共查询到20条相似文献,搜索用时 625 毫秒
1.
Purpose
The purposes of the present study are to determine the prevalence and demographic features of rapid eye movement (REM)-related sleep-disordered breathing (SDB) in Korean adults with newly diagnosed obstructive sleep apnea (OSA) and determine if REM-related SDB is associated with depressive symptoms and health-related quality of life (HRQoL) in OSA patients.Methods
In this cross-sectional study, we evaluated 1281 OSA adults who were consecutively recruited. REM-related SDB was defined as an overall apnea-hypopnea index (AHI) ≥5, an AHINREM <15, and AHIREM to AHINREM ratio of >2. The Epworth Sleepiness Scale (ESS), Beck Depression Inventory (BDI), and Medical Outcomes Study Short-Form Health survey (SF-36) were used to evaluate all patients. Multiple regression analyses were performed to determine the associations between REM-related SDB and clinical outcomes.Results
The prevalence of REM-related SDB was 18 % in this study. REM-related SDB was more commonly observed in patients with mild or moderate OSA (p < 0.001) and women (p < 0.001). The linear regression analysis showed that the presence of REM-related SDB was significantly associated with higher BDI scores, but only in men. AHIREM was positively associated with the BDI scores, but only in men with REM-related SDB. There were no differences in ESS and SF-36 scores between patients with and without REM-related SDB.Conclusions
Patients with REM-related SDB account for 18 % of Korean OSA adults. REM-related SDB was associated with depressive symptoms, but only in men. AHIREM is positively related to the degree of depressive symptoms in men with REM-related SDB.2.
Nikolaus C. Netzer János Juhász Markus Hofmann Kathrin Hohl Kingman P. Strohl Thomas E. A. H. Küpper 《Sleep & breathing》2011,15(1):107-112
Objective
The aim of the study was to investigate the need for pressure change in patients with sleep-disordered breathing (SDB) several weeks after therapy initiation. We prospectively studied 905 consecutive patients (740 men and 165 women) with SDB and therapeutic intervention with continuous positive airway pressure (CPAP)/bilevel PAP. 相似文献3.
Mohammad M. Amin Morris S. Gold Joan E. Broderick Avram R. Gold 《Sleep & breathing》2011,15(3):579-587
Purpose
We performed a pilot study to determine whether nasal continuous positive airway pressure (CPAP) alleviates the symptoms of veterans with Gulf War illness (GWI) and sleep disordered breathing (SDB). 相似文献4.
Effect of transnasal insufflation on sleep disordered breathing in acute stroke: a preliminary study
Background and Purpose
Sleep disordered breathing (SDB) is frequent in acute stroke patients and is associated with early neurologic worsening and poor outcome. Although continuous positive airway pressure (CPAP) effectively treats SDB, compliance is low. The objective of the present study was to assess the tolerance and the efficacy of a continuous high-flow-rate air administered through an open nasal cannula (transnasal insufflation, TNI), a less-intrusive method, to treat SDB in acute stroke patients.Methods
Ten patients (age, 56.8?±?10.7?years), with SDB ranging from moderate to severe (apnea?Chypopnea index, AHI, >15/h of sleep) and on a standard sleep study at a mean of 4.8?±?3.7?days after ischemic stroke (range, 1?C15?days), were selected. The night after, they underwent a second sleep study while receiving TNI (18?L/min).Results
TNI was well tolerated by all patients. For the entire group, TNI decreased the AHI from 40.4?±?25.7 to 30.8?±?25.7/h (p?=?0.001) and the oxygen desaturation index >3% from 40.7?±?28.4 to 31?±?22.5/h (p?=?0.02). All participants except one showed a decrease in AHI. The percentage of slow-wave sleep significantly increased with TNI from 16.7?±?8.2% to 22.3?±?7.4% (p?=?0.01). There was also a trend toward a reduction in markers of sleep disruption (number of awakenings, arousal index).Conclusions
TNI improves SDB indices, and possibly sleep parameters, in stroke patients. Although these changes are modest, our findings suggest that TNI is a viable treatment alternative to CPAP in patients with SDB in the acute phase of ischemic stroke. 相似文献5.
