Cardiovascular Disorders and Obstructive Sleep Apnea Syndrome

Coccagna, G; Pollini, A.; Provini, Federica

doi:10.1080/10641960600549090

Cited by 49 publications

(22 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Because sleep apnea (SA) is highly correlated with CHF, 29 and SA enhances arterial chemoreflex function (see discussion below), it is possible that SA may contribute to arterial chemoreflex activation in patients with CHF with breathing disturbances. However, chronic recordings of breathing in CHF rabbits discount this as an essential mechanism in this animal model.…”

Section: Mechanisms Of Enhanced Arterial Chemoreflex In Heart Failurementioning

confidence: 99%

Arterial Chemoreceptors and Sympathetic Nerve Activity

2007

View full text Add to dashboard Cite

C hronic elevation in sympathetic nerve activity (SNA) is associated with the development and maintenance of certain types of hypertension 1 and contributes to the progression of chronic heart failure (CHF). 2 The mechanisms involved in sympathetic dysfunction in these disorders appear to be complex and multifactorial. A unified hypothesis is likely to encompass alterations in multiple autonomic reflex pathways, central integratory sites, and chemical mediators that control sympathetic outflow. For example, tonic restraint of sympathetic outflow by arterial and cardiopulmonary baroreflexes is depressed in CHF 2 and depressed or reset in hypertension. 3 Moreover, maladaptive changes also occur in the central nervous system at integrative sites for autonomic control in both disease processes. 4,5 It is also clear that sympathoexcitatory cardiac, 6 somatic, 7 and central/peripheral chemoreceptor reflexes 8 are enhanced in CHF and hypertension.Arterial chemoreceptors serve an important regulatory role in the control of alveolar ventilation, but they also exert a powerful influence on cardiovascular function. 9 Activation of arterial chemoreceptors by hypoxemia increases sympathetic outflow to systemic vascular beds to compensate for the direct vasodilating effects of hypoxia on these vessels and to redistribute blood flow to essential organs. In this review, we highlight relevant information that implicates the arterial chemoreflex as a contributory mechanism for the sympathetic hyperactivity in CHF and hypertension and illustrate proposed mechanisms for this altered function. The Sympathetic Response to Arterial Chemoreceptor ActivationArterial chemoreceptors located in the aortic and carotid bodies (CBs) respond to hypoxemia and hypercapnia. Because central chemoreceptors also respond to hypercapnia, hypoxia is typically used as a specific stimulus to arterial chemoreceptors. In some mammals, such as rats and rabbits, reflex responses to hypoxemia arise solely from the CB, whereas in other species, the aortic chemoreceptor contribution can be significant. However, it is not possible to experimentally separate the relative contribution of the aortic and CBs to reflex responses in conscious animals or humans. For these reasons, discussions on the arterial chemoreflex generally relate functionality to that of the CB, which has been more extensively studied. Glomus cells in the CB depolarize in response to hypoxia and release multiple putative neurotransmitters (including acetylcholine, serotonin, ATP, and substance P) that activate impulses in afferent fibers traveling to the medulla via the carotid sinus nerve. 10 Arterial chemoreceptor stimulation in freely breathing humans and conscious animals increases sympathetic vasoconstrictor outflow to muscle, splanchnic, and renal beds to elevate arterial pressure, and, in humans, increases cardiac sympathetic activity to increase heart rate and contractility. 9 There is preferential activation of sympathetic fibers going to the adrenal gland to increase norepinephrine but...

show abstract

Section: Mechanisms Of Enhanced Arterial Chemoreflex In Heart Failurementioning

confidence: 99%

Arterial Chemoreceptors and Sympathetic Nerve Activity

2007

View full text Add to dashboard Cite

show abstract

“…It is characterized by recurring episodes of sleep-related collapse of the UA at the level of the pharynx and is usually associated with loud snoring and increased daytime sleepiness. It is a serious threat to an individual's health if not treated, as it is known to be a risk factor for hypertension and, possibly, cardiovascular diseases [9] and even cancer [10]. Quite recently, it has also been related to traffic accidents caused by somnolent drivers [8,9,11] and might lead to a poor quality of life and impaired work performance.…”

Section: Obstructive Sleep Apneamentioning

confidence: 99%

Improving Automatic Detection of Obstructive Sleep Apnea Through Nonlinear Analysis of Sustained Speech

et al. 2012

View full text Add to dashboard Cite

We present a novel approach for the detection of severe obstructive sleep apnea (OSA) based on patients' voices introducing nonlinear measures to describe sustained speech dynamics. Nonlinear features were combined with state-of-the-art speech recognition systems using statistical modeling techniques (Gaussian mixture models, GMMs) over cepstral parameterization (MFCC) for both continuous and sustained speech. Tests were performed on a database including speech records from both severe OSA and control speakers. A 10 % relative reduction in classification error was obtained for sustained speech when combining MFCC-GMM and nonlinear features, and 33 % when fusing nonlinear features with both sustained and continuous MFCC-GMM. Accuracy reached 88.5 % allowing the system to be used in OSA early detection. Tests showed that nonlinear features and MFCCs are lightly correlated on sustained speech, but uncorrected on continuous speech. Results also suggest the existence of nonlinear effects in OSA patients' voices, which should be found in continuous speech.

show abstract

“…It is characterized by recurrent episodes of sleep-related collapses of the Upper Airway (UA) at the level of the pharynx, and is usually associated to loud snoring and increased daytime sleepiness. It is a serious threat to an individual's health as it is known to be a risk factor for hypertension and, possibly, cardiovascular diseases (Coccagna et al, 2006). Recently it has also been related to traffic accidents caused by somnolent drivers (Puertas et al, 2005;Coccagna et al, 2006;Lloberes et al, 2000), and to a poor quality of life and impaired work performance.…”

Section: Introductionmentioning

confidence: 99%

GMM-based Classifiers for the Automatic Detection of Obstructive Sleep Apnea

García

Blanco-Murillo²,

Godino-Llorente

et al. 2013

Proceedings of the International Conference on Bio-Inspired Systems and Signal Processing

View full text Add to dashboard Cite

Abstract:The aim of automatic pathological voice detection systems is to serve as tools, to medical specialists, for a more objective, less invasive and improved diagnosis of diseases. In this respect, the gold standard for those systern^ include the usage of a^optimized representation of the spectral envelope, either based on cepstral coefficients from the mel-scaled Fourier spectral envelope (Mel-Frequency Cepstral Coefficients) or from an all-pole estimation (Linear Prediction Coding Cepstral Coefficients) for characterization, and Gaussian Mixture Models for posterior classification. However, the study of recently proposed GMM-based classifiers as well as Nuisance mitigation techniques, such as those employed in speaker recognition, has not been widely considered in pathology detection labours. The present work aims at testing whether or not the employmenl|of such speaker recognition tools might contribute to improve system performance in pathology detection systems, specifically in the automatic detection of Obstructive Sleep Apnea. The testing procedure employs^arj^Ob3tructivo Sloop Apnoa database^ in conjunction with GMM-based classifiers looking for a better performance. The results show that an improved performance might be obtained by using such approach.

show abstract

Cardiovascular Disorders and Obstructive Sleep Apnea Syndrome

Cited by 49 publications

References 29 publications

Arterial Chemoreceptors and Sympathetic Nerve Activity

Arterial Chemoreceptors and Sympathetic Nerve Activity

Improving Automatic Detection of Obstructive Sleep Apnea Through Nonlinear Analysis of Sustained Speech

GMM-based Classifiers for the Automatic Detection of Obstructive Sleep Apnea

Contact Info

Product

Resources

About