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Sample records for apnea list mode

  1. APNEA list mode data acquisition and real-time event processing

    Energy Technology Data Exchange (ETDEWEB)

    Hogle, R.A.; Miller, P. [GE Corporate Research & Development Center, Schenectady, NY (United States); Bramblett, R.L. [Lockheed Martin Specialty Components, Largo, FL (United States)

    1997-11-01

    The LMSC Active Passive Neutron Examinations and Assay (APNEA) Data Logger is a VME-based data acquisition system using commercial-off-the-shelf hardware with the application-specific software. It receives TTL inputs from eighty-eight {sup 3}He detector tubes and eight timing signals. Two data sets are generated concurrently for each acquisition session: (1) List Mode recording of all detector and timing signals, timestamped to 3 microsecond resolution; (2) Event Accumulations generated in real-time by counting events into short (tens of microseconds) and long (seconds) time bins following repetitive triggers. List Mode data sets can be post-processed to: (1) determine the optimum time bins for TRU assay of waste drums, (2) analyze a given data set in several ways to match different assay requirements and conditions and (3) confirm assay results by examining details of the raw data. Data Logger events are processed and timestamped by an array of 15 TMS320C40 DSPs and delivered to an embedded controller (PowerPC604) for interim disk storage. Three acquisition modes, corresponding to different trigger sources are provided. A standard network interface to a remote host system (Windows NT or SunOS) provides for system control, status, and transfer of previously acquired data. 6 figs.

  2. APNEA list mode data acquisition and real-time event processing

    International Nuclear Information System (INIS)

    The LMSC Active Passive Neutron Examinations and Assay (APNEA) Data Logger is a VME-based data acquisition system using commercial-off-the-shelf hardware with the application-specific software. It receives TTL inputs from eighty-eight 3He detector tubes and eight timing signals. Two data sets are generated concurrently for each acquisition session: (1) List Mode recording of all detector and timing signals, timestamped to 3 microsecond resolution; (2) Event Accumulations generated in real-time by counting events into short (tens of microseconds) and long (seconds) time bins following repetitive triggers. List Mode data sets can be post-processed to: (1) determine the optimum time bins for TRU assay of waste drums, (2) analyze a given data set in several ways to match different assay requirements and conditions and (3) confirm assay results by examining details of the raw data. Data Logger events are processed and timestamped by an array of 15 TMS320C40 DSPs and delivered to an embedded controller (PowerPC604) for interim disk storage. Three acquisition modes, corresponding to different trigger sources are provided. A standard network interface to a remote host system (Windows NT or SunOS) provides for system control, status, and transfer of previously acquired data. 6 figs

  3. List mode multichannel analyzer

    Science.gov (United States)

    Archer, Daniel E.; Luke, S. John; Mauger, G. Joseph; Riot, Vincent J.; Knapp, David A.

    2007-08-07

    A digital list mode multichannel analyzer (MCA) built around a programmable FPGA device for onboard data analysis and on-the-fly modification of system detection/operating parameters, and capable of collecting and processing data in very small time bins (<1 millisecond) when used in histogramming mode, or in list mode as a list mode MCA.

  4. Screening of Obstructive Sleep Apnea with Empirical Mode Decomposition of Pulse Oximetry

    CERN Document Server

    Schlotthauer, Gastón; Larrateguy, Luis D; Milone, Diego H

    2014-01-01

    Detection of desaturations on the pulse oximetry signal is of great importance for the diagnosis of sleep apneas. Using the counting of desaturations, an index can be built to help in the diagnosis of severe cases of obstructive sleep apnea-hypopnea syndrome. It is important to have automatic detection methods that allows the screening for this syndrome, reducing the need of the expensive polysomnography based studies. In this paper a novel recognition method based on the empirical mode decomposition of the pulse oximetry signal is proposed. The desaturations produce a very specific wave pattern that is extracted in the modes of the decomposition. Using this information, a detector based on properly selected thresholds and a set of simple rules is built. The oxygen desaturation index constructed from these detections produces a detector for obstructive sleep apnea-hypopnea syndrome with high sensitivity ($0.838$) and specificity ($0.855$) and yields better results than standard desaturation detection approach...

  5. LIST-mode applications for neutron multiplicity counting

    International Nuclear Information System (INIS)

    In recent years, the data acquisition in neutron multiplicity measurements is rapidly changing from traditional shift-register electronics into fully digital LIST-mode acquisition machinery, allowing us to digitally record the detection time of each neutron. In the present study, we introduce two novel applications to the LIST-mode acquisition in neutron multiplicity counting. In the first application, we estimate the statistical uncertainty of the measurement using bootstrap analysis, and in the second application, we use the LIST mode acquisition to preform dead time corrections using a backward extrapolation technique. The applications were first tested by computer based simulations, and later applied to actual low mass fissile measurements conducted by the Institute of Isotopes in Hungary, showing satisfactory results. The methods presented in this study, while fairly easy to implement and do not require any prior calibration, often provide increased accuracy and higher reliability, when compared to the current methods traditionally used for shift-register multiplicity measurements

  6. Obstructive Sleep Apnea

    Science.gov (United States)

    ... to find out more. Obstructive Sleep Apnea Obstructive Sleep Apnea Obstructive sleep apnea (OSA) is a serious ... to find out more. Obstructive Sleep Apnea Obstructive Sleep Apnea Obstructive sleep apnea (OSA) is a serious ...

  7. A complete implementation of list-mode reconstruction for PET

    International Nuclear Information System (INIS)

    Tomography reconstruction algorithm is one of the key components of positron emission tomography (PET) scanners, most PET scanners use statistical iterative reconstruction algorithms from data in sinograms currently. However tomography reconstruction using list-mode data has many unique advantages, in recent years great attention has been paid to it, being in the process of rapid development and improvement. In this paper, using experimental data of small animal PET scanner Eplus-166, exploiting ordinary subsidized list-mode EM (S-LMEM) algorithm and orthogonal distance-based ray-tracer (OD-RT), we eventually achieve list-mode tomography reconstruction. System response matrix (SRM), which establishes mapping relationship between the image and the projection space, is one key problem in iterative reconstruction algorithm. OD-RT is based on an optimization Siddon's algorithm to calculate the SRM, generating line-of-response (LOR) which is approximately Gaussian-shaped, achieving better modeling of detector response function (DRF). The results demonstrate that image resolution recovery achieves the inherent properties of the scanner and that on-the-fly ray-tracer for real-time calculation of system response matrix is feasible for dynamic reconstruction. Meanwhile, the optimal parameters for calculating SRM are found by experiments. (authors)

  8. A Prescription for List-Mode Data Processing Conventions

    Energy Technology Data Exchange (ETDEWEB)

    Beddingfield, David H. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Swinhoe, Martyn Thomas [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Huszti, Jozsef [Hungarian Academy of Sciences (Hungary). Centre For Energy Research; Newell, Matthew R. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2015-10-08

    There are a variety of algorithmic approaches available to process list-mode pulse streams to produce multiplicity histograms for subsequent analysis. In the development of the INCC v6.0 code to include the processing of this data format, we have noted inconsistencies in the “processed time” between the various approaches. The processed time, tp, is the time interval over which the recorded pulses are analyzed to construct multiplicity histograms. This is the time interval that is used to convert measured counts into count rates. The observed inconsistencies in tp impact the reported count rate information and the determination of the error-values associated with the derived singles, doubles, and triples counting rates. This issue is particularly important in low count-rate environments. In this report we will present a prescription for the processing of list-mode counting data that produces values that are both correct and consistent with traditional shift-register technologies. It is our objective to define conventions for list mode data processing to ensure that the results are physically valid and numerically aligned with the results from shift-register electronics.

  9. Automatic screening of obstructive sleep apnea from the ECG based on empirical mode decomposition and wavelet analysis

    International Nuclear Information System (INIS)

    This study analyses two different methods to detect obstructive sleep apnea (OSA) during sleep time based only on the ECG signal. OSA is a common sleep disorder caused by repetitive occlusions of the upper airways, which produces a characteristic pattern on the ECG. ECG features, such as the heart rate variability (HRV) and the QRS peak area, contain information suitable for making a fast, non-invasive and simple screening of sleep apnea. Fifty recordings freely available on Physionet have been included in this analysis, subdivided in a training and in a testing set. We investigated the possibility of using the recently proposed method of empirical mode decomposition (EMD) for this application, comparing the results with the ones obtained through the well-established wavelet analysis (WA). By these decomposition techniques, several features have been extracted from the ECG signal and complemented with a series of standard HRV time domain measures. The best performing feature subset, selected through a sequential feature selection (SFS) method, was used as the input of linear and quadratic discriminant classifiers. In this way we were able to classify the signals on a minute-by-minute basis as apneic or nonapneic with different best-subset sizes, obtaining an accuracy up to 89% with WA and 85% with EMD. Furthermore, 100% correct discrimination of apneic patients from normal subjects was achieved independently of the feature extractor. Finally, the same procedure was repeated by pooling features from standard HRV time domain, EMD and WA together in order to investigate if the two decomposition techniques could provide complementary features. The obtained accuracy was 89%, similarly to the one achieved using only Wavelet analysis as the feature extractor; however, some complementary features in EMD and WA are evident

  10. Sleep Apnea

    Science.gov (United States)

    Sleep apnea is a common disorder that causes your breathing to stop or get very shallow. Breathing ... an hour. The most common type is obstructive sleep apnea. It causes your airway to collapse or ...

  11. Videoradiography at submental electrical stimulation during apnea in obstructive sleep apnea syndrome; A case report

    Energy Technology Data Exchange (ETDEWEB)

    Hillarp, B.; Rosen, I.; Wickstroem, O. (Malmoe Allmaenna Sjukhus (Sweden). Dept. of Diagnostic Radiology Malmoe Allmaenna Sjukhus (Sweden). Dept. of Clinical Neurophysiology)

    1991-05-01

    Percutaneous submental electrical stimulation during sleep may be a new therapeutic method for patients with obstructive sleep apnea syndrome (OSAS). Electrical stimulation to the submental region during obstructive apnea is reported to break the apnea without arousal and to diminish apneic index, time spent in apnea, and oxygen desaturation. The mode of breaking the apnea by electrical stimulation has not yet been shown. However, genioglossus is supposed to be the muscle responsible for breaking the apnea by forward movement of the tongue. To visualize the effect of submental electrical stimulation, one patient with severe OSAS has been examined with videoradiography. Submental electrical stimulation evoked an immediate complex muscle activity in the tongue, palate, and hyoid bone. This was followed by a forward movement of the tongue which consistently broke obstructive apnea without apparent arousal. Time spent in apnea was diminished but intervals between apnea were not affected. (orig.).

  12. Videoradiography at submental electrical stimulation during apnea in obstructive sleep apnea syndrome

    International Nuclear Information System (INIS)

    Percutaneous submental electrical stimulation during sleep may be a new therapeutic method for patients with obstructive sleep apnea syndrome (OSAS). Electrical stimulation to the submental region during obstructive apnea is reported to break the apnea without arousal and to diminish apneic index, time spent in apnea, and oxygen desaturation. The mode of breaking the apnea by electrical stimulation has not yet been shown. However, genioglossus is supposed to be the muscle responsible for breaking the apnea by forward movement of the tongue. To visualize the effect of submental electrical stimulation, one patient with severe OSAS has been examined with videoradiography. Submental electrical stimulation evoked an immediate complex muscle activity in the tongue, palate, and hyoid bone. This was followed by a forward movement of the tongue which consistently broke obstructive apnea without apparent arousal. Time spent in apnea was diminished but intervals between apnea were not affected. (orig.)

  13. Spatiotemporal reconstruction of list-mode PET data

    CERN Document Server

    Nichols, T E; Asma, E; Leahy, R M

    2002-01-01

    We describe a method for computing a continuous time estimate of tracer density using list-mode positron emission tomography data. The rate function in each voxel is modeled as an inhomogeneous Poisson process whose rate function can be represented using a cubic B-spline basis. The rate functions are estimated by maximizing the likelihood of the arrival times of detected photon pairs over the control vertices of the spline, modified by quadratic spatial and temporal smoothness penalties and a penalty term to enforce non-negativity. Randoms rate functions are estimated by assuming independence between the spatial and temporal randoms distributions. Similarly, scatter rate functions are estimated by assuming spatiotemporal independence and that the temporal distribution of the scatter is proportional to the temporal distribution of the trues. A quantitative evaluation was performed using simulated data and the method is also demonstrated in a human study using 11C-raclopride.

  14. Pediatric sleep apnea

    Science.gov (United States)

    Sleep apnea - pediatric; Apnea - pediatric sleep apnea syndrome; Sleep-disordered breathing - pediatric ... Untreated pediatric sleep apnea may lead to: High blood pressure Heart or lung problems Slow growth and development

  15. Sleep Apnea (For Parents)

    Science.gov (United States)

    ... 5 Things to Know About Zika & Pregnancy Obstructive Sleep Apnea KidsHealth > For Parents > Obstructive Sleep Apnea Print ... kids and teens can develop it, too. About Sleep Apnea Sleep apnea happens when a person stops ...

  16. Sleep Apnea Information Page

    Science.gov (United States)

    ... Awards Enhancing Diversity Find People About NINDS NINDS Sleep Apnea Information Page Table of Contents (click to ... en Español Additional resources from MedlinePlus What is Sleep Apnea? Sleep apnea is a common sleep disorder ...

  17. Pediatric sleep apnea

    Science.gov (United States)

    Sleep apnea - pediatric; Apnea - pediatric sleep apnea syndrome; Sleep-disordered breathing - pediatric ... During sleep, all of the muscles in the body become more relaxed. This includes the muscles that help keep ...

  18. Obstructive sleep apnea - adults

    Science.gov (United States)

    Sleep apnea - obstructive - adults; Apnea - obstructive sleep apnea syndrome - adults; Sleep-disordered breathing - adults; OSA - adults ... When you sleep, all of the muscles in your body become more relaxed. This includes the muscles that help keep your ...

  19. Optimized list-mode acquisition and data processing procedures for ACS2 based PET systems

    International Nuclear Information System (INIS)

    PET systems using the acquisition control system version 2 (ACS2), e.g. the ECAT Exact HR PET scanner series, offer a rather restricted list-mode functionality. For instance, typical transfers of acquisition data consume a considerable amount of time. This represents a severe obstacle to the utilization of potential advantages of list-mode acquisition. In our study, we have developed hardware and software solutions which do not only allow for the integration of list-mode into routine procedures, but also improve the overall runtime stability of the system. We show that our methods are able to speed up the transfer of the acquired data to the image reconstruction and processing workstations by a factor of up to 140. We discuss how this improvement allows for the integration of list-mode-based post-processing methods such as an event-driven movement correction into the data processing environment, and how list-mode is able to improve the overall flexibility of PET investigations in general. Furthermore, we show that our methods are also attractive for conventional histogram-mode acquisition, due to the improved stability of the ACS2 system. (orig.)

  20. Novel scatter compensation of list-mode PET data using spatial and energy dependent corrections

    OpenAIRE

    Guérin, Bastien; Fakhri, Georges El

    2010-01-01

    With the widespread use of PET crystals with greatly improved energy resolution (e.g., 11.5% with LYSO as compared to 20% with BGO) and of list-mode acquisitions, the use of the energy of individual events in scatter correction schemes becomes feasible. We propose a novel scatter approach that incorporates the energy of individual photons in the scatter correction and reconstruction of list-mode PET data in addition to the spatial information presently used in clinical scanners. First, we rew...

  1. Statistical list-mode image reconstruction for the high resolution research tomograph

    Science.gov (United States)

    Rahmim, A.; Lenox, M.; Reader, A. J.; Michel, C.; Burbar, Z.; Ruth, T. J.; Sossi, V.

    2004-09-01

    We have investigated statistical list-mode reconstruction applicable to a depth-encoding high resolution research tomograph. An image non-negativity constraint has been employed in the reconstructions and is shown to effectively remove the overestimation bias introduced by the sinogram non-negativity constraint. We have furthermore implemented a convergent subsetized (CS) list-mode reconstruction algorithm, based on previous work (Hsiao et al 2002 Conf. Rec. SPIE Med. Imaging 4684 10-19 Hsiao et al 2002 Conf. Rec. IEEE Int. Symp. Biomed. Imaging 409-12) on convergent histogram OSEM reconstruction. We have demonstrated that the first step of the convergent algorithm is exactly equivalent (unlike the histogram-mode case) to the regular subsetized list-mode EM algorithm, while the second and final step takes the form of additive updates in image space. We have shown that in terms of contrast, noise as well as FWHM width behaviour, the CS algorithm is robust and does not result in limit cycles. A hybrid algorithm based on the ordinary and the convergent algorithms is also proposed, and is shown to combine the advantages of the two algorithms (i.e. it is able to reach a higher image quality in fewer iterations while maintaining the convergent behaviour), making the hybrid approach a good alternative to the ordinary subsetized list-mode EM algorithm.

  2. Sensitivity estimation in time-of-flight list-mode positron emission tomography

    Energy Technology Data Exchange (ETDEWEB)

    Herraiz, J. L. [Madrid-MIT M+Visión Consortium, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139 and Grupo de Física Nuclear, Departamento de Física Atómica, Molecular y Nuclear, Universidad Complutense de Madrid, CEI Moncloa, Madrid 28040 (Spain); Sitek, A., E-mail: sarkadiu@gmail.com [Center for Advanced Medical Imaging Sciences, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114 (United States)

    2015-11-15

    Purpose: An accurate quantification of the images in positron emission tomography (PET) requires knowing the actual sensitivity at each voxel, which represents the probability that a positron emitted in that voxel is finally detected as a coincidence of two gamma rays in a pair of detectors in the PET scanner. This sensitivity depends on the characteristics of the acquisition, as it is affected by the attenuation of the annihilation gamma rays in the body, and possible variations of the sensitivity of the scanner detectors. In this work, the authors propose a new approach to handle time-of-flight (TOF) list-mode PET data, which allows performing either or both, a self-attenuation correction, and self-normalization correction based on emission data only. Methods: The authors derive the theory using a fully Bayesian statistical model of complete data. The authors perform an initial evaluation of algorithms derived from that theory and proposed in this work using numerical 2D list-mode simulations with different TOF resolutions and total number of detected coincidences. Effects of randoms and scatter are not simulated. Results: The authors found that proposed algorithms successfully correct for unknown attenuation and scanner normalization for simulated 2D list-mode TOF-PET data. Conclusions: A new method is presented that can be used for corrections for attenuation and normalization (sensitivity) using TOF list-mode data.

  3. Sensitivity estimation in time-of-flight list-mode positron emission tomography

    International Nuclear Information System (INIS)

    Purpose: An accurate quantification of the images in positron emission tomography (PET) requires knowing the actual sensitivity at each voxel, which represents the probability that a positron emitted in that voxel is finally detected as a coincidence of two gamma rays in a pair of detectors in the PET scanner. This sensitivity depends on the characteristics of the acquisition, as it is affected by the attenuation of the annihilation gamma rays in the body, and possible variations of the sensitivity of the scanner detectors. In this work, the authors propose a new approach to handle time-of-flight (TOF) list-mode PET data, which allows performing either or both, a self-attenuation correction, and self-normalization correction based on emission data only. Methods: The authors derive the theory using a fully Bayesian statistical model of complete data. The authors perform an initial evaluation of algorithms derived from that theory and proposed in this work using numerical 2D list-mode simulations with different TOF resolutions and total number of detected coincidences. Effects of randoms and scatter are not simulated. Results: The authors found that proposed algorithms successfully correct for unknown attenuation and scanner normalization for simulated 2D list-mode TOF-PET data. Conclusions: A new method is presented that can be used for corrections for attenuation and normalization (sensitivity) using TOF list-mode data

  4. The effects of CPAP treatment on task positive and default mode networks in obstructive sleep apnea patients: an fMRI study.

    Directory of Open Access Journals (Sweden)

    Olga Prilipko

    Full Text Available INTRODUCTION: Functional magnetic resonance imaging studies enable the investigation of neural correlates underlying behavioral performance. We investigate the effect of active and sham Continuous Positive Airway Pressure (CPAP treatment on working memory function of patients with Obstructive Sleep Apnea Syndrome (OSAS considering Task Positive and Default Mode networks (TPN and DMN. METHODS: An experiment with 4 levels of visuospatial n-back task was used to investigate the pattern of cortical activation in 17 men with moderate or severe OSAS before and after 2 months of therapeutic (active or sub-therapeutic (sham CPAP treatment. RESULTS: Patients with untreated OSAS had significantly less deactivation in the temporal regions of the DMN as compared to healthy controls, but activation within TPN regions was comparatively relatively preserved. After 2 months of treatment, active and sham CPAP groups exhibited opposite trends of cerebral activation and deactivation. After treatment, the active CPAP group demonstrated an increase of cerebral activation in the TPN at all task levels and of task-related cerebral deactivation in the anterior midline and medial temporal regions of the DMN at the 3-back level, associated with a significant improvement of behavioral performance, whereas the sham CPAP group exhibited less deactivation in the temporal regions of Default Mode Network and less Task Positive Network activation associated to longer response times at the 3-back. CONCLUSION: OSAS has a significant negative impact primarily on task-related DMN deactivation, particularly in the medial temporal regions, possibly due to nocturnal hypoxemia, as well as TPN activation, particularly in the right ventral fronto-parietal network. After 2 months of active nasal CPAP treatment a positive response was noted in both TPN and DMN but without compete recovery of existing behavioral and neuronal deficits. Initiation of CPAP treatment early in the course of the

  5. Image properties of list mode likelihood reconstruction for a rectangular positron emission mammography with DOI measurements

    International Nuclear Information System (INIS)

    A positron emission mammography scanner is under development at our Laboratory. The tomograph has a rectangular geometry consisting of four banks of detector modules. For each detector, the system can measure the depth of interaction information inside the crystal. The rectangular geometry leads to irregular radial and angular sampling and spatially variant sensitivity that are different from conventional PET systems. Therefore, it is of importance to study the image properties of the reconstructions. We adapted the theoretical analysis that we had developed for conventional PET systems to the list mode likelihood reconstruction for this tomograph. The local impulse response and covariance of the reconstruction can be easily computed using FFT. These theoretical results are also used with computer observer models to compute the signal-to-noise ratio for lesion detection. The analysis reveals the spatially variant resolution and noise properties of the list mode likelihood reconstruction. The theoretical predictions are in good agreement with Monte Carlo results

  6. List mode reconstruction for PET with motion compensation: A simulation study

    OpenAIRE

    Qi, Jinyi; Huesman, Ronald H.

    2002-01-01

    Motion artifacts can be a significant factor that limits the image quality in high-resolution PET. Surveillance systems have been developed to track the movements of the subject during a scan. Development of reconstruction algorithms that are able to compensate for the subject motion will increase the potential of PET. In this paper we present a list mode likelihood reconstruction algorithm with the ability of motion compensation. The subject moti is explicitly modeled in the likelihood...

  7. Performance evaluation and optimization for a newly developed digital list-mode data acquisition Compton suppression spectrometer.

    Science.gov (United States)

    Zhang, Weihua; Keeshan, Benjamin; Mekarski, Pawel; Yi, Jing; Ungar, Kurt

    2013-11-01

    A comparative study was carried out between an analog timing and a digital list-mode data acquisition system for a Compton suppression spectrometer. The performance of both Compton suppression systems has been evaluated using the conventional, coincidence and anticoincidence spectra measured by (60)Co and (137)Cs point sources. The present study focuses on improving and optimizing the energy peak resolution and peak-to-Compton background ratios of the digital list-mode system. PMID:23497957

  8. Rapid processing of PET list-mode data for efficient uncertainty estimation and data analysis

    Science.gov (United States)

    Markiewicz, P. J.; Thielemans, K.; Schott, J. M.; Atkinson, D.; Arridge, S. R.; Hutton, B. F.; Ourselin, S.

    2016-07-01

    In this technical note we propose a rapid and scalable software solution for the processing of PET list-mode data, which allows the efficient integration of list mode data processing into the workflow of image reconstruction and analysis. All processing is performed on the graphics processing unit (GPU), making use of streamed and concurrent kernel execution together with data transfers between disk and CPU memory as well as CPU and GPU memory. This approach leads to fast generation of multiple bootstrap realisations, and when combined with fast image reconstruction and analysis, it enables assessment of uncertainties of any image statistic and of any component of the image generation process (e.g. random correction, image processing) within reasonable time frames (e.g. within five minutes per realisation). This is of particular value when handling complex chains of image generation and processing. The software outputs the following: (1) estimate of expected random event data for noise reduction; (2) dynamic prompt and random sinograms of span-1 and span-11 and (3) variance estimates based on multiple bootstrap realisations of (1) and (2) assuming reasonable count levels for acceptable accuracy. In addition, the software produces statistics and visualisations for immediate quality control and crude motion detection, such as: (1) count rate curves; (2) centre of mass plots of the radiodistribution for motion detection; (3) video of dynamic projection views for fast visual list-mode skimming and inspection; (4) full normalisation factor sinograms. To demonstrate the software, we present an example of the above processing for fast uncertainty estimation of regional SUVR (standard uptake value ratio) calculation for a single PET scan of 18F-florbetapir using the Siemens Biograph mMR scanner.

  9. Rapid processing of PET list-mode data for efficient uncertainty estimation and data analysis.

    Science.gov (United States)

    Markiewicz, P J; Thielemans, K; Schott, J M; Atkinson, D; Arridge, S R; Hutton, B F; Ourselin, S

    2016-07-01

    In this technical note we propose a rapid and scalable software solution for the processing of PET list-mode data, which allows the efficient integration of list mode data processing into the workflow of image reconstruction and analysis. All processing is performed on the graphics processing unit (GPU), making use of streamed and concurrent kernel execution together with data transfers between disk and CPU memory as well as CPU and GPU memory. This approach leads to fast generation of multiple bootstrap realisations, and when combined with fast image reconstruction and analysis, it enables assessment of uncertainties of any image statistic and of any component of the image generation process (e.g. random correction, image processing) within reasonable time frames (e.g. within five minutes per realisation). This is of particular value when handling complex chains of image generation and processing. The software outputs the following: (1) estimate of expected random event data for noise reduction; (2) dynamic prompt and random sinograms of span-1 and span-11 and (3) variance estimates based on multiple bootstrap realisations of (1) and (2) assuming reasonable count levels for acceptable accuracy. In addition, the software produces statistics and visualisations for immediate quality control and crude motion detection, such as: (1) count rate curves; (2) centre of mass plots of the radiodistribution for motion detection; (3) video of dynamic projection views for fast visual list-mode skimming and inspection; (4) full normalisation factor sinograms. To demonstrate the software, we present an example of the above processing for fast uncertainty estimation of regional SUVR (standard uptake value ratio) calculation for a single PET scan of (18)F-florbetapir using the Siemens Biograph mMR scanner. PMID:27280456

  10. A transputer-based list mode parallel system for digital radiography with 2D silicon detectors

    International Nuclear Information System (INIS)

    The authors believe that a dedicated parallel computer system can represent an effective and flexible approach to the problem of list mode acquisition and reconstruction of digital radiographic images obtained with a double-sided silicon microstrip detector. They present a Transputer-based implementation of a parallel system for the data acquisition and image reconstruction from a silicon crystal with 200μm read-out pitch. They are currently developing a prototype of the system connected to a detector with a 10mm2 sensitive area

  11. Sleep apnea and stroke.

    Science.gov (United States)

    Culebras, Antonio

    2015-01-01

    Clinical evidence has established that sleep apnea is a risk factor for stroke. Patients with stroke have a high prevalence of sleep apnea that may have preceded or developed as a result of the stroke. Well-established concurrent stroke risk factors for stroke like hypertension and atrial fibrillation respond favorably to the successful treatment of sleep apnea. The gold standard diagnosis of sleep apnea is obtained in the sleep laboratory, but unattended polysomnography is gaining acceptance. Positive airway pressure (PAP) (continuous positive airway pressure [CPAP] or bilevel positive airway pressure [BiPAP]) applications are the gold-standard treatment of sleep apnea. Suggestive evidence indicates that stroke occurrence or recurrence may be reduced with treatment of sleep apnea. PMID:25407131

  12. Complex Sleep Apnea Syndrome

    OpenAIRE

    Muhammad Talha Khan; Rose Amy Franco

    2014-01-01

    Complex sleep apnea is the term used to describe a form of sleep disordered breathing in which repeated central apneas (>5/hour) persist or emerge when obstructive events are extinguished with positive airway pressure (PAP) and for which there is not a clear cause for the central apneas such as narcotics or systolic heart failure. The driving forces in the pathophysiology are felt to be ventilator instability associated oscillation in PaCO2 arterial partial pressure of Carbon Dioxide, continu...

  13. Automatic cardiac gating of small-animal PET from list-mode data

    Energy Technology Data Exchange (ETDEWEB)

    Herraiz, J.L.; Udias, J.M. [Universidad Complutense de Madrid Univ. (Spain). Grupo de Fisica Nuclear; Vaquero, J.J.; Desco, M. [Universidad Carlos III de Madrid (Spain). Dept. de Bioingenieria e Ingenieria Aeroespacial; Cusso, L. [Hospital General Universitario Gregorio Maranon, Madrid (Spain). Unidad de Medicina y Cirugia Experimental

    2011-07-01

    This work presents a method to obtain automatically the cardiac gating signal in a PET study of rats, by employing the variation with time of the counts in the cardiac region, that can be extracted from list-mode data. In an initial step, the cardiac region is identified in the image space by backward-projecting a small fraction of the acquired data and studying the variation with time of the counts in each voxel inside said region, with frequencies within 2 and 8 Hz. The region obtained corresponds accurately to the left-ventricle of the heart of the rat. In a second step, the lines-of-response (LORs) connected with this region are found by forward-projecting this region. The time variation of the number of counts in these LORs contains the cardiac motion information that we want to extract. This variation of counts with time is band-pass filtered to reduce noise, and the time signal so obtained is used to create the gating signal. The result was compared with a cardiac gating signal obtained from an ECG acquired simultaneously to the PET study. Reconstructed gated images obtained from both gating information are similar. The method proposed demonstrates that valid cardiac gating signals can be obtained for rats from PET list-mode data. (orig.)

  14. Comparison of external motion tracking systems for PET list-mode reconstruction

    DEFF Research Database (Denmark)

    Olesen, Oline Vinter; Paulsen, Rasmus Reinhold; Keller, Sune H.; Højgaard, Liselotte; Roed, Bjarne; Larsen, Rasmus

    attachment of markers to the subject introducing image artifacts on human scans. We have previously designed a camera-based structured light (SL) system for 3D head tracking used with the high resolution research tomograph (HRRT, Siemens, Knoxville, USA) [5]. The system was modified to use invisible light...... markerless tracking system is not trivial to provide and to our knowledge not presently existent. The Polaris Vicra optical tracking system (Northern Digital Inc.) is generally used with PET brain imaging and has been demonstrated to work very well on phantoms [4]. However, it suffers from the necessary...... and the accuracy was demonstrated similar to a commercial system [6]. Presently, we show the SL system integrated with the HRRT PET scanner ready for PET motion correction. We show a comparison study with the Polaris Vicra based on list-mode motion corrected [7]....

  15. Fourier-processed images of dynamic lung function from list-mode data

    Energy Technology Data Exchange (ETDEWEB)

    Zubal, I.G.; Rowe, R.W.; Bizais, Y.; Susskind, H.; Bennett, G.W.; Brill, A.B.

    1983-01-01

    Time and volume correlated amplitude and phase images are computed from nuclear medical ventilation studies and for dynamic transmission scans of the lungs. This is made possible by a hardware interface and data acquisition system, developed in-house, allowing camera events and multiple ancillary physiological signals (including lung volume) to be acquired simultaneously in list mode. The first harmonic amplitude and phase images are constructed on an event by event basis. These are computed for both equal time and equal lung volume increments. Time and volume correlated Fourier images for ventilation studies have shown details and functional structures not usually seen in conventional imaging techniques. Processed transmission scans show similar results compared to ventilation images.

  16. Development of an Ideal Observer that Incorporates Nuisance Parameters and Processes List-Mode Data

    CERN Document Server

    MacGahan, Christopher J; Hilton, Nathan R; Brubaker, Erik M; Johnson, William C

    2016-01-01

    Observer models were developed to process data in list-mode format in order to perform binary discrimination tasks for use in an arms-control-treaty context. Data used in this study was generated using GEANT4 Monte Carlo simulations for photons using custom models of plutonium inspection objects and a radiation imaging system. Observer model performance was evaluated and presented using the area under the receiver operating characteristic curve. The ideal observer was studied under both signal-known-exactly conditions and in the presence of unknowns such as object orientation and absolute count-rate variability; when these additional sources of randomness were present, their incorporation into the observer yielded superior performance.

  17. A regularized relaxed ordered subset list-mode reconstruction algorithm and its preliminary application to undersampling PET imaging

    International Nuclear Information System (INIS)

    List mode format is commonly used in modern positron emission tomography (PET) for image reconstruction due to certain special advantages. In this work, we proposed a list mode based regularized relaxed ordered subset (LMROS) algorithm for static PET imaging. LMROS is able to work with regularization terms which can be formulated as twice differentiable convex functions. Such a versatility would make LMROS a convenient and general framework for fulfilling different regularized list mode reconstruction methods. LMROS was applied to two simulated undersampling PET imaging scenarios to verify its effectiveness. Convex quadratic function, total variation constraint, non-local means and dictionary learning based regularization methods were successfully realized for different cases. The results showed that the LMROS algorithm was effective and some regularization methods greatly reduced the distortions and artifacts caused by undersampling. (paper)

  18. Performance evaluation and optimization for a newly developed digital list-mode data acquisition Compton suppression spectrometer

    International Nuclear Information System (INIS)

    A comparative study was carried out between an analog timing and a digital list-mode data acquisition system for a Compton suppression spectrometer. The performance of both Compton suppression systems has been evaluated using the conventional, coincidence and anticoincidence spectra measured by 60Co and 137Cs point sources. The present study focuses on improving and optimizing the energy peak resolution and peak-to-Compton background ratios of the digital list-mode system. - Highlights: ► A digital list-mode data acquisition Compton suppression spectrometer was developed. ► The study is conducted to assess the performance of newly-developed spectrometer. ► The digital and analog counting systems are compatible in peak-to-Compton ratio. ► The full-energy peak losses can be recovered in the reconstructed anticoincidence spectrum

  19. Sleep apnea and sleep : diagnostic aspects

    OpenAIRE

    Sahlin, Carin

    2009-01-01

    Background: Patients with sleep apnea have frequent apneas and hypopneas during sleep. Apneas can be either central or obstructive. The apnea-hypopnea index (AHI) is the mean number of apneas and hypopneas per hour of sleep. Aims: 1) To evaluate the effect of a mandibular advancement device on obstructive apneas and sleep; 2) to evaluate the influence of body position on central apnea frequency; 3) to investigate whether obstructive or central apnea is related to mortality in patients with st...

  20. Listes

    OpenAIRE

    2015-01-01

    LISTE DES CARTES ET DES FIGURES 1. La population municipale au Mexique (1991) 16 2. Les municipes de l'Etat du Michoacán (Mexique) 17 3. La population municipale au Brésil (1991) 18 4. La population des Guyanes côtières (1991) 36 5. La Guyane côtière : la fin du splendide isolement ? 46 6. Aménagements du littoral en Guyane 50 7. Les polders de Nickérie (Surinam) 51 8. Paysages du littoral de l'Amapá (Brésil) 52 9. L'organisation de l'espace haïtien 61 10. Les réseaux de communication au Brés...

  1. Apnea of prematurity

    Science.gov (United States)

    ... Fox WW, Abman SH. eds. Fetal and Neonatal Physiology . 4th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 91. Patrinos ME. Neonatal apnea and the foundation of respiratory control. In: Martin RJ, Fanaroff AA, Walsh MC, eds. ...

  2. Sleep Apnea Detection

    Science.gov (United States)

    ... Prenatal Baby Bathing & Skin Care Breastfeeding Crying & Colic Diapers & Clothing Feeding & Nutrition Preemie Sleep Teething & Tooth Care Toddler Preschool Gradeschool Teen Young Adult Healthy Children > Ages & Stages > Baby > Sleep > Sleep Apnea ...

  3. List-Mode PET Motion Correction Using Markerless Head Tracking: Proof-of-Concept With Scans of Human Subject

    DEFF Research Database (Denmark)

    Olesen, Oline Vinter; Sullivan, Jenna M.; Mulnix, Tim;

    2013-01-01

    ) PET scanner. Head motion was independently measured, with a commercial marker-based device and the proposed vision-based system. A list-mode event-by-event reconstruction algorithm using the detected motion was applied. A phantom study with hand-controlled continuous random motion was obtained. Motion...

  4. List-mode-based reconstruction for respiratory motion correction in PET using non-rigid body transformations

    International Nuclear Information System (INIS)

    Respiratory motion in emission tomography leads to reduced image quality. Developed correction methodology has been concentrating on the use of respiratory synchronized acquisitions leading to gated frames. Such frames, however, are of low signal-to-noise ratio as a result of containing reduced statistics. In this work, we describe the implementation of an elastic transformation within a list-mode-based reconstruction for the correction of respiratory motion over the thorax, allowing the use of all data available throughout a respiratory motion average acquisition. The developed algorithm was evaluated using datasets of the NCAT phantom generated at different points throughout the respiratory cycle. List-mode-data-based PET-simulated frames were subsequently produced by combining the NCAT datasets with Monte Carlo simulation. A non-rigid registration algorithm based on B-spline basis functions was employed to derive transformation parameters accounting for the respiratory motion using the NCAT dynamic CT images. The displacement matrices derived were subsequently applied during the image reconstruction of the original emission list mode data. Two different implementations for the incorporation of the elastic transformations within the one-pass list mode EM (OPL-EM) algorithm were developed and evaluated. The corrected images were compared with those produced using an affine transformation of list mode data prior to reconstruction, as well as with uncorrected respiratory motion average images. Results demonstrate that although both correction techniques considered lead to significant improvements in accounting for respiratory motion artefacts in the lung fields, the elastic-transformation-based correction leads to a more uniform improvement across the lungs for different lesion sizes and locations

  5. Evaluation of bias and variance in low-count OSEM list mode reconstruction

    International Nuclear Information System (INIS)

    Statistical algorithms have been widely used in PET image reconstruction. The maximum likelihood expectation maximization reconstruction has been shown to produce bias in applications where images are reconstructed from a relatively small number of counts. In this study, image bias and variability in low-count OSEM reconstruction are investigated on images reconstructed with MOLAR (motion-compensation OSEM list-mode algorithm for resolution-recovery reconstruction) platform. A human brain ([11C]AFM) and a NEMA phantom are used in the simulation and real experiments respectively, for the HRRT and Biograph mCT. Image reconstructions were repeated with different combinations of subsets and iterations. Regions of interest were defined on low-activity and high-activity regions to evaluate the bias and noise at matched effective iteration numbers (iterations × subsets). Minimal negative biases and no positive biases were found at moderate count levels and less than 5% negative bias was found using extremely low levels of counts (0.2 M NEC). At any given count level, other factors, such as subset numbers and frame-based scatter correction may introduce small biases (1–5%) in the reconstructed images. The observed bias was substantially lower than that reported in the literature, perhaps due to the use of point spread function and/or other implementation methods in MOLAR. (paper)

  6. Home apnea monitor use - infants

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000755.htm Home apnea monitor use - infants To use the sharing ... portable. Why is an Apnea Monitor Used at Home? A monitor may be needed when: Your baby ...

  7. List mode acquisition for examining kinetic processes in thin film systems

    International Nuclear Information System (INIS)

    Many systems that are studied by reflectometry techniques exhibit interesting kinetic behaviour over a wide range of timescales. Instruments that possess a wide dynamic Q range, such as energy dispersive reflectometers, have the greatest ability to follow such pathways. The most common case is where the kinetics are reasonably slow compared to acquisition time — one takes repeated measurements over a long period, with each of those measurements representing the sample at a particular time. Another example is a stroboscopic experiment (such as oscillatory shear), where the sample has an external stimulus applied to it at regular intervals and the sample response is repeatable. Here one accumulates statistics in several reflectivity curves that correspond to different subperiods in the time frame between applied stimuli. However, most of the current approaches to acquiring kinetic information are suboptimal. In the first case one has to decide on how long an individual measurement will be, but what happens if the kinetics occur on a much faster or much slower time scale — sometimes you only get one shot! In the second case has to decide on how many subperiods are required, and the possibility of the sample changing over time is ignored. At the Platypus reflectometer at ANSTO we have been pioneering the application of list mode acquisition to study kinetic processes. Here, the X/Y/Time-of-flight/Frame number of each neutron hitting the detector is recorded (the frame structure is created by the pulsed nature of our beam). By the use of processing techniques we can produce reflectivity profiles corresponding to the desired time periods of interest. Quite simply, one can add all neutron events together if there is no kinetic evolution, or divide into arbitrary periods if the sample changes. This processing can occur during or after acquisition. In this paper we outline the utility of this method and describe its application in a couple of different experimental

  8. Psoriasis and Sleep Apnea

    DEFF Research Database (Denmark)

    Egeberg, Alexander; Khalid, Usman; Gislason, Gunnar Hilmar;

    2016-01-01

    STUDY OBJECTIVES: Psoriasis and sleep apnea are associated with significant morbidity and mortality. Although both diseases have been linked with systemic inflammation, studies on their potential bidirectional association are lacking. We investigate the potential association between psoriasis and...... sleep apnea. METHODS: All Danish citizens age 18 y or older between January 1, 1997 and December 31, 2011 (n = 5,522,190) were linked at individual level in nationwide registries. Incidence rates (IRs) per 10,000 person-years were calculated and incidence rate ratios (IRRs) adjusted for age, sex......, socioeconomic status, smoking history, alcohol abuse, medication, and comorbidity were estimated by Poisson regression. RESULTS: There were 53,290, 6,885, 6,348, and 39,908 incident cases of mild psoriasis, severe psoriasis, psoriatic arthritis, and sleep apnea, respectively. IRRs (95% confidence interval) for...

  9. Psoriasis and Sleep Apnea

    DEFF Research Database (Denmark)

    Egeberg, Alexander; Khalid, Usman; Gislason, Gunnar Hilmar;

    2015-01-01

    STUDY OBJECTIVES: Psoriasis and sleep apnea are associated with significant morbidity and mortality. Although both diseases have been linked with systemic inflammation, studies on their potential bidirectional association are lacking. We investigate the potential association between psoriasis and...... sleep apnea. METHODS: All Danish citizens age 18 y or older between January 1, 1997 and December 31, 2011 (n = 5,522,190) were linked at individual level in nationwide registries. Incidence rates (IRs) per 10,000 person-years were calculated and incidence rate ratios (IRRs) adjusted for age, sex......, socioeconomic status, smoking history, alcohol abuse, medication, and comorbidity were estimated by Poisson regression. RESULTS: There were 53,290, 6,885, 6,348, and 39,908 incident cases of mild psoriasis, severe psoriasis, psoriatic arthritis, and sleep apnea, respectively. IRRs (95% confidence interval) for...

  10. A digital Compton suppression spectroscopy without gamma-ray coincidence-summing loss using list-mode multispectral data acquisition

    International Nuclear Information System (INIS)

    The study demonstrates the advantages of an innovative list-mode multispectral data acquisition system that allows simultaneous creation of several different single, summed, coincident and anticoincident spectra with a single measurement. One of the consequences of list-mode data file offline processing is a reconstructed spectrum with Compton continuum suppression and without any full-energy peak efficiency deduction owing to true coincidence summing. The spectrometer is designed to read out analogue signal from preamplifier of gamma-ray detectors and to digitalize it using DGF/Pixie-4 software and card package (XIA LLC). This is realized by converting an Ortec Compton suppression data acquisition system into an all-digital spectrometer. Instead of using its timing electronic chain to determine the coincidence event, the analog signals from primary and guard detectors were connected directly into the Pixie-4 card for pulse height and time coincident measurement by individually logging and time stamping each electronic pulse. The data acquired in list-mode included coincidence and anticoincidence events consisting of records of energy and timestamp from primary and guard detectors. Every event was stored in a text file for offline processing and spectral reconstruction. A sophisticated computer simulation was also created with the goals of obtaining a better understanding of the experimental results and calculating efficiency. (author)

  11. An updated list of AGILE bright γ-ray sources and their variability in pointing mode

    Science.gov (United States)

    Verrecchia, F.; Pittori, C.; Chen, A. W.; Bulgarelli, A.; Tavani, M.; Lucarelli, F.; Giommi, P.; Vercellone, S.; Pellizzoni, A.; Giuliani, A.; Longo, F.; Barbiellini, G.; Trifoglio, M.; Gianotti, F.; Argan, A.; Antonelli, L. A.; Caraveo, P.; Cardillo, M.; Cattaneo, P. W.; Cocco, V.; Colafrancesco, S.; Contessi, T.; Costa, E.; Del Monte, E.; De Paris, G.; Di Cocco, G.; Di Persio, G.; Donnarumma, I.; Evangelista, Y.; Fanari, G.; Feroci, M.; Ferrari, A.; Fiorini, M.; Fornari, F.; Fuschino, F.; Froysland, T.; Frutti, M.; Galli, M.; Labanti, C.; Lapshov, I.; Lazzarotto, F.; Liello, F.; Lipari, P.; Mattaini, E.; Marisaldi, M.; Mastropietro, M.; Mauri, A.; Mauri, F.; Mereghetti, S.; Morelli, E.; Moretti, E.; Morselli, A.; Pacciani, L.; Perotti, F.; Piano, G.; Picozza, P.; Pilia, M.; Pontoni, C.; Porrovecchio, G.; Prest, M.; Primavera, R.; Pucella, G.; Rapisarda, M.; Rappoldi, A.; Rossi, E.; Rubini, A.; Sabatini, S.; Santolamazza, P.; Soffitta, P.; Stellato, S.; Striani, E.; Tamburelli, F.; Traci, A.; Trois, A.; Vallazza, E.; Vittorini, V.; Zanello, D.; Salotti, L.; Valentini, G.

    2013-10-01

    Aims: We present a variability study of a sample of bright γ-ray(30 Mev-50 Gev) sources. This sample is an extension of the first AGILE catalogue of γ-ray sources (1AGL), obtained using the complete set of AGILE observations in pointing mode performed during a 2.3 year period from July 9, 2007 until October 30, 2009. Methods: The dataset of AGILE pointed observations covers a long time interval and its γ-ray data archive is useful for monitoring studies of medium-to-high brightness γ-ray sources. In the analysis reported here, we used data obtained with an improved event filter that covers a wider field of view, on a much larger (about 27.5 months) dataset, integrating data on observation block time scales, which mostly range from a few days to thirty days. Results: The data processing resulted in a better characterized source list than 1AGL was, and includes 54 sources, 7 of which are new high galactic latitude (|BII| ≥ 5) sources, 8 are new sources on the galactic plane, and 20 sources from the previous catalogue with revised positions. Eight 1AGL sources (2 high-latitude and 6 on the galactic plane) were not detected in the final processing either because of low OB exposure and/or due to their position in complex galactic regions. We report the results in a catalogue of all the detections obtained in each single OB, including the variability results for each of these sources. In particular, we found that 12 sources out of 42 or 11 out of 53 are variable, depending on the variability index used, where 42 and 53 are the number of sources for which these indices could be calculated. Seven of the 11 variable sources are blazars, the others are Crab pulsar+nebula, LS I +61°303, Cyg X-3, and 1AGLR J2021+4030. Table 5 is only available at the CDS via anonymous ftp to http://cdsarc.u-strasbg.fr (ftp://130.79.128.5) or via http://cdsarc.u-strasbg.fr/viz-bin/qcat?J/A+A/558/A137

  12. Sleep apnea headaches

    Directory of Open Access Journals (Sweden)

    Reza Boostani

    2016-12-01

    Full Text Available Obstructive sleep apnea syndrome (OSAS is a common disorder characterized by recurrent apnea during sleep. Nocturnal laboratory-based polysomnography (PSG is the gold standard test for diagnosis of OSA. The sufferers may complain from daytime sleepiness, snoring or occasional headaches. Serious consequences such as cardiovascular complications, stroke or symptoms of depression may complicate the syndrome. Headache prevalence due to sleep apnea is estimated 1%-2% in general population and affects 2%-8% of middle age population. Morning headache is more common in the OSAS patients. OSAS patients present with various characteristics of morning headache. Treatment with continuous positive airway pressure usually reduces headache. The pathophysiologic background for a relation between obstructive sleep apnea and morning headache is multifactorial. Some theories have been proposed for OSAS-related headaches such as changing oxygen saturation during sleep, cerebral vasodilation and increased intracranial pressure due to cerebral vasodilation, sleep disruption and depression but the definite cause of headaches in OSAS patients is not yet clear.

  13. Fast GPU-based computation of the sensitivity matrix for a PET list-mode OSEM algorithm

    International Nuclear Information System (INIS)

    During the last decade, studies have shown that 3D list-mode ordered-subset expectation-maximization (LM-OSEM) algorithms for positron emission tomography (PET) reconstruction could be effectively computed and considerably accelerated by graphics processing unit (GPU) devices. However, most of these studies rely on pre-calculated sensitivity matrices. In many cases, the time required to compute this matrix can be longer than the reconstruction time itself. In fact, the relatively long time required for the calculation of the patient-specific sensitivity matrix is considered as one of the main obstacle in introducing a list-mode PET reconstruction algorithm for routine clinical use. The objective of this work is to accelerate a fully 3D LM-OSEM algorithm, including the calculation of the sensitivity matrix that accounts for the patient-specific attenuation and normalization corrections. For this purpose, sensitivity matrix calculations and list-mode OSEM reconstructions were implemented on GPUs, using the geometry of a commercial PET system. The system matrices were built on-the-fly by using an approach with multiple rays per detector pair. The reconstructions were performed for a volume of 188×188×57 voxels of 2×2×3.15 mm3 and for another volume of 144×144×57 voxels of 4×4×3.15 mm3. The time to compute the sensitivity matrix for the 188×188×57 array was 9 s while the LM-OSEM algorithm performed at a rate of 1.1 millions of events per second. For the 144×144×57 array, the respective numbers are 8 s for the sensitivity matrix and 0.8 million of events per second for the LM-OSEM step. This work lets envision fast reconstructions for advanced PET applications such as real time dynamic studies and parametric image reconstructions. (paper)

  14. Fast GPU-based computation of the sensitivity matrix for a PET list-mode OSEM algorithm

    Energy Technology Data Exchange (ETDEWEB)

    Nassiri, Moulay Ali; Carrier, Jean-Francois [Montreal Univ., QC (Canada). Dept. de Radio-Oncologie; Hissoiny, Sami [Ecole Polytechnique de Montreal, QC (Canada). Dept. de Genie Informatique et Genie Logiciel; Despres, Philippe [Quebec Univ. (Canada). Dept. de Radio-Oncologie

    2011-07-01

    One of the obstacle in introducing a list-mode PET reconstruction algorithm for routine clinical use is the long computation time required for the sensitivity matrix calculation. This matrix must be computed for each study because it depends on the object attenuation map. During the last decade, studies have shown that 3D list-mode OSEM reconstruction algorithms could be effectively performed and considerably accelerated by GPU devices. However, most of that preliminary work (1) was done for pre-clinical PET systems in which the number of LORs is small compared to modern human PET systems and (2) supposed that the sensitivity matrix is pre-calculated. The time required to compute this matrix can however be longer than the reconstruction time itself. The objective of this work is to investigate the performance of sensitivity matrix calculations in terms of computation time with modern GPUs, for clinical fully 3D LM-OSEM for modern PET scanners. For this purpose, sensitivity matrix calculations and full list-mode OSEM reconstruction for human PET systems were implemented on GPUs using the CUDA framework. The system matrices were built on-the-fly by using the multi-ray Siddon algorithm. The time to compute the sensitivity matrix for 288 x 288 x 57 arrays using 3 tangential LORs was 29 seconds. The 3D LM-OSEM algorithm, including the sensitivity matrix calculation, was performed for the same LORs in 71 seconds for 62 millions events, 6 frames and 1 iterations. This work let envision fast reconstructions for advanced PET application such as dynamic studies and parametric image reconstruction. (orig.)

  15. Apnea of prematurity

    Directory of Open Access Journals (Sweden)

    Piermichele Paolillo

    2013-06-01

    Full Text Available Apnea of prematurity (AOP is one of the most frequent pathologies in the Neonatal Intensive Care Unit, with an incidence inversely related to gestational age. Its etiology is often multi factorial and diagnosis of idiopathic forms requires exclusion of other underlying diseases. Despite being a self-limiting condition which regresses with the maturation of the newborn, possible long-term effects of recurring apneas and the degree of desaturation and bradycardia who may lead to abnormal neurological outcome are not yet clarified. Therefore AOP needs careful evaluation of its etiology and adequate therapy that can be both pharmacological and non-pharmacological. Proceedings of the 9th International Workshop on Neonatology · Cagliari (Italy · October 23rd-26th, 2013 · Learned lessons, changing practice and cutting-edge research

  16. Pathophysiology of Sleep Apnea

    OpenAIRE

    Dempsey, Jerome A; Veasey, Sigrid C.; Morgan, Barbara J.; O'Donnell, Christopher P.

    2010-01-01

    Sleep-induced apnea and disordered breathing refers to intermittent, cyclical cessations or reductions of airflow, with or without obstructions of the upper airway (OSA). In the presence of an anatomically compromised, collapsible airway, the sleep-induced loss of compensatory tonic input to the upper airway dilator muscle motor neurons leads to collapse of the pharyngeal airway. In turn, the ability of the sleeping subject to compensate for this airway obstruction will determine the degree o...

  17. Obstructive sleep apnea

    Directory of Open Access Journals (Sweden)

    Steven D. Brass

    2011-11-01

    Full Text Available Obstructive sleep apnea (OSA affects millions of Americans and is estimated to be as prevalent as asthma and diabetes. Given the fact that obesity is a major risk factor for OSA, and given the current global rise in obesity, the prevalence of OSA will increase in the future. Individuals with sleep apnea are often unaware of their sleep disorder. It is usually first recognized as a problem by family members who witness the apneic episodes or is suspected by their primary care doctor because of the individual’s risk factors and symptoms. The vast majority remain undiagnosed and untreated, despite the fact that this serious disorder can have significant consequences. Individuals with untreated OSA can stop breathing hundreds of times a night during their sleep. These apneic events can lead to fragmented sleep that is of poor quality, as the brain arouses briefly in order for the body to resume breathing. Untreated, sleep apnea can have dire health consequences and can increase the risk of hypertension, diabetes, heart disease, and heart failure. OSA management has also become important in a number of comorbid neurological conditions, including epilepsy, stroke, multiple sclerosis, and headache. Diagnosis typically involves use of screening questionnaires, physical exam, and an overnight polysomnography or a portable home study. Treatment options include changes in lifestyle, positive airway pressure, surgery, and dental appliances.

  18. Simulated one-pass list-mode: an approach to on-the-fly system matrix calculation

    International Nuclear Information System (INIS)

    In the development of prototype systems for positron emission tomography a valid and robust image reconstruction algorithm is required. However, prototypes often employ novel detector and system geometries which may change rapidly under optimization. In addition, developing systems generally produce highly granular, or possibly continuous detection domains which require some level of on-the-fly calculation for retention of measurement precision. In this investigation a new method of on-the-fly system matrix calculation is proposed that provides advantages in application to such list-mode systems in terms of flexibility in system modeling. The new method is easily adaptable to complicated system geometries and available computational resources. Detection uncertainty models are used as random number generators to produce ensembles of possible photon trajectories at image reconstruction time for each datum in the measurement list. However, the result of this approach is that the system matrix elements change at each iteration in a non-repetitive manner. The resulting algorithm is considered the simulation of a one-pass list (SOPL) which is generated and the list traversed during image reconstruction. SOPL alters the system matrix in use at each iteration and so behavior within the maximum likelihood-expectation maximization algorithm was investigated. A two-pixel system and a small two dimensional imaging model are used to illustrate the process and quantify aspects of the algorithm. The two-dimensional imaging system showed that, while incurring a penalty in image resolution, in comparison to a non-random equal-computation counterpart, SOPL provides much enhanced noise properties. In addition, enhancement in system matrix quality is straightforward (by increasing the number of samples in the ensemble) so that the resolution penalty can be recovered when desired while retaining improvement in noise properties. Finally the approach is tested and validated against a

  19. Event-by-event PET image reconstruction using list-mode origin ensembles algorithm

    Science.gov (United States)

    Andreyev, Andriy

    2016-03-01

    There is a great demand for real time or event-by-event (EBE) image reconstruction in emission tomography. Ideally, as soon as event has been detected by the acquisition electronics, it needs to be used in the image reconstruction software. This would greatly speed up the image reconstruction since most of the data will be processed and reconstructed while the patient is still undergoing the scan. Unfortunately, the current industry standard is that the reconstruction of the image would not start until all the data for the current image frame would be acquired. Implementing an EBE reconstruction for MLEM family of algorithms is possible, but not straightforward as multiple (computationally expensive) updates to the image estimate are required. In this work an alternative Origin Ensembles (OE) image reconstruction algorithm for PET imaging is converted to EBE mode and is investigated whether it is viable alternative for real-time image reconstruction. In OE algorithm all acquired events are seen as points that are located somewhere along the corresponding line-of-responses (LORs), together forming a point cloud. Iteratively, with a multitude of quasi-random shifts following the likelihood function the point cloud converges to a reflection of an actual radiotracer distribution with the degree of accuracy that is similar to MLEM. New data can be naturally added into the point cloud. Preliminary results with simulated data show little difference between regular reconstruction and EBE mode, proving the feasibility of the proposed approach.

  20. Multi-GPU based acceleration of a list-mode DRAMA toward real-time OpenPET imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kinouchi, Shoko [Chiba Univ. (Japan); National Institute of Radiological Sciences, Chiba (Japan); Yamaya, Taiga; Yoshida, Eiji; Tashima, Hideaki [National Institute of Radiological Sciences, Chiba (Japan); Kudo, Hiroyuki [Tsukuba Univ., Ibaraki (Japan); Suga, Mikio [Chiba Univ. (Japan)

    2011-07-01

    OpenPET, which has a physical gap between two detector rings, is our new PET geometry. In order to realize future radiation therapy guided by OpenPET, real-time imaging is required. Therefore we developed a list-mode image reconstruction method using general purpose graphic processing units (GPUs). For GPU implementation, the efficiency of acceleration depends on the implementation method which is required to avoid conditional statements. Therefore, in our previous study, we developed a new system model which was suited for the GPU implementation. In this paper, we implemented our image reconstruction method using 4 GPUs to get further acceleration. We applied the developed reconstruction method to a small OpenPET prototype. We obtained calculation times of total iteration using 4 GPUs that were 3.4 times faster than using a single GPU. Compared to using a single CPU, we achieved the reconstruction time speed-up of 142 times using 4 GPUs. (orig.)

  1. The shareholding similarity of the shareholders of the worldwide listed energy companies based on a two-mode primitive network and a one-mode derivative holding-based network

    Science.gov (United States)

    Li, Huajiao; Fang, Wei; An, Haizhong; Yan, LiLi

    2014-12-01

    Two-mode and multi-mode networks represent new directions of simulating a complex network that can simulate the relationships among the entities more precisely. In this paper, we constructed two different levels of networks: one is the two-mode primitive networks of the energy listed companies and their shareholders on the basis of the two-mode method of complex theory, and the other is the derivative one-mode holding-based network based on the equivalence network theory. We calculated two different topological characteristics of the two networks, that is, the out-degree of the actor nodes of the two-mode network (9003 nodes) and the weights of the edges of the one-mode network (619,766 edges), and we analyzed the distribution features of both of the two topological characteristics. In this paper, we define both the weighted and un-weighted Shareholding Similarity Coefficient, and using the data of the worldwide listed energy companies and their shareholders as empirical study subjects, we calculated and compared both the weighted and un-weighted shareholding similarity coefficient of the worldwide listed energy companies. The result of the analysis indicates that (1) both the out-degree of the actor nodes of the two-mode network and the weights of the edges of the one-mode network follow a power-law distribution; (2) there are significant differences between the weighted and un-weighted shareholding similarity coefficient of the worldwide listed energy companies, and the weighted shareholding similarity coefficient is of greater regularity than the un-weighted one; (3) there are a vast majority of shareholders who hold stock in only one or a few of the listed energy companies; and (4) the shareholders hold stock in the same listed energy companies when the value of the un-weighted shareholding similarity coefficient is between 0.4 and 0.8. The study will be a helpful tool to analyze the relationships of the nodes of the one-mode network, which is constructed based

  2. Sleep Apnea Tied to Complications After Angioplasty

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_159391.html Sleep Apnea Tied to Complications After Angioplasty Nightly breathing ... 15, 2016 WEDNESDAY, June 15, 2016 (HealthDay News) -- Sleep apnea may increase the risk of serious complications ...

  3. Sleep Apnea and Heart Disease, Stroke

    Science.gov (United States)

    ... Pressure High Blood Pressure Tools & Resources Stroke More Sleep Apnea and Heart Disease, Stroke Updated:Sep 16, ... be life-threatening. It’s a condition known as sleep apnea, in which the person may experience pauses ...

  4. Sleep apnea hypopnea syndrome and liver injury

    Institute of Scientific and Technical Information of China (English)

    TIAN Jian-li; ZHANG Yun; CHEN Bao-yuan

    2010-01-01

    Objective A general review was made of studies involving: (1) the relationship between sleep apnea hypopneasyndrome/sleep apnea style intermittent hypoxia and liver injury and (2) the mechanism that causes the liver injury.Data sources The data used in this review were mainly from Medline and PubMed published in English from 1993 toFebruary 2009. The search term was "sleep apnea hypopnea syndrome".Study selection (1) Clinical and laboratory evidence that sleep apnea hypopnea syndrome and sleep apnea styleintermittent hypoxia leads to liver injury; (2) the mechanism that causes the liver injury.Results The effect of sleep apnea hypopnea syndrome and sleep apnea style intermittent hypoxia on the liver functionis characterized by serum aminotransferase elevation. The liver histological injury includes hepatic steatosis, hepatocyteballooning, lobular inflammation, lobular necrosis, and liver fibrosis. Sleep apnea hypopnea syndrome and sleep apneastyle intermittent hypoxia can cause insulin resistance and oxidative stress.Conclusions Sleep apnea hypopnea syndrome and sleep apnea style intermittent hypoxia can lead to chronic liverinjury, which, in most cases, is shown as nonalcoholic fatty liver disease. Insulin resistance and oxidative stress causedby sleep apnea hypopnea syndrome and sleep apnea style intermittent hypoxia play an important role in the mechanismof chronic liver disease development.