Connor P. Oates Manjula Ananthram Stephen S. Gottlieb 《Current heart failure reports》2018,15(3):123-130
Purpose of Review
This paper reviews treatment options for sleep disordered breathing (SDB) in patients with heart failure. We sought to identify therapies for SDB with the best evidence for long-term use in patients with heart failure and to minimize uncertainties in clinical practice by examining frequently discussed questions: what is the role of continuous positive airway pressure (CPAP) in patients with heart failure? Is adaptive servo-ventilation (ASV) safe in patients with heart failure? To what extent is SDB a modifiable risk factor?Recent Findings
Consistent evidence has demonstrated that the development of SDB in patients with heart failure is a poor prognostic indicator and a risk factor for cardiovascular mortality. However, despite numerous available interventions for obstructive sleep apnea and central sleep apnea, it remains unclear what effect these therapies have on patients with heart failure. To date, all major randomized clinical trials have failed to demonstrate a survival benefit with SDB therapy and one major study investigating the use of adaptive servo-ventilation demonstrated harm.Summary
Significant questions persist regarding the management of SDB in patients with heart failure. Until appropriately powered trials identify a treatment modality that increases cardiovascular survival in patients with SDB and heart failure, a patient’s heart failure management should remain the priority of medical care.6.
Background
This study aimed to assess the prevalence of complex sleep apnoea (CompSA), defined as central sleep apnoea (CSA) emerging after the initiation of continuous positive airway pressure (CPAP) therapy for obstructive sleep apnoea (OSA), in patients with normal brain natriuretic peptide (BNP) levels, along with assessing the prevalence of CSA persisting in such patients after the onset of CPAP therapy. We hypothesised that the prevalence of CompSA and persistent CSA after CPAP initiation would be low in patients with OSA and normal BNP levels. 相似文献7.
OBJECTIVE: The existence of a rapid eye movement (REM)-specific sleep-disordered breathing (SDB) has been suggested based on the finding of an association between sleepiness and respiratory disturbances confined primarily to REM sleep. The aim of the study was to define the frequency and the clinical and polysomnographic features of REM SDB in a large clinical population. METHODS: Anthropometric, clinical, and polysomnographic characteristics of 415 patients undergoing polysomnography for SDB were examined. For all patients the apnea-hypopnea index (AHI) during total sleep time, the AHI during REM (AHI-REM), and the AHI during non-REM sleep (AHI-NREM) were calculated. REM SDB was defined as an AHI-REM/AHI-NREM ratio >2. Patients were stratified according to the severity of disease in mild, moderate, and severe cases. Daytime sleepiness was assessed subjectively by the Epworth sleepiness scale (ESS), and objectively, in a subgroup of 228 patients, by the maintenance wakefulness test (MWT). RESULTS: Of the initial sample, 36.4% of cases (n = 151) fulfilled the REM SDB criteria. No significant differences in subjective complaints, medical history, and drug intake were present between REM and non-REM SDB patients, and no significant differences were found in ESS scores and mean sleep latency of the MWT between groups. A high occurrence of REM SDB was found in mild (73.1%) and moderate cases (47.2%). While in the entire group and in non-REM SDB patients a strong male prevalence was found, the incidence of REM SDB was similar in men and women. CONCLUSION: Our results show that neither clinical history nor daytime sleepiness differentiate patients with REM SDB from non-REM SDB patients. The disorder is more common in mild and moderate cases; there is an equal incidence in women and men. These findings may suggest that REM-related SDB is a part of the spectrum of SDB. 相似文献
8.
Reshma Amin Priya Sayal Aarti Sayal Colin Massicote Robin Pham Suhail Al-Saleh James Drake Indra Narang 《Canadian respiratory journal》2015,22(1):31-36
BACKGROUND:
The prevalence of sleep-disordered breathing (SDB) reported in the literature for Chiari malformation type 1 (CM1) is uniformly high (24% to 70%). In Canada, there is limited access to pediatric polysomnography (PSG). Therefore, the identification of clinical features would be invaluable for triaging these children.OBJECTIVE:
To identify demographic features, clinical symptoms/signs and radiological findings associated with SDB in a large pediatric cohort with CM1.METHODS:
A retrospective review was conducted on children with CM1 who underwent baseline PSG. Data were collected on patient demographics (age, sex, weight, height, body mass index), clinical symptoms (chart review and clinical questionnaires), diagnostic imaging of the brain and cervicothoracic spine, and medical history at the time of referral.RESULTS:
A total of 68 children were included in the review. The mean (± SD) age of the children at the time of PSG was 7.33±4.01 years; 56% (n=38) were male. There was a 49% prevalence of SDB in this cohort based on the overall apnea-hypopnea index. Obstructive sleep apnea was the predominant type of SDB. Tonsillar herniation was significantly correlated with obstructive apnea-hypopnea index (r=0.24; P=0.036).CONCLUSIONS:
A direct relationship between the degree of cerebellar tonsillar herniation and obstructive sleep apnea was demonstrated. However, further prospective studies that include neurophysiological assessment are needed to further translate the central nervous system imaging findings to predict the presence of SDB. 相似文献9.
