Sleep & breathing = Schlaf & Atmung
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Comparative Study
Diagnostic performance of single airflow channel recording (ApneaLink) in home diagnosis of sleep apnea.
ApneaLink is a novel single-channel screening device for sleep apnea detection which is based on pressure-transduced measurement of oronasal airflow, summarised as respiratory disturbance index per hour of recording time (RDI(ApneaLink)). We tested ApneaLink's diagnostic performance in a patient population with high prevalence of sleep apnea. ⋯ ApneaLink is an accurate screening tool for sleep apnea in a population with high prevalence of the disorder.
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Sleep apnea is common in myotonic dystrophy (MD) and may cause respiratory failure. Most of the sleep studies have been performed in patients with excessive daytime sleepiness (EDS), which is a characteristic and strong predictor of sleep apnea. Therefore, we investigated the prevalence of sleep apnea in adult MD patients who have no EDS. ⋯ Sleep apnea and oxygen desaturations are very common in MD patients who report no excessive daytime sleepiness. Daytime lung function parameters are not sufficiently reliable for screening sleep apnea. Therefore, we recommend routine polysomnography in MD patients.
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Elevated economic burden in obstructive lung disease patients with concomitant sleep apnea syndrome.
The purpose of this study is to examine the incremental economic burden of sleep apnea syndrome (SAS) among individuals with concomitant asthma, chronic obstructive pulmonary disease (COPD), or both (i.e., asthma/COPD). ⋯ SAS may add additional economic burden on beneficiaries who already have COPD or asthma/COPD.
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Autotitrating continuous positive airway pressure (auto-CPAP) devices now have a smart card (a pocket-sized card with embedded integrated circuits which records data from the CPAP machine such as CPAP usage, CPAP pressure, large leak, etc.) which can estimate the Apnea-Hypopnea Index (AHI) on therapy. The aim of this study was to determine the accuracy of auto-CPAP in estimating the residual AHI in patients with obstructive sleep apnea (OSA) who were treated with auto-CPAP without a CPAP titration study. ⋯ Auto-CPAP estimate of AHI may be used to estimate residual AHI in patients with OSA of varying severity treated with auto-CPAP.
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The coexistence of obstructive sleep apnea (OSA) and chronic obstructive pulmonary diseases (COPD) is known as overlap syndrome (OS); it occurs in 10-20% of patients with OSA. Patients with OS have a higher risk of pulmonary hypertension and worse nocturnal hypoxemia than those with either disease alone. Differences may be seen according to severity of COPD, anthropometric measures, and polysomnography (PSG) features of patients. Recent studies have suggested that long-term use of continuous positive airway pressure for OSA is associated with worsening of coexistent COPD. This stresses the importance of identifying this subgroup of patients in order to provide adequate therapy. ⋯ In these preliminary results, the prevalence of OS in our population is similar to that previously reported. Daytime hypercapnia correlated with the more severe sleep-disordered breathing (SDB) and worse nocturnal hypoxemia in all subjects. Severity of obstructive ventilatory impairment is associated with worse SDB during REM sleep. Randomized trials to determine if PSGs are indicated in all patients with severe COPD should be considered. This is an ongoing study.