BACKGROUND: Lymphangioleiomyomatosis (LAM) is characterised by progressive airway obstruction and hypoxaemia in young women. Although sleep may trigger hypoxaemia in patients with airway obstruction, it has not been previously investigated in patients with LAM. METHODS: Consecutive women with lung biopsy proven LAM and absence of hypoxaemia while awake were evaluated ...

Chronic cough is defined as cough lasting more than 2 months. Common causes for chronic cough in nonsmokers with normal chest radiographs and pulmonary functions include gastroesophageal reflux disease (GERD), cough-variant asthma (CVA), and upper airway cough syndrome (UACS). Current guidelines recommend diagnosing the etiology of chronic cough based upon ...

Obstructive sleep apnea (OSA) is a sleep-disordered breathing condition, which is increasingly being recognized as having wide-ranging pathophysiological effects on multiple organ systems. Although multiple factors affect the incidence and severity of OSA, male sex and obesity seem to play an influential role. The apnea-ventilation cycle, characterized by abnormalities in ...

Obstructive sleep apnea syndrome (OSAS) due to adenotonsillar hypertrophy (ATH) is a common and important problem in children. OSAS can lead to significant cardiopulmonary complications, poor growth and problems with learning and behavior. Many studies in the literature show that OSAS due to ATH causes pulmonary hypertension, ventricular hypertrophy and ...

INTRODUCTION: We report a 16-year-old female with Melnick-Needles syndrome complicated with severe obstructive sleep apnea-hypoxia syndrome. CLINICAL REPORT: An overnight sleep study demonstrated that the patient had severe obstructive sleep apnea with an apnea-hypopnea index of 95/h. The lowest oxygen saturation was only 34%. The distraction osteogenesis technique was used ...

BACKGROUND: Long-term survivors of childhood cancer are at risk for fatigue, sleep problems, and neurocognitive impairment, although the association between these outcomes has not been previously examined. METHODS: Outcomes were evaluated in 1426 survivors from the Childhood Cancer Survivor Study using a validated Neurocognitive Questionnaire. Relative risks for neurocognitive impairment ...

The obstructive sleep apnea-hypopnea syndrome (OSAHS) is a sleep related breathing disorder. A popular treatment is the use of a mandibular repositioning appliance (MRA) which advances the mandibula during the sleep and decreases the collapsibility of the upper airway. The success rate of such a device is, however, limited and ...

BACKGROUND: The eye of the domestic pig (Sus scrofa domestica) is an ex vivo animal model often used in vision sciences research (retina studies, glaucoma, cataracts, etc.). However, only a few papers have compiled pig eye anatomical descriptions. The purpose of this paper is to describe pig and human eye ...

The aims of this study were to evaluate the correlation between oropharyngeal examination and objective palatine tonsil volume in snoring adults and verify the influence of the oropharyngeal anatomy, body mass index, age, and severity of obstructive sleep apnea on actual tonsil volume. In addition, we aimed to assess the ...

OBJECTIVE: Obstructive sleep apnea is characterized by increased upper airway collapsibility during sleep. The present study investigated the use of the negative expiratory pressure test as a method to rule out obstructive sleep apnea. METHODS: Flow limitation was evaluated in 155 subjects. All subjects underwent a diurnal negative expiratory pressure ...

Significant heterogeneity of clinical presentation and disease progression exists within chronic obstructive pulmonary disease (COPD). Although forced expiratory volume in 1 second (FEV(1)) inadequately describes this heterogeneity, a clear alternative has not emerged. This article discusses and refines the concept of phenotyping desaturators in COPD and shows a possible pattern ...

To discuss the relationship between obesity and obstructive sleep apnea as they relate to the growing atrial fibrillation epidemic, and to discuss possible mechanistic links and implications for treatment of atrial fibrillation. Increasing BMI plays an important role in development of atrial fibrillation in both men and women. Sleep-disordered breathing ...

