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Obstructive Sleep Apnea

OSA


Presentation

  • However, they did not present a higher prevalence of resistant high blood pressure (RHBP).[ncbi.nlm.nih.gov]
  • RESULTS: 80% of Marfan children presented an AHI 1 and a diagnosis of OSA. MG presented statistically significant lower values of palatal surface area (662.68 mm 2 ; P 3 ; P 2 and 3756.6 mm 3 , respectively).[ncbi.nlm.nih.gov]
  • We present five cases of children with OSA without adenotonsillar hypertrophy who were treated with HFNC. We demonstrated a statistically significant improvement in apnea-hypopnea index and nadir oxygen saturation in this small cohort.[ncbi.nlm.nih.gov]
  • We report the case of a 41-year-old man who presented with bilateral 9th rib fractures and was found to have obstructive sleep apnea and osteoporosis. We also present a literature review on this topic.[ncbi.nlm.nih.gov]
  • This case was presenting with a clinical and biochemical picture indistinguishable from that of pheochromocytoma.[ncbi.nlm.nih.gov]
Fatigue
  • However, the effect on fatigue as major complaint in chronic fatigue patients without excessive daytime sleepiness, is not fully understood nor explored.[ncbi.nlm.nih.gov]
  • 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).[ncbi.nlm.nih.gov]
  • Its effect on nocturnal sleep quality and ensuing daytime fatigue and sleepiness are widely acknowledged.[ncbi.nlm.nih.gov]
  • RSIA requires a railroad to consider the need to include in its fatigue management plan “opportunities for identification, diagnosis, and treatment of any medical condition that may affect alertness or fatigue, including sleep disorders.” ( Id. at section[federalregister.gov]
Coronary Artery Disease
  • It has been associated with hypertension, coronary artery disease, cardiac arrhythmias, sudden cardiac death, and heart failure.[ncbi.nlm.nih.gov]
  • Any diabetes-related complications (retinopathy, neuropathy, nephropathy, or coronary artery disease) were present in 55.5%, and 70.2% of the participants had hypertension.[ncbi.nlm.nih.gov]
  • Stroke and hypertension and coronary artery disease are associated with sleep apnea. Cross-sectional studies indicate an association between OSA and diabetes mellitus.[ncbi.nlm.nih.gov]
  • Coronary artery disease OSA frequently coexists, but is usually being undiagnosed in patients with cardiovascular disease and several cross-sectional studies support a strong association between OSA and prevalent coronary artery disease, defined as myocardial[doi.org]
  • The MEDLINE database from January 1966 to March 2003 was searched using the Medical Subject Headings sleep, sleep apnea, obesity, hypertension, heart failure, cardiac arrhythmia, coronary artery disease, stroke, sympathetic activity, endothelium, inflammation[ncbi.nlm.nih.gov]
Weight Gain
  • Observational studies showed that lack of sleep is correlated with weight gain and an increased risk of obesity; this relationship was confirmed by mutually reinforcing pathophysiological mechanisms.[ncbi.nlm.nih.gov]
  • We report a patient with anti-muscle kinase receptor MG with severe OSA and hypoventilation that resolved upon successful treatment of MG despite a 60-lb weight gain.[ncbi.nlm.nih.gov]
  • gain) Excessive daytime sleepiness[stanfordhealthcare.org]
  • If left untreated, OSA can cause daytime sleepiness, poor sleep quality, high blood pressure, increased blood sugar levels (as in diabetes), heart disease, cerebrovascular disease, depression, memory problems, sexual difficulties, weight gain and headaches[hospitals.jefferson.edu]
Nocturnal Awakening
  • Frequent nocturnal awakening in early life is associated with nonatopic asthma in children. Eur Respir J. 34 , 1288–95 (2009). 19. Shen, T. C. et al .[nature.com]
  • Frequent nocturnal awakening in early life is associated with nonatopic asthma in children. Eur Respir J. 34, 1288–95 (2009). 19. Shen, T. C. et al.[nature.com]
Myxedema
  • Associated conditions include obesity; acromegaly; myxedema; micrognathia; myotonic dystrophy; adenotonsilar dystrophy; and neuromuscular diseases.[icd9data.com]
Sleep Apnea