  5. Testosterone Deficiency and Sleep Apnea.

    Science.gov (United States)

    Burschtin, Omar; Wang, Jing

    2016-05-01

    Obstructive sleep apnea (OSA) is a common condition among middle-aged men and is often associated with reduced testosterone (T) levels. OSA can contribute to fatigue and sexual dysfunction in men. There is suggestion that T supplementation alters ventilatory responses, possibly through effects on central chemoreceptors. Traditionally, it has been recommended that T replacement therapy (TRT) be avoided in the presence of untreated severe sleep apnea. With OSA treatment, however, TRT may not only improve hypogonadism, but may also alleviate erectile/sexual dysfunction. PMID:27132581

  6. Management of Obstructive Sleep Apnea

    OpenAIRE

    Vijayan, V.K.

    2014-01-01

    Obstructive Sleep Apnea (OSA) is an important public health problem and is associatedwith considerable morbidity and mortality. Therefore, treatment of this condition is ofparamount importance. The treatment of OSA includes general and behaviouralmeasures, mechanical measures including continuous positive airway pressure(CPAP), Bilevel positive airway pressure (BiPAP) and Oral Appliances (OA),pharmacological treatment and surgical procedures. Continuous positive airwaypressure (CPAP) treatmen...

  7. Infant apnea and gastroesophageal reflux

    International Nuclear Information System (INIS)

    The value of a combination of ultrasound studies and barium swallow examination in the analysis of temporal relationships between apnea and reflux is demonstrated. The two techniques allow acute apneic spells induced by gastrosophageal reflux to be documented and underlying specific digestive tract disorders demonstrated. The high incidence of digestive tract disorders in this area has been identified. (orig.)

  8. Infant apnea and gastroesophageal reflux

    Energy Technology Data Exchange (ETDEWEB)

    Gomes, H.; Lallemand, P. (AMH, 51 - Reims (France). Service d' Imagerie Pediatrique)

    1992-04-01

    The value of a combination of ultrasound studies and barium swallow examination in the analysis of temporal relationships between apnea and reflux is demonstrated. The two techniques allow acute apneic spells induced by gastrosophageal reflux to be documented and underlying specific digestive tract disorders demonstrated. The high incidence of digestive tract disorders in this area has been identified. (orig.).

  9. Erroneous cardiac ECG-gated PET list-mode trigger events can be retrospectively identified and replaced by an offline reprocessing approach: first results in rodents

    Science.gov (United States)

    Böning, Guido; Todica, Andrei; Vai, Alessandro; Lehner, Sebastian; Xiong, Guoming; Mille, Erik; Ilhan, Harun; la Fougère, Christian; Bartenstein, Peter; Hacker, Marcus

    2013-11-01

    The assessment of left ventricular function, wall motion and myocardial viability using electrocardiogram (ECG)-gated [18F]-FDG positron emission tomography (PET) is widely accepted in human and in preclinical small animal studies. The nonterminal and noninvasive approach permits repeated in vivo evaluations of the same animal, facilitating the assessment of temporal changes in disease or therapy response. Although well established, gated small animal PET studies can contain erroneous gating information, which may yield to blurred images and false estimation of functional parameters. In this work, we present quantitative and visual quality control (QC) methods to evaluate the accuracy of trigger events in PET list-mode and physiological data. Left ventricular functional analysis is performed to quantify the effect of gating errors on the end-systolic and end-diastolic volumes, and on the ejection fraction (EF). We aim to recover the cardiac functional parameters by the application of the commonly established heart rate filter approach using fixed ranges based on a standardized population. In addition, we propose a fully reprocessing approach which retrospectively replaces the gating information of the PET list-mode file with appropriate list-mode decoding and encoding software. The signal of a simultaneously acquired ECG is processed using standard MATLAB vector functions, which can be individually adapted to reliably detect the R-peaks. Finally, the new trigger events are inserted into the PET list-mode file. A population of 30 mice with various health statuses was analyzed and standard cardiac parameters such as mean heart rate (119 ms ± 11.8 ms) and mean heart rate variability (1.7 ms ± 3.4 ms) derived. These standard parameter ranges were taken into account in the QC methods to select a group of nine optimal gated and a group of eight sub-optimal gated [18F]-FDG PET scans of mice from our archive. From the list-mode files of the optimal gated group, we

  10. Erroneous cardiac ECG-gated PET list-mode trigger events can be retrospectively identified and replaced by an offline reprocessing approach: first results in rodents

    International Nuclear Information System (INIS)

    The assessment of left ventricular function, wall motion and myocardial viability using electrocardiogram (ECG)-gated [18F]-FDG positron emission tomography (PET) is widely accepted in human and in preclinical small animal studies. The nonterminal and noninvasive approach permits repeated in vivo evaluations of the same animal, facilitating the assessment of temporal changes in disease or therapy response. Although well established, gated small animal PET studies can contain erroneous gating information, which may yield to blurred images and false estimation of functional parameters. In this work, we present quantitative and visual quality control (QC) methods to evaluate the accuracy of trigger events in PET list-mode and physiological data. Left ventricular functional analysis is performed to quantify the effect of gating errors on the end-systolic and end-diastolic volumes, and on the ejection fraction (EF). We aim to recover the cardiac functional parameters by the application of the commonly established heart rate filter approach using fixed ranges based on a standardized population. In addition, we propose a fully reprocessing approach which retrospectively replaces the gating information of the PET list-mode file with appropriate list-mode decoding and encoding software. The signal of a simultaneously acquired ECG is processed using standard MATLAB vector functions, which can be individually adapted to reliably detect the R-peaks. Finally, the new trigger events are inserted into the PET list-mode file. A population of 30 mice with various health statuses was analyzed and standard cardiac parameters such as mean heart rate (119 ms ± 11.8 ms) and mean heart rate variability (1.7 ms ± 3.4 ms) derived. These standard parameter ranges were taken into account in the QC methods to select a group of nine optimal gated and a group of eight sub-optimal gated [18F]-FDG PET scans of mice from our archive. From the list-mode files of the optimal gated group, we

  11. Obstructive sleep apnea in ischemic stroke patients

    Directory of Open Access Journals (Sweden)

    Aliye Tosun

    2008-01-01

    Full Text Available OBJECTIVE: To investigate the prevalence of obstructive sleep apnea in patients with ischemic stroke and to evaluate the effectiveness of nasal continuous positive airway pressure treatment. METHODS: Overnight polysomnography was performed by a computerized system in 19 subjects with ischemic stroke. Patients with an apnea-hypopnea index > 5 were considered to have obstructive sleep apnea. The appropriate level of continuous positive airway pressure for each patient was determined during an all-night continuous positive airway pressure determination study. Attended continuous positive airway pressure titration was performed with a continuous positive airway pressure auto-titrating device. RESULTS: Obstructive sleep apnea prevalence among patients with ischemic stroke was 73.7%. The minimum SaO2 was significantly lower, and the percent of total sleep time in the wake stage and stage 1 sleep was significantly longer in patients with obstructive sleep apnea. In two patients with severe obstructive sleep apnea, we observed a decrease in the apnea-hypopnea index, an increase in mean wake time, mean SaO2, and minimum SaO2, and alterations in sleep structures with continuous positive airway pressure treatment. CONCLUSION: As the diagnosis and treatment of obstructive sleep apnea is of particular importance in secondary stroke prevention, we suggest that the clinical assessment of obstructive sleep apnea be part of the evaluation of stroke patients in rehabilitation units, and early treatment should be started.

  12. Pathophysiology of central sleep apneas.

    Science.gov (United States)

    Hernandez, Adam B; Patil, Susheel P

    2016-05-01

    The transition from wake to sleep is accompanied by a host of physiologic changes, which result in major alterations in respiratory control and may result in sleep-related breathing disorders. The central sleep apneas are a group of sleep-related breathing disorders that are characterized by recurrent episodes of airflow reduction or cessation due to a temporary reduction or absence of central respiratory drive. The fundamental hallmark of central sleep apnea (CSA) disorders is the presence of ventilatory control instability; however, additional mechanisms play a role in one or more specific manifestations of CSA. CSA may manifest during conditions of eucapnia/hypocapnia or chronic hypercapnia, which is a useful clinical classification that lends understanding to the underlying pathophysiology and potential therapies. In this review, an overview of normal breathing physiology is provided, followed by a discussion of pathophysiologic mechanisms that promote CSA and the mechanisms that are specific to different manifestations of CSA. PMID:26782104

  13. Obstructive sleep apnea and asthma*

    OpenAIRE

    Cristina Salles; Regina Terse-Ramos; Adelmir Souza-Machado; Cruz, Alvaro A

    2013-01-01

    Symptoms of sleep-disordered breathing, especially obstructive sleep apnea syndrome (OSAS), are common in asthma patients and have been associated with asthma severity. It is known that asthma symptoms tend to be more severe at night and that asthma-related deaths are most likely to occur during the night or early morning. Nocturnal symptoms occur in 60-74% of asthma patients and are markers of inadequate control of the disease. Various pathophysiological mechanisms are related to the worseni...

  14. Obstructive sleep apnea and asthma

    OpenAIRE

    Cristina Salles; Regina Terse-Ramos; Adelmir Souza-Machado; Cruz, Alvaro A.

    2013-01-01

    Symptoms of sleep-disordered breathing, especially obstructive sleep apnea syndrome (OSAS), are common in asthma patients and have been associated with asthma severity. It is known that asthma symptoms tend to be more severe at night and that asthma-related deaths are most likely to occur during the night or early morning. Nocturnal symptoms occur in 60-74% of asthma patients and are markers of inadequate control of the disease. Various pathophysiological mechanisms are related to the worseni...

  15. Holding-based network of nations based on listed energy companies: An empirical study on two-mode affiliation network of two sets of actors

    Science.gov (United States)

    Li, Huajiao; Fang, Wei; An, Haizhong; Gao, Xiangyun; Yan, Lili

    2016-05-01

    Economic networks in the real world are not homogeneous; therefore, it is important to study economic networks with heterogeneous nodes and edges to simulate a real network more precisely. In this paper, we present an empirical study of the one-mode derivative holding-based network constructed by the two-mode affiliation network of two sets of actors using the data of worldwide listed energy companies and their shareholders. First, we identify the primitive relationship in the two-mode affiliation network of the two sets of actors. Then, we present the method used to construct the derivative network based on the shareholding relationship between two sets of actors and the affiliation relationship between actors and events. After constructing the derivative network, we analyze different topological features on the node level, edge level and entire network level and explain the meanings of the different values of the topological features combining the empirical data. This study is helpful for expanding the usage of complex networks to heterogeneous economic networks. For empirical research on the worldwide listed energy stock market, this study is useful for discovering the inner relationships between the nations and regions from a new perspective.

  16. A method to synchronize signals from multiple patient monitoring devices through a single input channel for inclusion in list-mode acquisitions

    Energy Technology Data Exchange (ETDEWEB)

    O’Connor, J. Michael; Pretorius, P. Hendrik; Johnson, Karen; King, Michael A., E-mail: Michael.King@umassmed.edu [Department of Radiology, University of Massachusetts Medical School, Worcester, Massachusetts 01655 (United States)

    2013-12-15

    Purpose: This technical note documents a method that the authors developed for combining a signal to synchronize a patient-monitoring device with a second physiological signal for inclusion into list-mode acquisition. Our specific application requires synchronizing an external patient motion-tracking system with a medical imaging system by multiplexing the tracking input with the ECG input. The authors believe that their methodology can be adapted for use in a variety of medical imaging modalities including single photon emission computed tomography (SPECT) and positron emission tomography (PET). Methods: The authors insert a unique pulse sequence into a single physiological input channel. This sequence is then recorded in the list-mode acquisition along with the R-wave pulse used for ECG gating. The specific form of our pulse sequence allows for recognition of the time point being synchronized even when portions of the pulse sequence are lost due to collisions with R-wave pulses. This was achieved by altering our software used in binning the list-mode data to recognize even a portion of our pulse sequence. Limitations on heart rates at which our pulse sequence could be reliably detected were investigated by simulating the mixing of the two signals as a function of heart rate and time point during the cardiac cycle at which our pulse sequence is mixed with the cardiac signal. Results: The authors have successfully achieved accurate temporal synchronization of our motion-tracking system with acquisition of SPECT projections used in 17 recent clinical research cases. In our simulation analysis the authors determined that synchronization to enable compensation for body and respiratory motion could be achieved for heart rates up to 125 beats-per-minute (bpm). Conclusions: Synchronization of list-mode acquisition with external patient monitoring devices such as those employed in motion-tracking can reliably be achieved using a simple method that can be implemented using

  17. A method to synchronize signals from multiple patient monitoring devices through a single input channel for inclusion in list-mode acquisitions

    International Nuclear Information System (INIS)

    Purpose: This technical note documents a method that the authors developed for combining a signal to synchronize a patient-monitoring device with a second physiological signal for inclusion into list-mode acquisition. Our specific application requires synchronizing an external patient motion-tracking system with a medical imaging system by multiplexing the tracking input with the ECG input. The authors believe that their methodology can be adapted for use in a variety of medical imaging modalities including single photon emission computed tomography (SPECT) and positron emission tomography (PET). Methods: The authors insert a unique pulse sequence into a single physiological input channel. This sequence is then recorded in the list-mode acquisition along with the R-wave pulse used for ECG gating. The specific form of our pulse sequence allows for recognition of the time point being synchronized even when portions of the pulse sequence are lost due to collisions with R-wave pulses. This was achieved by altering our software used in binning the list-mode data to recognize even a portion of our pulse sequence. Limitations on heart rates at which our pulse sequence could be reliably detected were investigated by simulating the mixing of the two signals as a function of heart rate and time point during the cardiac cycle at which our pulse sequence is mixed with the cardiac signal. Results: The authors have successfully achieved accurate temporal synchronization of our motion-tracking system with acquisition of SPECT projections used in 17 recent clinical research cases. In our simulation analysis the authors determined that synchronization to enable compensation for body and respiratory motion could be achieved for heart rates up to 125 beats-per-minute (bpm). Conclusions: Synchronization of list-mode acquisition with external patient monitoring devices such as those employed in motion-tracking can reliably be achieved using a simple method that can be implemented using

  18. What Can You Do About Sleep Apnea?

    Medline Plus

    Full Text Available ... seem to stop breathing, they may have a sleep disturbance known as obstructive sleep apnea. It's estimated that more than 15 million ... men. But only one in 10 people with sleep apnea is actually diagnosed. Barbara Peck: When John ...

  19. Obstructive sleep apnea in atrial fibrillation patients.

    Science.gov (United States)

    Arias, Miguel A; Alonso-Fernández, Alberto; García-Río, Francisco; Sánchez, Ana; López, Juana M; Pagola, Carlos

    2006-06-28

    A high prevalence of obstructive sleep apnea has been demonstrated in patients with atrial fibrillation. Our comments want to emphasize the importance of identifying and treating a large proportion of patients with atrial fibrillation who have undiagnosed obstructive sleep apnea as an additional preventive strategy for atrial fibrillation patients. PMID:16309764

  20. Clinical consequences and economic costs of untreated obstructive sleep apnea syndrome

    Institute of Scientific and Technical Information of China (English)

    Melissa Knauert; Sreelatha Naik; M.Boyd Gillespie; Meir Kryger

    2015-01-01

    Objective: To provide an overview of the healthcare and societal consequences and costs of untreated obstructive sleep apnea syndrome.Data sources: PubMed database for English-language studies with no start date restrictions and with an end date of September 2014.Methods: A comprehensive literature review was performed to identify all studies that discussed the physiologic, clinical and societal consequences of obstructive sleep apnea syndrome as well as the costs associated with these consequences.There were 106 studies that formed the basis of this analysis.Conclusions: Undiagnosed and untreated obstructive sleep apnea syndrome can lead to abnormal physiology that can have serious implications including increased cardiovascular disease, stroke, metabolic disease, excessive daytime sleepiness, work-place errors, traffic accidents and death.These consequences result in significant economic burden.Both, the health and societal consequences and their costs can be decreased with identification and treatment of sleep apnea.Implications for practice: Treatment of obstructive sleep apnea syndrome, despite its consequences, is limited by lack of diagnosis, poor patient acceptance, lack of access to effective therapies, and lack of a variety of effective therapies.Newer modes of therapy that are effective, cost efficient and more accepted by patients need to be developed.

  1. Engineering task plan for the annual revision of the rotary mode core sampling system safety equipment list

    International Nuclear Information System (INIS)

    This Engineering Task Plan addresses an effort to provide an update to the RMCS Systems 3 and 4 SEL and DCM in order to incorporate the changes to the authorization basis implemented by HNF-SD-WM-BIO-001, Rev. 0 (Draft), Addendum 5 , Safety Analysis for Rotary Mode Core Sampling. Responsibilities, task description, cost estimate, and schedule are presented

  2. Mild obstructive sleep apnea: beyond the AHI

    Directory of Open Access Journals (Sweden)

    Lee-Iannotti J

    2014-07-01

    Full Text Available No abstract available. Article truncated at 150 words. A common conundrum faced by sleep medicine practitioners is how to manage the large group of patients with mild sleep apnea. Many patients are referred for sleep evaluation, with symptoms thought to be due to obstructive sleep apnea (OSA. Often polysomnography demonstrates only mild sleep apnea, and the clinician and patient are faced with the dilemma of whether to use continuous positive airway pressure (CPAP therapy or an oral appliance. In making this important decision the clinician incorporates the commonly used definition of mild sleep apnea as an apnea-hypopnea index of between 5 and 14 apneas or hypopneas per hour of sleep. Moderate sleep apnea is defined as 15-29 events per hour, and severe is 30 and above events per hour. These arbitrary thresholds originated in the early 1980s when knowledge of this condition was in its infancy and little was known about the long term health effects. The definition ...

  3. What Can You Do About Sleep Apnea?

    Medline Plus

    Full Text Available ... Three-quarters of them are men. But only one in 10 people with sleep apnea is actually ... becoming a sleep problem for me, a major one. Announcer: John Peck's wife, Barbara, suffered for years ...

  4. What Can You Do About Sleep Apnea?

    Medline Plus

    Full Text Available ... one. Announcer: John Peck's wife, Barbara, suffered for years because of her husband's snoring. John Peck: You ... it's up to full speed. Announcer: After many years of living with sleep apnea, in just one ...

  5. What Can You Do About Sleep Apnea?

    Medline Plus

    Full Text Available ... sleep apnea, it was successfully treated with a CPAP -- continuous positive airway pressure machine. John Peck: And ... over my nose just like this. Announcer: The CPAP keeps his air passages open by supplying a ...

  6. What Can You Do About Sleep Apnea?

    Medline Plus

    Full Text Available ... sleep apnea is actually diagnosed. Barbara Peck: When John was snoring, I dreaded going to bed. I ... sleep problem for me, a major one. Announcer: John Peck's wife, Barbara, suffered for years because of ...

  7. Sleep Apnea in Adults (Beyond the Basics)

    Science.gov (United States)

    ... has promising success rates in very selected people. Tracheostomy creates a permanent opening in the neck. It ... is always successful in eliminating obstructive sleep apnea, tracheostomy requires significant lifestyle changes and carries some serious ...

  8. What Can You Do About Sleep Apnea?

    Medline Plus

    Full Text Available ... was, really. I thought it might have been depression. All kinds of things went through my head. ... to full speed. Announcer: After many years of living with sleep apnea, in just one night John ...

  9. Prevalence of symptoms and risk of sleep apnea in Dubai, UAE

    OpenAIRE

    Mahboub B; Afzal S; Alhariri H; Alzaabi A; Vats M; Soans A

    2013-01-01

    Bassam Mahboub, Shahid Afzal, Hassan Alhariri, Ashraf Alzaabi, Mayank Vats, Annie SoansSleep Disorders Center, Department of Medicine, Rashid Hospital, Dubai Health Authority, Dubai, United Arab EmiratesPurpose: The United Arab Emirates (UAE) ranks 18th on the 2007 Forbes list of fattest countries with 68.3% of its citizens with an unhealthy weight and it is well known that weight gain and obesity are important determinants in the progression of obstructive sleep apnea syndrome (OSAS). The pu...

  10. Central sleep apnea – a case report

    OpenAIRE

    Dybala Andrzej; Dyczko Monika; Makaruk Boguslaw; Kicinski Pawel; Bartoszek Elzbieta; Myslinski Wojciech; Rahnama Mansur; Mosiewicz Jerzy

    2014-01-01

    Central sleep apnea (CSA) is a disease characterized by repetitive episodes of the socalled central apneas during sleep. The disease has a very complex etiology. In clinical practice, the most important causes of CSA are disorders of the central nervous system, congestive heart failure or certain pathological changes of the respiratory muscles. We present a case of a 43-year-old male with severe CSA, who was successfully treated with BiPAP ST equipment.

  11. Central sleep apnea – a case report

    Directory of Open Access Journals (Sweden)

    Dybala Andrzej

    2014-06-01

    Full Text Available Central sleep apnea (CSA is a disease characterized by repetitive episodes of the socalled central apneas during sleep. The disease has a very complex etiology. In clinical practice, the most important causes of CSA are disorders of the central nervous system, congestive heart failure or certain pathological changes of the respiratory muscles. We present a case of a 43-year-old male with severe CSA, who was successfully treated with BiPAP ST equipment.

  12. Asthma and Obstructive Sleep Apnea

    Institute of Scientific and Technical Information of China (English)

    Yi-Xian Qiao; Yi Xiao

    2015-01-01

    Objective:To get a comprehensive understanding about the relationship between obstructive sleep apnea (OSA) and asthma by reviewing the epidemiology,pathophysiology,and clinical manifestation and then summarizing the latest progress on diagnosis and treatment.Data Sources:Articles referred in this review were mainly collected from a comprehensive search of the PubMed published in English from 1990 to 2015 with the terms "OSA" and “asthma'" as the main keywords.Highly regarded older publications were also included.Study Selection:Information about the features of the two diseases in common,the pathophysiologic association between them and their current treatments from the literature search were identified,retrieved,and summarized.Results:Both OSA and asthma are very prevalent conditions.The incidences of them have kept on rising in recent years.Asthma is often accompanied by snoring and apnea,and OSA often combines with asthma,as well.They have many predisposing and aggravating factors in common.Possible shared direct mechanistic links between them include mechanical effects,intermittent hypoxia,nerve reflex,inflammation,leptin,etc.Indirect mechanistic links include medication,nose diseases,smoking,obesity,and gastroesophageal reflux disease.Since OSA presents many similar features with nocturnal asthma,some scholars termed them as a sole syndrome "alternative overlap syndrome,"and proved that asthma symptoms in those patients could be improved through the treatment of continuous positive airway pressure.Conclusions:OSA and asthma are closely associated in pathogenesis,symptoms,and therapies.With the growing awareness of the relationship between them,we should raise our vigilance on the coexistence of OSA in those difficult-to-control asthmatic patients.Further studies are still needed to guide the clinical works.

  13. Sleep Apnea May Raise Heart Risks in People with Pacemakers

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_158688.html Sleep Apnea May Raise Heart Risks in People With ... 2016 (HealthDay News) -- People with heart pacemakers and sleep apnea are at much greater risk for a ...

  14. Sleep Apnea May Raise Heart Risks in People with Pacemakers

    Science.gov (United States)

    ... nlm.nih.gov/medlineplus/news/fullstory_158688.html Sleep Apnea May Raise Heart Risks in People With ... 2016 (HealthDay News) -- People with heart pacemakers and sleep apnea are at much greater risk for a ...

  15. Patients with Obstructive Sleep Apnea at Altitude.

    Science.gov (United States)

    Bloch, Konrad E; Latshang, Tsogyal D; Ulrich, Silvia

    2015-06-01

    Bloch, Konrad E., Tsogyal D. Latshang, and Silvia Ulrich. Patients with obstructive sleep apnea at altitude. High Alt Med Biol 16:110-116, 2015.--Obstructive sleep apnea (OSA) is highly prevalent in the general population, in particular in men and women of older age. In OSA patients sleeping near sea level, the apneas/hypopneas associated with intermittent hypoxemia are predominantly due to upper airway collapse. When OSA patients stay at altitudes above 1600 m, corresponding to that of many tourist destinations, hypobaric hypoxia promotes frequent central apneas in addition to obstructive events, resulting in combined intermittent and sustained hypoxia. This induces strong sympathetic activation with elevated heart rate, cardiac arrhythmia, and systemic hypertension. There are concerns that these changes expose susceptible OSA patients, in particular those with advanced age and co-morbidities, to an excessive risk of cardiovascular and other adverse events during a stay at altitude. Based on data from randomized trials, it seems advisable for OSA patients to use continuous positive airway pressure treatment with computer controlled mask pressure adjustment (autoCPAP) in combination with acetazolamide during an altitude sojourn. If CPAP therapy is not feasible, acetazolamide alone is better than no treatment at all, as it improves oxygenation and sleep apnea and prevents excessive blood pressure rises of OSA patients at altitude. PMID:25973669

  16. Management of Obstructive Sleep Apnea

    Directory of Open Access Journals (Sweden)

    V K Vijayan

    2014-03-01

    Full Text Available Obstructive Sleep Apnea (OSA is an important public health problem and is associatedwith considerable morbidity and mortality. Therefore, treatment of this condition is ofparamount importance. The treatment of OSA includes general and behaviouralmeasures, mechanical measures including continuous positive airway pressure(CPAP, Bilevel positive airway pressure (BiPAP and Oral Appliances (OA,pharmacological treatment and surgical procedures. Continuous positive airwaypressure (CPAP treatment reverses the repetitive upper airway obstruction of sleepapnea and associated daytime sleepiness and is the most effective treatment for OSA.However maintaining patient adherence to CPAP therapy is a challenge. Weight lossshould be recommended to overweight patients with OSA, as it has been shown thatweight reduction has additional health benefits. Treatment of underlying medicalconditions such as hypothyroidism or acromegaly has profound effect onapnea/hypopnea index. A subset of patients with OSA may benefit from supplementaloxygen and positional therapy. Presently, there are no effective pharmacotherapeuticagents for treatment of patients with OSA and the role of surgical treatment in OSA iscontroversial. However, pharmacological treatment of persisting residual sleepiness,despite adequate positive airway pressure therapy delivery and adherence, is indicatedand may improve daytime sleepiness.Key words : CPAP, Oral appliances, Modafinil, CPAP complianceUvulopalatopharyngoplasty, positional therapy

  17. Obstructive sleep apnea and inflammation.

    LENUS (Irish Health Repository)

    McNicholas, Walter T

    2012-02-01

    The pathogenesis of cardiovascular complications in obstructive sleep apnea syndrome (OSAS) is not fully understood but is likely multifactorial in origin. Inflammatory processes play an important role in the pathogenesis of atherosclerosis, and circulating levels of several markers of inflammation have been associated with future cardiovascular risk. These include cell adhesion molecules such as intercellular adhesion molecule-1 and selectins, cytokines such as tumour necrosis factor alpha and interleukin 6, chemokines such as interleukin 8, and C-reactive protein. There is also increasing evidence that inflammatory processes play an important role in the cardiovascular pathophysiology of OSAS and many of the inflammatory markers associated with cardiovascular risk have been reported as elevated in patients with OSAS. Furthermore, animal and cell culture studies have demonstrated preferential activation of inflammatory pathways by intermittent hypoxia, which is an integral feature of OSAS. The precise role of inflammation in the development of cardiovascular disease in OSAS requires further study, particularly the relationship with oxidative stress, metabolic dysfunction, and obesity.

  18. Quality of Life in Obstructive Sleep Apnea

    Directory of Open Access Journals (Sweden)

    Naveen Dutt

    2014-03-01

    Full Text Available Obstructive sleep apnea (OSA is associated with significant cardiovascular andcerebrovascular morbidity and mortality. Usual parameters studied in sleep laboratoryare unable to measure overall impact of OSA on human life. Consequently, it isimportant to measure Quality of Life (QoL in OSA. QoL can be measured with genericinstruments like SF-36 or OSA specific questionnaires like Calgary Sleep ApneaQuality of Life (SAQLI questionnaire. Most of the studies suggest that there issignificant impairment of QoL in patients of OSA. But the present evidence suggeststhat impairment in QoL is not proportional to severity of OSA. There is no consensus onthe question of improvement in QoL with Continuous Positive Airway Pressure(CPAP therapy. A recent Cochrane review concluded that CPAP improves QoL inpeople with moderate and severe OSA.Key words : Obstructive sleep apnea, Quality of Life, Continuous Positive AirwayPressure

  19. Efficient fully 3D list-mode TOF PET image reconstruction using a factorized system matrix with an image domain resolution model

    International Nuclear Information System (INIS)

    A factorized system matrix utilizing an image domain resolution model is attractive in fully 3D time-of-flight PET image reconstruction using list-mode data. In this paper, we study a factored model based on sparse matrix factorization that is comprised primarily of a simplified geometrical projection matrix and an image blurring matrix. Beside the commonly-used Siddon’s ray-tracer, we propose another more simplified geometrical projector based on the Bresenham’s ray-tracer which further reduces the computational cost. We discuss in general how to obtain an image blurring matrix associated with a geometrical projector, and provide theoretical analysis that can be used to inspect the efficiency in model factorization. In simulation studies, we investigate the performance of the proposed sparse factorization model in terms of spatial resolution, noise properties and computational cost. The quantitative results reveal that the factorization model can be as efficient as a non-factored model, while its computational cost can be much lower. In addition we conduct Monte Carlo simulations to identify the conditions under which the image resolution model can become more efficient in terms of image contrast recovery. We verify our observations using the provided theoretical analysis. The result offers a general guide to achieve the optimal reconstruction performance based on a sparse factorization model with an image domain resolution model. (paper)

  20. Evaluation of list-mode ordered subset expectation maximization image reconstruction for pixelated solid-state compton gamma camera with large number of channels

    International Nuclear Information System (INIS)

    The Voxel Imaging PET (VIP) Pathfinder project intends to show the advantages of using pixelated solid-state technology for nuclear medicine applications. It proposes designs for Positron Emission Tomography (PET), Positron Emission Mammography (PEM) and Compton gamma camera detectors with a large number of signal channels (of the order of 106). For Compton camera, especially with a large number of readout channels, image reconstruction presents a big challenge. In this work, results are presented for the List-Mode Ordered Subset Expectation Maximization (LM-OSEM) image reconstruction algorithm on simulated data with the VIP Compton camera design. For the simulation, all realistic contributions to the spatial resolution are taken into account, including the Doppler broadening effect. The results show that even with a straightforward implementation of LM-OSEM, good images can be obtained for the proposed Compton camera design. Results are shown for various phantoms, including extended sources and with a distance between the field of view and the first detector plane equal to 100 mm which corresponds to a realistic nuclear medicine environment

  1. BMI in patients with obstructive sleep apnea

    OpenAIRE

    Dobrowolska-Zarzycka Magdalena; Dunin-Wilczynska Izabella; Mitura Iwona; Szymanska Jolanta

    2015-01-01

    Obstructive sleep apnea (OSA) is a disease of multicasual etiology. The risk factors include obesity, among other issues. Hence, it is extremely important to determine the effect of body weight on the severity of OSA. The aim of the study was to evaluate the influence of the body weight expressed as body mass index (BMI), on the value of upper airways diameter and on the AHI (Apnea-Hypopnea Index) value. The study was comprised of 41 patients diagnosed with OSA by way of polysomnography. Each...

  2. What Can You Do About Sleep Apnea?

    Medline Plus

    Full Text Available ... all work? John Peck: Well, this is the air pump right here. Announcer: Like most moderate cases of sleep apnea, it was successfully treated with a CPAP -- continuous positive airway ... The CPAP keeps his air passages open by supplying a steady stream of ...

  3. Modeling sleep apnea severity using bioimpedance measurements.

    Science.gov (United States)

    Gavrilovic, Bojan; Popovic, Milos R; Yadollahi, Azadeh

    2015-08-01

    Obstructive sleep apnea (OSA) is a common disorder in adults characterized by repetitive collapse of the pharynx. OSA prevalence increases in fluid retaining patients such as those with heart or renal failure, and worsens with overnight fluid accumulation in the neck. The objective of this study was to develop a new method of measuring changes in intracellular water (ICW) in the neck, and investigate metrics that represent total neck impedance and their relationship to sleep apnea severity. In 18 non-obese men, neck fluid volume (NFV) was measured before and after sleep using bioelectrical impedance at 50 kHz. For each participant, resistance and reactance was extracted from the impedance measurements. A model was developed to estimate the cell membrane capacitance which could represent changes in intracellular fluid in the neck. OSA severity was assessed using polysomnography to estimate the apnea-hypopnea index (AHI) as well as the obstructive AHI (OAHI). Our results showed a strong correlation between the changes in NFV from before to after sleep with the changes in cell membrane capacitance from before to after sleep, indicating an increase in ICW in the neck during sleep. Using linear stepwise regression we were also able to develop models to accurately predict AHI and OAHI using baseline anthropometric and bioimpedance measurements. These promising results demonstrate that non-invasive measurements of bioimpedance can be used to develop a novel biomarker to model sleep apnea severity, and assess patients at high risk of OSA. PMID:26737658

  4. What Can You Do About Sleep Apnea?

    Medline Plus

    Full Text Available ... night, is small in the younger person. When you're talking about people in their 50s or 60s, though, the risk of heart attack or stroke at night is not trivial. John Peck: And in five minutes, it's up to full speed. Announcer: After many years of living with sleep apnea, in ...

  5. High prevalence of obstructive sleep apnea in Marfan's syndrome

    Institute of Scientific and Technical Information of China (English)

    Mo Li; He Quanying; Wang Yinna; Dong Birong; He Jinhan

    2014-01-01

    Objective To review the current evidence about the prevalence of obstructive sleep apnea in patients with Marfan's syndrome,and discuss some proposed potential mechanisms for this relationship.Data sources The data in this review were mainly from Medline and PubMed articles published in English from 1990 to 2013.The search term was "Marfan's syndrome and sleep apnea".Study selection Clinical evidence about the epidemiology of obstructive sleep apnea in patients with Marfan's syndrome; the mechanism that causes obstructive sleep apnea; interventional therapy for patients with Marfan's syndrome,and coexisting obstructive sleep apnea.Results A high prevalence of obstructive sleep apnea exists in patients with Marfan's syndrome.The potential reasons are craniofacial abnormalities and lax upper airway muscles,which lead to high nasal airway resistance and upper airway collapse.Obstructive sleep apnea mechanically deteriorates aortic dilatation and accelerates progression of aortic aneurysms.The condition is reversible and rapid maxillary expansion and adequate continuous positive airway pressure therapy are possible effective therapies to delay the expansion of aortic diameter in patients with Marfan's syndrome.Conclusions Obstructive sleep apnea is strongly associated with Marfan's syndrome.Craniofacial abnormalities and lax upper airway are the main mechanisms.Untreated obstructive sleep apnea accelerates progression of aortic dissection and rupture.Effective therapies for obstructive sleep apnea could postpone the aortic dilatation in patients with Marfan's syndrome.

  6. Sleep apnea-hypopnea quantification by cardiovascular data analysis

    CERN Document Server

    Camargo, Sabrina; Anteneodo, Celia; Kurths, Juergen; Penzel, Thomas; Wessel, Niels

    2014-01-01

    Sleep apnea is the most common sleep disturbance and it is an important risk factor for cardiovascular disorders. Its detection relies on a polysomnography, a combination of diverse exams. In order to detect changes due to sleep disturbances such as sleep apnea occurrences, without the need of combined recordings, we mainly analyze systolic blood pressure signals (maximal blood pressure value of each beat to beat interval). Nonstationarities in the data are uncovered by a segmentation procedure, which provides local quantities that are correlated to apnea-hypopnea events. Those quantities are the average length and average variance of stationary patches. By comparing them to an apnea score previously obtained by polysomnographic exams, we propose an apnea quantifier based on blood pressure signal. This furnishes an alternative procedure for the detection of apnea based on a single time series, with an accuracy of 82%.

  7. A new algorithm for detecting central apnea in neonates

    International Nuclear Information System (INIS)

    Apnea of prematurity is an important and common clinical problem, and is often the rate-limiting process in NICU discharge. Accurate detection of episodes of clinically important neonatal apnea using existing chest impedance (CI) monitoring is a clinical imperative. The technique relies on changes in impedance as the lungs fill with air, a high impedance substance. A potential confounder, however, is blood coursing through the heart. Thus, the cardiac signal during apnea might be mistaken for breathing. We report here a new filter to remove the cardiac signal from the CI that employs a novel resampling technique optimally suited to remove the heart rate signal, allowing improved apnea detection. We also develop an apnea detection method that employs the CI after cardiac filtering. The method has been applied to a large database of physiological signals, and we prove that, compared to the presently used monitors, the new method gives substantial improvement in apnea detection. (paper)

  8. Obesity and Obstructive Sleep Apnea: Pathogenic Mechanisms and Therapeutic Approaches

    OpenAIRE

    Schwartz, Alan R.; Patil, Susheel P.; Laffan, Alison M.; Polotsky, Vsevolod; Schneider, Hartmut; Smith, Philip L.

    2008-01-01

    Obstructive sleep apnea is a common disorder whose prevalence is linked to an epidemic of obesity in Western society. Sleep apnea is due to recurrent episodes of upper airway obstruction during sleep that are caused by elevations in upper airway collapsibility during sleep. Collapsibility can be increased by underlying anatomic alterations and/or disturbances in upper airway neuromuscular control, both of which play key roles in the pathogenesis of obstructive sleep apnea. Obesity and particu...

  9. Sleep apnea symptoms in diabetics and their first degree relatives

    OpenAIRE

    Babak Amra; Farideh Sheikh Bahaee; Masoud Amini; Mohammad Golshan; Ingo Fietze; Thomas Penzel

    2012-01-01

    Background: Sleep apnea is associated with increased risk of diabetes mellitus. However, no studies have compared sleep apnea symptoms in diabetic patients and their first degree relatives. The purpose of our study was to investigate high risk for sleep apnea syndrome, in diabetics and their first degree relatives for prevention of diabetes in family. Methods: As a part of a cohort study, all of diabetic and their first degree relatives who came for glucose control in diabetes clinic were...

  10. The clinical and polysomnographic features in complex sleep apnea syndrome

    OpenAIRE

    İNÖNÜ, Handan; ÇİFTÇİ, Tansu Ulukavak; KÖKTÜRK, Oğuz

    2010-01-01

    Complex sleep apnea syndrome (CompSAS) is characterized by the onset of central apneas or a Cheyne-Stokes breathing pattern in some patients with obstructive sleep apnea syndrome (OSAS) who were treated with continuous positive airway pressure (CPAP). The etiology of CompSAS is unclear, but derangement of respiratory control has been proposed. We sought to compare clinical and polysomnography (PSG) features of patients with CompSAS and OSAS. Materials and methods: Records of PSG were evaluat...

  11. Ictal central apnea and bradycardia in temporal lobe epilepsy complicated by obstructive sleep apnea syndrome

    Directory of Open Access Journals (Sweden)

    Yoko Nishimura

    2015-01-01

    Full Text Available We describe the case of a 12-year-old boy who developed temporal lobe epilepsy (TLE with daily complex partial seizures (CPS and monthly generalized seizures. Moreover, he frequently snored while asleep since early childhood. Polysomnography (PSG revealed severe obstructive sleep apnea with apnea–hypopnea index (AHI of 37.8/h. Video-PSG with simultaneous electroencephalography (EEG recording captured two ictal apneic episodes during sleep, without any motor manifestations. The onset of rhythmic theta activity in the midtemporal area on EEG was preceded by the onset of apnea by several seconds and disappeared soon after cessation of central apnea. One episode was accompanied by ictal bradycardia of <48 beats/min which persisted for 50 s beyond the end of epileptic activity. After treatment with carbamazepine and tonsillectomy/adenoidectomy, the seizures were well controlled and AHI decreased to 2.5/h. Paroxysmal discharges also disappeared during this time. Uncontrolled TLE complicated by sleep apnea should be evaluated for the presence of ictal central apnea/bradycardia.

  12. Treatment of the Obstructive Sleep Apnea Syndrome

    OpenAIRE

    Wiggins, Robert V.; Schmidt-Nowara, Wolfgang W.

    1987-01-01

    The obstructive sleep apnea syndrome is a disorder of sleep and breathing that is being recognized with increasing frequency. The pathophysiologic consequences range from mild sleepiness to life-threatening cardiovascular and respiratory decompensation. The primary forms of treatment are directed at modifying the upper airway with either an operation or continuous positive airway pressure. Aside from tracheostomy, which is virtually always successful, other forms of treatment have met with va...

  13. Predictors of obstructive sleep apnea in snorers

    Directory of Open Access Journals (Sweden)

    Ibrahim Abdulsalam

    2007-01-01

    Full Text Available Background: Snoring is a common problem that poses a high risk for obstructive sleep apnea (OSA. We studied the contribution of risk factors for OSA in snorers referred for full-night polysomnography (PSG. Methods: A questionnaire was administered to subjects referred for PSG in the period from April 2002 to March 2005. Results: There were 191 (84% snorers identified by 227 PSG studies. They had a mean age of 48.1±9.8 years, (age range, 23-73 years and 78.5% were males. OSA as indicated by a respiratory disturbance index (RDI of> 5 events/hour was seen in 126 (66% subjects. In males, 72.7% had OSA, with a mean RDI of 43.0±26 events/hour, versus 39% with OSA in females with a mean RDI of 27.8±26.5 events/hour (P< 0.001. The OSA group had a higher mean Epworth Sleepiness Scale (ESS (P< 0.001, a larger mean neck circumference (P< 0.01, an increased mean age (P< 0.05, and more witnessed apneas (P< 0.001 but not choking (P=0.096. The mean increase in body mass index was linked to OSA only in females (P< 0.05 but not in the overall study (P=0.507. Multivariate analysis showed that ESS, male gender, and a history of witnessed apnea were associated with OSA, while controlling for obesity, large neck circumference, age, and history of choking. Conclusion: In screening snorers for PSG, male gender, ESS and a history of witnessed apneas were the most important predictors of OSA, but other factors should be considered in referring snorers for PSG. In males, obesity did not contribute to the risk of OSA in our study population.

  14. The pathogenesis of obstructive sleep apnea

    OpenAIRE

    Pham, Luu V.; Schwartz, Alan R.

    2015-01-01

    Obstructive sleep apnea (OSA) is a major source of cardiovascular morbidity and mortality, and represents an increasing burden on health care resources. Understanding underlying pathogenic mechanisms of OSA will ultimately allow for the development of rational therapeutic strategies. In this article, we review current concepts about the pathogenesis of OSA. Specifically, we consider the evidence that the upper airway plays a primary role in OSA pathogenesis and provide a framework for modelli...

  15. Apnea of prematurity: from cause to treatment

    OpenAIRE

    Zhao, Jing; Gonzalez, Fernando; Mu, Dezhi

    2011-01-01

    Apnea of prematurity (AOP) is a common problem affecting premature infants, likely secondary to a “physiologic” immaturity of respiratory control that may be exacerbated by neonatal disease. These include altered ventilatory responses to hypoxia, hypercapnia, and altered sleep states, while the roles of gastroesophageal reflux and anemia remain controversial. Standard clinical management of the obstructive subtype of AOP includes prone positioning and continuous positive or nasal intermittent...

  16. Study of Selection and Application of Incentive Mode of Stock Rrights of Listed Company%我国上市公司股权激励模式选择与应用研究

    Institute of Scientific and Technical Information of China (English)

    胡艳霞

    2011-01-01

    激励有助于解决股东与经营者的代理问题,实现剩余索取权和控制权的对应,促使公司管理层规避短期行为而更多关注长期可持续发展。随着激励模式的发展,如何选择合理的股权激励模式已成为我国上市公司最为关注的问题。通过对不同股权激励模式的差异比较,同时对我国上市公司股权激励模式的实施现状进行分析,在充分考虑股权激励模式中存在问题的基础上,有针对性地提出股权激励模式选择的因素及选择方法,使股权激励模式的实施在我国上市公司中取得理想效果。%Incentive is helpful to solve agency problem of shareholder and operator, it can make residual claims conformed to fight of control and urged company management layer pay more attention to long-time sustainable development and avoid short-time action. With development of incentive mode, how to select reasonable incentive mode of stock fight became the major concerns of listed companies in China. Different incentive modes of stock fight were compared and implementing situation of incentive mode of stock fight of listed companies were analyzed. Factors and choosing method incentive mode of stock fight were post forward on the basis of fully considering existing problems in incentive mode of stock fight. It is hoped that listed companies can get ideal effect through implementing incentive mode of stock right.

  17. Sleep apnea symptoms in diabetics and their first degree relatives

    Directory of Open Access Journals (Sweden)

    Babak Amra

    2012-01-01

    Conclusions : Sleep apnea symptoms may not have significant difference between diabetics and their relatives. We need more study on sleep apnea in the family of diabetic patients. We hope that more studies on mentioned field may help prevention of diabetes in their family.

  18. 77 FR 25226 - Proposed Recommendations on Obstructive Sleep Apnea

    Science.gov (United States)

    2012-04-27

    ... was published in the Federal Register on April 20, 2012 (77 FR 23794) announcing proposed regulatory... Federal Motor Carrier Safety Administration Proposed Recommendations on Obstructive Sleep Apnea AGENCY... withdrawing its proposed regulatory guidance for obstructive sleep apnea (OSA) and request for comment...

  19. Correlation between cephalometric data and severity of sleep apnea

    Directory of Open Access Journals (Sweden)

    Vanessa Gonçalves Silva

    2014-06-01

    Full Text Available INTRODUCTION: Obstructive sleep apnea syndrome has a high prevalence among adults. Cephalometric variables can be a valuable method for evaluating patients with this syndrome. OBJECTIVE: To correlate cephalometric data with the apnea-hypopnea sleep index. METHODS: We performed a retrospective and cross-sectional study that analyzed the cephalometric data of patients followed in the Sleep Disorders Outpatient Clinic of the Discipline of Otorhinolaryngology of a university hospital, from June 2007 to May 2012. RESULTS: Ninety-six patients were included, 45 men, and 51 women, with a mean age of 50.3 years. A total of 11 patients had snoring, 20 had mild apnea, 26 had moderate apnea, and 39 had severe apnea. The distance from the hyoid bone to the mandibular plane was the only variable that showed a statistically significant correlation with the apnea-hypopnea index. CONCLUSION: Cephalometric variables are useful tools for the understanding of obstructive sleep apnea syndrome. The distance from the hyoid bone to the mandibular plane showed a statistically significant correlation with the apnea-hypopnea index.

  20. Time Clustering of the Occurrence of Sleep Apnea

    Directory of Open Access Journals (Sweden)

    Nur Z.M. Saat

    2011-01-01

    Full Text Available Problem statement: In this study, the inequality of apnea rates during sleep was investigated. Approach: This study used a database comprising 13 patients with apnea problems. The data was extracted from the MIT-BIH database. The Lorenz curve and the Gini index were used to determine the inequality of apnea rates. In order to test for cluster, random or regular patterns of apnea, an index of runs was used. Results: The Lorenz curve showed that the distribution of apnea events for every 10% period of sleep varied between each patient. Meanwhile, the Gini index ranged between 0.148 and 0.614. Most of the patients had a Gini coefficient lower than 0.5. The index of runs was between 0.115 and 0.353, which indicates that most patients have a regular pattern of apnea and that it is not random. Conclusion: The distribution of the apnea is almost equal and most patients have regular patterns of occurrence of apnea.

  1. Obstructive sleep apnea hypopnea syndrome:a proinflammatory disorder

    Institute of Scientific and Technical Information of China (English)

    HAN Fang

    2007-01-01

    @@ Obstructive sleep apnea hypopnea syndrome (OSAHS) is a rather frequent disorder affecting 2%-4% of the general population. Large cohort studies have confirmed that obstructive sleep apnea (OSA) is an independent risk factor for cardiovascular disease (CVD), including myocardial infarction, hypertension, stroke and so on. For example, Sleep Heart Health Study (SHHS) demonstrated that the prevalence of CVD (including myocardial infarction, angina, coronary revascularization, heart failure, stroke) was 1.42 times greater in patients with OSA (apnea/hypopnea index (AHI)>11 events/hour) than in those without OSA.1 However, the exact mechanisms linking sleep apnea to cardiovascular morbidity remain unclear. Two studies2,3 published in this issue of the Journal measured a series of subclinical inflammatory factors in patients with OSA, and added new evidence linking sleep apnea to cardiovascular morbidity.

  2. Obstructive apnea during sleep is associated with peripheral vasoconstriction

    Science.gov (United States)

    Imadojemu, Virginia A.; Gleeson, Kevin; Gray, Kristen S.; Sinoway, Lawrence I.; Leuenberger, Urs A.

    2002-01-01

    Obstructive apnea during sleep is associated with a substantial transient blood pressure elevation. The mechanism of this pressor response is unclear. In this study we measured muscle sympathetic nerve activity (MSNA), mean arterial pressure (Psa), and mean limb blood velocity as an index of blood flow (MBV, Doppler) and calculated changes in limb vascular resistance during and after apneas during both wakefulness and sleep in patients with the obstructive sleep apnea syndrome. Immediately postapnea during sleep Psa increased significantly compared with the earlier stages of apnea and this was preceded by a rise of MSNA (n = 5). In contrast to blood pressure, MBV remained unchanged. Because resistance = blood pressure/blood flow, limb vascular resistance increased by 29 +/- 8% from late apnea to postapnea (n = 7, p vasoconstriction. This vasoconstrictor response appears to be, at least in part, mediated by the sympathetic nervous system and may be linked to hypoxia.

  3. Sleep apnea syndrome after irradiation of the neck

    Energy Technology Data Exchange (ETDEWEB)

    Herlihy, J.P.; Whitlock, W.L.; Dietrich, R.A.; Shaw, T. (Pulmonary Disease Service, Presidio of San Francisco, CA (USA))

    1989-12-01

    After irradiation of the neck for a squamous cell carcinoma of the tonsillar pillar and vocal cord, a 71-year-old man presented with a rapidly progressive sleep apnea syndrome. Previous reports describe the condition of patients with obstructive sleep apnea that developed after neck irradiation and secondary to supraglottic edema. Our patient had an obstructive component to his apnea similar to that described in previous cases, but, in addition, he had hypothyroidism. Myxedema is a well-described cause of both obstructive and central apnea. We believe both contributed to his condition. He was successfully treated by placement of a tracheostomy and by thyroid supplementation. In patients who present with sleep apnea after neck irradiation, especially with acute or severe symptoms, the differential diagnosis should include both a central cause from hypothyroidism as well as a peripheral obstructive cause from laryngeal edema.

  4. Sleep apnea syndrome after irradiation of the neck

    International Nuclear Information System (INIS)

    After irradiation of the neck for a squamous cell carcinoma of the tonsillar pillar and vocal cord, a 71-year-old man presented with a rapidly progressive sleep apnea syndrome. Previous reports describe the condition of patients with obstructive sleep apnea that developed after neck irradiation and secondary to supraglottic edema. Our patient had an obstructive component to his apnea similar to that described in previous cases, but, in addition, he had hypothyroidism. Myxedema is a well-described cause of both obstructive and central apnea. We believe both contributed to his condition. He was successfully treated by placement of a tracheostomy and by thyroid supplementation. In patients who present with sleep apnea after neck irradiation, especially with acute or severe symptoms, the differential diagnosis should include both a central cause from hypothyroidism as well as a peripheral obstructive cause from laryngeal edema

  5. Sexual function in female patients with obstructive sleep apnea

    DEFF Research Database (Denmark)

    Giraldi, Annamaria G.E.; Petersen, Marian; Kristensen, Ellids;

    2011-01-01

    . Female Sexual Function Index, Female Sexual Distress Scale and four questions from Life Satisfaction-11 (Lisat-11). Results. Female Sexual Function Index indicated that obstructive sleep apnea patients were at a higher risk for having sexual difficulties. Female Sexual Distress Scale showed significantly...... more sexual distress in the obstructive sleep apnea group. Manifest Female Sexual Dysfunction (combined data from Female Sexual Function Index and Female Sexual Distress Scale) showed that female patients with obstructive sleep apnea also had more sexual dysfunction. Severity of sleep apnea was...... function and distress are sparse. Aim. To investigate sexual dysfunction and sexual distress in female patients with obstructive sleep apnea and to determine which factors are of importance for their sexual function. Methods. We investigated 80 female patients (ages 28–64) admitted to a sleep laboratory...

  6. A Sludge Drum in the APNea System

    Energy Technology Data Exchange (ETDEWEB)

    Hensley, D.

    1998-11-17

    The assay of sludge drums pushes the APNea System to a definite extreme. Even though it seems clear that neutron based assay should be the method of choice for sludge drums, the difficulties posed by this matrix push any NDA technique to its limits. Special emphasis is given here to the differential die-away technique, which appears to approach the desired sensitivity. A parallel analysis of ethafoam drums will be presented, since the ethafoam matrix fits well within the operating range of the AIWea System, and, having been part of the early PDP trials, has been assayed by many in the NDA community.

  7. Reduction of internal carotid artery intima-media thickness in patients with moderate-to-severe obstructive sleep apnea syndrome after nasal surgery and uvulopalatopharyngoplasty.

    Science.gov (United States)

    Peng, Yikun; Zhang, Liangchun; Hu, Defeng; Dai, Yubing; Wang, Shuhui; Liao, Hongyong; Xiong, Yan

    2016-05-01

    Conclusion Multi-level surgeries for the nasal cavity and palate can reduce the severity of obstructive sleep apnea with major narrowing above the retropalatal airway and reduce the carotid intima-media thickness, which can provide cardiovascular benefits to patients. Objective To evaluate the outcomes of moderate-to-severe obstructive sleep apnea syndrome by surgeries and the change of internal carotid artery intima-media thickness after surgeries. Subjects and methods Sixty-four patients with obstructive sleep apnea, narrowing at the nasal cavity, and retropalatal airways were enrolled in this study. Fifty-two patients underwent nasal surgery and modified uvulopalatopharyngoplasty. Twelve patients who refused surgeries and continuous positive airway pressure treatment received only conservative treatment. All patients were evaluated within 1 month before and 6 months after treatment using polysomnography, upper airway endoscopy, and B mode ultrasound. Results The success rate was 61.5% (32/52 patients) in the surgery group. There were significant differences between the surgery group and non-surgery group 6 months after treatment in the apnea hypopnea index, minimum and mean oxygen saturation, blood pressure, triglyceride, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and internal Carotid intima-media thickness. The changes in the oxygen saturation and the apnea hypopnea index showed significant correlations with the changes in the intima-media thickness. PMID:26824298

  8. Respiratory sound recordings for detection of sleep apnea

    Science.gov (United States)

    Waldemark, Karina E.; Agehed, Kenneth I.; Lindblad, Thomas

    1999-03-01

    Sleep apnea is characterized by frequent prolonged interruptions of breathing during sleep. This syndrome causes severe sleep disorders and is often responsible for development of other diseases such as heart problems, high blood pressure and daytime fatigue, etc. After diagnosis, sleep apnea is often successfully treated by applying positive air pressure (CPAP) to the mouth and nose. Although effective, the (CPAP) equipment takes up a lot of space and the connected mask causes a lot of inconvenience for the patients. This raised interest in developing new techniques for treatment of sleep apnea syndrome. Several studies indicated that electrical stimulation of the hypoglossal nerve and muscle in the tongue may be a useful method for treating patients with severe sleep apnea. In order to be able to successfully prevent the occurrence of apnea it is necessary to have some technique for early and fast on-line detection or prediction of the apnea events. This paper suggests using measurements of respiratory airflow (mouth temperature). The signal processing for this task includes the use of a window short-FFT technique and uses an artificial back propagation neural net to model or predict the occurrence of apneas. The results show that early detection of respiratory interruption is possible and that the delay time for this is small.

  9. Diagnosis and Treatment of Obstructive Sleep Apnea in Adults.

    Science.gov (United States)

    Semelka, Michael; Wilson, Jonathan; Floyd, Ryan

    2016-09-01

    Obstructive sleep apnea is a common disorder that causes patients to temporarily stop or decrease their breathing repeatedly during sleep. This results in fragmented, nonrestful sleep that can lead to symptoms such as morning headache and daytime sleepiness. Obstructive sleep apnea affects persons of all ages, with an increasing prevalence in those older than 60 years. The exact prevalence is unknown but is estimated to be between 2% and 14%. There are many health conditions associated with obstructive sleep apnea, including hypertension, coronary artery disease, cardiac arrhythmias, and depression. Loud snoring, gasping during sleep, obesity, and enlarged neck circumference are predictive clinical features. Screening questionnaires can be used to assess for sleep apnea, although their accuracy is limited. The diagnostic standard for obstructive sleep apnea is nocturnal polysomnography in a sleep laboratory. Home sleep apnea tests can be performed for certain patients but are generally considered less accurate. Continuous positive airway pressure is the first-line treatment; adherence rates are variable and seem to improve with early patient education and support. Other treatment modalities include weight reduction, oral appliance therapy, and surgery to correct anatomic obstructions, although there is insufficient evidence to support these types of surgeries. Bariatric surgery can improve sleep parameters and symptoms in obese patients with obstructive sleep apnea and can result in remission in many patients. PMID:27583421

  10. Sex differences in sleep apnea predictors and outcomes from home sleep apnea testing

    Science.gov (United States)

    Cairns, Alyssa; Poulos, Greg; Bogan, Richard

    2016-01-01

    Study objectives To evaluate sex differences in predictors of obstructive sleep apnea (OSA) as per outcomes from home sleep apnea testing. Design This was a retrospective analysis of a large repository of anonymous test results and pretest risk factors for OSA. Setting and patients A total of 272,705 patients were referred for home sleep apnea testing from a variety of clinical practices for suspected sleep disordered breathing across North America from 2009 to 2013. Interventions Not applicable. Measurements and results Predictors of OSA (apnea hypopnea index4%≥5) were evaluated by multiple logistic regression; sex differences were evaluated by interaction effects. Middle age was the single most robust predictor of OSA for both sexes and was particularly foretelling for females (P<0.001) even after controlling for measures of adiposity and medical conditions. Females over the age of 45 years were much more likely to have OSA compared to their younger counterparts (78.7% vs 42.5%, respectively; odds ratio: 5.0) versus males (88.1% vs 68.8%, respectively; odds ratio: 3.4). Snoring, although more frequently reported by males, was similarly predictive of OSA for both sexes. Witnessed apneas and measures of adiposity were better predictors of OSA for males than females. Insomnia, depression, and use of sleep medication, although more commonly reported in females, did not predict OSA. Hypertension, although equally reported by both sexes, performed better as a predictor in females (P<0.001), even after controlling for age, measures of adiposity, and other medical conditions. Diabetes, heart disease, stroke, and sleepiness did not contribute unique variance in OSA in adjusted models. Conclusion This study found that males and females report different symptoms upon clinical evaluation for suspected sleep apnea, with some of the “classic” OSA features to be more common in and robustly predictive for males. The finding that advancing age uniquely and robustly

  11. Facial morphology and obstructive sleep apnea

    Science.gov (United States)

    Capistrano, Anderson; Cordeiro, Aldir; Capelozza, Leopoldino; Almeida, Veridiana Correia; Silva, Priscila Izabela de Castro e; Martinez, Sandra; de Almeida-Pedrin, Renata Rodrigues

    2015-01-01

    Objective: This study aimed at assessing the relationship between facial morphological patterns (I, II, III, Long Face and Short Face) as well as facial types (brachyfacial, mesofacial and dolichofacial) and obstructive sleep apnea (OSA) in patients attending a center specialized in sleep disorders. Methods: Frontal, lateral and smile photographs of 252 patients (157 men and 95 women), randomly selected from a polysomnography clinic, with mean age of 40.62 years, were evaluated. In order to obtain diagnosis of facial morphology, the sample was sent to three professors of Orthodontics trained to classify patients' face according to five patterns, as follows: 1) Pattern I; 2) Pattern II; 3) Pattern III; 4) Long facial pattern; 5) Short facial pattern. Intraexaminer agreement was assessed by means of Kappa index. The professors ranked patients' facial type based on a facial index that considers the proportion between facial width and height. Results: The multiple linear regression model evinced that, when compared to Pattern I, Pattern II had the apnea and hypopnea index (AHI) worsened in 6.98 episodes. However, when Pattern II was compared to Pattern III patients, the index for the latter was 11.45 episodes lower. As for the facial type, brachyfacial patients had a mean AHI of 22.34, while dolichofacial patients had a significantly statistical lower index of 10.52. Conclusion: Patients' facial morphology influences OSA. Pattern II and brachyfacial patients had greater AHI, while Pattern III patients showed a lower index. PMID:26691971

  12. Childhood Obesity and Obstructive Sleep Apnea

    Directory of Open Access Journals (Sweden)

    Indra Narang

    2012-01-01

    Full Text Available The global epidemic of childhood and adolescent obesity and its immediate as well as long-term consequences for obese individuals and society as a whole cannot be overemphasized. Obesity in childhood and adolescence is associated with an increased risk of adult obesity and clinically significant consequences affecting the cardiovascular and metabolic systems. Importantly, obesity is additionally complicated by obstructive sleep apnea (OSA, occurring in up to 60% of obese children. OSA, which is diagnosed using the gold standard polysomnogram (PSG, is characterised by snoring, recurrent partial (hypopneas or complete (apneas obstruction of the upper airway. OSA is frequently associated with intermittent oxyhemoglobin desaturations, sleep disruption, and sleep fragmentation. There is emerging data that OSA is associated with cardiovascular burden including systemic hypertension, changes in ventricular structure and function, arterial stiffness, and metabolic syndromes. Thus, OSA in the context of obesity may independently or synergistically magnify the underlying cardiovascular and metabolic burden. This is of importance as early recognition and treatment of OSA in obese children are likely to result in the reduction of cardiometabolic burden in obese children. This paper summarizes the current state of understanding of obesity-related OSA. Specifically, this paper will discuss epidemiology, pathophysiology, cardiometabolic burden, and management of obese children and adolescents with OSA.