PURPOSE:: To determine the association between mucin ball formation and corneal infiltrative events (CIEs) during continuous wear with lotrafilcon A silicone hydrogel contact lenses. METHODS:: Subjects (n = 205) in the Longitudinal Analysis of Silicone Hydrogel Contact Lens Study wore lotrafilcon A contact lenses for 12 months of continuous wear. ...

Although precise localization of obstruction sites in the upper airway during sleep is essential in subjects with obstructive sleep apnea syndrome (OSAS), no gold standard diagnostic method has been established. This study aimed to evaluate the dynamic collapse inside the upper airway by using cine magnetic resonance imaging (MRI), also ...

Obstructive sleep apnea syndrome (OSAS) is associated with cardiovascular morbidity and mortality, and increased sympathetic activity is considered to be a causative link in this association. Higher levels of sympathetic activity have been reported in children with OSAS. Sympathetic predominance is indicated on heart rate variability (HRV) analysis by increased ...

Abstract Conclusions: This study has shown that the body mass index (BMI), neck circumference, and modified Mallanpati grade (MMP) are predictive of severity of obstructive sleep apnea/hypopnea syndrome (OSAHS). The neck circumference and MMP were revealed to be important morphological features in the responders whose apnea/hyoponea index (AHI) was substantially ...

Obstructive sleep apnea occurs frequently in patients with drug-resistant hypertension. The factors accounting for this observation, however, are unclear. Both conditions demonstrate clinical features suggestive of extracellular fluid volume overload. The aims of this study were to examine whether the spontaneous overnight fluid shift from the legs to the upper ...

The purpose of this study was to review available evidence on the efficacy of various oral appliances on subjectively perceived symptoms of obstructive sleep apnea syndrome. A search of 4 databases was carried out. Articles were initially selected based on their titles or abstracts. Full articles were then retrieved and ...

Obstructive sleep apnea is a prevalent disease that is associated with significant morbidity and mortality, particularly due to cardiovascular disease. An emerging cardiovascular risk factor, arterial stiffness, may also be involved in the cardiovascular complications of obstructive sleep apnea. The purpose of this review was to summarize the current literature ...

We aimed to evaluate the severity of upper airway obstruction at the retropalatal and retroglossal regions in obstructive sleep apnea (OSA) patients. This is a descriptive cross-sectional study at the Sleep Clinic, Department of Otorhinolaryngology-Head and Neck Surgery. Flexible nasopharyngolaryngoscopy was performed in seated erect and supine position. Retropalatal and ...

Chiari malformation (CM) is the downward herniation of the caudal part of the cerebellum and/or medulla oblongata into the spinal canal. It can alter several neurological functions, including respiratory control and upper airway motility, and can be the cause of sleep-disordered breathing (SDB). The authors describe a 6-year-old boy affected ...

Practice parameters for the treatment of obstructive sleep apnea syndrome (OSAS) in adults by surgical modification of the upper airway were first published in 1996 by the American Academy of Sleep Medicine (formerly ASDA). The following practice parameters update the previous practice parameters. These recommendations were reviewed and approved by ...

Obstructive sleep apnea syndrome affects 1% to 2% of children. It is caused mainly by upper airway obstruction and manifests as snoring and sleep disturbance. Adenotonsillectomy can improve quality of life because airway obstruction occurs when both tonsils and adenoids are enlarged. We describe an 8-year-old girl with a recurrence ...

This study demonstrates that there is a significant difference in sound spectrum between first snoring sound after upper level and lower level obstructive apneas, and it is possible to use sound spectrum analysis as a supplementary method to determine the obstructive site of a patient with obstructive sleep apnea syndrome ...

Understanding the sites of pharyngeal collapse is mandatory for surgical treatment decision-making in obstructive sleep-apnea-hypopnea syndrome patients. Drug-induced sleep endoscopy (DISE) allows for the direct observation of the upper airway during sedative-induced sleep. In order to re-create snoring and apnea patterns related to a spontaneous sleep situation, the authors used ...