  • […] to obstuctive sleep apnea Acute respiratory failure from obstuctive sleep apnea Adult obstructive sleep apnea Complex sleep apnea Obstructive sleep apnea Obstructive sleep apnea of adult Obstructive sleep apnea of child Obstructive sleep apnea syndrome[icd9data.com]
  • Before you have surgery, tell your doctor if you have obstructive sleep apnea or symptoms related to obstructive sleep apnea. If you have obstructive sleep apnea symptoms, your doctor may test you for obstructive sleep apnea prior to surgery.[mayoclinic.org]
  • Obstructive Sleep Apnea syndrome was confirmed by polysomnography.[ncbi.nlm.nih.gov]
  • Previous studies have suggested that the obstructive sleep apnea syndrome may be an important risk factor for stroke.[ncbi.nlm.nih.gov]
  • KEYWORDS: Obstructive sleep apnea; aortic dissection; apnea–hypopnea index; risk[ncbi.nlm.nih.gov]
Snoring
  • Eligibility: (1) Patients: controls, snoring or OSA patients (2) Intervention: neuromuscular evaluation of the palate and/or uvula (3) Comparison: differences between controls, snoring and OSA patients (4) Outcomes: neuromuscular outcomes (5) Study design[ncbi.nlm.nih.gov]
  • Snoring alone had no impact on mortality in any of the age groups ( Table 2 ).[doi.org]
  • Be sure to talk to your doctor if you experience loud snoring, especially snoring that's punctuated by periods of silence.[mayoclinic.org]
  • Subjective assessments of clinical symptoms/signs, including snoring visual analog scale (VAS), nasal obstruction, and mouth breathing, were recorded.[ncbi.nlm.nih.gov]
  • Loud snoring is a telltale symptom of OSA. Snoring is caused by air squeezing through the narrowed or blocked airway. Not everyone who snores has sleep apnea though.[nlm.nih.gov]
Loud Snoring
  • OSA related symptoms included loud snoring, apneas, awakenings with gasping breaths, enuresis, and daytime sleepiness.[ncbi.nlm.nih.gov]
  • Simple queries of the patient or bed-partner for the symptoms and signs of the disorder, namely, loud snoring, observed apneas, and daytime sleepiness, would help identify those in need of further diagnostic evaluation.[ncbi.nlm.nih.gov]
  • Loud snoring is a telltale symptom of OSA. Snoring is caused by air squeezing through the narrowed or blocked airway. Not everyone who snores has sleep apnea though.[nlm.nih.gov]
  • Be sure to talk to your doctor if you experience loud snoring, especially snoring that's punctuated by periods of silence.[mayoclinic.org]
Nasal Congestion
  • Chronic nasal congestion. Obstructive sleep apnea occurs twice as often in those who have consistent nasal congestion at night, regardless of the cause. This may be due to narrowed airways. Smoking.[mayoclinic.org]
  • This can be the result of an upper respiratory infection that causes nasal congestion, along with swelling of the throat, or tonsillitis that temporarily produces very enlarged tonsils.[sciencedaily.com]
  • congestion – OSA occurs more often in people with nasal congestion, such as a deviated septum, where the tissue in the nose that divides the two nostrils is bent to one side, or nasal polyps , which may be a result of the airways being narrowed Treating[nhs.uk]
  • congestion – OSA occurs more often in people with nasal congestion, such as a deviated septum, where the tissue in the nose that divides the two nostrils is bent to one side, or nasal polyps, which may be a result of the airways being narrowed Treating[nhs.uk]
  • Have a deviated septum or other nasal congestion issues. Prognosis Prognosis for those who have sleep apnea is positive.[baptisthealth.com]
Mouth Breathing
  • Subjective assessments of clinical symptoms/signs, including snoring visual analog scale (VAS), nasal obstruction, and mouth breathing, were recorded.[ncbi.nlm.nih.gov]
  • Common symptoms of obstructive sleep apnea in children may include: Snoring Daytime cognitive and behavior problems, including problems paying attention, easy distractibility, aggressive behavior and hyperactivity Mouth breathing Enlarged tonsils and[stanfordhealthcare.org]
  • Loud or noisy breathing, snoring, or mouth breathing during sleep Brief pauses in breathing during sleep or difficulty breathing during sleep Restless sleep (i.e., lots of tossing and turning) Sweating heavily during sleep Bedwetting Sleeping in odd positions[my.clevelandclinic.org]
