Pathology of unexpected sudden cardiac death: Obstructive sleep apnea is part of the challenge

Ottaviani, Giulia; Buja, L. Maximilian

doi:10.1016/j.carpath.2020.107221

Cited by 11 publications

(6 citation statements)

References 27 publications

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“…It causes nocturnal hypoxemia, sleep rhythm disorders, etc. OSA is associated with increased cardiovascular and cerebrovascular morbidity and mortality, including sudden cardiac death (SCD) [ 38 , 39 ]. Real-time monitoring is important for preventing sudden cardiac death during sleep.…”

Section: Sleep Monitoringmentioning

confidence: 99%

Recent Progress in Long-Term Sleep Monitoring Technology

Yin

Ren

2023

Biosensors

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Sleep is an essential physiological activity, accounting for about one-third of our lives, which significantly impacts our memory, mood, health, and children’s growth. Especially after the COVID-19 epidemic, sleep health issues have attracted more attention. In recent years, with the development of wearable electronic devices, there have been more and more studies, products, or solutions related to sleep monitoring. Many mature technologies, such as polysomnography, have been applied to clinical practice. However, it is urgent to develop wearable or non-contacting electronic devices suitable for household continuous sleep monitoring. This paper first introduces the basic knowledge of sleep and the significance of sleep monitoring. Then, according to the types of physiological signals monitored, this paper describes the research progress of bioelectrical signals, biomechanical signals, and biochemical signals used for sleep monitoring. However, it is not ideal to monitor the sleep quality for the whole night based on only one signal. Therefore, this paper reviews the research on multi-signal monitoring and introduces systematic sleep monitoring schemes. Finally, a conclusion and discussion of sleep monitoring are presented to propose potential future directions and prospects for sleep monitoring.

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Section: Sleep Monitoringmentioning

confidence: 99%

Recent Progress in Long-Term Sleep Monitoring Technology

Yin

Ren

2023

Biosensors

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“…We have already discussed SIDS and its impact on infants. While the pathogenesis of SUDS has not yet been elucidated, families with a significant history of this disorder are more likely to present with significant nocturnal hypoxia [92][93][94] and a lack of ARAS neurotransmitters [95].…”

Section: Sleep Apnea and Sudden Unexplained Death During Sleep (Suds)mentioning

confidence: 99%

Sleep apnea pathophysiology

Andrisani

2023

Sleep Breath

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Objective The purpose of this study is to examine the pathophysiology underlying sleep apnea (SA). Background We consider several critical features of SA including the roles played by the ascending reticular activating system (ARAS) that controls vegetative functions and electroencephalographic findings associated with both SA and normal sleep. We evaluate this knowledge together with our current understanding of the anatomy, histology, and physiology of the mesencephalic trigeminal nucleus (MTN) and mechanisms that contribute directly to normal and disordered sleep. MTN neurons express γ-aminobutyric acid (GABA) receptors which activate them (make chlorine come out of the cells) and that can be activated by GABA released from the hypothalamic preoptic area. Method We reviewed the published literature focused on sleep apnea (SA) reported in Google Scholar, Scopus, and PubMed databases. Results The MTN neurons respond to the hypothalamic GABA release by releasing glutamate that activates neurons in the ARAS. Based on these findings, we conclude that a dysfunctional MTN may be incapable of activating neurons in the ARAS, notably those in the parabrachial nucleus, and that this will ultimately lead to SA. Despite its name, obstructive sleep apnea (OSA) is not caused by an airway obstruction that prevents breathing. Conclusions While obstruction may contribute to the overall pathology, the primary factor involved in this scenario is the lack of neurotransmitters.

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“…Bonuck et al reported in a study on questionnaires in 12 447 infants a prevalence of habitual snoring of about 4%, however OSA was not confirmed by PSG studies [3]. The main complications are feeding difficulties, obstruction of the upper airway with growth failure, cardiovascular outcomes, apparent life-threatening events, risk of sudden death, and neurological impacts [1,4,5,6,7,8,9]. The clinical signs suggestive of OSA in infants are classically typical: snoring, labored breathing, respiratory irregularities, apneas, sleep with the neck in hyperextension, hypersudation, irritability, and growth failure [10].…”

Section: Introductionmentioning

confidence: 99%

Gas exchange parameters for the prediction of obstructive sleep apnea in infants

Gyapay

Ioan

Thieux

et al. 2023

Preprint

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Objectives/background: Sleep laboratory polysomnography (PSG) is the gold standard for obstructive sleep apnea (OSA) diagnosis in infants, but its access remains limited. Another simple and widely used tool, oximetry-capnography can provide information on the presence of desaturations and alveolar hypoventilation. However, its reliability is debated. This study aimed at examining its use in determining OSA severity in infants. Patients/methods: This retrospective study was conducted in a sleep unit in a tertiary hospital, in infants < 4 months old with clinical signs of OSA or Pierre Robin Sequence (PRS) who underwent a one-night PSG coupled with oximetry-capnography. Results: Among the 78 infants included (median [IQR] age: 61 [45-89] days at PSG), 44 presented with PRS, and 34 presented with isolated airway obstruction. The clinical, sleep and respiratory characteristics were not significantly different between the two subgroups. In the entire cohort, 63.5% had severe OSA. Median OAHI was 14.5/h [7.4-5.9], Spo2 was 97.4% [96.5-98.1], and PtCO2 was 41.1 mmHg [38.3-44.9]. The optimal threshold to predict OAHI > 10/h was 6/h for OD3% (sensitivity 95.7%, specificity 51.9%) and 2/h for OD4% (sensitivity 95.7%, specificity 48.1%). Conclusion: Whereas transcutaneous capnography does not appear to be sufficient in predicting severe OSA in infants < 4 months old with PRS or clinical signs of OSA, oximetry may be a useful alternative for the screening of severe OSA in infants in the absence of PSG.

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Pathology of unexpected sudden cardiac death: Obstructive sleep apnea is part of the challenge

Cited by 11 publications

References 27 publications

Recent Progress in Long-Term Sleep Monitoring Technology

Recent Progress in Long-Term Sleep Monitoring Technology

Sleep apnea pathophysiology

Gas exchange parameters for the prediction of obstructive sleep apnea in infants

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