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Locke BW, Sellman J, McFarland J, Uribe F, Workman K, Sundar KM. Predictors of Initial CPAP Prescription and Subsequent Course with CPAP in Patients with Central Sleep Apneas at a Single Center. Lung 2023; 201:625-634. [PMID: 37987861 PMCID: PMC10869204 DOI: 10.1007/s00408-023-00657-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 11/07/2023] [Indexed: 11/22/2023]
Abstract
PURPOSE Guidelines recommend considering an initial trial of continuous positive airway pressure (CPAP) to treat central sleep apnea (CSA). However, practice patterns vary widely. This study investigated predictors for an initial trial of CPAP in patients with central apneas and whether those factors predict adequate treatment response in patients receiving an initial CPAP trial. METHODS Charts of patients receiving a diagnostic code for CSA following a sleep study during 2016-2018 at a single center were reviewed. Patient factors, initial treatment prescriptions, and subsequent changes to therapy were extracted from electronic health records. Regression models were used to estimate factors associated with an initial CPAP prescription and the likelihood of an adequate CPAP response (no subsequent therapy change and no discontinuation of therapy) among patients prescribed CPAP. RESULTS 429/588 (73%) patients with central apneas received an initial trial of CPAP. Younger age, diagnosis by home sleep testing, non-opiate etiology of central apneas, and a lower proportion of central apneas at diagnosis were independently associated with a higher likelihood of an initial CPAP trial. A lower proportion of central apneas was associated with a higher probability of adequate response, while current smoking and opiate-related central apneas predicted an unsuccessful CPAP trial. A new finding was that older age predicted a lower likelihood of an initial CPAP prescription but did not predict an unsatisfactory response to CPAP. CONCLUSION Clinicians may incorrectly weigh certain clinical and sleep study characteristics when deciding whether to trial CPAP for patients with central apneas.
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Affiliation(s)
- Brian W Locke
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Jeffrey Sellman
- Division of Pulmonary and Critical Care, Department of Internal Medicine, Boston University, Boston, MA, USA
| | - Jonathan McFarland
- Department of Internal Medicine, Michigan State University, East Lansing, MI, USA
| | - Francisco Uribe
- Department of Psychiatry, Texas Tech University Health Sciences Center, El Paso, TX, USA
| | - Kimberly Workman
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Krishna M Sundar
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA.
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2
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Locke BW, Sellman J, McFarland J, Uribe F, Workman K, Sundar KM. Predictors of Initial CPAP Prescription and Subsequent Course with CPAP in Patients with Central Sleep Apneas. RESEARCH SQUARE 2023:rs.3.rs-3199807. [PMID: 37547021 PMCID: PMC10402256 DOI: 10.21203/rs.3.rs-3199807/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
Purpose Guidelines recommend considering an initial trial of continuous positive airway pressure (CPAP) to treat central sleep apnea (CSA). However, practice patterns vary widely. This study investigated predictors for an initial trial of CPAP in patients with central apneas and whether those factors predict adequate treatment response in patients receiving an initial CPAP trial. Methods Charts of patients receiving a diagnostic code for CSA following a sleep study during 2016-2018 at a single center were reviewed. Patient factors, initial treatment prescriptions, and subsequent changes to therapy were extracted from electronic health records. Regression models were used to estimate factors associated with an initial CPAP prescription and the likelihood of an adequate CPAP response (no subsequent therapy change or nonadherence) among patients prescribed CPAP. Results 429/588 (73%) patients with central apneas received an initial trial of CPAP. Younger age, diagnosis by home sleep testing, non-opiate etiology of central apneas, and a lower proportion of central apneas at diagnosis were independently associated with a higher likelihood of an initial CPAP trial. A lower proportion of central apneas was associated with a higher probability of adequate response, while current smoking and opiate-related central apneas predicted an unsuccessful CPAP trial. A new finding was that older age predicted a lower likelihood of an initial CPAP prescription but did not predict a suboptimal response to CPAP. Conclusion Clinicians may incorrectly weigh certain clinical and sleep study characteristics when deciding whether to trial CPAP for patients with central apneas.
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3
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Ni YN, Holzer RC, Thomas RJ. Acute and long-term effects of acetazolamide in presumed high loop gain sleep apnea. Sleep Med 2023; 107:137-148. [PMID: 37178545 DOI: 10.1016/j.sleep.2023.04.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/22/2023] [Accepted: 04/11/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND The acute effect during positive pressure titration and long term efficacy of acetazolamide (AZT) in high loop gain sleep apnea (HLGSA) is inadequately assessed. We predicted that AZT may improve HLGSA in both conditions. METHODS A retrospective analysis of polysomnograms from patients with presumed HLGSA and residual respiratory instability administered AZT (125 or 250 mg) about 3 h into an initially drug-free positive pressure titration. A responder was defined as ≥ 50% reduction of the apnea hypopnea index(AHI 3% or arousal) before and after AZT. A multivariable logistic regression model estimated responder predictors. Long term efficacy of AZT was assessed by comparing both auto-machine (aREIFLOW) and manually scored respiratory events (sREIFLOW) extracted from the ventilator, prior to and after 3 months of AZT, in a subset. RESULTS Of the 231 participants (median age of 61[51-68] years) and 184 (80%) males in the acute effect testing: 77 and 154 patients were given 125 mg and 250 mg AZT. Compared to PAP alone, PAP plus AZT was associated with a lower breathing related arousal index (8 [3-16] vs. 5 [2-10], p < 0.001), and AHI3% (19 [7-37] vs. 11 [5-21], p < 0.001); 98 patients were responders. The non-rapid eye movement sleep (NREM) AHI3% (OR 1.031, 95%CI [1.016-1.046], p < 0.001) was a strong predictor for responder status with AZT exposure. In the 109 participants with 3-month data, both aREIFLOW and sREIFLOWwere significantly reduced after AZT. CONCLUSIONS AZT acutely and chronically reduced residual sleep apnea in presumed HLGSA; NREM AHI3% is a response predictor. AZT was well tolerated and beneficial for at least 3 months.
