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1

van Houwelingen, K. "The sleep apnoea syndromes." European Heart Journal 20, no. 12 (June 1999): 858–66. http://dx.doi.org/10.1053/euhj.1998.1484.

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2

Pepperell, Justin C. "Sleep apnoea syndromes and the cardiovascular system." Clinical Medicine 11, no. 3 (June 2011): 275–78. http://dx.doi.org/10.7861/clinmedicine.11-3-275.

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3

Cielo, Christopher M., and Carole L. Marcus. "Obstructive sleep apnoea in children with craniofacial syndromes." Paediatric Respiratory Reviews 16, no. 3 (June 2015): 189–96. http://dx.doi.org/10.1016/j.prrv.2014.11.003.

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4

Szymanski, Filip M., Anna E. Platek, and Krzysztof J. Filipiak. "Obstructive Sleep Apnoea, Atrial Fibrillation and Erectile Dysfunction – The OSAFED Syndrome – Is there More than Meets the Eye?" European Journal of Arrhythmia & Electrophysiology 01, no. 01 (2015): 19. http://dx.doi.org/10.17925/ejae.2015.01.01.19.

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Obstructive sleep apnoea, atrial fibrillation and erectile dysfunction (OSAFED) syndrome is a new clinical entity recently introduced into clinical practice. The acronym consists of the first letters of the three clinical entities that comprise the disease, namely obstructive sleep apnoea (OSA), atrial fibrillation (AF) and erectile dysfunction (ED). As with many other clinical syndromes, OSAFED syndrome groups several clinical entities, which seemingly concern various organs and have different symptoms, but are closely associated by sharing risk factors and phenotype, and effecting cardiovascular risk in the same manner. OSA, AF and ED are also highly prevalent in the general population and tend to coexist. OSAFED syndrome was named as such to show how important diagnosis is of all these components in specific groups of patient. It is crucial for clinicians to improve the diagnosis and early treatment of all – OSA, AF and ED – and the incorporation of all these factors into one syndrome might help to facilitate this process.
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5

Nagarajan, Lakshmi, Peter Walsh, Pauline Gregory, Stephen Stick, Jennifer Maul, and Soumya Ghosh. "Respiratory Pattern Changes in Sleep in Children on Vagal Nerve Stimulation for Refractory Epilepsy." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 30, no. 3 (August 2003): 224–27. http://dx.doi.org/10.1017/s0317167100002638.

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Background:An altered breathing pattern in sleep, over two to three weeks, reported by the parents of a child on Vagal Nerve Stimulation (VNS) therapy for refractory epilepsy, prompted a sleep study in him. His polysomnography (PSG) revealed respiratory irregularity concordant with VNS activation. Dyspnoea is a well recognised and reported side effect of the VNS. However there are only a few studies looking at respiration in sleep with VNS. We therefore undertook PSGs in seven other children on VNS.Methods:Sleep studies were undertaken, in accordance with standard clinical practice. Sleep and apnoeas and hypopneas were scored in accordance with conventional criteria. Respiratory pattern changes in sleep (RPCS) with VNS were looked for.Results:Respiratory pattern changes in sleep were seen during PSG in seven of eight children on VNS for refractory epilepsy. Decreased effort and tidal volume occurred in seven children, concordant with VNS activation. In one child, this was associated with a fall in respiratory rate, in the other six children with an increase. No study showed an apnoea/hypopnoea index in the abnormal range. The RPCS were not associated with significant hypoxia or hypercapnoea.Conclusion:Our results suggest that RPCS occur in most children with VNS. This is not surprising in view of the significant influence vagal afferents have on respiratory control centres. The RPCS did not appear to have a clinical impact in our group. However further investigations are suggested to explore this phenomenon, especially in patients with sleep apnoea syndromes or compromised respiratory function.
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6

Walker, Matthew C., and Sofia H. Eriksson. "Epilepsy and Sleep Disorders." European Neurological Review 6, no. 1 (2011): 60. http://dx.doi.org/10.17925/enr.2011.06.01.60.

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There is a close association between sleep and epilepsy. In some epilepsy syndromes, seizures occur predominantly (or even exclusively) during sleep or on awakening. Excessive daytime sleepiness is common in patients with epilepsy and may be due not only to medication but also to nocturnal seizures or concomitant sleep disorders. Sleep disorders such as obstructive sleep apnoea can worsen epilepsy, with improvement of seizure control following appropriate treatment of the sleep disorder. Conversely, epilepsy and antiepileptic medication can worsen sleep disorders. Nocturnal epileptic seizures may be difficult to differentiate from parasomnias, in particular non-rapid eye movement parasomnias such as night terrors, sleepwalking and confusional arousals, on history alone since there are semiological similarities between the two disorders. Schemes have been developed to facilitate differential diagnosis, although this remains a challenge even using the gold standard, video-electroencephalography telemetry.
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7

Shikhmirzaeva, E. K., and A. P. Zilber. "A.43 “Ohmeda” monitors in diagnostics and management of sleep apnoea syndromes." British Journal of Anaesthesia 76 (June 1996): 13–14. http://dx.doi.org/10.1016/s0007-0912(18)30898-5.

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8

Carneiro-Barrera, Almudena, Francisco J. Amaro-Gahete, Amparo Díaz-Román, Alejandro Guillén-Riquelme, Lucas Jurado-Fasoli, Germán Sáez-Roca, Carlos Martín-Carrasco, Jonatan R. Ruiz, and Gualberto Buela-Casal. "Interdisciplinary Weight Loss and Lifestyle Intervention for Obstructive Sleep Apnoea in Adults: Rationale, Design and Methodology of the INTERAPNEA Study." Nutrients 11, no. 9 (September 15, 2019): 2227. http://dx.doi.org/10.3390/nu11092227.

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Obesity is a major risk factor for obstructive sleep apnoea (OSA), the most common sleep-disordered breathing related to neurocognitive and metabolic syndromes, type II diabetes, and cardiovascular diseases. Although strongly recommended for this condition, there are no studies on the effectiveness of an interdisciplinary weight loss and lifestyle intervention including nutrition, exercise, sleep hygiene, and smoking and alcohol cessation. INTERAPNEA is a randomised controlled trial with a two-arm parallel design aimed at determining the effects of an interdisciplinary tailored weight loss and lifestyle intervention on OSA outcomes. The study will include 84 males aged 18–65 with a body mass index of ≥25 kg/m2 and severe to moderate OSA randomly assigned to usual care (i.e., continuous positive airway pressure), or interdisciplinary weight loss and lifestyle intervention combined with usual care. Outcomes will be measured at baseline, intervention end-point, and six-month post-intervention, including apnoea-hypopnoea index (primary outcome), other neurophysical and cardiorespiratory polysomnographic outcomes, sleep quality, daily functioning and mood, body weight and composition, physical fitness, blood biomarkers, health-related quality of life, and cost-effectiveness. INTERAPNEA may serve to establish a cost-effective treatment not only for the improvement of OSA and its vast and severe comorbidities, but also for a potential remission of this condition.
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9

Moruzzi, P., S. Sarzi-Braga, M. Rossi, and M. Contini. "Sleep apnoea in ischaemic heart disease: differences between acute and chronic coronary syndromes." Heart 82, no. 3 (September 1, 1999): 343–47. http://dx.doi.org/10.1136/hrt.82.3.343.

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10

MacLean, Joanna E., David Fitzsimons, Dominic A. Fitzgerald, and Karen A. Waters. "The spectrum of sleep-disordered breathing symptoms and respiratory events in infants with cleft lip and/or palate." Archives of Disease in Childhood 97, no. 12 (October 6, 2012): 1058–63. http://dx.doi.org/10.1136/archdischild-2012-302104.

