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Other Complications of Diabetes
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
Signs and symptoms of obstructive sleep apnea and central sleep apnea somewhat overlap. The most common signs and symptoms include loud snoring, stopping breathing during sleep, gasping for air during sleep, waking up with a dry mouth, a morning headache, insomnia, hypersomnia, difficulty paying attention when awake, and irritability.
Obesity
Published in Judy Bothamley, Maureen Boyle, Medical Conditions Affecting Pregnancy and Childbirth, 2020
Obstructive sleep apnoea is a disorder which features repetitive episodes of breathing cessation with complete or partial collapse of the upper airway during sleep62. Daytime sleepiness is a key symptom of obstructive sleep apnoea. A combination of the physiological changes in pregnancy such as capillary engorgement in the upper airway and the cardio-respiratory demands of obesity predisposes women with raised BMI to obstructive sleep apnoea. Complications of pregnancy linked to this condition include hypertension, gestational diabetes, stillbirth, fetal growth restriction, cardiomyopathy and increased risk of admission to the intensive care unit63.
Medical Care of the Child with Down Syndrome
Published in Merlin G. Butler, F. John Meaney, Genetics of Developmental Disabilities, 2019
The midfacial hypoplasia, which provides the characteristic facial appearance of children with DS often, results in narrow airways and sinus ostia. As such, these children are frequently susceptible to chronic infections. Obstructive sleep apnea often occurs in the face of tonsillar and adenoidal tissue blocking the narrow airways. Hypotonia of the pharyngeal musculature and blockage of the hypopharynx by the tongue may also be contributing factors. Snoring and sleep apnea warrant an evaluation by an otolaryngologist and/or sleep center.
Interaction between slow wave sleep and elevated office blood pressure in non-hypertensive obstructive sleep apnea patients: a cross-sectional study
Published in Blood Pressure, 2023
Ning Xia, Hao Wang, Lin Zhang, Xiao-Jun Fan, Xiu-Hong Nie
Obstructive sleep apnea (OSA) is a common sleep disorder characterized by recurrent episodes of apnea during sleep that leads to intermittent hypoxemia and arousals [11]. There are accumulating evidences that OSA increased incidence of hypertension compared with individuals without OSA [2,12–14], and the different measurements of BP had the same results [2,12,15]. SWS is significantly reduced because of frequent respiratory events in OSA patients [16,17]. Recently, in a cross-sectional study, Ren et al. [18] found decreased SWS was associated with higher risk for hypertension in OSA patients than primary snoring, especially in men and younger patients. Moreover, Zhang et al. [19] demonstrated the incidence of hypertension was increased in patients with lower SWS percentage and OSA. However, the subjects of two studies included patients with hypertension. Almost half of the patients were diagnosed with hypertension in the two studies, which may produce confusion on the relationship of SWS and BP. Up to now, the association between decreased SWS and incident elevated office BP in non-hypertensive OSA patients has not been determined. The presence of obstructive sleep apnea and chronic diseases can worsen the prognosis of sleep problems in non hypertensive people. Therefore, we sought to determine whether low proportion of SWS is associated with incident elevated office BP in a large cohort of non-hypertensive OSA patients.
Parents’ Experiences of Having a Child with Down Syndrome and Sleep Difficulties
Published in Behavioral Sleep Medicine, 2023
Jasneek K. Chawla, Emma Cooke, Maria Carmen Miguel, Scott Burgess, Sally Staton
In two recent studies, published by our group, we highlighted the need to raise awareness of sleep problems in children with DS, demonstrating that obstructive sleep apnea prevalence is high and persists in children referred to tertiary services (Waters et al., 2020) and that the community prevalence of non-respiratory sleep problems is also high (Chawla et al., 2021). None of the participants in our study recalled receiving information regarding sleep and the difficulties that can arise in children with DS at a routine appointment during early childhood. It is, of course, possible that some participants received this information but did not retain this. However, it seems unlikely that this is the case given that parents were able to readily recall information provided about other expected comorbidities that required vigilance or routine screening in their child with DS, such as thyroid, cardiac, and hearing issues. Given that sleep difficulties were described as significantly impacting on quality of life for these families, we recommend that information regarding sleep problems that can occur in children with DS needs to be provided early on in childhood, using methods that are understandable, retainable by parents and counteract normalization of these issues. This is an important area for future development to improve care delivery.
A multidisciplinary approach to heart failure care in the hospital: improving the patient journey
Published in Hospital Practice, 2022
Vijay U. Rao, Atul Bhasin, Jesus Vargas, Vijaya Arun Kumar
3.2.b. Leverage a patient’s hospital stay to screen for risk factors for adverse outcomes in HF. Obstructive sleep apnea, cognitive impairment, and frailty affect up to 70%, 80%, and 49% of patients with HF, respectively [59–61]. These highly prevalent comorbidities are concerning given their relationships with clinical outcomes and prognosis. Obstructive sleep apnea is a risk factor for poor CV outcomes and mortality and is linked to atrial fibrillation, which can worsen HF [59]. Cognitive impairment can limit self-care and can lead to functional impairment, hospitalization, and mortality [60]. In a study of 720 patients hospitalized for HF, an abnormal Mini-Cog® was identified as the most important predictor of readmission or mortality at 6 months, suggesting that cognitive function is a novel marker of post-hospitalization risk in HF [62]. Frailty contributes a 1.5-fold increased risk of hospitalization and mortality in older adults [61]. Taken together, screening for and addressing these factors during hospitalization can likely improve short- and long-term patient outcomes.