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Affiliation(s)
- Yue-Nan Ni
- Department of Respiratory and Critical Care Medicine, West China School of Medicine and West China Hospital, Sichuan University, 610041, China.
| | - Rena C Holzer
- Division of Pulmonary, Critical Care and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
| | - Robert Joseph Thomas
- Division of Pulmonary, Critical Care and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
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Prigent A, Serandour A, Luraine R, Poineuf JS, Bosseau C, Pépin J. Interrelated atrial fibrillation and leaks triggering and maintaining central sleep apnoea and periodic breathing in a CPAP-treated patient. Respirol Case Rep 2020; 8:e00666. [PMID: 32999724 PMCID: PMC7507557 DOI: 10.1002/rcr2.666] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 08/31/2020] [Accepted: 09/07/2020] [Indexed: 11/08/2022] Open
Abstract
We report the case of a 71-year-old obese continuous positive airway pressure (CPAP)-treated man who developed an acute cardiac failure (ACF) triggered by atrial fibrillation. CPAP data downloaded from the CPAP software (Rescan®) retrospectively demonstrated the progressive development of a high residual central apnoea-hypopnoea index (AHI) with Cheyne-Stokes respiration (CSR). The AHI decreased after cardioversion allowing normalization of cardiac rhythm and function. Raw data extracted from CPAP software showed a gradual decrease in the periodic breathing cycle length related to a simultaneous improvement in left ventricular ejection fraction (LVEF) after cardioversion. During this clinical period of respiratory instability in the presence of cardiac failure, CSR episodes were exacerbated by ventilation overshoots followed by micro-arousals induced by leaks. This might explain the high night to night variability of CSR occurrence in susceptible patients with impaired cardiac function. Beyond attempts to improve cardiac function, leak reduction might represent an important target for CSR management.
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Affiliation(s)
- Arnaud Prigent
- Groupe Médical de PneumologiePolyclinique Saint‐LaurentRennesFrance
- Centre du sommeilPolyclinique Saint‐LaurentRennesFrance
| | | | - Régis Luraine
- Groupe Médical de PneumologiePolyclinique Saint‐LaurentRennesFrance
- Centre du sommeilPolyclinique Saint‐LaurentRennesFrance
| | - Jean Sébastien Poineuf
- Groupe Médical de PneumologiePolyclinique Saint‐LaurentRennesFrance
- Centre du sommeilPolyclinique Saint‐LaurentRennesFrance
| | | | - Jean‐Louis Pépin
- HP2 Laboratory, Inserm Unit 1042University Grenoble AlpesGrenobleFrance
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Prigent A, Gentina T, Launois S, Meurice JC, Pia d'Ortho M, Philippe C, Tamisier R, Gagnadoux F, Jaffuel D. [Telemonitoring in continuous positive airway pressure-treated patients with obstructive sleep apnoea syndrome: An algorithm proposal]. Rev Mal Respir 2020; 37:550-560. [PMID: 32402599 DOI: 10.1016/j.rmr.2020.04.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 12/20/2019] [Indexed: 12/19/2022]
Abstract
Most of the continuous positive airway pressure (CPAP) devices currently in use allow telemonitoring of observance, leaks and the apnoea-hypopnoea index (AHI). La Société française de recherche et de médecine du sommeil (SFRMS) and La Société de pneumologie de langue française (SPLF) workgroup offer to CPAP prescribers and to home care providers a scientific document which has the following purposes: to underline the relevance of the telemonitoring of leaks and the AHI, to define alert thresholds, to describe the principal mechanisms generating excessive leaks and high AHI, and to propose a diagnostic algorithm.
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Affiliation(s)
- A Prigent
- Groupe médical de pneumologie, polyclinique Saint-Laurent, 35000 Rennes, France.
| | - T Gentina
- Centre CESAL groupe Ramsay générale de Santé, hôpital privé Louvière, Lille, France
| | - S Launois
- CEREVES Paris Jean-Jaurès, hôpital Jean-Jaurès, 75019 Paris, France
| | - J C Meurice
- Département de pneumologie, CHU de Poitiers, Poitiers, France
| | - M Pia d'Ortho
- NeuroDiderot, Inserm, université de Paris, 75019 Paris, France; Département de physiologie - explorations fonctionnelles, hôpital Bichat, AP-HP, 75018 Paris, France
| | - C Philippe
- Unité des pathologies du sommeil, groupe hospitalier Pitié-Salpêtrière, Paris, France
| | - R Tamisier
- Inserm, HP2, université Grenoble Alpes, CHU Grenoble Alpes, 38000 Grenoble, France
| | - F Gagnadoux
- Département de pneumologie et médecine du sommeil, CHU d'Angers, Angers, France; Inserm UMR 1063, université d'Angers, Angers, France
| | - D Jaffuel
- Département des maladies respiratoires, hôpital Arnaud-de-Villeneuve, CHU de Montpellier, 34000 Montpellier, France; Unité des maladies respiratoires/troubles respiratoires du sommeil, polyclinique Saint-Privat, 34760 Boujan-sur-Libron, France
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Abstract
RATIONALE The use of real-time magnetic resonance imaging (MRI) for the evaluation during sleep-related respiratory events can lead to better understanding of airway dynamics. OBJECTIVES To investigate the dynamic anatomy of the upper airway during central apnea. METHODS The study included obese adolescents who snore and were otherwise healthy. Subjects underwent an overnight baseline polysomnogram. Subjects slept during a 24-minute real-time upper airway MRI scan wearing a full face mask attached to a pneumotach. Sleep versus wakefulness during the MRI was inferred from the heart rate and respiratory patterns. Central apneas were scored using tracings of facemask airflow and abdominal bellows. The cross-sectional area of the upper airway before, during, and after each central apnea event was recorded. RESULTS Eight subjects were studied and 57 central apnea events were observed during real-time MRI scanning during natural sleep. The median age of subjects was 14.0 years (interquartile range [IQR], 13.5 to 15.5). The median average reduction in cross-sectional area during central apnea events was -38% (IQR, -27 to -51) for primary snorers and -45% (IQR, -40 to -54) for subjects with obstructive sleep apnea. The percentage decrease in cross-sectional area of upper airway during a central apnea event was positively correlated to the length of the central apnea (ρ = 0.389; r2 = 0.152; P = 0.003). CONCLUSIONS We observed that there is upper airway narrowing during central apneas during natural sleep in obese adolescent subjects, using real-time MRI.