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ObjectiveTo determine the prevalence of sleep-disordered breathing (SDB) symptoms and respiratory events during sleep in infants with cleft lip and/or palate (CL/P).DesignProspective observational study.SettingCleft palate clinic, tertiary care paediatric hospital, before palate surgery.PatientsConsecutive newborn infants with CL/P.Main outcome measuresDemographics, clinical history, sleep symptoms, facial measurement and polysomnography (PSG; sleep study) data.ResultsFifty infants completed PSG at 2.7±2.3 months; 56% were male, and 30% had a clinical diagnosis of Pierre Robin sequence (PRS) or a syndrome. The majority of infants (75%) were reported to snore frequently or constantly, while 74% were reported to have heavy or loud breathing during sleep. The frequency of parent-reported difficulty with breathing during sleep was 10% for infants with isolated CL/P, 33% for those with syndrome, and 43% for PRS (χ2 16.1, p<0.05). All infants had an Obstructive–Mixed Apnoea–Hypopnoea Index (OMAHI) >1 event/h, and 75% had an OMAHI >3 events/h. Infants with PRS had higher OMAHI (34.3±5.1) than infants with isolated CL/P (7.6±1.2) or infants with syndromes (15.6±5.7, F stat, p<0.001). Multivariate analysis showed that PRS was associated with higher OMAHI (B 0.53±0.22, p=0.022), but the majority of the variance for SDB was unexplained (constant B 1.31±0.55, p=0.024).ConclusionsThe results highlight that infants across the spectrum of CL/P have a high risk of SDB symptoms and obstructive respiratory events before palate surgery. Clinicians should enquire about symptoms of SDB and consider investigation with polysomnography in all infants with CL/P.
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11

Kabeloğlu, Vasfiye, and Aylin Reyhani. "Clinical and Polysomnographic Comparison of Patients with Rapid Eye Movementdependent and Positional Obstructive Sleep Apnoea Syndromes." Journal of Turkish Sleep Medicine 8, no. 3 (August 11, 2021): 197–202. http://dx.doi.org/10.4274/jtsm.galenos.2021.41636.

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12

Levi, Eric, Andrés Alvo, Brian J. Anderson, and Murali Mahadevan. "Postoperative admission to paediatric intensive care after tonsillectomy." SAGE Open Medicine 8 (January 2020): 205031212092202. http://dx.doi.org/10.1177/2050312120922027.

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Objectives: To review interventions required by children admitted for intensive care management following tonsillectomy or adenotonsillectomy either as elective or unplanned admission in a tertiary children’s hospital. Methods: A retrospective chart review over a 10-year period between April 2007 and March 2017 was performed. Charts were interrogated for treatments that were administered in the paediatric intensive care unit. Respiratory support therapies such as supplemental oxygen administration, high-flow nasal oxygen, positive pressure ventilation, continuous positive airway pressure, airway interventions and tracheal intubation were reviewed. Results: There were 103 children admitted to the paediatric intensive care unit following tonsillectomy or adenotonsillectomy. The average age was 6.2 years (range 7 months–17 years). The main indications for the procedure were sleep disordered breathing or obstructive sleep apnoea syndrome. In all, 53 children had syndromes with medical comorbidities, 31 were current continuous positive airway pressure users and 5 had a tracheostomy in situ. Forty children admitted to paediatric intensive care unit did not require any high-level care. Ten children who had an unplanned admission had their respiratory interventions started in the theatre or in the post-anaesthetic care unit, before paediatric intensive care unit admission, and did not require escalation of care. Conclusion: Children may not require admission for intensive care after tonsillectomy if they have had an incident-free period in the post-anaesthetic care unit. Some of those who required high-flow nasal oxygen could have been managed on the ward provided with adequate training and monitoring facilities. The level of care they require in post-anaesthetic care unit reflected the level of care for the immediate postoperative period in the paediatric intensive care unit.
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Anne, Pratibha, Rupa Koothirezhi, Ugorji Okorie, Minh Tam Ho, Brittany Monceaux, Cesar Liendo, Sheila Asghar, and Oleg Chernyshev. "833 Evolution of sleep disordered breathing types in heart failure." Sleep 44, Supplement_2 (May 1, 2021): A324—A325. http://dx.doi.org/10.1093/sleep/zsab072.830.

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Abstract Introduction Central sleep apnea is commonly seen in patients with heart failure. Here we present a case demonstrating shifting of predominant apneic events from central to obstructive type after placement of left ventricular assist device (LVAD) in end stage heart failure patient. Report of case(s) Case Presentation: 66 year-old African American male has past medical history of chronic congestive heart failure diabetes, hypertension, paroxysmal atrial fibrillation, anemia, hypothyroidism, chronic kidney disease and sleep apnea. Prior to his LVAD placement, his left ventricular ejection fraction (EF) was &lt;10%. Patient was diagnosed with central sleep apnea with AHI of 58 (with 92% of apneic events being central events), oxygen nadir of 74%. Subsequently, patient had LVAD placed for symptomatic heart failure and repeat polysomnogram repeated at six month demonstrated an improved AHI of 45.8 with predominantly obstructive and mixed apneic events, with only 12.5% being central events. Conclusion This case report highlights not only the improvement of the sleep apnea in CHF treated with LVAD but also shows the shift of apneic events from predominantly central to obstructive type post LVAD. Support (if any) 1. Henein MY, Westaby S, Poole-Wilson PA, Cowie MR, Simonds AK. Resolution of central sleep apnoea following implantation of a left ventricular assist device. Int J Cardiol. 2010 Feb 4;138(3):317–9. PMID: 18752859. 2. Köhnlein T, Welte T, Tan LB, Elliott MW. Central sleep apnoea syndrome in patients with chronic heart disease: a critical review of the current literature. Thorax. 2002 Jun;57(6):547–54. PMID: 12037232 3. Monda C, Scala O, Paolillo S, Savarese G, Cecere M, D’Amore C, Parente A, Musella F, Mosca S, Filardi PP. Apnee notturne e scompenso cardiaco: fisiopatologia, diagnosi e terapia [Sleep apnea and heart failure: pathophysiology, diagnosis and therapy]. G Ital Cardiol (Rome). 2010 Nov;11(11):815–22. Italian. PMID: 21348318.
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14

Bhandarkar, Dr Ajay M., Dr Rukma Bhandary, and Dr Suraj S. Nair. "Clinical Indicators of Obstructive Sleep Apnea Syndrome." International Journal of Scientific Research 2, no. 12 (June 1, 2012): 399–400. http://dx.doi.org/10.15373/22778179/dec2013/120.

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15

Khan, Muhammad Talha, and Rose Amy Franco. "Complex Sleep Apnea Syndrome." Sleep Disorders 2014 (2014): 1–6. http://dx.doi.org/10.1155/2014/798487.

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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 PaCO2arterial partial pressure of Carbon Dioxide, continuous cositive airway pressure (CPAP) related increased CO2carbon dioxide elimination, and activation of airway and pulmonary stretch receptors triggering these central apneas. The prevalence ranges from 0.56% to 18% with no clear predictive characteristics as compared to simple obstructive sleep apnea. Prognosis is similar to obstructive sleep apnea. The central apnea component in most patients on followup using CPAP therap, has resolved. For those with continued central apneas on simple CPAP therapy, other treatment options include bilevel PAP, adaptive servoventilation, permissive flow limitation and/or drugs.
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Suto, Y., and Y. Inoue. "Sleep Apnea Syndrome." Acta Radiologica 37, no. 1P1 (January 1996): 315–20. http://dx.doi.org/10.1177/02841851960371p166.

