Obstructive Sleep Apnea

Strollo, Patrick J.; Rogers, Robert M.

doi:10.1056/nejm199601113340207

Cited by 763 publications

(410 citation statements)

References 51 publications

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“…2). However, similar inefficiency is observed during conventional nCPAP treatment, which involves use of a ramp of up to 45 min [28] to gradually increase the positive pressure to the prescribed level. The disablement period of the recently commercialized device (REM+ auto, SEFAM, Nancy, France) has been reduced to 1 min.…”

Section: Discussionmentioning

confidence: 81%

Evaluation of an auto-nCPAP device based on snoring detection

Lofaso¹,

Lorino²,

Duizabo³

et al. 1996

Eur Respir J

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E Ev va al lu ua at ti io on n o of f a an n a au ut to o--n nC CP PA AP P d de ev vi ic ce e b ba as se ed d o onWe observed that a single night of auto-nCPAP improved the apnoea/hypnoea index (AHI) (12±21 vs 51±31 disordered breathing events·h -1 of sleep (mean±SD)), the awakening-arousal index (13±20 vs 40±26 arousals·h -1 of sleep), and duration of slow wave sleep (102±49 vs 71±56 min) but not of rapid eye movement (REM) sleep (55±31 vs 64±38 min). Auto-nCPAP was effective (apnoea/hypopnoea and arousal indices <10 events·h -1 ) in all but three patients. Auto-nCPAP was ineffective in one patient, whose obstructive respiratory events were not preceded by nasal mask pressure vibration detection, and in two patients who were quasi-permanent mouth breathers.Snoring detection may be effective in sleep apnoea syndrome with heavy snoring and without permanent mouth breathing, during the first night of nasal continuous positive airway pressure treatment.

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Section: Discussionmentioning

confidence: 81%

Evaluation of an auto-nCPAP device based on snoring detection

Lofaso¹,

Lorino²,

Duizabo³

et al. 1996

Eur Respir J

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“…Alcohol minimization or abstinence is frequently recommended in the management of patients with obstructive sleep apnoea [1]. Proposed mechanisms for the adverse effects of alcohol upon OSA include selective reduction in genioglossus and hypoglossal motor nerve activity [20±23], increased nasal mucosa oedema and thereby increased resistance [21], a reduction in arousal response [8±10] and a reduced haemoglobin affinity for oxygen [23].…”

Section: Discussionmentioning

confidence: 99%

“…The treatment of obstructive sleep apnoea (OSA), a condition commonly associated with cardiovascular disease and autonomic disturbance, usually includes lifestyle modification such as avoidance or minimization of alcohol [1]. However, health practitioners frequently tell patients that alcohol, taken in moderate quantities, has beneficial effects upon cardiovascular mortality [2,3].…”

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confidence: 99%

Effect of moderate alcohol upon obstructive sleep apnoea

Scanlan

Roebuck²,

Little

et al. 2000

European Respiratory Journal

132

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Moderate-to-large quantities of alcohol are known to aggravate severe obstructive sleep apnoea (OSA), however, the reported effects of moderate alcohol consumption upon mild-to-moderate OSA are inconsistent. Given the reported benefits of moderate alcohol consumption on cardiovascular mortality, recommendations regarding the management of patients with OSA are difficult to formulate. The aim of this study was to evaluate the effects of moderate alcohol on sleep and breathing in subjects with mild-to-moderate OSA.Twenty-one male volunteers, who snored habitually, underwent polysomnography with and without 0.5 g alcohol . kg body weight (BW) -1 consumed 90 min prior to sleep time, in random order. The mean blood alcohol concentration (BAC) following alcohol at the time of lights out was 0.07 g . dL -1 . The distribution amongst the various sleep stages was not significantly altered by alcohol. The mean apnoea/hypopnoea index rose from 7.11.9 to 9.72.1 events . h -1 (meanSEM, p=0.017); however, there was no significant change in the minimum arterial oxygen saturation measured by pulse oximetry Sp,O 2 , apnoea length or snoring intensity. Mean sleep cardiac frequency rose significantly from 53.91.4 to 59.91.9 beats . min -1 (p<0.001) and overnight urinary noradrenalin increased from 14.92.3 to 18.82.3 nmol . mmol creatinine -1 (p=0.061) on the alcohol night compared to the nonalcohol night.To conclude, modest alcohol consumption, giving a mean blood alcohol concentration of 0.07 g . dL