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Fields DP, Braegelmann KM, Meza AL, Mickelson CR, Gumnit MG, Baker TL. Competing mechanisms of plasticity impair compensatory responses to repetitive apnoea. J Physiol 2019; 597:3951-3967. [PMID: 31280489 DOI: 10.1113/jp277676] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 06/03/2019] [Indexed: 12/21/2022] Open
Abstract
KEY POINTS Intermittent reductions in respiratory neural activity, a characteristic of many ventilatory disorders, leads to inadequate ventilation and arterial hypoxia. Both intermittent reductions in respiratory neural activity and intermittent hypoxia trigger compensatory enhancements in inspiratory output when experienced separately, forms of plasticity called inactivity-induced inspiratory motor facilitation (iMF) and long-term facilitation (LTF), respectively. Reductions in respiratory neural activity that lead to moderate, but not mild, arterial hypoxia occludes plasticity expression, indicating that concurrent induction of iMF and LTF impairs plasticity through cross-talk inhibition of their respective signalling pathways. Moderate hypoxia undermines iMF by enhancing NR2B-containing NMDA receptor signalling, which can be rescued by exogenous retinoic acid, a molecule necessary for iMF. These data suggest that in ventilatory disorders characterized by reduced inspiratory motor output, such as sleep apnoea, endogenous mechanisms of compensatory plasticity may be impaired, and that exogenously activating respiratory plasticity may be a novel strategy to improve breathing. ABSTRACT Many forms of sleep apnoea are characterized by recurrent reductions in respiratory neural activity, which leads to inadequate ventilation and arterial hypoxia. Both recurrent reductions in respiratory neural activity and hypoxia activate mechanisms of compensatory plasticity that augment inspiratory output and lower the threshold for apnoea, inactivity-induced inspiratory motor facilitation (iMF) and long-term facilitation (LTF), respectively. However, despite frequent concurrence of reduced respiratory neural activity and hypoxia, mechanisms that induce and regulate iMF and LTF have only been studied separately. Here, we demonstrate that recurrent reductions in respiratory neural activity ('neural apnoea') accompanied by cessations in ventilation that result in moderate (but not mild) hypoxaemia do not elicit increased inspiratory output, suggesting that concurrent induction of iMF and LTF occludes plasticity. A key role for NMDA receptor activation in impairing plasticity following concurrent neural apnoea and hypoxia is indicated since recurrent hypoxic neural apnoeas triggered increased phrenic inspiratory output in rats in which spinal NR2B-containing NMDA receptors were inhibited. Spinal application of retinoic acid, a key molecule necessary for iMF, bypasses NMDA receptor-mediated constraints, thereby rescuing plasticity following hypoxic neural apnoeas. These studies raise the intriguing possibility that endogenous mechanisms of compensatory plasticity may be impaired in some individuals with sleep apnoea, and that exogenously activating pathways giving rise to respiratory plasticity may be a novel pharmacological strategy to improve breathing.
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Affiliation(s)
- Daryl P Fields
- Department of Comparative Biosciences, University of Wisconsin, Madison, WI, USA
| | - Kendra M Braegelmann
- Department of Comparative Biosciences, University of Wisconsin, Madison, WI, USA
| | - Armand L Meza
- Department of Comparative Biosciences, University of Wisconsin, Madison, WI, USA
| | - Carly R Mickelson
- Department of Comparative Biosciences, University of Wisconsin, Madison, WI, USA
| | - Maia G Gumnit
- Department of Comparative Biosciences, University of Wisconsin, Madison, WI, USA
| | - Tracy L Baker
- Department of Comparative Biosciences, University of Wisconsin, Madison, WI, USA
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8
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Dedhia RC, Quyyumi AA, Park J, Shah AJ, Strollo PJ, Bliwise DL. Cardiovascular endpoints for obstructive sleep apnea with twelfth cranial nerve stimulation (CARDIOSA-12): Rationale and methods. Laryngoscope 2018; 128:2635-2643. [PMID: 30194765 DOI: 10.1002/lary.27284] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2018] [Indexed: 11/08/2022]
Abstract
OBJECTIVES/HYPOTHESIS To determine the effect of therapeutic levels of hypoglossal nerve stimulation therapy (HGNS), compared to subtherapeutic levels of HGNS, on 24-hour ambulatory blood pressure, sympathetic activity, and vascular function. STUDY DESIGN Double-blind, sham-controlled, randomized crossover trial of 10-week duration at a university medical center METHODS: The target enrollment is 60 randomly assigned subjects. Interventions are active versus sham (subtherapeutic) HGNS therapy. RESULTS The primary outcome is 24-hour ambulatory systolic blood pressure. Secondary outcomes include 24-hour ambulatory diastolic blood pressure, nocturnal systolic and diastolic pressure, muscle sympathetic nerve activity, pre-ejection period, flow-mediated dilation, and pulse wave velocity. CONCLUSIONS The Cardiovascular Endpoints for Obstructive Sleep Apnea With Twelfth Cranial Nerve Stimulation study is designed to examine obstructive sleep apnea and test the effects of HGNS on the cardiovascular system through a sham-controlled trial in patients with moderate-severe obstructive sleep apnea. LEVEL OF EVIDENCE 1 Laryngoscope, 2635-2643, 2018.
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Affiliation(s)
- Raj C Dedhia
- Emory Sleep Center, Emory Healthcare, Atlanta, Georgia.,Department of Otolaryngology-Head and Neck Surgery, Atlanta, Georgia
| | - Arshed A Quyyumi
- Division of Cardiology, Department of Medicine, Atlanta, Georgia
| | - Jeanie Park
- Division of Nephrology, Department of Medicine, Atlanta, Georgia.,Research Service Line, Atlanta Veterans Affairs Medical Center, Decatur, Georgia
| | - Amit J Shah
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Patrick J Strollo
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, U.S.A
| | - Donald L Bliwise
- Emory Sleep Center, Emory Healthcare, Atlanta, Georgia.,Department of Neurology, Emory University School of Medicine, Atlanta, Georgia
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Silveira MG, Sampol G, Cambrodi R, Ferre À, Lloberes P. Adaptive Servoventilation Device Software in the Assessment of Residual Respiratory Events in Patients With Central or Complex Apnoeas. Arch Bronconeumol 2017; 53:455-457. [PMID: 28209445 DOI: 10.1016/j.arbres.2016.11.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 10/17/2016] [Accepted: 11/28/2016] [Indexed: 10/20/2022]
Affiliation(s)
- María-Guadalupe Silveira
- Servei de Pneumologia, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona (UAB), Barcelona, España; Unitat del Son, Hospital Universitari Vall d'Hebron, Barcelona, España
| | - Gabriel Sampol
- Servei de Pneumologia, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona (UAB), Barcelona, España; Unitat del Son, Hospital Universitari Vall d'Hebron, Barcelona, España; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, España
| | - Roser Cambrodi
- Unitat del Son, Hospital Universitari Vall d'Hebron, Barcelona, España
| | - Àlex Ferre
- Unitat del Son, Hospital Universitari Vall d'Hebron, Barcelona, España
| | - Patrícia Lloberes
- Servei de Pneumologia, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona (UAB), Barcelona, España; Unitat del Son, Hospital Universitari Vall d'Hebron, Barcelona, España; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, España.