  13. Relationship Between Snoring Intensity and Severity of Obstructive Sleep Apnea

    OpenAIRE

    Kim, Jeong-Whun; Lee, Chul Hee; Rhee, Chae Seo; Mo, Ji-Hun

    2015-01-01

    Objectives The aim of this study was to determine the relationship between the intensity of snoring and severity of sleep apnea using Watch-PAT (peripheral arterial tone) 100. Methods A total of 404 patients (338 males and 66 females) who underwent home-based portable sleep study using Watch-PAT 100 for obstructive sleep apnea (OSA) from January 2009 through December 2011 were included in this study. Subjects were divided into 4 groups; no OSA (PAT apnea hypopnea index [pAHI

  14. Sleep Apnea and Cognitive Function in Heart Failure

    Directory of Open Access Journals (Sweden)

    Krysten M. Knecht

    2012-01-01

    Full Text Available Background. Prior research indicates that heart failure (HF patients exhibit significant cognitive deficits on neuropsychological testing. Sleep apnea is associated with both HF and reduced cognitive function, but the combined impact of these conditions on cognitive function is unknown. Methods. In the current study, 172 older adults with a dual diagnosis of HF and sleep apnea or HF alone completed a battery of cognitive tests measuring attention, executive functioning, and memory. Results. Relative to patients with HF alone, persons with both HF and sleep apnea performed worse on measures of attention after adjusting for demographic and medical variables. Conclusions. The current findings suggest that HF patients with comorbid sleep apnea may be at greater risk for cognitive impairment relative to HF patient without such history. Further work is needed to clarify mechanisms for these findings and to determine whether the interactive effects on cognitive function lead to poorer patient outcomes.

  15. Study Finds a Connection between Glaucoma and Sleep Apnea

    Science.gov (United States)

    ... an Ophthalmologist Patient Stories Español Eye Health / News Study Finds a Connection Between Glaucoma and Sleep Apnea Sep. 06, 2013 Over the years, several studies have demonstrated an increased rate of glaucoma among ...

  16. Sleep Apnea May Take Toll on Your Mood, Thinking Skills

    Science.gov (United States)

    ... Apnea May Take Toll on Your Mood, Thinking Skills Study found altered levels of brain chemicals that ... of Health, the U.S. Department of Health and Human Services, or federal policy. More Health News on: ...

  17. CT demonstration of pharyngeal narrowing in adult obstructive sleep apnea

    International Nuclear Information System (INIS)

    Sleep apnea is a major cause of daytime hypersomnolence. Among the proposed etiologies, focal obstruction of the airways at the level of the pharynx has been suggested but not proven. Using computed tomography, the cross-sectional area of the airway can be readily assessed. Thirty-three adults with clinically proven sleep apnea and 12 normal adults underwent systematic computed tomography of the neck. Significant airway narrowing was demonstrated in all the patients with obstructive sleep apnea, whereas no such narrowing was seen in the controls. In 11, the narrowing was at a single level, whereas in 22 patients two or more levels were affected. This study has shown that a structurally abnormal airway may serve as an anatomic substrate for the development of sleep apnea. On the basis of this evidence, uvulopalatopharyngoplasty has been performed in two patients with relief of symptoms in one

  18. Depressive symptoms and childhood sleep apnea syndrome

    Directory of Open Access Journals (Sweden)

    Carotenuto M

    2012-08-01

    Full Text Available Marco Carotenuto,1 Maria Esposito,1 Lucia Parisi,2 Beatrice Gallai,3 Rosa Marotta,4 Antonio Pascotto,1 Michele Roccella21Sleep Clinic for Developmental Age, Clinic of Child and Adolescent Neuropsychiatry, Second University of Naples, Naples, Italy; 2Child Neuropsychiatry, Department of Psychology, University of Palermo, Palermo, Italy; 3Unit of Child and Adolescent Neuropsychiatry, University of Perugia, Perugia, 4Department of Psychiatry, "Magna Graecia" University of Catanzaro, Catanzaro, ItalyBackground: The relationship between sleep and mood regulation is well known, and some reports suggest a key role of sleep-related breathing disorders (SRBD in the development of the symptomatology of depression, even if no conclusive data are actually found in the clinical literature. The aim of this study was to assess the relationship between SRBD and depressive symptoms in a population of school-aged children.Methods: The study population comprised 94 children affected by SRBD and 107 healthy children. To identify the severity of SRBD, an overnight respiratory evaluation was performed. All subjects filled out the Italian version of the Children Depression Inventory (CDI to screen for the presence of depressive symptoms.Results: The group with SRBD showed higher CDI scores than the group without SRBD, with a positive correlation found between CDI scores, apnea-hypopnea index, and oxygen desaturation index values. Logistic regression showed that an apnea-hypopnea index ≥ 3 and an oxygen desaturation index ≥ 1 could be risk factors for development of depressive symptoms. According to receiver-operating characteristic curve analysis, the cutoff point for the apnea-hypopnea index that could cause a pathological CDI score (≥19 was >5.66, and the cutoff point for the oxygen desaturation index was >4.2. The limitations of this study are that our data are derived from one single psychometric test and not from a complete psychiatric evaluation, and our

  19. A Clinical Prediction Formula for Apnea-Hypopnea Index

    OpenAIRE

    Mustafa Sahin; Cem Bilgen; M. Sezai Tasbakan; Rasit Midilli; Basoglu, Ozen K.

    2014-01-01

    Objectives. There are many studies regarding unnecessary polysomnography (PSG) when obstructive sleep apnea syndrome (OSAS) is suspected. In order to reduce unnecessary PSG, this study aims to predict the apnea-hypopnea index (AHI) via simple clinical data for patients who complain of OSAS symptoms. Method. Demographic, anthropometric, physical examination and laboratory data of a total of 390 patients (290 men, average age 50 ± 11) who were subject to diagnostic PSG were obtained and evaluat...

  20. Sex differences in forearm vasoconstrictor response to voluntary apnea

    OpenAIRE

    Patel, Hardikkumar M.; Heffernan, Matthew J.; Ross, Amanda J.; Muller, Matthew D.

    2013-01-01

    Clinical evidence indicates that obstructive sleep apnea is more common and more severe in men compared with women. Sex differences in the vasoconstrictor response to hypoxemia-induced sympathetic activation might contribute to this clinical observation. In the current laboratory study, we determined sex differences in the acute physiological responses to maximal voluntary end-expiratory apnea (MVEEA) during wakefulness in healthy young men and women (26 ± 1 yr) as well as healthy older men a...

  1. Prevalence of cardiac arrhythmia in obstructive sleep apnea syndrome

    OpenAIRE

    Bayram, Nihal Akar; ÇİFTÇİ, Bülent; GÜVEN, Selma FIRAT; Bayram, Hüseyin; DİKER, Hasbi Erdem; Durmaz, Tahir; KELEŞ, TELAT; Bozkurt, Engin

    2010-01-01

    Repetitive transient activation of the parasympathetic and sympathetic systems in obstructive sleep apnea syndrome (OSAS) constitutes the basis for development of cardiac arrhythmias. We aimed to examine the prevalence of arrhythmias in OSAS. Materials and methods: Eighty-eight patients with suspected OSAS were included in the study. Polysomnography was performed overnight in all patients. Patients with apnea-hypopnea index (AHI) < 5 were considered OSAS negative, while patients with AHI ...

  2. Prediction of Effective CPAP Level in Obstructive Sleep Apnea Syndrome

    OpenAIRE

    Selda KORKMAZ; İSMAİLOĞULLARI, Sevda; Duman, Ayşe; Aksu, Murat

    2012-01-01

    Background: Prediction of effective CPAP level to treat obstructive sleep apnea syndrome (OSAS) before CPAP titration helps the effectiveness of titration. Several algorithms that predict the optimal continuous positive airways pressure (CPAP) level have been developed. However, a standard algorithm has not been composed.There are two aims of this study. First, to examine the factors that account for the variability in CPAP levels required to abolish apnea and hypopnea in patients with OSAS. ...

  3. Sleep Apnea and Nocturnal Cardiac Arrhythmia: A Populational Study

    Directory of Open Access Journals (Sweden)

    Fatima Dumas Cintra

    2014-11-01

    Full Text Available Background: The mechanisms associated with the cardiovascular consequences of obstructive sleep apnea include abrupt changes in autonomic tone, which can trigger cardiac arrhythmias. The authors hypothesized that nocturnal cardiac arrhythmia occurs more frequently in patients with obstructive sleep apnea. Objective: To analyze the relationship between obstructive sleep apnea and abnormal heart rhythm during sleep in a population sample. Methods: Cross-sectional study with 1,101 volunteers, who form a representative sample of the city of São Paulo. The overnight polysomnography was performed using an EMBLA® S7000 digital system during the regular sleep schedule of the individual. The electrocardiogram channel was extracted, duplicated, and then analyzed using a Holter (Cardio Smart® system. Results: A total of 767 participants (461 men with a mean age of 42.00 ± 0.53 years, were included in the analysis. At least one type of nocturnal cardiac rhythm disturbance (atrial/ventricular arrhythmia or beat was observed in 62.7% of the sample. The occurrence of nocturnal cardiac arrhythmias was more frequent with increased disease severity. Rhythm disturbance was observed in 53.3% of the sample without breathing sleep disorders, whereas 92.3% of patients with severe obstructive sleep apnea showed cardiac arrhythmia. Isolated atrial and ventricular ectopy was more frequent in patients with moderate/severe obstructive sleep apnea when compared to controls (p < 0.001. After controlling for potential confounding factors, age, sex and apnea-hypopnea index were associated with nocturnal cardiac arrhythmia. Conclusion: Nocturnal cardiac arrhythmia occurs more frequently in patients with obstructive sleep apnea and the prevalence increases with disease severity. Age, sex, and the Apnea-hypopnea index were predictors of arrhythmia in this sample.

  4. Osteopathy may decrease obstructive apnea in infants: a pilot study

    OpenAIRE

    Vandenplas, Yvan; Denayer, Etienne; Vandenbossche, Thierry; Vermet, Luc; Hauser, Bruno; Deschepper, Jean; Engelen, Agnes

    2008-01-01

    Background Obstructive apnea is a sleep disorder characterized by pauses in breathing during sleep: breathing is interrupted by a physical block to airflow despite effort. The purpose of this study was to test if osteopathy could influence the incidence of obstructive apnea during sleep in infants. Methods Thirty-four healthy infants (age: 1.5–4.0 months) were recruited and randomized in two groups; six infants dropped out. The osteopathy treatment group (n = 15 infants) received 2 osteopathi...

  5. Stochastic modeling of central apnea events in preterm infants.

    Science.gov (United States)

    Clark, Matthew T; Delos, John B; Lake, Douglas E; Lee, Hoshik; Fairchild, Karen D; Kattwinkel, John; Randall Moorman, J

    2016-04-01

    A near-ubiquitous pathology in very low birth weight infants is neonatal apnea, breathing pauses with slowing of the heart and falling blood oxygen. Events of substantial duration occasionally occur after an infant is discharged from the neonatal intensive care unit (NICU). It is not known whether apneas result from a predictable process or from a stochastic process, but the observation that they occur in seemingly random clusters justifies the use of stochastic models. We use a hidden-Markov model to analyze the distribution of durations of apneas and the distribution of times between apneas. The model suggests the presence of four breathing states, ranging from very stable (with an average lifetime of 12 h) to very unstable (with an average lifetime of 10 s). Although the states themselves are not visible, the mathematical analysis gives estimates of the transition rates among these states. We have obtained these transition rates, and shown how they change with post-menstrual age; as expected, the residence time in the more stable breathing states increases with age. We also extrapolated the model to predict the frequency of very prolonged apnea during the first year of life. This paradigm-stochastic modeling of cardiorespiratory control in neonatal infants to estimate risk for severe clinical events-may be a first step toward personalized risk assessment for life threatening apnea events after NICU discharge. PMID:26963049

  6. Obstructive Sleep Apnea: A Cluster Analysis at Time of Diagnosis

    Science.gov (United States)

    Grillet, Yves; Richard, Philippe; Stach, Bruno; Vivodtzev, Isabelle; Timsit, Jean-Francois; Lévy, Patrick; Tamisier, Renaud; Pépin, Jean-Louis

    2016-01-01

    Background The classification of obstructive sleep apnea is on the basis of sleep study criteria that may not adequately capture disease heterogeneity. Improved phenotyping may improve prognosis prediction and help select therapeutic strategies. Objectives: This study used cluster analysis to investigate the clinical clusters of obstructive sleep apnea. Methods An ascending hierarchical cluster analysis was performed on baseline symptoms, physical examination, risk factor exposure and co-morbidities from 18,263 participants in the OSFP (French national registry of sleep apnea). The probability for criteria to be associated with a given cluster was assessed using odds ratios, determined by univariate logistic regression. Results: Six clusters were identified, in which patients varied considerably in age, sex, symptoms, obesity, co-morbidities and environmental risk factors. The main significant differences between clusters were minimally symptomatic versus sleepy obstructive sleep apnea patients, lean versus obese, and among obese patients different combinations of co-morbidities and environmental risk factors. Conclusions Our cluster analysis identified six distinct clusters of obstructive sleep apnea. Our findings underscore the high degree of heterogeneity that exists within obstructive sleep apnea patients regarding clinical presentation, risk factors and consequences. This may help in both research and clinical practice for validating new prevention programs, in diagnosis and in decisions regarding therapeutic strategies. PMID:27314230

  7. Obstructive sleep apnea presenting as pseudopheochromocytoma

    Science.gov (United States)

    Marmouch, Hela; Arfa, Sondes; Graja, Sameh; Slim, Tensim; Khochtali, Ines

    2016-01-01

    A 52-year-old female with a history of poorly controlled resistant hypertension was admitted to our hospital with severe hypertension. She had a history of fatigue and intermittent episodes of palpitations. Laboratory evaluation was significant for elevated 24-h urinary catecholamine levels (3,5 times the upper normal levels). This case was presenting with a clinical and biochemical picture indistinguishable from that of pheochromocytoma. However, neither computed tomography nor meta-iodo-benzyl-guanidine scintigraphy detected any catecholamine-producing tumor in or outside the adrenal glands. Our patient was screened with full polysomnography because of heavy snoring, daytime somnolence and obesity. It revealed severe obstructive sleep apnea syndrome. After three months of continuous positive airway pressure therapy, the patient experienced resolution of his presenting symptoms, improved blood pressure control and normalization of his urinary catecholamine levels. This case highlights sleep disordered breathing as a potentially reversible cause of pseudo-pheochromocytoma. PMID:27217898

  8. Contemporary surgery for obstructive sleep apnea syndrome.

    Science.gov (United States)

    Powell, Nelson B

    2009-09-01

    Surgical treatment of obstructive sleep apnea syndrome (OSAS) has been available in some form for greater than three decades. Early management for airway obstruction during sleep relied on tracheotomy which although life saving was not well accepted by patients. In the early eighties two new forms of treatment for OSAS were developed. Surgically a technique described as a uvulopalatopharyngoplasty (UPPP) was used to treat the retropalatal region for snoring and sleep apnea. Concurrently sleep medicine developed a nasal continuous positive airway pressure (CPAP) device to manage nocturnal airway obstruction. Both of these measures were used to expand and stabilize the pharyngeal airway space during sleep. The goal for each technique was to limit or alleviate OSAS. Almost 30 yr later these two treatment modalities continue to be the mainstay of contemporary treatment. As expected, CPAP device technology improved over time along with durable goods. Surgery followed suit and additional techniques were developed to treat soft and bony structures of the entire upper airway (nose, palate and tongue base). This review will only focus on the contemporary surgical methods that have demonstrated relatively consistent positive clinical outcomes. Not all surgical and medical treatment modalities are successful or even partially successful for every patient. Advances in the treatment of OSAS are hindered by the fact that the primary etiology is still unknown. However, both medicine and surgery continue to improve diagnostic and treatment methods. Methods of diagnosis as well as treatment regimens should always include both medical and surgical collaborations so the health and quality of life of our patients can best be served. PMID:19784401

  9. Washout of {sup 82}Rb as a marker of impaired tissue integrity, obtained by list-mode cardiac PET/CT: relationship with perfusion/metabolism patterns of myocardial viability

    Energy Technology Data Exchange (ETDEWEB)

    Chien, David T.; Bravo, Paco; Higuchi, Takahiro; Merrill, Jennifer [Johns Hopkins University School of Medicine, Division of Nuclear Medicine, Russell H Morgan Department of Radiology, Baltimore, MD (United States); Bengel, Frank M. [Johns Hopkins University School of Medicine, Division of Nuclear Medicine, Russell H Morgan Department of Radiology, Baltimore, MD (United States); Hannover Medical School, Department of Nuclear Medicine, Hannover (Germany)

    2011-08-15

    Myocardial washout of the potassium analogue {sup 82}Rb may indicate tissue impairment. Few studies have evaluated its usefulness for viability assessment, and controversial results were reported. We revisited this topic using list-mode positron emission tomography (PET)/CT. A total of 22 patients with chronic ischemic cardiomyopathy (ICM) and 11 control subjects with normal CT coronary angiogram were studied. Rest {sup 82}Rb PET/CT studies were acquired in list mode and resampled to static, gated, and dynamic images. Using a 17-segment model, {sup 82}Rb washout was determined by monoexponential fitting of myocardial time-activity curves. In ICM patients, {sup 18}F-fluorodeoxyglucose (FDG) studies were obtained in the same session and segments were classified as normally perfused, mismatch, or matched defect. {sup 82}Rb washout was minimal and homogeneous in control subjects. Normally perfused segments of ICM did not differ (p = 0.33). ICM patients had a left ventricular ejection fraction (LVEF) of 25 {+-} 12%, 25/353 mismatched, and 46/353 matched defect segments. {sup 82}Rb washout was higher in hypoperfused vs normal segments (p < 0.05), but not different between mismatch and matched defect (p = 0.18). Intraindividual analysis in nine patients showing both FDG mismatch and matched defect confirmed absence of differences. Overall, segmental {sup 82}Rb washout correlated inversely with {sup 82}Rb uptake (r = -0.70; p < 0.05) and less well with FDG uptake (r = -0.31; p < 0.05). Using state-of-the-art PET/CT technology for myocardial viability assessment, {sup 82}Rb washout does not distinguish between perfusion/metabolism patterns of hibernating myocardium and scar. Tissue integrity may be at least partially impaired in hibernation. (orig.)

  10. Low-grade albuminuria in children with obstructive sleep apnea.

    Science.gov (United States)

    Varlami, Vasiliki; Malakasioti, Georgia; Alexopoulos, Emmanouel I; Theologi, Vasiliki; Theophanous, Eleni; Liakos, Nikolaos; Daskalopoulou, Euphemia; Gourgoulianis, Konstantinos; Kaditis, Athanasios G

    2013-06-01

    Small urinary protein loss (low-grade albuminuria or microalbuminuria) may reflect altered permeability of the glomerular filtration barrier. In the present study, it was hypothesized that children with obstructive sleep apnea have an increased risk of microalbuminuria compared with control subjects without sleep-disordered breathing. Albumin-to-creatinine ratio was measured in morning spot urine specimens collected from consecutive children with or without snoring who were referred for polysomnography. Three groups were studied: (i) control subjects (no snoring, apnea-hypopnea index  5 episodes∙h(-1) ; n = 27). Indications for polysomnography in control subjects included nightmares, somnambulism and morning headaches. An albumin-to-creatinine ratio > median value in the control group (1.85 mg of albumin per g of creatinine) was defined as elevated. Logistic regression analysis revealed that children with moderate-to-severe obstructive sleep apnea, but not those with mild obstructive sleep apnea, had increased risk of elevated albumin-to-creatinine ratio relative to controls (reference) after adjustment for age, gender and presence of obesity: odds ratio 3.8 (95% confidence interval 1.1-12.6); P = 0.04 and 1.5 (0.6-3.7); P > 0.05, respectively. Oxygen desaturation of hemoglobin and respiratory arousal indices were significant predictors of albumin-to-creatinine ratio (r = 0.31, P = 0.01; and r = 0.43, P < 0.01, respectively). In conclusion, children with moderate-to-severe obstructive sleep apnea are at significantly higher risk of increased low-grade excretion of albumin in the morning urine as compared with control subjects without obstructive sleep apnea. These findings may reflect altered permeability of the glomerular filtration barrier related to nocturnal hypoxemia and sympathetic activation which are induced by obstructive sleep apnea. PMID:23228180

  11. Upper airway neuromuscular compensation during sleep is defective in obstructive sleep apnea

    OpenAIRE

    McGinley, Brian M.; Schwartz, Alan R.; Schneider, Hartmut; Kirkness, Jason P.; Smith, Philip L; Patil, Susheel P.

    2008-01-01

    Obstructive sleep apnea is the result of repeated episodes of upper airway obstruction during sleep. Recent evidence indicates that alterations in upper airway anatomy and disturbances in neuromuscular control both play a role in the pathogenesis of obstructive sleep apnea. We hypothesized that subjects without sleep apnea are more capable of mounting vigorous neuromuscular responses to upper airway obstruction than subjects with sleep apnea. To address this hypothesis we lowered nasal pressu...

  12. Degeneration in Arousal Neurons in Chronic Sleep Disruption Modeling Sleep Apnea

    OpenAIRE

    Zhu, Yan; Fenik, Polina; Zhan, Guanxia; Xin, Ryan; Veasey, Sigrid C.

    2015-01-01

    Chronic sleep disruption (CSD) is a cardinal feature of sleep apnea that predicts impaired wakefulness. Despite effective treatment of apneas and sleep disruption, patients with sleep apnea may have persistent somnolence. Lasting wake disturbances in treated sleep apnea raise the possibility that CSD may induce sufficient degeneration in wake-activated neurons (WAN) to cause irreversible wake impairments. Implementing a stereological approach in a murine model of CSD, we found reduced neurona...

  13. Upper GI examinations in older premature infants with persistent apnea: Correlation with simultaneous cardiorespiratory monitoring

    Energy Technology Data Exchange (ETDEWEB)

    Itani, Y.; Niitsu, N.; Oono, T.; Fujioka, M.; Nishimura, G.

    1988-09-01

    Upper gastrointestinal examinations with simultaneous cardiorespiratory monitoring were performed in 39 older premature infants with persistent apnea. Swallowing incoordination was documented to be causatively related to persistent apnea in such infants, especially with feeding. Direct relationship between apnea and gastroesophageal reflux was not documented in this study.

  14. Upper GI examinations in older premature infants with persistent apnea: Correlation with simultaneous cardiorespiratory monitoring

    International Nuclear Information System (INIS)

    Upper gastrointestinal examinations with simultaneous cardiorespiratory monitoring were performed in 39 older premature infants with persistent apnea. Swallowing incoordination was documented to be causatively related to persistent apnea in such infants, especially with feeding. Direct relationship between apnea and gastroesophageal reflux was not documented in this study. (orig.)

  15. Radionuclide assessment of left ventricular diastolic function in patients with mitral stenosis before and after percutaneous transvenous mitral commissurotomy; Use of list mode method in patients with atrial fibrillation

    Energy Technology Data Exchange (ETDEWEB)

    Nakamura, Seishi; Iwasaka, Toshiji; Kimura, Yutaka; Ohkubo, Naohiko; Matsuura, Takashi; Inada, Mitsuo; Shiraishi, Tomokuni (Kansai Medical School, Moriguchi, Osaka (Japan))

    1991-07-01

    To evaluate the effect of percutaneous transvenous mitral commissurotomy (PTMC), equilibrium radionuclide angiocardiography was performed in eight patients with mitral stenosis who had atrial fibrillation. Accurate cardiac function in patients with atrial fibrillation is difficult to assess, since the wide fluctation of cardiac cycle makes the ventricular hemodynamics variable. A new processing algorhythm was devised to make multiple gated images discriminated from a heart rate distribution histogram. We obtained about 1,000 beats data by list mode acquisition, and processed a heart rate distribution histogram. The data in the area {+-}5% of the most frequent heart rate were converted into frame mode and a representative time activity curve was derived. Mitral valve area calculated by echocardiography increased from 1.3{+-}0.5 to 2.0{+-}0.6 (cm{sup 2}) significantly (p<0.01). The mean transmitral pressure gradient measured by catheterization decreased from 12.4{+-}5.9 to 4.9{+-}3.7 (mmHg) significantly (p<0.01) and the clinical symptoms improved in all patients. The change in left ventricular ejection fraction from 43{+-}9 to 48{+-}13 (%) was not statistically significant, but peak filling rate (PFR) derived from the time activity curve increased from 1.5{+-}0.3 to 2.0{+-}0.4 (EDV/sec) significantly (p<0.01). Thus PFR is a noninvasive parameter that can evaluate the effect of PTMC. (author).

  16. Utility of ApneaLinkTM for the diagnosis of sleep apnea-hypopnea syndrome Utilidad del ApneaLinkT para el diagnóstico del síndrome apnea-hipopnea del sueño

    Directory of Open Access Journals (Sweden)

    Carlos A. Nigro

    2010-02-01

    Full Text Available Portable sleep studies may play an important role to take decisions on patients referred for suspicion of Sleep Apnea-Hypopnea Syndrome (SAHS. The aim of this study was to evaluate the diagnostic accuracy of automated analysis of ApneaLinkT in patients with suspicion of SAHS. All participants (75 performed the ApneaLink and polysomnography (PSG simultaneously in the sleep laboratory. The two recordings were interpreted blindly. The ApneaLink software calculated: (1 risk indicator (RI-a combination of apnea/hypopnea index (AHI plus inspiratory flow limitation events and (2 the AHI. ApneaLinkT and SAHS were defined in three ways: AHI or respiratory disturbance index (RDI = 5, 10 and 15 respectively. ROC curves analysis was performed. The sensitivity (S, specificity (E and positive and negative likelihood ratio (LR+, LR- for the different thresholds for RI or AHI were calculated; 66 patients were included (47 men, mean age 51, median RDI 10.6, mean BMI 29.3 kg/m². The best cut off points of RI were: SAHS = RDI = 5: RI > 9 (S 80%, E 100%, LR- 0.20; SAHS = RDI = 10: RI > 13 (S 92%, E 93%, LR+ 13.7 LR- 0.089; SAHS = RDI = 15 =: RI > 16 (S 93.5%, E 91%, LR+ 10.9, LR- 0.071. The AHI had a similar diagnostic accuracy to RI for the different definitions of SAHS. The RI and AHI obtained from automated analysis of ApneaLinkT were highly sensitive and specific to diagnose moderate to severe SAHS.Los equipos portátiles para estudios del sueño pueden tener un rol importante para tomar decisiones en pacientes con sospecha de Síndrome Apneas-Hipopneas del Sueño (SAHS. El objetivo del estudio fue evaluar la exactitud diagnóstica del análisis automático del ApneaLinkT en pacientes con sospecha de SAHS. Setenta y cinco sujetos realizaron simultáneamente el ApneaLinkT y una polisomnografía (PSG en el laboratorio de sueño. Los dos registros fueron interpretados en forma ciega. Un programa calculó: (1 el índice apnea/hipopnea (IAH, (2 el indicador de

  17. Operation and control software for APNEA

    Energy Technology Data Exchange (ETDEWEB)

    McClelland, J.H.; Storm, B.H. Jr.; Ahearn, J. [Lockheed-Martin Specialty Components, Largo, FL (United States)] [and others

    1997-11-01

    The human interface software for the Lockheed Martin Specialty Components (LMSC) Active/Passive Neutron Examination & Analysis System (APENA) provides a user friendly operating environment for the movement and analysis of waste drums. It is written in Microsoft Visual C++ on a Windows NT platform. Object oriented and multitasking techniques are used extensively to maximize the capability of the system. A waste drum is placed on a loading platform with a fork lift and then automatically moved into the APNEA chamber in preparation for analysis. A series of measurements is performed, controlled by menu commands to hardware components attached as peripheral devices, in order to create data files for analysis. The analysis routines use the files to identify the pertinent radioactive characteristics of the drum, including the type, location, and quantity of fissionable material. At the completion of the measurement process, the drum is automatically unloaded and the data are archived in preparation for storage as part of the drum`s data signature. 3 figs.

  18. OBSTRUCTIVE SLEEP APNEA: A REVIEW IN ADULTS

    Directory of Open Access Journals (Sweden)

    Elavarasi

    2014-07-01

    Full Text Available Obstructive sleep apnea (OSA is the most prevalent sleep disorder in the adult population. There is accumulating evidence that OSA is being considered as an independent risk factor for hypertension, diabetes mellitus, cardiovascular diseases and stroke leading to increased cardio metabolic morbidity and mortality. The prevalence of OSA is higher in patients presenting for surgery than in general population and a significant proportion of OSA patients remain undiagnosed, when they present for surgery. This is of concern to the anesthesiologist and the peri-operative physician, as OSA has been associated with increased peri-operative risk and post-operative complications. Hence a protocol designed to provide practical solutions and strategies for the peri- operative /post-operative care of these patients needs to be followed and optimal use of it requires our attention. Early recognition and treatment of OSA may prevent from adverse health consequences. A multidisciplinary approach to peri-operative care and constant vigilance by experienced anesthesia providers is paramount to ensuring positive patient outcome.

  19. Papilledema in obstructive sleep apnea syndrome

    International Nuclear Information System (INIS)

    We report a diagnostically challenging case of papilloedema in a morbidly obese, 25 year old male who presented to us with blurring of vision of both eyes, but more marked in the right. Fundus examination revealed severe papilloedema, with corresponding visual field and colour vision defects. He was worked up for possible life threatening causes of papilloedema like intracranial space occupying lesion but his CT scan was normal. As his hematocrit was in the polycythemic range, multiple venesections were performed in fear that the hyperviscosity picture could be a contributing factor. However there was no change in symptoms or the fundus appearance. We could not come to a diagnosis of idiopathic intracranial hypertension too because he refused lumbar puncture. A sleep study was done as he did give symptoms of mild obstructive sleep apnea but the results were that of severe disease. He was given therapeutic nocturnal oxygen by CPAP to prevent further cardiovascular and respiratory complications and interestingly enough it helped in treating the papilloedema. He was seen 2 months after commencement of continuous positive airway pressure (CPAP) with good functional and anatomical recovery. (author)

  20. Genioglossus fatigue in obstructive sleep apnea.

    LENUS (Irish Health Repository)

    McSharry, David

    2012-08-15

    Obstructive sleep apnea (OSA) is a prevalent disorder that may cause cardiovascular disease and fatal traffic accidents but the pathophysiology remains incompletely understood. Increased fatigability of the genioglossus (the principal upper airway dilator muscle) might be important in OSA pathophysiology but the existing literature is uncertain. We hypothesized that the genioglossus in OSA subjects would fatigue more than in controls. In 9 OSA subjects and 9 controls during wakefulness we measured maximum voluntary tongue protrusion force (Tpmax). Using surface electromyography arrays we measured the rate of decline in muscle fiber conduction velocity (MFCV) during an isometric fatiguing contraction at 30% Tpmax. The rate of decline in MFCV provides an objective means of quantifying localized muscle fatigue. Linear regression analysis of individual subject data demonstrated a significantly greater decrease in MFCV in OSA subjects compared to control subjects (29.2 ± 20.8% [mean ± SD] versus 11.2 ± 20.8%; p=0.04). These data support increased fatigability of the genioglossus muscle in OSA subjects which may be important in the pathophysiology of OSA.

  1. Obstructive sleep apnea and hypertension: a critical review.

    Science.gov (United States)

    Mohsenin, Vahid

    2014-10-01

    Obstructive sleep apnea (OSA) is a prevalent sleep disorder which is characterized by recurrent upper closure with oxygen desaturation and sleep disruption. OSA increases the risk of vascular disorders in the form of stroke, myocardial infarction, congestive heart failure, and hypertension. The mechanisms underlying the vascular disorders are several and include intermittent hypoxia with release of cytokines, angiogenic inhibitors, free radicals, and adhesion molecules. During apneas, arterial blood pressure gradually rises and surges abruptly after the termination of apnea. Two thirds of patients with OSA will ultimately have diurnal hypertension. This review discusses the literature supporting the significant role of OSA in hypertension and the effect of OSA treatment on blood pressure. PMID:25139780

  2. Use of modified silicone tracheal cannula for obstructive sleep apnea.

    Science.gov (United States)

    Strauss, M

    1990-02-01

    Experience with the original Montgomery silicone tracheal cannulas in 47 patients with obstructive sleep apnea has been reported. Further experience with 10 obstructive sleep apnea patients who used modified silicone tracheal cannulas that permit periodic self-removal, cleaning, and reinsertion was analyzed. Two patients used the tube briefly and without complications. The remaining eight patients used the modified cannula for 18 to 24 months. The average number of office visits following insertion was three. Compared to the original cannulas, there were markedly fewer difficulties with granulations, infection, and tube malposition with the modified cannulas. The improvements make this modified device a useful tool worth further study in obstructive sleep apnea patients requiring tracheostomy. PMID:2299956

  3. [Progress in research on obstructive sleep apnea syndrome].

    Science.gov (United States)

    Li, Jie; Xie, Jing; Jiang, Mao; Huang, Juanjuan; Yang, Tianlun

    2016-02-28

    Obstructive sleep apnea syndrome (OSAS) is a complicated chronic disease caused by certain reasons, characterized by obstruction of the upper airway and apnea or hypopnea during sleep, which can be followed by anoxia, snoring and daytime sleepiness. Recent studies have shown that hypertension is closely connected to OSAS. OSAS can lead to hypertension by several possible mechanisms. The diagnosis of OSAS mainly depends on the medical history, sign, polysomnogram (PSG) result and the frequency of apnea and hypopnea. OSAS can be relieved by continuous positive airway pressure (CPAP), oral orthodontic treatment, medicine, change of lifestyles and others. This brief review focuses on the mechanism of hypertension due to OSAS and the diagnosis criteria and treatment of OSAS. PMID:26932221

  4. CT findings in adults with obstructive sleep apnea

    International Nuclear Information System (INIS)

    The obstructive sleep apnea syndrome (OSAS) is characterized by recurrent obstruction of the upper airway during sleep. In this study, we performed CT scans in 20 adult OSAS patients and 6 control subjects, and measured the airspaces in the nasopharynx, mesopharynx and hypopharynx, using an image analyzer. The airspaces were significantly smaller at all sites of the pharynx in OSAS patients than in the control subjects, but they did not show a positive correlation with the apnea index or the body mass index. In good responders whose apnea indexes improved more than 50% after uvulo-palato-pharyngoplasty (UPPP), the nasopharyngeal and mesopharyngeal airspaces were significantly smaller, and the hypopharyngeal space tended to be larger than in poor responders. Our results suggest that CT scan is a helpful method for analyzing the area of the upper airway, especially in relation to the response to UPPP in adults with OSAS. (author)

  5. Obstructive Sleep Apnea Related Symptom Prevalence in Patients with Headache Presented to Neurology Outpatient Clinic: Results of a Preliminary Study*

    OpenAIRE

    Yildiz Degirmenci; Ege Gulec Balbay; Ayhan Ozturk; Hulusi Kececi; Mehmet Altan

    2014-01-01

    Approximately 20% of patients with sleep apnea will have headaches and 25% of patients with other sleep disorders will also experience headaches. We aim to evaluate sleep apnea related symptom prevalence in patient with headache presenting to neurology outpatient clinics. Twenty four patients with headache were asked for sleep apnea symptoms. The prevalence of snoring, excessive daytime sleepiness and witnessed apnea was 33.3%, 20.8% and 4.2%, respectively. Among sleep apnea symptoms, the pre...

  6. The Influence of a Mandibular Advancement Plate on Polysomnography in Different Grades of Obstructive Sleep Apnea

    Directory of Open Access Journals (Sweden)

    Antti Raunio

    2015-03-01

    Full Text Available Objectives: The purpose of this study was to investigate the effect of a mandibular advancement device on different grades of obstructive sleep apnea using a relatively simple test for the apnea-hypopnea index to determine if a mandibular device will be effective. Material and Methods: A total of 68 patients with obstructive sleep apnea syndrome (OSAS including, 31 with mild, 23 with moderate and 14 with severe OSAS were treated with a mandibular advancement device (MAD and monitored with polysomnography. Results: 25 of the 31 mild, 15 of the 23 moderate and 2 of the 14 severe OSAS patients were cured of their OSAS if a post treatment apnea-hypopnea index of less than 5 is regarded as cured. The odds ratios for success with MAD therapy are 3 for women over men, 14.9 for mild obstructive sleep apnea, 5.42 for moderate obstructive sleep apnea if severe obstructive sleep apnea is assigned an odds ratio of 1. Conclusions: The use of the apnea-hypopnea index alone is useful in mild and moderate disease to predict the effectiveness of mandibular advancement device. Treatment with a mandibular advancement device is very effective in treating mild and moderate obstructive sleep apnea. Conservative treatment with a mandibular advancement device can be successful in less severe grades of sleep apnea and may be an alternative for non-surgical patients with severe obstructive sleep apnea intolerant of Continuous Positive Airway Pressure management.

  7. Evaluation of neuromuscular activity in patients with obstructive sleep apnea using chin surface electromyography of polysomnography

    Institute of Scientific and Technical Information of China (English)

    YIN Guo-ping; YE Jing-ying; HAN De-min; WANG Xiao-yi; ZHANG Yu-huan; LI Yan-ru

    2013-01-01

    Background It is believed that defects in upper airway neuromuscular control play a role in sleep apnea pathogenesis.Currently,there is no simple and non-invasive method for evaluating neuromuscular activity for the purpose of screening in patients with obstructive sleep apnea.This study was designed to assess the validity of chin surface electromyography of routine polysomnography in evaluating the neuromuscular activity of obstructive sleep apnea subjects and probe the neuromuscular contribution in the pathogenesis of the condition.Methods The chin surface electromyography of routine polysomnography during normal breathing and obstructive apnea were quantified in 36 male patients with obstructive sleep apnea.The change of chin surface electromyography from normal breathing to obstructive apnea was expressed as the percent compensated electromyography value,where the percent compensated electromyography value =(normal breath surface electromyography-apnea surface electromyography)/normal breath surface electromyography,and the percent compensated electromyography values among subjects were compared.The relationship between sleep apnea related parameters and the percent compensated electromyography value was examined.Results The percent compensated electromyography value of the subjects varied from 1% to 90% and had a significant positive correlation with apnea hypopnea index (R2=0.382,P <0.001).Conclusions Recording and analyzing chin surface electromyography by routine polysomnography is a valid way of screening the neuromuscular activity in patients with obstructive sleep apnea.The neuromuscular contribution is different among subjects with obstructive sleep apnea.

  8. Anesthetic and postoperative management of the obstructive sleep apnea patient.

    Science.gov (United States)

    Mickelson, Samuel A

    2009-11-01

    Sleep apnea patients pose a challenge for surgeons, anesthesiologists, and surgical facilities as there is increased risk for anesthetic and postoperative complications. Precautions before and after surgery minimize these risks. Screening for sleep apnea should be done for all surgical patients. Safe perioperative management requires judicious use of narcotics and sedating medications, reducing upper airway edema, prevention of aspiration and deep vein thrombosis, blood pressure control, use of positive airway pressure, and proper postoperative monitoring. Although the literature lacks specific recommendations, the guidelines presented in this article are based on more than 20 years of experience and supported by peer-reviewed medical literature. PMID:19944343

  9. Atrial arrhythmogenesis in obstructive sleep apnea: Therapeutic implications.

    Science.gov (United States)

    Linz, Dominik; Linz, Benedikt; Hohl, Mathias; Böhm, Michael

    2016-04-01

    The prevalence of sleep disordered breathing like obstructive sleep apnea (OSA) among patients with atrial fibrillation (AF) is 40-50%. OSA reduces success rate of catheter based and pharmacological antiarrhythmic treatment. Additionally, efficient treatment of OSA by continuous positive airway pressure ventilation (CPAP), the first line therapy of OSA, has been shown to improve catheter ablation success rates in AF-patients. A systematic literature search using several databases was performed to review the pathophysiology of obstructive apneas in OSA potentially leading to the development of a substrate for AF and to explain potential mechanisms involved in the clinically observed atrial antiarrhythmic effect of effective CPAP therapy. PMID:26186892

  10. Adaptation of the modified Bouc–Wen model to compensate for hysteresis in respiratory motion for the list-mode binning of cardiac SPECT and PET acquisitions: Testing using MRI

    Energy Technology Data Exchange (ETDEWEB)

    Dasari, Paul K. R.; Shazeeb, Mohammed Salman [Department of Radiology, Division of Nuclear Medicine, University of Massachusetts Medical School, Worcester, Massachusetts 01655 and Department of Biomedical Engineering, Worcester Polytechnic Institute, Worcester, Massachusetts 01609 (United States); Könik, Arda; Lindsay, Clifford; Mukherjee, Joyeeta M.; Johnson, Karen L.; King, Michael A., E-mail: Michael.King@umassmed.edu [Department of Radiology, Division of Nuclear Medicine, University of Massachusetts Medical School, Worcester, Massachusetts 01655 (United States)

    2014-11-01

    Purpose: Binning list-mode acquisitions as a function of a surrogate signal related to respiration has been employed to reduce the impact of respiratory motion on image quality in cardiac emission tomography (SPECT and PET). Inherent in amplitude binning is the assumption that there is a monotonic relationship between the amplitude of the surrogate signal and respiratory motion of the heart. This assumption is not valid in the presence of hysteresis when heart motion exhibits a different relationship with the surrogate during inspiration and expiration. The purpose of this study was to investigate the novel approach of using the Bouc–Wen (BW) model to provide a signal accounting for hysteresis when binning list-mode data with the goal of thereby improving motion correction. The study is based on the authors’ previous observations that hysteresis between chest and abdomen markers was indicative of hysteresis between abdomen markers and the internal motion of the heart. Methods: In 19 healthy volunteers, they determined the internal motion of the heart and diaphragm in the superior–inferior direction during free breathing using MRI navigators. A visual tracking system (VTS) synchronized with MRI acquisition tracked the anterior–posterior motions of external markers placed on the chest and abdomen. These data were employed to develop and test the Bouc–Wen model by inputting the VTS derived chest and abdomen motions into it and using the resulting output signals as surrogates for cardiac motion. The data of the volunteers were divided into training and testing sets. The training set was used to obtain initial values for the model parameters for all of the volunteers in the set, and for set members based on whether they were or were not classified as exhibiting hysteresis using a metric derived from the markers. These initial parameters were then employed with the testing set to estimate output signals. Pearson’s linear correlation coefficient between the

  11. Adaptation of the modified Bouc–Wen model to compensate for hysteresis in respiratory motion for the list-mode binning of cardiac SPECT and PET acquisitions: Testing using MRI

    International Nuclear Information System (INIS)

    Purpose: Binning list-mode acquisitions as a function of a surrogate signal related to respiration has been employed to reduce the impact of respiratory motion on image quality in cardiac emission tomography (SPECT and PET). Inherent in amplitude binning is the assumption that there is a monotonic relationship between the amplitude of the surrogate signal and respiratory motion of the heart. This assumption is not valid in the presence of hysteresis when heart motion exhibits a different relationship with the surrogate during inspiration and expiration. The purpose of this study was to investigate the novel approach of using the Bouc–Wen (BW) model to provide a signal accounting for hysteresis when binning list-mode data with the goal of thereby improving motion correction. The study is based on the authors’ previous observations that hysteresis between chest and abdomen markers was indicative of hysteresis between abdomen markers and the internal motion of the heart. Methods: In 19 healthy volunteers, they determined the internal motion of the heart and diaphragm in the superior–inferior direction during free breathing using MRI navigators. A visual tracking system (VTS) synchronized with MRI acquisition tracked the anterior–posterior motions of external markers placed on the chest and abdomen. These data were employed to develop and test the Bouc–Wen model by inputting the VTS derived chest and abdomen motions into it and using the resulting output signals as surrogates for cardiac motion. The data of the volunteers were divided into training and testing sets. The training set was used to obtain initial values for the model parameters for all of the volunteers in the set, and for set members based on whether they were or were not classified as exhibiting hysteresis using a metric derived from the markers. These initial parameters were then employed with the testing set to estimate output signals. Pearson’s linear correlation coefficient between the

  12. Depression and Obstructive Sleep Apnea (OSA

    Directory of Open Access Journals (Sweden)

    O'Hara Ruth

    2005-06-01

    Full Text Available Abstract For over two decades clinical studies have been conducted which suggest the existence of a relationship between depression and Obstructive Sleep Apnea (OSA. Recently, Ohayon underscored the evidence for a link between these two disorders in the general population, showing that 800 out of 100,000 individuals had both, a breathing-related sleep disorder and a major depressive disorder, with up to 20% of the subjects presenting with one of these disorders also having the other. In some populations, depending on age, gender and other demographic and health characteristics, the prevalence of both disorders may be even higher: OSA may affect more than 50% of individuals over the age of 65, and significant depressive symptoms may be present in as many as 26% of a community-dwelling population of older adults. In clinical practice, the presence of depressive symptomatology is often considered in patients with OSA, and may be accounted for and followed-up when considering treatment approaches and response to treatment. On the other hand, sleep problems and specifically OSA are rarely assessed on a regular basis in patients with a depressive disorder. However, OSA might not only be associated with a depressive syndrome, but its presence may also be responsible for failure to respond to appropriate pharmacological treatment. Furthermore, an undiagnosed OSA might be exacerbated by adjunct treatments to antidepressant medications, such as benzodiazepines. Increased awareness of the relationship between depression and OSA might significantly improve diagnostic accuracy as well as treatment outcome for both disorders. In this review, we will summarize important findings in the current literature regarding the association between depression and OSA, and the possible mechanisms by which both disorders interact. Implications for clinical practice will be discussed.

  13. [Diagnostic criteria for obstructive sleep apnea syndrome].

    Science.gov (United States)

    Beydon, N; Aubertin, G

    2016-04-01

    The prevalence of obstructive sleep apnea syndrome (OSAS) is 1-4 % in school-aged children. Adenotonsillar hypertrophy is the most common etiology of OSAS in children. Other causes are obesity; facial or skeletal malformations; and neuromuscular, respiratory, or metabolic diseases. OSAS has been associated with sleep quality disturbance (frequent arousals) and nocturnal gas exchange abnormalities (hypoxemia and sometimes hypercapnia), which can both result in negative health outcomes. The analysis of clinical symptoms and physical examination cannot always distinguish between children with primary snoring and children with OSAS. However, the association of at least one sign of nocturnal upper airway obstruction with other diurnal or nocturnal symptoms can be sufficient to establish OSAS diagnosis in a child more than 3 years of age with clear enlarged tonsils but who is otherwise healthy. In all other cases, polysomnography (the gold standard for the diagnosis of sleep-disordered breathing) must be performed either to declare the diagnosis when clinical assessment is not conclusive or when risk factors are present, or to follow up children with an associated health condition or initial severe OSAS. The equipment used to record sleep and the interpretation criteria are all pediatric-specific. Other methods, such as respiratory polygraphy, are simpler to implement, but further studies are warranted to validate the interpretation criteria of these methods in children. However, in centers with experienced personnel, polygraphy can be used in place of polysomnography. In all cases, the analysis of sleep traces must be manual and performed by personnel under the supervision of medical staff trained to interpret pediatric sleep studies. PMID:26968302

  14. Ischemic Preconditioning of One Forearm Enhances Static and Dynamic Apnea

    DEFF Research Database (Denmark)

    Kjeld, Thomas; Rasmussen, Mads Reinholdt; Jattu, Timo;

    2014-01-01

    .05). CONCLUSIONS: We conclude that while the effect of ischemic preconditioning (of one forearm) on ergometer rowing was minimal, probably because of reduced muscle oxygenation during the warm-up, ischemic preconditioning does enhance both static and dynamic apnea, supporting that muscle ischemia is an important...

  15. Sleep board review question: insomnia in obstructive sleep apnea

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    Budhiraja R

    2013-11-01

    Full Text Available No abstract available. Article truncated after first page. What is the estimated prevalence of insomnia symptoms in patients with obstructive sleep apnea? 1. Less than 1% 2. 5%-10% 3. 20-30% 4. 40%-60% 5. Greater than 80%

  16. Swallowing and pharyngo-esophageal manometry in obstructive sleep apnea

    Directory of Open Access Journals (Sweden)

    Luciana Almeida Moreira da Paz Oliveira

    2015-06-01

    Full Text Available INTRODUCTION: Upper airway nerve and muscle damage associated with obstructive sleep apnea may impair the strength and dynamics of pharyngeal and esophageal contractions during swallowing. OBJECTIVE: To evaluate the presence of alterations in pharyngoesophageal manometry in patients with obstructive sleep apnea with and without oropharyngeal dysphagia. METHODS: This study prospectively evaluated 22 patients with obstructive sleep apnea without spontaneous complaints of dysphagia, using a questionnaire, fiberoptic endoscopic evaluation of swallowing, and pharyngoesophageal manometry, including measurement of the upper and lower esophageal sphincter pressures and mean pharyngeal pressures at three levels during swallowing. RESULTS: The dysphagia group consisted of 17 patients (77.3% in whom swallowing abnormalities were detected on fiberoptic endoscopic evaluation of swallowing (n = 15; 68.2% and/or in the questionnaire (n = 7; 31.8%. The five remaining cases comprised a control group without oropharyngeal dysphagia. In all cases of abnormalities on fiberoptic endoscopic evaluation of swallowing, there was premature bolus leakage into the pharynx. There was no statistically significant difference between the groups regarding any of the pharyngoesophageal manometry measurements, age, or severity of obstructive sleep apnea. CONCLUSION: Pharyngoesophageal manometry detected no statistically significant difference between the groups with and without oropharyngeal dysphagia.

  17. Videoradiography of patients with habitual snoring and/or sleep apnea. Technical description and presentation of videoradiographic results during sleep concerning occurrence of apnea, type of apnea, and site of obstruction

    Energy Technology Data Exchange (ETDEWEB)

    Hillarp, B. [Dept. of Diagnostic Radiology, Malmoe Univ. Hospital (Sweden); Nylander, G. [Dept. of Diagnostic Radiology, Malmoe Univ. Hospital (Sweden); Rosen, I. [Dept. of Neurophysiology, Malmoe Univ. Hospital (Sweden); Wickstroem, O. [Dept. of Neurophysiology, Malmoe Univ. Hospital (Sweden)

    1995-05-01

    The videoradiographic examination described was designed for habitual snorers and sleep apnea syndrome (SAS) patients and was performed during wakefulness and sleep. During wakefulness the purpose was to reveal any dysfunction in deglutiton and speech as well as morphologic abnormalities. The purpose during sleep, which usually was induced by low-dose midazolam intravenously, was to reveal the site and form of obstruction in obstructive sleep apnea patients and the site of snoring in habitual snorers. The preoperative results of 104 patients are presented. In 57 patients who had apneas, the occurrence and type of apnea could be determined. A continuous recording over some minutes gave a rough estimate of the degree of SAS and mean duration of apnea. Although much information on SAS can be obtained by this method, it cannot replace polygraphic sleep recording in the investigation of habitual snorers and SAS patients. However, these 2 methods are complementary and can be performed simultaneously as polygraphic videoradiography. (orig.).

  18. Videoradiography of patients with habitual snoring and/or sleep apnea. Technical description and presentation of videoradiographic results during sleep concerning occurrence of apnea, type of apnea, and site of obstruction

    International Nuclear Information System (INIS)

    The videoradiographic examination described was designed for habitual snorers and sleep apnea syndrome (SAS) patients and was performed during wakefulness and sleep. During wakefulness the purpose was to reveal any dysfunction in deglutiton and speech as well as morphologic abnormalities. The purpose during sleep, which usually was induced by low-dose midazolam intravenously, was to reveal the site and form of obstruction in obstructive sleep apnea patients and the site of snoring in habitual snorers. The preoperative results of 104 patients are presented. In 57 patients who had apneas, the occurrence and type of apnea could be determined. A continuous recording over some minutes gave a rough estimate of the degree of SAS and mean duration of apnea. Although much information on SAS can be obtained by this method, it cannot replace polygraphic sleep recording in the investigation of habitual snorers and SAS patients. However, these 2 methods are complementary and can be performed simultaneously as polygraphic videoradiography. (orig.)

  19. Prevalence of symptoms and risk of sleep apnea in Dubai, UAE

    Directory of Open Access Journals (Sweden)

    Mahboub B

    2013-03-01

    Full Text Available Bassam Mahboub, Shahid Afzal, Hassan Alhariri, Ashraf Alzaabi, Mayank Vats, Annie SoansSleep Disorders Center, Department of Medicine, Rashid Hospital, Dubai Health Authority, Dubai, United Arab EmiratesPurpose: The United Arab Emirates (UAE ranks 18th on the 2007 Forbes list of fattest countries with 68.3% of its citizens with an unhealthy weight and it is well known that weight gain and obesity are important determinants in the progression of obstructive sleep apnea syndrome (OSAS. The purpose of this study is to estimate the prevalence of symptoms and risk of OSAS in the primary health care setting in Dubai, and the relationship between obesity and sleep apnea.Methods: In this prospective survey, a trained medical nurse administered the Berlin Questionnaire to a consecutive random sample of patients in the age group older than 14 years, who attended the primary health care center in Dubai Health Authority, Dubai, UAE, from September 2011 to March 2012. Based on the questionnaire answers, individuals were classified into high risk and low risk groups for OSAS.Results: Based on the responses and measurement of the Berlin Questionnaire of 1214 subjects studied, 58% (n = 704 of the respondents were female, while 42% (n = 510 were male. Two-hundred-fifty-four respondents met the criteria for the high risk scoring. This gives a prevalence rate of 20.9% (out of which 22.9% of the male respondents were high risk for OSAS, while 19.5% of the females were high risk for OSAS, while the remainder of the participants were classified as low risk. The overall mean age of the high risk for OSAS female respondents was 39.95 years (standard deviation [SD] 11.73 years and was 41.18 years (SD 14.95 years for male respondents The highest prevalence was observed between age 51 to 60 in both genders. Seventy percent of the high risk group had a body mass index (BMI ≥ 30 kg/m2 and nearly 75% of the low risk group had a BMI < 30 kg/m2, and the mean BMI was 32.06 kg

  20. Obstructive sleep apnea and endothelial progenitor cells

    Directory of Open Access Journals (Sweden)

    Wang Q

    2013-10-01

    Full Text Available Qing Wang,1,* Qi Wu,2,* Jing Feng,3,4 Xin Sun5 1The Second Respiratory Department of the First People's Hospital of Kunming, Yunnan, People's Republic of China; 2Tianjin Haihe Hospital, Tianjin, People's Republic of China; 3Respiratory Department of Tianjin Medical University General Hospital, Tianjin, People's Republic of China; 4Division of Pulmonary and Critical Care Medicine, Duke University Medical Center, Durham, NC, USA; 5Respiratory Department of Tianjin Haihe Hospital, Tianjin, People's Republic of China *These authors contributed equally to this work Background: Obstructive sleep apnea (OSA occurs in 4% of middle-aged men and 2% of middle-aged women in the general population, and the prevalence is even higher in specific patient groups. OSA is an independent risk factor for a variety of cardiovascular diseases. Endothelial injury could be the pivotal determinant in the development of cardiovascular pathology in OSA. Endothelial damage ultimately represents a dynamic balance between the magnitude of injury and the capacity for repair. Bone marrow–derived endothelial progenitor cells (EPCs within adult peripheral blood present a possible means of vascular maintenance that could home to sites of injury and restore endothelial integrity and normal function. Methods: We summarized pathogenetic mechanisms of OSA and searched for available studies on numbers and functions of EPCs in patients with OSA to explore the potential links between the numbers and functions of EPCs and OSA. In particular, we tried to elucidate the molecular mechanisms of the effects of OSA on EPCs. Conclusion: Intermittent hypoxia cycles and sleep fragmentation are major pathophysiologic characters of OSA. Intermittent hypoxia acts as a trigger of oxidative stress, systemic inflammation, and sympathetic activation. Sleep fragmentation is associated with a burst of sympathetic activation and systemic inflammation. In most studies, a reduction in circulating EPCs has

  1. Comparison of AutoSetä and polysomnography for the detection of apnea-hypopnea events

    Directory of Open Access Journals (Sweden)

    M.C. Bagnato

    2000-05-01

    Full Text Available The use of the flow vs time relationship obtained with the nasal prongs of the AutoSetä (AS system (diagnosis mode has been proposed to detect apneas and hypopneas in patients with reasonable nasal patency. Our aim was to compare the accuracy of AS to that of a computerized polysomnographic (PSG system. The study was conducted on 56 individuals (45 men with clinical characteristics of obstructive sleep apnea (OSA. Their mean (± SD age was 44.6 ± 12 years and their body mass index was 31.3 ± 7 kg/m2. Data were submitted to parametric analysis to determine the agreement between methods and the intraclass correlation coefficient was calculated. The Student t-test and Bland and Altman plots were also used. Twelve patients had an apnea-hypopnea index (AHI 40. The mean (± SD AHI PSG index of 37.6 (28.8 was significantly lower (P = 0.0003 than AHI AS (41.8 (25.3, but there was a high intraclass correlation coefficient (0.93, with 0.016 variance. For a threshold of AHI of 20, AS showed 73.0% accuracy, 97% sensitivity and 60% specificity, with positive and negative predictive values of 78% and 93%, respectively. Sensitivity, specificity and negative predictive values increased in parallel to the increase in AHI threshold for detecting OSA. However, when the differences of AHI PSG-AS were plotted against their means, the limits of agreement between the methods (95% of the differences were +13 and -22, showing the discrepancy between the AHI values obtained with PSG and AS. Finally, cubic regression analysis was used to better predict the result of AHI PSG as a function of the method proposed, i.e., AHI AS. We conclude that, despite these differences, AHI measured by AutoSetä can be useful for the assessment of patients with high pre-test clinical probability of OSA, for whom standard PSG is not possible as an initial step in diagnosis.

  2. Maxillomandibular Advancement in Obstructive Sleep Apnea Syndrome Patients: a Restrospective Study on the Sagittal Cephalometric Variables

    OpenAIRE

    Paolo Ronchi; Valentina Cinquini; Alessandro Ambrosoli; Alberto Caprioglio

    2013-01-01

    ABSTRACT Objectives The present retrospective study analyzes sagittal cephalometric changes in patients affected by obstructive sleep apnea syndrome submitted to maxillomandubular advancement. Material and Methods 15 adult sleep apnea syndrome (OSAS) patients diagnosed by polysomnography (PSG) and treated with maxillomandubular advancement (MMA) were included in this study. Pre- (T1) and postsurgical (T2) PSG studies assessing the apnea/hypopnea index (AHI) and the lowest oxygen saturation (L...

  3. Identification of sleep apnea events using discrete wavelet transform of respiration, ECG and accelerometer signals

    OpenAIRE

    Sweeney, Kevin; Mitchell, Edmond; Gaughran, Jennifer; Kane, Thomas; Coyle, Shirley; O''Connor, Noel E.; Diamond, Dermot

    2013-01-01

    Sleep apnea is a common sleep disorder in which patient sleep patterns are disrupted due to recurrent pauses in breathing or by instances of abnormally low breathing. Current gold standard tests for the detection of apnea events are costly and have the addition of long waiting times. This paper investigates the use of cheap and easy to use sensors for the identification of sleep apnea events. Combinations of respiration, electrocardiography (ECG) and acceleration signals were analysed. ...

  4. Snoring and risk for obstructive sleep apnea among nigerians with heart failure: Prevalence and clinical correlates

    OpenAIRE

    Akintunde, Adeseye A

    2013-01-01

    Background: Heart failure is an important cause of morbidity and mortality in developing nations like Nigeria. Sleep apnea and snoring has recently been recognized to be a cardiovascular risk factor. Sleep apnea is yet to be well studied among Africans with heart failure. We aimed to determine the prevalence of snoring and high risk for obstructive sleep apnea among Nigerians with stable heart failure. Materials and Methods: We studied 103 subjects that included 62 patients with heart fail...

  5. Prevalence of Snoring and Witnessed Apnea in Taiwanese Adults

    Directory of Open Access Journals (Sweden)

    Ying-Huang Tsai

    2008-04-01

    Full Text Available Background: Sleep-disordered breathing (SDB is a prevalent disorder that has a hugeimpact on the public. It has been proposed that Chinese populations have ahigher incidence of SDB than Caucasians due to a narrow cranial base andflat mid-face structure. Few studies have investigated the prevalence of SDBin Taiwan. This study prospectively assesses the complaints of SDB andrelated conditions via telephone interviews with individual older than fifteenin Taiwan to calculate a possible prevalence.Methods: Computer-assisted telephone interviews were conducted from Oct. 25, 2006to Nov. 6, 2006. Individuals aged over 15 years were interviewed. The numberof successful interviews was calculated based on the population prior tothe study. Demographic data and data for symptoms of SDB and medicalconditions were obtained.Results: In total, 4,011 individuals, 1,634 males and 2,377 females, completed theinterviews. The prevalence of snoring in these Taiwanese individuals was51.9% [95% confidence interval (CI 51.13%-52.67%], 60.8% (95% CI58.67%-62.93% in males and 42.5% (95% CI 40.26%-44.74% in females.The prevalence of witnessed apnea during sleep was 2.6% (95% CI 2.1%-3.1%, 3.4% (95% CI 2.6%-4.2% in males and 1.9% (95% CI 1.28%-2.52% in females. The prevalence of snoring and witnessed apnea was significantlyhigher in males than in females (p < 0.05. Prevalence of hypertension,cardiovascular disease, diabetes mellitus, arthritis and backache washigher in those who snored or had witnessed apnea than those without thesesymptoms (p < 0.05.Conclusion: This study determined that 51.9% (95% CI 51.13%-52.67% of Taiwanesesnore and 2.6% (95% CI 2.1%-3.1% have witnessed apnea. Those whosnore or have witnessed apnea have a higher incidence of comorbidity withmajor medical diseases compared to those who do not snore or do not havewitnessed apnea.

  6. Sleep disruption increases seizure susceptibility: Behavioral and EEG evaluation of an experimental model of sleep apnea.

    Science.gov (United States)

    Hrnčić, Dragan; Grubač, Željko; Rašić-Marković, Aleksandra; Šutulović, Nikola; Šušić, Veselinka; Bjekić-Macut, Jelica; Stanojlović, Olivera

    2016-03-01

    Sleep disruption accompanies sleep apnea as one of its major symptoms. Obstructive sleep apnea is particularly common in patients with refractory epilepsy, but causing factors underlying this are far from being resolved. Therefore, translational studies regarding this issue are important. Our aim was to investigate the effects of sleep disruption on seizure susceptibility of rats using experimental model of lindane-induced refractory seizures. Sleep disruption in male Wistar rats with implanted EEG electrodes was achieved by treadmill method (belt speed set on 0.02m/s for working and 0.00m/s for stop mode, respectively). Animals were assigned to experimental conditions lasting 6h: 1) sleep disruption (sleep interrupted, SI; 30s working and 90s stop mode every 2min; 180cycles in total); 2) activity control (AC, 10min working and 30min stop mode, 9cycles in total); 3) treadmill chamber control (TC, only stop mode). Afterwards, the animals were intraperitoneally treated with lindane (L, 4mg/kg, SI+L, AC+L and TC+L groups) or dimethylsulfoxide (DMSO, SIc, ACc and TCc groups). Convulsive behavior was assessed by seizure incidence, latency time to first seizure, and its severity during 30min after drug administration. Number and duration of ictal periods were determined in recorded EEGs. Incidence and severity of lindane-induced seizures were significantly increased, latency time significantly decreased in animals undergoing sleep disruption (SI+L group) compared with the animals from TC+L. Seizure latency was also significantly decreased in SI+L compared to AC+L groups. Number of ictal periods were increased and duration of it presented tendency to increase in SI+L comparing to AC+L. No convulsive signs were observed in TCc, ACc and SIc groups, as well as no ictal periods in EEG. These results indicate sleep disruption facilitates induction of epileptic activity in rodent model of lindane-epilepsy enabling translational research of this phenomenon. PMID:26705666

  7. Effects of one-week tongue-task training on sleep apnea severity: A pilot study

    OpenAIRE

    Eric Rousseau; César Augusto Melo-Silva; Simon Gakwaya; Frédéric Sériès

    2015-01-01

    The aim of the present study was to assess the effects of one-week tongue-task training (TTT) on sleep apnea severity in sleep apnea subjects. Ten patients with sleep apnea (seven men, mean [± SD] age 52±8 years; mean apnea-hypopnea [AHI] index 20.9±5.3 events/h) underwent 1 h TTT in the authors’ laboratory on seven consecutive days. A complete or limited recording and tongue maximal protruding force were assessed before and after one-week TTT. One-week TTT was associated with a global AHI de...

