Global burden of sleep‐disordered breathing and its implications

Respirology, Journal Year: 2020, Volume and Issue: 25(7), P. 690 - 702

Published: May 21, 2020

ABSTRACT One‐seventh of the world's adult population, or approximately one billion people, are estimated to have OSA. Over past four decades, obesity, main risk factor for OSA, has risen in striking proportion worldwide. In 5 years, WHO estimates global obesity affect almost two adults. A second major OSA is advanced age. As prevalence ageing population and increases, vulnerability towards having increases. addition these traditional factors, studies reveal select contributing features phenotypes, including extreme phenotypes symptom clusters that deserve further examination. Untreated associated with significant comorbidities mortality. These represent a tremendous threat individual health. Beyond personal toll, economic costs far‐reaching, affecting individual, family society directly indirectly, terms productivity public safety. better understanding pathophysiology, ethnic similarities differences needed facilitate management this chronic disease. some countries, measures disease burden sparse. its projected increase, infrastructure diagnose manage will need adapt. The use novel approaches (electronic health records artificial intelligence) stratify risk, treatment necessary. Together, unified multi‐disciplinary, multi‐organizational, approach be

Language: Английский

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International Consensus Statement on Obstructive Sleep Apnea

International Forum of Allergy & Rhinology, Journal Year: 2022, Volume and Issue: 13(7), P. 1061 - 1482

Published: Sept. 7, 2022

Evaluation and interpretation of the literature on obstructive sleep apnea (OSA) allows for consolidation determination key factors important clinical management adult OSA patient. Toward this goal, an international collaborative multidisciplinary experts in evaluation treatment have produced International Consensus statement Obstructive Sleep Apnea (ICS:OSA).

Language: Английский

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Pathophysiological mechanisms and therapeutic approaches in obstructive sleep apnea syndrome

Signal Transduction and Targeted Therapy, Journal Year: 2023, Volume and Issue: 8(1)

Published: May 25, 2023

Abstract Obstructive sleep apnea syndrome (OSAS) is a common breathing disorder in which the airways narrow or collapse during sleep, causing obstructive apnea. The prevalence of OSAS continues to rise worldwide, particularly middle-aged and elderly individuals. mechanism upper airway incompletely understood but associated with several factors, including obesity, craniofacial changes, altered muscle function airway, pharyngeal neuropathy, fluid shifts neck. main characteristics are recurrent pauses respiration, lead intermittent hypoxia (IH) hypercapnia, accompanied by blood oxygen desaturation arousal sharply increases risk diseases. This paper first briefly describes epidemiology, incidence, pathophysiological mechanisms OSAS. Next, alterations relevant signaling pathways induced IH systematically reviewed discussed. For example, can induce gut microbiota (GM) dysbiosis, impair intestinal barrier, alter metabolites. These ultimately secondary oxidative stress, systemic inflammation, sympathetic activation. We then summarize effects on disease pathogenesis, cardiocerebrovascular disorders, neurological metabolic diseases, cancer, reproductive COVID-19. Finally, different therapeutic strategies for caused causes proposed. Multidisciplinary approaches shared decision-making necessary successful treatment future, more randomized controlled trials needed further evaluation define what treatments best specific patients.

Language: Английский

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Evaluation and Management of Adults with Obstructive Sleep Apnea Syndrome

Lung, Journal Year: 2021, Volume and Issue: 199(2), P. 87 - 101

Published: March 13, 2021

Language: Английский

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Tirzepatide for the treatment of obstructive sleep apnea: Rationale, design, and sample baseline characteristics of the SURMOUNT -OSA phase 3 trial

Contemporary Clinical Trials, Journal Year: 2024, Volume and Issue: 141, P. 107516 - 107516

Published: March 26, 2024

Weight reduction is a standard recommendation for obstructive sleep apnea (OSA) treatment in people with obesity or overweight; however, weight loss can be challenging to achieve and maintain without bariatric surgery. Currently, no approved anti-obesity medication has demonstrated effectiveness OSA management. This study evaluating the efficacy safety of tirzepatide moderate severe obesity. SURMOUNT-OSA, randomized, placebo -controlled, 52-week phase 3 trial, investigating (apnea hypopnea- index ≥15 events/h) participants (body mass ≥30 kg/m2) an established diagnosis. SURMOUNT-OSA made 2 intervention-specific appendices (ISAs): ISA-1 includes current treatment, ISA-2 using positive airway pressure therapy. Overall, 469 have been randomized 1:1 receive across master protocol (ISA-1, n = 234; ISA-2, 235). All are also receiving lifestyle intervention reduction. The primary endpoint individual ISAs difference response, as measured by polysomnography, between arms at week 52. Secondary endpoints include apnea-specific hypoxic burden, functional outcomes, cardiometabolic biomarkers. trial employs digital wearables, including home testing capture time improvement accelerometry daily physical activity assessment, evaluate exploratory outcomes. brings novel design investigate if provides clinically meaningful obesity-related targeting underlying etiology. Trial registration: ClinicalTrials.gov, NCT05412004

