Klaus-Jürgen Gutleben, Thomas Eitz, Randy Westlund, Jan F Gummert, Philipp Sommer, Henrik Fox
The remedē System is a novel fully implantable transvenous phrenic nerve stimulation (TPNS) device developed to treat central sleep apnea. No information is published how to explant or replace its leads. An 81-year-old had a fractured lead and we removed it over a wire. However, unbreachable resistances occurred with a new lead deployed over the enclosed wire and interventional endovascular techniques were performed to reimplant a new fully functioning system. This first report demonstrates TPNS lead exchange is possible but can be challenging...
August 25, 2020: Journal of Cardiovascular Electrophysiology
Wei-Che Lin, Tun-Wei Hsu, Cheng-Hsien Lu, Hsiu-Ling Chen
OBJECTIVE/BACKGROUND: Obstructive sleep apnea (OSA) patients experience hypoxia and, potentially, autonomic impairments stemming from neural damage. In this study, the executive control networks (ECNs), salience networks (SNs), and default mode networks (DMNs) of adult OSA patients, as well as their relationships with autonomic impairment, were investigated through independent component analysis (ICA). PATIENTS/METHODS: A total of 41 OSA patients and 19 healthy controls volunteers were recruited and subjected to polysomnography to ascertain their degree, if any, of sleep apnea...
June 4, 2020: Sleep Medicine
Daniel Falik, Tatiana Rabinski, Dor Zlotnik, Reut Eshel, Meshi Zorsky, Tali Garin-Shkolnik, Rivka Ofir, Avital Adato, Avraham Ashkenazi, Gad D Vatine
Congenital central hypoventilation syndrome (CCHS) is a rare life-threatening condition affecting the autonomic nervous system that usually presents shortly after birth as hypoventilation or central apnea during sleep. In the majority of cases, heterozygous polyalanine expansion mutations within the third exon of the paired-like homeobox 2B (PHOX2B) gene underlie CCHS. Here, we report the generation of two induced pluripotent stem cell (iPSC) lines from two identical twins with a heterozygous PHOX2B expansion mutation (+5 alanine residues)...
August 14, 2020: Stem Cell Research
Scott Maresh, Joel L Prowting, Sarah Vaughan, Elizabeth Kruppe, Bander Alsabri, Hossein Yarandi, M Safwan Badr, Abdulghani Sankari
Spinal cord injury (SCI) is a risk factor for central sleep apnea (CSA). Previous studies in animal models with SCI have demonstrated a promising recovery in respiratory and phrenic nerve activity post-injury induced by the systemic and local administration of serotonin receptor agonists such as Buspirone and Trazodone. Human trials must be performed to determine if individuals with SCI respond similarly. We hypothesized that Buspirone and Trazodone would decrease the propensity to hypocapnic CSA during sleep...
August 20, 2020: Journal of Applied Physiology
Maria Rosa Costanzo
PURPOSE OF REVIEW: Central sleep apnea occurs in up to 50% of heart failure patients and worsens outcomes. Established therapies are limited by minimal supporting evidence, poor patient adherence, and potentially adverse cardiovascular effects. However, transvenous phrenic nerve stimulation, by contracting the diaphragm, restores normal breathing throughout sleep and has been shown to be safe and effective. This review discusses the mechanisms, screening, diagnosis, and therapeutic approaches to CSA in patients with HF...
August 17, 2020: Current Heart Failure Reports
Maria Tafelmeier, Lili Luft, Elisabeth Zistler, Bernhard Floerchinger, Daniele Camboni, Marcus Creutzenberg, Florian Zeman, Christof Schmid, Lars Siegfried Maier, Stefan Wagner, Michael Arzt
BACKGROUND: Postoperative major pulmonary complications (MPCs) continue to be a leading cause of increased morbidity and mortality after cardiac surgery. Although various risk factors have been identified, reports on the association between sleep-disordered breathing (SDB) and postoperative MPCs remain inconclusive. RESEARCH QUESTION: The objectives of the present study were to determine the incidence of the composite endpoint postoperative MPCs and to identify predictors for postoperative MPCs in patients without SDB, with obstructive sleep apnea (OSA) and with central sleep apnea (CSA) undergoing cardiac surgery...
August 13, 2020: Chest
Anastasios Serbis, Vasileios Giapros, Assimina Galli-Tsinopoulou, Ekaterini Siomou
The concept of metabolic syndrome (MetS) as a cluster of cardiovascular risk factors (obesity, altered glucose metabolism, dyslipidemia, and hypertension) has been around for more than 30 years. It is considered to be the result of complex interactions between centrally located fat, insulin resistance, subclinical inflammation, and other factors in genetically predisposed individuals. MetS diagnosis in adults has been linked to increased risk for cardiovascular disease (CVD) and type 2 diabetes mellitus (T2D)...