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10
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Pathophysiology of central sleep apneas. Sleep Breath 2016; 20:467-82. [DOI: 10.1007/s11325-015-1290-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Revised: 11/10/2015] [Accepted: 11/23/2015] [Indexed: 11/26/2022]
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11
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Tellez HF, Pattyn N, Mairesse O, Dolenc-Groselj L, Eiken O, Mekjavic IB, Migeotte PF, Macdonald-Nethercott E, Meeusen R, Neyt X. eAMI: a qualitative quantification of periodic breathing based on amplitude of oscillations. Sleep 2015; 38:381-9. [PMID: 25581914 DOI: 10.5665/sleep.4494] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Accepted: 09/26/2014] [Indexed: 12/16/2022] Open
Abstract
STUDY OBJECTIVES Periodic breathing is sleep disordered breathing characterized by instability in the respiratory pattern that exhibits an oscillatory behavior. Periodic breathing is associated with increased mortality, and it is observed in a variety of situations, such as acute hypoxia, chronic heart failure, and damage to respiratory centers. The standard quantification for the diagnosis of sleep related breathing disorders is the apnea-hypopnea index (AHI), which measures the proportion of apneic/ hypopneic events during polysomnography. Determining the AHI is labor-intensive and requires the simultaneous recording of airflow and oxygen saturation. In this paper, we propose an automated, simple, and novel methodology for the detection and qualification of periodic breathing: the estimated amplitude modulation index (eAMI). PATIENTS OR PARTICIPANTS Antarctic Cohort (3800 meters): 13 normal individuals. Sleep Clinic Cohort: 39 different patients suffering from diverse sleep-related pathologies. MEASUREMENTS AND RESULTS When tested in a population with high levels of periodic breathing (Antarctic Cohort), eAMI was closely correlated with AHI (r = 0.95, P < 0.001). When tested in the clinical setting, the proposed method was able to detect portions of the signal in which subclinical periodic breathing was validated by an expert (n = 93; accuracy = 0.85). Average eAMI was also correlated with the loop gain for the combined clinical and Antarctica cohorts (r = 0.58, P < 0.001). CONCLUSIONS In terms of quantification and temporal resolution, the eAMI is able to estimate the strength of periodic breathing and the underlying loop gain at any given time within a record. The impaired prognosis associated with periodic breathing makes its automated detection and early diagnosis of clinical relevance.
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Affiliation(s)
- Helio Fernandez Tellez
- Vrije Universiteit Brussel, Human Physiology & Sportsmedicine Department, Brussels, Belgium.,Royal Military Academy of Brussels, VIPER Research Unit, Brussels, Belgium
| | - Nathalie Pattyn
- Vrije Universiteit Brussel, Human Physiology & Sportsmedicine Department, Brussels, Belgium.,Royal Military Academy of Brussels, VIPER Research Unit, Brussels, Belgium.,Vrije Universiteit Brussels, Biological Psychology Department, Brussels, Belgium
| | - Olivier Mairesse
- Royal Military Academy of Brussels, VIPER Research Unit, Brussels, Belgium.,Vrije Universiteit Brussels, Biological Psychology Department, Brussels, Belgium.,Sleep Laboratory & Unit for Chronobiology - Brugmann University Hospital Free University of Brussels, Brussels, Belgium
| | - Leja Dolenc-Groselj
- Clinical Institute of Clinical Neurophysiology, University Clinical Centre, Ljubljana, Slovenia
| | - Ola Eiken
- Department of Environmental Physiology, Swedish Aerospace Physiology Centre, Royal Institute of Technology, Stockholm, Sweden
| | - Igor B Mekjavic
- Deptartment of Automation, Biocybernetics, and Robotics, Jozef Stefan Institute, Ljubljana, Slovenia
| | - P F Migeotte
- Université Libre de Bruxelles, Erasmus Hospital, Brussels, Belgium
| | - Em Macdonald-Nethercott
- The Princess Alexandra Hospital NHS Trust, Harlow, UK.,Institut polaire français Paul-Emile Victor, France
| | - Romain Meeusen
- Vrije Universiteit Brussel, Human Physiology & Sportsmedicine Department, Brussels, Belgium
| | - Xavier Neyt
- Royal Military Academy of Brussels, VIPER Research Unit, Brussels, Belgium.,CISS Department, Royal Military Academy of Brussels, Brussels, Belgium
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12
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Zuo L, Hemmelgarn BT, Jouett NP, Smith ML, Eugenín J, Beltrán-Castillo S, von Bernhardi R, de Figueiredo Müller-Ribeiro FC, Ribeiro-Marins F, Fontes MAP, Cysique LA, Gandevia SC, Tellez HF, Mekjavic IB, Perlitz V, Kerkhof PLM, de Munck J, Moret-Bonillo V, Nieman G, Gatto LA. Commentaries on Viewpoint: The ongoing need for good physiological investigation: Obstructive sleep apnea in HIV patients as a paradigm. J Appl Physiol (1985) 2015; 118:247-50. [PMID: 25593220 DOI: 10.1152/japplphysiol.00989.2014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Affiliation(s)
- Li Zuo
- Radiologic Sciences and Respiratory Therapy Division School of Health and Rehabilitation Sciences The Ohio State University College of MedicineUniversity of North Texas Health Science Center and Cardiovascular Research Institute Fort Worth, TexasLab. Sistemas Neurales Facultad de Química y Biología Depto. Biología, Universidad de Santiago (USACH) Lab. Neurociencias Facultad de Medicina Depto. Neurología P. Universidad Católica de ChileDepartment of Physiology & Biophysics Federal University of Minas Gerais Belo Horizonte, BrazilNeuroscience Research Australia UNSW Australia Sydney, Australia St. Vincent's Hospital Applied Medical Research Center Sydney, AustraliaNeuroscience Research Australia UNSW Australia Sydney, AustraliaDepartment of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital Aachen, GermanyVU University Medical Center The NetherlandsDepartment of Computer Science University of A Coruña, SpainDepartment of Surgery Upstate Medical University Syracuse, New YorkDepartment of Biology SUNY Cortland Cortland, New York
| | - Benjamin T Hemmelgarn