  • Symptoms of Obstructive Sleep Apnea (OSA) are: snoring, restless/disturbed sleep, frequent partial or total wakenings and daytime mouth breathing.[ds-health.com]
  • Snoring, mouth breathing, and obstructive sleep apnea (OSA) often prompt parents to seek medical attention for their children.[aafp.org]
Hypertension
  • Odds ratios for apnoea-hypopnoea index, body mass index, sex, age, and hypertension Fig 1.[doi.org]
  • We aimed to clarify the association between OSA and hypertension, including essential and medication-resistant hypertension. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was followed.[ncbi.nlm.nih.gov]
  • Background: Pericardial effusion in chronic hypoxemic lung diseases, such as Obstructive Sleep Apnea syndrome, usually occurs after the development of severe pulmonary arterial hypertension.[ncbi.nlm.nih.gov]
  • Any diabetes-related complications (retinopathy, neuropathy, nephropathy, or coronary artery disease) were present in 55.5%, and 70.2% of the participants had hypertension.[ncbi.nlm.nih.gov]
  • There is limited data on the relationship between OSA and PLMs with atrial fibrillation and resistant hypertension in stroke and transient ischemic attack (TIA) patients.[ncbi.nlm.nih.gov]
Tachycardia
  • Heart rates often change during apneic episodes, with relative bradycardia occurring during airway obstruction followed by tachycardia during arousals. Specific cranio-facial and oropharyngeal features also predispose a person to develop OSA.[todaysgeriatricmedicine.com]
  • Activation of the sympathetic nervous system, by both hypoxia and arousal, may induce tachycardia and peripheral vasoconstriction, further increasing ventricular afterload (67) .[onlinejacc.org]
  • Obstructive sleep apnea-induced supraventricular tachycardia. J Electrocardiol. 1996;29:65-67. Google Scholar 135. Becker HF, Koehler U, Stammnitz A, Peter JH. Heart block in patients with sleep apnoea. Thorax. 1998;53:S29-S32. Google Scholar 136.[doi.org]
Blurred Vision
  • To report a case of superficial punctate keratopathy (SPK) which coexisted with floppy eyelid syndrome (FES) and presented as intermittent red eye and blurred vision in an 11-year-old boy who slept in the prone position.[ncbi.nlm.nih.gov]
Emotional Lability
  • Childhood sleep apnea differs from adult obstructive sleep apnea in that adults with sleep apnea frequently present with hypersomnia, whereas children often demonstrate short attention spans, emotional lability, and behavioral problems.[emedicine.com]
Headache
  • A 36-year-old active duty male with migraine headaches presented for evaluation of poorly controlled hypertension.[ncbi.nlm.nih.gov]
  • A 64-year-old woman was referred to the department of otolaryngology because of daytime sleepiness and morning headaches. The patient refused polysomnographic evaluation because of claustrophobia.[ncbi.nlm.nih.gov]
  • During last year, the patient was accusing excessive daytime somnolence, breath arrests during sleep, intense snoring, morning headaches, morning oral dryness, pin point chest pain, nocturia (4-5 nocturnal urination), concentration difficulties and an[ncbi.nlm.nih.gov]
  • There was no obvious bone resorption or pain in the temporomandibular region, limited mouth opening (maximum mouth opening: 33.0 mm), myofascial pain or headache, downward rotation of the mandible, or lateral shift of mandibular position evident at 5[ncbi.nlm.nih.gov]
  • If left untreated, OSA can cause daytime sleepiness, poor sleep quality, high blood pressure, increased blood sugar levels (as in diabetes), heart disease, cerebrovascular disease, depression, memory problems, sexual difficulties, weight gain and headaches[hospitals.jefferson.edu]
Irritability
  • Irritability/personality change. Nocturia. Decreased libido. Symptoms such as personality change, episodes of apnoea, irritability and restlessness at night may be better elicited by taking a history from a partner.[patient.info]
  • Ask your doctor about any sleep problem that leaves you chronically fatigued, sleepy and irritable. Excessive daytime drowsiness may be due to other disorders, such as narcolepsy.[mayoclinic.org]
  • Common adverse effects of CPAP and MADs included oral or nasal dryness, irritation, and pain, among others. In cohort studies, there was a consistent association between AHI and all-cause mortality.[ncbi.nlm.nih.gov]