August 13, 2020: Metabolic Syndrome and related Disorders
Chen Feng, Huidong Zhang, Yingying Han, Xiaoxue Jin, Feilun Yang, Juanjuan Zou, Yan Wang, Yanzhong Li
Objective: To compare the effect of impulse-radio ultrawideband(IR-UWB) radar technology and polysomnography(PSG) in sleep assessment. Method: A total of 79 OSA patients were randomly divided into two groups: 40 patients in group A received PSG and IR-UWB, and 39 patients in group B received micromovement sensitive mattress(MSM) and IR-UWB. Pearson correlation and ROC curve were used for statistics. Result: AHI PSG and AHI MSM were significantly correlated with AHI IR-UWB( r =0.91, P =0.00; r =0...
July 2020: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
Gian Domenico Pinna, Maria Teresa La Rovere, Elena Robbi, Luigi Tavazzi, Roberto Maestri
It is still not known whether the oscillation in heart rate (HR) induced by sleep-disordered breathing (SDB) in patients with heart failure entails significant chronotropic effects. We hypothesised that since cyclical changes in ventilation and arterial blood gases during SDB affect HR through multiple and complexly interacting mechanisms characterised by large inter-subject variability, chronotropic effects may change from patient to patient. A total of 42 patients with moderate-to-severe chronic heart failure with systolic dysfunction underwent an in-hospital sleep study...
August 13, 2020: Journal of Sleep Research
Olaf Oldenburg, Maria Rosa Costanzo, Robin Germany, Scott McKane, Timothy E Meyer, Henrik Fox
Nocturnal hypoxemic burden is established as a robust prognostic metric of sleep-disordered breathing (SDB) to predict mortality and treating hypoxemic burden may improve prognosis. The aim of this study was to evaluate improvements in nocturnal hypoxemic burden using transvenous phrenic nerve stimulation (TPNS) to treat patients with central sleep apnea (CSA). The remedē System Pivotal Trial population was examined for nocturnal hypoxemic burden. The minutes of sleep with oxygen saturation < 90% significantly improved in Treatment compared with control (p < ...
August 12, 2020: Journal of Cardiovascular Translational Research
Daniel Ignatiuk, Britta Schaer, Brian McGinley
BACKGROUND: Continuous positive airway pressure (CPAP) is the nonsurgical treatment of choice for children with obstructive sleep apnea (OSA). However, CPAP limitations include difficulty with adherence and midface hypoplasia risk. We, therefore, sought to assess the effect of warm humidified air delivered via open nasal cannula (HFNC) on OSA in children in the sleep laboratory and at home. METHODS: A retrospective review was performed among children recommended treatment of OSA with HFNC...
August 12, 2020: Pediatric Pulmonology
Anna E Mullins, Jong W Kim, Keith K H Wong, Delwyn J Bartlett, Andrew Vakulin, Derk-Jan Dijk, Nathaniel S Marshall, Ronald R Grunstein, Angela L D'Rozario
PURPOSE: Using quantitative EEG (qEEG) analysis, we investigated sleep EEG microstructure as correlates of neurobehavioural performance after 24 h of extended wakefulness in untreated OSA. METHODS: Eight male OSA patients underwent overnight polysomnography (PSG) at baseline followed by 40 h awake with repeated performance testing (psychomotor vigilance task [PVT] and AusEd driving simulator). EEG slowing during REM and spindle density during NREM sleep were calculated using power spectral analysis and a spindle detection algorithm at frontal and central electrode sites...
August 9, 2020: Sleep & Breathing
Christopher N Schmickl, Shane A Landry, Jeremy E Orr, Kazuo Chin, Kimihiko Murase, Johan Verbraecken, Shahrokh Javaheri, Bradley A Edwards, Robert L Owens, Atul Malhotra
BACKGROUND: Therapy options for obstructive (OSA) and central (CSA) sleep apnea are limited, thus many patients remain untreated. Clinically acetazolamide is sometimes used for central sleep apnea (CSA), but given overlapping pathophysiology of OSA and CSA, we hypothesized that acetazolamide is equally effective for both types. Prior reviews focused on specific subtypes of sleep apnea, study designs and languages, thus including few studies (typically ≤3) limiting insights. RESEARCH QUESTION: How efficacious is acetazolamide for sleep apnea, and is its effect modified by sleep apnea type or acetazolamide dose? STUDY DESIGN AND METHODS: We queried MEDLINE, EMBASE and ClinicalTrials...
