Obstructive sleep apnea: transition from pathophysiology to an integrative disease model

Journal of Sleep Research, Год журнала: 2022, Номер 31(4)

Опубликована: Май 24, 2022

Summary Obstructive sleep apnea (OSA) is characterised by recurring episodes of upper airway obstruction during and the fundamental abnormality reflects inability dilating muscles to withstand negative forces generated within inspiration. Factors that result in narrowing oropharynx such as abnormal craniofacial anatomy, soft tissue accumulation neck, rostral fluid shift recumbent position increase collapsing airway. The counteracting muscles, especially genioglossus, are negatively influenced onset, inadequacy genioglossus responsiveness, ventilatory instability, post arousal, loop gain. OSA frequently associated with comorbidities include metabolic, cardiovascular, renal, pulmonary, neuropsychiatric, there growing evidence bidirectional relationships between comorbidity, for heart failure, metabolic syndrome, stroke. A detailed understanding complex pathophysiology encourages development therapies targeted at pathophysiological endotypes facilitates a move towards precision medicine potential alternative continuous positive pressure therapy selected patients.

Язык: Английский

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Airway Analysis and Morphometric Assessment of Dental Arches in Obstructive Sleep Apnea Patients

Journal of Clinical Medicine, Год журнала: 2025, Номер 14(2), С. 296 - 296

Опубликована: Янв. 7, 2025

Background: Obstructive sleep apnea is a sleep-related breathing disorder associated with craniofacial morphology and dental arches. The aim of this study was to evaluate the correlation between obstructive morphometry arches upper airways. Methods: Forty patients were enrolled in study, polysomnographic parameters evaluated hypopnea index (AHI) oxygen desaturation (ODI). Dental measurements taken from 3D models included anterior arch widths, posterior maxillary mandibular lengths, palatal surface area. A cone beam computed tomography (CBCT) evaluation also performed. Results: In moderate OSA, width significantly correlated both minimal airway area (rho = 0.65, p < 0.01) its transverse diameter 0.68, 0.01). Similarly, severe showed significant total volume 1, 0.01), Conclusions: Craniofacial malocclusion can contribute syndrome.

Язык: Английский

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Night-to-Night Variability of Polysomnography-Derived Physiologic Endotypic Traits in Patients With Moderate to Severe OSA

CHEST Journal, Год журнала: 2023, Номер 163(5), С. 1266 - 1278

Опубликована: Янв. 4, 2023

Emerging data suggest that determination of physiologic endotypic traits (eg, loop gain) may enable precision medicine in OSA.

Язык: Английский

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Translation of obstructive sleep apnea pathophysiology and phenotypes to personalized treatment: a narrative review

Frontiers in Neurology, Год журнала: 2023, Номер 14

Опубликована: Авг. 24, 2023

Obstructive Sleep Apnea (OSA) arises due to periodic blockage of the upper airway (UA) during sleep, as negative pressure generated inspiration overcomes force exerted by UA dilator muscles maintain patency. This imbalance is primarily seen in individuals with a narrowed UA, attributable factors such inherent craniofacial anatomy, neck fat accumulation, and rostral fluid shifts supine posture. Sleep-induced attenuation dilating muscle responsiveness, respiratory instability, high loop gain further exacerbate obstruction. The widespread comorbidity profile OSA, encompassing cardiovascular, metabolic, neuropsychiatric domains, suggests complex bidirectional relationships conditions like heart failure, stroke, metabolic syndrome. Recent advances have delineated distinct OSA phenotypes beyond mere obstruction frequency, showing links specific symptomatic manifestations. It vital bridge gap between measurable patient characteristics, phenotypes, underlying pathophysiological traits enhance our understanding its interplay related outcomes. knowledge could stimulate development tailored therapies targeting phenotypic endotypes. review aims elucidate multifaceted pathophysiology focusing on functional traits, clinical manifestations, comorbidities. ultimate objective pave way for more personalized treatment paradigm offering alternatives continuous positive therapy selected patients thereby optimizing efficacy adherence. There an urgent need strategies ever-evolving field sleep medicine, we progress from ‘one-size-fits-all’ ‘tailored-therapy’ approach.