  8. Prolonged apnea following modified electroconvulsive therapy with suxamethonium

    Directory of Open Access Journals (Sweden)

    T M Omprakash

    2011-01-01

    Full Text Available A 36-year-old male from an urban middleclass family with strained relationship among family members was referred from a corporate hospital for further management of psychological problem. As he was attempting suicide repeatedly, Electroconvulsive Therapy (ECT was planned. After preoperative assessment and preparation, modified ECT was done with thiopentone and 0.5 mg/kg of suxamethonium. Apnea following suxamethonium was prolonged for 2 hours. Subsequent enquiry revealed that patient was treated for organophosphate poisoning and was on ventilator support for 15 days. This was concealed by the relatives. On searching patient previous records, Butyrylcholinesterase levels were very low, i.e., 350 u/l (normal reference range is 5 500 - 12 500 u/l. Prolonged suxamethonium apnea should be anticipated in patients with recent history of organophosphate poisoning; it is advisable to estimate the levels of butyrylcholinesterase and avoid suxamethonium in patients with low enzyme levels.

  9. Role of Sensory Stimulation in Amelioration of Obstructive Sleep Apnea

    Directory of Open Access Journals (Sweden)

    Mak Adam Daulatzai

    2011-01-01

    Full Text Available Obstructive sleep apnea (OSA, characterized by recurrent upper airway (UA collapse during sleep, is associated with significant morbidity and disorders. Polysomnogram is employed in the evaluation of OSA and apnea-hypopnea number per hour reflects severity. For normal breathing, it is essential that the collapsible UA is patent. However, obstruction of the UA is quite common in adults and infants. Normally, important reflex mechanisms defend against the UA collapse. The muscle activity of UA dilators, including the genioglossus, tensor palatini (TP, and pharyngeal constrictors, is due to the integrated mechanism of afferent sensory input → to motor function. Snoring is harsh breathing to prevent UA obstruction. Unfortunately, snoring vibrations, pharyngeal suction collapse, negative pressure, and hypoxia cause pathological perturbations including dysfunctional UA afferent sensory activity. The current paper posits that peripheral sensory stimulation paradigm, which has been shown to be efficacious in improving several neurological conditions, could be an important therapeutic strategy in OSA also.

  10. MR imaging evaluation of neck anatomy in sleep apnea

    International Nuclear Information System (INIS)

    Neck anatomy was evaluated by MR imaging in sleep apnea patients and healthy volunteers. The fascial layers of the neck divide the neck into an inner rigid compartment (muscle groups, vertebrae, and pharynx) and an outer flaccid compartment (skin, subcutaneous fat). Although the flaccid compartment doubled in cross-sectional area in patients with sleep apnea, the area of the rigid compartment also increased by over 30% relative to the area in healthy volunteers, resulting in airway narrowing. Rigid compartment enlargement resulted from an increase in the bulk of muscular groups, as well as from increased intermuscular fat. The epiglottis was not enlarged, while the volume of the tongue increased proportionately with the rigid compartment. No significant changes were detected in the relaxation times of either muscle or fat

  11. Simulated central apnea detection using the pressure variance.

    Science.gov (United States)

    Townsend, Daphne I; Holtzman, Megan; Goubran, Rafik; Frize, Monique; Knoefel, Frank

    2009-01-01

    This paper presents use of an unobtrusive pressure sensor array for simulated central apnea detection. Data was collected from seven volunteers who performed a series of regular breathing and breath holding exercises to simulate central apneas. Results of the feature extraction from the breathing signals show that breathing events may be differentiated with epoch based variance calculations. Two approaches were considered: the single sensor approach and the multisensor vote approach. The multisensor vote approach can decrease false positives and increase the value of Matthew's Correlation Coefficient. The effect of lying position on correct classification was investigated by modifying the multisensor vote approach to reduce false positives segments caused by the balistocardiogram signal and as such increase sensitivity while maintaining a low false positive rate. Intersubject classification results had low variability in both approaches. PMID:19964320

  12. Respiratory rate variability in sleeping adults without obstructive sleep apnea.

    Science.gov (United States)

    Gutierrez, Guillermo; Williams, Jeffrey; Alrehaili, Ghadah A; McLean, Anna; Pirouz, Ramin; Amdur, Richard; Jain, Vivek; Ahari, Jalil; Bawa, Amandeep; Kimbro, Shawn

    2016-09-01

    Characterizing respiratory rate variability (RRV) in humans during sleep is challenging, since it requires the analysis of respiratory signals over a period of several hours. These signals are easily distorted by movement and volitional inputs. We applied the method of spectral analysis to the nasal pressure transducer signal in 38 adults with no obstructive sleep apnea, defined by an apnea-hypopnea index respiratory rate and sleep stage, being greater in wakefulness than in any sleep stage. We conclude that RRV varies according to sleep stage. Moreover, spectral analysis of nasal pressure signal appears to provide a valid measure of RRV during sleep. It remains to be seen if the method can differentiate normal from pathological sleep patterns. PMID:27597768

  13. Cardiac function and hypertension in patients with obstructive sleep apnea

    OpenAIRE

    Bertolami A; Gonzaga C; Amodeo C

    2014-01-01

    Adriana Bertolami, Carolina Gonzaga, Celso AmodeoSleep Laboratory of Dante Pazzanese Institute of Cardiology, Sao Paulo, BrazilAbstract: Cardiovascular disease is one of the major causes of death worldwide. Among its risk factors, obstructive sleep apnea (OSA) is a common but still underestimated condition. OSA often coexists and interacts with obesity, sharing multiple pathophysiological mechanisms and subsequent cardiovascular risk factors, such as type 2 diabetes, dyslipidemia, systemic in...

  14. Cardiac function and hypertension in patients with obstructive sleep apnea

    Directory of Open Access Journals (Sweden)

    Bertolami A

    2014-08-01

    Full Text Available Adriana Bertolami, Carolina Gonzaga, Celso AmodeoSleep Laboratory of Dante Pazzanese Institute of Cardiology, Sao Paulo, BrazilAbstract: Cardiovascular disease is one of the major causes of death worldwide. Among its risk factors, obstructive sleep apnea (OSA is a common but still underestimated condition. OSA often coexists and interacts with obesity, sharing multiple pathophysiological mechanisms and subsequent cardiovascular risk factors, such as type 2 diabetes, dyslipidemia, systemic inflammation, and in particular hypertension. There is also evidence suggesting an increased risk of arrhythmia, heart failure, renal failure, acute myocardial infarction, stroke, and death. OSA is characterized by recurrent episodes of partial (hypopnea or complete interruption (apnea of breathing during sleep due to airway collapse in the pharyngeal region. The main mechanisms linking OSA to impaired cardiovascular function are secondary to hypoxemia and reoxygenation, arousals, and negative intrathoracic pressure. Consequently, the sympathetic nervous and the renin-angiotensin-aldosterone systems may be overestimulated, and blood pressure increased. Resistance to treatment for hypertension represents a growing issue, and given that OSA has been recognized as the major secondary cause of resistant hypertension, clinical investigation for apnea is mandatory in this population. Standard diagnosis includes polysomnography, and treatment for OSA should include control of risk factors for cardiovascular disease, including obesity. So far, continuous positive airway pressure is the treatment of choice for OSA, impacting positively on blood pressure goals; however, the impact on long-term follow-up and on cardiovascular disease should be better assessed.Keywords: obstructive sleep apnea, hypertension, cardiac function

  15. Obstructive sleep apnea in chronic obstructive pulmonary disease patients.

    LENUS (Irish Health Repository)

    Lee, Ruth

    2011-03-01

    Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) represent two of the most prevalent chronic respiratory disorders and cardiovascular diseases are major co-morbidities in both. Co-existence of both disorders (overlap syndrome) occurs in 1% of adults and overlap patients have worse nocturnal hypoxemia and hypercapnia than COPD and OSA patients alone. The present review discusses recent data concerning the pathophysiological and clinical significance of the overlap syndrome.

  16. Sleep Apnea and Fatty Liver Are Coupled Via Energy Metabolism

    OpenAIRE

    Arısoy, Ahmet; Sertoğullarından, Bunyamin; Ekin, Selami; Özgökçe, Mesut; Bulut, Mehmet Deniz; Huyut, Mehmet Tahir; Ölmez, Şehmus; Turan, Mahfuz

    2016-01-01

    Background Obstructive sleep apnea (OSA) is a common sleep-related breathing disorder characterized by intermittent hypoxia. Non-alcoholic fatty liver disease is the most common cause of chronic liver disease worldwide. We aimed to evaluate the relationship between OSA and fatty liver. Material/Methods We enrolled 176 subjects to this study who underwent polysomnography (PSG) for suspected OSA. The control group included 42 simple snoring subjects. PSG, biochemical tests, and ultrasonographic...

  17. Pathogenic roles of the carotid body inflammation in sleep apnea

    OpenAIRE

    2014-01-01

    Breathing difficulties in sleep are a hallmark of sleep-disordered breathing commonly observed in patients with sleep disorders. The pathophysiology of sleep apnea is in part due to an augmented activity of the carotid body chemoreflex. Arterial chemoreceptors in the carotid body are sensitive to inflammatory cytokines and immunogenic molecules in the circulation, because cytokine receptors are expressed in the carotid body in experimental animals and human. Intriguingly, proinflammatory cyto...

  18. Depression, insomnia and sleep apnea in patients on maintenance hemodialysis

    OpenAIRE

    Rai, M.; Rustagi, T.; Rustagi, S.; Kohli, R.

    2011-01-01

    Depression and sleep disorders are more frequent in patients on maintenance hemodialysis (HD) than the general population, and are associated with reduced quality of life and increased mortality risk. The purpose of this study was to assess the prevalence of depression, sleep apnea, insomnia in patients on HD as well as depression in their primary caregiver and to correlate these with the demographic profile. A cross-sectional study was conducted among 69 patients on maintenance HD for more t...

  19. Determinants of CPAP Adherence in Hispanics with Obstructive Sleep Apnea

    OpenAIRE

    Montserrat Diaz-Abad; Wissam Chatila; Matthew R. Lammi; Irene Swift; Gilbert E. D’Alonzo; Krachman, Samuel L.

    2014-01-01

    Purpose. We hypothesized that socioeconomic factors and a language barrier would impact adherence with continuous positive airway pressure (CPAP) among Hispanics with obstructive sleep apnea (OSA). Methods. Patients with OSA who were prescribed CPAP for at least 1 year and completed a questionnaire evaluating demographic data, socioeconomic status, and CPAP knowledge and adherence participated in the study. Results. Seventy-nine patients (26 males; 53 ± 11 yrs; body mass index (BMI) = 45 ± 9 ...

  20. Cephalometric comparison of obstructive sleep apnea patients and healthy controls

    OpenAIRE

    Gungor, Ahmet Yalcin; Turkkahraman, Hakan; Yilmaz, H. Huseyin; Yariktas, Murat

    2013-01-01

    Objective: This study aimed to compare the cephalometric characteristics of obstructive sleep apnea (OSA) patients with those of healthy subjects and to determine possible relationships between cephalometric measurements of OSA patients and control subjects. Methods: Standardized lateral cephalograms of 16 OSA patients and 16 healthy controls were obtained. Airway dimensions and dentofacial parameters were measured using a cephalometric analysis program (Dolphin Imaging Cephalometric and Trac...

  1. Cognitive profile and brain morphological changes in obstructive sleep apnea

    OpenAIRE

    Torelli, Federico; Moscufo, Nicola; Garreffa, Girolamo; Placidi, Fabio; Romigi, Andrea; Zannino, Silvana; Bozzali, Marco; Fasano, Fabrizio; Giulietti, Giovanni; Djonlagic, Ina; Malhotra, Atul; Marciani, Maria Grazia; Guttmann, Charles RG

    2010-01-01

    Obstructive sleep apnea (OSA) is accompanied by neurocognitive impairment, likely mediated by injury to various brain regions. We evaluated brain morphological changes in patients with OSA and their relationship to neuropsychological and oximetric data. Sixteen patients affected by moderate-severe OSA (age: 55.8±6.7 years, 13 males) and fourteen control subjects (age: 57.6±5.1 years, 9 males) underwent 3.0 Tesla brain magnetic resonance imaging (MRI) and neuropsychological testing evaluating ...

  2. Intention to Exercise in Patients with Obstructive Sleep Apnea

    OpenAIRE

    Smith, Simon S.; Doyle, Geoffrey; Pascoe, Thomas; Douglas, James A; Jorgensen, Greg

    2007-01-01

    Obstructive sleep apnea (OSA) is a common and serious health issue that is strongly associated with excess weight. Exercise may be an effective mechanism for reducing the severity of OSA both in association with, and independent of, reduction in body weight. As such, increased exercise has been suggested as a potential intervention for OSA, particularly for patients with mild to moderate clinical severity. However, it is unknown how ready to engage in exercise patients with OSA are. Self-repo...

  3. Does obstructive sleep apnea associate with atrial fibrillation?

    Institute of Scientific and Technical Information of China (English)

    TAO Hai-long; LONG De-yong; DONG Jian-zeng; MA Chang-sheng

    2008-01-01

    @@ Obstructive sleep apnea(OSA)is a disorder in which transient obstruction fcomplete or partiall of the airway during sleep causes loud snoring,oxyhemoglobin desaturation and frequent arousal.1-4 OSA has been identified to relate to many cardiovascular diseases such as hypertension,coronary heart disease,heart failure,and cardiac arrhythmia.In this article,we attempt to discuss the association between OSA and atrial fibrillation (AF) while reviewing the recent data on OSA and AF.

  4. Attention Deficit/Hyperactivity Disorder in Adults with Sleep Apnea

    OpenAIRE

    Oğuztürk, Ömer; Ekici, Mehmet; Çimen, Dilay; Ekici, Aydanur; Senturk, Erol

    2012-01-01

    AAttention deficit hyperactivity disorder (ADHD) is a common childhood illness. In some patients, this illness may persist into adulthood and an association between ADHD and Obstructive Sleep Apnea (OSA) has been found in childhood. However, it is unclear how OSA and ADHD coincide in adulthood. Therefore, to explore the relationship between OSA and adult ADHD the current investigation utilized a clinically-based cross-sectional survey. Subjects consisted of 81 treatment-naïve OSA patients and...

  5. Role of Sleep Apnea and Gastroesophageal Reflux in Severe Asthma.

    Science.gov (United States)

    Rogers, Linda

    2016-08-01

    Gastroesophageal reflux and obstructive sleep apnea syndrome are conditions that practitioners have been encouraged to evaluate and treat as part of a comprehensive approach to achieving asthma control. In this review, the author looks at the evidence linking these two conditions as factors that may impact difficult-to-control asthma and looks critically at the evidence suggesting that evaluation and treatment of these conditions when present impacts asthma control. PMID:27401619

  6. CO(2) homeostasis during periodic breathing in obstructive sleep apnea.

    Science.gov (United States)

    Berger, K I; Ayappa, I; Sorkin, I B; Norman, R G; Rapoport, D M; Goldring, R M

    2000-01-01

    The contribution of apnea to chronic hypercapnia in obstructive sleep apnea (OSA) has not been clarified. Using a model (D. M. Rapoport, R. G. Norman, and R. M. Goldring. J. Appl. Physiol. 75: 2302-2309, 1993), we previously illustrated failure of CO(2) homeostasis during periodic breathing resulting from temporal dissociation between ventilation and perfusion ("temporal V/Q mismatch"). This study measures acute kinetics of CO(2) during periodic breathing and addresses interapnea ventilatory compensation for maintenance of CO(2) homeostasis in 11 patients with OSA during daytime sleep (37-171 min). Ventilation and expiratory CO(2) and O(2) fractions were measured on a breath-by-breath basis by means of a tight-fitting full facemask. Calculations included CO(2) excretion, metabolic CO(2) production, and CO(2) balance (metabolic CO(2) production - exhaled CO(2)). CO(2) balance was tabulated for each apnea/hypopnea event-interevent cycle and as a cumulative value during sleep. Cumulative CO(2) balance varied (-3,570 to +1,388 ml). Positive cumulative CO(2) balance occurred in the absence of overall hypoventilation during sleep. For each cycle, positive CO(2) balance occurred despite increased interevent ventilation to rates as high as 45 l/min. This failure of CO(2) homeostasis was dependent on the event-to-interevent duration ratio. The results demonstrate that 1) periodic breathing provides a mechanism for acute hypercapnia in OSA, 2) acute hypercapnia during periodic breathing may occur without a decrease in average minute ventilation, supporting the presence of temporal V/Q mismatch, as predicted from our model, and 3) compensation for CO(2) accumulation during apnea/hypopnea may be limited by the duration of the interevent interval. The relationship of this acute hypercapnia to sustained chronic hypercapnia in OSA remains to be further explored. PMID:10642388

  7. Ophthalmic Diseases in Patients With Obstructive Sleep Apnea.

    Science.gov (United States)

    Skorin, Leonid; Knutson, Rachel

    2016-08-01

    Symptomatic obstructive sleep apnea (OSA) affects 2% of women and 4% of men, but the prevalence of asymptomatic OSA is significantly higher. Several ophthalmic conditions are associated with OSA, including floppy eyelid syndrome, glaucoma, nonarteritic anterior ischemic optic neuropathy, papilledema, keratoconus, and central serous chorioretinopathy. The purpose of this review is to provide primary care physicians with a general knowledge of the signs, symptoms, and management of the ophthalmic diseases associated with OSA. PMID:27455101

  8. Obstructive Sleep Apnea and Kidney Disease: A Potential Bidirectional Relationship?

    OpenAIRE

    Abuyassin, Bisher; Sharma, Kumar; Ayas, Najib T.; Laher, Ismail

    2015-01-01

    Chronic kidney disease (CKD) is associated with high mortality rates and heavy economic and social burdens. Nearly 10% of the United States population suffer from CKD, with fatal outcomes increased by 16–40 times even before reaching end-stage renal disease. The prevalence of obstructive sleep apnea (OSA) is between 3% and 7% in the general population, and has increased dramatically during the last 2 decades along with increased rates of obesity. However, the prevalence of OSA is much greater...

  9. OBSTRUCTIVE SLEEP APNEA AND METABOLIC DYSFUNCTION IN POLYCYSTIC OVARY SYNDROME

    OpenAIRE

    Nitsche, Katie; Ehrmann, David A.

    2010-01-01

    Obstructive sleep apnea (OSA) is an underrecognized, yet significant factor in the pathogenesis of metabolic derangements in polycystic ovary syndrome (PCOS). Recent findings suggest that there may be two “subtypes” of PCOS, i.e. PCOS with or without OSA, and these two subtypes may be associated with distinct metabolic and endocrine alterations. PCOS women with OSA may be at much higher risk for diabetes and cardiovascular disease than PCOS women without OSA and may benefit from therapeutic i...

  10. Compliance with Positive Airway Pressure Treatment for Obstructive Sleep Apnea

    OpenAIRE

    Kim, Ji Heui; Kwon, Min Su; Song, Hyung Min; Lee, Bong-Jae; Jang, Yong Ju; Chung, Yoo-Sam

    2009-01-01

    Objectives Positive airway pressure (PAP) is considered a standard treatment for moderate-to-severe obstructive sleep apnea (OSA) patients. However, compliance with PAP treatment is suboptimal because of several types of discomfort experienced by patients. This study investigated compliance with PAP therapy, and affecting factors for such compliance, in OSA patients. Methods We performed a survey on 69 patients who engaged in PAP therapy between December 2006 and November 2007. After diagnost...

  11. Update on obstructive sleep apnea and its relation to COPD

    OpenAIRE

    Mieczkowski B; Ezzie ME

    2014-01-01

    Brian Mieczkowski, Michael E Ezzie Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Ohio State University, Wexner Medical Center, Columbus, OH, USA Abstract: Chronic obstructive pulmonary disease (COPD) is a common and preventable lung disease that affects millions of people in the United States. Sleep disorders including obstructive sleep apnea (OSA) are also common. It is not surprising that many people with COPD also suffer from OSA. This relationship, however, puts peopl...

  12. Correlation between severity of endoscopic findings and apnea-hypopnea index in patients with gastroesophageal reflux disease and obstructive sleep apnea

    Institute of Scientific and Technical Information of China (English)

    P(a)l Demeter; Katalin V(a)rdi Visy; P(a)l Magyar

    2005-01-01

    AIM: To assess the relationship between severity of gastroesophageal reflux disease and apnea-hypopnea index (AHI) as an indicator of the severity of obstructive sleep apnea.METHODS: Data of 57 patients with proven obstructive sleep apnea and gastroesophageal reflux disease were analyzed. Patients were divided into two groups according to severity of the sleep apnea: "mild-moderate" (A)-AHI ≥5-30, n = 27, "severe" (B)-AHI >30, n = 30. All patients underwent apnea monitoring during the night, upper panendoscopy and were asked about typical reflux symptoms.RESULTS: All examined patients in both groups showed a significant overweight and there was a positive correlation between body mass index and the degree of sleep apnea (P = 0.0002). The occurence of erosive reflux disease was significantly higher in "severe" group (P = 0.0001).Using a logistic regression analysis a positive correlation was found between the endoscopic severity of reflux disease and the AHI (P = 0.016). Forty-nine point five percent of the patients experienced the typical symptoms of reflux disease at least three times a week and there was no significant difference between the two groups.CONCLUSION: A positive correlation can be found between the severity of gastroesophageal reflux disease and obstructive sleep apnea.

  13. Analysis of Advantages and Disadvantages of the Mode of Local Additional Varieties of Essential Drug List and Its Relevant Countermeasures%基本药物目录地方增补品种模式的利弊分析及对策研究

    Institute of Scientific and Technical Information of China (English)

    孙利华; 王长之; 孙晓燕

    2011-01-01

    目的 为选择适合我国现阶段国情的基本药物目录制定模式提供参考.方法 在研究国家相关政策和查阅相关文献的基础上,通过分析总结和逻辑推理,对现行的基本药物目录制定所采用的地方增补品种这一模式进行利弊分析.结果与结论 笔者认为,基本药物目录地方增补品种模式的弊明显大于利,不适应现阶段我国国情.建议我国采用多品种无增补模式制定基本药物目录.%OBJECTIVE: To provide the references for selecting the mode of the development of essential drug list which is consistent with the current conditions of China. METHODS: Based on the study of national policies and relevant documents, the advantage and disadvantage of the current mode of local additional varieties of the essential drug list were analyzed through the method of summary and logical reasoning. RESULTS & CONCLUSION: The mode of local additional varieties of essential drug list apparently has more disadvantages than advantages, which is not fit for national conditions in China. Our country should adopt the mode of multi-species without addition to develop essential drug list.

  14. Obstructive sleep apnea in chronic obstructive pulmonary disease patients.

    LENUS (Irish Health Repository)

    Lee, Ruth

    2012-02-01

    PURPOSE OF REVIEW: Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) represent two of the most prevalent chronic respiratory disorders and cardiovascular diseases are major co-morbidities in both. Co-existence of both disorders (overlap syndrome) occurs in 1% of adults and overlap patients have worse nocturnal hypoxemia and hypercapnia than COPD and OSA patients alone. The present review discusses recent data concerning the pathophysiological and clinical significance of the overlap syndrome. RECENT FINDINGS: The severity of obstructive ventilatory impairment and hyperinflation, especially the inspiratory capacity to total lung capacity (TLC) ratio, correlates with the severity of sleep-related breathing disturbances. Early treatment with continuous positive airway pressure (CPAP) improves survival, reduces hospitalization and pulmonary hypertension, and also reduces hypoxemia. Evidence of systemic inflammation and oxidative stress in COPD and sleep apnea provides insight into potential interactions between both disorders that may predispose to cardiovascular disease. Long-term outcome studies of overlap patients currently underway should provide further evidence of the clinical significance of the overlap syndrome. SUMMARY: Studies of overlap syndrome patients at a clinical, physiological and molecular level should provide insight into disease mechanisms and consequences of COPD and sleep apnea, in addition to identifying potential relationships with cardiovascular disease.

  15. Pure Obstructive Sleep Apnea Syndrome and Erectile Dysfunction

    Directory of Open Access Journals (Sweden)

    Cenk Gürbüz

    2011-11-01

    Full Text Available Objective: The aim of this study is to investigate the existence of erectile dysfunction in patients with obstructive sleep apnea syndrome (OSAS in which the other possible causes of erectile dysfunction were eliminated.Material and Methods: The study group consisted of 24 patients diagnosed as OSAS with polysomnographic evaluation, and 15 non-apneic controls (mean age; 41.0±8.8 and 42.3±7.9 year respectively whose comorbidities which might be associated with erectile dysfunction were excluded. Daytime sleepiness was evaluated by Epworth Sleepiness Scale (ESS and measurement of erectile function was performed by International Index of Erectile Function.Results: The rate of erectile dysfunction in OSAS and control groups were 54.2% and 33.3% respectively (p=0.204. The difference between mean erectile function scores of patient and control groups was non-significant (26.1±4.5 and 26.3±4.3 respectively, p=0.900. There was no correlation between erectile function scores and apnea hypnoea index (r=-0.140; p=0.395.Conclusion: Findings obtained from this study suggest that the high incidence of erectile dysfunction reported in OSAS patients seems to be related with concomitant comorbidities such as diabetes, atherosclerosis and neuroendocrine disorders rather than sleep apnea.

  16. Predicting performance in competitive apnea diving. Part III: deep diving.

    Science.gov (United States)

    Schagatay, Erika

    2011-12-01

    The first of these reviews described the physiological factors defining the limits of static apnea, while the second examined performance in apneic distance swimming. This paper reviews the factors determining performance in depth disciplines, where hydrostatic pressure is added to the stressors associated with apnea duration and physical work. Apneic duration is essential for performance in all disciplines, and is prolonged by any means that increases gas storage or tolerance to asphyxia or reduces metabolic rate. For underwater distance swimming, the main challenge is to restrict metabolism despite the work of swimming, and to redirect blood flow to allow the most vital functions. Here, work economy, local tissue energy and oxygen stores, anaerobic capacity of the muscles, and possibly technical improvements will be essential for further development. In the depth disciplines, direct pressure effects causing barotrauma, the narcotic effects of gases, decompression sickness (DCS) and possibly air embolism during ascent need to be taken into account, as does the risk of hypoxia when the dive cannot be rapidly interrupted before the surface is reached again. While in most deep divers apneic duration is not the main limitation thus far, greater depths may call for exceptionally long apneas and slower ascents to avoid DCS. Narcotic effects may also affect the ultimate depth limit, which the divers currently performing 'constant weight with fins' dives predict to be around 156 metres' sea water. To reach these depths, serious physiological challenges have to be met, technical developments needed and safety procedures developed concomitantly. PMID:22183699

  17. Obstructive sleep apnea syndrome and cognitive impairment: effects of CPAP

    Directory of Open Access Journals (Sweden)

    Alessandra Giordano

    2011-10-01

    Full Text Available Obstructive Sleep Apnea Syndrome (OSAS is a sleep disorder characterised by repetitive episodes of upper airway obstruction (apnea or reduced airflow (hypopnoea despite persistent respiratory effort. Apnea is defined as the cessation of breathing for at least 10 seconds during sleep, while hypopnoea is defined as at least 30% reduction in airflow for 10 seconds associated with oxygen desaturation and sleep fragmentation. The presence in the general population is about 4%. The principal symptoms are: excessive daytime sleepiness (EDS, snoring, dry throat, morning headache, night sweats, gastro-esophageal reflux, and increased blood pressure.Long term complications can be: increased cardio-cerebrovascular risk and cognitive impairment such as deficiency in attention, vigilance, visual abilities, thought, speech, perception and short term memory.Continuous Positive Airway Pressure (CPAP is currently the best non-invasive therapy for OSAS.CPAP guarantees the opening of upper airways using pulmonary reflexive mechanisms increasing lung volume during exhalation and resistance reduction, decreasing electromyografical muscular activity around airways.The causes of cognitive impairments and their possible reversibility after CPAP treatment have been analysed in numerous studies. The findings, albeit controversial, show that memory, attention and executive functions are the most compromised cognitive functions.The necessity of increasing the patient compliance with ventilotherapy is evident, in order to prevent cognitive deterioration and, when possible, rehabilitate the compromised functions, a difficult task for executive functions.

  18. Follow-up of obstructive sleep apnea in children

    Directory of Open Access Journals (Sweden)

    Emília Leite de Barros

    2014-07-01

    Full Text Available INTRODUCTION: the evolution of snoring and OSAS in children is not well established since few studies of patients without surgical treatment have been published. OBJECTIVE: to evaluate the evolution of sleep disordered breathing in children who had not been submitted to upper airway surgery. METHOD: twenty-six children with snoring who had not undergone upper airway surgery were evaluated prospectively. Patients were evaluated by full physical examination and nocturnal polysomnography, after which they were divided into 2 groups: apnea (16 children and snoring (10 children. After 6 months following the initial evaluation, patients were submitted to a new nocturnal polysomnography, and all data were compared to those of the first examination. RESULTS: the groups did not show any differences regarding age, weight, height and airway physical examination. After 6 months of follow-up, the apnea index did not change, but the respiratory disturbance index increased in the snoring group and the number of hypopneas decreased in the group apnea. CONCLUSION: there was an increase in the percentage of N1 sleep stage and the respiratory disturbance index in the patients with primary snore. The AHI did not show significant alteration in both groups, but the number of hypopneas decreased in patients with SAOS.

  19. Fasting improves static apnea performance in elite divers without enhanced risk of syncope.

    Science.gov (United States)

    Schagatay, Erika; Lodin-Sundström, Angelica

    2014-01-01

    In competitive apnea divers, the nutritional demands may be essentially different from those of, for example, endurance athletes, where energy resources need to be maximised for successful performance. In competitive apnea, the goal is instead to limit metabolism, as the length of the sustainable apneic period will depend to a great extent on minimising oxygen consumption. Many but not all elite divers fast before performing static apnea in competition. This may increase oxygen consumption as mainly lipid stores are metabolised but could also have beneficial effects on apneic duration. Our aim was to determine the effect of over-night fasting on apnea performance. Six female and seven male divers performed a series of three apneas after eating and fasting, respectively. The series consisted of two 2-min apneas spaced by 3 min rest and, after 5 min rest, one maximal effort apnea. Apneas were performed at supine rest and preceded by normal respiration and maximal inspiration. Mean (± SD) time since eating was 13 h (± 2 h 43 min) for the fasting and 1 h 34 min (± 33 min) for the eating condition (P eating (Peating and ETCO2 was lower in the fasting condition (P eating conditions (P eating (P eating (P < 0.01). The 22% longer apnea duration after fasting with analogous end apnea SaO2 levels suggests that fasting is beneficial for static apnea performance in elite divers, likely via metabolism-limiting mechanisms. The oxygen-conserving effect of the more pronounced diving response and possibly other metabolism-limiting mechanisms related to fasting apparently outweigh the enhanced oxygen consumption caused by lipid metabolism. PMID:24444200

  20. Association of Obstructive Sleep Apnea Syndrome and Buerger's Disease: a Pilot Study

    Directory of Open Access Journals (Sweden)

    Gholam Hosein Kazemzadeh

    2015-10-01

    Full Text Available In this study we evaluated the incidence and severity of obstructive sleep apnea and Obstructive sleep apnea syndrome in patients with thromboangiitis obliterans for reduction of crisis. In 40 patients with Buerger's disease daily sleepiness and risk of Obstructive sleep apnea were evaluated using the Epworth sleeping scale (ESS and the Stop-Bang score. An Apnea-link device was used for evaluation of chest motion, peripheral oxygenation, and nasal airflow during night-time sleep. The apnea/hypopnea index (AHI and respiratory tdisurbance index were used for Obstructive sleep apnea syndrome diagnosis. All subjects were cigarette smokers and 80% were opium addicted. The prevalence of Obstructive sleep apnea (AHI>5 was 80%, but incidence of Obstructive sleep apnea syndrome (AHI>5 + ESS≥10 was 5% (2/40. There was no association between duration or frequency of hospitalization and Obstructive sleep apnea syndrome (P=0.74 and 0.86, respectively. In addition, no correlation between ESS and Stop-Bang scores and AHI was observed (P=0.58 and 0.41, respectively. There was an inverse correlation between smoking rate and AHI (P=0.032, r = −0.48. We did not find an association between Buerger's disease and Obstructive sleep apnea syndrome. Although the AHI was high (80% and daily sleepiness was low. The negative correlation of smoking with AHI and on the other hand daily napping in addiction may be caused by the absence of a clear relationship between Obstructive sleep apnea syndrome and Buerger's disease.

  1. List based prefetch

    Energy Technology Data Exchange (ETDEWEB)

    Boyle, Peter; Christ, Norman; Gara, Alan; Kim, Changhoan; Mawhinney, Robert; Ohmacht, Martin; Sugavanam, Krishnan

    2014-08-12

    A list prefetch engine improves a performance of a parallel computing system. The list prefetch engine receives a current cache miss address. The list prefetch engine evaluates whether the current cache miss address is valid. If the current cache miss address is valid, the list prefetch engine compares the current cache miss address and a list address. A list address represents an address in a list. A list describes an arbitrary sequence of prior cache miss addresses. The prefetch engine prefetches data according to the list, if there is a match between the current cache miss address and the list address.

  2. Is the severity of obstructive sleep apnea or the magnitude of respiratory effort associated with gastroesophageal reflux?

    Institute of Scientific and Technical Information of China (English)

    Levent Ozturk; Zerrin Pelin

    2005-01-01

    @@ TO THE EDITOR In a tecent issue of World Journal of Gastroenterology,Demeter et al.[1],reported that in patients having both gastro-esophageal reflux disease(GERD)and obstructive sleep apnea(OSA),there was a positive correlation between endoscopic findings of GERD and the number of apneas and hypopneas per hour,namely apnea hypopnea index.

  3. Quality of life in patients with obstructive sleep apnea: Relationship with daytime sleepiness, sleep quality, depression, and apnea severity.

    Science.gov (United States)

    Lee, Wonhee; Lee, Sang-Ahm; Ryu, Han Uk; Chung, Yoo-Sam; Kim, Woo Sung

    2016-02-01

    The aim of this study was to investigate the relative contributions of daytime sleepiness, sleep quality, depression, and apnea severity to mental and physical quality of life (QoL) in obstructive sleep apnea (OSA) patients. This was a cross-sectional study. Participants were adults diagnosed with OSA. Medical Outcomes Study-Short Form 36 (SF-36), Epworth Sleepiness Scale (ESS), Medical Outcomes Study-Sleep Scale, and Beck Depression Inventory (BDI) were used. The factors predicting the physical and mental QoL were evaluated using multiple linear regression analysis. Seven hundred ninety three OSA patients participated in the study. The average age was 48.9 years (SD = 11.7 years). The mean apnea-hypopnea index (AHI) was 29.5 hour(-1) (SD = 20.6 hour(-1)). The SF-36 scores were 72.6 (SD = 18.5). The BDI, sleep quality, and age were related to both mental and physical QoL. However, ESS, minimal arterial oxygen saturation, gender, and body mass index were associated with the physical but not mental QoL. The BDI was the strongest predictor of both physical and mental QoL. AHI was related to neither physical nor mental QoL. The potential factors affecting QoL are different between physical and mental dimensions of QoL. Depressive mood was the strongest predictor of both the physical and mental QoL. PMID:26396158

  4. Circulating KL-6, a Biomarker of Lung Injury, in Obstructive Sleep Apnea

    OpenAIRE

    Lederer, David J.; Jelic, Sanja; Basner, Robert C.; Ishizaka, Akitoshi; Bhattacharya, Jahar

    2009-01-01

    In obstructive sleep apnea (OSA), oxidative stress contributes to endothelial dysfunction in the peripheral circulation. In the lung, oxidative stress can lead to alveolar injury. We hypothesized that patients with obstructive sleep apnea would have biomarker evidence of increased alveolar wall permeability.

  5. Making Sense of Oxidative Stress in Obstructive Sleep Apnea: Mediator or Distracter in Brain Injury?

    Directory of Open Access Journals (Sweden)

    SigridVeasey

    2012-12-01

    Full Text Available Obstructive sleep apnea is increasingly recognized as an important contributor to cognitive impairment, metabolic derangements and cardiovascular disease and mortality. Identifying the mechanisms by which this prevalent disorder influences health outcomes is now of utmost importance. As the prevalence of this disorder steadily increases, therapies are needed to prevent or reverse sleep apnea morbidities now more than ever before. Oxidative stress is implicated in cardiovascular morbidities of sleep apnea. What role oxidative stress plays in neural injury and cognitive impairments has been difficult to understand without readily accessible tissue to biopsy in persons with and without sleep apnea. An improved understanding of the role oxidative stress plays in neural injury in sleep apnea may be developed by integrating information gained examining neural tissue in animal models of sleep apnea with key features of redox biochemistry and clinical sleep apnea studies where extra-neuronal oxidative stress characterizations have been performed. Collectively, this information sets the stage for developing and testing novel therapeutic approaches to treat and prevent, not only central nervous system injury and dysfunction in sleep apnea, but also the cardiovascular and potentially metabolic conditions associated with this prevalent, disabling disorder.

  6. Apnea and infection in neonates : Mediatory role of interleukin-1Beta and prostaglandin E2

    OpenAIRE

    Olsson Hofstetter, Annika

    2006-01-01

    The breathing pattern of infants, particularly preterm infants, is often irregular or periodic and is frequently interrupted by apnea The latter represents a major concern in haematology, yet much remains unknown about its incidence, appearance, and pathophysiology. This thesis further characterizes cardiorespiratory activity in preterm infants during postnatal development and investigates the association between infection and apnea in neonates, focusing on the mediatory rol...

  7. Association of obstructive sleep apnea severity with exercise capacity and health-related quality of life

    Directory of Open Access Journals (Sweden)

    Katrina L Butner

    2013-01-01

    Full Text Available Background: Current research is inconclusive as to whether obstructive sleep apnea severity directly limits exercise capacity and lowers health-related quality of life (HRQoL. Aims: The aim of this study was to evaluate the association of obstructive sleep apnea severity with determinants of exercise capacity and HRQoL. Subjects and Methods: Subjects were evaluated by home somnography and classified as no obstructive sleep apnea ( n = 43 or as having mild ( n = 27, moderate or severe obstructive sleep apnea ( n = 21. Exercise capacity was assessed by a ramping cycle ergometer test, and HRQoL was assessed with the SF-36 questionnaire. Results: Greater obstructive sleep apnea severity was associated with older age, higher body weight, higher body mass index, lower peak aerobic capacity, a higher percentage of peak aerobic capacity at a submaximal exercise intensity of 55 watts, and lower physical component summary score from the SF-36. None of these variables were statistically different among obstructive sleep apnea severity groups after controlling for age and body weight. Obstructive sleep apnea severity was not associated with any cardiorespiratory fitness or HRQoL parameter. Conclusions: Obstructive sleep apnea severity has no independent association with exercise capacity or HRQoL.

  8. Dynamics of Snoring Sounds and Its Connection with Obstructive Sleep Apnea

    CERN Document Server

    Alencar, Adriano M; Oliveira, Carolina Beatriz; Vieira, Andre P; Moriya, Henrique T; Lorenzi-Filho, Geraldo

    2012-01-01

    Snoring is extremely common in the general population and when irregular may indicate the presence of obstructive sleep apnea. We analyze the overnight sequence of wave packets --- the snore sound --- recorded during full polysomnography in patients referred to the sleep laboratory due to suspected obstructive sleep apnea. We hypothesize that irregular snore, with duration in the range between 10 and 100 seconds, correlates with respiratory obstructive events. We find that the number of irregular snores --- easily accessible, and quantified by what we call the snore time interval index (STII) --- is in good agreement with the well-known apnea-hypopnea index, which expresses the severity of obstructive sleep apnea and is extracted only from polysomnography. In addition, the Hurst analysis of the snore sound itself, which calculates the fluctuations in the signal as a function of time interval, is used to build a classifier that is able to distinguish between patients with no or mild apnea and patients with mod...

  9. DisLexList

    DEFF Research Database (Denmark)

    2013-01-01

    DisLexList is a simple analysis script for the generation of lists of lexemes in discourses, and may be used as a tool in discourse analysis (critical and otherwise). DisLexList is, in its current state, able to generate simple word lists and lexeme list based on output from VISL's flat structure...

  10. Cardiac sympathetic modulation in response to apneas/hypopneas through heart rate variability analysis.

    Directory of Open Access Journals (Sweden)

    Florian Chouchou

    Full Text Available Autonomic dysfunction is recognized to contribute to cardiovascular consequences in obstructive sleep apnea/hypopnea syndrome (OSAHS patients who present predominant cardiovascular sympathetic activity that persists during wakefulness. Here, we examined 1 the factors that influence sympathetic cardiac modulation in response to apneas/hypopneas; and 2 the influence of autonomic activity during apneas/hypopneas on CA. Sixteen OSAHS patients underwent in-hospital polysomnography. RR interval (RR and RR spectral analysis using wavelet transform were used to study parasympathetic (high frequency power: HF(WV and sympathetic (low frequency power: LF(WV and LF(WV/HF(WV ratio activity before and after apnea/hypopnea termination. Autonomic cardiac modulations were compared according to sleep stage, apnea/hypopnea type and duration, arterial oxygen saturation, and presence of CA. At apnea/hypopnea termination, RR decreased (p<0.001 while LF(WV (p = 0.001 and LF(WV/HF(WV ratio (p = 0.001 increased. Only RR and LF(WV/HF(WV ratio changes were higher when apneas/hypopneas produced CA (p = 0.030 and p = 0.035, respectively or deep hypoxia (p = 0.023 and p = 0.046, respectively. Multivariate statistical analysis showed that elevated LF(WV (p = 0.006 and LF(WV/HF(WV ratio (p = 0.029 during apneas/hypopneas were independently related to higher CA occurrence. Both the arousal and hypoxia processes may contribute to sympathetic cardiovascular overactivity by recurrent cardiac sympathetic modulation in response to apneas/hypopneas. Sympathetic overactivity also may play an important role in the acute central response to apneas/hypopneas, and in the sleep fragmentation.

  11. Supine sleep and positional sleep apnea after acute ischemic stroke and intracerebral hemorrhage

    Directory of Open Access Journals (Sweden)

    Millene R. Camilo

    2012-12-01

    Full Text Available OBJECTIVE: Obstructive sleep apnea is frequent during the acute phase of stroke, and it is associated with poorer outcomes. A well-established relationship between supine sleep and obstructive sleep apnea severity exists in non-stroke patients. This study investigated the frequency of supine sleep and positional obstructive sleep apnea in patients with ischemic or hemorrhagic stroke. METHODS: Patients who suffered their first acute stroke, either ischemic or hemorrhagic, were subjected to a full polysomnography, including the continuous monitoring of sleep positions, during the first night after symptom onset. Obstructive sleep apnea severity was measured using the apnea-hypopnea index, and the NIHSS measured stroke severity. RESULTS: We prospectively studied 66 stroke patients. The mean age was 57.6±11.5 years, and the mean body mass index was 26.5±4.9. Obstructive sleep apnea (apnea-hypopnea index >5 was present in 78.8% of patients, and the mean apnea-hypopnea index was 29.7±26.6. The majority of subjects (66.7% spent the entire sleep time in a supine position, and positional obstructive sleep apnea was clearly present in the other 23.1% of cases. A positive correlation was observed between the NIHSS and sleep time in the supine position (r s = 0.5; p<0.001. CONCLUSIONS: Prolonged supine positioning during sleep was highly frequent after stroke, and it was related to stroke severity. Positional sleep apnea was observed in one quarter of stroke patients, which was likely underestimated during the acute phase of stroke. The adequate positioning of patients during sleep during the acute phase of stroke may decrease obstructive respiratory events, regardless of the stroke subtype.

  12. Indication of CPAP in Patients with Suspected Obstructive Sleep Apnea, Based on Clinical Parameters and a Novel Two-Channel Recording Device (ApneaLink): A Pilot Study

    OpenAIRE

    Carlos Alberto Nigro; Eduardo Dibur; Sofía Grandval; Facundo Nogueira

    2012-01-01

    Objective. To evaluate the accuracy and reliability of the medical decision based on the results of the hand scoring from a two-channel recording device (ApneaLink) plus clinical data for the prescription of a CPAP assay in patients with suspected OSA. Methods. 39 subjects were assessed in the sleep laboratory with polysomnography and ApneaLink. The patients completed the Epworth sleepiness scale and a clinical history. Two blinded independent observers decided to prescribe CPAP according to ...

  13. Sleep Apnea Clinical Score, Berlin Questionnaire, or Epworth Sleepiness Scale: which is the best obstructive sleep apnea predictor in patients with COPD?

    OpenAIRE

    Faria AC; Costa CH; Rufino R

    2015-01-01

    Anamelia Costa Faria, Cláudia Henrique da Costa, Rogério Rufino Cardiopulmonology Department, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil Introduction: The Sleep Apnea Clinical Score (SACS) and the Berlin Questionnaire (BQ) are used to predict the likelihood of obstructive sleep apnea (OSA). The Epworth Sleepiness Scale (ESS) is used to assess daytime sleepiness, a common OSA symptom. These clinical tools help prioritize individuals with the most severe illne...

  14. Case Study on the Impact of Treating Sleep Apnea in Commercial Motor Vehicle Drivers: Sleep Apnea Programs from Two Leading U.S. Carriers and Focus Group Findings

    OpenAIRE

    Mabry, J. Erin; Baker, Stephanie Ann; Hickman, Jeffrey S.; Hanowski, Richard J.

    2012-01-01

    Approximately one in four commercial motor vehicle (CMV) drivers in the U.S. are estimated to possess mild or higher levels of obstructive sleep apnea (OSA), the most common sleep-breathing disorder that is associated with significant medical consequences (including cardiovascular disease and diabetes). A major symptom of sleep apnea is excessive daytime sleepiness, which is highly correlated to impaired driving performance and may result in an increased risk of being in traffic--or work-rela...

  15. Non drowsy obstructive sleep apnea as a potential cause of resistant hypertension: a case report

    Directory of Open Access Journals (Sweden)

    Mirrakhimov Aibek E

    2012-05-01

    Full Text Available Abstract Background Obstructive sleep apnea (OSA and arterial hypertension (AH are common and underrecognized medical disorders. OSA is a potential risk factor for the development of AH and/or may act as a factor complicating AH management. The symptoms of excessive daytime sleepiness (EDS are considered essential for the initiation of continuous positive airway pressure (CPAP therapy, which is a first line treatment of OSA. The medical literature and practice is controversial about the treatment of people with asymptomatic OSA. Thus, OSA patients without EDS may be left at increased cardiovascular risk. Case presentation The report presents a case of 42year old Asian woman with symptoms of heart failure and angina like chest pain upon admission. She didnt experience symptoms of EDS, and the Epworth Sleepiness Scale was seven points. Snoring was reported on direct questioning. The patient had prior medical history of three unsuccessful pregnancies complicated by gestational AH and preeclampsia with C-section during the last pregnancy. The admission blood pressure (BP was 200/120mm Hg. The patients treatment regimen consisted of five hypotensive medications including diuretic. However, a target BP wasnt achieved in about one and half month. The patient was offered to undergo a polysomnography (PSG study, which she rejected. One month after discharge the PSG study was done, and this showed an apnea-hypopnea index (AHI of 46 events per hour. CPAP therapy was initiated with a pressure of 11H20cm. After 2months of compliant CPAP use, adherence to pharmacologic regimen and lifestyle modifications the patients BP decreased to 134/82mm Hg. Conclusions OSA and AH are common and often underdiagnosed medical disorders independently imposing excessive cardiovascular risk on a diseased subject. When two conditions coexist the cardiovascular risk is likely much greater. This case highlights a possible clinical phenotype of OSA without EDS and its association

  16. Comorbidities Associated with Obstructive Sleep Apnea: a Retrospective Study

    Science.gov (United States)

    Pinto, José Antonio; Ribeiro, Davi Knoll; Cavallini, Andre Freitas da Silva; Duarte, Caue; Freitas, Gabriel Santos

    2016-01-01

    Introduction Obstructive sleep apnea (OSA) is characterized by partial or complete recurrent upper airway obstruction during sleep. OSA brings many adverse consequences, such as hypertension, obesity, diabetes mellitus, cardiac and encephalic alterations, behavioral, among others, resulting in a significant source of public health care by generating a high financial and social impact. The importance of this assessment proves to be useful, because the incidence of patients with comorbidities associated with AOS has been increasing consistently and presents significant influence in natural disease history. Objective The objective of this study is to assess major comorbidities associated with obstructive sleep apnea (OSA) and prevalence in a group of patients diagnosed clinically and polysomnographically with OSA. Methods This is a retrospective study of 100 charts from patients previously diagnosed with OSA in our service between October 2010 and January 2013. Results We evaluated 100 patients with OSA (84 men and 16 women) with a mean age of 50.05 years (range 19–75 years). The prevalence of comorbidities were hypertension (39%), obesity (34%), depression (19%), gastroesophageal reflux disease (GERD) (18%), diabetes mellitus (15%), hypercholesterolemia (10%), asthma (4%), and no comorbidities (33%). Comorbidities occurred in 56.2% patients diagnosed with mild OSA, 67.6% with moderate OSA, and 70% of patients with severe OSA. Conclusion According to the current literature data and the values obtained in our paper, we can correlate through expressive values obesity with OSA and their apnea hypopnea index (AHI) values. However, despite significant prevalence of OSA with other comorbidities, our study could not render expressive significance values able to justify their correlations. PMID:27096019

  17. Prevalence of Obstructive Sleep Apnea in Patients with Chronic Wounds

    Science.gov (United States)

    Patt, Brian T.; Jarjoura, David; Lambert, Lynn; Roy, Sashwati; Gordillo, Gayle; Schlanger, Richard; Sen, Chandan K.; Khayat, Rami N.

    2010-01-01

    Study Objectives: Chronic non-healing wounds are a major human and economic burden. Obstructive sleep apnea (OSA) is prevalent in patients with obesity, diabetes, aging, and cardiovascular disease, all of which are risk factors for chronic wounds. We hypothesized that OSA would have more prevalence in patients of a wound center than the general middle-aged population. Methods: Consecutive patients of the Ohio State University Comprehensive Wound Center (CWC) were surveyed with the Berlin and Epworth questionnaires. In the second stage of the protocol, 50 consecutive unselected CWC patients with lower extremity wounds underwent home sleep studies. Results: In 249 patients of the CWC who underwent the survey study, OSA had been previously diagnosed in only 22%. The prevalence of high-risk status based on questionnaires for OSA was 46% (95% CI 40%, 52%). In the 50 patients who underwent home sleep studies, and using an apnea hypopnea index of 15 events per hour, the prevalence of OSA was 57% (95% CI 42%, 71%). There was no difference between the Berlin questionnaire score and weight between patients with OSA and those without. Conclusions: The prevalence of OSA in patients with chronic wounds exceeds the estimated prevalence of OSA in the general middle aged population. This study identifies a previously unrecognized population with high risk for OSA. Commonly used questionnaires were not sufficiently sensitive for the detection of high risk status for OSA in this patient population. Citation: Patt BT; Jarjoura D; Lambert L; Roy S; Gordillo G; Schlanger R; Sen CK; Khayat RN. Prevalence of obstructive sleep apnea in patients with chronic wounds. J Clin Sleep Med 2010;6(6):541-544. PMID:21206743

  18. Comorbidities Associated with Obstructive Sleep Apnea: a Retrospective Study.

    Science.gov (United States)

    Pinto, José Antonio; Ribeiro, Davi Knoll; Cavallini, Andre Freitas da Silva; Duarte, Caue; Freitas, Gabriel Santos

    2016-04-01

    Introduction Obstructive sleep apnea (OSA) is characterized by partial or complete recurrent upper airway obstruction during sleep. OSA brings many adverse consequences, such as hypertension, obesity, diabetes mellitus, cardiac and encephalic alterations, behavioral, among others, resulting in a significant source of public health care by generating a high financial and social impact. The importance of this assessment proves to be useful, because the incidence of patients with comorbidities associated with AOS has been increasing consistently and presents significant influence in natural disease history. Objective The objective of this study is to assess major comorbidities associated with obstructive sleep apnea (OSA) and prevalence in a group of patients diagnosed clinically and polysomnographically with OSA. Methods This is a retrospective study of 100 charts from patients previously diagnosed with OSA in our service between October 2010 and January 2013. Results We evaluated 100 patients with OSA (84 men and 16 women) with a mean age of 50.05 years (range 19-75 years). The prevalence of comorbidities were hypertension (39%), obesity (34%), depression (19%), gastroesophageal reflux disease (GERD) (18%), diabetes mellitus (15%), hypercholesterolemia (10%), asthma (4%), and no comorbidities (33%). Comorbidities occurred in 56.2% patients diagnosed with mild OSA, 67.6% with moderate OSA, and 70% of patients with severe OSA. Conclusion According to the current literature data and the values obtained in our paper, we can correlate through expressive values obesity with OSA and their apnea hypopnea index (AHI) values. However, despite significant prevalence of OSA with other comorbidities, our study could not render expressive significance values able to justify their correlations. PMID:27096019

  19. Cognition and biomarkers of oxidative stress in obstructive sleep apnea

    Directory of Open Access Journals (Sweden)

    Leticia Viana Sales

    2013-04-01

    Full Text Available OBJECTIVES: The aim of this study was to investigate neuropsychological performance and biomarkers of oxidative stress in patients with obstructive sleep apnea and the relationships between these factors. METHODS: This was an observational, cross-sectional study of 14 patients (36.0±6.5 years old with obstructive sleep apnea and 13 controls (37.3±6.9 years old. All of the participants were clinically evaluated and underwent full-night polysomnography as well as neuropsychological tests. Blood samples were used to assay superoxide dismutase, catalase, glutathione and homocysteine, as well as vitamins E, C, B11 and B12. RESULTS: The patients performed poorly relative to the controls on several neuropsychological tests, such as the attention test and tests of long-term memory and working memory/executive function. They also had lower levels of vitamin E (p<0.006, superoxide dismutase (p<0.001 and vitamin B11 (p<0.001, as well as higher concentrations of homocysteine (p<0.02. Serum concentrations of vitamin C, catalase, glutathione and vitamin B12 were unaltered. Vitamin E levels were related to performance in the backward digit span task (F = 15.9; p = 0.002 and this correlation remained after controlling for age and body mass index (F = 6.3, p = 0.01. A relationship between superoxide dismutase concentrations and executive non-perseveration errors in the Wisconsin Card Sorting Test (F = 7.9; p = 0.01 was also observed. CONCLUSIONS: Decreased levels of antioxidants and lower performance on the neuropsychological tasks were observed in patients with obstructive sleep apnea. This study suggests that an imbalance between antioxidants and pro-oxidants may contribute to neuropsychological alterations in this patient population.

  20. Co-morbidities associated with obstructive sleep apnea

    Directory of Open Access Journals (Sweden)

    V K Vijayan

    2014-03-01

    Full Text Available There are many co-morbid conditions that are associated with obstructive sleep apnea(OSA. Though a causative relationship between OSA and some of the co-morbiditiesis well established or strongly associated, many risk factors of OSA (age, male genderand obesity are also known risk factors especially for cardiovascular diseases. Otherimportant co-morbid conditions associated with OSA are neurocognitive dysfunctionand, erectile dysfunction. Recently there are reports that ocular manifestations areassociated with OSA. It is expected that more co-morbidities will be reported in OSA asthe research in this area progresses.Key words: Co-morbidities in OSA, Hypertension, Cardiac arrhythmias, Stoke,Erectile dysfunction

  1. Novel Surgical Approaches for the Treatment of Obstructive Sleep Apnea.

    Science.gov (United States)

    Soose, Ryan J

    2016-06-01

    Novel approaches to upper airway anatomic phenotyping, more reconstructive upper airway surgical techniques, and new implantable hypoglossal neurostimulation technology have very favorable potential to improve symptoms and quality-of-life measures, to reduce obstructive sleep apnea (OSA) disease severity and associated cardiovascular risk, and to serve as an adjunct to continuous positive airway pressure, oral appliances, and other forms of OSA medical therapy. Successful surgical therapy depends critically on accurate diagnosis, skillful knowledge and examination of the upper airway anatomy, proper procedure selection, and proficient technical application. PMID:27236056

  2. Copeptin: a new predictor for severe obstructive sleep apnea

    Directory of Open Access Journals (Sweden)

    Çınarka H

    2015-04-01

    Full Text Available Halit Çinarka,1 Servet Kayhan,1 Mevlüt Karataş,1 Asiye Yavuz,1 Aziz Gümüş,1 Songül Özyurt,1 Medine Cumhur Cüre,2 Ünal Şahin1 1Department of Chest Diseases, 2Department of Biochemistry, Recep Tayyip Erdoğan University, Rize, Turkey Introduction: Copeptin which is the C-terminal fragment of antidiuretic hormone (ADH, is a biomarker that has been reported to be increased in various cardiovascular disorders, cerebrovascular diseases and associated with prognosis. Patients with obstructive sleep apnea syndrome (OSAS have a tendency to develop coronary and cerebral atherosclerotic diseases. Objectives: The aim of the present study was to study copeptin levels in patients with obstructive sleep apnea and in a control group in order to determine whether copeptin could be used as a biomarker predicting the severity of OSAS and possible complications in this group. Methods: A total of 116 patients with OSAS, diagnosed by polysomnography, and 27 controls were included in the study. Blood samples were collected after overnight fasting, and copeptin levels were measured with enzyme-linked immunosorbent assay. Results: Copeptin levels were significantly higher in the OSAS group compared to control group (2,156±502; 1,845±500 pg/mL, respectively, P=0.004. Mean copeptin level of the patients having apnea-hypopnea index (AHI ≥30 was significantly higher than that of the patients having AHI <30 (2,392±415; 2,017±500 pg/mL, respectively, P<0.001. A multivariate regression analysis showed that copeptin level, (hazard ratio: 1.58; 95% confidence interval: 1.09–2.30 was a predictor of severe OSAS (P=0.016. Copeptin levels showed significant positive correlation with AHI (r=0.32; P<0.001, desaturation index (r=0.23; P=0.012, arousal index (r=0.24; P=0.010 and CRP (r=0.26; P=0.011 respectively. Conclusion: Copeptin levels are high in OSAS patients and copeptin is a potential marker for identifying patients with a high risk of early cardiovascular

  3. Diagnosis and Treatment of Insomnia Comorbid with Obstructive Sleep Apnea.

    Science.gov (United States)

    Lack, Leon; Sweetman, Alexander

    2016-09-01

    Insomnia is often comorbid with obstructive sleep apnea. It reduces positive airway pressure (PAP) therapy acceptance and adherence. Comorbid patients show greater daytime impairments and poorer health outcomes. The insomnia often goes undiagnosed, undertreated, or untreated. Pharmacotherapy is not recommended for long-term treatment. Although care should be taken administering behavioral therapies to patients with elevated sleepiness, cognitive behavior therapy for insomnia (CBTi) is an effective and durable nondrug therapy that reduces symptoms and may increase the effectiveness of PAP therapy. Sleep clinics should be alert to comorbid insomnia and provide adequate diagnostic tools and clinicians with CBTi expertise. PMID:27542883

  4. An Odontoid Fracture Causing Apnea, Cardiac Instability, and Quadriplegia

    Directory of Open Access Journals (Sweden)

    Christian A. Bowers

    2012-01-01

    Full Text Available Odontoid fractures are typically associated with low rates of acute neurologic deficit and morbidity/mortality in nonelderly patients. In the patient in this case, traumatic injury triggered by a syncopal event led to a combined C1-C2 fracture and a fatal spinal cord injury with apnea, quadriplegia, and cardiovascular instability. We briefly review the anatomical basis for the pathophysiology of cardiac dysfunction following high-cervical spine injury and present an example of a worst-case scenario.

  5. The Prevalence and Natural History of Complex Sleep Apnea

    Science.gov (United States)

    Javaheri, Shahrokh; Smith, Jason; Chung, Eugene

    2009-01-01

    Rationale: Central sleep apnea (CSA) may occasionally occur in patients with obstructive sleep apnea during titration with a continuous positive airway pressure (CPAP) device. Objectives: To determine the prevalence and the natural history of CPAP-emergent CSA. Methods: This is a retrospective study of 1286 patients with a diagnosis of OSA who underwent titration with a positive airway device during a 1-year period. Patients were seen in consultation and underwent full-night attended polysomnography followed by full-night attended CPAP titration. Four weeks after CPAP therapy, patients returned to the clinic for follow-up, and objective adherence to CPAP was recorded. In patients who had CSA on CPAP, a second full-night attended CPAP titration was recommended. Results: Eighty-four of the 1286 patients developed a central apnea index (CAI) of 5 or greater per hour while on CPAP. The incidence of CSA varied from 3% to 10% monthly, with an overall incidence of 6.5%. Forty--two of the 84 patients returned for a second CPAP titration. In 33 patients, CSA was eliminated. In each of the remaining 9 patients, the CAI remained at 5 or greater per hour, with an average of 13 per hour. These patients characteristically had the most severe OSA, and 5 had a CAI of 5 or more per hour at baseline. Two of the 9 patients were on opioids Conclusions: In this large retrospective study of 1286 patients with a diagnosis of OSA, 6.5% had CPAP-emergent or persistent CSA. However, CPAP-emergent CSA was generally transitory and was eliminated within 8 weeks after CPAP therapy. The prevalence of CPAP-persistent CSA was about 1.5%. Severity of OSA, a CAI of 5 or greater per hour, and use of opioids were potential risk factors. Citation: Javaheri S; Smith J; Chung E. The prevalence and natural history of complex sleep apnea. J Clin Sleep Med 2009;5(3):205-211. PMID:19960639

  6. Pure Obstructive Sleep Apnea Syndrome and Erectile Dysfunction

    OpenAIRE

    Cenk Gürbüz; Hacer Kuzu Okur; Selamettin Demir; Salih Ordu; Turhan Caşkurlu

    2011-01-01

    Objective: The aim of this study is to investigate the existence of erectile dysfunction in patients with obstructive sleep apnea syndrome (OSAS) in which the other possible causes of erectile dysfunction were eliminated.Material and Methods: The study group consisted of 24 patients diagnosed as OSAS with polysomnographic evaluation, and 15 non-apneic controls (mean age; 41.0±8.8 and 42.3±7.9 year respectively) whose comorbidities which might be associated with erectile dysfunction were exclu...