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Purpose: 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). Subjects and Methods: 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. Results: 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. Conclusion: Analysis of pharyngeal dynamics using high-speed MR may provide some useful information for evaluating the severity of SAS.
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Benedek, Pálma, Gabriella Kiss, Eszter Csábi, and Gábor Katona. "Postoperative monitoring of children with obstructive sleep apnea syndrome." Orvosi Hetilap 155, no. 18 (May 2014): 703–7. http://dx.doi.org/10.1556/oh.2014.29879.

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Introduction: Treatment of pediatric obstructive sleep apnea syndrome is surgical. The incidence of postoperative respiratory complications in this population is 5–25%. Aim: The aim of the authors was to present the preoperative evaluation and monitoring procedure elaborated in Heim Pál Children Hospital, Budapest. Method: 142 patients were involved in the study. Patient history was obtained and physical examination was performed in all cases. Thereafter, polysomnography was carried out, the severity of the obstructive sleep apnea syndrome was determined, and the patients underwent tonsilloadenotomy. Results: 45 patients with mild, 50 patients with moderate and 47 patients with severe obstructive sleep apnea syndrome were diagnosed. There was no complication in patients with mild disease, while complications were observed in 6 patients in the moderate group and 24 patients in the severe group (desaturation, apnea, stridor, stop breathing) (p<0.000). In patients with severe obstructive sleep apnea syndrome, no significant difference was noted in preoperative apnoea-hypapnea index (p = 0.23) and in nadir oxygen saturation values (p = 0.73) between patients with and without complication. Conclusions: Patients with severe obstructive sleep apnea syndrome should be treated in hospital where pediatric intensive care unit is available. Orv. Hetil., 2014, 155(18), 703–707.
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18

Sil, A., and G. Barr. "Assessment of predictive ability of Epworth scoring in screening of patients with sleep apnoea." Journal of Laryngology & Otology 126, no. 4 (December 13, 2011): 372–79. http://dx.doi.org/10.1017/s0022215111003082.

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AbstractMethod:Numerous studies have considered the benefits, and the disadvantages, of the Epworth Sleepiness Scale. Following an extensive literature review, we found that the evidence was inconclusive as regards the diagnostic efficacy of Epworth scoring for obstructive sleep apnoea syndrome. We undertook a retrospective study of 343 patients who underwent a sleep assessment over a 10-year period at the Monklands Hospital.Analysis and results:A total of 238 patients did not have sleep apnoea whereas 105 patients did. The mean Epworth score in patients with obstructive sleep apnoea syndrome was 10.94 (95 per cent confidence interval 9.46–11.42), and in the non-apnoeic group it was 7.73 (95 per cent confidence interval 7.04–8.41). Logistic regression and receiver operating characteristic curves were used to assess the predictive ability of Epworth scoring. The scores only explained 7–10 per cent of the variation in the probability of occurrence of obstructive sleep apnoea syndrome. The odds ratio for Epworth scoring was 1.118, and only 69 per cent of cases were correctly classified by the Scale.Conclusions:The literature review suggested that the Epworth Sleepiness Scale is associated with a low effect size and/or low predictive value when correlated or regressed on the Apnoea–Hypopnoea Index or Respiratory Disturbance Index, thus limiting its value as a screening test. Our study concluded that the Epworth Scale is only marginally useful in predicting the occurrence of obstructive sleep apnoea syndrome. We believe that every patient with a direct or witnessed history of sleep apnoea with obstructive symptoms have some form of sleep assessment.
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19

Csiszer Iren, Csiszer Iren, Solyom Arpad, Solyom Reka, and Neagos Adriana. "The Metabolic Syndrome and its Correlations with the Obstructive Sleep Apnea Syndrome." Indian Journal of Applied Research 3, no. 8 (October 1, 2011): 50–52. http://dx.doi.org/10.15373/2249555x/aug2013/179.

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20

Sun, Huibo, Yanhua Zhang, Jing Wang, and Jie Kong. "Correlation of serum meteorin-like concentration with the presence and severity of obstructive sleep apnoea syndrome." Annals of Clinical Biochemistry: International Journal of Laboratory Medicine 56, no. 5 (June 8, 2019): 593–97. http://dx.doi.org/10.1177/0004563219854115.

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Objective Inflammatory processes that occur in subjects with obstructive sleep apnoea syndrome may contribute to progressive atherosclerosis and increased cardiovascular and cerebrovascular morbidity. Meteorin-like protein, which is also known as subfatin, is transcribed similarly to meteorin protein. Meteorin-like alleviates skeletal muscle inflammation. We aimed to investigate the serum meteorin-like status of obstructive sleep apnoea syndrome subjects and determine the potential link between serum meteorin-like concentration with the presence and severity of obstructive sleep apnoea syndrome. Methods The obstructive sleep apnoea syndrome group was composed of 207 obstructive sleep apnoea syndrome subjects diagnosed via polysomnography. A total of 106 healthy volunteers without clinical symptoms of obstructive sleep apnoea syndrome were recruited as the control group. Blood samples were obtained from all subjects to evaluate the serum meteorin-like concentrations via enzyme-linked immunosorbent assay method. Results Decreased serum meteorin-like concentration was found in obstructive sleep apnoea syndrome subjects compared with the controls. Serum meteorin-like concentration was associated with a reduced OR for having obstructive sleep apnoea syndrome (OR 0.97, 95% CI 0.961 to 0.98; P < 0.001). Severe obstructive sleep apnoea syndrome subjects showed significantly lower meteorin-like concentration compared with mild and moderate cases. Moderate subjects exhibited decreased serum meteorin-like concentration compared with mild cases. Pearson correlation analysis revealed that serum meteorin-like concentration was negatively correlated with obstructive sleep apnoea syndrome severity. Serum meteorin-like concentration negatively correlated with body mass index, low-density lipoprotein cholesterol, apnoea–hypopnea index, number of arousals, hypopnoea and apnoea in subjects with obstructive sleep apnoea syndrome. Conclusion Serum meteorin-like concentration is inversely correlated with the presence and severity of obstructive sleep apnoea syndrome.
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21

Altintas, Nejat, and Renata L. Riha. "Non-sleepy obstructive sleep apnoea: to treat or not to treat?" European Respiratory Review 28, no. 154 (December 23, 2019): 190031. http://dx.doi.org/10.1183/16000617.0031-2019.

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Non-sleepy obstructive sleep apnoea (OSA) is thought to have a prevalence of around 20–25% in industrialised countries. However, the question of whether it should be routinely treated or not is controversial. This review collates the results from recent randomised controlled trials addressing OSA and examines whether treating the condition leads to improvements in quality of life and reduced cardiometabolic dysfunction, comorbidities generally attributed to untreated obstructive sleep apnoea/hypopnoea syndrome.
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Anand, Neesha, Roberta M. Leu, Dawn Simon, and Ajay S. Kasi. "Recurrent apnoea and respiratory failure in an infant: congenital central hypoventilation syndrome with a novel PHOX2B gene variant." BMJ Case Reports 14, no. 3 (March 2021): e239633. http://dx.doi.org/10.1136/bcr-2020-239633.

