Impairment of pulmonary functions
Ramar Sabapathi Vinayagam in Integrated Evaluation of Disability, 2019
Sleep apnea results in disturbed sleep during the night and excessive daytime sleepiness. There are multiple events of apnea or hypopnea throughout sleep. It may last longer than 3 months (16). The sleep apnea may be either central apnea or obstructive sleep apnea. Obstructive sleep apnea is due to occlusion of the upper airway. There is a reduction in airflow due to the resistance of the upper airway passage in obstructive sleep apnea. Respiratory effort accompanies respiratory event in obstructive sleep apnea. In central apnea, there is a reduction in airflow due to decreased ventilatory drive. There is lack of respiratory effort in central apnea (17). The criteria for obstructive sleep hypopneas are snoring, drop in positive-airway-pressure device flow signal, or flattening of the nasal pressure from the pre-hypopnea reference level, and thoracoabdominal paradox during hypopnea. Snoring, drop in positive-airway-pressure device flow signal or flattening of nasal pressure, and thoracoabdominal paradox is absent in central apnea (18).
The Crucial Role of Craniofacial Growth on Airway, Sleep, and the Temporomandibular Joint
Aruna Bakhru in Nutrition and Integrative Medicine, 2018
Sleep apnea is a condition marked by pauses in breathing during sleep. A pause, called an apnea, can last between 10 seconds to minutes. Pauses can occur 5 to 30 or more times per hour. Figure 8.6. shows an obstructed airway because of lax muscular tone of the pharyngeal airway as well as an edematous tongue and narrow palatal arch. Obstructive sleep apnea occurs when a physical barrier blocks or collapses the air passageway.Central sleep apnea occurs when the brain fails to send signals to muscles that control breathing.Complex or mixed sleep apnea is a combination of both obstructive and central sleep apnea.
Sleep
Hilary McClafferty in Integrative Pediatrics, 2017
The clinical hallmarks of obstructive sleep apnea include repeated episodes of apnea during sleep, followed by loud gasping or choking that repeatedly interrupt the normal sleep cycle. The desaturations caused by the apnea have been associated with both metabolic and behavioral comorbidities. Some of the most serious are cardiovascular effects including elevated autonomic variability, increased mean arterial pressure, tachycardia, arrhythmias, and strain on both right and left ventricular function. Decreased cerebral brain flow has also been documented. Increase in systemic inflammatory markers are seen in children with OSA, thought to be related to the recurring physiologic stress of intermittent hypoxia and reactive sympathetic nervous system activation (Gileles-Hillel et al. 2014).
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.
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.
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
Related Knowledge Centers
- Airway Obstruction
- Apnea
- Central Sleep Apnea
- Fatigue
- Hypopnea
- Sleep
- Oxygen Saturation
- Sleep-Related Breathing Disorder
- Snoring
- International Classification of Sleep Disorders