  7. Diagnosis and Treatment of Obstructive Sleep Apnea Syndrome in Children.

    Science.gov (United States)

    Tsubomatsu, Chieko; Shintani, Tomoko; Abe, Ayumi; Yajima, Ryoto; Takahashi, Nozomi; Ito, Fumie; Takano, Kenichi; Himi, Tetsuo

    2016-01-01

    Sleep is important for children pertaining to their physical and mental growth. Obstructive sleep apnea syndrome (OSAS) in children has been shown to have different effects as compared to OSAS in adults, including deficits in cognition and neuropsychological functions, hyperactivity, ADHD, behavior problems, aggressive behavior, learning problems and nocturnal enuresis. Hypertrophy of the adenoids and tonsils is a major cause of OSAS in children; therefore, adenotonsillectomy may decrease the effects of OSAS pertaining to physical and mental growth. It is important to accurately diagnose and appropriately treat OSAS in children to prevent OSAS in their adulthood. PMID:27115764

  8. Innovative treatments for adults with obstructive sleep apnea

    Directory of Open Access Journals (Sweden)

    Weaver TE

    2014-11-01

    Full Text Available Terri E Weaver,1,2 Michael W Calik,1,2 Sarah S Farabi,1,2 Anne M Fink,1,2 Maria T Galang-Boquiren,2,3 Mary C Kapella,1,2 Bharati Prasad,2,4 David W Carley1,21Biobehavioral Health Science Department, College of Nursing, University of Illinois at Chicago; 2Center for Narcolepsy, Sleep and Health, University of Illinois at Chicago College of Nursing, 3Department of Orthodontics, University of Illinois at Chicago College of Dentistry, 4Sleep Center, Department of Medicine, University of Illinois at Chicago College of Medicine, Chicago, IL, USAAbstract: Obstructive sleep apnea (OSA affects one in five adult males and is associated with significant comorbidity, cognitive impairment, excessive daytime sleepiness, and reduced quality of life. For over 25 years, the primary treatment has been continuous positive airway pressure, which introduces a column of air that serves as a pneumatic splint for the upper airway, preventing the airway collapse that is the physiologic definition of this syndrome. However, issues with patient tolerance and unacceptable levels of treatment adherence motivated the exploration of other potential treatments. With greater understanding of the physiologic mechanisms associated with OSA, novel interventions have emerged in the last 5 years. The purpose of this article is to describe new treatments for OSA and associated complex sleep apnea. New approaches to complex sleep apnea have included adaptive servoventilation. There is increased literature on the contribution of behavioral interventions to improve adherence with continuous positive airway pressure that have proven quite effective. New non-surgical treatments include oral pressure devices, improved mandibular advancement devices, nasal expiratory positive airway pressure, and newer approaches to positional therapy. Recent innovations in surgical interventions have included laser-assisted uvulopalatoplasty, radiofrequency ablation, palatal implants, and electrical

  9. Radiological findings in patients with obstructive sleep apnea

    International Nuclear Information System (INIS)

    Obstructive sleep apnea (OSA) is characterized by recurrent upper airway obstruction occurring at the level of the pharynx during sleep. Although cephalometric analysis is an important method in the diagnosis of craniofacial deformities, CT and magnetic resonance imaging have been highlighted as the major imaging methods to investigate the possible causes of OSA, which, in most cases, is multifactorial. Magnetic resonance and CT both allow an excellent evaluation of the various anatomical planes of the site of obstruction, which enables better clinical assessment and surgical approach. This pictorial essay aims to describe the aspects that must be evaluated in the diagnostic imaging of patients presenting with the major predisposing factors for OSA. (author)

  10. Radiological findings in patients with obstructive sleep apnea

    Energy Technology Data Exchange (ETDEWEB)

    Mello Junior, Carlos Fernando de; Guimaraes Filho, Helio Antonio; Gomes, Camila Albuquerque de Brito; Paiva, Camila Caroline de Amorim, E-mail: carlosfmello@hotmail.com [Universidade Federal da Paraiba UFPB, Joao Pessoa (Brazil)

    2013-01-15

    Obstructive sleep apnea (OSA) is characterized by recurrent upper airway obstruction occurring at the level of the pharynx during sleep. Although cephalometric analysis is an important method in the diagnosis of craniofacial deformities, CT and magnetic resonance imaging have been highlighted as the major imaging methods to investigate the possible causes of OSA, which, in most cases, is multifactorial. Magnetic resonance and CT both allow an excellent evaluation of the various anatomical planes of the site of obstruction, which enables better clinical assessment and surgical approach. This pictorial essay aims to describe the aspects that must be evaluated in the diagnostic imaging of patients presenting with the major predisposing factors for OSA. (author)

  11. Obstructive sleep apnea and psychomotor vigilance task performance

    Directory of Open Access Journals (Sweden)

    Batool-Anwar S

    2014-05-01

    Full Text Available Salma Batool-Anwar,1 Stefanos N Kales,3,4 Sanjay R Patel,1 Vasileia Varvarigou,3 Pamela N DeYoung,2 Atul Malhotra21Department of Medicine, Sleep Disorders Program, Brigham and Women's Hospital, Boston, MA, USA; 2Pulmonary Critical Care Division, University of California San Diego, La Jolla, CA, USA; 3Department of Environmental and Occupational Medicine and Epidemiology, Harvard School of Public Health, Boston, 4Department of Occupational Medicine, The Cambridge Health Alliance, Cambridge, MA, USABackground: Obstructive sleep apnea (OSA is a highly prevalent disorder with considerable morbidity and mortality. Vigilance and attentiveness are often impaired in OSA patients. In occupational medicine settings, subjective reports of sleepiness are notoriously inaccurate, making the identification of objective measures of vigilance potentially important for risk assessments of fitness for duty. In order to evaluate the effects of OSA on attentiveness and vigilance, we conducted a cross-sectional study to examine the association between OSA and psychomotor vigilance task (PVT performance.Methods: Patients attending sleep clinics for evaluation of possible sleep apnea were recruited. The subjects underwent either a standard overnight laboratory polysomnography or home sleep study. Subjective daytime sleepiness was assessed by Epworth sleepiness scale, and vigilance was tested using a portable device. The participants were asked to respond to the PVT signals using their dominant hand. Each PVT administration lasted 10 minutes, with stimuli signals appearing randomly at variable intervals of 2–10 seconds.Results: Mean age of the participants was 46±15 years, and mean body mass index was 34.3±9.8 kg/m2. Participants with higher Epworth scores had worse PVT performance (P<0.05. In multivariate analyses, age, body mass index, and poor sleep efficiency (measured by Pittsburgh sleep quality index score were associated with worse PVT performance (P<0.05. In

  12. Management of obstructive sleep apnea: A dental perspective

    Directory of Open Access Journals (Sweden)

    Padma Ariga

    2007-01-01

    Full Text Available Sleep disordered breathing is a term which includes simple snoring, upper airway resistance syndrome, and obstructive sleep apnea (OSA. Simple snoring is a common complaint affecting 45% of adults occasionally and 25% of adults habitually and is a sign of upper airway obstruction. Snoring has also been identified as a possible risk factor for hypertension, ischemic heart disease, and stroke. The role of dentistry in sleep disorders is becoming more significant, especially in co-managing patients with simple snoring and mild to moderate OSA. The practicing dental professional has the opportunity to assist patients at a variety of levels, starting with the recognition of a sleep-related disorder, referring patients to a physician for evaluation, and assisting in the management of sleep disorders. Obesity is the main predisposing factor for OSA. In nonobese patients, craniofacial anomalies like micrognathia and retrognathia may also predispose to OSA. Diagnosis of OSA is made on the basis of the history and physical examination and investigations such as polysomnography, limited channel testing, split-night testing, and oximetry. Nocturnal attended polysomnography, which requires an overnight stay in a sleep facility, is the standard diagnostic modality in determining if a patient has OSA. As far as treatment is concerned, the less invasive procedures are to be preferred to the more invasive options. The first and simplest option would be behavior modification, followed by insertion of oral devices suited to the patient, especially in those with mild to moderate OSA. Continuous positive airway pressure (CPAP and surgical options are chosen for patients with moderate to severe OSA. The American Academy of Sleep Medicine (AAOSM has recommended oral appliances for use in patients with primary snoring and mild to moderate OSA. It can also be used in patients with a lesser degree of oxygen saturation, relatively less day time sleepiness, lower frequency

  13. Self shielding in cylindrical fissile sources in the APNea system

    Energy Technology Data Exchange (ETDEWEB)

    Hensley, D.

    1997-02-01

    In order for a source of fissile material to be useful as a calibration instrument, it is necessary to know not only how much fissile material is in the source but also what the effective fissile content is. Because uranium and plutonium absorb thermal neutrons so Efficiently, material in the center of a sample is shielded from the external thermal flux by the surface layers of the material. Differential dieaway measurements in the APNea System of five different sets of cylindrical fissile sources show the various self shielding effects that are routinely encountered. A method for calculating the self shielding effect is presented and its predictions are compared with the experimental results.

  14. Heart rate recovery in patients with obstructive sleep apnea syndrome

    OpenAIRE

    Karaşen, Rıza Murat; ÇİFTÇİ, Bülent; Acar, Baran; YALÇIN, Ahmet Arif; GÜVEN, Selma FIRAT

    2012-01-01

    To demonstrate the effects of obstructive sleep apnea syndrome (OSAS) on baroregulatory function by using heart rate recovery (HRR) parameters. Materials and methods: Fifty-four moderate and severe OSAS patients were included in the study. HRR was defined as the difference in heart rate between peak exercise and 1 min later; a value of 18 beats/min was considered abnormal. OSAS patients were enrolled in the study as group 1 (normal HRR; n = 12) and group 2 (abnormal HRR, n = 42). Left ventr...

  15. Sleep Endoscopy in the Evaluation of Pediatric Obstructive Sleep Apnea

    Directory of Open Access Journals (Sweden)

    Aaron C. Lin

    2012-01-01

    Full Text Available Pediatric obstructive sleep apnea (OSA is not always resolved or improved with adenotonsillectomy. Persistent or complex cases of pediatric OSA may be due to sites of obstruction in the airway other than the tonsils and adenoids. Identifying these areas in the past has been problematic, and therefore, therapy for OSA in children who have failed adenotonsillectomy has often been unsatisfactory. Sleep endoscopy is a technique that can enable the surgeon to determine the level of obstruction in a sleeping child with OSA. With this knowledge, site-specific surgical therapy for persistent and complex pediatric OSA may be possible.

  16. Detection of apnea using a short-window FFT technique and an artificial neural network

    Science.gov (United States)

    Waldemark, Karina E.; Agehed, Kenneth I.; Lindblad, Thomas; Waldemark, Joakim T. A.

    1998-03-01

    Sleep apnea is characterized by frequent prolonged interruptions of breathing during sleep. This syndrome causes severe sleep disorders and is often responsible for development of other diseases such as heart problems, high blood pressure and daytime fatigue, etc. After diagnosis, sleep apnea is often successfully treated by applying positive air pressure (CPAP) to the mouth and nose. Although effective, the (CPAP) equipment takes up a lot of space and the connected mask causes a lot of inconvenience for the patients. This raised interest in developing new techniques for treatment of sleep apnea syndrome. Several studies have indicated that electrical stimulation of the hypoglossal nerve and muscle in the tongue may be a useful method for treating patients with severe sleep apnea. In order to be able to successfully prevent the occurrence of apnea it is necessary to have some technique for early and fast on-line detection or prediction of the apnea events. This paper suggests using measurements of respiratory airflow (mouth temperature). The signal processing for this task includes the use of a short window FFT technique and uses an artificial back propagation neural net to model or predict the occurrence of apneas. The results show that early detection of respiratory interruption is possible and that the delay time for this is small.

  17. Cephalometric and anthropometric data of obstructive apnea in different age groups

    Directory of Open Access Journals (Sweden)

    Paulo de Tarso Moura Borges

    2015-02-01

    Full Text Available Introduction: Patients with obstructive sleep apnea syndrome usually present with changes in upper airway morphology and/or body fat distribution, which may occur throughout life and increase the severity of obstructive sleep apnea syndrome with age. Objective: To correlate cephalometric and anthropometric measures with obstructive sleep apnea syndrome severity in different age groups. Methods: A retrospective study of cephalometric and anthropometric measures of 102 patients with obstructive sleep apnea syndrome was analyzed. Patients were divided into three age groups (≥20 and <40 years, ≥40 and <60 years, and ≥60 years. Pearson's correlation was performed for these measures with the apnea-hypopnea index in the full sample, and subsequently by age group. Results: The cephalometric measures MP-H (distance between the mandibular plane and the hyoid bone and PNS-P (distance between the posterior nasal spine and the tip of the soft palate and the neck and waist circumferences showed a statistically significant correlation with apnea-hypopnea index in both the full sample and in the ≥40 and <60 years age group. These variables did not show any significant correlation with the other two age groups (<40 and ≥60 years. Conclusion: Cephalometric measurements MP-H and PNS-P and cervical and waist circumfer- ences correlated with obstructive sleep apnea syndrome severity in patients in the ≥40 and <60 age group.

  18. Sleep apnea syndrome. Examination of pharyngeal obstruction with high-speed MR and polysomnography

    International Nuclear Information System (INIS)

    We attempted to determine the usefulness of high-speed MR imaging for evaluating the severity of sleep apnea syndrome (SAS) by comparing findings of pharyngeal obstruction obtained with high-speed MR with those of all-night polysomnography (PSG). A total of 33 patients with SAS underwent turbo-FLASH MR examination, while awake and after i.v. injection of hydroxyzine hydrochloride. Serial images were examined by cinemode. Pharyngeal findings on MR were divided into single-site obstruction (SO) at the velopharynx, multiple-site obstruction (MO), and no obstruction (NO). PSG findings were analyzed to determine the predominant type of apnea, severity as evaluated by an apnea index (AI), and the lowest SaO2 value during sleep. Seventy-five percent of the central apnea group had SO, and 70% of the mixed apneas had MO, while only 15% of the obstructed apneas had MO. The percentage of patients with severe SAS (AI of 20% or higher) was 48% for the SO, and 70% for the MO. The lowest SaO2 value tended to be low in the mixed apnea in the case of PSG, and tended to be low in the MO at MR examination. Analysis of pharyngeal dynamics using high-speed MR may provide some useful information for evaluating the severity of SAS. (orig.)

  19. Sleep apnea syndrome. Examination of pharyngeal obstruction with high-speed MR and polysomnography

    Energy Technology Data Exchange (ETDEWEB)

    Suto, Y. [Dept. of Radiology, Tottori Univ. School of Medicine, Yonago (Japan); Inoue, Y. [Dept. of Neuropsychiatry, Tottori Univ. School of Medicine, Yonago (Japan)

    1995-05-01

    We attempted to determine the usefulness of high-speed MR imaging for evaluating the severity of sleep apnea syndrome (SAS) by comparing findings of pharyngeal obstruction obtained with high-speed MR with those of all-night polysomnography (PSG). A total of 33 patients with SAS underwent turbo-FLASH MR examination, while awake and after i.v. injection of hydroxyzine hydrochloride. Serial images were examined by cinemode. Pharyngeal findings on MR were divided into single-site obstruction (SO) at the velopharynx, multiple-site obstruction (MO), and no obstruction (NO). PSG findings were analyzed to determine the predominant type of apnea, severity as evaluated by an apnea index (AI), and the lowest SaO{sub 2} value during sleep. Seventy-five percent of the central apnea group had SO, and 70% of the mixed apneas had MO, while only 15% of the obstructed apneas had MO. The percentage of patients with severe SAS (AI of 20% or higher) was 48% for the SO, and 70% for the MO. The lowest SaO{sub 2} value tended to be low in the mixed apnea in the case of PSG, and tended to be low in the MO at MR examination. Analysis of pharyngeal dynamics using high-speed MR may provide some useful information for evaluating the severity of SAS. (orig.).

  20. Complications associated with the apnea test in the determination of the brain death

    Institute of Scientific and Technical Information of China (English)

    WU Xiao-liang; FANG Qiang; LI Li; QIU Yun-qing; LUO Ben-yan

    2008-01-01

    Background An apnea test is essentialin the clinical determination of brain death.This study was conducted to analyse complications associated with the apnea test in the determination of the brain death.Methods On 93 adult patients In coma in Zhejiang Province of China from January 2003 to December 2006,179 apnea tests were performed as a part of the determination of brain death.Potential risk conditions and complications were analysed during apnea tests.Results During apnea,sedous cardiac arrhythmia did not occur in all patients.Complications occurred in 37 of 179 (21%)apnea tests.Hypotension occurred in 30 patients(17%)and it was obsewed in 8/94(9%)tests with baseline value of systolic arterial blood pressure not less than 120 mmHg,and 22/85(26%)lass than 120 mmHg(P<0.05).Severe hypoxaemia occurred in 10 patients(6%)of which 3/138(2%)tests with baseline value of arterial oxygen pressure not less than 200 mmHg,and 7/41(17%)less than 200 mmHg(P<0.05).Conclusions This study demonstrated that complications occurred mostly in patients with inadequate baseline systolic arterial blood pressure and preoxygenation.Adequate precautions during the apnea tests may reduce the risk of cardiovascular and oxygenation complication.

  1. Tonsil volume, tonsil grade and obstructive sleep apnea: is there any meaningful correlation?

    Directory of Open Access Journals (Sweden)

    Michel Burihan Cahali

    2011-01-01

    Full Text Available OBJECTIVES: The aims of this study were to evaluate the correlation between oropharyngeal examination and objective palatine tonsil volume in snoring adults and verify the influence of the oropharyngeal anatomy, body mass index, age, and severity of obstructive sleep apnea on actual tonsil volume. In addition, we aimed to assess the influence of tonsil size on obstructive sleep apnea in adults. INTRODUCTION: Pharyngeal wall geometry is often altered in adults who have obstructive sleep apnea, and this might influence the findings of the oropharyngeal examination that, in turn, are the key factors when considering surgical management for this condition. Furthermore, the correlation between the actual tonsil volume and the severity of obstructive sleep apnea in adults is currently unknown. METHODS: We prospectively studied 130 patients with obstructive sleep apnea or primary snoring who underwent pharyngeal surgery with intraoperative measurement of tonsil volume. We compared tonsil volume with preoperative polysomnography, oropharyngeal examination, and anthropometric data. RESULTS: We found a significant correlation between actual tonsil volume and subjective tonsil grade. We also found a significant correlation between tonsil volume and the apnea-hypopnea index. Using a multivariate linear regression model, tonsil volume was found to be significantly correlated with age, body mass index, and oropharyngeal examination, but not with polysomnography. Clinically, only the rare tonsil grade IV was indicative of more severe obstructive sleep apnea. CONCLUSIONS: There is a strong correlation between clinical tonsil grade and objective tonsil volume in snoring adults, and this correlation exists regardless of the presence or severity of obstructive sleep apnea. Pharyngeal tissue volume likely reflects the body mass index rather than obstructive sleep apnea severity.

  2. Sleep Apnea and Fatty Liver Are Coupled Via Energy Metabolism.

    Science.gov (United States)

    Arısoy, Ahmet; Sertoğullarından, Bunyamin; Ekin, Selami; Özgökçe, Mesut; Bulut, Mehmet Deniz; Huyut, Mehmet Tahir; Ölmez, Şehmus; Turan, Mahfuz

    2016-01-01

    BACKGROUND Obstructive sleep apnea (OSA) is a common sleep-related breathing disorder characterized by intermittent hypoxia. Non-alcoholic fatty liver disease is the most common cause of chronic liver disease worldwide. We aimed to evaluate the relationship between OSA and fatty liver. MATERIAL AND METHODS We enrolled 176 subjects to this study who underwent polysomnography (PSG) for suspected OSA. The control group included 42 simple snoring subjects. PSG, biochemical tests, and ultrasonographic examination were performed all subjects. RESULTS The simple snoring and mild, moderate, and severe OSA groups included 18/42 (42.86%), 33/52 (63.5%), 27/34 (79.4%), and 28/48 (79.2%) subjects with hepatosteatosis, respectively. There were significant differences in hepatosteatosis and hepatosteatosis grade between the simple snoring and the moderate and severe OSA groups. Logistic regression analysis showed that BMI and average desaturation were independently and significantly related to hepatic steatosis. CONCLUSIONS Our study shows that BMI and the average desaturation contribute to non-alcoholic fatty liver in subjects with OSA. In this regard, sleep apnea may trigger metabolic mitochondrial energy associated processes thereby altering lipid metabolism and obesity as well. PMID:26993969

  3. Determinants of CPAP Adherence in Hispanics with Obstructive Sleep Apnea

    Directory of Open Access Journals (Sweden)

    Montserrat Diaz-Abad

    2014-01-01

    Full Text Available Purpose. We hypothesized that socioeconomic factors and a language barrier would impact adherence with continuous positive airway pressure (CPAP among Hispanics with obstructive sleep apnea (OSA. Methods. Patients with OSA who were prescribed CPAP for at least 1 year and completed a questionnaire evaluating demographic data, socioeconomic status, and CPAP knowledge and adherence participated in the study. Results. Seventy-nine patients (26 males; 53±11 yrs; body mass index (BMI=45±9 kg/m2 with apnea-hypopnea index (AHI 33±30 events/hr completed the study. Included were 25 Hispanics, 39 African Americans, and 15 Caucasians, with no difference in age, AHI, CPAP use, or BMI between the groups. While there was a difference in educational level (P=0.006, income level (P<0.001, and employment status (P=0.03 between the groups, these did not influence CPAP adherence. Instead, overall improvement in quality of life and health status and perceived benefit from CPAP influenced adherence, both for the group as a whole (P=0.03, P=0.004, and P=0.001, resp., as well as in Hispanics (P=0.02, P=0.02, P=0.03, resp.. Conclusion. In Hispanic patients with OSA, perceived benefit with therapy, rather than socioeconomic status or a language barrier, appears to be the most important factor in determining CPAP adherence.

  4. Determinants of CPAP Adherence in Hispanics with Obstructive Sleep Apnea.

    Science.gov (United States)

    Diaz-Abad, Montserrat; Chatila, Wissam; Lammi, Matthew R; Swift, Irene; D'Alonzo, Gilbert E; Krachman, Samuel L

    2014-01-01

    Purpose. We hypothesized that socioeconomic factors and a language barrier would impact adherence with continuous positive airway pressure (CPAP) among Hispanics with obstructive sleep apnea (OSA). Methods. Patients with OSA who were prescribed CPAP for at least 1 year and completed a questionnaire evaluating demographic data, socioeconomic status, and CPAP knowledge and adherence participated in the study. Results. Seventy-nine patients (26 males; 53 ± 11 yrs; body mass index (BMI) = 45 ± 9 kg/m(2)) with apnea-hypopnea index (AHI) 33 ± 30 events/hr completed the study. Included were 25 Hispanics, 39 African Americans, and 15 Caucasians, with no difference in age, AHI, CPAP use, or BMI between the groups. While there was a difference in educational level (P = 0.006), income level (P improvement in quality of life and health status and perceived benefit from CPAP influenced adherence, both for the group as a whole (P = 0.03, P = 0.004, and P = 0.001, resp.), as well as in Hispanics (P = 0.02, P = 0.02, P = 0.03, resp.). Conclusion. In Hispanic patients with OSA, perceived benefit with therapy, rather than socioeconomic status or a language barrier, appears to be the most important factor in determining CPAP adherence. PMID:24649371

  5. [Epworth drowsiness scale value in obstructive sleep apnea syndrome].

    Science.gov (United States)

    Uribe Echevarría, E M; Alvarez, D; Giobellina, R; Uribe Echevarría, A M

    2000-01-01

    Hypersomnia is one of the most consulted symptoms among patients evaluated at sleep disorder centers and it is frequently related to obstructive sleep apnea syndrome (OSAS). Our hypothesis is that Epworth sleepiness scale (ESS) is the parameter with the greatest predictive value in the OSAS diagnosis. We compared patients with OSAS diagnosis to a control group. In both groups we compared ESS with body mass index (BMI), neck circumference (NC), waist perimeter (WP). Anthropometric index (BMI, NC and WC), were similar in both groups (p < 0.10). When we analyzed ESS, a score greater than 10 was observed in the OSAS group, with a significant difference between groups (p < 0.001). Epworth sleepiness scale yielded 60% of sensibility, 82% of specificity and a positive predictive value of 85%. The negative predictive value was 52%. Confidence index was 70%. The relationship between OSAS and ESS scale was significant (Pearson Chi-Square value 7.5). Odds Ratio for apneas was 15 and its confidence interval was lower than 1.5 and upper than 141. We conclude that with ESS score exceeding 10 points OSAS should be suspected. PMID:11436699

  6. Obstructive sleep apnea: management considerations in psychiatric patients

    Directory of Open Access Journals (Sweden)

    Heck T

    2015-10-01

    Full Text Available Taryn Heck,1 Monica Zolezzi21Pharmacy Department, University of Alberta Hospital, Alberta Health Services, Edmonton, AB, Canada; 2Clinical Pharmacy and Practice, College of Pharmacy, Qatar University, Doha, QatarAbstract: Psychiatric disorders and obstructive sleep apnea (OSA are often comorbid. However, there is limited information on the impact of psychotropic medications on OSA symptoms, on how to manage psychiatric pharmacotherapy in patients presenting with OSA, or on the effectiveness and challenges of OSA treatments in patients with comorbid mental illness. As such, the objective of this article is to provide an overview of some epidemiological aspects of OSA and treatment considerations in the management of OSA in individuals with comorbid psychiatric disorders. Predefined keywords were used to search for relevant literature in electronic databases. Data show that OSA is particularly prevalent in patients with psychiatric disorders. The medical care that patients with these comorbidities require can be challenging, as some of the psychiatric medications used by these patients may exacerbate OSA symptoms. As such, continuous positive airway pressure continues to be the first-line treatment, even in patients with psychiatric comorbidity. However, more controlled studies are required, particularly to determine continuous positive airway pressure compliance in patients with mental illness, the impact of treating OSA on psychiatric symptoms, and the impact of the use of psychotropic medications on OSA symptoms.Keywords: obstructive sleep apnea, psychiatric disorders, comorbidity, psychotropic medications

  7. Ventricular dysfunction in children with obstructive sleep apnea: radionuclide assessment

    International Nuclear Information System (INIS)

    Ventricular function was evaluated using radionuclide ventriculography in 27 children with oropharyngeal obstruction and clinical features of obstructive sleep apnea. Their mean age was 3.5 years (9 months to 7.5 years). Conventional clinical assessment did not detect cardiac involvement in 25 of 27 children; however, reduced right ventricular ejection fraction (less than 35%) was found in 10 (37%) patients (mean: 19.5 +/- 2.3% SE, range: 8-28%). In 18 patients wall motion abnormality was detected. In 11 children in whom radionuclide ventriculography was performed before and after adenotonsillectomy, right ventricular ejection fraction rose from 24.4 +/- 3.6% to 46.7 +/- 3.4% (P less than 0.005), and in all cases wall motion showed a definite improvement. In five children, left ventricular ejection fraction rose greater than 10% after removal of oropharyngeal obstruction. It is concluded that right ventricular function may be compromised in children with obstructive sleep apnea secondary to adenotonsillar hypertrophy, even before clinical signs of cardiac involvement are present

  8. Ventricular dysfunction in children with obstructive sleep apnea: radionuclide assessment

    Energy Technology Data Exchange (ETDEWEB)

    Tal, A.; Leiberman, A.; Margulis, G.; Sofer, S.

    1988-01-01

    Ventricular function was evaluated using radionuclide ventriculography in 27 children with oropharyngeal obstruction and clinical features of obstructive sleep apnea. Their mean age was 3.5 years (9 months to 7.5 years). Conventional clinical assessment did not detect cardiac involvement in 25 of 27 children; however, reduced right ventricular ejection fraction (less than 35%) was found in 10 (37%) patients (mean: 19.5 +/- 2.3% SE, range: 8-28%). In 18 patients wall motion abnormality was detected. In 11 children in whom radionuclide ventriculography was performed before and after adenotonsillectomy, right ventricular ejection fraction rose from 24.4 +/- 3.6% to 46.7 +/- 3.4% (P less than 0.005), and in all cases wall motion showed a definite improvement. In five children, left ventricular ejection fraction rose greater than 10% after removal of oropharyngeal obstruction. It is concluded that right ventricular function may be compromised in children with obstructive sleep apnea secondary to adenotonsillar hypertrophy, even before clinical signs of cardiac involvement are present.

  9. Obstructive Sleep Apnea: Preoperative Screening and Postoperative Care.

    Science.gov (United States)

    Wolfe, Robert M; Pomerantz, Jonathan; Miller, Deborah E; Weiss-Coleman, Rebecca; Solomonides, Tony

    2016-01-01

    The incidence of obstructive sleep apnea (OSA) has reached epidemic proportions, and it is an often unrecognized cause of perioperative morbidity and mortality. Profound hypoxic injury from apnea during the postoperative period is often misdiagnosed as cardiac arrest due to other causes. Almost a quarter of patients entering a hospital for elective surgery have OSA, and >80% of these cases are undiagnosed at the time of surgery. The perioperative period puts patients at high risk of apneic episodes because of drug effects from sedatives, narcotics, and general anesthesia, as well as from the effects of postoperative rapid eye movement sleep changes and postoperative positioning in the hospital bed. For adults, preoperative screening using the STOP or STOP-Bang questionnaires can help to identify adult patients at increased risk of OSA. In the pediatric setting, a question about snoring should be part of every preoperative examination. For patients with known OSA, continuous positive airway pressure should be continued postoperatively. Continuous pulse oximetry monitoring with an alarm system can help to prevent apneic catastrophes caused by OSA in the postoperative period. PMID:26957384

  10. Development of an apnea detection algorithm based on temporal analysis of thoracic respiratory effort signal

    Science.gov (United States)

    Dell’Aquila, C. R.; Cañadas, G. E.; Correa, L. S.; Laciar, E.

    2016-04-01

    This work describes the design of an algorithm for detecting apnea episodes, based on analysis of thorax respiratory effort signal. Inspiration and expiration time, and range amplitude of respiratory cycle were evaluated. For range analysis the standard deviation statistical tool was used over respiratory signal temporal windows. The validity of its performance was carried out in 8 records of Apnea-ECG database that has annotations of apnea episodes. The results are: sensitivity (Se) 73%, specificity (Sp) 83%. These values can be improving eliminating artifact of signal records.

  11. The effectiveness of nasal surgery on psychological symptoms in patients with obstructive sleep apnea and nasal obstruction.

    Science.gov (United States)

    Xiao, Yang; Han, Demin; Zang, Hongrui; Wang, Danni

    2016-06-01

    Conclusion Nasal obstruction can aggravate the psychological status of OSA patients, and nasal surgery should reduce this aggravation. Nasal surgery significantly improved sleep latency and ameliorated several polysomnographic characteristics. Background The aim of this study was to investigate the psychological status of patients with obstructive sleep apnea (OSA) and nasal obstruction and to evaluate the effects of nasal surgery on the psychological symptoms and polysomnographic (PSG) parameters of these patients. Methods The study was designed as a prospective comparative study. This study compared 30 patients (all male) with nasal obstruction and 30 matched patients without nasal obstruction using the Pittsburgh Sleep Quality Index (PSQI) and the Symptom Check List 90 (SCL-90). All of the patients had been previously diagnosed with OSA (apnea hypopnea index [AHI] ≥ 5 events/h) via a whole-night polysomnographic examination. Nasal obstruction was assessed using a visual analogue scale (VAS). The patients with nasal obstruction underwent nasal surgery, and their weight, VAS, nocturnal PSG characteristics, and psychological symptoms at baseline and 3 months after surgery were compared. Results The OSA patients with nasal obstruction suffered from significantly longer sleep latency on the PSQI and higher somatization and anxiety scores on the SCL-90 than the subjects without nasal obstruction (p symptoms significantly improved after surgery (VAS decreased from 6.18 ± 1.85 to 1.87 ± 1.76, p symptoms on the SCL-90 (p symptoms on the SCL-90, including inter-personal sensitivity, depression, hostility, paranoid ideation, psychoticism, global symptom index, and the number of positive symptoms (r > 0.3, p < 0.05). PMID:26903174

  12. Pneumothorax and pneumoperitoneum during the apnea test: how safe is this procedure? Pneumotorax y pneumoperitoneo durante el test de apnea: cuán seguro es este procedimiento?

    Directory of Open Access Journals (Sweden)

    GUSTAVO SAPOSNIK

    2000-09-01

    Full Text Available Apnea test is a crucial requirement for determining the diagnosis of brain death (BD. There are few reports considering clinical complications during this procedure. We describe a major complication during performing the apnea test. We also analyse their practical and legal implications, and review the complications of this procedure in the literature. A 54 year-old man was admitted for impaired consciousness due to a massive intracerebral hemorrhage. Six hours later, he had no motor response, and all brainstem reflexes were negative. The patient fulfilled American Academy of Neurology (AAN criteria for determining BD. During the apnea test, the patient developed pneumothorax, pneumoperitoneum, and finally cardiac arrest. Apnea test is a necessary requirement for the diagnosis of brain death. However, it is not innocuous and caution must be take in particular clinical situations. Complications during the apnea test could be more frequent than reported and may have practical and legal implications. Further prospective studies are necessary to evaluate the frequency and nature of complications during this practice.El test de apnea (AT es un requerimiento esencial para el diagnóstico de muerte encefálica. Hay pocos estudios que consideren complicaciones clínicas relacionadas con este procedimiento. Describimos un paciente que desarrolló una complicación mayor mientras se efectuaba el test de apnea. Realizamos una revisión de las complicaciones relacionadas con este procedimiento en la literatura. CASO CLÍNICO: Un hombre de 54 años fue admitido por deterioro del sensorio debido a una hemorragia intracerebral. Seis horas posteriores, el paciente no tenía respuesta motora, y todos los reflejos del tronco cerebral estaban abolidos. El paciente cumplía con los criterios diagnósticos de Muerte Encefálica de acuerdo a lo establecido por la Academia Americana de Neurología. Durante el test de apnea, el paciente desarrolla s

  13. Analysis of Sleep Parameters in Patients with Obstructive Sleep Apnea Studied in a Hospital vs. a Hotel-Based Sleep Center

    Science.gov (United States)

    Hutchison, Kimberly N.; Song, Yanna; Wang, Lily; Malow, Beth A.

    2008-01-01

    Background: Polysomnography is associated with changes in sleep architecture called the first-night effect. This effect is believed to result from sleeping in an unusual environment and the technical equipment used to study sleep. Sleep experts hope to decrease this variable by providing a more familiar, comfortable atmosphere for sleep testing through hotel-based sleep centers. In this study, we compared the sleep parameters of patients studied in our hotel-based and hospital-based sleep laboratories. Methods: We retrospectively reviewed polysomnograms completed in our hotel-based and hospital-based sleep laboratories from August 2003 to July 2005. All patients were undergoing evaluation for obstructive sleep apnea. Hospital-based patients were matched for age and apnea-hypopnea index with hotel-based patients. We compared the sleep architecture changes associated with the first-night effect in the two groups. The associated conditions and symptoms listed on the polysomnography referral forms are also compared. Results: No significant differences were detected between the two groups in sleep onset latency, sleep efficiency, REM sleep latency, total amount of slow wave sleep (NREM stages 3 and 4), arousal index, and total stage 1 sleep. Conclusions: This pilot study failed to show a difference in sleep parameters associated with the first-night effect in patients undergoing sleep studies in our hotel and hospital-based sleep laboratories. Future studies need to compare the first-night effect in different sleep disorders, preferably in multi-night recordings. Citation: Hutchison KN; Song Y; Wang L; Malow BA. Analysis of sleep parameters in patients with obstructive sleep apnea studied in a hospital vs. A hotel-based sleep center. J Clin Sleep Med 2008;4(2):119–122. PMID:18468309

  14. Clinical observation of glucose metabolism disorders in elderly patients with obstructive sleep apnea disorder

    Institute of Scientific and Technical Information of China (English)

    张蔷

    2013-01-01

    Objective To explore the correlation between obstructive sleep apnea hypoventilation syndrome (OSAHS) and glucose metabolism disorders in patients without diabetes mellitus.Methods A total of 88 patients with OSAHS but without diabetes mellitus from 2009 to 2011 in

  15. Snoring and risk for obstructive sleep apnea among nigerians with heart failure: Prevalence and clinical correlates

    Directory of Open Access Journals (Sweden)

    Adeseye A Akintunde

    2013-01-01

    Conclusion: Heart failure seems to be associated with snoring and a high risk for obstructive sleep apnea among Africans with heart failure. Assessment for sleep disordered breathing should be incorporated into their routine clinical workup.

  16. Development of an apnea detector for neonates using diaphragmatic surface electromyography.

    Science.gov (United States)

    Ochoa, J Mauricio; Osorio, Juan S; Torres, Robinson; McLeod, Chris N

    2009-01-01

    Respiratory diseases are among the most important and serious conditions that can affect the newborn baby. A cessation of breathing, longer than 15 seconds, or accompanied by hypoxia or bradycardia, is called apnea of prematurity (AOP) and has been found in more than 50% of premature infants. An apnea detector used in infant monitoring has been designed and constructed and is intended to be applied in a clinical environment. Diaphragmatic surface EMG has been used as the technique for detecting apnea episodes due to a direct relation with the respiratory drive. Both obstructive and central apnea can be determined as well as heart rate. Good performance and feasibility have been shown by the prototype. PMID:19963943

  17. Effect of obstructive sleep apnea on mitral valve tenting.

    Science.gov (United States)

    Pressman, Gregg S; Figueredo, Vincent M; Romero-Corral, Abel; Murali, Ganesan; Kotler, Morris N

    2012-04-01

    Obstructive apneas produce high negative intrathoracic pressure that imposes an afterload burden on the left ventricle. Such episodes might produce structural changes in the left ventricle over time. Doppler echocardiograms were obtained within 2 months of attended polysomnography. Patients were grouped according to apnea-hypopnea index (AHI): mild/no obstructive sleep apnea (OSA; AHI <15) and moderate/severe OSA (AHI ≥15). Mitral valve tenting height and area, left ventricular (LV) long and short axes, and LV end-diastolic volume were measured in addition to tissue Doppler parameters. Comparisons of measurements at baseline and follow-up between and within groups were obtained; correlations between absolute changes (Δ) in echocardiographic parameters were also performed. After a mean follow-up of 240 days mitral valve tenting height increased significantly (1.17 ± 0.12 to 1.28 ± 0.17 cm, p = 0.001) in moderate/severe OSA as did tenting area (2.30 ± 0.41 to 2.66 ± 0.60 cm(2), p = 0.0002); Δtenting height correlated with ΔLV end-diastolic volume (rho 0.43, p = 0.01) and Δtenting area (rho 0.35, p = 0.04). In patients with mild/no OSA there was no significant change in tenting height; there was a borderline significant increase in tenting area (2.20 ± 0.44 to 2.31 ± 0.43 cm(2), p = 0.05). Septal tissue Doppler early diastolic wave decreased (8.04 ± 2.49 to 7.10 ± 1.83 cm/s, p = 0.005) in subjects with moderate/severe OSA but not in in those with mild/no OSA. In conclusion, in patients with moderate/severe OSA, mitral valve tenting height and tenting area increase significantly over time. This appears to be related, at least in part, to changes in LV geometry. PMID:22264596

  18. Impaired Performance in Commercial Drivers: Role of Sleep Apnea and Short Sleep Duration

    OpenAIRE

    Pack, Allan I.; Maislin, Greg; Staley, Bethany; Pack, Frances M.; Rogers, William C.; George, Charles F. P.; Dinges, David F.

    2006-01-01

    Sleepiness plays an important role in major crashes of commercial vehicles. Because determinants are likely to include inadequate sleep and sleep apnea, we evaluated the role of short sleep durations over 1 wk at home and sleep apnea in subjective sleepiness (Epworth Sleepiness Scale), objective sleepiness (reduced sleep latency as determined by the Multiple Sleep Latency Test), and neurobehavioral functioning (lapses in performance, tracking error in Divided Attention Driving Task) in commer...

  19. Application of Dual Mask for Postoperative Respiratory Support in Obstructive Sleep Apnea Patient

    OpenAIRE

    Jahan Porhomayon; Gino Zadeii; Nader, Nader D; Bancroft, George R.; Alireza Yarahamadi

    2013-01-01

    In some conditions continuous positive airway pressure (CPAP) or bilevel positive airway pressure (BIPAP) therapy alone fails to provide satisfactory oxygenation. In these situations oxygen (O2) is often being added to CPAP/BIPAP mask or hose. Central sleep apnea and obstructive sleep apnea (OSA) are often present along with other chronic conditions, such as chronic obstructive pulmonary disease (COPD), congestive heart failure, pulmonary fibrosis, neuromuscular disorders, chronic narcotic us...

  20. Chronic obstructive pulmonary disease and obstructive sleep apnea: overlaps in pathophysiology, systemic inflammation, and cardiovascular disease.

    LENUS (Irish Health Repository)

    McNicholas, Walter T

    2012-02-01

    Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea syndrome represent two of the most prevalent chronic respiratory disorders in clinical practice, and cardiovascular diseases represent a major comorbidity in each disorder. The two disorders coexist (overlap syndrome) in approximately 1% of adults but asymptomatic lower airway obstruction together with sleep-disordered breathing is more prevalent. Although obstructive sleep apnea syndrome has similar prevalence in COPD as the general population, and vice versa, factors such as body mass index and smoking influence relationships. Nocturnal oxygen desaturation develops in COPD, independent of apnea\\/hypopnea, and is more severe in the overlap syndrome, thus predisposing to pulmonary hypertension. Furthermore, upper airway flow limitation contributes to nocturnal desaturation in COPD without apnea\\/hypopnea. Evidence of systemic inflammation in COPD and sleep apnea, involving C-reactive protein and IL-6, in addition to nuclear factor-kappaB-dependent pathways involving tumor necrosis factor-alpha and IL-8, provides insight into potential basic interactions between both disorders. Furthermore, oxidative stress develops in each disorder, in addition to activation and\\/or dysfunction of circulating leukocytes. These findings are clinically relevant because systemic inflammation may contribute to the pathogenesis of cardiovascular diseases and the cell\\/molecular pathways involved are similar to those identified in COPD and sleep apnea. However, the pathophysiological and clinical significance of systemic inflammation in COPD and sleep apnea is not proven, and thus, studies of patients with the overlap syndrome should provide insight into the mechanisms of systemic inflammation in COPD and sleep apnea, in addition to potential relationships with cardiovascular disease.

  1. Management of Obstructive Sleep Apnea in an Edentulous Lower Jaw Patient with a Mandibular Advancement Device

    OpenAIRE

    Filiz Keyf; Bülent Çiftci; Selma Fırat Güven

    2014-01-01

    Obstructive sleep apnea (OSA) is the most common sleep-related breathing disorder with periodic reduction or cessation of airflow during sleep. It is associated with loud snoring, disrupted sleep, and witnessed apneas. Treatment of OSA varies from simple measures such as oral appliances and nasal continuous positive airway pressure (CPAP) to surgical procedures like uvulopalatopharyngoplasty and tracheostomy. Oral appliances are a viable nonsurgical treatment alternative in patients with OSA,...

  2. Making Sense of Oxidative Stress in Obstructive Sleep Apnea: Mediator or Distracter?

    OpenAIRE

    SigridVeasey; JingZhang

    2012-01-01

    Obstructive sleep apnea is increasingly recognized as an important contributor to cognitive impairment, metabolic derangements and cardiovascular disease and mortality. Identifying the mechanisms by which this prevalent disorder influences health outcomes is now of utmost importance. As the prevalence of this disorder steadily increases, therapies are needed to prevent or reverse sleep apnea morbidities now more than ever before. Oxidative stress is implicated in cardiovascular morbidities o...

  3. Hindi translation of Berlin questionnaire and its validation as a screening instrument for obstructive sleep apnea

    OpenAIRE

    Ravi Gupta; Ramjan Ali; Mohan Dhyani; Sourav Das; Ashwini Pundir

    2016-01-01

    Background: Obstructive sleep apnea (OSA) is a fairly common problem with adverse health consequences. However, any screening questionnaire is not available in Hindi to screen sleep apnea. Materials and Methods: Subjects undergoing video-synchronized in laboratory attended polysomnography were requested to participate in this study. They were screened with the help of Hindi version of Berlin questionnaire (BQ). Outcome of the BQ was tested against the gold standard polysomnography. Descriptiv...

  4. Prevalence of Obstructive Sleep Apnea Syndrome and CPAP Adherence in the Elderly Chinese Population

    OpenAIRE

    Ng, Susanna S. S.; Chan, Tat-On; To, Kin-Wang; Chan, Ken K. P.; Ngai, Jenny; Tung, Alvin; Ko, Fanny W S; Hui, David S. C.

    2015-01-01

    Background This study assessed the prevalence of obstructive sleep apnea syndrome (OSAS) and CPAP adherence in the elderly Chinese in Hong Kong. Methods We conducted a sleep questionnaire survey among the elders aged ≥60 years in the community centres followed by level 3 home sleep study (Embletta). Subjects with an apnea hypopnea index (AHI) ≥ 15/hr alone and those with AHI ≥ 5/hr plus either cardiovascular risk factors or Epworth Sleepiness Score (ESS) ≥ 10 were offered CPAP treatment. Resu...

  5. Sleep apnea in rheumatoid arthritis patients with occipitocervical lesions: the prevalence and associated radiographic features

    OpenAIRE

    Shoda, Naoki; Seichi, Atsushi; Takeshita, Katsushi; Chikuda, Hirotaka; Ono, Takashi; Oka, Hiroyuki; Kawaguchi, Hiroshi; Nakamura, Kozo

    2009-01-01

    Since sleep apnea is a risk factor for high mortality of rheumatoid arthritis (RA) patients, this study examined the prevalence in RA patients with occipitocervical lesions, and the associated radiographic features. Twenty-nine RA patients requiring surgery for progressive myelopathy due to occipitocervical lesions (3 males, 26 females, average age 65 years) were preoperatively evaluated. Twenty-three (79%) had sleep apnea defined as apnea–hypopnea index >5 events per hour measured by a porta...

  6. High Mallampati score, obesity and obstructive sleep apnea: triple insult to lung function?

    Directory of Open Access Journals (Sweden)

    Nazia Uzma

    2014-07-01

    Full Text Available The paper assesses the combined effect of high Mallampati score, obesity and obstructive sleep apnea (OSA on lung function as measured by spirometry. Our results showed that the combination of sleep apnea, obesity and high Mallampati score resulted in a degree of restriction that was significantly greater than that produced by each factor alone. These observations underscore the importance of factoring in the Mallampati score in the assessment of respiratory disease.

  7. Data-Driven Phenotyping: Graphical models for model-based phenotyping of sleep apnea

    OpenAIRE

    Nemati, S; Orr, J.; Malhotra, A

    2014-01-01

    © 2010-2012 IEEE. Sleep apnea is a multifactorial disease with a complex underlying physiology, which includes the chemoreflex feedback loop controlling ventilation. The instability of this feedback loop is one of the key factors contributing to a number of sleep disorders, including Cheyne?Stokes respiration and obstructive sleep apnea (OSA). A major limitation of the conventional characterization of this feedback loop is the need for labor-intensive and technically challenging experiments. ...

  8. Prevalence and Correlates of Insomnia and Obstructive Sleep Apnea in Chronic Kidney Disease

    OpenAIRE

    Shahbaj Ahmad; Manan Gupta; Ravi Gupta; Mohan Dhyani

    2013-01-01

    Background: Poor sleep quality, insomnia, and restless legs syndrome (RLS) and sleep apnea are common in patients with chronic kidney disease (CKD). Clinical correlates of these problems are poorly understood. Aims: This study was to find out the prevalence and correlates of insomnia and subjects with ′high risk for obstructive sleep apnea (OSA)′ in adults with chronic kidney disease. Materials and Methods: One hundred and four adults with CKD were included. Their demographic data, details re...

  9. Obstructive sleep apnea in combat-related posttraumatic stress disorder: a controlled polysomnography study

    OpenAIRE

    van Liempt, Saskia; Westenberg, Herman G.M.; Arends, Johan; Vermetten, Eric

    2011-01-01

    Background: Obstructive sleep apnea (OSA) may be highly prevalent in posttraumatic stress disorder (PTSD) and may exacerbate PTSD complaints. Objective: Our objective was to determine whether the prevalence of OSA was high in a sample of Dutch veterans with PTSD as compared to age- and trauma-matched controls, and whether OSA was associated with more severe PTSD complaints. Methods: We determined the apnea hypopnea indices (AHI) with polysomnographic registrations in 20 veterans with PTSD, 24...

  10. Capnography improves detection of apnea during procedural sedation for percutaneous transhepatic cholangiodrainage

    OpenAIRE

    Schlag, Christoph; Wörner, Alexandra; Wagenpfeil, Stefan; Kochs, Eberhard F.; Schmid, Roland M; von Delius, Stefan

    2013-01-01

    BACKGROUND: Capnography provides noninvasive monitoring of ventilation and can enable early recognition of altered respiration patterns and apnea.OBJECTIVE: To compare the detection of apnea and the prediction of oxygen desaturation and hypoxemia using capnography versus clinical surveillance during procedural sedation for percutaneous transhepatic cholangiodrainage (PTCD).METHODS: Twenty consecutive patients scheduled for PTCD were included in the study. All patients were sedated during the ...

  11. Lack of Impact of Mild Obstructive Sleep Apnea on Sleepiness, Mood and Quality of Life

    OpenAIRE

    Quan SF; Budhiraja R; Batool-Anwar S; Gottlieb DJ; Eichling P; Patel S; Shen W; Walsh JK; Kushida CA

    2014-01-01

    Background and Objectives: Obstructive sleep apnea (OSA) is associated with sleepiness, depression and reduced quality of life. However, it is unclear whether mild OSA has these negative impacts. Using data from the Apnea Positive Pressure Long-term Efficacy Study (APPLES), this study determined whether participants with mild OSA had greater sleepiness, more depressive symptoms and poorer quality of life in comparison to those without OSA. Methods: 239 persons evaluated for participation ...

  12. The relationships of sleep apnea, hypertension, and resistant hypertension on chronic kidney disease

    Science.gov (United States)

    Chang, Chih-Ping; Li, Tsai-Chung; Hang, Liang-Wen; Liang, Shinn-Jye; Lin, Jen-Jyn; Chou, Che-Yi; Tsai, Jeffrey J.P.; Ko, Po-Yen; Chang, Chiz-Tzung

    2016-01-01

    Abstract Hypertension, blood pressure variation, and resistant hypertension have close relations to sleep apnea, which lead to target organ damage, including the kidney. The complex relationships between sleep apnea and blood pressure cause their interactions with chronic kidney disease ambiguous. The aim of the study was to elucidate the separate and joint effects of sleep apnea, hypertension, and resistant hypertension on chronic kidney disease. A cross-sectional study was done to see the associations of sleep apnea, hypertension, and resistant hypertension with chronic kidney disease in 998 subjects underwent overnight polysomnography without device-therapy or surgery for their sleep-disordered breathing. Multivariate logistic regression was used to analyze the severity of SA, hypertension stage, resistant hypertension, and their joint effects on CKD. The multivariable relative odds (95% CI) of chronic kidney disease for the aged (age ≥65 years), severe sleep apnea, stage III hypertension, and resistant hypertension were 3.96 (2.57–6.09) (P < 0.001), 2.28 (1.13–4.58) (P < 0.05), 3.55 (1.70–7.42) (P < 0.001), and 9.42 (4.22–21.02) (P < 0.001), respectively. In subgroups analysis, the multivariable relative odds ratio of chronic kidney disease was highest in patients with both resistant hypertension and severe sleep apnea [13.42 (4.74–38.03)] (P < 0.001). Severe sleep apnea, stage III hypertension, and resistant hypertension are independent risk factors for chronic kidney disease. Patients with both severe sleep apnea and resistant hypertension have the highest risks. PMID:27281098

  13. Asthma Control and Its Relationship with Obstructive Sleep Apnea (OSA) in Older Adults

    OpenAIRE

    Mihaela Teodorescu; Polomis, David A.; Gangnon, Ronald E.; Fedie, Jessica E.; Flavia B. Consens; Chervin, Ronald D.; Teodorescu, Mihai C.

    2013-01-01

    Background/Objectives. Asthma in older individuals is poorly understood. We aimed to characterize the older asthma phenotype and test its association with obstructive sleep apnea (OSA). Design. Cross-sectional. Setting. Pulmonary and Asthma/Allergy clinics. Participants. 659 asthma subjects aged 18–59 years (younger) and 154 aged 60–75 (older). Measurements. Sleep Apnea scale of Sleep Disorders Questionnaire (SA-SDQ), asthma severity step (1–4, severe if step 3 or 4), established OSA diagnosi...

  14. Problems associated with the apnea test in the diagnosis of brain death

    Directory of Open Access Journals (Sweden)

    Saposnik Gustavo

    2004-07-01

    Full Text Available Background: Brain death is the absence of all cortical functions, including the brainstem. The apnea test (AT is a necessary requisite to complete this diagnosis. Anecdotal reports describing hypotension and acidosis due to apnea test have been reported. However, there are few studies that evaluate complications or difficulties related to this procedure. Objective: To analyze medical problems associated with the apnea test. Methods and Patients: We analyzed clinical features, potential risk conditions, and problems in 129 brain dead patients during the apnea test. The diagnosis of brain death was made according to the American Academy of Neurology recommendations. Results: Clinical problems during the apnea test were detected in more than two thirds of patients, including: arterial hypotension (12%, acidosis (68%, and hypoxemia (23%. Four patients developed major complications, including: pneumothorax, cardiac arrest, bradycardia, atrial fibrillation and myocardial infarction. Conclusion: The apnea test is not an innocuous procedure. Complications during the AT are more common than reported and limit organ procurement for transplantation. Guidelines for performing the AT should be followed in order to avoid clinical complications.

  15. Autonomous identification of matrices in the APNea system

    International Nuclear Information System (INIS)

    The APNea System is a passive and active neutron assay device which features imaging to correct for nonuniform distributions of source material. Since the imaging procedure requires a detailed knowledge of both the detection efficiency and the thermal neutron flux for (sub)volumes of the drum of interest, it is necessary to identify which mocked-up matrix, to be used for detailed characterization studies, best matches the matrix of interest. A methodology referred to as the external matrix probe (EMP) has been established which links external measures of a drum matrix to those of mocked-up matrices. These measures by themselves are sufficient to identify the appropriate mock matrix, from which the necessary characterization data are obtained. This independent matrix identification leads to an autonomous determination of the required system response parameters for the assay analysis

  16. Relationship between central sleep apnea and Cheyne-Stokes Respiration.

    Science.gov (United States)

    Flinta, Irena; Ponikowski, Piotr

    2016-03-01

    Central sleep apnea (CSA) in patients with heart failure (HF) occurs frequently and shows a serious influence on prognosis in this population. The key elements in the pathophysiology of CSA are respiratory instability with chronic hyperventilation, changes of arterial carbon dioxide pressure (pCO2) and elongated circulation time. The main manifestation of CSA in patients with HF is Cheyne-Stokes Respiration (CSR). The initial treatment is the optimization of HF therapy. However, many other options of the therapeutic management have been studied, particularly those based on positive airway pressure methods. In patients with heart failure we often can observe the overlap of CSA and CSR; we will discuss the differences between these forms of breathing disorders during sleep. We will also discuss when CSA and CSR occur independently of each other and the importance of CSR occurring during the daytime in context of CSA during the nighttime. PMID:26961739

  17. Severe onychophagia and finger mutilation associated with obstructive sleep apnea.

    Science.gov (United States)

    Nino, Gustavo; Singareddy, Ravi

    2013-04-15

    Untreated obstructive sleep apnea (OSA) can lead to important neurobehavioral consequences including cognitive deficits, hyperactivity/inattention, daytime sleepiness, and mood disturbances. Interestingly, the potential role of OSA in the pathogenesis of impulse-control disorders such as nail biting (onychophagia) is currently unknown. We present a case of a man with severe onychophagia and biting-induced finger mutilation that was completely resolved after diagnosis and treatment of severe OSA. Accordingly, this report represents an important clinical observation that suggests a connection between sleep physiology and the neurobiological circuits implicated in the regulation of impulse-control behaviors. Further research in this area may improve our current understanding of the neurobehavioral consequences of untreated OSA. PMID:23585754

  18. Intracerebroventricular injections of dronabinol, a cannabinoid receptor agonist, does not attenuate serotonin-induced apnea in Sprague-Dawley rats

    OpenAIRE

    Calik, Michael W.; Carley, David W

    2016-01-01

    Background Evidence suggests that vagal nerve activity may play a role in sleep apnea induction. In anesthetized rats, dronabinol, a cannabinoid (CB) receptor agonist, injected into the nodose ganglia attenuates reflex apnea and increases genioglossus activity, and reflex apnea attenuation is blocked by systemic pre-treatment with cannabinoid type 1 and/or type 2 receptor antagonists. However, it is unclear whether dronabinol has similar effects in the central nervous system; CB receptors are...

  19. Measurement properties of a screening questionnaire of obstructive sleep apnea risk: Little information, great prediction?☆ ☆

    OpenAIRE

    Sargento, Paulo; Perea, Victoria; Ladera, Valentina; Lopes, Paulo; Oliveira, Jorge

    2014-01-01

    Introduction Previous research had shown the suitability of several questionnaires predicting the obstructive sleep apnea syndrome. Measurement properties of an online screening questionnaire were studied. Methods The sample consisted of 184 Portuguese adults (89 men and 95 women); 46 of them were polysomnographically diagnosed with the untreated obstructive sleep apnea syndrome. The participants were assessed with an online questionnaire of sleep apnea risk, from University of Maryland. Resu...

  20. Prevalence of sleep apnea and excessive day time sleepiness in patients with end-stage renal disease on dialysis

    OpenAIRE

    Hamdan Al-Jahdali

    2012-01-01

    Sleep apnea (SA) and excessive daytime sleepiness (EDS) are common sleep disorders among patients with end-stage renal disease (ESRD). This cross-sectional study, carried out in two dialysis centers in Saudi Arabia, assessed the prevalence of sleep apnea and sleepiness in Saudi patients with ESRD who are on maintenance dialysis with either peritoneal or hemodialysis. We used questionnaires to assess the prevalence of SA and EDS. The association between sleep apnea, EDS, and other sleep disord...

  1. Induced apnea enhances image quality and visualization of cardiopulmonary anatomic during contrastenhanced cardiac computerized tomographic angiography in children

    OpenAIRE

    Murali Chakravarthy; Gubbihalli Sunilkumar; Sumant Pargaonkar; Rajathadri Hosur; Chidananda Harivelam; Deepak Kavaraganahalli; Pradeep Srinivasan

    2015-01-01

    Objective: The purpose of our study was to determine the effect of induced apnea on quality of cardiopulmonary structures during computerized tomographic (CT) angiography images in children with congenital heart diseases. Methods: Pediatric patients with congenital heart defects undergoing cardiac CT angiography at our facility in the past 3 years participated in this study. The earlier patients underwent cardiac CT angiography without induced apnea and while, later, apnea was induced in pati...

