Reflex swallowing elicited by electrical stimulation in obstructive sleep apnea patients: a preliminary study

This study tested whether electrical stimulation of the pharyngeal mucosa is able to induce reliably the swallowing reflex in awake and asleep obstructive sleep apnea (OSA) patients, and whether the induced reflexes affect the sleep variables. In addition, the latency, occurrence, and morphology of swallows were evaluated. Eight patients received an esophageal catheter that was used on three consecutive nights for electrical stimulation and manometric recordings. The electrical stimulation proved itself safe, but its efficiency in inducing swallows sank from 80.0% in awake to 37.4% in sleeping subjects and was lowest in the sleep stage N3. The swallowing reflex was triggered with a mean latency of 3.69 ± 0.70 s, was predominantly induced in the hyperventilation phase, and had no significant effect on the subject's sleep variables. These findings indicate that electrical stimulation can more effectively trigger the swallowing reflex while the subjects are awake than during sleep without showing remarkable clinical benefits in terms of apnea-hypopnea index (AHI) improvement.
Source: Respiratory Physiology and Neurobiology - Category: Respiratory Medicine Source Type: research

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Patients interested in testing themselves at home for sleep apnea now have a few more options. Earlier this year Itamar Medical Ltd. introduced its third-generation WatchPAT home sleep apnea test (HSAT), the WatchPAT 300, and in June 2019, it debuted WatchPAT ONE, which the company calls the first and only disposable HSAT in the market. This month Blue Shield of California (BSC) and the Blue Cross Blue Shield Federal Employee Plan (BCBS FEP) included WatchPAT as a covered HSAT, Itamar reported in a news release. It added that changes in the U.S. Centers for Medicare &Medicaid Services (CMS) 2020 Fee Schedule are expect...
Source: MDDI - Category: Medical Devices Authors: Tags: Digital Health Source Type: news
Background: Obstructive sleep apnea (OSA) has been associated with worsening heart failure. Sleep fragmentation (SF), one of the major hallmarks of OSA, induces inflammation, oxidative stress and sympathetic activation, and could potentially contribute to OSA-induced cardiovascular consequences. However, it remains unclear whether SF per se is deleterious to cardiac function.Aim: To evaluate the effect of SF mimicking OSA on echocardiographically-measured cardiac function (ECHO) in otherwise healthy mice and in a murine model of heart failure.Methods: Forty C57BL/6J male mice were randomized into 4 treatment groups: contro...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Sleep and control of breathing Source Type: research
Background: Obstructive sleep apnea (OSA) is associated with an increased risk of cardiovascular burden, but the underlying mechanisms are not well understood. The aim of this investigation was to elucidate the effect of continuous positive airway pressure(CPAP)-withdrawal on neurometabolic and cardiometabolic markers in OSA.Methods: We evaluated 70 patients (mean age 61±10 years, 82% male)treated with CPAP for>1 year with high compliance in two 2-week, parallel, randomised controlled trials. Blood samples were taken at baseline in the morning prior to CPAP interruption, and after two weeks of CPAP withdrawal. Sa...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Sleep and control of breathing Source Type: research
Purpose of review This review provides a contemporary review of sleep apnea with emphasis on definitions, epidemiology, and consequences. Recent findings Amyloid β-42 is one of the main peptides forming amyloid plaques in the brains of Alzheimer patients. Poorer sleep quality and shorter sleep duration have been associated with a higher amyloid burden. Decreased sleep time in the elderly is a precipitating factor in amyloid retention. Studies have shown that the dysregulation of the homeostatic balance of the major inhibitory and excitatory amino acid neurotransmitter systems of gamma-aminobutyric acid (GABA) and...
Source: Current Opinion in Pulmonary Medicine - Category: Respiratory Medicine Tags: SLEEP AND RESPIRATORY NEUROBIOLOGY: Edited by Lee Brown and Brian D. Kent Source Type: research
Source: Dysphagia - Category: Speech-Language Pathology Source Type: research
CONCLUSION: In patients with severe OSA and clinically apparent ED, CPAP therapy was associated with a decrease in nocturnal BP and serum noradrenaline levels, as well as a normalization of the 24-h BP profile. PMID: 31463779 [PubMed - as supplied by publisher]
Source: Sleep and Breathing - Category: Sleep Medicine Authors: Tags: Sleep Breath Source Type: research
akasawa Obstructive sleep apnea (OSA) causes many systemic disorders via mechanisms related to sympathetic nerve activation, systemic inflammation, and oxidative stress. OSA typically shows repeated sleep apnea followed by hyperventilation, which results in intermittent hypoxia (IH). IH is associated with an increase in sympathetic activity, which is a well-known pathophysiological mechanism in hypertension and insulin resistance. In this review, we show the basic and clinical significance of IH from the viewpoint of not only systemic regulatory mechanisms focusing on pulmonary circulation, but also cellular mechanisms...
Source: International Journal of Environmental Research and Public Health - Category: Environmental Health Authors: Tags: Review Source Type: research
Authors: Isobe Y, Nakatsumi Y, Sugiyama Y, Hamaoka T, Murai H, Takamura M, Kaneko S, Takada S, Takamura T Abstract Objective We aimed to identify obstructive sleep apnea syndrome (OSAS) severity indices reflecting the anthropometric and metabolic characteristics of patients with OSAS. Methods A total of 76 patients with OSAS underwent nasal continuous positive airway pressure (nCPAP). We also investigated the effects of nCPAP on OSAS-associated muscle sympathetic nerve activity (MSNA), risk for cardiovascular diseases, and insulin secretion and sensitivity. Results Among the OSAS severity indices, HbA1c was signifi...
Source: Internal Medicine - Category: Internal Medicine Tags: Intern Med Source Type: research
We present herein two siblings with DM1, a thin elder brother and an obese younger sister with visceral fat accumulation. Although neither had voluntary symptoms related to respiratory dysfunction, their apnea-hypopnea indices revealed severe SAS and subsequent arterial blood gases studies showed hypercapnia as well as hypoxia, suggesting central nervous system involvement with peripheral respiratory dysfunction. Noninvasive positive pressure ventilation during sleep was started following pulmonary assessment. Respiratory function should be assessed in DM1 patients, even those free of respiratory symptoms, because respirat...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
CONCLUSION: Treatment of OSA in patients with systolic HF improves respiratory indices but does not have a favorable effect on sleep quality. While OSA per se was associated with an increase in sympathetic drive, APAP treatment was not associated with a reduction in sympathetic drive. After 6 months of treatment, there was even a trend towards additional increases in sympathetic drive in the APAP group. PMID: 31240541 [PubMed - as supplied by publisher]
Source: Sleep and Breathing - Category: Sleep Medicine Authors: Tags: Sleep Breath Source Type: research
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