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Sleep and gastrointestinal functioning
Published in S.R. Pandi-Perumal, Meera Narasimhan, Milton Kramer, Sleep and Psychosomatic Medicine, 2017
Since these studies examined only a single night of CPAP, it is important to note that this effect was replicated in a protocol that utilized 1 week of continuous CPAP treatment in patients with documented moderate/severe obstructive sleep apnea and abnormal acid contact time documented by 24-h esophageal pH monitoring.50 In this study, patients who were studied at the end of 1 week of CPAP treatment were shown to have a significant decrease in sleep-related acid contact time. Also of interest with regard to sleep apnea syndrome is a study by Graf et al.51 that found patients with sleep apnea to have a high incidence of GER. The authors further determined that there is no relation between severity of sleep apnea and GER, nor is there any relation between apneic events and reflux events. A similar conclusion was reached from a study reported by Tardif et al.52 Similar results have been reported by Ing and associates,53 but they also reported an overall increase in reflux events and acid clearance time in spite of the fact that there was no clear relationship between obstructive apneic events and reflux events.
Advanced Surgical Treatment of Obstructive Sleep Apnea Syndrome in the Pediatric Patient
Published in Mark A. Richardson, Norman R. Friedman, Clinician’s Guide to Pediatric Sleep Disorders, 2016
Jerome E. Hester, Nelson B. Powell, Robert R. Riley
Acknowledgment of obstructive sleep apnea syndrome (OSAS) as a significant cause of morbidity in the pediatric community has met with slow acceptance. Recent studies outlining its effects on cognitive development, memory, behavior, and growth certainly should accelerate its acceptance, and these factors, as well as others, have led the pediatric community to recommend evaluation of all children with signs and/or symptoms of OSAS (1–4). However, it is imperative that, as more children are diagnosed, our treatment options expand and improve.
The Realpolitik of Narcolepsy and Other Disorders with Impaired Alertness
Published in Meeta Goswami, Charles P. Pollak, Felissa L. Cohen, Michael J. Thorpy, Neil B. Kavey, Austin H. Kutscher, Jill C. Crabtree, Psychosocial Aspects of Narcolepsy, 2015
These data underscore the importance of medical evaluation of people who complain that they cannot stay awake. There are several etiologically distinct disorders that give rise to the symptom of excessive somnolence. For example, narcolepsy is a genetic neurological disorder linked to the human leukocyte antigen phenotype DR2 (Matsuki et al. 1985; Mitler et al. 1986) that best responds to stimulant drugs such as methylphenidate and pemoline. Sleep apnea syndrome is linked to anatomically abnormal narrowing of the upper airway that best responds to surgical revision or mechanical airway support (Strohl, Cherniak and Gothe 1986).
Epicardial adipose tissue, obesity, and the occurrence of atrial fibrillation: an overview of pathophysiology and treatment methods
Published in Expert Review of Cardiovascular Therapy, 2022
Juan Pablo Scarano Pereira, Eloise Owen, Alessandro Martinino, Kiran Akmal, Mohamed Abouelazayem, Yitka Graham, Sylvia Weiner, Nasser Sakran, Lukas R. Dekker, Chetan Parmar, Sjaak Pouwels
However, there are certain limitations to bear in mind when considering BMS for EAT reduction. Gaborit et al. [156] showed that the loss of EAT was reduced in patients with sleep apnea syndrome, despite sustained reduction in weight and an improved metabolic profile. This finding suggests that EAT is very sensitive to hypoxia, and it may over-express hypoxia-inducible factor alpha 1 leading to adipose tissue fibrosis and inflammation and consequently making it more resistant to weight loss [156,165,171,172]. Another important inconvenience is that BMS presents conflicting results in producing significant changes in myocardial triglyceride content (MTGC), a fat depot associated with myocardial oxidative damage and left ventricular hypertrophy [156,165,171,172]. Some authors have also proposed that different genetic polymorphisms may change the response of epicardial fat toward BS [154]. Additionally, race differences may also play an important role in the amount of EAT lost after BMS given that African-American men have less visceral fat than Caucasian patients [167].
Nocturnal Transcutaneous Blood Gas Measurements in a Pediatric Neurologic Population: A Quality Assessment
Published in Developmental Neurorehabilitation, 2021
Michel Toussaint, Lori Buggenhoudt, Karine Pelc
Children with neurological conditions can be at increased risk for respiratory problems due to several factors.1 Those children with Central Nervous System (CNS) disorders such as cerebral palsy (CP) or neurometabolic disorders can mainly be at risks for airway obstruction due to swallowing problems or mechanisms impairing cough and gag reflexes. Swallowing impairment and gastro-esophageal reflux may lead to lung aspiration. Other factors found in these children increase the risk of infections resulting in damage to the lungs. In addition, many children with neurodevelopmental disability have a history of perinatal complications, which may be associated with chronic lung disease (e.g. in the context of preterm birth). Neurologic disorders can manifest themselves with sleep disorders breathing (SDB) and, in turn, respiratory failure.2 This can be compounded by the development and deterioration of scoliosis. These children often have obstructive sleep apnea syndrome (OSAS)3 or even awake upper airway obstruction.1
A review of sleep research in patients with spinal cord injury
Published in The Journal of Spinal Cord Medicine, 2020
Victoria Dreier Thøfner Hultén, Fin Biering-Sørensen, Niklas Rye Jørgensen, Poul Jørgen Jennum
In the second study, Burns et al.22 investigated sleep apnea in chronic SCI individuals. Eight of the 20 individuals were diagnosed with sleep apnea syndrome. Individuals with sleep apnea had a mean apnea index of 17.1 ± 6.9, a mean respiratory distress index of 51.8 ± 16.1, and a mean nadir SaO2 of 68.6% (range, 61% – 85%). Apneic episodes were predominantly obstructive; however, two individuals demonstrated central apneas with an apnea index of 23.1 and 17.7, respectively, and two individuals had a mixed apnea type with apnea indexes of 19.6 and 21.0. This study compared data based on the presence of apnea, but did not compare paraplegic and tetraplegic individuals. Nevertheless, they reported that sleep apnea was diagnosed in 7 of 12 (58%) individuals with tetraplegia, but only in 1 of 8 (12.5%) individuals with paraplegia (P = 0.07).