  2. Biomarkers associated with obstructive sleep apnea: A scoping review.

    Science.gov (United States)

    Canto, Graziela De Luca; Pachêco-Pereira, Camila; Aydinoz, Secil; Major, Paul W; Flores-Mir, Carlos; Gozal, David

    2015-10-01

    The overall validity of biomarkers in the diagnosis of obstructive sleep apnea (OSA) remains unclear. We conducted a scoping review to provide assessments of biomarkers characteristics in the context of obstructive sleep apnea (OSA) and to identify gaps in the literature. A scoping review of studies in humans without age restriction that evaluated the potential diagnostic value of biological markers (blood, exhaled breath condensate, salivary, and urinary) in the OSA diagnosis was undertaken. Retained articles were those focused on the identification of biomarkers in subjects with OSA, the latter being confirmed with a full overnight or home-based polysomnography (PSG). Search strategies for six different databases were developed. The methodology of selected studies was classified using an adaptation of the evidence quality criteria from the American Academy of Pediatrics. Additionally the biomarkers were classified according to their potential clinical application. We identified 572 relevant studies, of which 117 met the inclusion criteria. Eighty-two studies were conducted in adults, 34 studies involved children, and one study had a sample composed of both adults and children. Most of the studies evaluated blood biomarkers. Potential diagnostic biomarkers were found in nine pediatric studies and in 58 adults studies. Only nine studies reported sensitivity and specificity, which varied substantially from 43% to 100%, and from 45% to 100%, respectively. Studies in adults have focused on the investigation of IL-6, TNF-α and hsCRP. There was no specific biomarker that was tested by a majority of authors in pediatric studies, and combinatorial urine biomarker approaches have shown preliminary promising results. In adults IL-6 and IL-10 seem to have a favorable potential to become a good biomarker to identify OSA. PMID:25645128

  3. Effect of Obstructive Sleep Apnea in Acute Coronary Syndrome.

    Science.gov (United States)

    Leão, Sílvia; Conde, Bebiana; Fontes, Paulo; Calvo, Teresa; Afonso, Abel; Moreira, Ilídio

    2016-04-01

    The effect of obstructive sleep apnea (OSA) on clinical outcomes after acute coronary syndrome (ACS) is incompletely defined. We sought to determine the prevalence of OSA in patients with ACS and evaluate prognostic impact of OSA and continuous positive airway pressure (CPAP) therapy in these patients. This was a prospective longitudinal cohort study of 73 patients admitted on cardiac intensive care unit for ACS. Cardiorespiratory sleep study and/or polysomnography were performed in all patients. CPAP was recommended if Apnea-Hypopnea Index ≥5. The main study outcome was a composite of death for any cause, myocardial infarction, and myocardial revascularization. OSA was diagnosed in 46 patients (63%). Age and cardiovascular risk factors were not significantly different between groups. OSA was classified as mild (m-OSA) in 14 patients (30%) and as moderate-to-severe (s-OSA) in 32 patients (70%). After a median follow-up of 75 months (interquartile range 71 to 79), patients with s-OSA had lower event-free survival rate. After adjustment for gender, patients with s-OSA showed a significantly higher incidence of the composite end point (hazard ratio 3.58, 95% CI 1.09 to 17.73, p = 0.035). Adherence to CPAP occurred in 19 patients (41%), but compliance to CPAP therapy did not reduce the risk of composite end point (hazard ratio 0.87, 95% CI 0.31 to 2.46, p = 0.798). In conclusion, OSA is an underdiagnosed disease with high prevalence in patients with ACS. It is urgent to establish screening protocols because those have high diagnostic yield and allow identifying a group of patients with manifestly unfavorable prognosis. PMID:26857162

  4. Early cardiovascular abnormalities in newly diagnosed obstructive sleep apnea

    Directory of Open Access Journals (Sweden)

    Jean-Philippe Baguet

    2009-12-01

    Full Text Available Jean-Philippe Baguet1, Marie Nadra1, Gilles Barone-Rochette1, Olivier Ormezzano1, Hélène Pierre1, Jean-Louis Pépin21Department of Cardiology, University Hospital, Grenoble, France; 2Sleep Laboratory, EFCR, University Hospital, Grenoble, FranceAbstract: Obstructive sleep apnea (OSA is associated with high cardiovascular morbidity and mortality. Recent studies have shown that it is associated with atherosclerosis and left ventricular dysfunction markers. The aim of this study was to assess the cardiovascular effects of OSA depending on its severity, in patients without clinically diagnosed cardiovascular disease. One hundred thirty newly diagnosed, nondiabetic OSA patients (mean age 49 ± 10 years, without vasoactive treatment were included. They underwent clinical and ambulatory blood pressure measurements, echocardiography, carotid ultrasound examination, and a carotid–femoral pulse wave velocity (PWV measurement. Seventy-five percent of the subjects were hypertensive according to the clinical or ambulatory measurement. More patients with the most severe forms (respiratory disturbance index >37/hour had a nondipper profile (52% vs 34%; P = 0.025 and their left ventricular mass was higher (40 ± 7 vs 36 ± 8 g/m, p = 0.014. This last parameter was independently and inversely associated with mean nocturnal oxygen saturation (P = 0.004. PWV and carotid intima-media thickness did not differ between one OSA severity group to another, but the prevalence of carotid hypertrophy was higher when mean SaO2 was below 93.5% (29.5 vs 16%; P = 0.05. Our study shows that in OSA patients without clinically diagnosed cardiovascular disease, there is a significant left ventricular and arterial effect, which is even more marked when OSA is severe.Keywords: obstructive sleep apnea, hypertension, left ventricular hypertrophy, intima-media thickness, arterial stiffness

  5. Predictors of obstructive sleep apnea in males with metabolic syndrome

    Directory of Open Access Journals (Sweden)

    Nikolaos Papanas

    2010-04-01

    Full Text Available Nikolaos Papanas1, Paschalis Steiropoulos2, Evangelia Nena2, Argyris Tzouvelekis2, Athanasios Skarlatos2, Maria Konsta2, Vasileios Vasdekis3, Efstratios Maltezos1, Demosthenes Bouros21Outpatient Clinic of Obesity, Diabetes and Metabolism, Second Department of Internal Medicine, Medical School, Democritus University of Thrace, Alexandroupolis, Greece; 2Sleep Laboratory, Department of Pneumonology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece; 3Department of Statistics, Athens University of Economic and Business, Athens, GreeceAbstract: The aim of the present study was to examine the prevalence of metabolic syndrome (MS and its components among obstructive sleep apnea (OSA patients vs controls, as well as to investigate which of these components are strongly associated with the presence of OSA in subjects reporting symptoms indicating sleep-disordered breathing. Included were 83 consecutive male subjects, without known concomitant diseases, who visited an outpatient clinic of obesity, diabetes and metabolism. Based on polysomnography, these were divided into two groups: OSA patients (n = 53 and controls (n = 30. Parameters indicating MS, according to the NCEP ATP III criteria (blood pressure, waist circumference, glucose, triglycerides, and HDL-cholesterol levels were evaluated in both groups. The criteria for MS were fulfilled in 49 participants. Presence of MS was significantly correlated with the presence of OSA. However, after adjustment for BMI, only serum glucose was significantly associated with the presence of OSA (P = 0.002. Conversely, the presence of MS was associated with a significant reduction in percentage of slow-wave sleep (P = 0.030. In conclusion, these results provide further evidence for the association between OSA and MS. Between subjects with MS, elevated serum glucose levels indicate a higher probability for the presence of OSA. Keywords: diabetes mellitus, glucose, metabolic syndrome

  6. Obstructive sleep apnea and bone mineral density in obese patients

    Directory of Open Access Journals (Sweden)

    Mariani S

    2012-11-01

    Full Text Available Stefania Mariani,1 Daniela Fiore,1 Laura Varone,2 Sabrina Basciani,1 Agnese Persichetti,1 Mikiko Watanabe,1 Maurizio Saponara,3 Giovanni Spera,1 Costanzo Moretti,4 Lucio Gnessi11Department of Experimental Medicine, Section of Medical Physiopathology and Endocrinology, Sapienza University of Rome, Italy; 2Department of Environmental Biology, Sapienza University of Rome, Italy; 3Department of Otolaryngology, Audiology and Phonation, Sapienza University of Rome, Italy; 4Division of Endocrinology, Department of System Medicine, Section of Reproductive Endocrinology University of TorVergata, Fatebenefratelli Hospital "San Giovanni Calibita" Rome, ItalyContext: Obesity and its co-morbidities may adversely affect bone mineral density (BMD. Obstructive sleep apnea (OSA is a major complication of obesity. To date, the effects of OSA on BMD in obese patients have been poorly studied.Objective: To examine whether the severity of OSA independently correlates with BMD in obese patients.Methods: One hundred and fifteen obese subjects with OSA (Apnea/Hypopnea Index [AHI] ≥5 events per hour were included in the study. BMD was measured at lumbar spine, total hip, and femoral neck by dual energy X-ray absorptiometry. Body mass index, lean mass, and representative measures of metabolic syndrome (waist circumference, fasting plasma glucose, blood pressure, HDL-cholesterol, triglycerides and inflammation (ESR, CRP, fibrinogen were also evaluated.Results: BMD did not differ among obese individuals regardless of OSA severity. Correlation coefficient analysis for all the covariates showed a lack of association between AHI and BMD that was strongly influenced by age and weight.Conclusion: Our study does not support an independent association between AHI and BMD in obese patients. Controlled studies involving a greater number of patients are warranted.Keywords: obesity, polysomnography, metabolic syndrome

  7. Craniocervical Posture in Patients with Obstructive Sleep Apnea

    Science.gov (United States)

    Piccin, Chaiane Facco; Pozzebon, Daniela; Scapini, Fabricio; Corrêa, Eliane Castilhos Rodrigues

    2016-01-01

    Introduction  Obstructive Sleep Apnea (OSA) is characterized by repeated episodes of upper airway obstruction during sleep. Objective  The objective of this study is to verify the craniofacial characteristics and craniocervical posture of OSA and healthy subjects, determining possible relationships with the apnea/hypopnea index (AHI). Methods  This case-control study evaluated 21 subjects with OSA, who comprised the OSA group (OSAG), and 21 healthy subjects, who constituted the control group (CG). Cephalometry analyzed head posture measurements, craniofacial measurements, and air space. Head posture was also assessed by means of photogrammetry. Results  The groups were homogeneous regarding gender (12 men and 9 women in each group), age (OSAG = 41.86 ± 11.26 years; GC = 41.19 ± 11.20 years), and body mass index (OSAG = 25.65 ± 2.46 kg/m2; CG = 24.72 ± 3.01 kg/m2). We found significant differences between the groups, with lower average pharyngeal space and greater distance between the hyoid bone and the mandibular plane in OSAG, when compared with CG. A positive correlation was found between higher head hyperextension and head anteriorization, with greater severity of OSA as assessed by AHI. Conclusion  OSAG subjects showed changes in craniofacial morphology, with lower average pharyngeal space and greater distance from the hyoid bone to the mandibular plane, as compared with healthy subjects. Moreover, in OSA subjects, the greater the severity of OSA, the greater the head hyperextension and anteriorization. PMID:27413397

  8. Acronym master list

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-06-01

    This document is a master list of acronyms and other abbreviations that are used by or could be useful to, the personnel at Los Alamos National Laboratory. Many specialized and well-known abbreviations are not included in this list.

  9. Hydrography - Integrated List Attaining

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This layer shows only attaining segments of the Integrated List. The Streams Integrated List represents stream assessments in an integrated format for the Clean...

  10. National List of Beaches

    Data.gov (United States)

    U.S. Environmental Protection Agency — EPA has published a list of coastal recreation waters adjacent to beaches (or similar points of access) used by the public in the U.S. The list, required by the...

  11. Retrofitting Listed Buildings

    DEFF Research Database (Denmark)

    Rasmussen, Torben Valdbjørn

    2011-01-01

    The paper presents a case study where the energy demand for a listed building constructed in 1900 is reduced. Many older buildings are listed and have restrictions that include the entire building or that include only its exterior. For the building presented, only its exterior facade is listed. The...... the local urban environment and therefore listed. The reduced energy demand, related to individual measures, is estimated and building physics requirements are addressed together with the economic options for evaluating the profitability....

  12. Essays on cross listings

    OpenAIRE

    Λουκά, Χριστόδουλος; Louca, Christodoulou

    2006-01-01

    This PhD dissertation consists of three essays on cross listings: a. The Operating Performance of Exchange-Listed American Depositary Receipts. b. Cross Listing, Bonding and Corporate Governance. c. Cross Listing on U.S. Stock Exchanges and the Earnings Management Hypothesis. The questions analyzed in this dissertation arise because of possible frictions in the transition of information from corporations to markets. To overcome informational frictions a company might choose to lis...

  13. Retail Shopping Lists

    DEFF Research Database (Denmark)

    Schmidt, Marcus

    2012-01-01

    The paper addresses consumers' shopping lists. The current study is based on a survey of 871 lists collected at retail grocery stores. Most items on shopping lists appear on the product category level rather than the brand level. The importance of the brand level varies considerably across produc...

  14. Acquisitions List No. 42.

    Science.gov (United States)

    Planned Parenthood--World Population, New York, NY. Katherine Dexter McCormick Library.

    The "Acquisitions List" of demographic books and articles is issued every two months by the Katharine Dexter McCormick Library. Divided into two parts, the first contains a list of books most recently acquired by the Library, each one annotated and also marked with the Library call number. The second part consists of a list of annotated articles,…

  15. Acquisitions List No. 43.

    Science.gov (United States)

    Planned Parenthood--World Population, New York, NY. Katherine Dexter McCormick Library.

    The "Acquisitions List" of demographic books and articles is issued every two months by the Katharine Dexter McCormick Library. Divided into two parts, the first contains a list of books most recently acquired by the Library, each one annotated and also marked with the Library call number. The second part consists of a list of annotated articles,…

  16. Prevalence and incidence of hypertension in obstructive sleep apnea patients and the relationship between obstructive sleep apnea and its confounders

    Institute of Scientific and Technical Information of China (English)

    FENG Jing; CHEN Bao-yuan

    2009-01-01

    @@ Based on available population-based studies, Obstructive Sleep Apnea (OSA) associated with accompanying daytime sleepiness affects 3% to 7% of adult men and 2% to 5% of adult women in the general population. In some population subsets, like obese or older people, this prevalence is even higher. The health risk in OSA patients shows a strong association with acute cardiovascular events such as stroke, myocardial infarction and nocturnal sudden death.1,2 And with chronic conditions such as coronary artery disease, heart failure, and especially, systemic hypertension.3,4 In this review, prevalence and incidence of hypertension in OSA patients and the relationships between OSA and its confounders are considered, and of course, these confounders are also generally taken as risk factors for hypertension.

  17. Síndrome de apnea hipopnea del sueño e ictus Sleep apnea-hypopnea syndrome and stroke

    Directory of Open Access Journals (Sweden)

    R. Muñoz

    2007-01-01

    Full Text Available Desde hace años se ha llamado la atención sobre la frecuente asociación entre el Síndrome de apnea hipopnea del Sueño (SAHS y el ictus. Disponemos de múltiples y muy diversos estudios epidemiológicos que señalan una posible relación causal. De forma paralela, a lo largo de estos años se ha incrementado el conocimiento de distintos mecanismos fisiopatológicos intermedios por los que teóricamente la apnea podría favorecer la aparición de isquemia cerebral. Entre estos destacaban un incremento de la presión arterial, la aparición de arritmias, cambios hemodinámicos de la circulación cerebral y un estado protrombótico. Asimismo, también se ha comprobado cómo el tratamiento con CPAP era beneficioso para normalizar algunas de estas alteraciones. Sin embargo, no ha sido hasta muy recientemente cuando, gracias a la aparición de diversos estudios prospectivos, se ha demostrado de forma fehaciente que el SAHS es un factor de riesgo que incrementa la posibilidad de padecer un ictus isquémico, de forma independiente a la presencia de otros factores de riesgo clásicos. En espera de nuevos estudios de intervención que confirmen si el tratamiento con CPAP reduce este riesgo, es importante incluir en la anamnesis de pacientes que hayan sufrido un ictus o un accidente isquémico transitorio la búsqueda de datos que nos hagan pensar en un SAHS y remitir a estos pacientes a valoración por el Servicio de Neumología en caso necesario.For many years attention has been drawn to the frequent association between sleep apnea-hypopnea syndrome and stroke. Numerous and very different epidemiological studies are available that point to a possible causal relation. In a parallel way, there has been an increase over these years in the knowledge of the different intermediate physiopathological mechanisms by which apnea could theoretically favour the appearance of cerebral ischemia. An increase in arterial pressure, the appearance of arrhythmias

  18. Cirugía como tratamiento de la apnea obstructiva del sueño Surgery for obstructive sleep apnea

    Directory of Open Access Journals (Sweden)

    P. M. Baptista

    2007-01-01

    Full Text Available El presión continua positiva en la vía aérea (CPAP nasal se considera como el tratamiento ideal para el tratamiento de Síndrome Apnea Obstructiva del Sueño (SAOS, debido a que es conservador y reversible, sin embargo, existe una pobre tasa de adherencia en su utilización a largo plazo, La cirugía podrá complementar de una manera importante aquellos casos en las cuales el CPAP no es tolerado. La cirugía para el SAOS se deberá realizar tomando en cuenta el grado de apnea obstructiva, el lugar de mayor obstrucción y la experiencia del equipo médico. Mientras más severo sea el SAOS se podrá ser más agresivo con la terapia quirúrgica. El lugar de obstrucción no deberá ser considerado de una manera simplista en la que se define un solo lugar de obstrucción, sino como una alteración general de la vía aérea donde el cirujano deberá actuar para remodelarlo de una manera efectiva. Se describen en el trabajo diversos tipos de cirugía y su eficacia en el SAOS de acuerdo al área anatómica comprometido (nariz, cirugía de adenoides, amígdalas, paladar blando, base de lengua, hipofaringe y el avance bimaxilar. La evidencia científica demuestra en los actuales momentos que la cirugía de reconstrucción de la vía aérea compite de una manera efectiva con el tratamiento médico.Nasal continuous positive airway pressure (CPAP is considered an ideal treatment for treating Obstructive Sleep Apnea Syndrome (OSAS, due to its being conservative and reversible; however, there is a poor rate of adherence in its long-term use. Surgery can significantly complement those cases where CPAP is not tolerated. Surgery for OSAS must be carried out taking into account the degree of obstructive apnea, the place of greatest obstruction and the experience of the medical team. The more severe the OSAS, the more aggressive the surgical therapy can be. The place of obstruction must not be considered in a simplistic way, in which only one place of

  19. Sleep Apnea Prevalence in Acute Myocardial Infarction - the Sleep Apnea in Post Acute Myocardial Infarction Patients (SAPAMI) Study

    Science.gov (United States)

    Ludka, Ondrej; Stepanova, Radka; Vyskocilova, Martina; Galkova, Lujza; Mikolaskova, Monika; Belehrad, Milos; Kostalova, Jana; Mihalova, Zuzana; Drozdova, Adela; Hlasensky, Jiri; Gacik, Michal; Pudilova, Lucie; Mikusova, Tereza; Fischerova, Blanka; Sert-Kuniyoshi, Fatima; Kara, Tomas; Spinar, Jindrich; Somers, Virend K.

    2014-01-01

    Background While sleep apnea (SA) might be a modifiable cardiovascular risk factor, recent data suggest that SA is severely underdiagnosed in patients after acute myocardial infarction (MI). There is limited evidence about day-night variation of onset of MI on dependence of having SA. We therefore investigated the prevalence of SA and examined the day-night variation of onset of MI in acute MI patients. Methods We prospectively studied 782 consecutive patients admitted to the hospital with the diagnosis of acute MI. All subjects underwent sleep evaluations using a portable device after at least 48 hours post-admission. Using the apnea-hypopnea index (AHI), groups were defined as patients without SA (<5 events/hour), mild SA (5–15 events/hour), moderate SA (15–30 events/hour), and severe SA (≥30 events/hour). Results Almost all patients (98%) underwent urgent coronary angiography and 91% of patients underwent primary PCI. Using a threshold of AHI ≥ 5 events/hour, SA was present in 65.7% of patients after acute MI. Mild SA was present in 32.6%, moderate in 20.4% and severe in 12.7%. The day-night variation in the onset of MI in all groups of SA patients was similar to that observed in non-SA patients. From 6AM–12PM, the frequency of MI was higher in both SA and non-SA patients, as compared to the interval from 12AM–6AM (all p<0.05). Conclusion There is a high prevalence of SA in patients presenting with acute MI. Peak time of MI onset in SA patients was between 6AM–noon, similar to that in the general population. Whether diagnosis and treatment of SA after MI will significantly improve outcomes in these patients remains to be determined. PMID:25064202

  20. Title III List of Lists -- Data Tool

    Data.gov (United States)

    U.S. Environmental Protection Agency — This list was prepared to help firms handling chemicals determine whether they need to submit reports under sections 302, 304, or 313 of the Emergency Planning and...

  1. The Severity of Nocturnal Hypoxia but Not Abdominal Adiposity Is Associated with Insulin Resistance in Non-Obese Men with Sleep Apnea

    OpenAIRE

    Anne-Laure Borel; Denis Monneret; Renaud Tamisier; Jean-Philippe Baguet; Patrice Faure; Patrick Levy; Serge Halimi; Jean-Louis Pépin

    2013-01-01

    BACKGROUND: Beyond obesity, sleep apnea syndrome is frequently associated with excess abdominal adiposity that could contribute to the deteriorated cardiometabolic risk profile of apneic patients. METHODS: The present study addressed the respective contribution of the severity of sleep apnea syndrome and excess abdominal adiposity to the cardiometabolic risk profile of 38 non obese men with polysomnography-diagnosed sleep apnea syndrome (apnea-hypopnea index >15 events/hour). These otherwise ...

  2. [Hungarian Society for Sleep Medicine guideline for detecting drivers with obstructive sleep apnea syndrome].

    Science.gov (United States)

    Szakács, Zoltán; Ádám, Ágnes; Annus, János Kristóf; Csatlós, Dalma; László, Andrea; Kalabay, László; Torzsa, Péter

    2016-06-01

    Obstructive sleep apnea is the most frequent sleep-disordered breathing. The prevalence of sleep apnea in the general population is 2-4% and the main characteristics of the disease are the intermittent cessation or substantial reduction of airflow during sleep, which is caused by complete, or near complete upper airway obstruction. Decreased airflow is followed by oxygen desaturation and intermittent arousals. Untreated patients are 4-6 times more likely to cause traffic accidents than their healthy counterparts. The aims of the obstructive sleep apnea screening are to prevent and reduce the incidence of serious car accidents, which are often caused by one of the most dangerous sleep disorders. Since April 1, 2015 a modification of the 13/1992 regulation has been in force in Hungary which orders screening of obstructive sleep apnea during medical checkup of drivers. The Hungarian Society for Sleep Medicine made a guideline according to the regulation which was adapted to national circumstances and family doctors, occupational health specialists can more easily screen obstructive sleep apnea in suspected patients. In sleep ambulances the disease can be diagnosed and effective treatment can be started. Patients receiving appropriate treatment and with appropriate compliance can get their driving licence under regular care and control. Orv. Hetil., 2016, 157(23), 892-900. PMID:27233832

  3. Effect of caffeine citrate on the blood gas indexes in newborns with apnea

    Institute of Scientific and Technical Information of China (English)

    Chun-Yan Wu; Xiao-Jiao Wang; Yuan-Yuan Wang

    2015-01-01

    Objective:To explore the effect of caffeine citrate on the blood gas indexes in newborns with apnea.Methods: A total of 108 primary premature infants diagnosed with apnea were included in the study and randomized into the caffeine citrate treatment group and the aminophylline control group with 54 cases in each group. The apnea episode duration 72 h after medication, and the blood gas before medication and 24, 48, 72 h after medication between the two groups were compared.Results: The apnea episode duration 24, 48, 72 h after medication in the treatment group was significantly shorter than that in the control group. PaO2 24, 48, 72 h after medication in the treatment group was significantly higher than that in the control group, while PaCO2 was significantly reduced when compared with the control group.Conclusions:Caffeine citrate has achieved a significantly clinical effect in the treatment of newborn apnea, as a new therapeutic drug, is worthy of being widely recommended in the clinic.

  4. Computational Modeling of Airway Obstruction in Sleep Apnea in Down Syndrome: A Feasibility Study.

    Science.gov (United States)

    Mylavarapu, Goutham; Subramaniam, Dhananjay; Jonnagiri, Raghuvir; Gutmark, Ephraim J; Fleck, Robert J; Amin, Raouf S; Mahmoud, Mohamed; Ishman, Stacey L; Shott, Sally R

    2016-07-01

    Current treatment options are successful in 40% to 60% of children with persistent obstructive sleep apnea after adenotonsillectomy. Residual obstruction assessments are largely subjective and do not clearly define multilevel obstruction. We endeavor to use computational fluid dynamics to perform virtual surgery and assess airflow changes in patients with Down syndrome and persistent obstructive sleep apnea. Three-dimensional airway models were reconstructed from respiratory-gated computed tomography and magnetic resonance imaging. Virtual surgeries were performed on 10 patients, mirroring actual surgeries. They demonstrated how surgical changes affect airflow resistance. Airflow and upper airway resistance was calculated from computational fluid dynamics. Virtual and actual surgery outcomes were compared with obstructive apnea-hypopnea index values. Actual surgery successfully treated 6 of 10 patients (postoperative obstructive apnea-hypopnea index <5). In 8 of 10 subjects, both apnea-hypopnea index and the calculated upper airway resistance after virtual surgery decreased as compared with baseline values. This is a feasibility and proof-of-concept study. Further studies are needed before using these techniques in surgical planning. PMID:27048669

  5. Oxygen Saturation and RR Intervals Feature Selection for Sleep Apnea Detection

    Directory of Open Access Journals (Sweden)

    Antonio G. Ravelo-García

    2015-05-01

    Full Text Available A diagnostic system for sleep apnea based on oxygen saturation and RR intervals obtained from the EKG (electrocardiogram is proposed with the goal to detect and quantify minute long segments of sleep with breathing pauses. We measured the discriminative capacity of combinations of features obtained from RR series and oximetry to evaluate improvements of the performance compared to oximetry-based features alone. Time and frequency domain variables derived from oxygen saturation (SpO2 as well as linear and non-linear variables describing the RR series have been explored in recordings from 70 patients with suspected sleep apnea. We applied forward feature selection in order to select a minimal set of variables that are able to locate patterns indicating respiratory pauses. Linear discriminant analysis (LDA was used to classify the presence of apnea during specific segments. The system will finally provide a global score indicating the presence of clinically significant apnea integrating the segment based apnea detection. LDA results in an accuracy of 87%; sensitivity of 76% and specificity of 91% (AUC = 0.90 with a global classification of 97% when only oxygen saturation is used. In case of additionally including features from the RR series; the system performance improves to an accuracy of 87%; sensitivity of 73% and specificity of 92% (AUC = 0.92, with a global classification rate of 100%.

  6. A new algorithm for detection of apnea in infants in neonatal intensive care units

    Science.gov (United States)

    Lee, Hoshik; Vergales, Brooke; Paget-Brown, Alix; Rusin, Craig; Moorman, Randall; Kattwinkel, John; Delos, John

    2011-03-01

    Apnea is a very common problem for premature infants: apnea of prematurity (AOP) occurs in >50% of babies whose birth weight is less than 1500 g, and AOP is found in almost all babies who are < 1000 g at birth. Current respiration detectors often fail to detect apnea, and also give many false alarms. We have created a new algorithm for detection of apnea. Respiration is monitored by continuous measurement of chest impedance (CI). However, the pulsing of the heart also causes fluctuations in CI. We developed a new adaptive filtering system to remove heart activity from CI, thereby giving much more reliable measurements of respiration. The new approach is to rescale the impedance measurement to heartbeat-time, sampling 30 times per interbeat interval. We take the Fourier transform of the rescaled signal, bandstop filter at 1 per beat to remove fluctuations due to heartbeats, and then take the inverse transform. The filtered signal retains all properties except the impedance changes due to cardiac filling and emptying. We convert the variance of CI into an estimated likelihood of apnea. This work is supported by NICHD 5RCZHD064488.

  7. 21 CFR 872.5570 - Intraoral devices for snoring and intraoral devices for snoring and obstructive sleep apnea.

    Science.gov (United States)

    2010-04-01

    ... devices for snoring and obstructive sleep apnea. 872.5570 Section 872.5570 Food and Drugs FOOD AND DRUG... Devices § 872.5570 Intraoral devices for snoring and intraoral devices for snoring and obstructive sleep... obstructive sleep apnea are devices that are worn during sleep to reduce the incidence of snoring and to...

  8. Urodynamic changes in a female case of obstructive sleep apnea syndrome with enuresis: 7 years' follow-up

    Institute of Scientific and Technical Information of China (English)

    CAO Xia; HU Ke; CHEN Xue-qin; XIANYU Yun-yan; Lü Sheng-qi; LI Qing-quan

    2010-01-01

    @@ Obstructive sleep apnea syndrome (OSAS) is characterized by repetitive upper airway occlusion resulting in apnea lasting 10 seconds or more. Clinical manifestations include snoring, daytime somnolence,intellectual deficiency, sexual impotence, and nocturnal polyuria. Enuresis associated with OSAS is suggested to be more common in children than in adults.1

  9. CRNL library serials list

    International Nuclear Information System (INIS)

    A list of 1900 serial publications (periodicals, society transactions and proceedings, annuals and directories, indexes, newspapers, etc.) is presented with volumes and years held by the Main Library. This library is the largest in AECL as well as one of the largest scientific and technical libraries in North America, and functions as a Canadian resource for nuclear information. A main alphabetical list is followed by broad subject field lists representing research interests, and lists of abstract and index serials, general bibliographic serials, conference indexes, press releases, English translations, and original language journals

  10. Oropharyngeal examination as a predictor of obstructive sleep apnea: pilot study of gag reflex and palatal reflex

    Directory of Open Access Journals (Sweden)

    Juliana Spelta Valbuza

    2011-10-01

    Full Text Available Obstructive sleep apnea (OSA has high prevalence and may cause serious comorbities. The aim of this trial was to show if simple noninvasive methods such as gag reflex and palatal reflex are prospective multivariate assessments of predictor variables for OSA. METHOD: We evaluate gag reflex and palatal reflex, of fifty-five adult patients, and their subsequent overnight polysomnography. RESULTS: Forty-one participants presented obstructive sleep apnea. The most relevant findings in our study were: [1] absence of gag reflex on patients with severe obstructive apnea (p=0.001; [2] absence of palatal reflex on moderate obstructive apnea patients (p=0.02. CONCLUSION: Gag reflex and palatal reflex, a simple noninvasive test regularly performed in a systematic neurological examination can disclose the impact of the local neurogenic injury associated to snoring and/or obstructive sleep apnea syndrome.

  11. Obstructive sleep apnea in children: a critical update

    Directory of Open Access Journals (Sweden)

    Tan HL

    2013-09-01

    Full Text Available Hui-Leng Tan,1,2 David Gozal,1 Leila Kheirandish-Gozal1 1Sections of Pediatric Sleep Medicine and Pediatric Pulmonology, Department of Pediatrics, Comer Children's Hospital, Pritzker School of Medicine, The University of Chicago, Chicago, IL, USA; 2Department of Paediatric Respiratory Medicine, Royal Brompton Hospital, London, UK Abstract: Obstructive sleep apnea (OSA in children is a highly prevalent disorder caused by a conglomeration of complex pathophysiological processes, leading to recurrent upper airway dysfunction during sleep. The clinical relevance of OSA resides in its association with significant morbidities that affect the cardiovascular, neurocognitive, and metabolic systems. The American Academy of Pediatrics recently reiterated its recommendations that children with symptoms and signs suggestive of OSA should be investigated with polysomnography (PSG, and treated accordingly. However, treatment decisions should not only be guided by PSG results, but should also integrate the magnitude of symptoms and the presence or absence of risk factors and signs of OSA morbidity. The first-line therapy in children with adenotonsillar hypertrophy is adenotonsillectomy, although there is increasing evidence that medical therapy, in the form of intranasal steroids or montelukast, may be considered in mild OSA. In this review, we delineate the major concepts regarding the pathophysiology of OSA, its morbidity, diagnosis, and treatment. Keywords: adenotonsillar hypertrophy, polysomnography, pathophysiology, morbidity, treatment, pediatric sleep disordered breathing

  12. Serotnin as a possible biomarker in obstructive sleep apnea.

    Science.gov (United States)

    Lipford, Melissa C; Ramar, Kannan; Liang, Yao-Jen; Lin, Chii-Wann; Chao, Yun-Ting; An, Jen; Chiu, Chih-Hsien; Tsai, Yi-Ju; Shu, Chih-Hung; Lee, Fei-Peng; Chiang, Rayleigh Ping-Ying

    2016-08-01

    Obstructive sleep apnea (OSA) is a highly prevalent disease which carries substantial public health burden. Polysomnography is the standard procedure used to diagnose OSA. However cost, accessibility, technical requirements, and skilled interpretation needs constrain its widespread use and have a role in the under-diagnosis of sleep disordered breathing. There is a clinical need to develop expedient and widely accessible tools to detect this disorder., Several biochemical markers have recently been proposed as diagnostic tools in OSA. Numerous neurochemicals directly influence the activity of upper airway dilator motor neurons, which subsequently influence respiration during sleep. Serotonin (5-HT) is one such neurochemical that has a key role in ventilatory stimulation. Herein, we review the current evidence demonstrating relationships between multiple biomarkers and sleep disordered breathing and focus on relationships between OSA and 5-HT. We discuss the possibility of biomarker-driven detection technology in the future as a means of diagnosing and monitoring OSA. Finally, we explore the specific role 5-HT may have in the future in both the diagnosis and treatment of OSA. PMID:26694311

  13. Importance of cephalographs in diagnosis of patients with sleep apnea

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    Nimma Vijaya Laxmi

    2015-01-01

    Full Text Available Introduction: Obstructive sleep apnea (OSA is considered to be a potentially life threatening disorder, which is characterized by repeated collapse of the upper airway during sleep with cessation of breathing. The cephalometric method despite being a static, two-dimensional evaluation of dynamic three-dimensional structures of the head and neck is useful in diagnosing patients with OSA, as they have shown that significant differences exist between asymptomatic controls and patients with OSA. Aims and Objectives: This study is designed to compare and validate the craniofacial morphology in patients with OSA using lateral cephalometry in both upright and supine position. Materials and Methods: Sixty subjects participated in the study of which 30 were patients with OSA diagnosed by questionnaire and 30 were healthy control group with age range of 25–45 years. Results: The study group demonstrated an increased ANB, mandibular plane angles (GoGn-SN, lower anterior facial height which are statistically significant with a significant P < 0.05. Significant decrease in posterior airway space, increased soft palate length, tongue length, and thickness suggesting reduced airway space in supine posture. Conclusion: Evaluation of craniofacial morphology in OSA patients using lateral cephalometry helps in recognizing the morphological changes induced by altered sleep pattern and for appropriate treatment planning.

  14. Sleep apnea and occupational accidents: Are oral appliances the solution?

    Directory of Open Access Journals (Sweden)

    Maria De Lourdes Rabelo Guimarães

    2014-01-01

    Full Text Available Background: Dental practitioners have a key role in the quality of life and prevention of occupational accidents of workers with Obstructive Sleep Apnea Syndrome (OSAS. Aim: The aim of this study was to review the impact of OSAS, the Continuous Positive Airway Pressure (CPAP therapy, and the evidence regarding the use of oral appliances (OA on the health and safety of workers. Materials and Methods: Searches were conducted in MEDLINE (PubMed, Lilacs and Sci ELO. Articles published from January 1980 to June 2014 were included. Results: The research retrieved 2188 articles and 99 met the inclusion criteria. An increase in occupational accidents due to reduced vigilance and attention in snorers and patients with OSAS was observed. Such involvements were related to excessive daytime sleepiness and neurocognitive function impairments. The use of OA are less effective when compared with CPAP, but the results related to excessive sleepiness and cognitive performance showed improvements similar to CPAP. Treatments with OA showed greater patient compliance than the CPAP therapy. Conclusion: OSAS is a prevalent disorder among workers, leads to increased risk of occupational accidents, and has a significant impact on the economy. The CPAP therapy reduces the risk of occupational accidents. The OA can improve the work performance; but there is no scientific evidence associating its use with occupational accidents reduction. Future research should focus on determining the cost-effectiveness of OA as well as its influence and efficacy in preventing occupational accidents.

  15. Nonalcoholic fatty liver disease and obstructive sleep apnea.

    Science.gov (United States)

    Aron-Wisnewsky, Judith; Clement, Karine; Pépin, Jean-Louis

    2016-08-01

    Obstructive sleep apnea (OSA) and more importantly its hallmark, chronic intermittent hypoxia (CIH), are established factors in the pathogenesis and exacerbation of nonalcoholic fatty liver disease (NAFLD). This has been clearly demonstrated in rodent models exposed to intermittent hypoxia, and strong evidence now also exists in both paediatric and adult human populations. OSA and CIH induce insulin-resistance and dyslipidemia which are involved in NAFLD physiopathogenesis. CIH increases the expression of the hypoxia inducible transcription factor HIF1α and that of downstream genes involved in lipogenesis, thereby increasing β-oxidation and consequently exacerbating liver oxidative stress. OSA also disrupts the gut liver axis, increasing intestinal permeability and with a possible role of gut microbiota in the link between OSA and NAFLD. OSA patients should be screened for NAFLD and vice versa those with NAFLD for OSA. To date there is no evidence that treating OSA with continuous positive airway pressure (CPAP) will improve NAFLD but it might at least stabilize and slow its progression. Nevertheless, these multimorbid patients should be efficiently treated for all their metabolic co-morbidities and be encouraged to follow weight stabilization or weight loss programs and physical activity life style interventions. PMID:27324067

  16. Biomarkers of cardiovascular stress in obstructive sleep apnea.

    Science.gov (United States)

    Maeder, Micha T; Mueller, Christian; Schoch, Otto D; Ammann, Peter; Rickli, Hans

    2016-09-01

    Obstructive sleep apnea (OSA) is a common sleep-related breathing disorder associated with "cardiovascular stress", i.e. cardiovascular risk factors, cardiovascular diseases, and an increased risk of heart failure, stroke, and death. Experimental and clinical studies have characterized potential underlying mechanisms including biventricular dysfunction, atherosclerosis, and arrhythmia. Assessment of these cardiovascular features of OSA requires a spectrum of clinical tools including ECG, echocardiography, exercise testing, and angiography. In contrast to many cardiovascular diseases, the role of blood biomarkers to characterize cardiovascular function and cardiovascular risk in OSA is poorly defined. In the present review we summarize the available data on biomarkers potentially providing information on cardiovascular features in OSA patients without overt cardiovascular disease. The vast majority of studies on biomarkers of cardiovascular stress in OSA evaluated B-type natriuretic peptide (BNP)/N-terminal-B-type natriuretic peptide (NT-proBNP), and cardiac troponins (cTn). Although some studies found significant associations between these cardiac biomarkers and the presence and severity of OSA, data remain conflicting. Also, the detailed pathophysiological mechanisms underlying the link between OSA and hemodynamic cardiac stress (BNP/NT-proBNP) and cardiomyocyte damage (cTn) are poorly understood. Major research efforts are required to establish the clinical role of cardiovascular biomarkers in patients with OSA. PMID:27380998

  17. Sleep Apnea and Other Sleep-Wake Disorders in Stroke.

    Science.gov (United States)

    Hermann, Dirk M.; Bassetti, Claudio L.

    2003-05-01

    Sleep-disordered breathing (SDB) and sleep-wake disturbances (SWD) are frequent in stroke patients. They deserve attention, because they may significantly influence rehabilitation process and functional outcome. In addition, SDB may increase the risk of stroke recurrence. More than 50% of stroke patients have SDB, mostly obstructive sleep apnea (OSA). In some patients, stroke recovery is accompanied by an improvement of SDB. The treatment of choice for OSA is continuous positive airway pressure. Oxygen, theophylline, and other forms of ventilation may be helpful in patients with other forms of SDB (eg, Cheyne-Stokes breathing). In at least 20% to 40% of stroke patients, SWD are present, mainly in form of increased sleep needs (hypersomnia), excessive daytime sleepiness, or insomnia. Depression, anxiety, SDB, stroke complications (eg, nocturia, dysphagia, and urinary or respiratory infections), and drugs may contribute to SWD and should be addressed first. In patients with SWD of primary neurologic origin, treatment with stimulants or dopaminergic drugs and hypnotics or sedating antidepressants, respectively, can be attempted. PMID:12670413

  18. Small B cell lymphocytic lymphoma presenting as obstructive sleep apnea

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    Chang Weng-Cheng

    2004-07-01

    Full Text Available Abstract Background Most lymphomas that involve the tonsil are large B cell lymphomas. Large B-cell lymphoma is a high grade malignancy which progresses rapidly. Tonsillar lymphoma usually presents as either a unilaterally enlarged palatine tonsil or as an ulcerative and fungating lesion over the tonsillar area. Small lymphocytic lymphomas (SLL of the Waldeyer's ring are uncommon. Case presentation We report a 41-year-old male who presented with a ten-year history of snoring. Physical examination revealed smooth bilateral symmetrically enlarged tonsils without abnormal surface change or cervical lymphadenopathy. Palatal redundancy and a narrowed oropharyngeal airway were also noted. The respiratory disturbance index (RDI was 66 per hour, and severe obstruction sleep apnea (OSA was suspected. No B symptoms, sore throat, odynophagia or dysphagia was found. We performed uvulopalatopharyngoplasty (UPPP and pathological examination revealed incidental small B-cell lymphocytic lymphoma (SLL. Conclusion It is uncommon for lymphoma to initially present as OSA. SLL is an indolent malignancy and is not easy to detect in the early stage. We conclude that SLL may be a contributing factor of OSA in the present case.

  19. Obstructive sleep apnea, pain, and opioids: is the riddle solved?

    Science.gov (United States)

    Lam, Karen K.; Kunder, Samuel; Wong, Jean; Doufas, Anthony G.; Chung, Frances

    2016-01-01

    Purpose of review Perioperative opioid-based pain management of patients suffering from obstructive sleep apnea (OSA) may present challenges because of concerns over severe ventilatory compromise. The interaction between intermittent hypoxia, sleep fragmentation, pain, and opioid responses in OSA, is complex and warrants a special focus of perioperative outcomes research. Recent findings Life-threatening opioid-related respiratory events are rare. Epidemiologic evidence suggests that OSA together with other serious renal and heart disease, is among those conditions predisposing patients for opioid-induced ventilatory impairment (OIVI) in the postoperative period. Both intermittent hypoxia and sleep fragmentation, two distinct components of OSA, enhance pain. Intermittent hypoxia may also potentiate opioid analgesic effects. Activation of major inflammatory pathways may be responsible for the effects of sleep disruption and intermittent hypoxia on pain and opioid analgesia. Recent experimental evidence supports that these, seemingly contrasting, phenotypes of pain-increasing and opioid-enhancing effects of intermittent hypoxia, are not mutually exclusive. Although the effect of intermittent hypoxia on OIVI has not been elucidated, opioids worsen postoperative sleep-disordered breathing in OSA patients. A subset of these patients, characterized by decreased chemoreflex responsiveness and high arousal thresholds, might be at higher risk for OIVI. Summary OSA may complicate opioid-based perioperative management of pain by altering both pain processing and sensitivity to opioid effect. PMID:26545144

  20. The consolidation of implicit sequence memory in obstructive sleep apnea.

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    Eszter Csabi

    Full Text Available Obstructive Sleep Apnea (OSA Syndrome is a relatively frequent sleep disorder characterized by disrupted sleep patterns. It is a well-established fact that sleep has beneficial effect on memory consolidation by enhancing neural plasticity. Implicit sequence learning is a prominent component of skill learning. However, the formation and consolidation of this fundamental learning mechanism remains poorly understood in OSA. In the present study we examined the consolidation of different aspects of implicit sequence learning in patients with OSA. We used the Alternating Serial Reaction Time task to measure general skill learning and sequence-specific learning. There were two sessions: a learning phase and a testing phase, separated by a 10-hour offline period with sleep. Our data showed differences in offline changes of general skill learning between the OSA and control group. The control group demonstrated offline improvement from evening to morning, while the OSA group did not. In contrast, we did not observe differences between the groups in offline changes in sequence-specific learning. Our findings suggest that disrupted sleep in OSA differently affects neural circuits involved in the consolidation of sequence learning.

  1. Obstructive Sleep Apnea-Hypopnea Syndrome and Hearing in Children

    Institute of Scientific and Technical Information of China (English)

    HE Xiao-zheng; XU Yao-dong; CAI Qian; ZHENG Yi-qing

    2008-01-01

    Objective To explore the relationship between hypoxemia and hearing in children with obstructive sleep apnea-hypopnea syndrome. Methods Auditory brainstem responses (ABRs) were recorded in 68 ears and distortion product otoacoustic emissions (DPOAEs) in 60 ears in children with OSAHS and type "A" tympanograms, and in 30 ears in normal children. Results ABR latencies of waves Ⅰ, Ⅲ and Ⅴ, and Ⅰ-Ⅲ, Ⅲ-Ⅴ and Ⅰ-Ⅴ intervals were not statistically different between OSAHS and normal children. Wave Ⅰlatency was delayed in children with OSAHS compared to normal children3 (P<0.05). DPOAE amplitudes in children with mild OSAHS were lower than normal children at 8 kHz (P<0.05). DPOAEs were lower at 6 kHz and 8 kHz in children with moderate/severe OSAHS than normal children (P<0.05). Conclusion Cochlear function was affected when AHI was at or greater than lO/hour. ABR and DPOAE can be used to detect early changes in auditory function in children with OSAHS.

  2. Clinical application ultrafast MRI to the sleep apnea syndrome, 1

    International Nuclear Information System (INIS)

    To evaluate the site of obstruction within upper airway, we observed the Turbo-fast low angle shot (FLASH) imaging, in 10 patients with sleep apnea syndrome (SAS) during wakefulness and sleep. After intravenous injection of Gd-DTPA (0.1 mmol/kg), sequential images of pharyngeal portion were obtained in midline sagittal section. An imaging protocol was 1.13s per image with a 1s delay between images, for a total of 30s. Then sequential images were displayed in a cine on C. R. T.. In eight patients, upper airway obstructions were present during sleep, while narrowings were present in four cases during awake. The sites of obstruction were located at the velopharynx exclusively in three cases, velopharynx plus glosspharynx in three cases, velopharynx plus glosspharynx in one case. Velopharynx plus hypopharynx in one case, respectively. It was concluded that ultrafast MRI had an important role in evaluating the sites of obstruction within upper airway in patients with SAS. (author)

  3. Obstructive Sleep Apnea and Kidney Disease: A Potential Bidirectional Relationship?

    Science.gov (United States)

    Abuyassin, Bisher; Sharma, Kumar; Ayas, Najib T; Laher, Ismail

    2015-08-01

    Chronic kidney disease (CKD) is associated with high mortality rates and heavy economic and social burdens. Nearly 10% of the United States population suffer from CKD, with fatal outcomes increased by 16-40 times even before reaching end-stage renal disease. The prevalence of obstructive sleep apnea (OSA) is between 3% and 7% in the general population, and has increased dramatically during the last 2 decades along with increased rates of obesity. However, the prevalence of OSA is much greater in patients with CKD. In addition, aggressive dialysis improves OSA. The current literature suggests a bidirectional association between CKD and OSA through a number of potential pathological mechanisms, which increase the possibility of both diseases being possible risk factors for each other. CKD may lead to OSA through a variety of mechanisms, including alterations in chemoreflex responsiveness, pharyngeal narrowing due to fluid overload, and accumulation of uremic toxins. It is also being increasingly recognized that OSA can also accelerate loss of kidney function. Moreover, animals exposed to intermittent hypoxia suffer histopathological renal damage. Potential mechanisms of OSA-associated renal dysfunction include renal hypoxia, hypertension, endothelial dysfunction, activation of the sympathetic nervous system, and increased oxidative stress. PMID:25845900

  4. Neuroendocrine Alterations in Obese Patients with Sleep Apnea Syndrome

    Directory of Open Access Journals (Sweden)

    Fabio Lanfranco

    2010-01-01

    Full Text Available Obstructive sleep apnea syndrome (OSAS is a serious, prevalent condition that has significant morbidity and mortality when untreated. It is strongly associated with obesity and is characterized by changes in the serum levels or secretory patterns of several hormones. Obese patients with OSAS show a reduction of both spontaneous and stimulated growth hormone (GH secretion coupled to reduced insulin-like growth factor-I (IGF-I concentrations and impaired peripheral sensitivity to GH. Hypoxemia and chronic sleep fragmentation could affect the sleep-entrained prolactin (PRL rhythm. A disrupted Hypothalamus-Pituitary-Adrenal (HPA axis activity has been described in OSAS. Some derangement in Thyroid-Stimulating Hormone (TSH secretion has been demonstrated by some authors, whereas a normal thyroid activity has been described by others. Changes of gonadal axis are common in patients with OSAS, who frequently show a hypogonadotropic hypogonadism. Altogether, hormonal abnormalities may be considered as adaptive changes which indicate how a local upper airway dysfunction induces systemic consequences. The understanding of the complex interactions between hormones and OSAS may allow a multi-disciplinary approach to obese patients with this disturbance and lead to an effective management that improves quality of life and prevents associated morbidity or death.

  5. Increased Ventricular Premature Contraction Frequency During REM Sleep in Patients with Coronary Artery Disease and Obstructive Sleep Apnea

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    Mari A. Watanabe

    2008-11-01

    Full Text Available Background Patients with obstructive sleep apnea are reported to have a peak of sudden cardiac death at night, in contrast to patients without apnea whose peak is in the morning. We hypothesized that ventricular premature contraction (VPC frequency would correlate with measures of apnea and sympathetic activity.Methods Electrocardiograms from a sleep study of 125 patients with coronary artery disease were evaluated. Patients were categorized by apnea-hypopnea index (AHI into Moderate (AHI 15 apnea groups. Sleep stages studied were Wake, S1, S2, S34, and rapid eye movement (REM. Parameters of a potent autonomically-based risk predictor for sudden cardiac death called heart rate turbulence were calculated.Results There were 74 Moderate and 51 Severe obstructive sleep apnea patients. VPC frequency was affected significantly by sleep stage (Wake, S2 and REM, F=5.8, p<.005 and by AHI (F=8.7, p<.005. In Severe apnea patients, VPC frequency was higher in REM than in Wake (p=.011. In contrast, patients with Moderate apnea had fewer VPCs and exhibited no sleep stage dependence (p=.19. Oxygen desaturation duration per apnea episode correlated positively with AHI (r2=.71, p<.0001, and was longer in REM than in non-REM (p<.0001. The heart rate turbulence parameter TS correlated negatively with oxygen desaturation duration in REM (r2=.06, p=.014.Conclusions Higher VPC frequency coupled with higher sympathetic activity caused by longer apnea episodes in REM sleep may be one reason for increased nocturnal death in apneic patients.

  6. A 45-year-old man with excessive daytime somnolence, and witnessed apnea at altitude

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    Welsh CH

    2011-04-01

    Full Text Available A sleepy man without sleep apnea at 1609m (5280 feet had disturbed sleep at his home altitude of 3200m (10500 feet. In addition to common disruptors of sleep such as psychophysiologic insomnia, restless leg syndrome, alcohol and excessive caffeine use, central sleep apnea with periodic breathing can be a significant cause of disturbed sleep at altitude. In symptomatic patients living at altitude, a sleep study at their home altitude should be considered to accurately diagnose the presence and magnitude of sleep disordered breathing as sleep studies performed at lower altitudes may miss this diagnosis. Treatments options differ from those to treat obstructive apnea. Supplemental oxygen is considered by many to be first-line therapy.

  7. Preliminary evaluation of Wearable Wellness System for Obstructive Sleep Apnea detection.

    Science.gov (United States)

    Crupi, R; Faetti, T; Paradiso, R

    2015-08-01

    Several studies have proven how sleep deprivation has a negative impact on daily life, affecting people's psychophysical state. In this field, research is focusing on the improvement of unobtrusive sleep monitoring devices for promoting sleep hygiene and early detection of sleep disorders. This study aims to assess the use of a textile-based wearable system, with its associated apnea detection algorithm, in monitoring of Obstructive Sleep Apnea Syndrome (OSAs). The system has been compared through the simultaneous acquisition of physiological signals in parallel with polysomnograph in laboratory and home environments. Results show that such a wearable system could be successfully used for early detection of OSAs (Obstructive Sleep Apnea Syndrome) and could stimulate people to a better self healthcare looking for a specialized medic examination and eventually undergoing to proper treatment avoiding the onset of OSAs co-morbidities. PMID:26737206

  8. Ultrafast CT in the diagnosis of sleep apnea during awake tidal breathing

    International Nuclear Information System (INIS)

    With sleep there is normally a decrease in neural output to upper airway muscles. If this decrease is superimposed on a structurally abnormal airway, then sleep apnea may result. Ultrafast CT axially images the upper airway in near real time. The authors compared 11 awake patients with sleep apnea with 24 healthy volunteers during quiet tidal breathing. They found that apneic patients have a small oropharyngeal airway (31.3 mm2 +- 30.2 vs 134.2 mm2 +- 46.6[P=<.0001]). Apneic patients also have significant collapsibility of the nasopharynx (75% +- 18% vs 27% +- 14% [P=<.0001]). Ultrafast CT gives dynamic anatomic definition of the upper airway and provides a means to eulcidate further the pathogenesis of sleep apnea

  9. CT findings in adults with obstructive sleep apnea; Measurement of pharyngeal spaces with an image analyzer

    Energy Technology Data Exchange (ETDEWEB)

    Matsuda, Fumiaki; Asakura, Kohji; Nakano, Yuji; Shintani, Tomoko; Akita, Nobuto; Kataura, Akikatsu (Sapporo Medical Coll. (Japan))

    1993-09-01

    The obstructive sleep apnea syndrome (OSAS) is characterized by recurrent obstruction of the upper airway during sleep. In this study, we performed CT scans in 20 adult OSAS patients and 6 control subjects, and measured the airspaces in the nasopharynx, mesopharynx and hypopharynx, using an image analyzer. The airspaces were significantly smaller at all sites of the pharynx in OSAS patients than in the control subjects, but they did not show a positive correlation with the apnea index or the body mass index. In good responders whose apnea indexes improved more than 50% after uvulo-palato-pharyngoplasty (UPPP), the nasopharyngeal and mesopharyngeal airspaces were significantly smaller, and the hypopharyngeal space tended to be larger than in poor responders. Our results suggest that CT scan is a helpful method for analyzing the area of the upper airway, especially in relation to the response to UPPP in adults with OSAS. (author).

  10. Sleep apnea in rheumatoid arthritis patients with occipitocervical lesions: the prevalence and associated radiographic features

    Science.gov (United States)

    Shoda, Naoki; Seichi, Atsushi; Takeshita, Katsushi; Chikuda, Hirotaka; Ono, Takashi; Oka, Hiroyuki; Nakamura, Kozo

    2009-01-01

    Since sleep apnea is a risk factor for high mortality of rheumatoid arthritis (RA) patients, this study examined the prevalence in RA patients with occipitocervical lesions, and the associated radiographic features. Twenty-nine RA patients requiring surgery for progressive myelopathy due to occipitocervical lesions (3 males, 26 females, average age 65 years) were preoperatively evaluated. Twenty-three (79%) had sleep apnea defined as apnea–hypopnea index >5 events per hour measured by a portable monitoring device, and all of them were classified as the obstructive type. Among gender, age, bone mass index (BMI), and radiographic parameters related to occipitocervical lesions: atlantodental interval (ADI), cervical angles (O/C1, C1/2, and C2/6), and cervical lengths (O–C2 and O–C6), the ADI and cervical lengths were shown to be significantly associated with the presence of sleep apnea by parametric statistical analysis. Since there were positive correlations between the ADI and cervical lengths by Pearson’s test, we performed a multivariate logistic regression analysis after adjustment for confounding factors and found that small ADI was the principle parameter associated with sleep apnea. We therefore conclude that the prevalence of sleep apnea is higher than that in a general RA population that was reported previously, and believe that occipitocervical lesions are an independent risk factor for this condition. Small ADI and short neck, secondary to the vertical translocation by RA, may cause obstructive sleep apnea, probably through mechanical or neurological collapse of the upper airway. PMID:19365641

  11. Prevalence and correlates of insomnia and obstructive sleep apnea in chronic kidney disease

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    Shahbaj Ahmad

    2013-01-01

    Full Text Available Background: Poor sleep quality, insomnia, and restless legs syndrome (RLS and sleep apnea are common in patients with chronic kidney disease (CKD. Clinical correlates of these problems are poorly understood. Aims: This study was to find out the prevalence and correlates of insomnia and subjects with ′high risk for obstructive sleep apnea (OSA′ in adults with chronic kidney disease. Materials and Methods: One hundred and four adults with CKD were included. Their demographic data, details regarding kidney disease and hemodialysis (HD were recorded. Presence of insomnia and its severity was assessed. They were screened for sleep apnea using a validated questionnaire. Results: Average age was 54.17 (΁ 12.96 years. 89.4% had stage 5 nephropathy and 78.8% subjects were on regular HD. Males outnumbered females. Insomnia was reported by 35.5%. Among these, 50% had chronic insomnia. Insomnia subjects had higher prevalence of diabetes (P = 0.01 and depression (P < 0.001. Fifty-one percent subjects were at "high risk for sleep apnea". They had higher prevalence of diabetes (P < 0.001, coronary disease (P = 0.02, insomnia (P = 0.008, and experienced daytime symptoms of insomnia (P < 0.001. However, in the logistic regression, only male gender (odds ratio, OR = 13.59 and daytime symptoms of insomnia (OR = 7.34 were found to be associated with "higher risk for sleep apnea". Conclusion: Insomnia was prevalent in CKD. Nearly half of these patients are at high risk for sleep apnea and a third of them suffer from insomnia. Hence, these patients should be screened for sleep disorders.

  12. Clinical predictors of central sleep apnea evoked by positive airway pressure titration

    Science.gov (United States)

    Moro, Marilyn; Gannon, Karen; Lovell, Kathy; Merlino, Margaret; Mojica, James; Bianchi, Matt T

    2016-01-01

    Purpose Treatment-emergent central sleep apnea (TECSA), also called complex apnea, occurs in 5%–15% of sleep apnea patients during positive airway pressure (PAP) therapy, but the clinical predictors are not well understood. The goal of this study was to explore possible predictors in a clinical sleep laboratory cohort, which may highlight those at risk during clinical management. Methods We retrospectively analyzed 728 patients who underwent PAP titration (n=422 split-night; n=306 two-night). Demographics and self-reported medical comorbidities, medications, and behaviors as well as standard physiological parameters from the polysomnography (PSG) data were analyzed. We used regression analysis to assess predictors of binary presence or absence of central apnea index (CAI) ≥5 during split-night PSG (SN-PSG) versus full-night PSG (FN-PSG) titrations. Results CAI ≥5 was present in 24.2% of SN-PSG and 11.4% of FN-PSG patients during titration. Male sex, maximum continuous positive airway pressure, and use of bilevel positive airway pressure were predictors of TECSA, and rapid eye movement dominance was a negative predictor, for both SN-PSG and FN-PSG patients. Self-reported narcotics were a positive predictor of TECSA, and the time spent in stage N2 sleep was a negative predictor only for SN-PSG patients. Self-reported history of stroke and the CAI during the diagnostic recording predicted TECSA only for FN-PSG patients. Conclusion Clinical predictors of treatment-evoked central apnea spanned demographic, medical history, sleep physiology, and titration factors. Improved predictive models may be increasingly important as diagnostic and therapeutic modalities move away from the laboratory setting, even as PSG remains the gold standard for characterizing primary central apnea and TECSA. PMID:27555802

  13. Evidence of neurodegeneration in obstructive sleep apnea: Relationship between obstructive sleep apnea and cognitive dysfunction in the elderly.

    Science.gov (United States)

    Daulatzai, Mak Adam

    2015-12-01

    The incidence of dementia and obstructive sleep apnea (OSA) increases with age. Late-onset Alzheimer's disease (AD) is an irreversible neurodegenerative disease of the elderly characterized by amyloid β (Aβ) plaques and neurofibrillary tangles. The disease involves widespread synaptic loss in the neocortex and the hippocampus. Rodent and clinical studies suggest that OSA impairs the structural integrity of several brain regions, including the medial temporal lobe. Indeed, hypoxia, hypertension, hypoperfusion, endothelial dysfunction, inflammation, and oxidative stress noted in OSA patients also occur in AD patients. This Review highlights pathological commonality, showing that OSA upregulates Aβ, tau hyperphosphorylation, and synaptic dysfunction. Indeed, OSA and hypertension trigger hypoperfusion and hypometabolism of brain regions, including cortex and hippocampus. Several studies show that hypertension-driven brain damage and pathogenic mechanisms lead to an Aβ increase. The pathophysiological mechanism by which OSA enhances hypertension may be linked to sympathoexcitation, oxidative stress, and endothelial dysfunction. Strong pathophysiological similarities that exist between OSA and AD are underscored here. For example, the hippocampus is negatively impacted in both OSA and AD. OSA promotes hippocampal atrophy, which is associated with memory impairment. Cognitive impairment, even in the absence of manifest dementia, is an important independent predictor of mortality. However, several pathophysiological mechanisms in OSA are reversible with appropriate therapy. OSA, therefore, is a modifiable risk factor of cognitive dysfunction, and treating OSA prior to mild cognitive impairment may be an effective prevention strategy to reduce risk for cognitive decline and AD in middle-aged persons and the elderly. PMID:26301370

  14. High Altitude, Continuous Positive Airway Pressure, and Obstructive Sleep Apnea: Subjective Observations and Objective Data

    OpenAIRE

    Ginosar, Yehuda; Malhotra, Atul; Schwartz, Eli

    2013-01-01

    Ginosar, Yehuda, Atul Malhotra, and Eli Schwartz. High altitude, continuous positive airway pressure, and obstructive sleep apnea: Subjective observations and objective data. High Alt Med Biol 14:186–189, 2013.—We report observations made by one of the authors who ascended to the Thorang La pass (5416 m) in the Nepal Himalaya in October 2010, despite moderate-severe obstructive sleep apnea. We report the first recorded use of nasal CPAP to treat high altitude pulmonary edema (progressively se...

  15. Development of the Korean Version of the Sleep Apnea Quality of Life Index

    OpenAIRE

    Jang, Hyun-Uk; Park, Ki-Soo; Cheon, Sang-Myung; Lee, Ho-Won; Kim, Sung-Wan; Lee, Seung-Hoon; Kim, Jung-Soo

    2014-01-01

    Objectives Obstructive sleep apnea (OSA) is a disorder characterized by repetitive partial or complete occlusion of the upper airway during sleep that affects quality of life. The aim of this study was to develop the Korean version of the sleep apnea quality of life index (K-SAQLI) and apply it in Korean patients with OSA. Methods Ninety-three patients with OSA completed the K-SAQLI. Its construct validity and responsiveness were tested by comparing the baseline and change scores obtained in ...

  16. Ambulatory Diagnosis and Management of Obstructive Sleep Apnea: Screening Questionnaires, Diagnostic Tests, and the Care Team.

    Science.gov (United States)

    McEvoy, R Doug; Chai-Coetzer, Ching Li; Antic, Nick A

    2016-09-01

    Obstructive sleep apnea has increased in prevalence in recent years and despite the expansion in sleep medicine services there is a significant unmet burden of disease. This burden presents a challenge to specialists and requires a reappraisal of service delivery, including a move toward lower-cost, simplified methods of diagnosis and treatment, an expansion of the sleep apnea workforce to include suitably trained and equipped primary care physicians and nurses, and the incorporation of chronic disease management principles that link patients to relevant community resources and empower them through new technologies to engage more fully in their own care. PMID:27542873

  17. Induced apnea enhances image quality and visualization of cardiopulmonary anatomic during contrastenhanced cardiac computerized tomographic angiography in children

    Directory of Open Access Journals (Sweden)

    Murali Chakravarthy

    2015-01-01

    Full Text Available Objective: The purpose of our study was to determine the effect of induced apnea on quality of cardiopulmonary structures during computerized tomographic (CT angiography images in children with congenital heart diseases. Methods: Pediatric patients with congenital heart defects undergoing cardiac CT angiography at our facility in the past 3 years participated in this study. The earlier patients underwent cardiac CT angiography without induced apnea and while, later, apnea was induced in patients, which was followed by electrocardiogram gated cardiac CT angiography. General anesthesia was induced using sleep dose of intravenous propofol. After the initial check CT, on request by the radiologist, apnea was induced by the anesthesiologist by administering 1 mg/kg of intravenous suxamethonium. Soon after apnea ensued, the contrast was injected, and CT angiogram carried out. CT images in the "apnea group" were compared with those in "nonapnea group." After the completion of the procedure, the patients were mask ventilated with 100% oxygen till the spontaneous ventilation was restored. Results: We studied 46 patients, of whom 36 with apnea and yet another 10 without. The quality of the image, visualization of structures such as cardiac wall, outflow tracts, lung field, aortopulmonary shunts, and coronary arteries were analyzed and subjected to statistical analysis (Mann-Whitney U, Fischer′s exact test and Pearson′s Chi-square test. In the induced apnea group, overall image quality was considered excellent in 89% (n = 33 of the studies, while in the "no apnea group," only 30% of studies were excellent. Absent or minimal motion artifacts were seen in a majority of the studies in apnea group (94%. In the nonapnea group, the respiratory and body motion artifacts were severe in 50%, moderate in 30%, and minimal in 20%, but they were significantly lesser in the apnea group. All the studied parameters were statistically significant in the apnea group in

  18. Rules for scoring respiratory events in sleep: update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events. Deliberations of the Sleep Apnea Definitions Task Force of the American Academy of Sleep Medicine.

