longer duration. Insomnia may affect a person’s ability to work or study, and can negatively affect their relationships with others. People with insomnia may experience a reduced quality of life because of the consequences of poor sleep. Approaches to treating insomnia
Impact of Dexmedetomidine on Intraoperative Wake-Up Tests in Patients Undergoing Spinal Surgery. To evaluate the impact of dexmedetomidine (DEX) on intraoperative wake-up tests.American Society of Anesthesiologists category I or II patients were divided into two groups: a propofol-remifentanil group (group R, n = 20) and a DEX-propofol-remifentanil group (group D, n = 20).The patients in group D received DEX, whereas the patients in group R received the same volume of saline. The other (...) anesthetic methods and drugs (propofol and remifentanil) were the same in both groups. During the wake-up test, patients were repeatedly asked to move their fingers.All the wake-up tests were successfully performed. There was no significant difference in the mean wake-up time between the two groups. Eighteen patients exhibited better wake-up quality in group D as did eight patients in group R. The patients in group D had a significantly better overall wake-up quality than those in group R (P <.05).DEX
Jet lag and sleep phase disorders Jet lag and sleep phase disorders - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Jet lag and sleep phase disorders Last reviewed: February 2019 Last updated: February 2018 Summary Affects millions of travellers worldwide. Rapid change in time zone produces a constellation of symptoms called jet lag disorder. Symptoms include difficulty initiating and maintaining sleep, reduced (...) daytime alertness, general malaise, and gastrointestinal symptoms. Severity of symptoms depends on the number of time zones crossed, times of travel, quality of sleep in flight, circadian time cues at the place of travel, individual propensity, and direction of travel. A temporary condition; symptoms are self-limited. Treatments include melatonin and alteration of light exposure. Definition This topic focuses on jet lag. Jet lag disorder is a temporary desynchronisation between endogenous body rhythms
, 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 breathingdisorders. The disorder may be asymptomatic, observed by a partner, or detected on testing. A polysomnogram is required for diagnosis. Definition Central sleepapnoea (CSA) syndromes are characterised by repetitive absent (...) Central sleepapnoea Central sleepapnoea - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Central sleepapnoea 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
diaries, actigraphy, and polysomnography may assist in confirming diagnosis. Identification of the correct aetiology is essential, as interventions differ and may be harmful in some cases if the diagnosis is incorrect. Education regarding sleep hygiene techniques is useful to prevent chronic insomnia. The significant morbidity of insomnia indicates that it is a condition that warrants treatment. Definition As per the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), American (...) Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed., (DSM-5). Washington, DC: American Psychiatric Publishing; 2013. insomnia is defined as difficulty initiating or maintaining sleep, or early-morning awakening that leads to dissatisfaction with sleep quantity or quality. The resulting sleep disturbance leads to impairment in social, occupational, educational, academic, behavioural, or other important areas of functioning, as well as causing significant distress
Obstructivesleepapnoea (OSA) is characterised by episodes of complete or partial upper airway obstruction during sleep. Episodic airway obstruction is usually associated with oxyhaemoglobin desaturations and arousals from sleep. The symptoms of sleepapnoea include chronic snoring, insomnia, gasping and breath holding, unrefreshing sleep, and daytime sleepiness. American Academy of Sleep Medicine. ICSD-2 international classification of sleepdisorders, 2nd ed: diagnostic and coding manual. Westchester (...) and exam obesity male sex maxillomandibular anomalies excessive daytime sleepiness episodes of apnoea episodic gasping restless sleepinsomnia macroglossia chronic snoring cardiovascular disease weight gain large neck circumference endocrine disorders hx of difficult intubation for general anaesthesia FHx of OSA or snoring hx of mucopolysaccharidoses hx of GORD hx of Down's syndrome hx of tooth extractions for crowding hx of motor vehicle accidents neurocognitive dysfunction mood disorders nocturia