Syed Fayyaz Hussain Yona Keich Cloonan Mohammad H. Rahbar Muhammad Islam 《Sleep & breathing》2010,14(4):345-351
Purpose
To assess prevalence of self-reported nasal congestion and its association with sleep-disordered breathing (SDB) and excessive daytime sleepiness (EDS) in Pakistani adults employed at a medical university. 相似文献10.
OBJECTIVE: To assess the prevalence of sleep-disordered breathing (SDB), continuous positive airway pressure (CPAP) acceptance, and CPAP compliance in patients who have experienced ischemic stroke. DESIGN: A case-controlled study. SETTING: A university hospital. MEASUREMENTS AND RESULTS: We recruited 23 women and 28 men, who were admitted to the hospital within 4 days of stroke onset, with a mean (+/- SD) age of 64.2 +/- 13.0 years and a body mass index (BMI) of 24.3 +/- 4.4 kg/m(2) for this study. Twenty-seven patients (53%) and 9 patients (17.6%), respectively, reported a history of snoring and severe daytime sleepiness prior to experiencing a stroke, while the mean Epworth sleepiness scale score was 6.8 +/- 3.6. Polysomnography revealed 34 patients (67%) with an apnea-hypopnea index (AHI) of > or = 10 events per hour, 31 patients (61%) with an AHI of > or = 15 events per hour, and 25 patients (49%) with an AHI of > or = 20 events per hour. Significant obstructive SDB, defined as an AHI of > or = 20/h, was more prevalent in ischemic stroke patients than in control subjects (49% vs 24%, respectively; p = 0.04) and was associated with a higher BMI (p = 0.046). Among the 34 patients with an AHI of > or = 10/h, CPAP titration was tolerated by 16 patients, but only 4 patients who had typical sleep apnea features proceeded to home CPAP treatment with objective compliance over a period of 3 months of 2.5 +/- 0.6 h per night. A subgroup of 20 patients not receiving CPAP showed partial spontaneous improvement of SDB at 1 month (baseline AHI, 32.3 +/- 17.6 events per hour; AHI at 1 month, 23.0 +/- 18.8 events per hour; p = 0.01) with a trend toward improvement for the obstructive but no significant change for the central events, whereas no improvement in AHI was noted for the four patients receiving CPAP. CONCLUSION: There is a high prevalence of obstructive SDB in patients who have experienced acute ischemic stroke, which, in many cases, is different from classic obstructive sleep apnea syndrome, and this is reflected by the lack of significant sleepiness, poor CPAP acceptance, and partial spontaneous improvement at 1 month. 相似文献
11.
Thibaut Gentina Francois Fortin Bernard Douay Jean Marc Dernis Frederic Herengt Jean Christophe Bout Catherine Lamblin 《Sleep & breathing》2011,15(1):21-27
Background
Continuous positive airways pressure (CPAP) is the accepted therapy for obstructive sleep apnoea (OSA), but compliance is variable. We hypothesised that an auto bi-level device with pressure relief during exhalation (auto bi-level) would treat OSA as well as CPAP and that transitioning non-compliant CPAP patients without modifiable causes of poor compliance to this device would improve compliance and clinical outcomes. 相似文献12.
Syed Fayyaz Hussain Yona Keich Cloonan Muhammad Islam Mohammad H. Rahbar 《Sleep & breathing》2010,14(2):137-144
Purpose
The objective of this study was to evaluate the prevalence of self-reported sleep-disordered breathing (SDB symptoms and its associated risk factors in Pakistani employed adults. 相似文献13.
Purpose
This study aims to use clinical scales in a standardized fashion in evaluating the frequency of a high and narrow hard palate and/or small and retroplaced mandible in children with polysomnographically demonstrated sleep-disordered breathing (SDB). 相似文献14.
