Sleep & breathing = Schlaf & Atmung
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Conventional therapies for obstructive sleep apnea (OSA) are effective but suffer from poor patient adherence and may not fully alleviate major OSA-associated cardiovascular risk factors or improve certain aspects of quality of life. Predicting the onset of disordered breathing events in OSA patients may lead to improved strategies for treating OSA and inform our understanding of underlying disease mechanisms. In this work, we describe a deployable system capable of performing real-time predictions of sleep disordered breathing events in patients diagnosed with OSA, providing a novel approach for gaining insight into OSA pathophysiology, discovering population subgroups, and improving therapies. ⋯ We report the first practical system to predict individual disordered breathing events in a heterogeneous group of patients diagnosed with OSA. The pattern of disordered breathing predictors suggests variable underlying pathophysiological mechanisms and highlights the need for an individualized approach to OSA diagnosis, therapy, and management.
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Obstructive sleep apnea (OSA) is a highly prevalent condition related to several cardiovascular complications. We assessed the effects of continuous positive airway pressure (CPAP) treatment on myocardial performance and various somatometric parameters in patients with severe OSA receiving CPAP. ⋯ CPAP therapy in OSA patients was found to improve right heart chambers remodeling and performance as well as somatometric characteristics. The impact of CPAP on LV performance seems less pronounced.
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Obstructive sleep apnea (OSA) is a risk factor for significant perioperative complications. This national survey study sought to determine the attitudes of physicians involved in the perioperative care of OSA patients. ⋯ The majority of physicians in this survey felt OSA was a significant risk factor for perioperative complications and most reported experience with OSA patients having an adverse outcome. Perioperative management guidelines for OSA are not available at most institutions. Further work is needed to help physicians identify and intervene on patients with OSA in the perioperative setting before adverse events develop.
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We sought to assess the rate of sleep complaints and sleep disorders among active duty soldiers with deployment-related PTSD and to determine whether any clinical features differentiated those with sleep disorders. ⋯ Sleep complaints are common among soldiers with PTSD. We observed significantly higher rates of OSAS among those without physical injuries, raising the possibility that underlying sleep-disordered breathing is a risk factor for the development of PTSD. This potential association requires further validation.
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Observational Study
Utility of extended cardiac monitoring to detect atrial fibrillation in patients with severe obstructive sleep apnea.
The relationship between obstructive sleep apnea (OSA) and increased risk for atrial fibrillation (AF) has been well established in previous studies. The relationship between OSA and silent AF is unknown. We hypothesized that patients with OSA but no known history of AF are at an increased risk for the arrhythmia and may be detectable by prolonged electrocardiogram (ECG) monitoring. In this study, we examined whether 7 days of extended cardiac monitoring with an ECG event recorder is an effective screening tool to detect intermittent, silent AF in patients with severe OSA. ⋯ In patients with severe OSA without a known history of AF, 7 days of extended cardiac monitoring with an ECG event recorder did not detect clinically meaningful, silent AF.