Language: Английский

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Estimating direct tissue effects versus weight loss effects of incretin-based drugs for obesity on various chronic conditions

The Lancet Diabetes & Endocrinology, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 1, 2025

Language: Английский

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Early‐to‐Midlife Body Mass Index Trajectories and Obstructive Sleep Apnoea Risk 10 Years Later

Respirology, Journal Year: 2025, Volume and Issue: 30(5), P. 435 - 445

Published: Feb. 11, 2025

While short-term weight changes are known to influence obstructive sleep apnoea (OSA), the impact of body mass index (BMI) over life course has been poorly documented. We examined association between BMI trajectories from childhood middle age and adult OSA, 10 years later. Five were previously identified in population-based cohort Tasmanian Longitudinal Health Study (TAHS), using eight time-point 5 43 years. The primary outcome was probable OSA at 53 years, defined STOP-Bang questionnaire, with Berlin OSA-50 questionnaires used ensure consistency findings. Clinically significant diagnosed as self-reported medical diagnosis or mild symptoms moderate-to-severe type-4 studies. Associations multivariable logistic regression. Compared average trajectory, child average-increasing (aOR = 5.28, 95% CI 3.38-8.27) persistently high 3.73, 2.06-6.74) associated increased risk OSA. These associations consistent when clinically (child trajectory: aOR 2.95, 1.30-6.72; 2.23, 0.82-6.09). Individuals belonging low trajectory less likely than have Notably, high-decreasing not Physicians public should be aware potential middle-aged adults is continuously increasing mid-40s. Obese children who subsequently lose higher age-a novel key finding.

Language: Английский

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Bi-directional relationships between co-morbid insomnia and sleep apnea (COMISA)

Sleep Medicine Reviews, Journal Year: 2021, Volume and Issue: 60, P. 101519 - 101519

Published: June 23, 2021

Language: Английский

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Endotypes and phenotypes in obstructive sleep apnea

Current Opinion in Pulmonary Medicine, Journal Year: 2020, Volume and Issue: 26(6), P. 609 - 614

Published: Sept. 3, 2020

Purpose of review The purpose this is to describe the variability obstructive sleep apnea (OSA), both from a standpoint underlying mechanisms and in terms clinical manifestations. Recent findings data suggest that not all patients with get their disease for same reason. As such, no one variable effective at defining which do or have apnea. Identifying mechanism(s) OSA an individual helpful as it can help determine whether personalized therapy could be developed based on individual's characteristics. In addition, these may predicting response prognosticating regarding future complications. Summary heterogeneous highly varying mechanisms. has manifestations definable subsets having risk particular Future studies will identify using clinically accessible tools then focus individualized treatment approaches.

Language: Английский

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Myofunctional Therapy App for Severe Apnea–Hypopnea Sleep Obstructive Syndrome: Pilot Randomized Controlled Trial

JMIR mhealth and uhealth, Journal Year: 2020, Volume and Issue: 8(11), P. e23123 - e23123

Published: Oct. 22, 2020

Myofunctional therapy has demonstrated efficacy in treating sleep-disordered breathing. We assessed the clinical use of a new mobile health (mHealth) app that uses smartphone to teach patients with severe obstructive sleep apnea-hypopnea syndrome (OSAHS) perform oropharyngeal exercises.We conducted pilot randomized trial evaluate effects OSAHS.Forty OSAHS (apnea-hypoxia index [AHI]>30) were enrolled prospectively and into an intervention group used for 90 sessions or control group. Anthropometric measures, Epworth Sleepiness Scale (0-24), Pittsburgh Sleep Quality Index (0-21), Iowa Oral Performance Instrument (IOPI) scores, oxygen desaturation measured before after intervention.After intervention, 28 remained. No significant changes observed group; however, showed improvements most metrics. AHI decreased by 53.4% from 44.7 (range 33.8-55.6) 20.88 (14.02-27.7) events/hour (P<.001). The 46.5% 36.31 (27.19-43.43) 19.4 (12.9-25.98) (P=.003). IOPI maximum tongue score increased 39.83 (35.32-45.2) 59.06 (54.74-64.00) kPa (P<.001), lip 27.89 (24.16-32.47) 44.11 (39.5-48.8) correlated significantly (Pearson correlation coefficient -0.56 -0.46, respectively; both P<.001). 10.33 (8.71-12.24) 5.37 (3.45-7.28) but did not change significantly.Orofacial exercises performed using mHealth reduced severity symptoms, represent promising treatment OSAHS.Spanish Registry Clinical Studies AWGAPN-2019-01, ClinicalTrials.gov NCT04438785; https://clinicaltrials.gov/ct2/show/NCT04438785.

Language: Английский

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