To sleep, perchance to leak

Rodenstein, Daniel; Levy, P.

doi:10.1183/09031936.99.14612419

Cited by 12 publications

(8 citation statements)

References 16 publications

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“…Two authors emphasised the importance of leaks in long-term NIV and their negative impact on sleep structure, as well as the improvement in quality of sleep after correction of leaks 6 9 28. When mouth leaks were abolished, both sleep and efficacy of ventilation improved.…”

Section: Discussionmentioning

confidence: 99%

Proposal for a systematic analysis of polygraphy or polysomnography for identifying and scoring abnormal events occurring during non-invasive ventilation

Gonzalez-Bermejo

Perrin

Janssens

et al. 2010

Thorax

137

131

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Non-invasive ventilation (NIV) is recognised as an effective treatment for chronic hypercapnic respiratory failure. Monitoring NIV during sleep may be preferable to daytime assessment. This paper reports the findings of an international consensus group which systematically analysed nocturnal polygraphic or polysomnographic tracings recorded with either volume-cycled or pressure-cycled ventilators. A systematic description of nocturnal respiratory events which occur during NIV is proposed: leaks, obstruction at different levels of the upper airway (glottis and/or pharynx), with or without decrease of respiratory drive and asynchrony

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Section: Discussionmentioning

confidence: 99%

Proposal for a systematic analysis of polygraphy or polysomnography for identifying and scoring abnormal events occurring during non-invasive ventilation

Gonzalez-Bermejo

Perrin

Janssens

et al. 2010

Thorax

137

131

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“…Higher pressures during ventilatory support (20–25 cm H 2 O) in patients with respiratory failure are frequently associated with MB [14,15,16,17]. These leaks cause ineffective ventilation with O 2 desaturations, hypercapnia and frequent arousals.…”

Section: Discussionmentioning

confidence: 99%

Mouth Breathing in Obstructive Sleep Apnea prior to and during Nasal Continuous Positive Airway Pressure

Rühle

Nilius²

2007

Respiration

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Background: Patients with obstructive sleep apnea syndrome (OSAS) often complain of dryness of mouth and throat prior to and during nasal continuous positive airway pressure (nCPAP). It is believed that this is due to mouth breathing (MB). However, the association between mouth breathing and apneas/hypopneas and the effect of CPAP on MB has not been studied. Objectives: The purpose of the present study was, therefore, to assess the frequency and duration of episodes of MB prior to and during treatment with nCPAP. Methods: MB was recorded prior to and during nCPAP with a closely fitting mouth mask connected to a pneumotachograph and nasal flow was measured via nasal prongs. MB episodes were expressed as the number of events divided by total sleep time × 60, to give the MB event index per hour of sleep. MB time divided by total sleep time × 60 was calculated in minutes to get the MB time index per hour of sleep. Patients: Eleven male patients with OSAS (mean age 57.9 ± 8.3 years, body mass index 30.2 ± 3.8) were recruited to the study. Results: Prior to nCPAP, the apnea/hypopnea index was 55.8 ± 26 and decreased during nCPAP to 8.0 ± 3.4. The lowest SaO₂ measured was 82.9 ± 4.7%, and increased to 87.5 ± 2.7% under nCPAP. The mean nCPAP was 7.8 ± 1.6 cm H₂O. MB event index per hour of sleep decreased from 35.2 ± 19.7 prior to treatment to 5.0 ± 5.2 under nCPAP (p < 0.01). In 52.2 ± 27.4% of obstructive respiratory events, MB started at the end of an apnea/hypopnea episode, decreasing to 8.5 ± 12.5% with nCPAP treatment. MB time index per hour of sleep was reduced from 13.5 ± 10.2 min prior to treatment to 4.6 ± 5.5 min under nCPAP (p < 0.05). Conclusions: In OSAS patients, MB episodes often appear at the termination of an apnea/hypopnea episode. In many cases, MB episodes can be markedly reduced by nCPAP treatment. When patients on nCPAP complain of dry mouth, appropriate measurements should be performed to verify MB.

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“…mouth or mask leaks). These leaks are associated with ineffective ventilation and induced sleep fragmentation (56) . When both are suppressed, there is an improvement in both alveolar ventilation and daytime function, with decreased morbidity (57) .…”

Section: Clinical Evaluation Overnight Sleep Studiesmentioning

confidence: 99%

“…It will also improve patient's compliance. After proper adjustment of the equipment, a full nocturnal polysomnography is indicated (56,57) . When not available, nocturnal oximetry with daytime arterial blood gas sampling while breathing spontaneously may help assessing the efficacy of nocturnal ventilation.…”

Section: E Continuous Positive Airway Pressure (Cpap)mentioning

confidence: 99%

Perturbação respiratória durante o sono em doença pulmonar obstrutiva crônica

Krieger¹

2005

J. bras. pneumol.

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Chronic obstructive pulmonary disease is a prevalent condition and is currently the forth leading cause of mortality in the US. The prevalence of respiratory disturbance during sleep, or overlap syndrome as it was commonly known in the past, is still undetermined as conflicting reports have been published. Because of the adverse effects of sleep-related respiratory impairment in patients with underlying pulmonary disease, this condition deserves further investigation. In this report, we will briefly discuss the mechanisms involved in generating respiratory disturbance during sleep in Chronic Obstructive Pulmonary Disease and will guide the reader into distinguishing those patients who would benefit from a more detailed sleep evaluation, discussing management issues and treatment options.A doença pulmonar obstrutiva crônica é uma condição freqüente e é hoje a quarta principal causa de mortes nos Estados Unidos. A prevalência de perturbação respiratória durante o sono, ou síndrome de superposição, como anteriormente denominada, ainda não foi determinada devido à publicação de relatos conflitantes. Esta condição deve continuar sendo investigada devido aos efeitos adversos causados por transtornos respiratórios relacionados ao sono em pacientes com doença pulmonar de base. Neste relato, discutiremos brevemente os mecanismos envolvidos na origem da perturbação respiratória durante o sono em doença pulmonar obstrutiva crônica e auxiliaremos o leitor a distinguir àqueles pacientes que se beneficiariam de uma avaliação do padrão do sono mais detalhada, com a discussão de tópicos de gerenciamento e opções de tratamento.

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To sleep, perchance to leak

Cited by 12 publications

References 16 publications

Proposal for a systematic analysis of polygraphy or polysomnography for identifying and scoring abnormal events occurring during non-invasive ventilation

Proposal for a systematic analysis of polygraphy or polysomnography for identifying and scoring abnormal events occurring during non-invasive ventilation

Mouth Breathing in Obstructive Sleep Apnea prior to and during Nasal Continuous Positive Airway Pressure

Perturbação respiratória durante o sono em doença pulmonar obstrutiva crônica

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