Sleep & breathing = Schlaf & Atmung
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Randomized Controlled Trial Multicenter Study Comparative Study
Home-use servo-ventilation therapy in chronic pain patients with central sleep apnea: initial and 3-month follow-up.
Opioid treatment of non-malignant chronic pain can result in hypoxemia, hypercarbia, and central sleep apnea. The aim of this study was to determine the initial efficacy of auto servo-ventilation (ASV) and after 3 months of home use. ⋯ Initial and home use of ASV for 3 months resulted in significantly lower AHI, CAI, and OAI. This reduction attests to the efficacy of ASV treatment in chronic pain patients on high doses of opioids.
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Comparative Study
Utility of the STOP-BANG components to identify sleep apnea using home respiratory polygraphy.
Utility of questionnaires to estimate the probability of obstructive sleep apneas (OSA) is varying, and it is challenging to know the performance of STOP (Snore, Tired, Observed apnea, and Pressure)-BANG (BMI, Age, Neck and Gender) with simplified methods. To assess the performance of STOP-BANG and its ability to predict sleep apnea in patients with high pre-test like-hood to present OSA referred for a home respiratory polygraphy (RP) were studied. ⋯ STOP-BANG shows different discrimination power for AHI >5 and ≥30/h using RP. Five components in any combination have acceptable diagnostic S to identify patients with severe OSA. STOP-BANG performed best to identify AHI ≥30/h.
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Comparative Study
Evaluation of the Arabic version of STOP-Bang questionnaire as a screening tool for obstructive sleep apnea.
Obstructive sleep apnea (OSA) is a sleep-related breathing disorder that is underdiagnosed. OSA is usually diagnosed by polysomnography (PSG) and, if untreated, could lead to life-threatening complications. Many screening questionnaires have been developed to screen and identify patients at high risk for OSA. This study aimed to evaluate and validate the Arabic version of Stop-Bang questionnaire as a screening tool for patients with OSA symptoms referred to a sleep clinic. ⋯ The Arabic version of STOP-Bang questionnaire is an easy-to-use tool that can be implemented as a reliable, quick screening tool for OSA in patients referred to sleep clinic. It demonstrated high sensitivity and NPV especially for patients with moderate to severe OSA. We believe that this tool will help physicians to earlier identify cases at risk of OSA.
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Overnight oximetry is a simple tool for investigation of obstructive sleep apnoea (OSA) in children, but only severe cases will be detected, and children with obstructive events resulting in arousal, but not desaturation, will have a normal (inconclusive) result. We hypothesised that pulse rate rises using pulse rate indices per hour (PRI) and pulse rate standard deviation (PR-SD) automatically calculated from commercially available software would improve oximetry as a diagnostic tool. ⋯ The PRI-15 shows promise as an indicator of OSA in children with normal oximetry.
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Observational Study
IGF-1: a potential biomarker for efficacy of sleep improvement with automatic airway pressure therapy for obstructive sleep apnea?
Positive airway pressure (PAP) reverses obstructive sleep apnea (OSA)-related hypoxia and restores slow wave sleep (SWS). Insulin-like growth factor 1 (IGF-1) is a neuropeptide that facilitates the repair of neurons from hypoxia and improves sleep regulation. IGF-1 concentrations are lower in OSA, and likely increase following PAP treatment; however, this relationship has not yet been determined in a younger cohort of OSA patients. ⋯ Adherence to PAP treatment leads to significant increases in IGF-1 concentrations in young men with OSA. While an objective measure of adherence exists, PAP usage does not allow for measure of sleep improvement. IGF-1 may serve as a potential biomarker for the efficacy of PAP therapy on improved sleep.