Latest Advances in Sleep Medicine Obstructive Sleep Apnea

Chest (Impact Factor: 7.48). 12/2012; 142(6):1645-51. DOI: 10.1378/chest.12-2391
Source: PubMed


This article is a review of the pertinent scientific data regarding obstructive sleep apnea (OSA) as presented in the medical literature. Attention regarding the diagnosis of OSA focused on the debate regarding home testing as compared with in-laboratory polysomnography (PSG), with a surprising result of possibly more cost benefit from PSG. New advances abound in the treatment of OSA, including those directed at preventing pharyngeal collapsibility. Multiple studies reviewed the comparative effects of oral appliances in conjunction with CPAP, with little difference between the two noted, especially for mild OSA. Finally, a number of studies evaluated both risks of OSA and outcomes from the use of CPAP, including functional outcomes, direct cardiac benefits, and overall cardiac mortality.

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    • "Obstructive sleep apnoea (OSA) is a disorder that consists of abnormal breathing pauses, irregular or superficial breathing that occurs during sleep [2] [11]. It has often been indicated as a serious, frequent but mostly underrated clinical problem. "
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    ABSTRACT: We present a complete technical solution for continuously monitoring vital signs required for observing sleep apnoea events, one of the major sleep respiratory disorders. Based on industry accepted medical devices, we developed a GSM-based remote data acquisition and transfer module that is integrated via a set of web services into the server side of the application. The back-end is responsible with aggregating all the data, and, based on machine learning techniques, it provides a first level of filtering in order to warn about possible abnormalities. The proposed solution is currently under the test phase at the "Victor Babes" Hospital in Timisoara, Romania.
    Studies in health technology and informatics 05/2015; 210:729-33. DOI:10.3233/978-1-61499-512-8-729
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    • "Indeed, OSAS can promote the development of all three factors of the so-called Virchow's triad (hypercoagulability, hemodynamic changes, endothelial dysfunction), and its association with all-cause mortality and cardiovascular disease is well-recognized [7]. "
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    ABSTRACT: Purpose To describe a case of bilateral and simultaneous central retinal vein occlusion (RVO) in a young patient diagnosed with obstructive sleep apnea syndrome (OSAS). Case Report A 38-year-old man with morbid obesity and daytime sleepiness presented with a history of bilateral vision loss. His visual acuity (VA) was hand movements, and fundus examination (FE) revealed bilateral central RVO. General medical examination revealed untreated hypertension and type II respiratory failure. Laboratory tests for thrombophilia showed increased hematocrit (59%) and high levels of fibrinogen and C-reactive protein. Other causes of congenital and acquired hypercoagulability were ruled out. Pathologic polysomnography led to the diagnosis of OSAS. The patient was treated with antihypertensive drugs and continuous positive air pressure. In addition, he received intravitreal ranibizumab. At 10 months after presentation, his VA was no light perception in the right eye and hand movements in the left eye. FE revealed bilateral retinal and optic nerve atrophy, and the occurrence of a nonarteritic anterior ischemic neuropathy in the right eye was considered.
    Case Reports in Ophthalmology 05/2014; 5(2):150-6. DOI:10.1159/000363132
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    ABSTRACT: Recently, portable sleep recording devices became an accepted alternative to polysomnography (PSG) for obstructive sleep apnoea (OSA) diagnosis in patients with a high pre-test probability of moderate to severe OSA but home polysomnography (H-PSG) was not recommended because there was insufficient data. The present review has analysed six prospective randomiszed cross-over studies comparing H-PSG to in-lab PSG. These studies convincingly showed that H-PSG allows complete sleep evaluation. The quality of patient's sleep tends to be better at home. H-PSG is accurate for OSA diagnosis and the failure rate is low despite the absence of supervision. In addition, it could offer a final and comprehensive diagnosis for many other sleep disorders. It is also likely that H-PSG can reduce PSG-related costs but complete cost-effectiveness analyses are not yet available. Recently, remotely attended H-PSG via telemonitoring has been tested and may reduce H-PSG failure rate. In conclusion, H-PSG can be used to rule-in and rule out OSA in suspected patients, even in the presence of co-morbidities and is an alternative when type 3 recording is negative. Future developments should target simplification of technical aspects of H-PSG, together with remote monitoring, in order to obtain good quality H-PSG performed in adequate conditions.
    Sleep Medicine Reviews 01/2013; 18(4). DOI:10.1016/j.smrv.2013.12.002 · 8.51 Impact Factor
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