Pro: can physiological risk factors for obstructive sleep apnea be determined by analysis of data obtained from routine polysomnography?

SLEEP, Journal Year: 2023, Volume and Issue: 46(5)

Published: Jan. 28, 2023

Journal Article Pro: can physiological risk factors for obstructive sleep apnea be determined by analysis of data obtained from routine polysomnography? Get access Scott A Sands, Sands Division Sleep Medicine, Brigham and Women's Hospital Harvard Medical School, 221 Longwood Avenue, Boston, MA 02115, USA Corresponding author. A. USA. Email: [email protected]. Search other works this author on: Oxford Academic Google Scholar Bradley Edwards Department Physiology, School Biomedical Sciences Discovery Institute, Monash University, Melbourne, VIC, AustraliaTurner Institute Brain Mental Health, Australia https://orcid.org/0000-0001-9383-1644 Sleep, Volume 46, Issue 5, May 2023, zsac310, https://doi.org/10.1093/sleep/zsac310 Published: 28 January 2023 history Received: 07 December 2022 Corrected typeset:

Language: Английский

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Adverse Pregnancy Outcomes and Pharyngeal Flow Limitation during Sleep: Nulliparous Pregnancy Outcomes Study Monitoring Mothers-to-be (nuMoM2b)

European Respiratory Journal, Journal Year: 2024, Volume and Issue: 64(1), P. 2301707 - 2301707

Published: April 4, 2024

Background Pharyngeal flow limitation during pregnancy may be a risk factor for adverse outcomes but was previously challenging to quantify. Our objective determine whether novel measure of identifies an increased pre-eclampsia (primary outcome) and other in prospective cohort: Nulliparous Pregnancy Outcomes Study Monitoring Mothers-to-be (nuMoM2b). Methods Flow severity scores (0%=fully obstructed, 100%=open airway), quantified from breath-by-breath airflow shape, were obtained home sleep tests early (6–15 weeks) mid (22–31 pregnancy. Multivariable logistic regression associations between (median overnight severity, both time-points averaged) pre-eclampsia, adjusting maternal age, body mass index (BMI), race, ethnicity, chronic hypertension wakefulness. Secondary hypertensive disorders (HDP), gestational diabetes mellitus (GDM) infant birthweight. Results Of 1939 participants with data at (mean± sd age 27.0±5.4 years BMI 27.7±6.1 kg·m −2 ), 5.8% developed 12.7% HDP 4.5% GDM. Greater associated risk: adjusted OR 2.49 (95% CI 1.69–3.69) per 2 increase severity. Findings persisted women without apnoea (apnoea–hypopnoea <5 events·h −1 ). (OR 1.77 1.33–2.38)) reduced birthweight (83.7 31.8–135.6) g), not Conclusions is lower provide target mitigating the consequences disordered breathing

Language: Английский

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Sleep apnea endotypes: from the physiological laboratory to scalable polysomnographic measures

Frontiers in Sleep, Journal Year: 2023, Volume and Issue: 2

Published: May 24, 2023

Obstructive sleep apnea (OSA) is a common disorder characterized by recurrent upper airway obstruction during sleep. Despite the availability of continuous positive pressure (CPAP) as gold standard treatment, it not well tolerated all patients. Accordingly, research has increasingly focused on developing methods for OSA endotyping, which aims to identify underlying pathophysiological mechanisms help guide treatment CPAP-intolerant individuals. Four key endotypic traits have been identified, namely: collapsibility, muscle compensation, arousal threshold and loop gain. However, most extracting these require specialized training equipment available in clinic, hampered ability assess full impact outcomes. This paper provide an overview current focusing Endo-Phenotyping Using Polysomnography (PUP) method its cloud-based extension, PUPpy, offer scalable accessible ways estimate from polysomnography. We discuss potential facilitate precision medicine patients challenges that need be addressed their translation into clinical practice.

Language: Английский

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Flow Limitation Is Associated with Excessive Daytime Sleepiness in Individuals without Moderate or Severe Obstructive Sleep Apnea

Annals of the American Thoracic Society, Journal Year: 2024, Volume and Issue: 21(8), P. 1186 - 1193

Published: March 26, 2024

Rationale: Moderate-severe obstructive sleep apnea (OSA) (apnea-hypopnea index [AHI], >15 events/h) disturbs through frequent bouts of and is associated with daytime sleepiness. However, many individuals without moderate-severe OSA (i.e., AHI <15 also report Objectives: To test the hypothesis that sleepiness in events/h group a consequence substantial flow limitation absence overt reductions airflow apnea/hypopnea). Methods: A total 1,886 participants from MESA cohort were analyzed for frequency polysomnogram-recorded nasal signal. Excessive (EDS) was defined by an Epworth Sleepiness Scale score ⩾11. Covariate-adjusted logistic regression assessed association between EDS (binary dependent variable) (continuous) events/h. Results: 772 included primary analysis. Flow (odds ratio, 2.04; 95% confidence interval, 1.17-3.54; per 2-standard deviation increase frequency) after adjusting age, sex, body mass index, race/ethnicity, duration. This effect size did not appreciably change AHI. Conclusions: In events/h, increasing 2 standard deviations twofold risk EDS. Future studies should investigate addressing low-AHI as potential mechanism ameliorating