  • OSA can cause children to be tired, irritable or hyperactive during the day and to perform below their potential at school.[childrenshospital.org]
Morning Headache
  • A 64-year-old woman was referred to the department of otolaryngology because of daytime sleepiness and morning headaches. The patient refused polysomnographic evaluation because of claustrophobia.[ncbi.nlm.nih.gov]
  • During last year, the patient was accusing excessive daytime somnolence, breath arrests during sleep, intense snoring, morning headaches, morning oral dryness, pin point chest pain, nocturia (4-5 nocturnal urination), concentration difficulties and an[ncbi.nlm.nih.gov]
  • People with obstructive sleep apnea may also complain of memory problems, morning headaches, mood swings or feelings of depression, and a need to urinate frequently at night (nocturia).[mayoclinic.org]
  • In many cases it leads to debilitating daytime sleepiness, morning headaches, depression, and a general sense of unwellness.[sleepapnea.org]
  • Symptoms include excessive daytime sleepiness, restlessness, snoring, recurrent awakening, and morning headache. Diagnosis is based on sleep history and polysomnography.[msdmanuals.com]
Sleep Disturbance
  • disturbance (difference -2.8, -4.7 to -0.9, P 0.01).[ncbi.nlm.nih.gov]
  • This update focuses on the physiology of sleep disturbances in COPD as well as the clinical implications of OSA in COPD.[ncbi.nlm.nih.gov]
  • In conclusion, didgeridoo playing improved daytime sleepiness in patients with moderate snoring and obstructive sleep apnoea and reduced sleep disturbance in their partners.[doi.org]
  • These are used at night to prevent apnoea, hypoxia and sleep disturbance. The objective was to assess the effects of CPAP in the treatment of obstructive sleep apnoea in adults.[ncbi.nlm.nih.gov]
  • The combination of sleep disturbance and oxygen starvation can result in multiple problems, including automobile accidents, hypertension, heart disease, and mood and memory problems. OSA affects approximately 20 million Americans.[holyname.org]
Somnolence
  • Neither patient exhibited daytime somnolence, although both were subsequently found to have severe obstructive sleep apnea.[ncbi.nlm.nih.gov]
  • Our patient was screened with full polysomnography because of heavy snoring, daytime somnolence and obesity. It revealed severe obstructive sleep apnea syndrome.[ncbi.nlm.nih.gov]
  • A 55-year-old woman who presented to the sleep clinic with severe sleep apnea (OSA) (apnea-hypopnea index [AHI] 62) and excessive somnolence (Epworth Sleepiness Scale score 18/24), was imaged with MRI using the Spatial Modulation of Magnetization tagging[ncbi.nlm.nih.gov]
  • Multilevel TCRFTA treatment of mild to moderate OSAS resulted in prolonged improvement in daytime somnolence, OSAS-related quality of life, psychomotor vigilance, and AHI in this group of subjects at extended follow-up.[ncbi.nlm.nih.gov]
  • The evaluation also included a sleep study for possible obstructive sleep apnea (OSA) because of a history of snoring, apneic episodes, and daytime somnolence. The sleep study confirmed the diagnosis of OSA.[ncbi.nlm.nih.gov]
Sexual Dysfunction
  • Sexual dysfunction severity in aging men is due to modifiable risk factors [ 70 ].[transbiomedicine.com]
  • Obstructive sleep apnea can cause excessive daytime sleepiness, increasing risks of automobile crashes, loss of employment, and sexual dysfunction.[msdmanuals.com]
  • dysfunction Headaches People with central sleep apnea more often report recurrent awakenings or insomnia, although they may also experience a choking or gasping sensation upon awakening.[my.clevelandclinic.org]
  • Since people with sleep apnea tend to be sleep deprived, they may suffer from sleeplessness and a wide range of other symptoms such as difficulty concentrating, depression, irritability, sexual dysfunction, learning and memory difficulties, and falling[sleepfoundation.org]
  • These include: Sensitivity to cold Constipation Dry skin Brittle nails Hair loss Unexplained weight gain High cholesterol Irritability Sexual dysfunction Slow heart rate Irregular uterine bleeding It is important to note that not all of these symptoms[verywell.com]