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“…These data indicate that the elevated leptin and ghrelin levels are not determined by obesity alone, since they rapidly decreased during continuous positive airways pressure therapy. Eur Respir J 2003; 22: 251-257 Obstructive sleep apnoea (OSA) is a common disorder affecting 2-4% of the adult population [1]. OSA is strongly associated with obesity.…”

mentioning

confidence: 99%

Leptin and ghrelin levels in patients with obstructive sleep apnoea: effect of CPAP treatment

Harsch¹,

Konturek²,

Koebnick³

et al. 2003

European Respiratory Journal

250

165

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Serum leptin and ghrelin levels were investigated in patients with obstructive sleep apnoea (OSA) syndrome before and during continuous positive airways pressure (CPAP) treatment and compared with body mass index (BMI)-matched controls without OSA.Male patients (n=30) with OSA (apnoea/hypopnoea index=58 ¡ 16, BMI=32.6 ¡ 5.3 kg?m -2 ) underwent CPAP treatment. Fasting leptin and ghrelin were measured at baseline and 2 days, and in the case of leptin 2 months after initiation of treatment.Baseline plasma ghrelin levels were significantly higher in OSA patients than in controls. After 2 days of CPAP treatment, plasma ghrelin decreased in almost all OSA patients (n=9) to levels that were only slightly higher than those of controls (n=9). Leptin levels did not change significantly from baseline after 2 days of CPAP treatment, but were higher than in the control group. After 8 weeks, leptin levels decreased significantly, although the BMI of the patients showed no change. The decrease in leptin levels was more pronounced in patients with a BMI v30 kg?m -2 . These data indicate that the elevated leptin and ghrelin levels are not determined by obesity alone, since they rapidly decreased during continuous positive airways pressure therapy. Eur Respir J 2003; 22: 251-257 Obstructive sleep apnoea (OSA) is a common disorder affecting 2-4% of the adult population [1]. OSA is strongly associated with obesity. In a recent study involving 773 patients with OSA, only 6.5% had a normal body mass index (BMI), while 75.2% were obese (BMIo30 kg?m -2 ) [2]. Patients with OSA appear to be more likely to put on weight than equally obese subjects without OSA [3]. The mechanisms underlying this phenomenon remain obscure. Recently, a number of authors have speculated that changes in serum leptin levels or leptin-receptor insensitivity may be involved in the pathogenesis of progressive obesity in patients with OSA [4]. Leptin has been found to reduce appetite and simultaneously to increase respiratory drive in an animal model [5,6]. In humans, the situation may be expected to be more complicated. In recent studies, fasting leptin levels in patients with OSA decreased after initiation of continuous positive airways pressure (CPAP) treatment [7,8]. However, those leptin measurements were performed on awake individuals in the morning, when the respiratory situation was normalised, so that any linkage between leptin levels and respiratory effects is difficult in this setting. Furthermore, leptin levels are influenced by a multitude of factors, such as sex, body weight [9,10], the presence of hypertension, or specific medications impacting on leptin levels. Diurnal and ultradian variations in serum leptin levels are further factors complicating profound insights concerning significant respiratory effects [11][12][13].However, the finding that a hormone like leptin is able to cover a variety of biological functions, beyond its well-investigated role for the regulation of body weight and energy expenditure, also prompted the present aut...

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Obstructive Sleep Apnea

Cited by 763 publications

References 51 publications

Evaluation of an auto-nCPAP device based on snoring detection

Evaluation of an auto-nCPAP device based on snoring detection

Effect of moderate alcohol upon obstructive sleep apnoea

Leptin and ghrelin levels in patients with obstructive sleep apnoea: effect of CPAP treatment

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