Respiratory care
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Obesity is one of the most prominent risk factors for obstructive sleep apnea (OSA). Weight loss decreases the number of shorter respiratory events (<40 s), whereas the number of longer events remains almost unchanged. However, it is unknown how body mass index (BMI) affects individual obstruction event severity within OSA severity categories when age, sex, smoking, daytime sleepiness, snoring, hypertension, heart failure, and sleeping posture are considered. Therefore, we investigated whether individual obstruction event severity varies with BMI within the OSA severity categories when considering the most important confounding factors. ⋯ Because BMI is related to the duration of individual obstruction events, its effect on OSA severity is more complex than its effect on AHI would implicate. Therefore, overall severity of OSA may not be the same for non-obese patient and obese patient who have similar AHI. Thus, these patient-specific characteristics of individual breathing cessations should be considered when estimating the severity of disease and risk of related adverse health effects.
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A simple exercise test to evaluate for exercise-induced bronchoconstriction (EIB) is routinely ordered in pediatric patients with exercise-induced dyspnea. However, the utility of this test in establishing the cause of exercise-induced dyspnea is not thoroughly examined in the pediatric population. We sought to assess the efficiency of a simple EIB challenge test in finding the cause of exercise-induced dyspnea in pediatric patients referred to our tertiary center in the last 5 y. ⋯ In a majority of subjects without asthma, a simple EIB challenge testing failed to uncover the cause of exercise-induced dyspnea and thus was inefficient. In these subjects, cardiopulmonary exercise testing may be more useful and cost-effective to explore other causes of dyspnea including EIB.