Deeban Ratneswaran

Deeban Ratneswaran
Guy's and St Thomas' NHS Foundation Trust · Lane Fox Respiratory Unit

BSc (hons) MBBS MRCP (UK) AMInstLM - Tweet @deeban_r - https://twitter.com/deeban_r

About

40
Publications
4,080
Reads
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234
Citations
Additional affiliations
December 2016 - present
Guy's and St Thomas' NHS Foundation Trust
Position
  • Researcher
August 2014 - December 2016
St George's, University of London
Position
  • Professor

Publications

Publications (40)
Conference Paper
Full-text available
Introduction Obstructive Sleep Apnoea (OSA) is commonly treated with Continuous Positive Airway Pressure (CPAP) therapy. Over the last decade, hypoglossal nerve stimulation in OSA has been tested in randomised controlled trials (RCT) to maintain the neuromuscular tone of the genioglossus muscle and treat OSA. We sought to analyse the qualitative fe...
Article
Background Hypoglossal nerve stimulation (HNS) for obstructive sleep apnoea (OSA) is a novel way to manage the condition. We hypothesised that in patients with OSA and limited adherence to continuous positive airway pressure (CPAP) therapy, domiciliary transcutaneous electrical stimulation (TESLA) would control sleep apnoea and provide health benef...
Article
Purpose of review: Obstructive sleep apnoea (OSA) is a highly prevalent condition affecting about 1 billion people worldwide. The first line therapy for most patients with OSA is continuous positive airway pressure (CPAP) therapy. However, there are significant limitations with long-term adherence to CPAP therapy, which may be as low as 30-60%. R...
Article
Full-text available
PurposeElectrical stimulation of the upper airway dilator muscles is an emerging treatment for obstructive sleep apnea (OSA). Invasive hypoglossal nerve stimulation (HNS) has been accepted as treatment alternative to continuous positive airway pressure (CPAP) for selected patients, while transcutaneous electrical stimulation (TES) of the upper airw...
Article
Full-text available
Background: Electrical current can be used to stimulate upper airway dilator muscles to treat obstructive sleep apnoea (OSA). Ultrasound devices are widely available and may be used to detect contraction of the upper airway dilator muscles assessing the functionality of electrical stimulation (ES) used for this treatment. Methods: In a physiolog...
Conference Paper
Introduction Electrical stimulation of the upper airway dilator muscles is an emerging treatment for obstructive sleep apnea (OSA). Hypoglossal nerve stimulation (HNS) has recently been approved as treatment alternative to continuous positive airway pressure (CPAP) for selected patients with moderate to severe OSA, while transcutaneous electrical s...
Article
Full-text available
Introduction In contrast to tobacco smoking, electronic cigarette (“vaping”) advertisement had been approved in the United Kingdom (UK) in January 2013. Currently, there are an estimated 3.2 million UK e-cigarette users. The impact of e-cigarette advertisement on tobacco use has not been studied in detail. We hypothesised that e-cigarette advertise...
Article
Full-text available
Obstructive sleep apnoea (OSA) is a global health problem of increasing prevalence. Effective treatments are available with continuous positive airway pressure (CPAP) therapy and mandibular advancement devices (MAD). However, there is limited long-term adherence to therapy, as CPAP and MAD require permanent usage to avoid recurrence of the symptoms...
Article
Full-text available
Objectives: Continuous positive airway pressure (CPAP) improves upper airway obstruction in patients with obstructive sleep apnoea (OSA), who often are overweight-obese. Although it is thought that CPAP improves long-term blood pressure control (BP), the impact of acute and short-term CPAP use on the cardiovascular system in obese patients has not...
Chapter
Obesity causes an increased load on the respiratory muscle pump that impacts on the work of breathing and requires high levels of neural respiratory drive. Elevated intra-abdominal pressures in obesity impose a preload on the diaphragm during inspiration, particularly in the supine posture. These forces contribute to a reduced transpulmonary pressu...
Article
Introduction Transcutaneous electrical stimulation (TES) provides neuromuscular tone to the pharyngeal dilator muscles of the upper airway (UA) while asleep, but feasibility of this method to treat obstructive sleep apnoea (OSA) throughout the whole night has not been tested. Patients and methods We conducted a phase two double-blind, sham-control...
Article
Obstructive sleep apnoea is characterised by a loss of neuromuscular tone of the upper airway dilator muscles while asleep. Continuous positive airway pressure is a well-established long-term treatment, but patient compliance is limited. This study investigated the effectiveness of transcutaneous electrical stimulation in patients with obstructive...
Article
Full-text available
Objectives We compared 2 sociocultural cohorts with different duration of exposure to graphic health warning labels (GHWL), to investigate a possible desensitisation to their use. We further studied how a differing awareness and emotional impact of smoking-associated risks could be used to prevent this. Setting Structured interviews of patients fr...
Article
Introduction: Transcutaneous electrical stimulation (TES) provides neuromuscular tone to the pharyngeal dilator muscles of the upper airway (UA) while asleep, but feasibility of this method to treat obstructive sleep apnoea (OSA) throughout the whole night has not been tested. Patients&Methods: We conducted a sham-controlled, randomised and control...
Article