Karavidas A Kapsimalis F Lazaros G Markozanes E Arapi S Cholidou K Matzaraki V Kyrkou K Tsiachris D Matsakas E Pyrgakis V Alchanatis M 《Sleep & breathing》2011,15(4):701-709
Introduction
Heart failure (HF) is a major public health problem associated with high rates of morbidity and mortality. Patients with HF exhibit a high prevalence of sleep-disordered breathing (SDB). We have investigated the long-term impact of positive airway pressure (PAP) therapy on heart function and clinical outcomes in patients with advanced HF and concomitant SDB.Materials and methods
We assessed 18 patients with advanced HF (New York Heart Association (NYHA) functional classification III?CIV) and concomitant SDB (diagnosed with polysomnography) either of obstructive or central type. Eleven patients who received PAP therapy (auto-titrating PAP or adaptive servo-ventilation) for 12 months were compared with seven patients who refused this therapy. All participants were assessed at both baseline and end of follow-up for NYHA functional status, left and right ventricular function, neurohormonal activation, and exercise tolerance. The rates of hospitalization, deaths, and the combination of both were also recorded.Results
Patients treated with PAP achieved better functional status, higher left ventricular ejection fraction, improved longitudinal right ventricular contractile function, lower levels of b-type natriuretic peptide, and greater exercise performance compared to those who remained untreated. PAP-treated group had a significantly lower incidence of the prespecified combined end-point (i.e., hospital admissions and death) than the control group (87.5 vs. 18.2%, p?=?0.013). Interestingly, the mortality rate was 28% (two out of seven patients) in the control group, while no deaths were recorded in the PAP-treated group.Discussion
In this preliminary study, we found that treatment of SDB, irrespective of type, in stable patients with advanced HF receiving optimal medical therapy was associated with improvement in cardiac functional status, ventricular contraction, physical performance, and neurohormonal status, leading to better clinical outcomes. 相似文献15.
Noninvasive ventilation initiation in clinical practice: A six-year prospective, observational study
BACKGROUND:
Despite evidence supporting the role of noninvasive ventilation (NIV) in diverse populations, few publications describe how NIV is used in clinical practice.OBJECTIVE:
To describe NIV initiation in a teaching hospital that has a guideline, and to characterize temporal changes in NIV initiation over time.METHODS:
A prospective, observational study of continuous positive airway pressure ventilation (CPAP) or bilevel NIV initiation from January 2000 to December 2005 was conducted. Registered respiratory therapists completed a one-page data collection form at NIV initiation.RESULTS:
Over a six-year period, NIV was initiated in 623 unique patients (531 bilevel NIV, 92 CPAP). Compared with bilevel NIV, CPAP was initiated more often using a nasal interface, with a machine owned by the patient, and for chronic conditions, especially obstructive sleep apnea. Whereas CPAP was frequently initiated and continued on the wards, bilevel NIV was most frequently initiated and continued in the emergency department, intensive care unit and the coronary care unit. Patients initiated on bilevel NIV were more likely to be female (OR 1.8, 95% CI 1.08 to 2.85; P=0.02) and to have an acute indication compared with CPAP initiations (OR 7.5, 95% CI 1.61 to 34.41; P=0.01). Bilevel NIV was initiated more often in the emergency department than in the intensive care unit (OR 5.8, 95% CI 0.89 to 38.17; P=0.07). Bilevel NIV initiation increased from 2000 to 2005.CONCLUSIONS:
The present study illustrates how NIV is used in clinical practice and confirms that NIV initiation has increased over time. 相似文献16.
The effect of correction of sleep-disordered breathing on BP in untreated hypertension 总被引:7,自引:0,他引:7
OBJECTIVES: To compare BP response to 3 weeks of nasal continuous positive airway pressure (CPAP) in hypertensive patients with and without sleep-disordered breathing (SDB). DESIGN: A controlled, interventional trial of nasal CPAP in patients with and without SDB. Participants and setting: Twenty-four men, aged 30 to 60 years, with mild to moderate untreated hypertension recruited from employee health and primary care clinics. METHODS: Based on in-laboratory polysomnography, 14 hypertensive patients had SDB, defined by five or more episodes of apnea and hypopnea per hour of sleep (apnea-hypopnea index [AHI], > or = 5), and 10 had no SDB (AHI, < 5). We performed 24-h ambulatory BP monitoring on all patients at baseline, during CPAP, and after CPAP treatment. In patients with an AHI > or = 5, nasal CPAP was titrated to reduce the AHI to < 5. Patients with an AHI < 5 received CPAP of 5 cm H(2)O to control for any potential effect of CPAP per se on BP. Both groups received CPAP for 3 weeks. RESULTS: After adjusting for age and body mass index, the mean nocturnal systolic and diastolic BP changes after CPAP treatment in the SDB group were significantly different from those in the no-SDB group: -7.8 vs +0.3 mm Hg (p = 0.02), and -5.3 vs -0.7 mm Hg (p = 0.03), respectively. There was a similar, although statistically insignificant, difference in the adjusted mean daytime systolic and diastolic BP changes after CPAP treatment between the two groups (-2.7 vs +0.4 mm Hg and -2.3 vs -1.7 mm Hg, respectively). CONCLUSIONS: Three weeks of nasal CPAP treatment of SDB in hypertensive men caused the lowering of nocturnal systolic and diastolic BP values, suggesting that increased nocturnal BP in persons with hypertension was causally related to the apnea and hypopnea events of SDB. 相似文献
17.