Language: Английский

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Guidelines for the assessment and management of residual sleepiness in obstructive apnea-hypopnea syndrome

Respiratory Medicine and Research, Journal Year: 2024, Volume and Issue: 86, P. 101105 - 101105

Published: April 6, 2024

Language: Английский

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Increased Flow Limitation During Sleep Is Associated With Increased Psychomotor Vigilance Task Lapses in Individuals With Suspected OSA

CHEST Journal, Journal Year: 2023, Volume and Issue: 165(4), P. 990 - 1003

Published: Dec. 2, 2023

Language: Английский

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Mandibular jaw movements as a non-invasive measure of respiratory effort during sleep: application in clinical practice

Frontiers in Sleep, Journal Year: 2023, Volume and Issue: 2

Published: May 12, 2023

Assessment of respiratory effort (RE) is key for characterization events. The discrimination between central and obstructive events important because these are caused by different physio-pathological mechanisms require treatment approaches. Many the currently available options home sleep apnea testing either do not measure RE, or RE signal recording always reliable. This due to a variety factors, including instance wrong placement inductance plethysmography (RIP) sensors leading artifacts loss. Monitoring mandibular jaw movements (MJM) provides ability accurately through single point contact sensor placed on patient's chin. inertial unit included in capturing technology overnight positional stability provide robust MJM bio-signal detect sleep-disordered breathing (SDB). pharyngeal muscles attached mandible directly, indirectly via hyoid bone. motor trigeminal nerve impulses contract relax generate discrete that reflect changes during sleep. Indeed, drive utilizes lower as fine-tuning lever stiffen upper airway musculature safeguard patency pharynx. Associations properties both physiological pathological patterns have been extensively studied. These show close relationship function similar levels measured simultaneously reference bio-signals such esophageal pressure crural diaphragmatic electromyography. Specific waveforms, frequencies, amplitudes seen across disturbances recommended be scored American Academy Sleep Medicine. Moreover, monitoring information about sleep/wake states arousals, which enables total time measurement accurate calculation conventional hourly indices. can interpreted its automatic analysis using dedicated machine learning algorithm delivers comprehensive clinically informative study report physicians with necessary aid diagnosis SDB.

Language: Английский

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Obstructive Sleep Apnea and Role of the Diaphragm

Cureus, Journal Year: 2022, Volume and Issue: unknown

Published: Sept. 10, 2022

Obstructive sleep apnea (OSA) causes multiple local and systemic pathophysiological consequences, which lead to an increase in morbidity mortality patients suffering from this disorder. OSA presents with various nocturnal events of apnoeas or hypopneas sub-clinical airflow limitations during wakefulness. involves a large percentage the population, particularly men, but estimate could be much broader than data literature. Most research carried out muscle field is understand presence chronic desaturation focus on genioglossus other muscles related dilating upper airways. Sparse has been published regarding diaphragm muscle, main structure insufflate air into The article reviews functional anatomy used open respiratory tract non-physiological adaptation that follows OSA, as well pathological adaptive aspects muscle. intent text highlight disparity clinical interest between dilator diaphragm, trying stimulate approach patient evaluation.

Language: Английский

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Flow Limitation Frequency

CHEST Journal, Journal Year: 2024, Volume and Issue: 165(4), P. 769 - 770

Published: April 1, 2024

Language: Английский

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A novel method to quantify breathing effort from respiratory mechanics and esophageal pressure

Journal of Applied Physiology, Journal Year: 2024, Volume and Issue: 136(6), P. 1418 - 1428

Published: April 11, 2024

Breathing effort is important to quantify understand mechanisms underlying central and obstructive sleep apnea, respiratory-related arousals, the timing effectiveness of invasive or noninvasive mechanically assisted ventilation. Current quantitative methods evaluate breathing rely on inspiratory esophageal epiglottic pressure swings changes in diaphragm electromyographic (EMG) activity, where units are problematic interpret compare between individuals measured This paper derives a novel method directly comparable with ventilation by applying respiratory mechanics first principles convert continuous transpulmonary measurements into "attempted" airflow expected have arisen without upper airway obstruction. The was evaluated using data from 11 subjects undergoing overnight polysomnography, including six patients obesity severe apnea (OSA), one who also had frequent events, five healthy-weight controls. Classic showed excellent fits volume pressures during wake periods stable unobstructed (means ± SD,

Language: Английский

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