    Science.gov (United States)

    Berry, Richard B; Budhiraja, Rohit; Gottlieb, Daniel J; Gozal, David; Iber, Conrad; Kapur, Vishesh K; Marcus, Carole L; Mehra, Reena; Parthasarathy, Sairam; Quan, Stuart F; Redline, Susan; Strohl, Kingman P; Davidson Ward, Sally L; Tangredi, Michelle M

    2012-10-15

    belts) and as an alternative sensor for detection of apnea and hypopnea (PVDFsum) only in adults.The task force recommends the following changes to the 2007 respiratory scoring rules. Apnea in adults is scored when there is a drop in the peak signal excursion by ≥ 90% of pre-event baseline using an oronasal thermal sensor (diagnostic study), PAP device flow (titration study), or an alternative apnea sensor, for ≥ 10 seconds. Hypopnea in adults is scored when the peak signal excursions drop by ≥ 30% of pre-event baseline using nasal pressure (diagnostic study), PAP device flow (titration study), or an alternative sensor, for ≥ 10 seconds in association with either ≥ 3% arterial oxygen desaturation or an arousal. Scoring a hypopnea as either obstructive or central is now listed as optional, and the recommended scoring rules are presented. In children an apnea is scored when peak signal excursions drop by ≥ 90% of pre-event baseline using an oronasal thermal sensor (diagnostic study), PAP device flow (titration study), or an alternative sensor; and the event meets duration and respiratory effort criteria for an obstructive, mixed, or central apnea. A central apnea is scored in children when the event meets criteria for an apnea, there is an absence of inspiratory effort throughout the event, and at least one of the following is met: (1) the event is ≥ 20 seconds in duration, (2) the event is associated with an arousal or ≥ 3% oxygen desaturation, (3) (infants under 1 year of age only) the event is associated with a decrease in heart rate to less than 50 beats per minute for at least 5 seconds or less than 60 beats per minute for 15 seconds. A hypopnea is scored in children when the peak signal excursions drop is ≥ 30% of pre-event baseline using nasal pressure (diagnostic study), PAP device flow (titration study), or an alternative sensor, for ≥ the duration of 2 breaths in association with either ≥ 3% oxygen desaturation or an arousal. In children

  19. COGNITIVE AND EMOTIONAL IMPAIRMENT IN OBSTRUCTIVE SLEEP APNEA SYNDROME

    Institute of Scientific and Technical Information of China (English)

    Bin Peng; Shun-wei Li; Hong Kang; Xi-zhen Huang

    2004-01-01

    Objective To evaluate the emotional and cognitive status in patients with obstructive sleep apnea syndrome (OSAS),using neuropsychological tests and evoked-related potential (P3).Methods Sixteen patients diagnosed of OSAS were tested by Hamilton rating scale for anxiety (HRSA) and Hamilton rating scale for depression (HRSD). Other three groups, OSAS patient group (n = 21), snoring group (n = 21), and control group (n = 21), were administered polysomnography (PSG), auditory evoked event-related potential (P3), and clinic memory test. The results were analyzed using general linear model (GLM) analysis and Post Hoc test.Results Twelve OSAS patients' scores of HRSA and HRSD were beyond the normal range, 26.42 ± 4.48 and 22.08 ±3.97 respectively. The auditory P3 latency in OSAS group was 363.1 ± 22.9 ms (Fz), 368.57 ± 28.03 ms (Cz), in snoring group 336.57 ± 31.08 ms (Fz), 339.81 ± 31.76 ms (Cz), in control group 340.8 ± 28.7 ms (Fz), 338.29 ± 29.21 ms (Cz).There were significant differences between OSAS group and snoring group, as well as control group (P < 0.05). No significant difference was seen between snoring group and control group. No significant difference was noted in P3 amplitude among three groups. Memory quotient (MQ) reduced in snoring group compared with control group.Conclusions Emotional disturbances are common clinical features in OSAS patients. Abnormal auditory P3 latency indicates the cognitive dysfunction in OSAS patients. Nocturnal hypoxaemia may play an important role on it. Snorers should be monitored because of the tendency to develop cognitive impairment.

  20. Topography-specific spindle frequency changes in Obstructive Sleep Apnea

    Directory of Open Access Journals (Sweden)

    V Suzana

    2012-07-01

    Full Text Available Abstract Background Sleep spindles, as detected on scalp electroencephalography (EEG, are considered to be markers of thalamo-cortical network integrity. Since obstructive sleep apnea (OSA is a known cause of brain dysfunction, the aim of this study was to investigate sleep spindle frequency distribution in OSA. Seven non-OSA subjects and 21 patients with OSA (11 mild and 10 moderate were studied. A matching pursuit procedure was used for automatic detection of fast (≥13Hz and slow (Hz spindles obtained from 30min samples of NREM sleep stage 2 taken from initial, middle and final night thirds (sections I, II and III of frontal, central and parietal scalp regions. Results Compared to non-OSA subjects, Moderate OSA patients had higher central and parietal slow spindle percentage (SSP in all night sections studied, and higher frontal SSP in sections II and III. As the night progressed, there was a reduction in central and parietal SSP, while frontal SSP remained high. Frontal slow spindle percentage in night section III predicted OSA with good accuracy, with OSA likelihood increased by 12.1%for every SSP unit increase (OR 1.121, 95% CI 1.013 - 1.239, p=0.027. Conclusions These results are consistent with diffuse, predominantly frontal thalamo-cortical dysfunction during sleep in OSA, as more posterior brain regions appear to maintain some physiological spindle frequency modulation across the night. Displaying changes in an opposite direction to what is expected from the aging process itself, spindle frequency appears to be informative in OSA even with small sample sizes, and to represent a sensitive electrophysiological marker of brain dysfunction in OSA.

  1. Is There A Post Listing Anomaly For IPOs Overseas Listing?

    OpenAIRE

    Moustafa Fadl

    2013-01-01

    Both the IPO literature and cross listing literature document that soon after the overseas listing of IPOs, the results are negative abnormal returns, and that phenomenon are “ post listing anomaly”. This paper checks whether there is a post listing anomaly and tries to find reasons for it. The paper concludes that the post listing anomaly does not exist. Further, some companies time the market while others do not when they consider listing their IPOs overseas.

  2. Contaminant Candidate List 1

    Data.gov (United States)

    U.S. Environmental Protection Agency — CCL 1 is a list of contaminants that are currently not subject to any proposed or promulgated national primary drinking water regulations, that are known or...

  3. Contaminant Candidate List 2

    Data.gov (United States)

    U.S. Environmental Protection Agency — CCL 2 is a list of contaminants that are currently not subject to any proposed or promulgated national primary drinking water regulations, that are known or...

  4. Preliminary Equipment List

    International Nuclear Information System (INIS)

    The methodology for assigning equipment identifiers and component identifiers for the MGR Site Recommendation or License Application is presented below. Engineering Computer Support (ECS) assigns all equipment and component identifiers and is responsible for entering equipment identifiers into the Plant Design System (PDS) Master Equipment List. A sample report from the PDS Master Equipment List is attached. The attached report is representative of the information that will be provided by the PDS system. Since the equipment list presented is only preliminary, actual equipment numbers are not assigned. It contains information required to maintain control of the equipment and components for MGR important to safety systems. Definitions for the fields that currently exist on the PDS Master Equipment List are given

  5. List of publications 1990

    International Nuclear Information System (INIS)

    The publication is a list of reports, of published or submitted journal articles, theses, conference papers, patents and internal reports by staff members of the Nuclear Research Institute (UJV) in Rez. (author). 232 refs

  6. List of publications 1991

    International Nuclear Information System (INIS)

    The publication is a list of reports, of published or submitted journal articles, theses, conference papers, patents and internal reports by staff members of the Nuclear Research Institute (UJV) in Rez. (author). 331 refs

  7. Contaminant Candidate List 3

    Data.gov (United States)

    U.S. Environmental Protection Agency — CCL 3 is a list of contaminants that are currently not subject to any proposed or promulgated national primary drinking water regulations, that are known or...

  8. List of publications 1989

    International Nuclear Information System (INIS)

    A list is given of reports, journal articles (published or submitted for publication), theses, conference papers, patents, and reports for internal use, published in 1989 by staff members of the Nuclear Research Institute in Rez, Czechoslovakia. (P.A.)

  9. Goat production check list

    DEFF Research Database (Denmark)

    Henriksen, Jørgen; Nielsen, Mette Benedicte Olaf; Madsen, Jørgen;

    2009-01-01

    This check list, financed by DanChurchAid, highlights all issues should be carefully investigated before investing in distribution of goats and in interventions to assist poor rural communities to improve their livelihood through goat production.......This check list, financed by DanChurchAid, highlights all issues should be carefully investigated before investing in distribution of goats and in interventions to assist poor rural communities to improve their livelihood through goat production....

  10. Incremental algorithms on lists

    OpenAIRE

    Jeuring, J.T.

    2007-01-01

    Incremental computations can improve the performance of interactive programs such as spreadsheet programs, program development environments, text editors, etc. Incremental algorithms describe how to compute a required value depending on the input, after the input has been edited. By considering the possible different edit actions on the data type lists, the basic data type used in spreadsheet programs and text editors, we define incremental algorithms on lists. Some theory for the constructio...

  11. Perioperative sleep apnea: a real problem or did we invent a new disease? [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Sebastian Zaremba

    2016-01-01

    Full Text Available Depending on the subpopulation, obstructive sleep apnea (OSA can affect more than 75% of surgical patients. An increasing body of evidence supports the association between OSA  and perioperative complications, but some data indicate important perioperative outcomes do not differ between patients with and without OSA. In this review we will provide an overview of the pathophysiology of sleep apnea and the risk factors for perioperative complications related to sleep apnea. We also discuss a clinical algorithm for the identification and management of OSA patients facing surgery.

  12. Sleep apnea classification using ECG-signal wavelet-PCA features.

    Science.gov (United States)

    Rachim, Vega Pradana; Li, Gang; Chung, Wan-Young

    2014-01-01

    Sleep apnea is often diagnosed using an overnight sleep test called a polysomnography (PSG). Unfortunately, though it is the gold standard of sleep disorder diagnosis, a PSG is time consuming, inconvenient, and expensive. Many researchers have tried to ameliorate this problem by developing other reliable methods, such as using electrocardiography (ECG) as an observed signal source. Respiratory rate interval, ECG-derived respiration, and heart rate variability analysis have been studied recently as a means of detecting apnea events using ECG during normal sleep, but these methods have performance weaknesses. Thus, the aim of this study is to classify the subject into normal- or apnea-subject based on their single-channel ECG measurement in regular sleep. In this proposed study, ECG is decomposed into five levels using wavelet decomposition for the initial processing to determine the detail coefficients (D3-D5) of the signal. Approximately 15 features were extracted from every minute of ECG. Principal component analysis and a support vector machine are used for feature dimension reduction and classification, respectively. According to classification that been done from a data set consisting of thirty-five patients, the proposed minute-to-minute classifier specificity, sensitivity, and subject-based classification accuracy are 95.20%, 92.65%, and 94.3%, respectively. Furthermore, the proposed system can be used as a basis for future development of sleep apnea screening tools. PMID:25226993

  13. Detection of cognitive impairment in patients with obstructive sleep apnea hypopnea syndrome using mismatch negativity

    Institute of Scientific and Technical Information of China (English)

    Xiaohui Wen; Ningyu Wang; Jinfeng Liu; Zhanfeng Yan; Zhonghai Xin

    2012-01-01

    In this experiment, 97 patients with obstructive sleep apnea hypopnea syndrome were divided into three groups (mild, moderate, severe) according to minimum oxygen saturation, and 35 healthy subjects were examined as controls. Cognitive function was determined using the mismatch negativity paradigm and the Montreal Cognitive Assessment. The results revealed that as the disease worsened, the mismatch negativity latency was gradually extended, and the amplitude gradually declined in patients with obstructive sleep apnea hypopnea syndrome. Importantly, mismatch negativity latency in severe patients with a persistent time of minimum oxygen saturation 60 seconds. Correlation analysis revealed a negative correlation between minimum oxygen saturation latency and Montreal Cognitive Assessment scores. These findings indicate that intermittent night-time hypoxemia affects mismatch negativity waveforms and Montreal Cognitive Assessment scores. As indicators for detecting the cognitive functional status of obstructive sleep apnea hypopnea syndrome patients, the sensitivity of mismatch negativity is 82.93%, the specificity is 73.33%, the accuracy rate is 81.52%, the positive predictive value is 85.00%, the negative predictive value is 70.21%, the positive likelihood ratio is 3, and the negative likelihood ratio is 0.23. These results indicate that mismatch negativity can be used as an effective tool for diagnosis of cognitive dysfunction in obstructive sleep apnea hypopnea syndrome patients.

  14. Available techniques for objective assessment of upper airway narrowing in snoring and sleep apnea

    DEFF Research Database (Denmark)

    Faber, Christian; Grymer, Luisa

    2003-01-01

    A number of techniques are available to determine the level of obstructive predominance in snoring and in the obstructive sleep apnea hypopnea syndrome (OSAHS): lateral cephalography, awake endoscopy, awake endoscopy with the Müller maneuver, endoscopy during sleep, endoscopy with nasal continuous...

  15. Myosin heavy chain proteins are responsible for the development of obstructive sleep apnea syndrome

    Czech Academy of Sciences Publication Activity Database

    Šedý, Jiří; Horká, E.; Pavlíková, G.; Bulík, O.; Foltán, R.

    2009-01-01

    Roč. 73, č. 6 (2009), s. 1014-1016. ISSN 0306-9877 Institutional research plan: CEZ:AV0Z50390512 Keywords : obstructive sleep apnea syndrome * MHC Subject RIV: FH - Neurology Impact factor: 1.393, year: 2009

  16. Using the Pathophysiology of Obstructive Sleep Apnea to Teach Cardiopulmonary Integration

    Science.gov (United States)

    Levitzky, Michael G.

    2008-01-01

    Obstructive sleep apnea (OSA) is a common disorder of upper airway obstruction during sleep. The effects of intermittent upper airway obstruction include alveolar hypoventilation, altered arterial blood gases and acid-base status, and stimulation of the arterial chemoreceptors, which leads to frequent arousals. These arousals disturb sleep…

  17. Low-frequency oscillations and vasoreactivity of cortical vessels in obstructive sleep apnea during wakefulness

    DEFF Research Database (Denmark)

    Schytz, Henrik Winther; Jensen, Benedicte Ersted; Jennum, Poul;

    2013-01-01

    Effective nasal continuous positive airway pressure (CPAP) therapy reduces the cardiovascular outcomes associated with obstructive sleep apnea (OSA), but the mechanism behind this effect is unclear. We investigated if OSA patients during wakefulness showed signs of increased sympathetic activity...... and decreased vasoreactivity in cerebral cortical vessels as measured with near-infrared spectroscopy (NIRS), and if this may be reversed by CPAP treatment....

  18. Complications of hyoid suspension in the treatment of obstructive sleep apnea syndrome.

    NARCIS (Netherlands)

    Richard, W.; Timmer, F.C.A.; Tinteren, H. van; Vries, N de

    2011-01-01

    The objectives of the study are to assess adverse events and complications of hyoid suspension (HS) as a treatment of obstructive sleep apnea syndrome (OSAS). The study design was cohort. Thirty-nine patients with OSAS and obstruction at tongue base level, as assessed by sleep endoscopy, underwent H

  19. Craniofacial, craniocervical, and pharyngeal morphology in bilateral cleft lip and palate and obstructive sleep apnea patients

    NARCIS (Netherlands)

    Oosterkamp, B.C.M.; Remmelink, H.J.; Pruim, G.J.; Hoekema, A.; Dijkstra, P.U.

    2007-01-01

    Objective: The aim of this study was to analyze craniofacial, craniocervical, and pharyngeal morphology in surgically treated bilateral cleft lip and palate (BCLP) men, untreated men with obstructive sleep apnea (OSA), and a reference group of men. Subjects and methods: Lateral cephalograms were obt

  20. Radiation necrosis causing failure of automatic ventilation during sleep with central sleep apnea

    Energy Technology Data Exchange (ETDEWEB)

    Udwadia, Z.F.; Athale, S.; Misra, V.P.; Wadia, N.H.

    1987-09-01

    A patient operated upon for a midline cerebellar hemangioblastoma developed failure of automatic respiration during sleep, together with central sleep apnea syndrome, approximately two years after receiving radiation therapy to the brain. Clinical and CT scan findings were compatible with a diagnosis of radiation necrosis as the cause of his abnormal respiratory control.

  1. Radiation necrosis causing failure of automatic ventilation during sleep with central sleep apnea

    International Nuclear Information System (INIS)

    A patient operated upon for a midline cerebellar hemangioblastoma developed failure of automatic respiration during sleep, together with central sleep apnea syndrome, approximately two years after receiving radiation therapy to the brain. Clinical and CT scan findings were compatible with a diagnosis of radiation necrosis as the cause of his abnormal respiratory control

  2. Association of adiponectin genotype polymorphisms at positions 45 and 276 with obstructive sleep apnea hypopnea syndrome

    Institute of Scientific and Technical Information of China (English)

    Mei Su; Xilong Zhang; Shicheng Su

    2009-01-01

    Objective: To investigate the relationship between adiponectin genotype polymorphisms and obstructive sleep apnea hypopnea syndrome (OSAHS). Methods: Using the TaqMan polymerase chain reaction(PCR) method, the single nucleotide polymorphisms(SNP)at positions 45 and 276 in the adiponectin gene were determined in Chinese of the Han nationality in the Nanjing district. The OSAHS group consisted of 78 patients, and the control group contained 40 subjects. The association of adiponectin genotype polymorphisms at positions 45 and 276 with obstructive sleep apnea hypopnea syndrome was analyzed. Results: No evidence of a direct association was found between OSAHS and adiponectin genotype SNP at positions 45 and 276(P> 0.05). However, compared with those OSAHS patients having G/T+T/T genotype at position 276, the OSAHS patients with the G/G genotype showed a greater neck circumference(NC), a prolonged duration of the longest apnea event, and elevated levels of blood cholesterol and low-density lipoprotein cholesterol(P < 0.05). Conclusion: No direct association was detected between OSAHS and adiponectin genotype distribution at positions 45 and 276 in Chinese of Han nationality in the Nanjing district. However, OSAHS patients with the adiponectin GIG genotype at position 276 had a larger NC and the longest apnea event compared to those having the adiponectin SNP276 G/T +T/T genotype. This may have an indirect influence on the development of OSAHS.

  3. List of figures, list of tables

    OpenAIRE

    2013-01-01

    LIST OF FIGURES 1. The extended model of market orientation 53 2. The key market actors in the global market 62 3. The global market : a dual-trading arena 68 4. Innovation and strategic marketing 69 5. Typical organisation of a market-driven company 79 6. The different customer roles 94 7. Competitors identification matrix 105 8. The prescription market 111 9. Who are the stakeholders 118 10. The home ownership virtual and meta markets 127 11. Measuring short-and long-term marketing effecti...

  4. Maxillomandibular Advancement in Obstructive Sleep Apnea Syndrome Patients: a Restrospective Study on the Sagittal Cephalometric Variables

    Directory of Open Access Journals (Sweden)

    Paolo Ronchi

    2013-06-01

    Full Text Available Objectives: The present retrospective study analyzes sagittal cephalometric changes in patients affected by obstructive sleep apnea syndrome submitted to maxillomandubular advancement. Material and Methods: 15 adult sleep apnea syndrome (OSAS patients diagnosed by polysomnography (PSG and treated with maxillomandubular advancement (MMA were included in this study. Pre- (T1 and postsurgical (T2 PSG studies assessing the apnea/hypopnea index (AHI and the lowest oxygen saturation (LSAT level were compared. Lateral cephalometric radiographs at T1 and T2 measuring sagittal cephalometric variables (SNA, SNB, and ANB were analyzed, as were the amount of maxillary and mandibular advancement (Co-A and Co-Pog, the distance from the mandibular plane to the most anterior point of the hyoid bone (Mp-H, and the posterior airway space (PAS.Results: Postoperatively, the overall mean AHI dropped from 58.7 ± 16 to 8.1 ± 7.8 events per hour (P < 0.001. The mean preoperative LSAT increased from 71% preoperatively to 90% after surgery (P < 0.001. All the patients in our study were successfully treated (AHI < 20 or reduced by 50%. Cephalometric analysis performed after surgery showed a statistically significant correlation between the mean SNA variation and the decrease in the AHI (P = 0.01. The overall mean SNA increase was 6°.Conclusions: Our findings suggest that the improvement observed in the respiratory symptoms, namely the apnea/hypopnea episodes, is correlated with the SNA increase after surgery. This finding may help maxillofacial surgeons to establish selective criteria for the surgical approach to sleep apnea syndrome patients.

  5. Long-term facilitation in obstructive sleep apnea patients during NREM sleep.

    Science.gov (United States)

    Aboubakr, S E; Taylor, A; Ford, R; Siddiqi, S; Badr, M S

    2001-12-01

    Repetitive hypoxia followed by persistently increased ventilatory motor output is referred to as long-term facilitation (LTF). LTF is activated during sleep after repetitive hypoxia in snorers. We hypothesized that LTF is activated in obstructive sleep apnea (OSA) patients. Eleven subjects with OSA (apnea/hypopnea index = 43.6 +/- 18.7/h) were included. Every subject had a baseline polysomnographic study on the appropriate continuous positive airway pressure (CPAP). CPAP was retitrated to eliminate apnea/hypopnea but to maintain inspiratory flow limitation (sham night). Each subject was studied on 2 separate nights. These two studies are separated by 1 mo of optimal nasal CPAP treatment for a minimum of 4-6 h/night. The device was capable of covert pressure monitoring. During night 1 (N1), study subjects used nasal CPAP at suboptimal pressure to have significant air flow limitation (>60% breaths) without apneas/hypopneas. After stable sleep was reached, we induced brief isocapnic hypoxia [inspired O(2) fraction (FI(O(2))) = 8%] (3 min) followed by 5 min of room air. This sequence was repeated 10 times. Measurements were obtained during control, hypoxia, and at 5, 20, and 40 min of recovery for ventilation, timing (n = 11), and supraglottic pressure (n = 6). Upper airway resistance (Rua) was calculated at peak inspiratory flow. During the recovery period, there was no change in minute ventilation (99 +/- 8% of control), despite decreased Rua to 58 +/- 24% of control (P changes compared with N1 during the recovery period. In conclusion, 1) reduced Rua in the recovery period indicates LTF of upper airway dilators; 2) lack of hyperpnea in the recovery period suggests that thoracic pump muscles do not demonstrate LTF; 3) we speculate that LTF may temporarily stabilize respiration in OSA patients after repeated apneas/hypopneas; and 4) nasal CPAP did not alter the ability of OSA patients to elicit LTF at the thoracic pump muscle. PMID:11717243

  6. Heart rate responses to autonomic challenges in obstructive sleep apnea.

    Directory of Open Access Journals (Sweden)

    Paul M Macey

    Full Text Available Obstructive sleep apnea (OSA is accompanied by structural alterations and dysfunction in central autonomic regulatory regions, which may impair dynamic and static cardiovascular regulation, and contribute to other syndrome pathologies. Characterizing cardiovascular responses to autonomic challenges may provide insights into central nervous system impairments, including contributions by sex, since structural alterations are enhanced in OSA females over males. The objective was to assess heart rate responses in OSA versus healthy control subjects to autonomic challenges, and, separately, characterize female and male patterns. We studied 94 subjects, including 37 newly-diagnosed, untreated OSA patients (6 female, age mean ± std: 52.1 ± 8.1 years; 31 male aged 54.3 ± 8.4 years, and 57 healthy control subjects (20 female, 50.5 ± 8.1 years; 37 male, 45.6 ± 9.2 years. We measured instantaneous heart rate with pulse oximetry during cold pressor, hand grip, and Valsalva maneuver challenges. All challenges elicited significant heart rate differences between OSA and control groups during and after challenges (repeated measures ANOVA, p<0.05. In post-hoc analyses, OSA females showed greater impairments than OSA males, which included: for cold pressor, lower initial increase (OSA vs. control: 9.5 vs. 7.3 bpm in females, 7.6 vs. 3.7 bpm in males, OSA delay to initial peak (2.5 s females/0.9 s males, slower mid-challenge rate-of-increase (OSA vs. control: -0.11 vs. 0.09 bpm/s in females, 0.03 vs. 0.06 bpm/s in males; for hand grip, lower initial peak (OSA vs. control: 2.6 vs. 4.6 bpm in females, 5.3 vs. 6.0 bpm in males; for Valsalva maneuver, lower Valsalva ratio (OSA vs. control: 1.14 vs. 1.30 in females, 1.29 vs. 1.34 in males, and OSA delay during phase II (0.68 s females/1.31 s males. Heart rate responses showed lower amplitude, delayed onset, and slower rate changes in OSA patients over healthy controls, and impairments may be more pronounced in

  7. Obstructive sleep apnea screening by integrating snore feature classes

    International Nuclear Information System (INIS)

    Obstructive sleep apnea (OSA) is a serious sleep disorder with high community prevalence. More than 80% of OSA suffers remain undiagnosed. Polysomnography (PSG) is the current reference standard used for OSA diagnosis. It is expensive, inconvenient and demands the extensive involvement of a sleep technologist. At present, a low cost, unattended, convenient OSA screening technique is an urgent requirement. Snoring is always almost associated with OSA and is one of the earliest nocturnal symptoms. With the onset of sleep, the upper airway undergoes both functional and structural changes, leading to spatially and temporally distributed sites conducive to snore sound (SS) generation. The goal of this paper is to investigate the possibility of developing a snore based multi-feature class OSA screening tool by integrating snore features that capture functional, structural, and spatio-temporal dependences of SS. In this paper, we focused our attention to the features in voiced parts of a snore, where quasi-repetitive packets of energy are visible. Individual snore feature classes were then optimized using logistic regression for optimum OSA diagnostic performance. Consequently, all feature classes were integrated and optimized to obtain optimum OSA classification sensitivity and specificity. We also augmented snore features with neck circumference, which is a one-time measurement readily available at no extra cost. The performance of the proposed method was evaluated using snore recordings from 86 subjects (51 males and 35 females). Data from each subject consisted of 6–8 h long sound recordings, made concurrently with routine PSG in a clinical sleep laboratory. Clinical diagnosis supported by standard PSG was used as the reference diagnosis to compare our results against. Our proposed techniques resulted in a sensitivity of 93±9% with specificity 93±9% for females and sensitivity of 92±6% with specificity 93±7% for males at an AHI decision threshold of 15 events

  8. A study on correlation of obstructive sleep apnea-hypopnea syndrome and perihematoma edema of hypertensive cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    高晓刚

    2013-01-01

    Objective To analyse the correlation of obstructive sleep apnea-hypopnea syndrome (OSAHS) and perihematoma edema of hypertensive cerebral hemorrhage.Methods One hundred and forty-four patients with hypertensive cerebral hemorrhage were collected and 78 of

  9. Superfund list adds Pantex

    International Nuclear Information System (INIS)

    While Congress crafts Superfund reauthorization to see that more money is spent on cleanups instead of legal fees, the U.S. Environmental Protection Agency added 24 federal facilities to the National Priorities List of the worst pollution problems. Three Department of Energy sites were added on May 31, despite objections from state and other officials about how sites were selected. The Pantex nuclear weapon plant in Amarillo, Texas, was included despite protests by state officials, while environmentalists claim that open-quotes political gamesmanshipclose quotes kept a Portsmouth, Ohio, uranium enrichment plant off the list. Other DOE sites listed were the Paducah (Kentucky) Gaseous Diffusion Plant and the Laboratory for Energy Related Health Research in Davis, California

  10. Obstructive sleep apnea syndrome with bilateral papilledema and vision loss in a 3-year-old child.

    Science.gov (United States)

    Quinn, Anthony G; Gouws, Pieter; Headland, Sophie; Oades, Patrick; Pople, Ian; Taylor, David; Benton, J Sarah; Buncic, J Raymond; Henderson, John; Fleming, Peter

    2008-04-01

    We describe bilateral papilledema and vision loss in a 3-year-old child with obstructive sleep apnea. Although lumbar puncture initially disclosed a normal opening pressure, cerebrospinal fluid (CSF) pressure monitoring during sleep confirmed intermittent episodes of elevated intracranial pressure corresponding to increased airway resistance. The association of obstructive sleep apnea and raised intracranial pressure is recognized in children with craniosynostosis but has not been reported in its absence. PMID:18289895

  11. TRANSPYLORIC TUBE FEEDING IN VERY LOW BIRTHWEIGHT INFANTS WITH SUSPECTED GASTROESOPHAGEAL REFLUX: IMPACT ON APNEA AND BRADYCARDIA

    OpenAIRE

    Malcolm, WF; Smith, PB; Mears, S.; Goldberg, RN; Cotten, CM

    2009-01-01

    OBJECTIVE Our aim was to assess safety and efficacy of transpyloric tube feeding as a therapeutic option to reduce apnea and bradycardia in hospitalized very low birthweight infants with clinical signs suggestive of gastroesophageal reflux. PATIENTS AND METHODS This was a retrospective single center cohort study of VLBW infants hospitalized from 2001–2004 with signs of GER who received transpyloric enteral tube feedings. Apnea (>10 sec) and bradycardia (

  12. Quality of life impairment in patients of obstructive sleep apnea and its relation with the severity of disease

    OpenAIRE

    Naveen Dutt; Ashok Kumar Janmeja; Prasanta Raghab Mohapatra; Anup Kumar Singh

    2013-01-01

    Background: Several studies have demonstrated considerable impairment of quality of life (QOL) in obstructive sleep apnea (OSA) patients, but its relation with severity of OSA is yet unclear. Study Objectives: To investigate the effects of OSA on the QOL and its association with the disease severity. Design and Setting: Observational, prospective case-control study. Materials and Methods: QOL of 69 OSA patients and 41 healthy controls were assessed using the Calgary sleep apnea quality of lif...

  13. Aromatherapy with Rosa Damascenes in Apnea, Bradycardia and Spo2 of Preterm Infants; a Randomized Clinical Trial

    OpenAIRE

    Saeideh Aghagoli; Amrollah Salimi; Mona Salimi; Zohreh Ghazavi; Maryam Marofi; Abolfazl Mohammadbeigi

    2016-01-01

    Background  Apnea is one of the most common problems in preterm neonates. This study aimed to evaluate the effectiveness of aromatherapy on the reduction of apnea, bradycardia, and Pulse Oximetry (SPO2) in premature infants. Materials and Methods In a clinical trial study, 60 preterm neonates randomly divided in two groups and exposed to aromatherapy with Rosa damascenes distillate or distilled water beside the routine treatment. In experimental group, two drops of 10% Rosa damascenes distill...

  14. Postoperative apnea after inguinal hernia repair in formerly premature infants: impacts of gestational age, postconceptional age and comorbidities

    OpenAIRE

    Özdemir, Tunç; Arıkan, Ahmet

    2013-01-01

    Purpose It is common practice for premature infants undergoing elective inguinal hernia (IH) repair to be hospitalized for postoperative apnea monitoring. This study evaluated the risk of apnea after IH repair with regard to gestational age (GA) and postconceptional age (PCA) in formerly premature infants. Methods Formerly premature infants who had undergone elective IH repair between 01/2000 and 12/2012 were reviewed retrospectively in terms of GA, PCA, body weight, and comorbidities. All po...

  15. STAFF VACANCY LIST

    CERN Multimedia

    Human Resources Division

    2002-01-01

    For economy reasons, it has been decided to stop printing and distributing this list to Staff Members. It can be found on the Web (LIST). Divisional Administrative Officers will receive an updated printed copy on a monthly basis and are asked to display this in a public place in their division. Copies will also be posted on the notice boards of the Administration Building (No. 60) in the glass-fronted cabinet (close to the lifts) and also on the notice board close to the Post Office. A copy will also be given to the Reception (Building No. 33). Human Resources Division Tel. 74606

  16. Correlation between chronic obstructive pulmonary disease and obstructive sleep apnea syndrome in a general population in Iran

    Directory of Open Access Journals (Sweden)

    Babak Amra

    2011-01-01

    Full Text Available Background: The aim of this study was to evaluate epidemiological relationship between chronic obstructive pulmonary disease and sleep apnea syndrome in a sample of Persian population. Methods: As a part of a population-based cross-sectional study, 3900 randomly selected individuals aged 15 years or older were invited to take part in the survey; 3770 individuals (96.6% agreed to fill out the respiratory and sleep questionnaire. Those subjects suspected to have either chronic obstructive pulmonary disease and/or obstructive sleep apnea underwent spirometry and polysomnography test if indicated. Spirometric measurements were performed on 420 invited responders. Polysomnography measurements were performed on 25 of the responders. Results: Prevalence rates for sleep apnea, chronic obstructive pulmonary disease and current asthma were 4.98%, 5.7% and 3.1%, respectively. Logistic regression showed independent associations between sleep apnea and chronic obstructive pulmonary disease. There was no significant independent association between sleep apnea symptoms and current asthma and wheeze ever. Conclusions: These observations indicated relationship between chronic obstructive pulmonary disease and obstructive sleep apnea. These observations indicated the necessity of further studies to explain the possible common pathogenic mechanisms involved in two disease entities.

  17. Development of sleep apnea syndrome screening algorithm by using heart rate variability analysis and support vector machine.

    Science.gov (United States)

    Nakayama, Chikao; Fujiwara, Koichi; Matsuo, Masahiro; Kano, Manabu; Kadotani, Hiroshi

    2015-08-01

    Although sleep apnea syndrome (SAS) is a common sleep disorder, most patients with sleep apnea are undiagnosed and untreated because it is difficult for patients themselves to notice SAS in daily living. Polysomnography (PSG) is a gold standard test for sleep disorder diagnosis, however PSG cannot be performed in many hospitals. This fact motivates us to develop an SAS screening system that can be used easily at home. The autonomic nervous function of a patient changes during apnea. Since changes in the autonomic nervous function affect fluctuation of the R-R interval (RRI) of an electrocardiogram (ECG), called heart rate variability (HRV), SAS can be detected through monitoring HRV. The present work proposes a new HRV-based SAS screening algorithm by utilizing support vector machine (SVM), which is a well-known pattern recognition method. In the proposed algorithm, various HRV features are derived from RRI data in both apnea and normal respiration periods of patients and healthy people, and an apnea/normal respiration (A/N) discriminant model is built from the derived HRV features by SVM. The result of applying the proposed SAS screening algorithm to clinical data demonstrates that it can discriminate patients with sleep apnea and healthy people appropriately. The sensitivity and the specificity of the proposed algorithm were 100% and 86%, respectively. PMID:26738189

  18. Variation of the anal resting pressure induced by postexpiratory apnea effort in patients with constipation

    Directory of Open Access Journals (Sweden)

    Thaís Helena Benetti

    2011-03-01

    Full Text Available CONTEXT: Intestinal constipation - a common symptom among the general population - is more frequent in women. It may be secondary to an improper diet or organic or functional disturbances, such as dyskinesia of the pelvic floor. This is basically characterized by the absence of relaxation or paradoxical contraction of the pelvic floor and anal sphincter during evacuation. OBJECTIVE: To analyze, by manometric data, the anal pressure variation at rest, during evacuation effort by using the Valsalva maneuver and forced post-expiratory apnea in subjects with secondary constipation. METHODS: Twenty-one patients (19 females - 90.4% with a mean age of 47.5 years old (23-72 were studied. The diagnosis was performed using anorectal manometry, with a catheter containing eight channels disposed at the axial axis, measuring the proximal (1 and distal (2 portions of the anal orifice. The elevation of the pressure values in relation to the resting with the evacuation effort was present in all patients. The Agachan score was used for clinical evaluation of constipation. The variables studied were: mean anal pressure of the anal orifice for 20 seconds at rest, the effort of evacuation using Valsalva maneuver and the effort of evacuation during apnea after forced expiration, as well as the area under the curve of the manometric tracing at moments Valsalva and apnea. RESULTS: The analysis of the mean values of the anal pressure variation at rest evidenced difference between proximal and distal channels (P = 0.007, independent of the moment and tendency to differ during moments Valsalva and apnea (P = 0.06. The mean of values of the area under the manometric tracing curve showed differences between moments Valsalva and apnea (P = 0.0008, either at the proximal portion or at the distal portion of the anal orifice. CONCLUSION: The effort of evacuation associated with postexpiratory apnea, when compared with the effort associated with the Valsalva maneuver, provides

  19. Prevalence of Treatment Choices for Snoring and Sleep Apnea in an Australian Population

    Science.gov (United States)

    Marshall, Nathaniel S.; Bartlett, Delwyn J; Matharu, Kabir S; Williams, Anthony; Grunstein, Ronald R

    2007-01-01

    Objectives: To assess the prevalence of treatment and diagnosis of snoring and sleep apnea in the population of New South Wales Australia. Methods: Postal survey of 10,000 people randomly selected from the electoral roll, half aged 18 to 24 and half aged 25 to 64, with telephone follow-up for some nonresponders. Weighted prevalences are reported. Results The overall response rate was 35.6% (18–24 n = 1421 and 25–64 n = 1879). One hundred and fifty-nine respondents reported seeking medical help for snoring or sleep apnea (6.3%, 95% confidence interval 5.46–7.12%), with 133 of these being aged 25 to 64. Fifty-one respondents reported subsequent treatment (2.0%; 95% CI 1.49–2.43), with some reporting more than 1 treatment. Continuous positive airway pressure was received in 17 cases, mandibular advancement splints in 9 cases, and upper airway or nasal surgery in 31 cases. Eighty-six reported receiving an overnight sleep study (polysomnography). Most surgical patients did not report having their sleep measured with a sleep study (22/31). Conclusions: The population of New South Wales has had the longest potential exposure to continuous positive airway pressure. However, few of those in even the middle-aged group reported ever being recommended continuous positive airway pressure treatment. It is more common to have a surgical intervention for snoring or sleep apnea. Surprisingly, most surgical patients do not report any associated sleep study to quantify their snoring or sleep apnea or measure the efficacy of surgery. Since a substantial proportion of patients who experience snoring and sleep apnea are not assessed via a sleep study, it is necessary to increase awareness of undergoing such clinical procedures. Citation: Marshall NS; Bartlett DJ; Matharu KS; Williams A; Grunstein RR. Prevalence of treatment choices for snoring and sleep apnea in an Australian population. J Clin Sleep Med 2007;3(7):695–699. PMID:18198802

  20. Effect of the definition of hypopnea on apnea/hypopnea index Influencia de la definición de hipopnea sobre el índice apnea/hipopnea

    Directory of Open Access Journals (Sweden)

    C. A. Nigro

    2003-04-01

    Full Text Available The objective of this study was to determine whether different decreases in oxygen saturation (SaO2 or the presence of electroencephalographic arousals (EEGA in the definition of hypopnea modify hypopnea index and apnea/hypopnea index and the prevalence of obstructive sleep apnea/hypopnea syndrome (OSAHS. A total of 20 polysomnographies performed in patients with OSAHS were analyzed. There are four different definitions of hypopnea: > 30% reduction in airflow or 50% decrease in abdominal movement associated with ¯SaO2 > 3% (type 1; ¯ SaO2 > 3% or EEGA (type 2; ¯ SaO2 > 4% (type 3; ¯ SaO2 > 4% or EEGA (type 4. The prevalence of OSAHS was calculated for an apnea/hypopnea index (AHI > 10 and > 15. Hypopnea index (HI and AHI types 2 and 4 were higher than type 3 (HI: type 2: 20±10.6, type 4: 18.6±10, type 3: 11.4±10, p 0.05. The prevalence of OSAHS was 30-55% in type 3, 70-85% in type 4 (p 0.05. In our patient´s population, the presence of EEGA in the definition of hypopnea significantly increased the HI, the AHI and the prevalence of OSAHS when associated with a > 4% decrease in SaO2.El objetivo del estudio fue evaluar si diferentes niveles de descenso de la saturación de O2 (SaO2 o la presencia de micro-despertares electroencefalográficos (MDEEG en la definición de hipopnea, modifican el índice de apnea/hipopnea y la prevalencia del síndrome apnea/hipopnea del sueño (SAHS. Se analizaron 20 polisomnografias de pacientes con SAHS. Hipopnea (H se definió de cuatro formas: descenso del flujo aéreo >30% o caída del 50% del movimiento abdominal asociado a: ¯ SaO2 > 3% (tipo 1 ; ¯ SaO2 > 3% o MDEEG (tipo 2; ¯ SaO2 > 4% (tipo 3; ¯ SaO2 > 4% o MDEEG (tipo 4. La prevalencia del SAHS se calculó para un índice apnea/hipopnea (IAH > 10 y > 15. El índice hipopnea (IH, el IAH tipo 2 y 4 fue mayor respecto al tipo 3 (IH: tipo 2: 20±10.6, tipo 4: 18.6±10, tipo 3: 11.4±10, p 0.05. La prevalencia de SAHS fue del 30-55% con el tipo 3, 70

  1. DEPARTMENT PUBLICATIONS LIST 2001

    OpenAIRE

    Kill, Sharon; Letnes, Louise

    2002-01-01

    This publication is a list of staff papers, extension publications, Economic Development Center bulletins, Center for International Food and Agricultural Policy papers, The Retail Food Industry Center working papers, journal articles, books, chapters, monographs, speeches, and theses published by the University of Minnesota Department of Applied Economics in 2001.

  2. DEPARTMENT PUBLICATIONS LIST 2000

    OpenAIRE

    Letnes, Louise; Kill, Sharon

    2001-01-01

    This publication is a list of staff papers, extension publications, Economic Development Center bulletins, Center for International Food and Agricultural Policy papers, The Retail Food Industry Center working papers, journal articles, books, chapters, monographs, speeches, and theses published by the University of Minnesota Department of Applied Economics in 2000.

  3. DEPARTMENT PUBLICATIONS LIST 1997

    OpenAIRE

    Letnes, Louise; Kill, Sharon

    1998-01-01

    This publication is a list of staff papers, extension publications, Economic Development Center bulletins, Center for International Food and Agricultural Policy papers, The Retail Food Industry Center working papers, journal articles, books, chapters, monographs, speeches, and theses published by the University of Minnesota, Department of Applied Economics in 1997.

  4. DEPARTMENT PUBLICATIONS LIST 1999

    OpenAIRE

    Letnes, Louise; Kill, Sharon

    2000-01-01

    This publication is a list of staff papers, extension publications, Economic Development Center bulletins, Center for International Food and Agricultural Policy papers, The Retail Food Industry Center working papers, journal articles, books, chapters, monographs, speeches, and theses published by the University of Minnesota, Department of Applied Economics in 1999.

  5. DEPARTMENT PUBLICATIONS LIST 2002

    OpenAIRE

    Letnes, Louise; Kill, Sharon

    2003-01-01

    This publication is a list of staff papers, extension publications, Economic Development Center bulletins, Center for International Food and Agricultural Policy papers, The Food Industry Center working papers, journal articles, books, chapters, monographs, speeches, and theses published by the University of Minnesota Department of Applied Economics in 2002.

  6. DEPARTMENT PUBLICATIONS LIST 1998

    OpenAIRE

    Letnes, Louise; Kill, Sharon

    1999-01-01

    This publication is a list of staff papers, extension publications, Economic Development Center bulletins, Center for International Food and Agricultural Policy papers, The Retail Food Industry Center working papers, journal articles, books, chapters, monographs, speeches, and theses published by the University of Minnesota, Department of Applied Economics in 1998.

  7. List of publications 1990

    International Nuclear Information System (INIS)

    AECL Research is engaged in research and development related to the peaceful applications of nuclear energy. Specifically, the company's mission is to perform the research, development, demonstration and marketing required to apply nuclear sciences and their related technologies for the maximum benefit of Canada. Among our most important products are scientific reports, publications and conference presentations. This document lists our publications for 1990

  8. The Christmas list

    CERN Multimedia

    James Gillies

    2010-01-01

    List making seems to be among mankind’s favourite activities, particularly as the old year draws to a close and the new one begins. It seems that we all want to know what the top 100 annoying pop songs are, who are the world’s most embarrassing people and what everyone’s been watching on TV. The transition from 2009 to 2010 was no different, but some of the latest batch of lists have a few surprising entries. According to the Global Language Monitor, ‘twitter’ was the top word of 2009. No surprises there, but ‘hadron’ came in at number 8 on the list. ‘King of pop’ was top phrase, according to the same source, but ‘god particle’ came in at number 10. And while ‘Barack Obama’ was the name of the year, ‘Large Hadron Collider’ came in at number four. The Global Language Monitor was not the only organization whose lists included particle physics references. &ls...

  9. Iterative List Decoding

    DEFF Research Database (Denmark)

    Justesen, Jørn; Høholdt, Tom; Hjaltason, Johan

    2005-01-01

    We analyze the relation between iterative decoding and the extended parity check matrix. By considering a modified version of bit flipping, which produces a list of decoded words, we derive several relations between decodable error patterns and the parameters of the code. By developing a tree of...

  10. Getting on the List

    Science.gov (United States)

    ... length of time because there are not enough donor organs for all who need them. The National Waiting ... transplant candidate, you are registered on the national organ transplant waiting list. A living donor may also be identified and evaluated for living ...

  11. QTL list - PGDBj Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods | LSDB Archive [Life Science Database Archive metadata

    Lifescience Database Archive (English)

    Full Text Available PGDBj Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods QTL list Data de...Policy | Contact Us QTL list - PGDBj Registered plant list, Marker list, QTL list, Plant DB link & Genome analysis methods | LSDB Archive ...

  12. Failure Modes

    DEFF Research Database (Denmark)

    Jakobsen, K. P.; Burcharth, H. F.; Ibsen, Lars Bo; Sørensen, John Dalsgaard

    1999-01-01

    The present appendix contains the derivation of ten different limit state equations divided on three different failure modes. Five of the limit state equations can be used independently of the characteristics of the subsoil, whereas the remaining five can be used for either drained or undrained s...

  13. High altitude, continuous positive airway pressure, and obstructive sleep apnea: subjective observations and objective data.

    Science.gov (United States)

    Ginosar, Yehuda; Malhotra, Atul; Schwartz, Eli

    2013-06-01

    We report observations made by one of the authors who ascended to the Thorang La pass (5416 m) in the Nepal Himalaya in October 2010, despite moderate-severe obstructive sleep apnea. We report the first recorded use of nasal CPAP to treat high altitude pulmonary edema (progressively severe dyspnea at rest and severe orthopnea, with tachycardia and tachypnea) that occurred at 4400 meters, when snow and darkness made safe evacuation difficult. We also present objective longitudinal data of the effects of altitude on auto-adjusting CPAP delivered via a portable nasal CPAP device, and on the apnea hypopnea index measured during sleep while using the device. OSA may be a risk factor for the development of high altitude pulmonary edema and we suggest that a nasal CPAP device located in high altitude trekking stations may provide an additional or alternative treatment option for managing high altitude pulmonary edema until evacuation is possible. PMID:23795742

  14. Pulmonary hypertension due to obstructive sleep apnea in a child with Rubinstein-Taybi syndrome

    Directory of Open Access Journals (Sweden)

    Hyung Soon Choi

    2012-06-01

    Full Text Available Rubinstein-Taybi syndrome (RTS is characterized by peculiar facies, mental retardation, broad thumbs, and great toes. Approximately onethird of the affected individuals have a variety of congenital heart diseases. They can also have upper airway obstruction during sleep, due to hypotonia and the anatomy of the oropharynx and airway, which make these patients susceptible to obstructive sleep apnea (OSA. In our case, pulmonary hypertension was caused, successively, by congenital heart defects (a large patent ductus arteriosus and arch hypoplasia and obstructive sleep apnea during early infancy. The congenital heart defects were surgically corrected, but persistent pulmonary hypertension was identified 2 months after the operation. This pulmonary hypertension was due to OSA, and it was relieved by nasal continuous positive airway pressure. This case is the first report of pulmonary hypertension from OSA in a young infant with RTS.

  15. Pulmonary hypertension due to obstructive sleep apnea in a child with Rubinstein-Taybi syndrome.

    Science.gov (United States)

    Choi, Hyung Soon; Yu, Jeong Jin; Kim, Young-Hwue; Ko, Jae-Kon; Park, In-Sook

    2012-06-01

    Rubinstein-Taybi syndrome (RTS) is characterized by peculiar facies, mental retardation, broad thumbs, and great toes. Approximately one-third of the affected individuals have a variety of congenital heart diseases. They can also have upper airway obstruction during sleep, due to hypotonia and the anatomy of the oropharynx and airway, which make these patients susceptible to obstructive sleep apnea (OSA). In our case, pulmonary hypertension was caused, successively, by congenital heart defects (a large patent ductus arteriosus and arch hypoplasia) and obstructive sleep apnea during early infancy. The congenital heart defects were surgically corrected, but persistent pulmonary hypertension was identified 2 months after the operation. This pulmonary hypertension was due to OSA, and it was relieved by nasal continuous positive airway pressure. This case is the first report of pulmonary hypertension from OSA in a young infant with RTS. PMID:22745646

  16. Application of Dual Mask for Postoperative Respiratory Support in Obstructive Sleep Apnea Patient

    Directory of Open Access Journals (Sweden)

    Jahan Porhomayon

    2013-01-01

    Full Text Available In some conditions continuous positive airway pressure (CPAP or bilevel positive airway pressure (BIPAP therapy alone fails to provide satisfactory oxygenation. In these situations oxygen (O2 is often being added to CPAP/BIPAP mask or hose. Central sleep apnea and obstructive sleep apnea (OSA are often present along with other chronic conditions, such as chronic obstructive pulmonary disease (COPD, congestive heart failure, pulmonary fibrosis, neuromuscular disorders, chronic narcotic use, or central hypoventilation syndrome. Any of these conditions may lead to the need for supplemental O2 administration during the titration process. Maximization of comfort, by delivering O2 directly via a nasal cannula through the mask, will provide better oxygenation and ultimately treat the patient with lower CPAP/BIPAP pressure.

  17. Application of dual mask for postoperative respiratory support in obstructive sleep apnea patient.

    Science.gov (United States)

    Porhomayon, Jahan; Zadeii, Gino; Nader, Nader D; Bancroft, George R; Yarahamadi, Alireza

    2013-01-01

    In some conditions continuous positive airway pressure (CPAP) or bilevel positive airway pressure (BIPAP) therapy alone fails to provide satisfactory oxygenation. In these situations oxygen (O2) is often being added to CPAP/BIPAP mask or hose. Central sleep apnea and obstructive sleep apnea (OSA) are often present along with other chronic conditions, such as chronic obstructive pulmonary disease (COPD), congestive heart failure, pulmonary fibrosis, neuromuscular disorders, chronic narcotic use, or central hypoventilation syndrome. Any of these conditions may lead to the need for supplemental O2 administration during the titration process. Maximization of comfort, by delivering O2 directly via a nasal cannula through the mask, will provide better oxygenation and ultimately treat the patient with lower CPAP/BIPAP pressure. PMID:23662212

  18. Management of Obstructive Sleep Apnea in an Edentulous Lower Jaw Patient with a Mandibular Advancement Device

    Directory of Open Access Journals (Sweden)

    Filiz Keyf

    2014-01-01

    Full Text Available Obstructive sleep apnea (OSA is the most common sleep-related breathing disorder with periodic reduction or cessation of airflow during sleep. It is associated with loud snoring, disrupted sleep, and witnessed apneas. Treatment of OSA varies from simple measures such as oral appliances and nasal continuous positive airway pressure (CPAP to surgical procedures like uvulopalatopharyngoplasty and tracheostomy. Oral appliances are a viable nonsurgical treatment alternative in patients with OSA, of which mandibular advancement devices are most common. Edentulism which contributes to the worsening of OSA reduces the number of available therapeutic strategies and is considered a contraindication to oral appliance therapy. This clinical report describes the treatment of a 63-year-old edentulous OSA patient for whom a mandibular advancement device was designed.

  19. [Prevalence of obstructive sleep apnea syndrome in a group of obese workers].

    Science.gov (United States)

    Nicosia, C; Vigna, L; Monsellato, S; Patrini, L; Consonni, D; Bertazzi, P A; Riboldi, L

    2012-01-01

    The Obstructive Sleep Apnea Syndrome (OSAS) is a quite diffused in workers disease, mainly in obese or overweight subjects. This syndrome can cause cardiovascular and cerebral complications and have negative effects on job performances. We evaluated 214 obese/overweight workers referred from different job areas. A diagnosis of OSAS was pre-existent in about 5% of the examined subjects, and clinical elements suggesting suspect of OSAS were present in about 15% of the sample. The risk of development Obstructive Sleep Apnea Syndrome seems to be linear correlated with BMI, neck and waist circumference. We did not find any correlation between OSAS risk and job area. We strongly suggest that health surveillance should include the evaluation of the possible presence of sleep disorders to reduce the risks associated and the negative consequences on job performances. PMID:23405669

  20. Data-Driven Multimodal Sleep Apnea Events Detection : Synchrosquezing Transform Processing and Riemannian Geometry Classification Approaches.

    Science.gov (United States)

    Rutkowski, Tomasz M

    2016-07-01

    A novel multimodal and bio-inspired approach to biomedical signal processing and classification is presented in the paper. This approach allows for an automatic semantic labeling (interpretation) of sleep apnea events based the proposed data-driven biomedical signal processing and classification. The presented signal processing and classification methods have been already successfully applied to real-time unimodal brainwaves (EEG only) decoding in brain-computer interfaces developed by the author. In the current project the very encouraging results are obtained using multimodal biomedical (brainwaves and peripheral physiological) signals in a unified processing approach allowing for the automatic semantic data description. The results thus support a hypothesis of the data-driven and bio-inspired signal processing approach validity for medical data semantic interpretation based on the sleep apnea events machine-learning-related classification. PMID:27194241

  1. Continuous positive airway pressure ameliorated severe pulmonary hypertension associated with obstructive sleep apnea.

    Directory of Open Access Journals (Sweden)

    Ogawa,Aiko

    2006-06-01

    Full Text Available

    A 52-year-old obese woman was admitted to our institution for evaluation of dyspnea and pulmonary hypertension (PH. Polysomnography revealed severe obstructive sleep apnea (OSA with an apnea hypopnea index of 99.8. Treatment with nocturnal continuous positive airway pressure (CPAP resulted in correction of daytime hypoxemia, hypercapnia, and near-normalization of pulmonary artery pressure. To our knowledge, this is the most severe case of OSA-associated PH (approximately70 mmHg reported to date, and it was successfully treated with nocturnal CPAP. This case demonstrates that OSA should be considered and polysomnography performed in all patients with PH, irrespective of severity, and that nocturnal CPAP has therapeutic effects on both OSA and daytime PH.

  2. Diagnostic and therapeutic approach to coexistent chronic obstructive pulmonary disease and obstructive sleep apnea

    Directory of Open Access Journals (Sweden)

    Sanja Jelic

    2008-06-01

    Full Text Available Sanja JelicDivision of Pulmonary, Allergy, and Critical Care Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USAAbstract: The high prevalence of both obstructive sleep apnea (OSA and chronic obstructive pulmonary disease (COPD in Western societies is well documented. However, OSA frequently remains unrecognized and untreated among patients with COPD. Patients with both conditions have a greater risk for fatal and nonfatal cardiovascular events compared with patients with COPD or OSA alone. Efficacious treatment with continuous positive airway pressure reduces the risk of cardiovascular complications in patients with OSA. The aim of the present review is to discuss the diagnostic approach to patients with both conditions and to delineate the benefits of timely ecognition and treatment of OSA in patients with COPD.Keywords: chronic obstructive pulmonary disease, obstructive sleep apnea, continuous positive airway pressure, nocturnal arterial oxyhemoglobin desaturation

  3. Relationships between enuresis and sleep parameters in patients with obstructive sleep apnea syndrome

    Directory of Open Access Journals (Sweden)

    Özlem Abakay

    2013-09-01

    Full Text Available Objective: This study was aimed to investigate the obstructivesleep apnea syndrome (OSAS in patients withenuresis the relationship between polysomnographic parameters.Methods: A total of 67 OSAS patients included. Datataken knowledge were recorded standard form that allpatients with night polysomnographic recordings parametersand the presence of enuresis.Results: The mean age of patients was 45.0 ± 11.7 years.54% of the patients were male and 46% female. Themean apnea-hypopnea index of the patients was 13.07events/h. Frequency of enuresis was found 19%, nocturiafrequency was found to be 55%. Arousal index, periodicleg movement index and oxygen desaturation index werefound different (p<0.05 between enuresis group and nonenuresisgroup.Conclusion: In our study was found to be associated thefrequency of nocturia and enuresis severity of oxygen desaturationin OSAS patients. J Clin Exp Invest 2013; 4(3: 313-317Key words: OSAS, enuresis, polysomnography

  4. Five cases of a Joseph disease family with non-REM sleep apnea and MRI study

    Energy Technology Data Exchange (ETDEWEB)

    Kitamura, Junichi; Tsuruta, Kazuhito; Yamamura, Yoshinori; Kurihara, Teruyuki; Matsukura, Shigeru

    1987-09-01

    Four male and one female patients of a new Joseph disease family in southern Kyushu are presented. This disorder is inherited by autosomal dominant trait. The clinical symptoms are characterized by bulging eyes, ophthalmoplegia, dysarthria, rigospasticity of the lower limbs, marked dystonia and bradykinesia. In our cases, extrapyramidal symptoms were improved by amantadine and L-dopa therapy. CSF homovanilic acid (HVA) was markedly reduced. Muscle biopsy and electromyographic studies revealed neurogenic changes. MRI revealed mild atrophy of frontal lobe and cerebellum, and marked atrophy of brain stem. These findings were consistent with the clinical manifestations. Our case had central type sleep apnea by sleep EEG and polygraphic studies. This is the first report about sleep apnea and MRI of Joseph disease.

  5. Five cases of a Joseph disease family with non-REM sleep apnea and MRI study

    International Nuclear Information System (INIS)

    Four male and one female patients of a new Joseph disease family in southern Kyushu are presented. This disorder is inherited by autosomal dominant trait. The clinical symptoms are characterized by bulging eyes, ophthalmoplegia, dysarthria, rigospasticity of the lower limbs, marked dystonia and bradykinesia. In our cases, extrapyramidal symptoms were improved by amantadine and L-Dopa therapy. CSF homovanilic acid (HVA) was markedly reduced. Muscle biopsy and electromyographic studies revealed neurogenic changes. MRI revealed mild atrophy of frontal lobe and cerebellum, and marked atrophy of brain stem. These findings were consistent with the clinical manifestations. Our case had central type sleep apnea by sleep EEG and polygraphic studies. This is the first report about sleep apnea and MRI of Joseph disease. (author)

  6. Automated detection of sleep apnea from electrocardiogram signals using nonlinear parameters

    International Nuclear Information System (INIS)

    Sleep apnoea is a very common sleep disorder which can cause symptoms such as daytime sleepiness, irritability and poor concentration. To monitor patients with this sleeping disorder we measured the electrical activity of the heart. The resulting electrocardiography (ECG) signals are both non-stationary and nonlinear. Therefore, we used nonlinear parameters such as approximate entropy, fractal dimension, correlation dimension, largest Lyapunov exponent and Hurst exponent to extract physiological information. This information was used to train an artificial neural network (ANN) classifier to categorize ECG signal segments into one of the following groups: apnoea, hypopnoea and normal breathing. ANN classification tests produced an average classification accuracy of 90%; specificity and sensitivity were 100% and 95%, respectively. We have also proposed unique recurrence plots for the normal, hypopnea and apnea classes. Detecting sleep apnea with this level of accuracy can potentially reduce the need of polysomnography (PSG). This brings advantages to patients, because the proposed system is less cumbersome when compared to PSG

  7. Fluoroscopic and computed tomographic features of the pharyngeal airway in obstructive sleep apnea.

    Science.gov (United States)

    Suratt, P M; Dee, P; Atkinson, R L; Armstrong, P; Wilhoit, S C

    1983-04-01

    Because it has been suggested that patients with obstructive sleep apnea have a narrower pharyngeal airway than normal persons, we performed lateral fluoroscopy and computed tomographic (CT) scans of the pharynx in patients with this syndrome. Fluoroscopy in 6 sleeping patients showed that the obstruction always began during inspiration when the soft palate touched the tongue and posterior pharyngeal wall. The CT scans in 9 awake subjects demonstrated that the narrowest section of the airway in patients and in control subjects was the region posterior to the soft palate. The cross-sectional area of this region was significantly narrower in patients than it was in control subjects (p less than 0.001). Because a narrow airway would be more likely to collapse during inspiration than a normal one would (Bernoulli's Principle), we conclude that the narrow airways we observed in awake patients may be an important contributing factor in the pathogenesis of obstructive sleep apnea. PMID:6838055

  8. Whole blood hypoxia-related gene expression reveals novel pathways to obstructive sleep apnea in humans.

    Science.gov (United States)

    Perry, Juliana C; Guindalini, Camila; Bittencourt, Lia; Garbuio, Silverio; Mazzotti, Diego R; Tufik, Sergio

    2013-12-01

    In this study, our goal was to identify the key genes that are associated with obstructive sleep apnea (OSA). Thirty-five volunteers underwent full in-lab polysomnography and, according to the sleep apnea hypopnea index (AHI), were classified into control, mild-to-moderate OSA and severe OSA groups. Severe OSA patients were assigned to participate in a continuous positive airway pressure (CPAP) protocol for 6 months. Blood was collected and the expression of 84 genes analyzed using the RT(2) Profiler™ PCR array. Mild-to-moderate OSA patients demonstrated down-regulation of 2 genes associated with induction of apoptosis, while a total of 13 genes were identified in severe OSA patients. After controlling for body mass index, PRPF40A and PLOD3 gene expressions were strongly and independently associated with AHI scores. This research protocol highlights a number of molecular targets that might help the development of novel therapeutic strategies. PMID:23994550

  9. Apnea-Induced Rapid Eye Movement Sleep Disruption Impairs Human Spatial Navigational Memory

    OpenAIRE

    Varga, Andrew W.; Kishi, Akifumi; Mantua, Janna; Lim, Jason; Koushyk, Viachaslau; Leibert, David P.; Osorio, Ricardo S.; Rapoport, David M.; Ayappa, Indu

    2014-01-01

    Hippocampal electrophysiology and behavioral evidence support a role for sleep in spatial navigational memory, but the role of particular sleep stages is less clear. Although rodent models suggest the importance of rapid eye movement (REM) sleep in spatial navigational memory, a similar role for REM sleep has never been examined in humans. We recruited subjects with severe obstructive sleep apnea (OSA) who were well treated and adherent with continuous positive airway pressure (CPAP). Restric...

