American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Dec 2016
Randomized Controlled TrialUpper-airway Collapsibility and Loop Gain Predict the Response to Oral Appliance Therapy in Obstructive Sleep Apnea Patients.
Oral appliances (OAs) are commonly used as an alternative treatment to continuous positive airway pressure for patients with obstructive sleep apnea (OSA). However, OAs have variable success at reducing the apnea-hypopnea index (AHI), and predicting responders is challenging. Understanding this variability may lie with the recognition that OSA is a multifactorial disorder and that OAs may affect more than just upper-airway anatomy/collapsibility. ⋯ Our findings suggest that OA therapy improves the upper-airway collapsibility under passive and active conditions. Importantly, a greater response to therapy occurred in those patients with a mild anatomic compromise and a lower loop gain.
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Am. J. Respir. Crit. Care Med. · Dec 2016
Randomized Controlled TrialAngiotensin-Converting Enzyme Inhibition as an Adjunct to Pulmonary Rehabilitation in COPD.
Epidemiological studies in older individuals have found an association between the use of angiotensin-converting enzyme (ACE) inhibition (ACE-I) therapy and preserved locomotor muscle mass, strength, and walking speed. ACE-I therapy might therefore have a role in the context of pulmonary rehabilitation (PR). ⋯ Use of the ACE inhibitor enalapril, together with a program of PR, in patients without an established indication for ACE-I, reduced the peak work rate response to exercise training in patients with chronic obstructive pulmonary disease.