- Radiologic Sciences and Respiratory Therapy Division School of Health and Rehabilitation Sciences The Ohio State University College of MedicineUniversity of North Texas Health Science Center and Cardiovascular Research Institute Fort Worth, TexasLab. Sistemas Neurales Facultad de Química y Biología Depto. Biología, Universidad de Santiago (USACH) Lab. Neurociencias Facultad de Medicina Depto. Neurología P. Universidad Católica de ChileDepartment of Physiology & Biophysics Federal University of Minas Gerais Belo Horizonte, BrazilNeuroscience Research Australia UNSW Australia Sydney, Australia St. Vincent's Hospital Applied Medical Research Center Sydney, AustraliaNeuroscience Research Australia UNSW Australia Sydney, AustraliaDepartment of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital Aachen, GermanyVU University Medical Center The NetherlandsDepartment of Computer Science University of A Coruña, SpainDepartment of Surgery Upstate Medical University Syracuse, New YorkDepartment of Biology SUNY Cortland Cortland, New York
| | - Noah P Jouett
- Radiologic Sciences and Respiratory Therapy Division School of Health and Rehabilitation Sciences The Ohio State University College of MedicineUniversity of North Texas Health Science Center and Cardiovascular Research Institute Fort Worth, TexasLab. Sistemas Neurales Facultad de Química y Biología Depto. Biología, Universidad de Santiago (USACH) Lab. Neurociencias Facultad de Medicina Depto. Neurología P. Universidad Católica de ChileDepartment of Physiology & Biophysics Federal University of Minas Gerais Belo Horizonte, BrazilNeuroscience Research Australia UNSW Australia Sydney, Australia St. Vincent's Hospital Applied Medical Research Center Sydney, AustraliaNeuroscience Research Australia UNSW Australia Sydney, AustraliaDepartment of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital Aachen, GermanyVU University Medical Center The NetherlandsDepartment of Computer Science University of A Coruña, SpainDepartment of Surgery Upstate Medical University Syracuse, New YorkDepartment of Biology SUNY Cortland Cortland, New York
| | - Michael L Smith
- Radiologic Sciences and Respiratory Therapy Division School of Health and Rehabilitation Sciences The Ohio State University College of MedicineUniversity of North Texas Health Science Center and Cardiovascular Research Institute Fort Worth, TexasLab. Sistemas Neurales Facultad de Química y Biología Depto. Biología, Universidad de Santiago (USACH) Lab. Neurociencias Facultad de Medicina Depto. Neurología P. Universidad Católica de ChileDepartment of Physiology & Biophysics Federal University of Minas Gerais Belo Horizonte, BrazilNeuroscience Research Australia UNSW Australia Sydney, Australia St. Vincent's Hospital Applied Medical Research Center Sydney, AustraliaNeuroscience Research Australia UNSW Australia Sydney, AustraliaDepartment of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital Aachen, GermanyVU University Medical Center The NetherlandsDepartment of Computer Science University of A Coruña, SpainDepartment of Surgery Upstate Medical University Syracuse, New YorkDepartment of Biology SUNY Cortland Cortland, New York
| | - Jaime Eugenín
- Radiologic Sciences and Respiratory Therapy Division School of Health and Rehabilitation Sciences The Ohio State University College of MedicineUniversity of North Texas Health Science Center and Cardiovascular Research Institute Fort Worth, TexasLab. Sistemas Neurales Facultad de Química y Biología Depto. Biología, Universidad de Santiago (USACH) Lab. Neurociencias Facultad de Medicina Depto. Neurología P. Universidad Católica de ChileDepartment of Physiology & Biophysics Federal University of Minas Gerais Belo Horizonte, BrazilNeuroscience Research Australia UNSW Australia Sydney, Australia St. Vincent's Hospital Applied Medical Research Center Sydney, AustraliaNeuroscience Research Australia UNSW Australia Sydney, AustraliaDepartment of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital Aachen, GermanyVU University Medical Center The NetherlandsDepartment of Computer Science University of A Coruña, SpainDepartment of Surgery Upstate Medical University Syracuse, New YorkDepartment of Biology SUNY Cortland Cortland, New York
| | - Sebastián Beltrán-Castillo
- Radiologic Sciences and Respiratory Therapy Division School of Health and Rehabilitation Sciences The Ohio State University College of MedicineUniversity of North Texas Health Science Center and Cardiovascular Research Institute Fort Worth, TexasLab. Sistemas Neurales Facultad de Química y Biología Depto. Biología, Universidad de Santiago (USACH) Lab. Neurociencias Facultad de Medicina Depto. Neurología P. Universidad Católica de ChileDepartment of Physiology & Biophysics Federal University of Minas Gerais Belo Horizonte, BrazilNeuroscience Research Australia UNSW Australia Sydney, Australia St. Vincent's Hospital Applied Medical Research Center Sydney, AustraliaNeuroscience Research Australia UNSW Australia Sydney, AustraliaDepartment of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital Aachen, GermanyVU University Medical Center The NetherlandsDepartment of Computer Science University of A Coruña, SpainDepartment of Surgery Upstate Medical University Syracuse, New YorkDepartment of Biology SUNY Cortland Cortland, New York
| | - Rommy von Bernhardi
- Radiologic Sciences and Respiratory Therapy Division School of Health and Rehabilitation Sciences The Ohio State University College of MedicineUniversity of North Texas Health Science Center and Cardiovascular Research Institute Fort Worth, TexasLab. Sistemas Neurales Facultad de Química y Biología Depto. Biología, Universidad de Santiago (USACH) Lab. Neurociencias Facultad de Medicina Depto. Neurología P. Universidad Católica de ChileDepartment of Physiology & Biophysics Federal University of Minas Gerais Belo Horizonte, BrazilNeuroscience Research Australia UNSW Australia Sydney, Australia St. Vincent's Hospital Applied Medical Research Center Sydney, AustraliaNeuroscience Research Australia UNSW Australia Sydney, AustraliaDepartment of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital Aachen, GermanyVU University Medical Center The NetherlandsDepartment of Computer Science University of A Coruña, SpainDepartment of Surgery Upstate Medical University Syracuse, New YorkDepartment of Biology SUNY Cortland Cortland, New York
| | - Flávia Camargos de Figueiredo Müller-Ribeiro