Workup

  • Side effects of prolonged tongue-lip adhesion and optimal workup and treatment of persistent OSA in the setting of a tongue-lip adhesion. Pierre Robin sequence (PRS), persistent obstructive sleep apnea (OSA), and tongue-lip adhesion (TLA).[ncbi.nlm.nih.gov]
  • The workup included an endocrinological examination, which revealed a moderately elevated urine normetanephrine level, suggesting the possibility of a pheochromocytoma.[ncbi.nlm.nih.gov]
  • The patient underwent a sleep medicine workup, including nocturnal video polysomnography (vPSG). The patient and his wife were unaware of any sleep problems.[ncbi.nlm.nih.gov]
Mediastinal Mass
  • We present a male patient with hypertension, obstructive sleep apnea, and acid-base disorder, in whom further investigation revealed an anterior mediastinal mass and Cushing syndrome.[ncbi.nlm.nih.gov]
Hypercapnia
  • Six months later, severe hypoxemia without hypercapnia was noted. Contrast transthoracic echocardiography showed right-to-left shunt through a patent foramen ovale.[ncbi.nlm.nih.gov]
  • The respiratory pauses may induce hypercapnia or hypoxia. Cardiac arrhythmias and elevation of systemic and pulmonary arterial pressures may occur.[icd9data.com]
  • References: [5] [3] Pathophysiology Obstruction of the upper airways apnea partial pressure of oxygen in arterial blood ( PaO 2 ) , partial pressure of carbon dioxide in arterial blood ( PaCO 2 , also known as hypercapnia ) Hypoxic pulmonary vasoconstriction[amboss.com]
  • Neural responses to hypoxia and hypercapnia have not been well studied in children with obstructive sleep apnea and underlying syndromes.[emedicine.com]
  • Patients with sleep apnea have reduced cerebral blood flow and altered cerebrovascular responses to hypercapnia [ 26, 27 ].[doi.org]

Treatment

  • Several surgical and non-surgical treatment options have been proposed for the treatment of OSAS.[ncbi.nlm.nih.gov]
  • Data obtained during APAP titration can be used to provide a fixed single pressure for subsequent treatment. Alternatively, APAP devices can be used in self-adjusting mode for treatment (APAP treatment).[ncbi.nlm.nih.gov]
  • A series of appointments prepared the patient for the required treatment procedures and desensitized him for use of the final appliance. The final appliance improved outcomes of a post-treatment sleep study, indicating successful treatment of OSA.[ncbi.nlm.nih.gov]
  • No adverse events of treatment with modafinil and intranasal mometasone furoate were reported. Cost of treatment and beneficial effect after discontinuation were both significantly greater for the IMFG compared with the MG.[ncbi.nlm.nih.gov]
  • Controlled study of treatment schemes for RFA suggests additional improvement in outcomes with repeated treatments.[web.archive.org]