Язык: Английский

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A Narrative Review of Self-Reported Scales to Evaluate Depression and Anxiety Symptoms in Adult Obstructive Sleep Apnea Patients

Medicina, Год журнала: 2024, Номер 60(2), С. 261 - 261

Опубликована: Фев. 2, 2024

Background and Objectives: Obstructive sleep apnea (OSA) is a prevalent chronic condition that has been associated with mental disorders like depression anxiety. This study intends to provide practical overview of the most relevant self-reported self-rating scales assess anxiety in OSA patients. Materials Methods: A search for articles was performed using PubMed, Google Scholar, Semantic Scholar combination words obstructive apnea, depression, anxiety, scales. The tools were ordered by type (screening rating) arranged chronologically according year publication. Results: Three identified assessing which Center Epidemiologic Studies Depression Scale (CES-D), Hospital Anxiety (HADS-D), Patient Health Questionnaire-9 (PHQ-9). For rating two discussed: Zung Self-Rating (SDS) Beck Inventory (BDI), three versions (the BDI, BDI-II, Fast Screen (BDI-FS)). Generalized Disorder-7 (GAD-7) scale identified. Two reviewed anxiety: State-Trait (STAI) (BAI). Each accompanied brief description its practicality psychometric qualities an analysis strengths limitations. Conclusions: findings this review will contribute understanding importance health comorbidities context OSA, ultimately guiding clinical practice future research area.

Язык: Английский

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POST-TRAUMATIC STRESS DISORDER, INSOMNIA, HEART RATE VARIABILITY AND METABOLIC SYNDROME (NARRATIVE REVIEW)

Proceedings of the Shevchenko Scientific Society Medical Sciences, Год журнала: 2024, Номер 73(1)

Опубликована: Июнь 28, 2024

This narrative review was aimed to analyze the scientific data about association of post-traumatic stress disorder, insomnia, obstructive sleep apnea syndrome, dyssomnias, heart rate variability, metabolic type 2 diabetes mellitus, and cardiovascular autonomic neuropathy, along with potential pathophysiological mechanisms underlying these associations. The results experimental, cohort, prospective, randomized clinical studies provide evidence common pathogenetic pathways contributing their development. Searches were conducted in Scopus, Science Direct (from Elsevier), EBSCO, PubMed databases, including Medline databases. Additionally, a manual search publication bibliographies undertaken uncover research outcomes not accessible through online searches.

Язык: Английский

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Obstructive Sleep Apnea

Primary Care Clinics in Office Practice, Год журнала: 2024, Номер 52(1), С. 47 - 59

Опубликована: Ноя. 16, 2024

Язык: Английский

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Systematic Item Content and Overlap Analysis of Self-Reported Multiple Sleep Disorder Screening Questionnaires in Adults

Journal of Clinical Medicine, Год журнала: 2023, Номер 12(3), С. 852 - 852

Опубликована: Янв. 20, 2023

Sleep disorders are defined on the basis of diagnostic criteria presented in medical classifications. However, no consensus has emerged exact list operational symptoms that should be systematically investigated field sleep medicine. We propose a systematic analysis figure set self-reported multiple disorder screening questionnaires for adult populations, to identify content overlap probe presence central symptoms, and highlight potential level heterogeneity among questionnaires. The method comprises three steps: (i) selection questionnaires; (ii) item extraction selection; (iii) from items. Frequency (Jaccard Index) analyzed. extracted 469 items provide 60 different 12 Insomnia, somnolence, sleep-related breathing were found all mean evaluated with Jaccard Index is 0.44, i.e., moderate similarity. Despite limitations related symptom harmonization, this study underlines need standardize contents medicine order enhance practicability, reliability, validity diagnoses.

Язык: Английский

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Symptom content analysis of OSA questionnaires: time to identify and improve relevance of diversity of OSA symptoms?

Journal of Clinical Sleep Medicine, Год журнала: 2024, Номер 20(7), С. 1105 - 1117

Опубликована: Фев. 29, 2024

Obstructive sleep apnea (OSA) is a heterogeneous condition covering many clinical phenotypes in terms of the diversity symptoms. Patient-based OSA screening questionnaires used routine practice contain significantly varying contents that can impact reliability and validity screening. We investigated to what extent common patient-based differ or overlap their item content by conducting rigorous, methodical, quantified analysis.

Язык: Английский

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Risk of Obstructive Sleep Apnea in Patients With Muscle Tension Dysphonia: A Prospective Pilot Study

Journal of Voice, Год журнала: 2025, Номер unknown

Опубликована: Янв. 1, 2025

Язык: Английский

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