- Radiologic Sciences and Respiratory Therapy Division School of Health and Rehabilitation Sciences The Ohio State University College of MedicineUniversity of North Texas Health Science Center and Cardiovascular Research Institute Fort Worth, TexasLab. Sistemas Neurales Facultad de Química y Biología Depto. Biología, Universidad de Santiago (USACH) Lab. Neurociencias Facultad de Medicina Depto. Neurología P. Universidad Católica de ChileDepartment of Physiology & Biophysics Federal University of Minas Gerais Belo Horizonte, BrazilNeuroscience Research Australia UNSW Australia Sydney, Australia St. Vincent's Hospital Applied Medical Research Center Sydney, AustraliaNeuroscience Research Australia UNSW Australia Sydney, AustraliaDepartment of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital Aachen, GermanyVU University Medical Center The NetherlandsDepartment of Computer Science University of A Coruña, SpainDepartment of Surgery Upstate Medical University Syracuse, New YorkDepartment of Biology SUNY Cortland Cortland, New York
| | - Fernanda Ribeiro-Marins
- Radiologic Sciences and Respiratory Therapy Division School of Health and Rehabilitation Sciences The Ohio State University College of MedicineUniversity of North Texas Health Science Center and Cardiovascular Research Institute Fort Worth, TexasLab. Sistemas Neurales Facultad de Química y Biología Depto. Biología, Universidad de Santiago (USACH) Lab. Neurociencias Facultad de Medicina Depto. Neurología P. Universidad Católica de ChileDepartment of Physiology & Biophysics Federal University of Minas Gerais Belo Horizonte, BrazilNeuroscience Research Australia UNSW Australia Sydney, Australia St. Vincent's Hospital Applied Medical Research Center Sydney, AustraliaNeuroscience Research Australia UNSW Australia Sydney, AustraliaDepartment of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital Aachen, GermanyVU University Medical Center The NetherlandsDepartment of Computer Science University of A Coruña, SpainDepartment of Surgery Upstate Medical University Syracuse, New YorkDepartment of Biology SUNY Cortland Cortland, New York
| | - Marco Antônio Peliky Fontes
- Radiologic Sciences and Respiratory Therapy Division School of Health and Rehabilitation Sciences The Ohio State University College of MedicineUniversity of North Texas Health Science Center and Cardiovascular Research Institute Fort Worth, TexasLab. Sistemas Neurales Facultad de Química y Biología Depto. Biología, Universidad de Santiago (USACH) Lab. Neurociencias Facultad de Medicina Depto. Neurología P. Universidad Católica de ChileDepartment of Physiology & Biophysics Federal University of Minas Gerais Belo Horizonte, BrazilNeuroscience Research Australia UNSW Australia Sydney, Australia St. Vincent's Hospital Applied Medical Research Center Sydney, AustraliaNeuroscience Research Australia UNSW Australia Sydney, AustraliaDepartment of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital Aachen, GermanyVU University Medical Center The NetherlandsDepartment of Computer Science University of A Coruña, SpainDepartment of Surgery Upstate Medical University Syracuse, New YorkDepartment of Biology SUNY Cortland Cortland, New York
| | - Lucette A Cysique
- Radiologic Sciences and Respiratory Therapy Division School of Health and Rehabilitation Sciences The Ohio State University College of MedicineUniversity of North Texas Health Science Center and Cardiovascular Research Institute Fort Worth, TexasLab. Sistemas Neurales Facultad de Química y Biología Depto. Biología, Universidad de Santiago (USACH) Lab. Neurociencias Facultad de Medicina Depto. Neurología P. Universidad Católica de ChileDepartment of Physiology & Biophysics Federal University of Minas Gerais Belo Horizonte, BrazilNeuroscience Research Australia UNSW Australia Sydney, Australia St. Vincent's Hospital Applied Medical Research Center Sydney, AustraliaNeuroscience Research Australia UNSW Australia Sydney, AustraliaDepartment of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital Aachen, GermanyVU University Medical Center The NetherlandsDepartment of Computer Science University of A Coruña, SpainDepartment of Surgery Upstate Medical University Syracuse, New YorkDepartment of Biology SUNY Cortland Cortland, New York
| | - Simon C Gandevia
- Radiologic Sciences and Respiratory Therapy Division School of Health and Rehabilitation Sciences The Ohio State University College of MedicineUniversity of North Texas Health Science Center and Cardiovascular Research Institute Fort Worth, TexasLab. Sistemas Neurales Facultad de Química y Biología Depto. Biología, Universidad de Santiago (USACH) Lab. Neurociencias Facultad de Medicina Depto. Neurología P. Universidad Católica de ChileDepartment of Physiology & Biophysics Federal University of Minas Gerais Belo Horizonte, BrazilNeuroscience Research Australia UNSW Australia Sydney, Australia St. Vincent's Hospital Applied Medical Research Center Sydney, AustraliaNeuroscience Research Australia UNSW Australia Sydney, AustraliaDepartment of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital Aachen, GermanyVU University Medical Center The NetherlandsDepartment of Computer Science University of A Coruña, SpainDepartment of Surgery Upstate Medical University Syracuse, New YorkDepartment of Biology SUNY Cortland Cortland, New York
| | - Helio Fernandez Tellez
- Radiologic Sciences and Respiratory Therapy Division School of Health and Rehabilitation Sciences The Ohio State University College of MedicineUniversity of North Texas Health Science Center and Cardiovascular Research Institute Fort Worth, TexasLab. Sistemas Neurales Facultad de Química y Biología Depto. Biología, Universidad de Santiago (USACH) Lab. Neurociencias Facultad de Medicina Depto. Neurología P. Universidad Católica de ChileDepartment of Physiology & Biophysics Federal University of Minas Gerais Belo Horizonte, BrazilNeuroscience Research Australia UNSW Australia Sydney, Australia St. Vincent's Hospital Applied Medical Research Center Sydney, AustraliaNeuroscience Research Australia UNSW Australia Sydney, AustraliaDepartment of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital Aachen, GermanyVU University Medical Center The NetherlandsDepartment of Computer Science University of A Coruña, SpainDepartment of Surgery Upstate Medical University Syracuse, New YorkDepartment of Biology SUNY Cortland Cortland, New York
| | - Igor B Mekjavic
