Advanced Concepts in the Pathophysiology of Obstructive Sleep Apnea.
Advanced Concepts in the Pathophysiology of Obstructive Sleep Apnea. Adv Otorhinolaryngol. 2017;80:7-16 Authors: White DP Abstract The primary pathological event in the disorder obstructive sleep apnea (OSA) is the partial or complete closure of the pharyngeal airway during sleep in an individual with a widely patent airway during wakefulness. This yields an apnea or hypopnea with resulting hypoxia and hypercapnia, and most often requires an arousal to terminate the event. These events occur in a repetitive manner during sleep, yielding intermittent hypoxia and sleep fragmentation with their associated adverse effects on the health and quality of life of the afflicted individual. Here, we focus on the events leading up to these apneas and hypopneas, primarily addressing pharyngeal anatomy, upper airway muscle control, the respiratory arousal threshold, and ventilatory control instability in OSA pathophysiology. PMID: 28738382 [PubMed - in process]
ConclusionsThe presence of dysphagia in patients with moderate to severe apnea is frequent and subclinical, reinforcing the need to investigate this symptom in this group of patients. However, the presence of dysphagia did not result in worsening in patients' quality of life, suggesting that, although frequent, its effect is mild. There was no relevance regarding the association of clinical and polysomnographic parameters with the presence of dysphagia.ResumoIntroduçãoExistem evidências de que o trauma ocasionado pelo ronco na faringe poderia ocasionar disfagia em pacientes com apneia obstrutiva do sono...
Authors: Marques JG PMID: 31721486 [PubMed - in process]
The dual-acting dopamine and norepinephrine reuptake inhibitor showed durable effects in reducing excessive sleepiness in patients with narcolepsy or obstructive sleep apnea (OSA).International Approvals
Solriamfetol is a dual-acting dopamine and norepinephrine reuptake inhibitor shown to improve wakefulness in adults living with excessive daytime sleepiness associated with narcolepsy or obstructive sleep apnea If approved by the European Commission for... Biopharmaceuticals, Regulatory Jazz Pharmaceuticals, solriamfetol, narcolepsy
Brooks DM, Brooks LJ. Reevaluating norms for childhood obstructive sleep apnea.J Clin Sleep Med. 2019;15(11):1557–1558.
Conclusions:The differential results of heritability and familial aggregation of OSA in normal weight and overweight subgroups substantiated the recommendation of separating childhood OSA into normal weight and overweight subtypes. In the overweight subgroup, there may be obesity-independent components involved in the genetic variance of OAHI, although a significant proportion of the genetic variance is shared with obesity.Citation:Au CT, Zhang J, Cheung JYF, Chan KCC, Wing YK, Li AM. Familial aggregation and heritability of obstructive sleep apnea using children probands.J Clin Sleep Med. 2019;15(11):1561–1570.
Conclusions:Our study suggests that patients with hypertension usingα1-adrenergic antagonists have a higher risk of sleep apnea. Routine sleep apnea screening would be beneficial for patients with hypertension who takeα1-adrenergic antagonists.Citation:Su P-L, Lin W-K, Lin C-Y, Lin S-H. Alpha-1 adrenergic-antagonist use increases the risk of sleep apnea: a nationwide population-based cohort study.J Clin Sleep Med. 2019;15(11):1571–1579.
Conclusions:OSA did not develop or worsen following primary palatoplasty. However, the oAHI increased by 5 or more events/h in approximately 20% of study participants. The presence of a syndrome was the only factor predictive of worsening OSA after palatoplasty. These findings suggest that palatoplasty does not worsen or cause OSA in most patients, and that nonsyndromic children are at low risk for the development or worsening of OSA.Citation:Bergeron M, Cohen AP, Maby A, Babiker HE, Pan BS, Ishman SL. The effect of cleft palate repair on polysomnography results.J Clin Sleep Med. 2019;15(11):1581–1586.
Study Objectives:Home sleep apnea testing (HSAT) is an efficient and cost-effective method of diagnosing obstructive sleep apnea (OSA). However, nondiagnostic HSAT necessitates additional tests that erode these benefits, delaying diagnoses and increasing costs. Our objective was to optimize this diagnostic pathway by using predictive modeling to identify patients who should be referred directly to polysomnography (PSG) due to their high probability of nondiagnostic HSAT.Methods:HSAT performed as the initial test for suspected OSA within the Veterans Administration Greater Los Angeles Healthcare System was analyzed retrospe...