Treating sleep apnea greatly improves stroke patients' neurological & functional recovery
(Regenstrief Institute) A large, randomized controlled trial has found that commencing treatment for sleep apnea as soon as possible after a stroke or a mini-stroke improves speech impairment and other neurological symptoms as well as walking and other physical functioning. Benefits of sleep apnea treatment after stroke are greater than benefits from tPA.
Conclusion: The causative mechanism seems to be multifactorial, but occurrence may differ depending on the stroke stage. Combined use of subjective and objective assessment methods may increase PSSD detection and early treatment.
ConclusionSleep apnea is associated with an increased risk of complications and resource utilization in patients undergoing shoulder arthroscopy.
Background: It is established that a strong correlation exists between morbid obesity and obstructive sleep apnea (OSA). OSA has been shown to be associated with increased incidence of stroke, hypertension and coronary artery disease. Current evidence suggests that a large number of patients with OSA deny experiencing symptoms. Despite these findings, there is a lack of data regarding the incidence of undiagnosed OSA in patients with obesity.
Dongmei Ye, Chen Chen, Dongdong Song, Mei Shen, Hongwei Liu, Surui Zhang, Hong Zhang, Jingya Li, Wenfei Yu, Qiwen Wang
Authors: Peng YJ, Zhang X, Nanduri J, Prabhakar NR Abstract Sleep apnea with periodic cessation of breathing during sleep is a highly prevalent respiratory disorder affecting an estimated 10% of adults. Patients with sleep apnea exhibit several co-morbidities including hypertension, stroke, disrupted sleep, and neurocognitive and metabolic complications. Emerging evidence suggests that a hyperactive carotid body (CB) chemo reflex is an important driver of apneas in sleep apnea patients. Gasotransmitters carbon monoxide (CO) and hydrogen sulfide (H2S) play important roles in oxygen sensing by the CB. We tested the h...
In 2015, a multi-national randomized controlled phase IV clinical trial of adaptive servo-ventilation for the management of heart failure with central sleep apnea was halted in progress because more patients in the study group were dying than in the control group. One year later, another large clinical trial reported results on the effectiveness of continuous positive airway pressure (CPAP) in preventing sudden death and other cardiovascular events such as heart attack and stroke in patients with pre-existing vascular disease as well as obstructive sleep apnea.
Continuous positive airway pressure (CPAP) has been shown to improve functional, motor and cognitive outcomes in post-stroke obstructive sleep apnea (OSA). However, rates of CPAP adherence are often low and factors impacting CPAP adherence remain under-explored. Our objective was to determine predictors of CPAP adherence in patients who had a stroke or transient ischemic attack (TIA).
This article will review the effectiveness of bariatric procedures on the remission and improvement of diabetes and its implicated mechanisms. PMID: 30298760 [PubMed]