- Radiologic Sciences and Respiratory Therapy Division School of Health and Rehabilitation Sciences The Ohio State University College of MedicineUniversity of North Texas Health Science Center and Cardiovascular Research Institute Fort Worth, TexasLab. Sistemas Neurales Facultad de Química y Biología Depto. Biología, Universidad de Santiago (USACH) Lab. Neurociencias Facultad de Medicina Depto. Neurología P. Universidad Católica de ChileDepartment of Physiology & Biophysics Federal University of Minas Gerais Belo Horizonte, BrazilNeuroscience Research Australia UNSW Australia Sydney, Australia St. Vincent's Hospital Applied Medical Research Center Sydney, AustraliaNeuroscience Research Australia UNSW Australia Sydney, AustraliaDepartment of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital Aachen, GermanyVU University Medical Center The NetherlandsDepartment of Computer Science University of A Coruña, SpainDepartment of Surgery Upstate Medical University Syracuse, New YorkDepartment of Biology SUNY Cortland Cortland, New York
| | - Volker Perlitz
- Radiologic Sciences and Respiratory Therapy Division School of Health and Rehabilitation Sciences The Ohio State University College of MedicineUniversity of North Texas Health Science Center and Cardiovascular Research Institute Fort Worth, TexasLab. Sistemas Neurales Facultad de Química y Biología Depto. Biología, Universidad de Santiago (USACH) Lab. Neurociencias Facultad de Medicina Depto. Neurología P. Universidad Católica de ChileDepartment of Physiology & Biophysics Federal University of Minas Gerais Belo Horizonte, BrazilNeuroscience Research Australia UNSW Australia Sydney, Australia St. Vincent's Hospital Applied Medical Research Center Sydney, AustraliaNeuroscience Research Australia UNSW Australia Sydney, AustraliaDepartment of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital Aachen, GermanyVU University Medical Center The NetherlandsDepartment of Computer Science University of A Coruña, SpainDepartment of Surgery Upstate Medical University Syracuse, New YorkDepartment of Biology SUNY Cortland Cortland, New York
| | - Peter L M Kerkhof
- Radiologic Sciences and Respiratory Therapy Division School of Health and Rehabilitation Sciences The Ohio State University College of MedicineUniversity of North Texas Health Science Center and Cardiovascular Research Institute Fort Worth, TexasLab. Sistemas Neurales Facultad de Química y Biología Depto. Biología, Universidad de Santiago (USACH) Lab. Neurociencias Facultad de Medicina Depto. Neurología P. Universidad Católica de ChileDepartment of Physiology & Biophysics Federal University of Minas Gerais Belo Horizonte, BrazilNeuroscience Research Australia UNSW Australia Sydney, Australia St. Vincent's Hospital Applied Medical Research Center Sydney, AustraliaNeuroscience Research Australia UNSW Australia Sydney, AustraliaDepartment of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital Aachen, GermanyVU University Medical Center The NetherlandsDepartment of Computer Science University of A Coruña, SpainDepartment of Surgery Upstate Medical University Syracuse, New YorkDepartment of Biology SUNY Cortland Cortland, New York
| | - Jan de Munck
- Radiologic Sciences and Respiratory Therapy Division School of Health and Rehabilitation Sciences The Ohio State University College of MedicineUniversity of North Texas Health Science Center and Cardiovascular Research Institute Fort Worth, TexasLab. Sistemas Neurales Facultad de Química y Biología Depto. Biología, Universidad de Santiago (USACH) Lab. Neurociencias Facultad de Medicina Depto. Neurología P. Universidad Católica de ChileDepartment of Physiology & Biophysics Federal University of Minas Gerais Belo Horizonte, BrazilNeuroscience Research Australia UNSW Australia Sydney, Australia St. Vincent's Hospital Applied Medical Research Center Sydney, AustraliaNeuroscience Research Australia UNSW Australia Sydney, AustraliaDepartment of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital Aachen, GermanyVU University Medical Center The NetherlandsDepartment of Computer Science University of A Coruña, SpainDepartment of Surgery Upstate Medical University Syracuse, New YorkDepartment of Biology SUNY Cortland Cortland, New York
| | - Vicente Moret-Bonillo
- Radiologic Sciences and Respiratory Therapy Division School of Health and Rehabilitation Sciences The Ohio State University College of MedicineUniversity of North Texas Health Science Center and Cardiovascular Research Institute Fort Worth, TexasLab. Sistemas Neurales Facultad de Química y Biología Depto. Biología, Universidad de Santiago (USACH) Lab. Neurociencias Facultad de Medicina Depto. Neurología P. Universidad Católica de ChileDepartment of Physiology & Biophysics Federal University of Minas Gerais Belo Horizonte, BrazilNeuroscience Research Australia UNSW Australia Sydney, Australia St. Vincent's Hospital Applied Medical Research Center Sydney, AustraliaNeuroscience Research Australia UNSW Australia Sydney, AustraliaDepartment of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital Aachen, GermanyVU University Medical Center The NetherlandsDepartment of Computer Science University of A Coruña, SpainDepartment of Surgery Upstate Medical University Syracuse, New YorkDepartment of Biology SUNY Cortland Cortland, New York
| | - Gary Nieman
- Radiologic Sciences and Respiratory Therapy Division School of Health and Rehabilitation Sciences The Ohio State University College of MedicineUniversity of North Texas Health Science Center and Cardiovascular Research Institute Fort Worth, TexasLab. Sistemas Neurales Facultad de Química y Biología Depto. Biología, Universidad de Santiago (USACH) Lab. Neurociencias Facultad de Medicina Depto. Neurología P. Universidad Católica de ChileDepartment of Physiology & Biophysics Federal University of Minas Gerais Belo Horizonte, BrazilNeuroscience Research Australia UNSW Australia Sydney, Australia St. Vincent's Hospital Applied Medical Research Center Sydney, AustraliaNeuroscience Research Australia UNSW Australia Sydney, AustraliaDepartment of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital Aachen, GermanyVU University Medical Center The NetherlandsDepartment of Computer Science University of A Coruña, SpainDepartment of Surgery Upstate Medical University Syracuse, New YorkDepartment of Biology SUNY Cortland Cortland, New York
| | - Louis A Gatto