The present position paper on the use of portable monitoring (PM) as a diagnostic tool for obstructive sleep apnea⁄hypopnea (OSAH) in adults was based on consensus and expert opinion regarding best practice standards from stakeholders across Canada. These recommendations were prepared to guide appropriate clinical use of this new technology ...

Over the past few decades, continuous positive airway pressure (CPAP) therapy for obstructive sleep apnea has evolved into more and more sophisticated modes of therapy for various forms of sleep-disordered breathing. While the principles of splinting the airway and delivering assisted ventilation underpin the basics of this therapy, the introduction ...

Portable-monitor testing is being used increasingly in ambulatory management pathways for the diagnosis and treatment of patients with obstructive sleep apnea. Wide varieties of portable monitors are commercially available and they range from single-channel recorders to units that record a full polysomnogram. Recent comparative effectiveness research studies have shown that ...

Obstructive sleep apnea/hypopnea syndrome (OSAHS) is a medical condition that has received significant attention within the medical community and mainstream media due to its potentially serious physiological consequences and relatively frequent occurrence within the general population. From the military perspective, the impact on individual readiness for deployment, and the potential ...

OPINION STATEMENT: An array of surgical, medical and orthodontic treatments is available for treating childhood obstructive sleep apnea. Adenotonsillectomy remains the first choice in treatment, with a need for subsequent clinical and polysomnographic reassessment in selected cases to determine residual sleep-disordered breathing. Residual obstructive sleep apnea is more likely in ...

We investigated difference of parameters of polysomnography, cephalometry and dynamic multi-detector computerized tomography (MD-CT) in wake and sleep states according to obesity. We evaluated 93 patients who underwent polysomnography and cephalometry. MD-CT was performed in 68 of these 93 patients. Fifty-nine and 34 patients were classified as obese and non-obese, ...

Anesthesia and sleep both predispose to upper airway obstruction through state-induced reductions in pharyngeal dilator muscle activation and lung volume. The tendencies are related in patients with obstructive sleep apnea commonly presenting with difficulties in airway management in the perioperative period. This is a period of great potential vulnerability for ...

OPINION STATEMENT: Obstructive sleep apnea is a highly prevalent disease that often goes undetected for many years before diagnosis. Although most patients seek treatment to improve symptoms of daytime sleepiness, a growing body of literature suggests that treatment may also modulate cardiovascular risk. This article summarizes the current literature regarding ...

The use of opioids has been associated with development of sleep-disordered breathing, including central apneas, nocturnal oxygen desaturations, and abnormal breathing patterns. We describe sleep-disordered breathing and its subsequent treatment in a group of obstructive sleep apneic patients on chronic opioid therapy. Clinical evaluation followed by diagnostic overnight polysomnogram was ...

INTRODUCTION: Snoring has received increased attention over the last years. Given its high prevalence and its impact on quality of life, diagnosis and treatment of snoring are of major importance. AIM OF THE GUIDELINE: This guideline aims to promote high-quality care by medical specialists for adults who snore. DIAGNOSTIC MEASURES: ...

OBJECTIVE: To analyze computer-assisted quantitative measurements of endoscopic images taken during fiberoptic nasopharyngoscopy with Müller's maneuver that were processed with the use of fractal geometry and correlate them with the apnea-hypopnea index of patients with obstructive sleep apnea syndrome as well as habitual snorers. STUDY DESIGN: Diagnostic test assessment for ...

OBJECTIVES/HYPOTHESIS: To evaluate the impact of multilevel obstructive sleep apnea surgical treatment on sleep-disordered breathing severity, health-related measures, and quality of life, and to examine the association between changes in sleep-disordered breathing severity and these other outcomes. STUDY DESIGN: Prospective cohort study. METHODS: Subjects with obstructive sleep apnea unable to ...

OBJECTIVE: To determine the predictors affecting treatment outcome after application of the mandibular advancement device (MAD). DESIGN: Retrospective analysis. SETTING: Tertiary care university hospital. PATIENTS: A total of 76 patients (68 men and 8 women) who were treated with the MAD for obstructive sleep apnea (OSA) were included from September ...

