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The Surgical Management of Snoring and Obstructive Sleep Apnoea
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
Bhik Kotecha, Mohamed Reda Elbadawey
Sleep-related breathing disorder (SRBD) encompasses a broad clinical spectrum of recurring partial or complete obstruction of the upper airway. This ranges from simple or primary snoring to severe obstructive sleep apnoea (OSA). Patients who have symptoms suggestive of OSA but do not have objective parameters in a sleep study confirming the condition can be classified as having upper airway resistance syndrome (UARS). These patients may have sleep fragmentation but do not have significant oxygen desaturation events or many obstructive events. A definition of apnoea, hypopnea and the apnoea-hypopnea index (AHI) is covered in Chapter 74, Obstructive sleep apnoea: medical management.
Sleep and coronary heart disease
Published in S.R. Pandi-Perumal, Meera Narasimhan, Milton Kramer, Sleep and Psychosomatic Medicine, 2017
Brush Elizabeth, Y. Baba Ridhwan, Shah Neomi
It is clear that OSA, via endothelial dysfunction, sympathetic activation, metabolic dysregulation, and mechanical load effects, initiates a complex cascade of cardiovascular-deleterious responses. Epidemiological evidence from numerous crosssectional observational studies suggests an independent association between OSA and CHD and CHD-related mortality. Further research from longitudinal and interventional studies is necessary in order to more accurately define the link between sleep and the sleep-related breathing disorder OSA and CHD. Given the prevalence of OSA in the general population and the public health burden of CHD, this is an area of great importance for continued investigation.
Driving Performance
Published in Clete A. Kushida, Sleep Deprivation, 2004
Pierre Philip, Jacques Taillard
Stoohs et al. (33) performed an integrated analysis of recordings of sleep-related breathing disorders and self-reported automotive and company-recorded automotive accidents in 90 commercial long-haul truck drivers (see also Chap. 15). Truck drivers with sleep-disordered breathing had a twofold higher accident rate per mile than drivers without sleep-disordered breathing. Accident frequency was not dependent on the severity of the sleep-related breathing disorder.
Effect of nasal and sinus surgery in patients with and without obstructive sleep apnea
Published in Acta Oto-Laryngologica, 2019
Mingjie Wang, Stanley Yung-Chuan Liu, Bing Zhou, Yunchuan Li, Shunjiu Cui, Qian Huang
The nose accounts for >50% of the total resistance of the upper airway. Physiologic mechanisms that explain the relationship between nasal airflow and breathing during sleep include the Starling resistor model, the unstable oral airway proposition, the nasal ventilatory reflex, and the role of NO [4]. The link between nasal pathology and sleep-related breathing disorder lead to attempt to improve sleep quality by treatment of nasal obstruction medically or surgically. Among 19 studies, there were nine studies reporting the results involving both of nasal surgery and endoscopic sinus surgery and three studies involving only endoscopic sinus surgery, and seven studies involving only nasal surgery. The selection of nasal procedure is based on pathology of nasal cavity and sinus. Compared to the outcomes of surgeries reported in the studies with only nasal surgery or endoscopic sinus surgery, there was no significant difference on the effect of surgeries to the sleep disorder. In other words, endoscopic sinus surgery could be as effective as nasal surgery in the treatment of sleep disorder (data could not be meta-analysed).
Physiological and pathological covariates of persistent concussion-related fatigue: results from two regression methodologies
Published in Brain Injury, 2019
Tatyana Mollayeva, David Stock, Angela Colantonio
People with sensory discomfort or restlessness in the legs while at rest (restless legs syndrome) may experience difficulty falling asleep due to a constant urge to move the legs (31). If these leg movements occur in a stereotyped fashion during sleep, a condition known as a periodic leg movement disorder, they can result in a full awakening and difficulty maintaining uninterrupted sleep (32). Sleep-related breathing disorder can also result in frequent arousal from sleep, often to complete awakenings with difficulty consolidating sleep and disturbed sleep continuity (33). These negative sleep effects can cause or exacerbate pre-existing fatigue (34,35). Therefore, the study of primary sleep disorders and their association with fatigue in mTBI has scientific merit.
Diagnosis and management of central sleep apnea syndrome
Published in Expert Review of Respiratory Medicine, 2019
Sébastien Baillieul, Bruno Revol, Ingrid Jullian-Desayes, Marie Joyeux-Faure, Renaud Tamisier, Jean-Louis Pépin
CSA can occur in several neuromuscular diseases (for review see [65]). There is a complex interplay between the pathophysiological characteristics of neuromuscular diseases and the physiology of sleep (NREM sleep, reduced lung volume in a supine position) that favors the occurrence of SRBD. Non-invasive ventilation (NIV) is required to replace the activity of the respiratory centers and support muscle weakness, and has many beneficial effects, improving the quality of life and survival of the patients. However, in some situations NIV should be used with caution (for instance, in the presence of concomitant cardiomyopathy) [65]. A precise diagnosis of the sleep-related breathing disorder and a fine appraisal of the underlying disease are obligatory [66].