Prognosis

  • We discuss the pathophysiology of obstructive sleep apnea, as well as its prevalence, treatment outcomes with continuous positive airway pressure, and prognosis in these 2 distinct types of heart failure.[ncbi.nlm.nih.gov]
  • Therefore, a delayed diagnosis is performed which compromises optimal therapy and hinders the prognosis. We present the case of a 5-year-old boy who was initially diagnosed with obstructive sleep apnea, without reported systemic complaints.[ncbi.nlm.nih.gov]
  • Herein, we describe the history, diagnosis, treatment, and prognosis of a rare case.[ncbi.nlm.nih.gov]
  • Prognosis is good with treatment.[msdmanuals.com]
  • Prognosis Prognosis for those who have sleep apnea is positive. There are treatments that can alleviate symptoms and lead to better sleep, including, dental appliances, therapies and CPAP machines.[baptisthealth.com]

Etiology

  • KEYWORDS: Continuous positive airway pressure/methods; heart diseases/epidemiology/etiology; heart failure/complications/therapy; prevalence; risk factors; sleep apnea syndromes/classification/physiopathology; sleep apnea, obstructive/complications/prevention[ncbi.nlm.nih.gov]
  • The observed group differences provide insight into the relationship between etiology of injury, neuropathological changes, and clinical presentation.[ncbi.nlm.nih.gov]
  • Etiology Obstruction of the upper airways due to the collapse of the pharyngeal muscles during sleep Risk factors Obesity , especially around the neck (short, wide “ bull neck ”) Structural abnormalities that impair respiratory flow : tonsillar hyperplasia[amboss.com]
  • This finding suggests that the etiology of OSA in children may result from a complex interplay between adenotonsillar hypertrophy and loss of neuromuscular tone.[aafp.org]

Epidemiology

  • The primary objective of this article is to review some of the epidemiologic aspects of obstructive sleep apnea in adults. Correspondence and requests for reprints should be addressed to Naresh M.[doi.org]
  • The prevalence of OSA has increased in epidemiological studies over time.[ncbi.nlm.nih.gov]
  • This review focuses on the pathogenesis, epidemiology, main features and diagnosis of the disease, and on its main forms of treatment.[ncbi.nlm.nih.gov]
  • The primary objective of this article is to review some of the epidemiologic aspects of obstructive sleep apnea in adults.[ncbi.nlm.nih.gov]
  • KEYWORDS: Continuous positive airway pressure/methods; heart diseases/epidemiology/etiology; heart failure/complications/therapy; prevalence; risk factors; sleep apnea syndromes/classification/physiopathology; sleep apnea, obstructive/complications/prevention[ncbi.nlm.nih.gov]
Sex distribution
Age distribution

Pathophysiology

  • We believe that this case exemplifies the relevant pathophysiological interdependence between obesity, metabolic syndrome and OSAS.[ncbi.nlm.nih.gov]
  • These findings of immediate benefit of reversal of OSA pathophysiology on cardiac arrhythmia suggest OSA may have acute influences on cardiac electrophysiology.[ncbi.nlm.nih.gov]
  • It highlights the need for further research into the pathophysiology of TAH in immunocompromised children and the effects of G-CSF on Waldeyer's Ring.[ncbi.nlm.nih.gov]
  • We discuss the pathophysiology of obstructive sleep apnea, as well as its prevalence, treatment outcomes with continuous positive airway pressure, and prognosis in these 2 distinct types of heart failure.[ncbi.nlm.nih.gov]
  • There is growing literature on phenotyping pathophysiologic mechanisms of OSA that may be exploited in strategic drug development programs.[ncbi.nlm.nih.gov]

Prevention

  • Mandibular DO using skeletal anchorage with intermaxillary elastics is useful for preventing extrusion of the upper and lower anterior teeth, thereby preventing rotation of the mandible.[ncbi.nlm.nih.gov]
  • "The findings of our small study present an interesting theory on preventative measures or treatment in sleep apnoea,” Silas Daniel Raj, author of the study, said in a statement.[web.archive.org]
  • 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.[ncbi.nlm.nih.gov]
  • For example, the patient's behavior made examining him very difficult and prevented ENT exam. Likewise, OSA was difficult to manage due to the patient's inability to cooperate with treatment.[ncbi.nlm.nih.gov]

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