- Radiologic Sciences and Respiratory Therapy Division School of Health and Rehabilitation Sciences The Ohio State University College of MedicineUniversity of North Texas Health Science Center and Cardiovascular Research Institute Fort Worth, TexasLab. Sistemas Neurales Facultad de Química y Biología Depto. Biología, Universidad de Santiago (USACH) Lab. Neurociencias Facultad de Medicina Depto. Neurología P. Universidad Católica de ChileDepartment of Physiology & Biophysics Federal University of Minas Gerais Belo Horizonte, BrazilNeuroscience Research Australia UNSW Australia Sydney, Australia St. Vincent's Hospital Applied Medical Research Center Sydney, AustraliaNeuroscience Research Australia UNSW Australia Sydney, AustraliaDepartment of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital Aachen, GermanyVU University Medical Center The NetherlandsDepartment of Computer Science University of A Coruña, SpainDepartment of Surgery Upstate Medical University Syracuse, New YorkDepartment of Biology SUNY Cortland Cortland, New York
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Javaheri S, Brown LK, Randerath WJ. Clinical Applications of Adaptive Servoventilation Devices. Chest 2014; 146:858-868. [DOI: 10.1378/chest.13-1778] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Orr J, Javaheri S, Malhotra A. Comparative effectiveness research in complex sleep apnea. Sleep 2014; 37:833-4. [PMID: 24790259 DOI: 10.5665/sleep.3638] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Jeremy Orr
- Division of Pulmonary and Critical Care Medicine, University of California, San Diego, CA
| | - Shahrokh Javaheri
- Emeritus Professor of Medicine, University of Cincinnati, Cincinnati, OH
| | - Atul Malhotra
- Division of Pulmonary and Critical Care Medicine, University of California, San Diego, CA
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Mogri M, Nadler J, Khan T, Mador MJ. Complex sleep apnea in patients with obstructive sleep apnea on opioids for chronic pain. Sleep Biol Rhythms 2014. [DOI: 10.1111/sbr.12051] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Mohammed Mogri
- Division of Pulmonary, Critical Care and Sleep Medicine; State University of New York at Buffalo; Buffalo NY USA
| | - Jamie Nadler
- Division of Pulmonary, Critical Care and Sleep Medicine; State University of New York at Buffalo; Buffalo NY USA
| | - Talha Khan
- Division of Pulmonary, Critical Care and Sleep Medicine; State University of New York at Buffalo; Buffalo NY USA
| | - M. Jeffery Mador
- Western New York Veteran Affairs Healthcare System and Division of Pulmonary, Critical Care and Sleep Medicine; State University of New York at Buffalo; Buffalo NY USA
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DelRosso LM, Harper MB, Hoque R. A Man in His 50s Develops 3-Min Central Apneas During a Titration Study. Chest 2014; 145:404-406. [DOI: 10.1378/chest.13-1020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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17
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Ryu HU, Lee EM, Lee GH, Kim B, Lee SA. Prevalence and Predicting Factors of Complex Sleep Apnea in Patients with Obstructive Sleep Apnea Syndrome. ACTA ACUST UNITED AC 2013. [DOI: 10.13078/jksrs.13010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Montesi SB, Bakker JP, Macdonald M, Hueser L, Pittman S, White DP, Malhotra A. Air leak during CPAP titration as a risk factor for central apnea. J Clin Sleep Med 2013; 9:1187-91. [PMID: 24235901 DOI: 10.5664/jcsm.3166] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Emergence of central sleep apnea has been described in the setting of continuous positive airway pressure (CPAP) initiation. The underlying mechanism is unclear; however, we postulate that air leak washing out anatomical dead space is a contributing factor. DESIGN Data were obtained from 310 patients with obstructive sleep apnea (OSA) who underwent either split-night or full-night CPAP titration during January to July of 2009. The majority (n = 245) underwent titration with a nasal mask. Average total leak and maximum total leak were measured at therapeutic CPAP level. Unintentional leak was calculated by subtracting manufacturer-defined intentional leak from maximum leak. RESULTS SUBJECTS WERE DIVIDED INTO TWO GROUPS: central apnea index (CAI) during titration < 5/hour and ≥ 5/hour. The groups were similar in terms of gender, age, BMI, and AHI. The CAI < 5 group had a median average leak of 45.5 L/min (IQR 20.8 L/min) versus 51.0 L/min (IQR 21.0 L/min) with CAI ≥ 5 (p = 0.056). Maximum leak was 59.5 L/min (IQR 27.0 L/min) with CAI < 5 and 75.0 L/min (IQR 27.8 L/min) with CAI ≥ 5 (p = 0.003). In the subset of subjects titrated using a nasal mask, median average leak was 42.0 L/min (IQR 17.0) in the CAI < 5 group and 50.0 L/min (IQR 16.8) in the CAI ≥ 5 group (p = 0.001). In the CAI < 5 group, median maximum leak was 57.0 L/min (IQR 23.0) versus 74.5 L/min (IQR 24.3) in the CAI ≥ 5 group (p < 0.001). CONCLUSIONS Leak during CPAP titration is associated with the development of acute central apnea; these data may have mechanistic and therapeutic implications for complex apnea. COMMENTARY A commentary on this article appears in this issue on page 1193.
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Affiliation(s)
- Sydney B Montesi
- Sleep Disorders Research Program, Brigham and Women's Hospital and Harvard Medical School, Boston, MA ; Pulmonary and Critical Care Unit, Massachusetts General Hospital, Boston, MA
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19
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Camacho M, Certal V, Brietzke SE, Holty JEC, Guilleminault C, Capasso R. Tracheostomy as Treatment for Adult Obstructive Sleep Apnea. Laryngoscope 2013; 124:803-11. [DOI: 10.1002/lary.24433] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2013] [Accepted: 09/10/2013] [Indexed: 11/08/2022]
Affiliation(s)
- Macario Camacho
- Department of Otolaryngology-Head and Neck Surgery; Sleep Surgery Division; Stanford University Medical Center; Stanford California U.S.A
| | - Victor Certal
- Department of Otorhinolaryngology; Hospital Sao Sebastiao, Sta Maria da Feira; CINTESIS-Center for Research in Health Technologies and Information Systems, University of Porto Porto; Portugal
| | - Scott E. Brietzke
- Department of Otolaryngology-Head and Neck Surgery; Walter Reed National Military Medical Center; Bethesda Maryland
| | - Jon-Erik C. Holty
- VA Palo Health Care System, Medical Service; Pulmonary, Critical Care and Sleep Medicine Section; Palo Alto
| | - Christian Guilleminault
- Sleep Medicine Division; Stanford University Hospital and Clinics Redwood City; and the Robson Capasso; MD
| | - Robson Capasso
- Department of Otolaryngology-Head and Neck Surgery; Sleep Surgery Division; Stanford University Medical Center; Stanford California U.S.A
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