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.
Troubled sleep and dreams
Frederick L. Coolidge, Ernest Hartmann in Dream Interpretation as a Psychotherapeutic Technique, 2018
The word apnea comes from Greek and means a lack of breathing. Sleep apnea occurs when people stop breathing or have trouble breathing while sleeping. In DSM-IV-TR sleep apnea is classified under the rubric ‘Breathing-Related Disorder’. By far the most common type of sleep apnea is obstructive sleep apnea. This type of apnea implies that something is blocking the trachea (windpipe). These obstructions tend to be more common in men (at a ratio of about 2:1 to 4:1) compared to women and seem to increase with age. The obstructions tend to be fatty tissue, relaxed throat muscles, tongue, tonsils, and other tissues. The more rare form of sleep apnea is central sleep apnea, and this form implies that the breathing problems are related to dysfunction in the central nervous system (CNS). Sleep apnea becomes a disorder when these periods of non-breathing, usually 10 to 30 seconds each, begin to disrupt sleep by waking a person up, or leave the person exhausted after a typical sleep period (e.g. 8 hours of sleep). As noted earlier, daytime sleepiness can have dire consequences when waking performance demands full alertness, e.g. driving a car.
Fundamentals of Infrared Thermal Imaging
U. Snekhalatha, K. Palani Thanaraj, Kurt Ammer in Artificial Intelligence-Based Infrared Thermal Image Processing and Its Applications, 2023
Jakkaw and Onoye (2020) monitored the respiratory activity and body movements during the sleep using the thermal imaging technique. The breathing patterns are detected during sleeping and identifying the sleep disorders such as sleep apnea caused due to hypertension, cardiovascular diseases, and arrhythmia. Hence, the authors demonstrated the non-contact method of respiratory and body movement detection using a thermal camera which detects the temperature changes due to breathing patterns. The thermal video frames of subjects in sleeping mode are considered the input images. The images are pre-processed using the Gaussian filter. In the respiration-monitoring method, ROIs are automatically detected from the input images by means of identifying the highest temperature point and massive portions of the high-temperature area. For automated ROI detection of the thermal image, sleeping position is considered. The highest temperature points are detected in the image by using minimum and maximum intensities found in the image. The maximum pixel intensities are associated with the highest temperature of the body. After determining the pixel at the center of the observation area, a rectangular ROI of pixel size either 10 × 10, 25 × 25, or 50 × 50 is applied. Among the ROI used, empirical research result shows that 50 × 50 pixels produced very good accuracy in compliance with an original frame 640 × 480. The massive portions of the high-temperature area are detected using the thresholding method. A threshold value of 176 was set, which produced best results in segregating the human skin area from the background.
Sleep apnea and atrial fibrillation: challenges in clinical and translational research
Published in Expert Review of Cardiovascular Therapy, 2022
Benedikt Linz, Julie Norup Hertel, Jeroen Hendriks, Arnela Saljic, Dobromir Dobrev, Mathias Baumert, Thomas Jespersen, Dominik Linz
Even though most AF patients suffer predominantly from obstructive sleep apnea (OSA) and single obstructive respiratory events are described to increase AF-susceptibility, central sleep apnea has also been associated with AF. The most common cause for central sleep apnea is congestive heart failure [31]. In heart failure patients, increased sensitivity of chemoreceptors, pulmonary congestion, and slowing in circulation may impair regulated respiratory control and predispose for central apneic events [32–34]. Additionally, a change in posture at night from upright to supine is associated with a prominent distribution of body fluid from the lower body part to the chest and neck area, also called rostral shift [35]. This is associated with an increase in neck volume, which increases the risk for upper airway collapsibility. Moreover, heart failure is associated with increased atrial volume and stretch and reduced repolarizing potassium currents, which might contribute to early or late afterdepolarizations, thus increasing AF-trigger formation [36].
Diabetes mellitus is associated with high sleep-time systolic blood pressure and non-dipping pattern
Published in Postgraduate Medicine, 2020
Aye Thandar Aung, Siew-Pang Chan, Than-Than Kyaing, Chi-Hang Lee
The present analysis clearly demonstrates that patients with DM are less likely to achieve the targeted sleep-time BP when compared with their non-DM counterparts. Many mechanisms have been postulated to explain the observed resistance to therapy among patients with DM [20], including DM-related renal dysfunction, the inadequate use of or poor adherence to antihypertensive drug therapy, volume overload due to a high salt intake, sympathetic hyperactivity, and undiagnosed obstructive sleep apnea. It has previously been shown that non-dipping in patients with DM is associated with microalbuminuria [21,22]. In addition to our finding that the DM and non-DM groups differed significantly in terms of achieving the sleep-time but not daytime target BP, previous studies have shown that obstructive sleep apnea is strongly associated with DM [23,24] and that patients with comorbid DM and obstructive sleep apnea have a particularly high cardiovascular event rate [25]. We therefore postulate that obstructive sleep apnea and associated nocturnal sympathetic hyperactivity might be a likely mechanism for the failure to achieve the targeted sleep-time BP in patients with DM. Indeed, the 2017 American College of Cardiology/American Heart Association Hypertension Guideline describes obstructive sleep apnea, which is present in 25–50% of hypertensive patients, as the most prevalent secondary cause of hypertension [26].
Secondary erythrocytosis due to hemoglobin San Diego
Published in Baylor University Medical Center Proceedings, 2021
In December 2014, a 37-year-old Hispanic man with known mild asthma presented to a local physician with a hemoglobin of 19.4 g/dL, platelet count of 178 × 109/L, and white blood cell count of 6.5 × 109/L. He had fatigue and intermittent headaches. Physical examination was unremarkable. Blood film revealed normal cellular morphology. Serum chemistry, erythropoietin, and testosterone were normal. Janus Kinase-2 mutations (including exon 12 and 13) were negative (Table 1). A sleep study ruled out sleep apnea. A bone marrow biopsy revealed normocellular marrow with trilineage hematopoiesis only. A bone marrow cytogenetic study revealed 46, XY in all 20 metaphases. Abdominal ultrasound ruled out masses, cysts, or hepatosplenomegaly. The asthma appeared to be too mild to be the culprit for SE. He was diagnosed with SE of unknown etiology and underwent intermittent therapeutic phlebotomy until mid-2019.
Related Knowledge Centers
- Apnea
- Central Sleep Apnea
- Hypopnea
- Hypoxemia
- Obstructive Sleep Apnea
- Polysomnography
- Sleep
- Sleep Disorder
- Snoring
- Tonsil