Background In clinical practice, we have found that premenopausal women have delayed diagnosis of sleep-disordered breathing (SDB).
Methods During a 4-year period, we systematically collected the clinical and polysomnographic variables for all women referred for
sleep complaints using preestablished questionnaires, scales, clinical grid, polygraphic montage, and scoring criteria. The
variables collected on premenopausal SDB women were analyzed and compared to those of postmenopausal women within 5 years
of menopause.
Results Of 977 women, 316 were premenopausal with SDB. Complaints of chronic insomnia and sleepwalking were the most common reasons
for referral, had been present for a mean of 6.4 ± 5.4 years, and had lead to unsuccessful symptomatic treatment. The normal-weight
premenopausal SDB group had anatomically small upper airways, while those with body mass index (BMI) ≥ 25 kg/m2 complained more frequently of snoring and daytime sleepiness and their clinical presentation was closer to those of the postmenopausal
SDB comparison group. Premenopausal women often had a low apnea-hypopnea index (AHI), but there was a discrepancy between
the low AHI and the amount of continuous positive airway pressure (CPAP) needed to control the SDB, and there was a need for
higher pressures in overweight premenopausal SDB women (mean 9.1 ± 1.9 and 10.1 ± 2.6 cmH2O).
Conclusion Normal-weight premenopausal SDB women often present with atypical sleep complaints of chronic insomnia and parasomnias. Clinical
attention paid to craniofacial features and use of specific scales such as Mallampati help with the suspicion of the presence
of SDB, and a low AHI is unrelated to the positive clinical impact of nasal CPAP treatment. 相似文献
18.
Ali El Solh Morohunfolu Akinnusi Anil Patel Abid Bhat Rachel TenBrock 《Sleep & breathing》2009,13(4):325-330
Purpose
Continuous positive airway pressure (CPAP) is considered the standard therapy for obstructive sleep apnea syndrome. In the absence of standard protocol, CPAP titration may be unsuccessful. The purpose of this study was to test the hypothesis that application of an artificial neural network (ANN) to CPAP titration would achieve an optimal CPAP pressure within a shorter time interval and would lead to a decrease in CPAP titration failure. 相似文献19.
Muslim M. Alsaadi Shaikh M. Iqbal Essam A. Elgamal Mustafa A. Salih David Gozal 《Sleep & breathing》2013,17(1):389-393
Background
Syndromic craniosynostosis (SC) is associated with a high prevalence of sleep-disordered breathing (SDB). However, it remains unclear whether non-syndromic craniosynostosis (NSC) is associated with an increased risk for SDB.Setting
This study was conducted at a tertiary referral pediatric medical center.Methods
A prospective polysomnographic (PSG) evaluation was conducted of all children diagnosed with craniosynostosis over a 3-year period and who had not undergone previous PSG for SDB-related symptoms.Results
Among 14 children fulfilling inclusion criteria, 10 had NSC and 4 were diagnosed with SC (Crouzon syndrome). SDB was present in 50 % of the NSC and in 75 % of SC. No associations emerged between the number of sutures affected and the presence of SDB.Conclusions
SDB is highly prevalent not only in SC but also among asymptomatic children with NSC. The diagnosis of NSC should prompt a diagnostic PSG as a routine component of the clinical evaluation, and PSG findings may aid in the formulation of decisions regarding timing and need for surgical interventions. 相似文献20.
Sophia E. Schiza Izolde Bouloukaki Charalampos Mermigkis Panagiotis Panagou Nikolaos Tzanakis Violeta Moniaki Eleni Tzortzaki Nikolaos M. Siafakas 《Sleep & breathing》2011,15(3):417-423