The objectives of this article are to (1) understand how respiratory event definitions and syndrome threshold values affect prevalence estimates of obstructive sleep apnea in adults, (2) recognize important risk factors for obstructive sleep apnea in adults, and (3) understand current theories of the underlying mechanisms for airway obstruction during ...

Portable monitor testing is being increasingly used as an alternative strategy for the diagnosis and treatment of patients with obstructive sleep apnea. Portable monitors have become progressively sophisticated but lack standardization. Recent studies comparing clinical outcomes of ambulatory management pathways using portable monitor testing support their use in patients with ...

Obstructive sleep apnea is the most prevalent breathing disturbance in sleep. It is linked to a host of preexisting medical conditions, and associated with poorer postoperative outcomes. Screening and vigilance during the preoperative assessment identifies patients at high risk of obstructive sleep apnea. Further diagnostic tests may be performed, and ...

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: The attitudes of general dental practitioners and medical specialists to the provision of intra-oral appliances for the management of snoring and sleep apnoea Jauhar S, Lyons MF, Banham SW, Orchardson R, Livingston E. Br Dent J 2008;205(12):653-7. REVIEWER: Mike T. John, DDS, PhD PURPOSE/QUESTION: Should ...

Sleep-disordered breathing (SDB) consists of episodes of periodic obstructive or central sleep apnea and partial upper airway obstruction. The first two are well recognized and diagnosed, although still underdiagnosed. Traditionally, research in SDB has focused mainly on male patients with obstructive sleep apnea using apnea/hypopnea index (AHI) as a measure ...

CONCLUSION: Patients with upper airway narrowing at the soft palate level and partial upper airway obstruction during sleep seem to benefit from laser-assisted uvulopalatoplasty (LUPP) in terms of decreased velopharyngeal collapsibility and improved nocturnal breathing. OBJECTIVES: The current operative treatments for obstructive sleep apnea syndrome (OSAS) are not very effective ...

Adenoidal hypertrophy is probably the most frequent pathology in the pediatric population. This disorder manifests with several symptoms such as bilateral nasal obstruction, rhinorrhea, cough, snoring, hyponasal speech, hypopnea, and sleep apnea. When tonsillar hypertrophy is also present, obstructive sleep apnea syndrome can manifest. To date, nasal endoscopic examination is ...

The purpose of the prominent human external nose remains unclear. The external nose may play a compensatory role in the aerodynamic support of the upper airway, which in humans has been severely narrowed to enable spoken language. During times of decreased muscle tone, the wing-like soft palate may be supported ...

A 39-year-old man with a history of poorly controlled hypertension presented with a 2-year history of fatigue, daytime somnolence, and intermittent episodes of diaphoresis and palpitations. Episodes were self-limiting, lasting approximately 5-10 minutes and occurred several times per month, most notably at night. Laboratory evaluation was significant for elevated 24-h ...

OBJECTIVES: To determine the effect of the drug combination domperidone and pseudoephedrine on nocturnal oximetry measurements and daytime sleepiness in patients with obstructive sleep apnea. METHODS: We recruited patients with severe snoring and apneic episodes willing to undergo repeated nocturnal oximetry testing. Following baseline clinical history, Epworth Sleepiness Scale administration, ...

Identifying the site of obstruction and the pattern of airway change during sleep are the key points essential to guide surgical treatment decision making for Obstructive Sleep Apnoea-Hypopnoea Syndrome in adults. In this investigation, 250 cases were retrospectively analyzed in order to compare the pharyngolaryngeal endoscopic findings detected in the ...

INTRODUCTION: We report on the use of an oral appliance fitted to a few maxillary and mandibular teeth to treat obstructive sleep apnea syndrome. METHODS: We used a mandibular repositioning appliance, the adjustable PMPositioner. Polysomnograms were taken before and after use of the appliance. RESULTS: The apnea-hypopnea index decreased from ...