Mixed Apnea Metrics in Obstructive Sleep Apnea Predict Treatment-Emergent Central Sleep Apnea

Pavsic, Katja; Herkenrath, Simon; Treml, Marcel; Hagmeyer, Lars; Khayat, Rami; Hellmich, Martin; Randerath, Winfried

doi:10.1164/rccm.202007-2816le

Cited by 12 publications

(6 citation statements)

References 10 publications

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“…The relevance of loop gain in CSA has been emphasised. In a study conducted by P avsic et al [ 21 ], they have measured loop gain in polysomnograms and have detected significant differences in the loop gain characteristics between patients. While some patients have demonstrated narrow spectrum of loop gain, some of the patients have demonstrated a very wide spectrum of loop gain with increased variances in regards to body position, sleep stage and across different nights.…”

Section: Phenotypes Of Csa: Therapeutic Options and Future Management...mentioning

confidence: 99%

ERS International Congress 2023: highlights from the Sleep Disordered Breathing Assembly

Siciliano,

Bradicich,

Tondo

et al. 2023

ERJ Open Res

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The topic of sleep-related breathing disorders is always evolving, and during the European Respiratory Society (ERS) International Congress 2023 in Milano (Italy), the latest research and clinical topics in respiratory medicine have been presented. The most interesting issues ranged from new diagnostic tools, including cardiovascular parameters and artificial intelligence, pathophysiological traits of SDB from routine polysomnography or polygraphy signals, up to new biomarkers and the diagnostic approach in patients with excessive daytime sleepiness. This article summarises the most relevant studies and topics to this extent presented at the ERS International Congress 2023. Each section has been written by Early Career Members of the ERS Assembly 4.

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Section: Phenotypes Of Csa: Therapeutic Options and Future Management...mentioning

confidence: 99%

ERS International Congress 2023: highlights from the Sleep Disordered Breathing Assembly

Siciliano,

Bradicich,

Tondo

et al. 2023

ERJ Open Res

Self Cite

View full text Add to dashboard Cite

show abstract

“…These components contribute to various degrees in individual patients and may differ with sleep stages or body position. There is growing evidence applying these experimental findings and theoretical considerations to standard clinical diagnostics and therapeutic decision making [ 20 , 21 ].…”

Section: Phenotyping Multifaceted Pathophysiology and A Concept Of In...mentioning

confidence: 99%

Current and novel treatment options for obstructive sleep apnoea

et al. 2022

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Obstructive sleep apnoea (OSA) is challenging medical problem due to its prevalence, its impact on quality of life and performance in school and profession, the implications on risk of accidents and comorbidities and mortality. Current research has carved out a broad spectrum of clinical phenotypes and defined major pathophysiological components. These findings indicate to the concept of personalised therapy, oriented on both the distinct clinical presentation and the most relevant pathophysiology in the individual patient. This leads to the question if sufficient therapeutical options other than positive airway pressure (PAP) alone are available, for which patients they may be useful, if there are specific indications for single or combined treatment, and if there is solid scientific evidence for recommendations. This review describes our knowledge on PAP and non-PAP therapies to address upper airway collapsibility, muscle responsiveness, arousability and respiratory drive. The spectrum is broad and heterogeneous, including technical and pharmaceutical options, already in clinical use or in an advanced experimental stage. Although there is an obvious need for more research on single or combined therapies, the available data demonstrate the variety of effective options, which should replace the unidirectional focus on PAP therapy.

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“…A high level of suspicion and additional diagnostic tests during positive airway pressure (PAP) treatment have been recommended in patients with persistently elevated AHI on treatment [39,40] since the reliability of event identification by the PAP device algorithm may be far from optimal [41,42]. PAP treatment may also be associated with treatment-emergent central sleep apnoea, especially in the first period of use [43], which resolves spontaneously over time in most cases [44]. Finally, poor adherence to PAP treatment, i.e.…”

Section: Eds In Treated Osa Patientsmentioning

confidence: 99%

Investigation and management of residual sleepiness in CPAP-treated patients with obstructive sleep apnoea: the European view

et al. 2022

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Excessive daytime sleepiness (EDS) is a major symptom of obstructive sleep apnoea (OSA), defined as the inability to stay awake during the day. Its clinical descriptors remain elusive, and the pathogenesis is complex, with disorders such as insufficient sleep and depression commonly associated. Subjective EDS can be evaluated using the Epworth Sleepiness Scale, in which the patient reports the probability of dozing in certain situations; however, its reliability has been challenged. Objective tests such as the multiple sleep latency test or the maintenance of wakefulness test are not commonly used in patients with OSA, since they require nocturnal polysomnography, daytime testing and are expensive. Drugs for EDS are available in the United States but were discontinued in Europe some time ago. For European respiratory physicians, treatment of EDS with medication is new and they may lack experience in pharmacological treatment of EDS, while novel wake-promoting drugs have been recently developed and approved for clinical use in OSA patients in the USA and Europe. This review will discuss 1) the potential prognostic significance of EDS in OSA patients at diagnosis, 2) the prevalence and predictors of residual EDS in treated OSA patients, and 3) the evolution of therapy for EDS specifically for Europe.

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Mixed Apnea Metrics in Obstructive Sleep Apnea Predict Treatment-Emergent Central Sleep Apnea

Cited by 12 publications

References 10 publications

ERS International Congress 2023: highlights from the Sleep Disordered Breathing Assembly

ERS International Congress 2023: highlights from the Sleep Disordered Breathing Assembly

Current and novel treatment options for obstructive sleep apnoea

Investigation and management of residual sleepiness in CPAP-treated patients with obstructive sleep apnoea: the European view

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