Obstructive sleep apnoea (OSA) is characterised by a loss of neuromuscular tone of the upper airway dilator muscles while asleep. Positive airway pressure is a well-established long-term treatment, but patient compliance is limited. Alternative treatment options include the use of electrical current for hypoglossal nerve stimulation. This study inv...
Article
Full-text available
Introduction: Obstructive sleep apnoea (OSA) is characterised by a loss of neuromuscular tone of the upper airway dilator muscles while asleep. This study investigated the effectiveness of transcutaneous electrical stimulation in patients with OSA. Patients and methods: This was a randomised, sham-controlled crossover trial using transcutaneous...
Article
Obstructive sleep apnea (OSA) is a common risk factor for cardiovascular disease. Continuous positive airway pressure (CPAP) improves OSA symptoms and blood pressure (BP) control. The effect of CPAP on BP variability (BPV) in patients with and without hypertension treated with autotitrating CPAP (APAP) for 2 weeks was studied. A total of 78 partici...
Article
Study objectives: Continuous positive airway pressure (CPAP) is an effective treatment for obstructive sleep apnea (OSA). However, long-term compliance with CPAP is limited. We tested the hypothesis that CPAP levels routinely used during sleep increase neural respiratory drive (NRD) and breathlessness, which may discourage compliance. Methods: T...
Article
Full-text available
Sleep disorders are becoming increasingly prevalent secondary to elevated levels of light-, noise- and stress-exposure in addition to rising levels of obesity. Sleep medicine is experiencing an exponential gain of knowledge that can be explained by several factors: (I) advanced physiological monitoring at night; (II) improved follow-up of patients;...
Article
Background Continuous positive airway pressure (CPAP) is an effective treatment for obstructive sleep apnoea (OSA). We assessed neural respiratory drive (NRD), as measured by the surface electromyogram of the parasternal intercostals (sEMGpara), during awake CPAP titration to quantify the effect of chest inflation on the load of the respiratory sys...
Article
Introduction Cigarette package graphic health warning labels (GHWL) remain an important means of communicating serious smoking risks. There were significant delays in implementing them in different countries around the world, partly due to tobacco company resistance; additionally, the messages used differ considerably. We expected a reduced cogniti...
Article
Introduction In contrast to tobacco smoking, electronic cigarette (“vaping”) advertisement has been approved in the UK since January 2013. Currently, there are 2.6 million e-cigarette users in the UK. The impact of e-cigarette advertisement on tobacco use has not been studied in detail. We hypothesised that e-cigarette advertisement impacts on smok...
Article
Full-text available
More than two thirds of the US population is obese or overweight, with worldwide obesity rates doubling since 1980. Obesity causes serious health risks including cardiovascular disease, diabetes and cancer (1). It is also associated with respiratory conditions like obesity hypoventilation syndrome, asthma and obstructive sleep apnoea (OSA). Obesity...
Article
Full-text available
Pain is the most common presenting complaint within the emergency department. Whilst national RCEM guidelines exist, there tends to be low compliance with its use. A retrospective, cross-sectional audit, over a 24 hour period, was carried out in the emergency department of a tertiary hospital in London on all patients with abdominal pain. Pain scor...
Article
Background: Lung function and peripheral skeletal muscle changes following PR in COPD have been studied in detail, whilst psychological changes have not. We investigated the relationship between psychological factors, HRQL and EC in COPD patients undergoing PR. Method: Patients were assessed before and after an 8-week 16-session PR programme. Body...
Article
Background CPAP is an effective treatment for OSA. We measured NRD during awake CPAP titration to quantify the effect of chest inflation on the load of the respiratory system. Patients and Methods Obese patients (BMI>30) with confirmed OSA were studied and NRD (surface electromyogram parasternal intercostals, sEMGpara) and surface EMG of the extern...
Article
Background: Continuous positive airway pressure (CPAP) improves long-term blood pressure control (BP) in obese patients with obstructive sleep apnoea (OSA). However, the impact of short-term CPAP use on BP has not been established. We measured continuous BP during CPAP titration. Patients and Methods: Obese patients (BMI>30) were studied awake, sup...
Article
Objective: Though obstructive sleep apnea syndrome (OSAS) is common in patients with resistant hypertension (RH), the prevalence of other sleep disorders, such as restless legs syndrome (RLS) is unknown. We aimend at investigating the prevalence of OSAS and RLS in a cohort of patients with RH recruited in two centres. Copyright
Article
Introduction and objectives Graphic Health Warning Labels (GHWL) assist in primary and secondary smoking prevention. A lack of evidence exists regarding their desensitisation with increased exposure. Investigating knowledge and attitudes around GHWL may allow better implementation of future public health policies. Singapore introduced GHWL in 2004,...
Article
Full-text available
Objectives There is a lack of evidence regarding the effectiveness of graphic health warning labels (GHWL) in different individuals, including patients with chronic obstructive pulmonary disease (COPD). Investigating knowledge and attitudes may allow better implementation of future public health policies. We hypothesised that differences in the imp...

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