Sleep & breathing = Schlaf & Atmung
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Comparative Study
Analysis of cardiopulmonary coupling to assess adaptive servo-ventilation success in complex sleep apnea management.
Adaptive servo-ventilation (ASV) is used to treat complex sleep apnea syndrome (CompSAS), but with variable success. Factors influencing success are poorly understood. ASV devices determine their output based upon characteristics of a given breath and on proprietary algorithms that assume a periodic breathing pattern. Periodic breathing patterns produce elevated narrow band low-frequency cardiopulmonary coupling (eNB-LFC). Therefore, we hypothesized that ASV success would correlate with elevated proportions of periodic breathing as marked by eNB-LFC on cardiopulmonary coupling (CPC) analysis. ⋯ ASV was successful in 81 % of patients with CompSAS. However, eNB-LFC calculated from CPC, a marker for periodic breathing, did not correlate with ASV success and therefore may not be a useful tool to predict ASV success.
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Sleep-disordered breathing (SDB) differs between genders in terms of the type, signs, and symptoms of the disease. Partial upper airway obstruction is underdiagnosed and undertreated. ⋯ These results indicate that partial upper airway obstruction in women should be clinically recognized like obstructive sleep apnea.
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Randomized Controlled Trial Comparative Study
Effects of treatment with oral appliance on 24-h blood pressure in patients with obstructive sleep apnea and hypertension: a randomized clinical trial.
Continuous positive airway pressure treatment has been shown to lower blood pressure (BP) in patients with obstructive sleep apnea (OSA). The aims of the present pilot study were to evaluate the potential effects of oral appliance (OA) therapy on BP, to assess various outcome BP measures, and to inform sample size calculation. ⋯ In patients with OSA and hypertension, OA treatment had a modest trend toward effect on reducing BP. A stronger trend toward treatment effect was seen after excluding patients with normal baseline ambulatory BP. Additional exclusion of patients with baseline AHI ≤15 showed a significant treatment effect. Data to inform sample size for an adequately powered randomized study are provided.
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Meta Analysis
Impact of continuous positive airway pressure on C-reactive protein in patients with obstructive sleep apnea: a meta-analysis.
C-reactive protein (CRP) is associated with the development of obstructive sleep apnea (OSA) and cardiovascular diseases. Continuous positive airway pressure (CPAP) is an effective treatment for OSA, but the impact of CPAP therapy on CRP levels in patients with OSA remains unclear. To obtain this information, we performed a meta-analysis to determine whether effective CPAP therapy could reduce serum CRP levels. ⋯ The systemic inflammation, as measured by CRP, was present and significantly reduced by effective CPAP therapy in patients with OSA. The use of CRP levels may be clinically recognized as a valuable predictor for OSA treatment monitoring.