  10. Diet, Body Fat Distribution, and Serum Leptin in Young Men with Undiagnosed Obstructive Sleep Apnea Syndrome

    OpenAIRE

    Jones, Emily Taylor

    2008-01-01

    Background and Purpose: Little is known about influences of obstructive sleep apnea syndrome (OSAS) on dietary intake and body composition. The purpose of this study was to evaluate dietary status, body fat distribution and leptin in overweight young men with and without OSAS in comparison to published values for normal weight counterparts. Methods: Groups were comprised of 24 sedentary overweight young men with and without OSAS, who had a body mass index (BMI) greater than 25 kg/m2. Serum ...

  11. Detection of sleep apnea-hypopnea syndrome with ECG derived respiration in Chinese population

    OpenAIRE

    Tong, Guang-Ming; Zhang, Hai-Cheng; Guo, Ji-Hong; Han, Fang

    2014-01-01

    Evaluation of sleep apnea-hypopnea syndrome (SAHS) is mainly based on the polysomnogram (PSG), which is considered as the golden diagnostic criteria. As a novel noninvasive and low cost alternative method to detect SAHS patients, the diagnostic power of ECG-derived respiration (EDR) hasn’t been well determined. In light of this, we tested whether EDR can be utilized as a feasible tool to diagnose SAHS in Chinese patients. Overnight sleep investigation was performed in 120 subjects using polys...

  12. Analysis of cerebral and autonomic response to respiratory events in patients with Sleep Apnea Syndrome

    OpenAIRE

    Milioli, Giulia

    2015-01-01

    The arousal scoring in Obstructive Sleep Apnea Syndrome (OSAS) is important to clarify the impact of the disease on sleep but the currently applied American Academy of Sleep Medicine (AASM) definition may underestimate the subtle alterations of sleep. The aims of the present study were to evaluate the impact of respiratory events on cortical and autonomic arousal response and to quantify the additional value of cyclic alternating pattern (CAP) and pulse wave amplitude (PWA) for a more ac...

  13. Pulmonary hypertension due to obstructive sleep apnea in a child with Rubinstein-Taybi syndrome

    OpenAIRE

    Hyung Soon Choi; Jeong Jin Yu; Young-Hwue Kim; Jae-Kon Ko; In-Sook Park

    2012-01-01

    Rubinstein-Taybi syndrome (RTS) is characterized by peculiar facies, mental retardation, broad thumbs, and great toes. Approximately one-third of the affected individuals have a variety of congenital heart diseases. They can also have upper airway obstruction during sleep, due to hypotonia and the anatomy of the oropharynx and airway, which make these patients susceptible to obstructive sleep apnea (OSA). In our case, pulmonary hypertension was caused, successively, by congenital heart defect...

  14. Patient Perspective on Use of an Interactive Website for Sleep Apnea

    OpenAIRE

    Carl Stepnowsky; Christine Edwards; Tania Zamora; Robert Barker; Zia Agha

    2013-01-01

    Incomplete patient adherence with nasal continuous positive airway pressure (CPAP) limits the effectiveness of treatment and results in suboptimal obstructive sleep apnea (OSA) outcomes. An interactive website specifically designed for patients with OSA was designed and utilized in a randomized clinical trial to test its effect on increasing CPAP adherence. The goal of this paper is to report on CPAP adherence, internet use, privacy concerns and user satisfaction in using the website. The ori...

  15. Cone-beam CT analysis of patients with obstructive sleep apnea compared to normal controls

    OpenAIRE

    Buchanan, Allison; Cohen, Ruben; Looney, Stephen; Kalathingal, Sajitha; De Rossi, Scott

    2016-01-01

    Purpose To evaluate the upper airway dimensions of obstructive sleep apnea (OSA) and control subjects using a cone-beam computed tomography (CBCT) unit commonly applied in clinical practice in order to assess airway dimensions in the same fashion as that routinely employed in a clinical setting. Materials and Methods This was a retrospective analysis utilizing existing CBCT scans to evaluate the dimensions of the upper airway in OSA and control subjects. The CBCT data of sixteen OSA and sixte...

  16. An evaluation of a novel mask in four patients with obstructive sleep apnea and overlap syndromes.

    Science.gov (United States)

    Yarahmadi, Alireza; Nader, Nader D; Zadeii, Gino; Porhomayon, Jahan

    2013-01-01

    We present four cases of adults with obstructive sleep apnea in whom positive airway pressure therapy alone failed to provide adequate oxygenation. We have previously reported the use of dual mask for ventilatory support of a patient postoperatively (Porhomayon et al., 2013). Here, we report an evaluation of the dual mask in four patients with overlap syndromes. Application of dual mask provided adequate oxygenation with lower continuous positive airway pressure (CPAP)/bilevel positive airway pressure (BIPAP) pressure levels. PMID:23970903

  17. An Evaluation of a Novel Mask in Four Patients with Obstructive Sleep Apnea and Overlap Syndromes

    OpenAIRE

    Alireza Yarahmadi; Nader, Nader D; Gino Zadeii; Jahan Porhomayon

    2013-01-01

    We present four cases of adults with obstructive sleep apnea in whom positive airway pressure therapy alone failed to provide adequate oxygenation. We have previously reported the use of dual mask for ventilatory support of a patient postoperatively (Porhomayon et al., 2013). Here, we report an evaluation of the dual mask in four patients with overlap syndromes. Application of dual mask provided adequate oxygenation with lower continuous positive airway pressure (CPAP)/bilevel positive airway...

  18. An Evaluation of a Novel Mask in Four Patients with Obstructive Sleep Apnea and Overlap Syndromes

    Directory of Open Access Journals (Sweden)

    Alireza Yarahmadi

    2013-01-01

    Full Text Available We present four cases of adults with obstructive sleep apnea in whom positive airway pressure therapy alone failed to provide adequate oxygenation. We have previously reported the use of dual mask for ventilatory support of a patient postoperatively (Porhomayon et al., 2013. Here, we report an evaluation of the dual mask in four patients with overlap syndromes. Application of dual mask provided adequate oxygenation with lower continuous positive airway pressure (CPAP/bilevel positive airway pressure (BIPAP pressure levels.

  19. Obstructive sleep apnea syndrome and fatty liver: Association or causal link?

    Institute of Scientific and Technical Information of China (English)

    Mohamed; H; Ahmed; Christopher; D; Byrne

    2010-01-01

    Obstructive sleep apnea (OSA) is a complex disorder that consists of upper airway obstruction, chronic intermittent hypoxia and sleep fragmentation. OSA is well known to be associated with hypoxia, insulin resistance and glucose intolerance, and these factors can occur in the presence or absence of obesity and metabolic syndrome. Although it is well established that insulin resistance, glucose intolerance and obesity occur frequently with non-alcoholic fatty liver disease (NAFLD), it is now becoming apparen...

  20. Obstructive Sleep Apnea, Hypoxia, and Metabolic Syndrome in Psychiatric and Nonpsychiatric Settings

    OpenAIRE

    Yarlagadda, Atmaram; Kaushik, Shaifali; Clayton, Anita H.

    2008-01-01

    Obesity continues to be a serious cause of morbidity and mortality globally and particularly in North America. Primary manifestations of obesity include obstructive sleep apnea (OSA) and depression associated with a decrease in immune defense mechanisms, possibly related to increased cytokine levels. Secondary manisfestations of obesity possibly result from a cascade of events and include insulin resistance/ hyperglycemia, hyperlipidemia, and hypertension—all of which comprise metabolic syndr...

  1. Relationship between obesity with symptoms and findings of obstructive sleep apnea syndrome

    OpenAIRE

    Ünlü, Murat; İriz, Ayşe; Doğan, Berçem Ayçiçek; Dinç, A. Seçil Kayalı; Dursun, Engin; Eryılmaz, Adil; Acar, Aydın

    2014-01-01

    Objective: To evaluate the effect of obesity on obstructive sleep apnea syndrome (OSAS) by means of objective and subjective data. Methods: A total of 70 patients were divided into obese (n=38; BMI>35 kg/m2) and non-obese patient groups (n=32; BMI Results: Obese patients had an average Mallampati score of Class III while the non-obese study participants had...

  2. Rapid Resolution of Intense Suicidal Ideation after Treatment of Severe Obstructive Sleep Apnea

    OpenAIRE

    Krahn, Lois E.; Miller, Bernard W.; Bergstrom, Larry R.

    2008-01-01

    Patients with insomnia may develop suicidal ideation; however, we know of no reports of suicidal ideation associated with obstructive sleep apnea. We report on a 74-year-old man who presented to his primary care physician with excessive daytime sleepiness, poor quality nocturnal sleep, depressed mood, and suicidal ideation with active suicide plans. An emergency outpatient psychiatry consultation was arranged. The patient declined psychiatric hospitalization. He agreed to a trial of continuou...

  3. Normal-tension glaucoma and obstructive sleep apnea syndrome: a prospective study

    OpenAIRE

    Bilgin, Gorkem

    2014-01-01

    Background Today, identified risk factors for normal-tension glaucoma (NTG) include abnormal ocular blood flow, abnormal blood coagulation, systemic hypotension, ischemic vascular disorders, and autoimmune diseases. However, pathogenesis of the condition remains unclear. On the other hand, there are also a few studies suggesting that the obstructive sleep apnea syndrome (OSAS) may compromise optic nerve head perfusion and cause glaucomatous optic neuropathy by creating transient hypoxemia and...

  4. Obstructive sleep apnea is associated with higher healthcare utilization in elderly patients

    OpenAIRE

    Karla Diaz; Paola Faverio; Angela Hospenthal; Marcos I. Restrepo; Amuan, Megan E; Pugh, Mary Jo V.

    2014-01-01

    Background: Obstructive sleep apnea (OSA) is an important cause of morbidity in the elderly population. Limited data are available regarding the healthcare utilization and predisposing conditions related to OSA in the elderly. Our aim was to evaluate the healthcare utilization and the conditions associated with new and chronic diagnosis of OSA in a large cohort of elderly patients in the Veterans Health Administration (VHA). Materials and Methods: This retrospective cohort study used inpa...

  5. Contemporary Insights and Novel Treatment Approaches to Central Sleep Apnea Syndrome in Heart Failure

    OpenAIRE

    Grayburn, Ryan L.; Kaka, Yaquta; Wilson Tang, W. H.

    2014-01-01

    Central sleep apnea (CSA) is a common and under-diagnosed condition commonly associated with Cheyne-Stokes respiration. It is particularly prevalent in the heart failure population affecting up to 40% of all patients with heart failure. The pathophysiology associated with CSA is based on the underlying effects of hypoventilation and hyperventilation, with neurologic dysregulation of respiratory control as the primary defect. However, therapeutic options are limited due to the prevailing perce...

  6. Prevalence of obstructive sleep apnea in Asian adults: a systematic review of the literature

    OpenAIRE

    Mirrakhimov Aibek E; Sooronbaev Talant; Mirrakhimov Erkin M

    2013-01-01

    Abstract Background Obstructive sleep apnea (OSA) is a common disease, affecting approximately 2% of women and 4% of men residing in Western communities. No systematically reviewed data are available about the prevalence of this disease in Asia, the most heavily populated continent. Methods PubMed/Medline, Scopus and Google Scholar were searched for articles published from 1993 to May 2012 that reported the prevalence of OSA diagnosed via sleep monitoring and the prevalence of patients at ris...

  7. Obstructive Sleep Apnea in Pregnancy: Reliability of Prevalence and Prediction Estimates

    OpenAIRE

    Antony, Kathleen M.; Agrawal, Alpna; Arndt, Melanie E.; Murphy, Adrienne M.; Alapat, Philip M.; Guntupalli, Kalpalatha K.; Aagaard, Kjersti M.

    2014-01-01

    Objective We sought to ascertain the validity of two screening scales for obstructive sleep apnea (OSA) in pregnancy and to establish the prevalence of OSA in pregnancy. Study Design In this prospective observational study, two screening scales were administered. Screen positive subjects were referred for diagnostic polysomnography (PSG); if admitted for antepartum care, screen positive subjects underwent a modified study with a type 3 device (T3D). Result 1509 subjects underwent OSA screenin...

  8. High prevalence of obstructive sleep apnea in patients with moderate to severe chronic obstructive pulmonary disease

    OpenAIRE

    Soler, X; Gaio, E.; Powell, FL; Ramsdell, JW; Loredo, JS; Malhotra, A; Ries, AL

    2015-01-01

    Copyright © 2015 by the American Thoracic Society. Rationale: When obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD) coexist in the so-called "overlap" syndrome,a high risk formortalityandmorbidity hasbeenreported.There is controversy about the prevalence of OSA in people affected by COPD. Objectives: The purpose of this study was to investigate objective meaures of sleep-disordered breathing in patients with moderate to severe COPD to test the hypothesis that COP...

  9. Prevalence and Diagnostic Approach to Sleep Apnea in Hemodialysis Patients: A Population Study

    OpenAIRE

    Valentina Forni Ogna; Adam Ogna; Menno Pruijm; Isabelle Bassi; Emilie Zuercher; Georges Halabi; Olivier Phan; Roberto Bullani; Daniel Teta; Thierry Gauthier; Anne Cherpillod; Claudine Mathieu; Alexandra Mihalache; Francoise Cornette; José Haba-Rubio

    2015-01-01

    Background. Previous observations found a high prevalence of obstructive sleep apnea (OSA) in the hemodialysis population, but the best diagnostic approach remains undefined. We assessed OSA prevalence and performance of available screening tools to propose a specific diagnostic algorithm. Methods. 104 patients from 6 Swiss hemodialysis centers underwent polygraphy and completed 3 OSA screening scores: STOP-BANG, Berlin’s Questionnaire, and Adjusted Neck Circumference. The OSA predictors were...

  10. Clinical Features of Obstructive Sleep Apnea That Determine Its High Prevalence in Resistant Hypertension

    OpenAIRE

    Min, Hyun Jin; Cho, Yang-Je; Kim, Chang-Hoon; Kim, Da Hee; Kim, Ha Yan; Choi, Ji In; Lee, Jeung-Gweon; Park, Sungha; Cho, Hyung-ju

    2015-01-01

    Purpose Resistant hypertension (HTN) occurs in 15-20% of treated hypertensive patients, and 70-80% of resistant hypertensive patients have obstructive sleep apnea (OSA). The characteristics of resistant HTN that predispose patients to OSA have not been reported. Therefore, we aimed to determine the clinical, laboratory, and polysomnographic features of resistant HTN that are significantly associated with OSA. Materials and Methods Hypertensive patients (n=475) who underwent portable polysomno...

  11. Prevalence of Primary Open Angle Glaucoma in Obstructive Sleep Apnea Syndrome

    OpenAIRE

    Mohammad Raza Besharati; Masoud Reza Manaviat; Ali Reza Azarpeikan

    2014-01-01

    Background: Obstructive sleep apnea (OSA) is partial or complete recurrent upper airway obstructions during sleep. Reduction in blood flow of the optic nerve head is an important causative factor in glaucoma. The objective of this study is to determine the prevalence of primary open angle glaucoma (POAG) in OSA patients. Materials and Methods: From September 2009 to January 2010 in this descriptive-analytic cross sectional study, 90 cases of patients with OSA referred to Yazd Shah...

  12. High risk for obstructive sleep apnea and other sleep disorders among overweight and obese pregnant women

    OpenAIRE

    Rice, JR; Larrabure-Torrealva, GT; Luque Fernandez, MA; Grande, M; Motta, V.; Barrios, YV; Sanchez, S.; Gelaye, B; Williams, MA

    2015-01-01

    BACKGROUND: Obstructive sleep apnea (OSA), a common and serious disorder in which breathing repeatedly stops during sleep, is associated with excess weight and obesity. Little is known about the co-occurrence of OSA among pregnant women from low and middle-income countries. METHODS: We examined the extent to which maternal pre-pregnancy overweight or obesity status are associated with high risk for OSA, poor sleep quality, and excessive daytime sleepiness in 1032 pregnant women in Lima, Peru....

  13. High risk for obstructive sleep apnea and other sleep disorders among overweight and obese pregnant women

    OpenAIRE

    Rice, Jayne R.; Larrabure-Torrealva, Gloria T.; Fernandez, Miguel Angel Luque; Grande, Mirtha; Motta, Vicky; Barrios, Yasmin V; Sanchez, Sixto; Gelaye, Bizu; Williams, Michelle A.

    2015-01-01

    Background: Obstructive sleep apnea (OSA), a common and serious disorder in which breathing repeatedly stops during sleep, is associated with excess weight and obesity. Little is known about the co-occurrence of OSA among pregnant women from low and middle-income countries. Methods: We examined the extent to which maternal pre-pregnancy overweight or obesity status are associated with high risk for OSA, poor sleep quality, and excessive daytime sleepiness in 1032 pregnant women in Lima, Peru....

  14. Adherence to Continuous Positive Airway Pressure Treatment for Obstructive Sleep Apnea: Implications for Future Interventions

    OpenAIRE

    Weaver, Terri E; Sawyer, Amy M.

    2010-01-01

    Adherence to continuous positive airway pressure (CPAP) treatment for obstructive sleep apnea (OSA) is a critical problem with adherence rates ranging from 30–60%. Poor adherence to CPAP is widely recognized as a significant limiting factor in treating OSA, reducing the overall effectiveness of the treatment and leaving many OSA patients at heightened risk for comorbid conditions, impaired function and quality of life. The extant literature examining adherence to CPAP provides critical insigh...

  15. Assessment of the impact on compliance of a new CPAP system in obstructive sleep apnea

    OpenAIRE

    Wimms, Alison J.; Richards, Glenn N.; Benjafield, Adam V.

    2012-01-01

    Background Despite the efficacy of continuous positive airway pressure (CPAP) for the treatment of obstructive sleep apnea (OSA), compliance with therapy remains suboptimal. The aim of this study was to determine whether the use of S9TM increased compliance in established CPAP users. Methods Subjects with OSA (50) were recruited into the study. When subjects entered the study, 28 days of respective compliance data were downloaded from the patient's usual CPAP device. Subjects trialled the S9 ...

  16. Prevalence and risks of habitual snoring and obstructive sleep apnea symptoms in adult dental patients

    OpenAIRE

    Al-Jewair, Thikriat S; Mohammed A. Nazir; Naif N. Al-Masoud; Nasser D. Alqahtani

    2016-01-01

    Objectives: To determine the prevalence of habitual snoring and risk of obstructive sleep apnea (OSA) among dental patients and investigate factors associated with high-risk OSA. Methods: This cross-sectional study was performed at the Department of Preventive Dental Sciences, College of Dentistry, University of Dammam, Kingdom of Saudi Arabia, between October and December 2014. A total of 200 consecutive female and male dental patients were included in this study. Subjective and objectiv...

  17. Age Differences in the Association of Obstructive Sleep Apnea Risk with Cognition and Quality of Life

    OpenAIRE

    Addison-Brown, Kristin J.; Letter, Abraham J.; Yaggi, Klar; McClure, Leslie A.; Unverzagt, Frederick W.; Howard, Virginia J.; Lichtman, Judith H.; Wadley, Virginia G.

    2013-01-01

    Using a sample of 2925 stroke-free participants drawn from a national population-based study, we examined cross-sectional associations of obstructive sleep apnea risk (OSA) with cognition and quality of life and whether these vary with age, while controlling for demographics and co-morbidities. Included participants from the REasons for Geographic And Racial Differences in Stroke Study were aged 47-93. OSA risk was categorized as high or low based on responses to the Berlin Sleep Questionnair...

  18. A combined neuropsychological and brain imaging study of obstructive sleep apnea.

    OpenAIRE

    Yaouhi, Khalid; Bertran, Françoise; Clochon, Patrice; Mézenge, Florence; Denise, Pierre; Foret, Jean; Eustache, Francis; Desgranges, Béatrice

    2009-01-01

    Patients with obstructive sleep apnea (OSA) show neuropsychological impairments ranging from vigilance decrements, attentional lapses and memory gaps to decreased motor coordination, but their cognitive profile, and the origin of the impairments, remain unclear. We sought to establish the neuropsychological profile of 16 newly diagnosed apneics and to highlight both their morphological and functional brain abnormalities. We used an extensive neuropsychological test battery to investigate atte...

  19. Physiology in Medicine: Obstructive sleep apnea pathogenesis and treatment—considerations beyond airway anatomy

    OpenAIRE

    Dempsey, Jerome A.; Xie, Ailiang; Patz, David S.; Wang, David

    2013-01-01

    We review evidence in support of significant contributions to the pathogenesis of obstructive sleep apnea (OSA) from pathophysiological factors beyond the well-accepted importance of airway anatomy. Emphasis is placed on contributions from neurochemical control of central respiratory motor output through its effects on output stability, upper airway dilator muscle activation, and arousability. In turn, we consider the evidence demonstrating effective treatment of OSA via approaches that addre...

  20. Impact Of Nasal Continuous Positive Airway Pressure On Excessive Daytime Sleepiness In Obstructive Sleep Apnea Patients

    Directory of Open Access Journals (Sweden)

    Geetha Kandasamy

    2013-01-01

    Full Text Available Purpose: To study the impact of nasal continuous positive airway pressure (nCPAP on excessive daytime sleepiness in obstructive sleep apnea patients (OSA. Method: Patient’s data were collected through direct patient interview and polysomnographic reports. Excessive daytime sleepiness (EDS was assessed by using Epworth Sleepiness Scale (ESS at baseline and after six months of nCPAP treatment. Results: This prospective study was conducted from August 2008 to June 2012. A total of 141patients were diagnosed as OSA based on Apnea Hypopnea Index. The study group (n=141 was further categorized based on AHI as Mild, Moderate and Severe. AHI 17.71% (31 had mild OSA (AHI 5-14.9, 33.14% (24 had moderate (AHI 15-29.9 Events/hourand 49.14% (86 were found to have severe OSA (AHI≥30. Evaluation of demographic data revealed that among the 141 patients, 121 were male (85.81% and 20 were female (14.48% and the mean age was 51.82±11.77 years. The mean ESS Score for mild OSA, moderate OSA, and severe obstructive sleep apnea groups were 8.13±1.78, 13.45±3.14, 15.48±5.22 respectively. The ESS score was significantly higher in severe obstructive sleep apnea patients as compared to mild and moderate OSA. ESS scores at baseline were 12.48±3.12 and after nCPAP treatment were 6.42±2.92. Significantly improved after 6 months of nCPAP treatment. Conclusion: Nasal CPAP reduces daytime sleepiness, resulting in an increased daytime activity. Subjective sleepiness was also (Excessive daytime sleepiness significantly improved after 6 months of nCPAP treatment.

  1. Association of Serum Hepcidin Levels with the Presence and Severity of Obstructive Sleep Apnea Syndrome

    OpenAIRE

    Liu, Yu; Yu, Zhengang; Hua, Defeng; Yan CHEN; Zheng, Shiliang; Wang, Leqiang

    2015-01-01

    Background Inflammation is thought to be involved in the pathogenesis of obstructive sleep apnea syndrome (OSAS). Hepcidin, a 25-kD peptide hormone produced by the liver, modulates acute inflammatory responses. This study aimed to determine the association of serum levels of hepcidin with the presence and severity of OSAS. Material/Methods We enrolled 184 patients with OSAS and 110 healthy subjects. Serum levels of hepcidin were evaluated using enzyme-linked immunosorbent assay (ELISA) method...

  2. Mitochondrial DNA mutation screening of male patients with obstructive sleep apnea-hypopnea syndrome

    OpenAIRE

    HUANG Xiao-ying; Li, Hong; XU, XIAO-MEI; Wang, Liang-xing

    2014-01-01

    The aim of the present study was to analyze the differences between the genes of the mitochondrial DNA (mtDNA) displacement loop (D-loop) region and the Cambridge Reference sequence, in order to screen the mutation sites and investigate the correlation between mutations, clinical parameters and complications associated with obstructive sleep apnea-hypopnea syndrome (OSAHS). mtDNA was obtained from male patients with OSAHS in the Zhejiang Province. In total, 60 male patients with OSAHS and 102...

  3. Treatment of Insomnia, Insomnia Symptoms, and Obstructive Sleep Apnea During and After Menopause: Therapeutic Approaches

    OpenAIRE

    Tal, Joshua Z.; Suh, Sooyeon A.; Dowdle, Claire L.; Nowakowski, Sara

    2015-01-01

    Understanding sleep complaints among menopausal women is an emerging area of clinical and research interest. Several recent reviews have focused on mechanisms of menopausal insomnia and symptoms. In this review, we present a discussion on the most relevant and recent publications on the treatment of sleep disorders for menopausal women, with a focus on menopause-related insomnia, insomnia symptoms, and obstructive sleep apnea. We discuss both nonpharmacological and pharmacological treatments,...

  4. The More the Merrier? Working Towards Multidisciplinary Management of Obstructive Sleep Apnea and Comorbid Insomnia

    OpenAIRE

    Ong, Jason C.; Crisostomo, M. Isabel

    2013-01-01

    Obstructive sleep apnea (OSA) is a sleep-related breathing disorder that is associated with negative cardiovascular consequences and adverse events from excessive daytime sleepiness. Insomnia is the inability to initiate or maintain sleep accompanied by daytime dysfunction. OSA and insomnia co-occur at a high rate, and such patients appear to have distinct clinical features of both disorders. Although empirically supported treatments are now available for OSA and insomnia independently, there...

  5. Evaluation of Ocular Surface Health in Patients with Obstructive Sleep Apnea Syndrome

    OpenAIRE

    Emine Esra Karaca; Hanife Tuba Akçam; Feyzahan Uzun

    2016-01-01

    Objectives: To evaluate ocular surface health in obstructive sleep apnea syndrome (OSAS) and to investigate the tendency of these patients toward dry eyes. Materials and Methods: Fifty patients who underwent polysomnography and were diagnosed with OSAS and 50 normal control subjects were compared with respect to ocular surface disease index (OSDI), Schirmer I test and tear film break-up time (TBUT) values. Results: Patients were grouped as mild (n=15, 30%), moderate (n=15, 30%) an...

  6. Serum S100B levels in patients with obstructive sleep apnea syndrome

    OpenAIRE

    Gülfer Öztürk; Zeynep Giniş; Berna Arlı; Şule Bilen; Gönül Erden; Ersin Kasım Ulusoy; Cevdet Züngün

    2012-01-01

    Objectives: Obstructive sleep apnea syndrome (OSAS)which is characterized by recurrent pharyngeal narrowingand breathing disturbances, can affect central neuralsystem (CNS). S100B, which exerts neurotrophic andgliotrophic features, is a calcium binding protein. The aimof this study was to evaluate serum levels of S100B inpatients with OSAS.Materials and methods: Clinical and laboratory assessmentwere performed in 26 patients (5 women and 21men) with OSAS and 28 (8 women and 20 men) age-,body ...

  7. Serum S100B levels in patients with obstructive sleep apnea syndrome

    OpenAIRE

    Öztürk, Gülfer; Giniş, Zeynep; Arlı, Berna; Bilen, Şule; ERDEN, GÖNÜL; Ulusoy, Ersin Kasım; Züngün, Cevdet

    2012-01-01

    Objectives: Obstructive sleep apnea syndrome (OSAS) which is characterized by recurrent pharyngeal narrowing and breathing disturbances, can affect central neural system (CNS). S100B, which exerts neurotrophic and gliotrophic features, is a calcium binding protein. The aim of this study was to evaluate serum levels of S100B in patients with OSAS. Materials and methods: Clinical and laboratory assessment were performed in 26 patients (5 women and 21 men) with OSAS and 28 (8 women and 20 me...

  8. Polymorphisms in nitric oxide synthase and endothelin genes among children with obstructive sleep apnea

    OpenAIRE

    Chatsuriyawong, Siriporn; Gozal, David; Kheirandish-Gozal, Leila; Bhattacharjee, Rakesh; Khalyfa, Ahamed A.; Wang, Yang; Sukhumsirichart, Wasana; Khalyfa, Abdelnaby

    2013-01-01

    Background Obstructive sleep apnea (OSA) is associated with adverse and interdependent cognitive and cardiovascular consequences. Increasing evidence suggests that nitric oxide synthase (NOS) and endothelin family (EDN) genes underlie mechanistic aspects of OSA-associated morbidities. We aimed to identify single nucleotide polymorphisms (SNPs) in the NOS family (3 isoforms), and EDN family (3 isoforms) to identify potential associations of these SNPs in children with OSA. Methods A pediatric ...

  9. Obstructive Sleep Apnea, Oxidative Stress, and Cardiovascular Disease: Evidence from Human Studies

    OpenAIRE

    Hans-Joachim Eisele; Philipp Markart; Richard Schulz

    2015-01-01

    Obstructive sleep apnea (OSA) is a frequent disease mainly affecting obese people and caused by repetitive collapse of the upper airways during sleep. The increased morbidity and mortality of OSA are mainly thought to be the consequence of its adverse effects on cardiovascular (CV) health. In this context, oxidative stress induced by nocturnal intermittent hypoxia has been identified to play a major role. This is suggested by biomarker studies in OSA patients showing excessively generated rea...

  10. Sleep Perception in Obstructive Sleep Apnea: A Study Using Polysomnography and the Multiple Sleep Latency Test

    OpenAIRE

    Nam, Hyunwoo; Lim, Jae-Sung; Kim, Jun-Soon; Lee, Keon-Joo; Koo, Dae Lim; Lee, Chulhee

    2016-01-01

    Background and Purpose Discrepancies between objectively measured sleep and subjective sleep perception in patients with insomnia have been reported. However, few studies have investigated sleep-state misperception in patients with obstructive sleep apnea (OSA). We designed this study to 1) delineate the factors that could affect this discrepancy and 2) infer an underlying mechanism in patients with OSA. Methods We recruited patients who visited our sleep clinic for the evaluation of their sn...

  11. More severe hypoxemia is associated with better subjective sleep quality in obstructive sleep apnea

    OpenAIRE

    Wu, Meng-Ni; Lai, Chiou-Lian; Liu, Ching-Kuan; Liou, Li-Min; Yen, Chen-Wen; Chen, Sharon Chia-Ju; Hsieh, Cheng-Fang; Hsieh, Sun-Wung; Lin, Feng-Cheng; Hsu, Chung-Yao

    2015-01-01

    Background Perceived sleep quality may play an important role in diagnosis and therapy for obstructive sleep apnea (OSA). However, few studies have assessed factors that are associated with perceived sleep quality in OSA patients. Hypoxemia depresses the central nervous system and attenuates the perceived respiratory load in asthmatic patients. This study aimed to investigate the factors related to perceived sleep quality, focusing on the role of hypoxemia. Methods Polysomnography studies of ...

  12. Relationship between the quality of life and the severity of obstructive sleep apnea syndrome

    Directory of Open Access Journals (Sweden)

    C. Lopes

    2008-10-01

    Full Text Available The effects of sleep disorders on the quality of life (QOL have been documented in the literature. Excessive sleepiness and altered circadian rhythms may negatively affect ability to learn, employment, and interpersonal relations, and directly degrade QOL. The objective of the present study was to evaluate the impact of obstructive sleep apnea syndrome of varying severity on QOL. The study was conducted on 1892 patients aged 18 years or older referred by a physician to the Sleep Institute, São Paulo, with complaints related to apnea (snoring, excessive daytime sleepiness, hyperarousal, and fatigue. They were submitted to overnight polysomnography for the diagnosis of sleep disorders from August 2005 through April 2006. The patients completed the Epworth Sleepiness Scale and QOL SF-36 sleep questionnaires. They were classified as non-physically active and physically active and not-sleepy and sleepy and the results of polysomnography were analyzed on the basis of the apnea hypopnea index (AHI. The apneic subjects showed a reduction in QOL which was proportional to severity. There was a significant decrease in all domains (physical functioning, role physical problems, bodily pain, general health perceptions, vitality, social functioning, emotional problems, general mental health for apneics with AHI >30, who generally were sleepy and did not participate in physical activities (P < 0.05. The present study provides evidence that the impact of sleep disorders on QOL in apneics is not limited to excessive daytime sleepiness and that physical activity can contribute to reducing the symptoms. Thus, exercise should be considered as an adjunct interventional strategy in the management of obstructive sleep apnea syndrome.

  13. Relationship between obstructive sleep apnea and 30-day mortality among patients with pulmonary embolism

    OpenAIRE

    Farzin Ghiasi; Amin Ahmadpoor; Babak Amra

    2015-01-01

    Background: Pulmonary embolism (PE) is the most life-threatening form of venous thrombosis which causes the majority of mortalities in this category. Obstructive sleep apnea (OSA) has been indicated as one of the risk factors for thromboembolism because of hemostatic alterations. The present study was designed to seek for the relationship between OSA and 30-day mortality of patients with PE. Materials and Methods: This prospective cohort study was conducted among 137 consecutive patients refe...

  14. Obstructive sleep apnea syndrome in children: Epidemiology, pathophysiology, diagnosis and sequelae

    OpenAIRE

    Chang, Sun Jung; Chae, Kyu Young

    2010-01-01

    The prevalence of pediatric obstructive sleep apnea syndrome (OSAS) is approximately 3% in children. Adenotonsillar hypertrophy is the most common cause of OSAS in children, and obesity, hypotonic neuromuscular diseases, and craniofacial anomalies are other major risk factors. Snoring is the most common presenting complaint in children with OSAS, but the clinical presentation varies according to age. Agitated sleep with frequent postural changes, excessive sweating, or abnormal sleep position...

  15. Time-on-task decrements in "steer clear" performance of patients with sleep apnea and narcolepsy

    Science.gov (United States)

    Findley, L. J.; Suratt, P. M.; Dinges, D. F.

    1999-01-01

    Loss of attention with time-on-task reflects the increasing instability of the waking state during performance in experimentally induced sleepiness. To determine whether patients with disorders of excessive sleepiness also displayed time-on-task decrements indicative of wake state instability, visual sustained attention performance on "Steer Clear," a computerized simple RT driving simulation task, was compared among 31 patients with untreated sleep apnea, 16 patients with narcolepsy, and 14 healthy control subjects. Vigilance decrement functions were generated by analyzing the number of collisions in each of six four-minute periods of Steer Clear task performance in a mixed-model analysis of variance and linear regression equations. As expected, patients had more Steer Clear collisions than control subjects (p=0.006). However, the inter-subject variability in errors among the narcoleptic patients was four-fold that of the apnea patients, and 100-fold that of the controls volunteers; the variance in errors among untreated apnea patients was 27-times that of controls. The results of transformed collision data revealed main effects for group (p=0.006), time-on-task (p=0.001), and a significant interaction (p=0.022). Control subjects showed no clear evidence of increasing collision errors with time-on-task (adjusted R2=0.22), while apnea patients showed a trend toward vigilance decrement (adjusted R2=0.42, p=0.097), and narcolepsy patients evidenced a robust linear vigilance decrement (adjusted R2=0.87, p=0.004). The association of disorders of excessive somnolence with escalating time-on-task decrements makes it imperative that when assessment of neurobehavioral performance is conducted in patients, it involves task durations and analyses that will evaluate the underlying vulnerability of potentially sleepy patients to decrements over time in tasks that require sustained attention and timely responses, both of which are key components in safe driving performance.

  16. Management of obstructive sleep apnea in edentulous patients: an overview of the literature

    OpenAIRE

    Heidsieck, David S. P.; de Ruiter, Maurits H. T.; Lange, Jan

    2015-01-01

    Purpose A high prevalence of obstructive sleep apnea (OSA) is seen in edentulous individuals. Treatment options for edentulous OSA patients however are limited with continuous positive airway pressure therapy (CPAP) remaining the current therapy of choice. As CPAP is associated with high non-adherence rates and oral appliance therapy requiring sufficient dentition, there is a clinical need for effective treatment strategies aimed at edentulous OSA patients. The purpose of this study was to pr...

  17. A Whole-Genome Scan for Obstructive Sleep Apnea and Obesity

    OpenAIRE

    Palmer, Lyle J; Buxbaum, Sarah G.; Larkin, Emma; Patel, Sanjay R; Elston, Robert C.; Tishler, Peter V.; Redline, Susan

    2002-01-01

    Obstructive sleep apnea (OSA) is a common, chronic, complex disease associated with serious cardiovascular and neuropsychological sequelae and with substantial social and economic costs. Along with male gender, obesity is the most characteristic feature of OSA in adults. To identify susceptibility loci for OSA, we undertook a 9-cM genome scan in 66 white pedigrees (n=349 subjects) ascertained on the basis of either an affected individual with laboratory-confirmed OSA or a proband who was a ne...

  18. A Nomogram for Predicting the Likelihood of Obstructive Sleep Apnea to Reduce the Unnecessary Polysomnography Examinations

    OpenAIRE

    Miao Luo; Hai-Yan Zheng; Ying Zhang; Yuan Feng; Dan-Qing Li; Xiao-Lin Li; Jian-Fang Han; Tao-Ping Li

    2015-01-01

    Background: The currently available polysomnography (PSG) equipments and operating personnel are facing increasing pressure, such situation may result in the problem that a large number of obstructive sleep apnea (OSA) patients cannot receive timely diagnosis and treatment, we sought to develop a nomogram quantifying the risk of OSA for a better decision of using PSG, based on the clinical syndromes and the demographic and anthropometric characteristics. Methods: The nomogram was constructed ...

  19. New Approaches to Positive Airway Pressure Treatment in Obstructive Sleep Apnea.

    Science.gov (United States)

    Kuźniar, Tomasz J

    2016-06-01

    Continuous positive airway pressure (CPAP) is a mainstay of therapy in patients with obstructive sleep apnea (OSA). This technology has gone through tremendous changes that resulted in devices that can recognize and differentiate sleep-disordered breathing events, adjust their output to these events, monitor usage, and communicate with the treatment team. This article discusses recent developments in treatment of OSA with PAP. PMID:27236053

  20. Wait Times for Sleep Apnea Care in Ontario: A Multidisciplinary Assessment

    OpenAIRE

    Rotenberg, Brian W; George, Charles F.; Sullivan, Kevin M; Eric Wong

    2010-01-01

    BACKGROUND: Obstructive sleep apnea (OSA) is a highly prevalent disorder that is associated with significant patient morbidity and societal burden. In general, wait times for health care in Ontario are believed to be lengthy; however, many diseases lack specific corroborative wait time data.OBJECTIVE: To characterize wait times for OSA care in Ontario.METHODS: Cross-sectional survey. A survey tool was designed and validated to question physicians involved in OSA care about the length of the w...

  1. Effect of Treatment of Obstructive Sleep Apnea on Depressive Symptoms: Systematic Review and Meta-Analysis

    OpenAIRE

    Marcus Povitz; Bolo, Carmelle E.; Heitman, Steven J; Willis H Tsai; JianLi Wang; James, Matthew T.

    2014-01-01

    Editors' Summary Background Obstructive sleep apnea (OSA) is a sleep-related breathing disorder that is particularly common among middle-aged and elderly people, although most are unaware that they have the condition. It is characterized by the occurrence of numerous brief (ten seconds or so) breathing interruptions during sleep. These “apneas” occur when relaxation of the upper airway muscles decreases airflow, which lowers the level of oxygen in the blood. Consequently, affected individuals...

  2. Lack of impact of mild obstructive sleep apnea on sleepiness, mood and quality of life

    Directory of Open Access Journals (Sweden)

    Quan SF

    2014-07-01

    Full Text Available Background and Objectives: Obstructive sleep apnea (OSA is associated with sleepiness, depression and reduced quality of life. However, it is unclear whether mild OSA has these negative impacts. Using data from the Apnea Positive Pressure Long-term Efficacy Study (APPLES, this study determined whether participants with mild OSA had greater sleepiness, more depressive symptoms and poorer quality of life in comparison to those without OSA. Methods: 239 evaluated for participation in APPLES with a baseline apnea hypopnea index (AHI < 15 /hour were assigned to 1 of 2 groups: No OSA (N=40, AHI < 5 /hour or Mild OSA (N=199, 5 to <15 /hour based on their screening polysomnogram. Scores on their Epworth Sleepiness Scale (ESS, Stanford Sleepiness Scale (SSS, Hamilton Rating Scale for Depression (HAM-D, Profile of Mood States (POMS and Sleep Apnea Quality of Life Index (SAQLI were compared between groups. Results: There were no significant differences between the No OSA and Mild OSA groups on any of the 5 measures: ESS (OSA, 9.8 + 3.5 vs Mild OSA, 10.6 + 4.3, p=0.26, SSS,(2.8 + 0.9 vs. 2.9 + 1.0, p=0.52, HAM-D (4.6 + 3.0 vs. 4.9 + 4.7, p=0.27, POMS (33.5 + 22.3 vs. 28.7 + 22.0, p=0.70, SAQLI (4.5 + 0.8 vs. 4.7 + 0.7, p=0.39. Conclusion: Individuals with mild OSA in this cohort do not have worse sleepiness, mood or quality of life in comparison to those without OSA.

  3. Timing Matters: Circadian Rhythm in Sepsis, Obstructive Lung Disease, Obstructive Sleep Apnea, and Cancer.

    Science.gov (United States)

    Truong, Kimberly K; Lam, Michael T; Grandner, Michael A; Sassoon, Catherine S; Malhotra, Atul

    2016-07-01

    Physiological and cellular functions operate in a 24-hour cyclical pattern orchestrated by an endogenous process known as the circadian rhythm. Circadian rhythms represent intrinsic oscillations of biological functions that allow for adaptation to cyclic environmental changes. Key clock genes that affect the persistence and periodicity of circadian rhythms include BMAL1/CLOCK, Period 1, Period 2, and Cryptochrome. Remarkable progress has been made in our understanding of circadian rhythms and their role in common medical conditions. A critical review of the literature supports the association between circadian misalignment and adverse health consequences in sepsis, obstructive lung disease, obstructive sleep apnea, and malignancy. Circadian misalignment plays an important role in these disease processes and can affect disease severity, treatment response, and survivorship. Normal inflammatory response to acute infections, airway resistance, upper airway collapsibility, and mitosis regulation follows a robust circadian pattern. Disruption of normal circadian rhythm at the molecular level affects severity of inflammation in sepsis, contributes to inflammatory responses in obstructive lung diseases, affects apnea length in obstructive sleep apnea, and increases risk for cancer. Chronotherapy is an underused practice of delivering therapy at optimal times to maximize efficacy and minimize toxicity. This approach has been shown to be advantageous in asthma and cancer management. In asthma, appropriate timing of medication administration improves treatment effectiveness. Properly timed chemotherapy may reduce treatment toxicities and maximize efficacy. Future research should focus on circadian rhythm disorders, role of circadian rhythm in other diseases, and modalities to restore and prevent circadian disruption. PMID:27104378

  4. Accurate method for home-based diagnosis of obstructive sleep apnea: a review

    Directory of Open Access Journals (Sweden)

    Hosna Ghandeharioun

    2016-12-01

    Full Text Available Overnight polysomnography is the gold standard for the detection of obstructive sleep apnea-hypopnea syndrome (OSAS. However, it is expensive and needs attending personnel. The study of simplified sleep apnea monitoring is one of the recent trends for sleep medicine research. The proposed clinical prediction rules employ the vital and social statistics, symptoms, craniofacial traits, and obesity-related measures for initial screening of OSAS in an ambulatory setting. However, most of them are partially or completely clinical and not home-based. One disadvantage of this sort of screening methods is their inability to asses OSAS severity. Another approach of initial OSAS screening is a usage of just one or two physiological signals such as electrocardiography (ECG, pulse oximetry, snoring, nasal airflow, or even speech sound. In this study, we aimed to review the different strategies and to compare their performances, reported by means of their sensitivity–specificity and accuracy for OSAS incidence and severity. OSAS severity is determined by apnea-hypopnea index (AHI value. Based on the data obtained from the related articles, the most accurate methods of AHI estimation exploit ECG and pulse oximetry signals.

  5. Toward numerical simulations of fluid-structure interactions for investigation of obstructive sleep apnea

    Science.gov (United States)

    Huang, Chien-Jung; Huang, Shao-Ching; White, Susan M.; Mallya, Sanjay M.; Eldredge, Jeff D.

    2016-04-01

    Obstructive sleep apnea (OSA) is a medical condition characterized by repetitive partial or complete occlusion of the airway during sleep. The soft tissues in the airway of OSA patients are prone to collapse under the low-pressure loads incurred during breathing. This paper describes efforts toward the development of a numerical tool for simulation of air-tissue interactions in the upper airway of patients with sleep apnea. A procedure by which patient-specific airway geometries are segmented and processed from dental cone-beam CT scans into signed distance fields is presented. A sharp-interface embedded boundary method based on the signed distance field is used on Cartesian grids for resolving the airflow in the airway geometries. For simulation of structure mechanics with large expected displacements, a cut-cell finite element method with nonlinear Green strains is used. The fluid and structure solvers are strongly coupled with a partitioned iterative algorithm. Preliminary results are shown for flow simulation inside the three-dimensional rigid upper airway of patients with obstructive sleep apnea. Two validation cases for the fluid-structure coupling problem are also presented.

  6. The Tongue Muscle Training (ZMT® in nCPAP Patients with Obstructive Sleep Apnea Syndrome (OSAS

    Directory of Open Access Journals (Sweden)

    Gessmann H.-W.

    2013-06-01

    Full Text Available Obstructive Sleep Apnea Syndrome is treated not only with the help of nCPAP but by other means which help to support the sufficient level of pharyngeal airways. In course of our experiment we investigated changes in parameters of breath during night sleep in patients with high indices of obstructive Sleep Apnea Syndrome after the tongue muscle training. 40 patients with OSAS treated only with the help of nCPAP underwent a 5-week course of electrical stimulation of upper pharyngeal muscles. This type of treatment was supposed to result in dilatation of pharyngeal airways and cure of occlusion and obstruction. Parameters of breath during the night sleep before- and after the treatment were detected with the help of somno-poligraphic investigations and compared. Indices of apnea and hypopnea decreased in 26 of 40 patients, which is more than half of the probands. We recommended the patients with a diagnosed OSAS without a risk of recurrence to add tongue muscle training to nCPAP. In case the course of nCPAP therapy is launched it helped achieve sufficient improvement of parameters affecting breath during the night sleep and in many cases decrease respiratory pressure of nCPAP therapy or its complete cessation.

  7. Impediment in upper airway stabilizing forces assessed by phrenic nerve stimulation in sleep apnea patients

    Directory of Open Access Journals (Sweden)

    Vérin E

    2005-09-01

    Full Text Available Abstract Background The forces developed during inspiration play a key role in determining upper airway stability and the occurrence of nocturnal breathing disorders. Phrenic nerve stimulation applied during wakefulness is a unique tool to assess Upper airway dynamic properties and to measure the overall mechanical effects of the inspiratory process on UA stability. Objectives To compare the flow/pressure responses to inspiratory and expiratory twitches between sleep apnea subjects and normal subjects. Methods Inspiratory and expiratory twitches using magnetic nerve stimulation completed in eleven untreated sleep apnea subjects and ten normal subjects. Results In both groups, higher flow and pressure were reached during inspiratory twitches. The two groups showed no differences in expiratory twitch parameters. During inspiration, the pressure at which flow-limitation occurred was more negative in normals than in apneic subjects, but not reaching significance (p = 0.07. The relationship between pharyngeal pressure and flow adequately fitted with a polynomial regression model providing a measurement of upper airway critical pressure during twitch. This pressure significantly decreased in normals from expiratory to inspiratory twitches (-11.1 ± 1.6 and -15.7 ± 1.0 cm H2O respectively, 95% CI 1.6–7.6, p Conclusion Inspiratory-related upper airway dilating forces are impeded in sleep apnea patients.

  8. Assessment of the sleep parameters in patients with obstructive sleep apnea syndrome with a

    Directory of Open Access Journals (Sweden)

    Özlem Abakay

    2013-06-01

    Full Text Available Objective: In this study, traffic accident with a history ofobstructive sleep apnea syndrome (OSAS in patientswith polysomnographic parameters was investigated.Methods: A total of 77 OSAS patients were included inthe study. All-night polysomnographic recordings obtainedfrom patients with enuresis parameters and thepresence of traffic accidents recorded in standard form.Results: The mean age of patients was 45.15 ± 11.53years. 53% of the patients were male and 47% female.The mean apnea hypopnea index (AHI in patients was13.54 events/h. History of traffic accidents was found in12% patients. Apnea hypopnea index, supine AHI, arousalindex and oxygen desaturation index were found significantlydifferent parameters between history of trafficaccidents group and non-history of traffic accidents group(p <0.05.Conclusion: In this study, patients with OSAS severity ofthe disease with a history of traffic accidents were associatedthe relationship between the parameters. This relationshipwith the severity of the disease might be due tothe negative effects on attention. J Clin Exp Invest 2013;4 (2: 204-207Key words: OSAS, traffic accident, AHI

  9. High risk for obstructive sleep apnea in patients with acute myocardial infarction

    Directory of Open Access Journals (Sweden)

    Carla Renata Silva Andrechuk

    2015-10-01

    Full Text Available Objectives: to stratify the risk for obstructive sleep apnea in patients with acute myocardial infarction, treated at a public, tertiary, teaching hospital of the state of São Paulo, Brazil, and to identify related sociodemographic and clinical factors.Method: cross-sectional analytical study with 113 patients (mean age 59.57 years, 70.8% male. A specific questionnaire was used for the sociodemographic and clinical characterization and the Berlin Questionnaire for the stratification of the risk of obstructive sleep apnea syndrome.Results: the prevalence of high risk was 60.2% and the outcome of clinical worsening during hospitalization was more frequent among these patients. The factors related to high risk were body mass index over 30 kg/m2, arterial hypertension and waist circumference indicative of cardiovascular risk, while older age (60 years and over constituted a protective factor.Conclusion: considering the high prevalence of obstructive sleep apnea and its relation to clinical worsening, it is suggested that nurses should monitor, in their clinical practice, people at high risk for this syndrome, guiding control measures of modifiable factors and aiming to prevent the associated complications, including worsening of cardiovascular diseases.

  10. Radiologic evaluation of adenoids and tonsils in children with obstructive sleep apnea: Plain films and fluoroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Kreplick Fernbach, S.; Brouillette, T.; Riggs, T.W.; Hunt, C.E.

    1983-07-01

    Twenty-six children with obstructive sleep apnea were evaluated by lateral neck radiographs during wakefulness, and by polygraphic monitoring and upper airway fluoreoscopy during natural sleep. Children with craniofacial abnormalities, palatal surgery, and central nervous system disease were excluded from the study. Moderate or marked enlargement of tonsils and adenoids was noted on lateral neck radiographs of 18 of 26 patients. An objective measure of adenoidal enlargement, the adenoidal-nasopharyngeal ratio, correlated well with subjective judgment of adenoidal size but was not generally more useful than subjective estimation. Upper airway fluroescopy demonstrated the site and mechanism of obstruction in all patients. Because all children with moderate to marked adenotonsillar enlargement demonstrated obstruction at the adenoidal or tonsillar level on fluoroscopy, we now screen children with suspected sleep apnea with lateral airway radiographs and polysomnography. Fluoroscopy is reserved for children with mild adenotosillar enlargement, craniofacial dysplasia, prior cleft palate repair, or neuromuscular disorders. These results suggest that the pathogenesis of obstuctive sleep apnea in children involve anatomic factors which narrow the upper airway, sleep-related hypotonia of pharyngeal dilator musculature, and compensatory mechanisms to prevent or alleviate asphyxia.

  11. Radiologic evaluation of adenoids and tonsils in children with obstructive sleep apnea: Plain films and fluoroscopy

    International Nuclear Information System (INIS)

    Twenty-six children with obstructive sleep apnea were evaluated by lateral neck radiographs during wakefulness, and by polygraphic monitoring and upper airway fluoreoscopy during natural sleep. Children with craniofacial abnormalities, palatal surgery, and central nervous system disease were excluded from the study. Moderate or marked enlargement of tonsils and adenoids was noted on lateral neck radiographs of 18 of 26 patients. An objective measure of adenoidal enlargement, the adenoidal-nasopharyngeal ratio, correlated well with subjective judgment of adenoidal size but was not generally more useful than subjective estimation. Upper airway fluroescopy demonstrated the site and mechanism of obstruction in all patients. Because all children with moderate to marked adenotonsillar enlargement demonstrated obstruction at the adenoidal or tonsillar level on fluoroscopy, we now screen children with suspected sleep apnea with lateral airway radiographs and polysomnography. Fluoroscopy is reserved for children with mild adenotosillar enlargement, craniofacial dysplasia, prior cleft palate repair, or neuromuscular disorders. These results suggest that the pathogenesis of obstuctive sleep apnea in children involve anatomic factors which narrow the upper airway, sleep-related hypotonia of pharyngeal dilator musculature, and compensatory mechanisms to prevent or alleviate asphyxia. (orig.)

  12. Upper airway finding on CT scan with and without nasal CPAP in obstructive sleep apnea patients

    Energy Technology Data Exchange (ETDEWEB)

    Akashiba, Tsuneto; Sasaki, Iwao; Kurashina, Keiji; Yoshizawa, Takayuki; Otsuka, Kenzo; Horie, Takashi (Nihon Univ., Tokyo (Japan). School of Medicine)

    1991-04-01

    The area of upper airway (from the nasopharynx to the hypopharynx) was measured by means of computed tomography (CT) scan in 15 confirmed cases of obstructive sleep apnea (OSA) and in 4 normal controls while they were awake. The minimum cross-sectional area (MA) of the upper airway was 14.7+-20.0 mm{sup 2} in OSA patients and 80.0+-33.1 mm{sup 2} in normal controls and the difference was statistically significant (p<0.01). In OSA patients, MA did not correlate with age, body weight, apnea index, desaturation index, mean nadir-SO{sub 2} and lowest SO{sub 2}. MA was also measured with OSA patients while nasal continuous positive airway pressure (NCPAP) of 10 cmH{sub 2}O was applied and it was found that MA was significantly widened when NCPAP therapy was performed. We conclude that upper airway narrowing is consistent finding in OSA patients but the degree of narrowing does not correlate with parameters of apnea and gas exchange during sleep, and NCPAP is effective to widen the area of upper airway in OSA patients. (author).

  13. Relationship between the severity of obstructive sleep apnea syndrome and asymptomatic cerebrovascular disease

    International Nuclear Information System (INIS)

    In this study, examined were prevalence of asymptomatic cerebrovascular disease (ACD) in patients with obstructive sleep apnea syndrome (OSAS) and relationship between its severity and ACD prevalence. Subjects were 192 cases (M 170/F 20, av. age 50.6 y) with chief complaint of snore, sleep apnea (apnea-hypopnea index/AHI 0-118.4/h), midday drowsiness and so on without CD history, who underwent the overnight polysomnographic recording, vascular risk assessment like life habits, blood pressure and impaired GT, and brain MRI. The last item was conducted with Siemence 1.5T machine to get T1-, T2-weighted and FLAIR images to evaluate asymptomatic lacunar infarction (ALI) and periventricular hyperintensity (PVH). Light (AHI<15/h), moderate (15≤AHI<30) and severe (AHI≥30) OSASs were found in 44, 35 and 61 cases, respectively. ALIs were found in 7 light, 17 moderate and 61 severe cases and PVH, in 9, 19 and 61 cases, respectively. Thus it was revealed that patients with moderate to severe OSAS had complication of ACD in a higher rate than those with light OSAS and that prevalence of ACD was higher in OSAS patients with AHI 15/h or more. (R.T.)

  14. Oxygen desaturation during night sleep affects decision-making in patients with obstructive sleep apnea.

    Science.gov (United States)

    Delazer, Margarete; Zamarian, Laura; Frauscher, Birgit; Mitterling, Thomas; Stefani, Ambra; Heidbreder, Anna; Högl, Birgit

    2016-08-01

    This study assessed decision-making and its associations with executive functions and sleep-related factors in patients with obstructive sleep apnea. Thirty patients with untreated obstructive sleep apnea and 20 healthy age- and education-matched controls performed the Iowa Gambling Task, a decision-making task under initial ambiguity, as well as an extensive neuropsychological test battery. Patients, but not controls, also underwent a detailed polysomnographic assessment. Results of group analyses showed that patients performed at the same level of controls on the Iowa Gambling Task. However, the proportion of risky performers was significantly higher in the patient group than in the control group. Decision-making did not correlate with executive functions and subjective ratings of sleepiness, whereas there was a significant positive correlation between advantageous performance on the Iowa Gambling Task and percentage of N2 sleep, minimal oxygen saturation, average oxygen saturation and time spent below 90% oxygen saturation level. Also, the minimal oxygen saturation accounted for 27% of variance in decision-making. In conclusion, this study shows that a subgroup of patients with obstructive sleep apnea may be at risk of disadvantageous decision-making under ambiguity. Among the sleep-related factors, oxygen saturation is a significant predictor of advantageous decision-making. PMID:26899164

  15. Department Publications List 2006

    OpenAIRE

    Letnes, Louise; Kill, Sharon

    2007-01-01

    This publication is a list of staff papers, extension publications, Center for International Food and Agricultural Policy papers, The Food Industry Center working papers, Economic Development Center papers, Center for Farm Financial Management papers, Minnesota Council on Economic Education publications, journal articles, books, chapters, monographs, speeches,web pages, computer software and theses authored by members of the University of Minnesota Department of Applied Economics in 2006.

  16. Department Publications List 2005

    OpenAIRE

    Letnes, Louise; Kill, Sharon

    2006-01-01

    This publication is a list of staff papers, extension publications, Center for International Food and Agricultural Policy papers, The Food Industry Center working papers, Economic Development Center papers, Center for Farm Financial Management papers, Minnesota Council on Economic Education publications, journal articles, books, chapters, monographs, speeches,web pages, computer software and theses authored by members of the University of Minnesota Department of Applied Economics in 2005.

  17. List of HMI reports

    International Nuclear Information System (INIS)

    The Hahn-Meitner-Institute Berlin publishes a series of reports with the results of R+D work of the institute. This list of publications contains also an author index in alphabetical order which points to annual reports of the institute as well as to the reports of the sections of nuclear and radiation physics, nuclear chemistry and reactor, and the section data processing and electronics. With 440 refs

  18. Bases for PUREX deactivation safety equipment list

    International Nuclear Information System (INIS)

    This document provides the basis and justification for changes in classification of equipment listed in WHC-SD-SEL-001 Rev 1, open-quotes PUREX Plant Safety Equipment List.close quotes The reference document will be re-issued as Rev 2 based on the DEACTIVATION mode as evaluated in this document. Systems, components, and structures are evaluated based on consequences of failure on the health and safety of the general public for Safety Class 1, the health and safety of the on-site worker for Safety Class 2, and the health and safety of the facility worker for Safety Class 3. The consequences of a failure on the environment are also addressed in this ranking based on the level of insult. The criteria for the three levels of Safety class equipment are given in Appendix I for ease of reference

  19. Inhibition of central Na+/H+ exchanger type 3 can alleviate sleep apnea in Sprague-Dawley rats

    Institute of Scientific and Technical Information of China (English)

    Wang Qimin; Zhou Rong; Zhang Cheng; Dong Hui; Ma Jing; Wang Guangfa

    2014-01-01

    Background Recent studies showed the central Na+/H+ exchanger type 3 (NHE3) has a close relationship with ventilation control.The objective of the study is to investigate the role of NHE3 in sleep apnea in Sprague-Dawley (SD) rats.Methods A sleep study was performed on 20 male SD rats to analyze the correlation between the sleep apneic events and total NHE3 protein content and inactive NHE3(pS552) in the brainstem measured by Western blotting.Another 20 adult male SD rats received 3 days of sleep and respiration monitoring for 6 hours a day,with adaption on the first day,0.5% DMSO microinjection into the fourth ventricle on the second day,and AVE0657 (specific inhibitor of NHE3) microinjection on the third day.Rats were divided into two groups with injection of 5 μmol/L or 8 μmol/L AVE0657 before the sleep study.The effects of AVE0657 on sleep apnea and sleep structure of rats were analyzed through self-control.Results The total post-sigh apnea index (TPSAI) and post-sigh apnea index in non-rapid eye movement (NREM) sleep (NPSAI) and total apnea index (AI) in NREM sleep (NAI) were negatively correlated with NHE3(pS552) protein contents in the brainstem (r=-0.534,-0.547 and-0.505,respectively,P<0.05).The spontaneous apnea index in REM sleep (RSPAI) was positively correlated with the level of NHE3(pS552) protein expression in the brainstem (r=0.556,P<0.05).However,the sleep AI had no relationship with total NHE3 protein.Compared with the blank control and microinjection of 0.5% DMSO,5 μmol/L AVE0657 significantly reduced the total AI and NPSAI (both P<0.05) without a significant effect on sleep architecture.In contrast to blank control and microinjection of 0.5% DMSO,injection of 8 μmol/L AVE0657 significantly reduced the AI and PSAI in NREM and REM sleep (all P<0.05).Conclusions The severity of sleep apnea was negatively correlated with central inactive NHE3.A specific inhibitor of NHE3 decreased the sleep AI.Thus,our results indicate that central

  20. Automatic classification of apnea/hypopnea events through sleep/wake states and severity of SDB from a pulse oximeter.

    Science.gov (United States)

    Park, Jong-Uk; Lee, Hyo-Ki; Lee, Junghun; Urtnasan, Erdenebayar; Kim, Hojoong; Lee, Kyoung-Joung

    2015-09-01

    This study proposes a method of automatically classifying sleep apnea/hypopnea events based on sleep states and the severity of sleep-disordered breathing (SDB) using photoplethysmogram (PPG) and oxygen saturation (SpO2) signals acquired from a pulse oximeter. The PPG was used to classify sleep state, while the severity of SDB was estimated by detecting events of SpO2 oxygen desaturation. Furthermore, we classified sleep apnea/hypopnea events by applying different categorisations according to the severity of SDB based on a support vector machine. The classification results showed sensitivity performances and positivity predictive values of 74.2% and 87.5% for apnea, 87.5% and 63.4% for hypopnea, and 92.4% and 92.8% for apnea + hypopnea, respectively. These results represent better or comparable outcomes compared to those of previous studies. In addition, our classification method reliably detected sleep apnea/hypopnea events in all patient groups without bias in particular patient groups when our algorithm was applied to a variety of patient groups. Therefore, this method has the potential to diagnose SDB more reliably and conveniently using a pulse oximeter. PMID:26261097