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A 20-day-old term infant presented with recurrent apnoea, lethargy and respiratory failure. Examination revealed episodes of apnoea and desaturation to 85% without any signs of respiratory distress requiring initiation of non-invasive positive pressure ventilation (NPPV). Capillary blood gas was indicative of respiratory acidosis and serum bicarbonate was elevated at 35 mmol/L. Chest radiograph, echocardiogram and evaluations for infectious aetiologies resulted normal. Due to inability to wean off NPPV with ensuing apnoea and desaturation, polysomnogram was performed and showed central and obstructive sleep apnoea, hypoxaemia and hypoventilation. Central apnoeas and hypoventilation were worse in non-rapid eye movement sleep. Paired-like homeobox 2B genetic studies showed a novel non-polyalanine repeat mutation (c.429+1G>A) establishing the diagnosis of congenital central hypoventilation syndrome (CCHS). Our case highlights the utility of polysomnography in the evaluation of term infants with apnoea. Although rare, clinicians should consider a diagnosis of CCHS in the evaluation of infants with apnoea and hypoventilation.
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Defabjanis, Patrizia. "Impact of nasal airway obstruction on dentofacial development and sleep disturbances in children: preliminary notes." Journal of Clinical Pediatric Dentistry 27, no. 2 (January 1, 2004): 95–100. http://dx.doi.org/10.17796/jcpd.27.2.27934221l1846711.

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Respiratory disorders in the upper respiratory tract during sleep are most often part of a continuous pathological process of long standing. Schematically, three clinical syndromes with increasing severity are described: breathing with the mouth open, snoring and sleep apneal hypopnea syndrome. Obstructive sleep apnea syndrome (OSAS) is a subtle, but severe sleep disorder of early childhood. It is often difficult to detect and may have long-term consequences, including failure to thrive, behavioral disturbances, developmental delay, and cor pulmonale.1 These conditions always include a functional maxillofacial perturbation, which may be associated with a constitutional or acquired morphological disorder. Pediatric dentists must be aware of the problems connected with mouth breathing and OSAS (obstructive sleep apnea syndrome) in children as any delay in diagnosis and treatment may cause prolonged morbidity. They also have a role in the diagnosis and co-management of these patients because the signs and symptoms may be recognizable in the dental practice. Besides the medical approach itself, the treatment sometimes is surgical, always orthopedic: the earlier it is initiated, the more effective, simple and unrestraining it is. The aim of this work is to focus attention on the early diagnosis and prevention of these pathologies. Diagnostic guidelines will be illustrated.
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Moore-Gillon, J. C., and I. R. Cameron. "Right ventricular hypertrophy and polycythaemia in rats after intermittent exposure to hypoxia." Clinical Science 69, no. 5 (November 1, 1985): 595–99. http://dx.doi.org/10.1042/cs0690595.

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1. Six groups of 20 male adult rats were maintained in an environmental chamber, each group for a period of 28 days. One group breathed air throughout its experimental period, and a second group breathed a normobaric atmosphere of 12% oxygen. The other four groups were exposed to this hypoxic atmosphere for only a proportion of each 24 h cycle: 2, 4 and 12 h daily, and eight periods of 30 min daily. 2. After 28 days, measurement was made, in each rat, of right ventricule (RV) weight and of red cell mass (RCM) by using 51Cr-labelled rat erythrocytes. 3. In the normoxic control group, RV weight corrected for log body weight in grams was 63.2 ± 1 mg/log body wt. and RCM was 2.02 ± 0.05 ml/100 g body wt. This was significantly less than in the group hypoxic for only 2 h each day for 28 days: RV weight 66.6 ± 0.8 mg/log body wt. (P < 0.05) and RCM 2.27 ± 0.05 ml/100g body wt. (P < 0.05). Greater increases compared with control were observed in all the other hypoxic groups. There was no significant difference in the increases in RV weight and RCM produced by daily hypoxia in a 4 h continuous period and daily hypoxia in eight 30 min periods. 4. The possible role of intermittent hypoxia in producing polycythaemia and pulmonary hypertension has been the subject of much speculation. Our results show that intermittent hypoxia is a potent stimulus to erythropoiesis and to pulmonary hypertension, reflected in RV hypertrophy. They support the view that abnormalities of respiration during sleep may be responsible for the polycythaemia and cor pulmonale seen in some patients with sleep apnoea syndromes and with chronic obstructive airways disease.
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Badr, M. S., F. Toiber, J. B. Skatrud, and J. Dempsey. "Pharyngeal narrowing/occlusion during central sleep apnea." Journal of Applied Physiology 78, no. 5 (May 1, 1995): 1806–15. http://dx.doi.org/10.1152/jappl.1995.78.5.1806.

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We hypothesized that subatmospheric intraluminal pressure is not required for pharyngeal occlusion during sleep. Six normal subjects and six subjects with sleep apnea or hypopnea (SAH) were studied during non-rapid-eye-movement sleep. Pharyngeal patency was determined by using fiber-optic nasopharyngoscopy during spontaneous central sleep apnea (n = 4) and induced hypocapnic central apnea via nasal mechanical ventilation (n = 10). Complete pharyngeal occlusion occurred in 146 of 160 spontaneously occurring central apneas in patients with central sleep apnea syndrome. During induced hypocapnic central apnea, gradual progressive pharyngeal narrowing occurred. More pronounced narrowing was noted at the velopharynx relative to the oropharynx and in subjects with SAH relative to normals. Complete pharyngeal occlusion frequently occurred in subjects with SAH (31 of 44 apneas) but rarely occurred in normals (3 of 25 apneas). Resumption of inspiratory effort was associated with persistent narrowing or complete occlusion unless electroencephalogram signs of arousal were noted. Thus pharyngeal cross-sectional area is reduced during central apnea in the absence of inspiratory effort. Velopharyngeal narrowing consistently occurs during induced hypocapnic central apnea even in normal subjects. Complete pharyngeal occlusion occurs during spontaneous or induced central apnea in patients with SAH. We conclude that subatmospheric intraluminal pressure is not required for pharyngeal occlusion to occur. Pharyngeal narrowing or occlusion during central apnea may be due to passive collapse or active constriction.
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Fairbanks, David W., and David N. F. Fairbanks. "Neurostimulation for Obstructive Sleep Apnea: Investigations." Ear, Nose & Throat Journal 72, no. 1 (January 1993): 52–57. http://dx.doi.org/10.1177/014556139307200111.

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Neurostimulation of the upper airway muscles (accessory muscles of respiration) was accomplished in anesthetized dogs and sleeping humans by electrical stimulation of the hypoglossal nerves. Such stimulations relieved partial airway obstructions in dogs. They also aborted (shortened) obstructive sleep apnea events in humans who suffer with obstructive sleep apnea syndrome. In one subject, stimulations delivered in advance of apneic events (by automatic cycling) prevented apneas. Neurostimulation for obstructive sleep apnea may be an important concept for future research and development.
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27

Baumert, Mathias, Yvonne Pamula, James Martin, Declan Kennedy, Anand Ganesan, Muammar Kabir, Mark Kohler, and Sarah A. Immanuel. "The effect of adenotonsillectomy for childhood sleep apnoea on cardiorespiratory control." ERJ Open Research 2, no. 2 (April 2016): 00003–2016. http://dx.doi.org/10.1183/23120541.00003-2016.

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The efficacy of adenotonsillectomy for relieving obstructive sleep apnoea symptoms in children has been firmly established, but its precise effects on cardiorespiratory control are poorly understood.In 375 children enrolled in the Childhood Adenotonsillectomy Trial, randomised to undergo either adenotonsillectomy (n=194) or a strategy of watching waiting (n=181), respiratory rate, respiratory sinus arrhythmia and heart rate were analysed during quiet, non-apnoeic and non-hypopnoeic breathing throughout sleep at baseline and at 7 months using overnight polysomnography.Children who underwent early adenotonsillectomy demonstrated an increase in respiratory rate post-surgery while the watchful waiting group showed no change. Heart rate and respiratory sinus arrhythmia were comparable between both arms. On assessing cardiorespiratory variables with regard to normalisation of clinical polysomnography findings during follow-up, heart rate was reduced in children who had resolution of obstructive sleep apnoea syndrome, while no differences in their respiratory rate or respiratory sinus arrhythmia were observed.Adenotonsillectomy for obstructive sleep apnoea increases baseline respiratory rate during sleep. Normalisation of apnoea–hypopnoea index, spontaneously orviasurgery, lowers heart rate. Considering the small average effect size, the clinical significance is uncertain.
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Gutierrez, T., A. C. Leong, L. Pang, E. Chevretton, J.-P. Jeannon, and R. Simo. "Multinodular thyroid goitre causing obstructive sleep apnoea syndrome." Journal of Laryngology & Otology 126, no. 2 (October 12, 2011): 190–95. http://dx.doi.org/10.1017/s0022215111002714.

