Sleep & breathing = Schlaf & Atmung
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Observational Study
IGF-1: a potential biomarker for efficacy of sleep improvement with automatic airway pressure therapy for obstructive sleep apnea?
Positive airway pressure (PAP) reverses obstructive sleep apnea (OSA)-related hypoxia and restores slow wave sleep (SWS). Insulin-like growth factor 1 (IGF-1) is a neuropeptide that facilitates the repair of neurons from hypoxia and improves sleep regulation. IGF-1 concentrations are lower in OSA, and likely increase following PAP treatment; however, this relationship has not yet been determined in a younger cohort of OSA patients. ⋯ Adherence to PAP treatment leads to significant increases in IGF-1 concentrations in young men with OSA. While an objective measure of adherence exists, PAP usage does not allow for measure of sleep improvement. IGF-1 may serve as a potential biomarker for the efficacy of PAP therapy on improved sleep.
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Comparative Study
Utility of the STOP-BANG components to identify sleep apnea using home respiratory polygraphy.
Utility of questionnaires to estimate the probability of obstructive sleep apneas (OSA) is varying, and it is challenging to know the performance of STOP (Snore, Tired, Observed apnea, and Pressure)-BANG (BMI, Age, Neck and Gender) with simplified methods. To assess the performance of STOP-BANG and its ability to predict sleep apnea in patients with high pre-test like-hood to present OSA referred for a home respiratory polygraphy (RP) were studied. ⋯ STOP-BANG shows different discrimination power for AHI >5 and ≥30/h using RP. Five components in any combination have acceptable diagnostic S to identify patients with severe OSA. STOP-BANG performed best to identify AHI ≥30/h.
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It is unclear whether obstructive sleep apnea (OSA) is independently associated with increased levels of the acute-phase reactant C-reactive protein (CRP). The purpose of this study was to evaluate the relationship between OSA and high-sensitivity CRP (hs-CRP) levels according to the presence or absence of metabolic syndrome (MetS). ⋯ Elevated hs-CRP level is associated with severe OSA, independent of known confounders. The effect of OSA in CRP is independent of MetS was identified.
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Overnight oximetry is a simple tool for investigation of obstructive sleep apnoea (OSA) in children, but only severe cases will be detected, and children with obstructive events resulting in arousal, but not desaturation, will have a normal (inconclusive) result. We hypothesised that pulse rate rises using pulse rate indices per hour (PRI) and pulse rate standard deviation (PR-SD) automatically calculated from commercially available software would improve oximetry as a diagnostic tool. ⋯ The PRI-15 shows promise as an indicator of OSA in children with normal oximetry.
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Continuous positive airway pressure (CPAP) devices can estimate apnea-hypopnea index (AHI) using respiratory event detection algorithms. In 2012, rules for manually scoring respiratory events during sleep were updated to version 2.0. The purpose of the present study was to compare residual AHI determined using the Sleepstyle HC608 CPAP device (HC) with those determined by the new manual scoring (NM) rules during CPAP titration in patients with obstructive sleep apnea (OSA). ⋯ Our findings indicate differences in scoring respiratory events between our CPAP device and new version 2.0 manual scoring and suggest that residual AHI values should be carefully interpreted.