August 5, 2020: Chest
Jan Kloka, Lea Valeska Blum, Florian Piekarski, Kai Zacharowski, Florian J Raimann
BACKGROUND Joubert syndrome is a rare autosomal recessive disorder first described in 1969, with an estimated prevalence of 1 in 100 000. Joubert syndrome is characterized by partial or complete agenesis of the cerebellar vermis - the structure that connects both parts of the cerebellum. This results in the main clinical symptoms, such as muscular hypotonia, ataxia, mental retardation, abnormal eye movements, and a central apnea breathing pattern. Joubert syndrome can combine neurological signs with variable multi-organ involvement, mainly of the retina, kidneys, liver, and musculoskeletal system...
August 7, 2020: American Journal of Case Reports
Fabio Scarinci, Francesca Romana Patacchioli, Cristina Mihaela Ghiciuc, Vittorio Pasquali, Raluca Mihaela Bercea, Sebastian Cozma, Mariacristina Parravano
Obstructive sleep apnea (OSA) and central serous chorioretinopathy (CSC) are in terms of nosography different pathologies, however they share a stress-related physio-pathogenetic component, not yet explored in depth. Therefore, the aim of the present study was to ascertain whether OSA and CSC share a common profile, specifically in cortisol production focusing on the cortisol awake response (CAR), the area under curve (AUCCAR ) and the SLOPECAR compared with healthy matched controls. Furthermore, standardized self-administered questionnaires were used to identify mental health status related to depression, anxiety and subjective stress perception levels in the study populations...
August 3, 2020: Journal of Clinical Medicine
Huan-Jan Lin, Jen-Hao Yeh, Meng-Tsang Hsieh, Chung-Yao Hsu
Obstructive sleep apnea (OSA), prevalent in patients with stroke, increases the risks of cardiovascular events and stroke. This meta-analysis evaluated the effectiveness of continuous positive airway pressure (CPAP) for preventing stroke in patients with OSA. Embase, PubMed, and Cochrane Central database (up to October 2019) were searched for studies that compared stroke risk in patients with OSA receiving CPAP or usual treatment. In total, 13 studies, comprising nine randomized control trials (RCTs) and four cohort studies, were included...
July 15, 2020: Sleep Medicine Reviews
Selahattin Ayas, Gülçin Benbir Şenel, Derya Karadeniz
Arnold Chiari malformation (ACM) is herniation of brain stem structures, especially cerebellar tonsils, from the foramen magnum into the cervical spinal canal. Sleep-related respiratory disorders are reported at a higher rate in this patient group than the general population, at about 60-75%. A 43-year-old male patient was diagnosed with ACM type 1.5 at the center where he applied with complaints of weakness in the extremities, speech disorder and syncope triggered by coughing, and a decompression of posterior fossa (PFD) was applied to the patient...
July 2020: Tüberküloz Ve Toraks
Hamed Amirifard, Khosro Sadeghniiat-Haghighi, Arezu Najafi
Patients with Chiari type I malformation may also present with sleep disordered breathing mainly central sleep apnea. Here, we report a patient with Chiari I malformation referred to our clinic because of snoring and sleep disordered breathing. He was a 28-year-old man referred to us for evaluation of snoring. An overnight polysomnography revealed central sleep apnea. On further evaluation of central sleep apnea, the patient found to have Chiari malformation type I on brain MRI. The patient developed obstructive sleep apnea after surgery for Chiari malformation...
April 2020: Sleep Science
Alvaro Emilio Ortiz-Naretto, Miriam Patricia Pereiro, Glenda Ernst, Juan Manuel Aramburo, Ana María Tovo, Andres Vázquez-Fernández, Eduardo Borsini
Objective: to compare mountaineers with and without asymptomatic sleep apnea (OSA) before the ascent and to study high altitude-related sleep disorders, its interaction with metabolic, neuroendocrine and immunological components. Material and Methods: During an expedition to Mount Aconcagua, researchers assessed the respiratory polygraphy (RP), clinical condition and inflammatory parameters, and rhythm of cortisol secretion in mountaineers sleeping at different altitude camps...
April 2020: Sleep Science
Rui-Ni Wu, Wei-Chen Hung, Ching-Tsuey Chen, Li-Ping Tsai, Wen-Sung Lai, Ming-Yuan Min, Shi-Bing Wong
BACKGROUND: Prader-Willi syndrome (PWS) is a neurodevelopmental disorder characterized by multiple respiratory, cognitive, endocrine, and behavioral symptoms, such as central apnea, intellectual disabilities, exaggerated stress responses, and temper tantrums. The locus coeruleus noradrenergic system (LC-NE) modulates a diverse range of behaviors, including arousal, learning, pain modulation, and stress-induced negative affective states, which are possibly correlated with the pathogenesis of PWS phenotypes...
July 29, 2020: Journal of Neurodevelopmental Disorders
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