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AbstractBackground:Obstructive sleep apnoea syndrome has been linked to obesity, nasal obstruction and adenotonsillar hypertrophy, but rarely to large thyroid goitres.Objective:To study the possible association between multinodular retrolaryngo-pharyngeal or retrosternal goitres and obstructive sleep apnoea syndrome.Subjects and methods:Retrospective case series at a tertiary referral centre (2000–2010). Study parameters included body mass index, Epworth sleep score and polysomnographic index.Results:Five patients were diagnosed with obstructive sleep apnoea syndrome and managed with nasal continuous positive airway pressure ventilation. Computed tomography showed a retrolaryngo-pharyngeal or retrosternal goitre with significant tracheal compression, displacement and laryngeal oedema. After total thyroidectomy, obstructive sleep apnoea resolved in all patients.Conclusion:Large, multinodular goitres with retrolaryngo-pharyngeal extension can cause obstructive sleep apnoea syndrome due to laryngeal compression and oedema. In such cases, total thyroidectomy enables resolution of symptoms. Patients with obstructive sleep apnoea syndrome should be screened for thyroid goitre.
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29

Jiang, H., H. Cao, P. Wang, W. Liu, F. Cao, and J. Chen. "Tumour necrosis factor-α/interleukin-10 ratio in patients with obstructive sleep apnoea hypopnoea syndrome." Journal of Laryngology & Otology 129, no. 1 (December 15, 2014): 73–78. http://dx.doi.org/10.1017/s0022215114002990.

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AbstractObjective:To explore the significance of the tumour necrosis factor-α/interleukin-10 ratio and the effect of continuous positive airway pressure in patients with different degrees of obstructive sleep apnoea hypopnoea syndrome severity.Method:This study comprised 135 patients with obstructive sleep apnoea hypopnoea syndrome and 94 control subjects.Results:Tumour necrosis factor-α and tumour necrosis factor-α/interleukin-10 ratio values were significantly higher in the obstructive sleep apnoea hypopnoea syndrome group than in the control group, but interleukin-10 was significantly lower. Tumour necrosis factor-α/interleukin-10 ratio values increased in line with the severity of obstructive sleep apnoea hypopnoea syndrome. In multivariate analysis, the tumour necrosis factor-α/interleukin-10 ratio correlated positively with the apnoea–hypopnoea index and all indices of obstructive sleep apnoea hypopnoea syndrome, except for age, body mass index and neck circumference. After one month of continuous positive airway pressure therapy, levels of tumour necrosis factor-α decreased; interleukin-10 showed no change.Conclusion:The results suggest that inflammation is activated and anti-inflammatory cytokines are decreased in obstructive sleep apnoea hypopnoea syndrome patients. Tumour necrosis factor-α/interleukin-10 ratio may prove useful for severity monitoring and management of obstructive sleep apnoea hypopnoea syndrome patients, and may reduce the need for polysomnography.
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30

Vaartjes, Martin, Rob L. M. Strijers, and Nico de Vries. "Posterior Nasal Packing and Sleep Apnea." American Journal of Rhinology 6, no. 2 (March 1992): 71–74. http://dx.doi.org/10.2500/105065892781874784.

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Posterior nasal packing has been reported to be associated with cardiorespiratory complications and, occasionally, with sudden death. To study the rate and incidence of sleep apnea, between October 1989 and September 1990 polysomnography (PSG) was performed in 10 patients who were treated for severe epistaxis with posterior nasal packing. Of these 10 patients, three had obstructive apneas, one had central apneas, and four had a combination of central and/or obstructive and mixed apneas. One patient had no apneas, and one was unable to sleep during PSG. In six patients, PSG was repeated a few months after removal of the packs. Four of these six patients no longer had apneas; one patient had a considerable decrease in number of apneas. One patient did not sleep during the second PSG, however, he had no apneas during the first PSG. This study demonstrates that posterior nasal packing can induce sleep apneas or enhance the severity of an apnea syndrome when present. This may contribute to the cardiorespiratory morbidity and sudden death that has been reported in epistaxis patients treated with posterior packing.
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Zivana, Fidela Hanan. "Obstructive Sleep Apnea Syndrome (OSAS) Decrease Concentration Levels in Young Adults." Diponegoro International Medical Journal 1, no. 2 (December 10, 2020): 17–20. http://dx.doi.org/10.14710/dimj.v1i2.9543.

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Background: Obstructive Sleep Apnea Syndrome (OSAS) is sleeping-disorder that’s characterized by recurrent episodes of upper airway obstruction during sleep. Fourteen percent of world populations suffer from OSAS. OSA patients are 7,5 to 20 times more likely to have difficulties with concentration, learning new tasks, and execution of monotonous tasks.Objective: The primary objective of this study was to investigate the relationship between Obstructive Sleep Apnea Syndrome (OSAS) and concentration level in young adults.Methods: This is an analytic observational study with cross-sectional design. Sampling was carried out with total sampling. Samples that qualified the inclusion and exclusion criteria were assessed by OSAS using the Epworth Sleepiness Scale (ESS) questionnaire and Digit Symbol Substitution Test was used to assess the concentration level. The data were analyzed, using the chi-square test and the prevalence (PR) test.Results: The Chi-square test showed that there was a significant relationship between OSAS and concentration level (p=0.033). The Prevalence Ratio test found that OSAS decreased concentration level by 1,55 compared to not OSAS.Conclusion: There was a significant relationship between OSAS and concentration level in young adults. OSAS patients are 1,55 more likely to have a decrease concentration level when compared with healthy individuals.
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Punjabi, Naresh M., and Vsevolod Y. Polotsky. "Disorders of glucose metabolism in sleep apnea." Journal of Applied Physiology 99, no. 5 (November 2005): 1998–2007. http://dx.doi.org/10.1152/japplphysiol.00695.2005.

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Sleep is a complex behavioral state that occupies one-third of the human life span. Although viewed as a passive condition, sleep is a highly active and dynamic process. The sleep-related decrease in muscle tone is associated with an increase in resistance to airflow through the upper airway. Partial or complete collapse of the airway during sleep can lead to the occurrence of apneas and hypopneas during sleep that define the syndrome of sleep apnea. Sleep apnea has become pervasive in Western society, affecting ∼5% of adults in industrialized countries. Given the pandemic of obesity, the prevalence of Type 2 diabetes mellitus and metabolic syndrome has also increased dramatically over the last decade. Although the role of sleep apnea in cardiovascular disease is uncertain, there is a growing body of literature that implicates sleep apnea in the pathogenesis of altered glucose metabolism. Intermittent hypoxemia and sleep fragmentation in sleep apnea can trigger a cascade of pathophysiological events, including autonomic activation, alterations in neuroendocrine function, and release of potent proinflammatory mediators such as tumor necrosis factor-α and interleukin-6. Epidemiologic and experimental evidence linking sleep apnea and disorders of glucose metabolism is reviewed and discussed here. Although the cause-and-effect relationship remains to be determined, the available data suggest that sleep apnea is independently associated with altered glucose metabolism and may predispose to the eventual development of Type 2 diabetes mellitus.
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Acar, M., İ. Türkcan, T. Özdaş, C. Bal, and C. Cingi. "Obstructive sleep apnoea syndrome does not negatively affect oral and dental health." Journal of Laryngology & Otology 129, no. 1 (January 2015): 68–72. http://dx.doi.org/10.1017/s0022215114003296.

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AbstractObjective:Obstructive sleep apnoea syndrome can lead to unhealthy open-mouth breathing. We investigated the possible relationship between obstructive sleep apnoea syndrome and dental health. We also evaluated other clinical factors that may affect oral health.Methods:We measured sleep using polysomnography and determined the apnoea–hypopnoea index for a total of 291 patients. We also recorded the demographic data, duration of snoring complaints, educational status and income levels for our patient cohort; finally, we calculated the decayed, missing and filled teeth index.Results:Forty-one patients presented with primary snoring (control group) and 250 patients (study group) presented with mild, moderate and severe obstructive sleep apnoea syndrome. We found no correlation between obstructive sleep apnoea syndrome severity and the decayed, missing and filled teeth index (p = 0.057). We also found no correlation between the apnoea–hypopnoea and decayed, missing and filled teeth indexes. Age and the duration of snoring complaints were positively correlated with the decayed, missing and filled teeth index while educational status and income levels were negatively correlated (p < 0.001).Conclusion:Obstructive sleep apnoea syndrome does not negatively affect oral and dental health.
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Dominici, Michele, Fernando Pompeu Filho, and Marleide da Mota Gomes. "Probable causal link between epilepsy and sleep apnea: case report." Arquivos de Neuro-Psiquiatria 65, no. 1 (March 2007): 164–66. http://dx.doi.org/10.1590/s0004-282x2007000100034.

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Patients with epilepsy were reported to have concomitant sleep apnea, but it has been rarely linked to the epilepsy itself. We present a case of a 28-year-old, obese man with secondary medically resistant partial complex epilepsy due to a brain trauma, with progressive snoring, and sleep agitation, apneas, and important daytime somnolence. It was noticed in the polysomnographic study that he had several sleep respiratory events, probably due both to the epileptic seizures and the sleep apnea syndrome as a co-morbidity. Apnea and epilepsy will be discussed. A careful video-EEG-polysomnography study is important in evaluating refractory epileptic patients and/or epileptic patients with snoring.
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35

Xie, Ailiang, Fiona Rankin, Ruth Rutherford, and T. Douglas Bradley. "Effects of inhaled CO2 and added dead space on idiopathic central sleep apnea." Journal of Applied Physiology 82, no. 3 (March 1, 1997): 918–26. http://dx.doi.org/10.1152/jappl.1997.82.3.918.

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Xie, Ailiang, Fiona Rankin, Ruth Rutherford, and T. Douglas Bradley. Effects of inhaled CO2 and added dead space on idiopathic central sleep apnea. J. Appl. Physiol. 82(3): 918–926, 1997.—We hypothesized that reductions in arterial [Formula: see text]([Formula: see text]) below the apnea threshold play a key role in the pathogenesis of idiopathic central sleep apnea syndrome (ICSAS). If so, we reasoned that raising[Formula: see text] would abolish apneas in these patients. Accordingly, patients with ICSAS were studied overnight on four occasions during which the fraction of end-tidal CO2 and transcutaneous[Formula: see text] were measured: during room air breathing ( N1), alternating room air and CO2 breathing ( N2), CO2 breathing all night ( N3), and addition of dead space via a face mask all night ( N4). Central apneas were invariably preceded by reductions in fraction of end-tidal CO2. Both administration of a CO2-enriched gas mixture and addition of dead space induced 1- to 3-Torr increases in transcutaneous [Formula: see text], which virtually eliminated apneas and hypopneas; they decreased from 43.7 ± 7.3 apneas and hypopneas/h on N1 to 5.8 ± 0.9 apneas and hypopneas/h during N3( P < 0.005), from 43.8 ± 6.9 apneas and hypopneas/h during room air breathing to 5.9 ± 2.5 apneas and hypopneas/h of sleep during CO2 inhalation during N2 ( P< 0.01), and to 11.6% of the room air level while the patients were breathing through added dead space during N4 ( P< 0.005). Because raising[Formula: see text] through two different means virtually eliminated central sleep apneas, we conclude that central apneas during sleep in ICSA are due to reductions in[Formula: see text] below the apnea threshold.
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36

Evers, Stefan, Birke Barth, Achim Frese, Ingo-W. Husstedt, and Svenja Happe. "Sleep apnea in patients with cluster headache: A case-control study." Cephalalgia 34, no. 10 (July 14, 2014): 828–32. http://dx.doi.org/10.1177/0333102414544038.

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Objective Polysomnographic investigations have shown an unspecific association between cluster headache and obstructive sleep apnea syndrome. The aim of this study was to investigate this association in a cluster episode compared with a symptom free interval, and to further characterize this association. Methods We investigated 42 patients with episodic ( n = 26) or chronic ( n = 16) cluster headache by means of polygraphic screening for sleep apnea and compared the data to 28 healthy control subjects matched according to age, sex, and BMI. The patients with episodic cluster headache were screened twice, once in a cluster episode and once in a symptom free interval. Results Patients with active cluster headache showed a significantly higher respiratory distress index (8.6 ± 16.0) compared with healthy control subjects (3.4 ± 2.1; p = 0.002). More patients fulfilled the criteria for an obstructive sleep apnea syndrome (29%) than control subjects (7%; p = 0.018). Patients only, but not the control subjects, had central apneas. These differences were only significant when measured during an active cluster episode but not during a symptom free interval. Conclusion Cluster headache is associated with a sleep apnea syndrome only in the active cluster episode. The increased rate of central apneas might be a result of involvement of the hypothalamus in the pathophysiology of cluster headache. Out of five anecdotal cases treated with nasal continuous positive airway pressure, only one patient showed benefit with respect to cluster headache attack frequency.
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Karpovich, A. A., and V. I. Shyshko. "Expression of melatonin receptors in the gastroesophageal reflux disease associated with obstructive sleep apnea/hypopnea syndrome." Proceedings of the National Academy of Sciences of Belarus, Medical series 17, no. 3 (August 29, 2020): 364–71. http://dx.doi.org/10.29235/1814-6023-2020-17-3-364-371.

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The aim of the present research was to assess the expression of melatonin receptors (MTNR1B) in the esophageal mucosa in the gastroesophageal reflux disease associated with obstructive sleep apnea/hypopnea syndrome and to study the relationship between the detected changes and the sleep apnea severity. 84 patients aged 30–60 years, including those with gastroesophageal reflux disease (group 1, n = 25), those with gastroesophageal reflux disease associated with sleep apnea/hypopnea (group 2, n = 23), those with obstructive sleep apnoe/ hypopnoe syndrome (group 3, n = 18), and almost healthy people (group 4, n = 18), were studied. Diagnoses were based on endoscopic imaging and respiratory monitoring. The MTNR1B expression in the esophageal mucosa was determined by the immunohistochemical method using specific antibodies. The MTNR1 B expression was evaluated quantitatively using the computer program Aperio ImageScope _v9.1.19.1567. The obtained material was analyzed statistically using the software Statistica 10.0. The group 2 patients were shown to have a higher MTNR1B expression compared to the group 1 patients (0.122 [0.064; 0.266] versus 0.620 [0.332; 0.983]; p = 0.00001) and the group 3 patients (0.620 [0.332; 0.983] versus 0.232 [0.120; 0.418]; р = 0.0098). The MTNR1 B expression increased with growing sleep apnea severity: it is 0.295 [0.198; 0.403] in patients with mild apnea versus 0.941 [0.345; 0.992] in patients with moderate and severe apnea (p = 0.0021). A direct correlation between the MTNR1B expression and the sleep apnea severity degree (r = 0.50; р = 0.0016) was revealed. Patients with gastroesophageal reflux disease combined with sleep apnea revealed an increase in the MTNR1 B expression associated with the apnea severity. The revealed features of the MTNR1 B expression secondary to esophageal mucosal damage indicate the MTNR1 B inactivation secondary to accompanying apnea of hypoxia.
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Riha, Renata L. "Defining obstructive sleep apnoea syndrome: a failure of semantic rules." Breathe 17, no. 3 (September 2021): 210082. http://dx.doi.org/10.1183/20734735.0082-2021.

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Obstructive sleep apnoea syndrome (OSAS) is one of the most ubiquitous medical conditions in industrialised society. Since the recognition that symptoms of excessive daytime somnolence, problems with concentration, mood and cognitive impairment, as well as cardiometabolic abnormalities can arise as a consequence of obstructed breathing during sleep, it has been subject to variation in its definition. Over the past five decades, attempts have been made to standardise the definitions and scoring criteria used for apnoeas and hypopnoea, which are the hallmarks of obstructive sleep apnoea (OSA). However, applying these definitions in clinical and research practice has resulted in over- and under-estimation of the severity and prevalence of OSAS. Furthermore, the definitions may eventually become redundant in the context of rapid technological advances in breathing measurement and other signal acquisition. Increased efforts towards precision medicine have led to a focus on the pathophysiology of obstructed breathing during sleep. However, the same degree of effort has not been focused on how and why the latter does or does not result in diurnal symptoms, integral to the definition of OSAS. This review focuses on OSAS in adults and discusses some of the difficulties with current definitions and the possible reasons behind them.
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URSAVAŞ, Ahmet, Önder ÖZTÜRK, Oğuz KÖKTÜRK, Pınar MUTLU, Hatice KILIÇ, Aygül GÜZEL, Özge AYDIN GÜÇLÜ, et al. "Türk popülasyonunda obstrüktif uyku apne sendromunda rol oynayan antropometrik ölçümlerin belirlenmesi." Tuberk Toraks 67, no. 4 (December 31, 2019): 248–57. http://dx.doi.org/10.5578/tt.68595.

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Ish, Pranav. "Obstructive Sleep Apnea and Chronic Obstructive Pulmonary Disease Overlap Syndrome - Double Trouble." Journal of Advanced Research in Medicine 05, no. 04 (December 13, 2018): 25–30. http://dx.doi.org/10.24321/2349.7181.201821.

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41

Stoohs, R., and C. Guilleminault. "Cardiovascular changes associated with obstructive sleep apnea syndrome." Journal of Applied Physiology 72, no. 2 (February 1, 1992): 583–89. http://dx.doi.org/10.1152/jappl.1992.72.2.583.

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Five men free of lung or cardiovascular diseases and with severe obstructive sleep apnea participated in a study on the impact of sleep states on cardiovascular variables during sleep apneas. A total of 128 obstructive apneas [72 from stage 2 non-rapid-eye-movement (NREM) sleep and 56 from rapid-eye-movement (REM) sleep] were analyzed. Each apnea was comprised of an obstructive period (OP) followed by a hyperventilation period, which was normally associated with an arousal. Heart rate (HR), stroke volume (SV), cardiac output (CO) (determined with an electrical impedance system), radial artery blood pressures (BP), esophageal pressure nadir, and arterial O2 saturation during each OP and hyperventilation period were calculated for NREM and REM sleep. During stage 2 NREM sleep, the lowest HR always occurred during the first third of the OP, and the highest was always seen during the last third. In contrast, during REM sleep the lowest HR was always noted during the last third of the OP. There was an inverse correlation when the percentage of change in HR over the percentage of change in SV during an OP was considered. The HR and SV changes during NREM sleep allowed maintenance of a near-stable CO during OPs. During REM sleep, absence of a compensatory change in SV led to a significant drop in CO. Systolic, diastolic, and mean BP always increased during the studied OPs.(ABSTRACT TRUNCATED AT 250 WORDS)
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42

Gurdán, Zsuzsanna, József Szalma, and Pálma Benedek. "Az achondroplasia a fogszabályozás szemszögéből." Orvosi Hetilap 162, no. 17 (April 25, 2021): 683–88. http://dx.doi.org/10.1556/650.2021.32074.

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Összefoglaló. Az achondroplasia kialakulásáért az FGFR3-gén mutációja tehető felelőssé, mely a porc növekedési lemezében található chondrocyták érésében okoz zavart. Az esetbemutatásban szereplő lánygyermeknél a születést követő első hónapban a klinikai, laboratóriumi és röntgenvizsgálatok alapján achondroplasia igazolódott. A klinikai tünetek közé tartoznak a rövid végtagok – különösen a proximalis szegmensben –, a macrocephalia, a hypotonia és a horkolás. Szembetűnő a középarc hypoplasiája. A középfül diszfunkciója tovább súlyosbítja a kórképet, sok esetben megfigyelhető a hallás nagyfokú csökkenése, illetve kezelés hiányában akár a hallás elvesztése. A közlemény részletesen bemutatja az obstruktív alvási apnoe szindróma diagnózisrendszerét és kezelési alternatíváit, hangsúlyozva az orthodontiai szempontokat. A fül-orr-gégészeti és a fogszabályozó terápiának köszönhetően, a diagnózistól számított harmadik évre, az alvási apnoe szindróma megszüntetésével a folyamatos pozitív nyomású lélegeztetést el lehetett hagyni. A horkolás és az alvási apnoe szindróma kezelése napjainkban egyre nagyobb hangsúlyt kap, melynek komplex kezelésében a fogszabályozás is jelentős lehet. A harmonikus együttműködés és teamkezelés betegünknél jelentős életminőség-javulást eredményezett. Orv Hetil. 2021; 162(17): 683–688. Summary. Development of achondroplasia is due to the mutation of FGFR3 gene, which disrupts the maturation of chondrocytes found in the growth plate. The diagnosis of the girl in the present case study was established based on clinical symptoms, laboratory tests and X-ray imaging in the first month following childbirth. Clinical symptoms include shorter limbs especially in the proximal segments, macrocephaly, hypotonia and snoring. Hypoplasia of the midface is apparent. Dysfunction of the middle ear further worsens the condition, in many cases severe hearing loss and, without treatment, even deafness can be observed. The publication describes the diagnostic criteria and therapeutic options of obstructive sleep apnea syndrome in detail, with an emphasis on the orthodontic aspects. A comprehensive combined three-year oto-laryngological and orthodontic treatment finally succeeded in controlling the sleep apnea syndrome and it was possible to discontinue the continuous positive airway pressure therapy by the end of the orthodontic therapy. Nowadays, even more alternative therapeutic approaches are available to treat snoring and sleep apnea syndromes, in which the role of orthodontics must not be neglected. Harmonic collaboration and team work treatment resulted in a significant improvement in the quality of life of our patient. Orv Hetil. 2021; 162(17): 683–688.
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Kamphuisen, H. A. C., and E. M. R. Critchley. "SLEEP APNOEA SYNDROME." Lancet 326, no. 8467 (December 1985): 1304–5. http://dx.doi.org/10.1016/s0140-6736(85)91587-9.

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McNicholas, W. T. "Sleep apnoea syndrome." Breathe 1, no. 3 (March 2005): 218–27. http://dx.doi.org/10.1183/18106838.0103.218.

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45

Goldstein, Nira A., Nancy Sculerati, Joyce A. Walsleben, Nasima Bhatia, Deborah M. Friedman, and David M. Rapoport. "Clinical Diagnosis of Pediatric Obstructive Sleep Apnea Validated by Polysomnography." Otolaryngology–Head and Neck Surgery 111, no. 5 (November 1994): 611–17. http://dx.doi.org/10.1177/019459989411100512.

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The decision to perform tonsillectomy and adenoidectomy for treatment of pediatric obstructive sleep apnea syndrome is often made on a clinical basis without formal polysomnography. To examine the accuracy of the clinical diagnosis of pediatric obstructive sleep apnea syndrome, we prospectively evaluated 30 children with obstructive symptoms by a standardized history, physical examination, and review of a tape recording of breathing during sleep. On the basis of this clinical evaluation, patients were divided into three predictive groups: (1) definite obstructive sleep apnea syndrome, (2) possible obstructive sleep apnea syndrome, and (3) unlikely to have obstructive sleep apnea syndrome. Nocturnal polysomnography was used to determine the presence or absence of true sleep apnea. Ten of 18 (55.6%) patients predicted clinically to have definite obstructive sleep apnea syndrome had positive nocturnal polysomnographies. Two of six (33.3%) patients predicted to have possible obstructive sleep apnea syndrome had positive nocturnal polysomnographies. One of six (16.7%) patients predicted to be unlikely to have obstructive sleep apnea syndrome had a positive nocturnal polysomnography. Six nocturnal polysomnographies negative by conventional criteria were suspicious for apnea, but considering these positive for obstructive sleep apnea syndrome did not improve the specificity of the clinical prediction. Our results show that clinical assessment of obstructive sleep apnea syndrome in children is sensitive (92.3%) but not specific (29.4%) for making the diagnosis of obstructive sleep apnea syndrome as compared with nocturnal polysomnography and may contribute to the decision to obtain nocturnal polysomnography in specific circumstances.
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Sultana, Adrian, David Torres, and Roman Schumann. "Special indications for Opioid Free Anaesthesia and Analgesia, patient and procedure related: Including obesity, sleep apnoea, chronic obstructive pulmonary disease, complex regional pain syndromes, opioid addiction and cancer surgery." Best Practice & Research Clinical Anaesthesiology 31, no. 4 (December 2017): 547–60. http://dx.doi.org/10.1016/j.bpa.2017.11.002.

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47

Kryger, Michael A., and Veronica J. Chehata. "Relationship Between Sleep-Disordered Breathing and Neurogenic Obesity in Adults With Spinal Cord Injury." Topics in Spinal Cord Injury Rehabilitation 27, no. 1 (January 1, 2021): 84–91. http://dx.doi.org/10.46292/sci20-00044.

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Spinal cord injury (SCI) substantially increases the risk of neurogenic obesity, diabetes, and metabolic syndrome. Much like in the general population, a discussion of these syndromes in SCI would be incomplete without acknowledging the association of SCI with sleep-disordered breathing (SDB). This article will outline the interplay between obesity and obstructive sleep apnea (OSA), discussing the pathophysiology of obesity in OSA both for the general population and SCI population. The role of insulin resistance in SDB and SCI will also be examined. The epidemiology and pathophysiology of OSA and central sleep apnea in SCI are discussed through an examination of current evidence, followed by a review of central sleep apnea in SCI. Principles of diagnosis and management of SDB will also be discussed. Because sleep deprivation in itself can be a risk factor for developing obesity, the significance of comorbid insomnia in SCI is explored. Ultimately, a thorough sleep history, testing, and treatment are key to improving the sleep of individuals with SCI and to potentially reducing the impact of neurogenic obesity and metabolic syndrome.
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48

Hillarp, B., G. Nylander, I. Rosén, and O. Wickström. "Videoradiography of Patients with Habitual Snoring and/or Sleep Apnea." Acta Radiologica 37, no. 1P1 (January 1996): 307–14. http://dx.doi.org/10.1177/02841851960371p165.

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Purpose: 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 deglutition 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. Material: The preoperative results of 104 patients are presented. In 57 patients who had apneas, the occurrence and type of apnea could be determined. Results and Conclusion: 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.
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49

Khositseth, Anant, Palinee Nantarakchaikul, Teeradej Kuptanon, and Aroonwan Preutthipan. "QT dispersion in childhood obstructive sleep apnoea syndrome." Cardiology in the Young 21, no. 2 (November 12, 2010): 130–35. http://dx.doi.org/10.1017/s1047951110001514.

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AbstractThe difference between maximal and minimal QT interval and corrected QT interval defined as QT dispersion and corrected QT dispersion may represent arrhythmogenic risks. This study sought to evaluate QT dispersion and corrected QT dispersion in childhood obstructive sleep apnoea syndrome. Forty-four children (34 male) with obstructive sleep apnoea syndrome, aged 6.2 plus or minus 3.5 years along with 38 healthy children (25 male), 6.6 plus or minus 2.1 years underwent electrocardiography to measure QT and RR intervals. Means QT dispersion and corrected QT dispersion were significantly higher in obstructive sleep apnoea syndrome than controls, 52 plus or minus 27 compared to 40 plus or minus 14 milliseconds (p equal to 0.014), and 71 plus or minus 29 compared to 57 plus or minus 19 milliseconds (p equal to 0.010), respectively. Interestingly, QT dispersion and corrected QT dispersion in obstructive sleep apnoea syndrome with obesity, 57 plus or minus 30 and 73 plus or minus 31 milliseconds, were significantly higher than in control, 40 plus or minus 14 and 57 plus or minus 19 milliseconds (p equal to 0.009 and 0.043, respectively). However, QT dispersion and corrected QT dispersion in obstructive sleep apnoea syndrome without obesity, 43 plus or minus 20 and 68 plus or minus 26 milliseconds, were not significantly different. In conclusion, QT dispersion and corrected QT dispersion were significantly increased only in childhood obstructive sleep apnoea syndrome with obesity. Obesity may be the factor affecting the increased QT dispersion and corrected QT dispersion.
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50

Dubey, A. P., Ashok K. Rajput, Virender Suhag, Durgesh Sharma, Ajay Kandpal, and Roshlin Keisham. "Prevalence of obstructive sleep apnoea in metabolic syndrome." International Journal of Advances in Medicine 4, no. 3 (May 23, 2017): 722. http://dx.doi.org/10.18203/2349-3933.ijam20172261.

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Background: The prevalence of both OSA and metabolic syndrome is increasing worldwide, in part linked to the epidemic of obesity. Beyond their epidemiologic relationship, growing evidence suggests that OSA may be causally related to metabolic syndrome. We are only beginning to understand the potential mechanisms underlying the OSA-metabolic syndrome interaction. Objectives were to study the clinical prevalence of obstructive sleep apnoea in metabolic syndrome; and to find risk factors associated with obstructive sleep apnoea (OSA).Methods: 50 patients attending various OPDs of a tertiary care research and referral hospital and found to have metabolic syndrome on the basis of NCEP criteria were selected. These patients were subjected to overnight polysomnography. Parameters such as apnea-hypopnoea index (AHI), respiratory efforts related arousals (RERA), minimum SpO2, pulse rate, blood pressure, and ECG were monitored throughout the study.Results: Central obesity was found in 34 patients, xanthelasmas in 12 patients and xanthomas in 08 patients. Pitting type of pedal oedema was noted in 14 patients. Epworth sleepiness score (ESS) was calculated in all the patients by interviewing them before the polysomnography. Most of the patients have ESS Score more than 11.03 out of 50 patients were found to have AHI<5.20 patients were found to have moderate AHI (AHI 15-30) whereas 22 were found to have severe AHI.Conclusions: Polysomnography provides a valuable tool to access non symptomatic sleep disordered breathing at an early stage in patients with metabolic syndrome.
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