Search Our Scientific Publications & Authors

Methodist Debakey Cardiovasc J 2021 Apr 25;17(1):49-52. Epub 2021 Mar 25.

Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, Texas.

Sleep apnea is highly associated with atrial fibrillation (AF), and both diseases are highly prevalent in the United States. The mechanistic underpinnings that contribute to their association remain uncertain, but numerous possible mechanisms have been proposed, including dysfunction of the cardiac autonomic nervous system (ANS). Studies have reported that apnea induces hyperactivity of the ANS, leading to increases in AF susceptibility. Read More

ESC Heart Fail 2021 Jun 8. Epub 2021 Jun 8.

PhyMedExp, University of Montpellier, INSERM U1046, CNRS UMR 9214, Montpellier, France.

Aims: Optimizing medical cardiac treatment for sleep apnoea (SA) in patients with chronic heart failure and reduced ejection fraction (HFrEF) is an expert Grade C recommendation based on six studies encompassing a total of 67 patients only. Whether sacubitril-valsartan (SV), a cornerstone of HFrEF medical treatment, impacts SA is unknown and requires evaluation.

Methods And Results: The ENTRESTO-SAS trial is a six-centre, prospective, open-label real-life cohort study (NCT02916160). Read More

Arch Bronconeumol 2021 Jun;57(6):393-398

University of Health Science, Dr. Suat Seren Chest Diseases and Chest Surgery Training and Research Hospital, Department of Neurology, Izmir, Turkey.

Objective: To evaluate the impact of the body position on primary central sleep apnea syndrome.

Methods: Fifty-five subjects diagnosed with central sleep apnea (CSA) through polysomnographic examinations were prospectively enrolled in the study. All patients underwent cardiologic and neurologic examinations. Read More

J Appl Physiol (1985) 2021 06 3. Epub 2021 Jun 3.

Sleep Research Laboratory, John D. Dingell VA Medical Center, United States.

Studies in those with spinal cord injury (SCI) have demonstrated that medications targeting serotonin receptors may decrease the susceptibility to central sleep-disordered breathing (SDB). We hypothesized that mirtazapine would decrease the propensity to develop hypocapnic central sleep apnea (CSA) during sleep. We performed a single-blind pilot study on a total of 10 men with SDB (seven with chronic SCI and three non-injured) aged 52. Read More

J Sleep Res 2021 Jun 2:e13388. Epub 2021 Jun 2.

Assistance Publique-Hôpitaux de Paris (AP-HP), Pediatric Noninvasive Ventilation and Sleep Unit, Hôpital Necker-Enfants Malades, Paris, France.

Central sleep apneas and periodic breathing are poorly described in childhood. The aim of the study was to describe the prevalence and characteristics of central sleep apnea and periodic breathing in children with associated medical conditions, and the therapeutic management. We retrospectively reviewed all poly(somno)graphies with a central apnea index ≥ 5 events per hr in children aged > 1 month performed in a paediatric sleep laboratory over a 6-year period. Read More

South Med J 2021 Jun;114(6):339-342

From the Division of General Internal Medicine, University of Florida College of Medicine, Jacksonville.

As advances in medicine continue to extend the lifespan of patients with cerebral palsy (CP), emphasis must be placed on evaluating patients for chronic health issues common in the general adult population. Sleep-disordered breathing (SDB) affects a large number of otherwise healthy adults and is even more common in individuals with disability. SDB includes the following subtypes: obstructive sleep apnea, central sleep apnea, and sleep-related hypoventilation/hypoxemia. Read More

Entropy (Basel) 2021 May 31;23(6). Epub 2021 May 31.

Department of Engineering, University of Palermo, 90128 Palermo, Italy.

Apnea and other breathing-related disorders have been linked to the development of hypertension or impairments of the cardiovascular, cognitive or metabolic systems. The combined assessment of multiple physiological signals acquired during sleep is of fundamental importance for providing additional insights about breathing disorder events and the associated impairments. In this work, we apply information-theoretic measures to describe the joint dynamics of cardiorespiratory physiological processes in a large group of patients reporting repeated episodes of hypopneas, apneas (central, obstructive, mixed) and respiratory effort related arousals (RERAs). Read More

Paediatr Anaesth 2021 May 30. Epub 2021 May 30.

Consultant Anaesthetist, Department of Anaesthesia and Pain Management, Perth Children's Hospital, Perth, Western Australia, Australia.

Background: Obstructive sleep apnea (OSA) is a risk factor for respiratory depression following opioid administration as well as opioid-induced hyperalgesia. Little is known on how OSA status is associated with central ventilatory depression in pediatric surgical patients given a single dose of fentanyl.

Methods: This was a single center, prospective trial in children undergoing surgery requiring intubation and opioid administration. Read More

Heart Fail Clin 2021 Jul;17(3):369-376

Department of Cardiovascular Medicine, and Endocrinology and Metabolism, Faculty of Medicine, Tottori University, 36-1 Nishicho, Yonago, Japan.

It is generally considered that obstructive sleep apnea is a potential cause of heart failure (HF), and insomnia and central sleep apnea are results of HF. However, the number of reports describing the bidirectional relationship between sleep disorder and HF has increased. Sleep disorder may contribute to left ventricular diastolic dysfunction via left atrial overload, left ventricular remodeling, pulmonary hypertension, and atrial fibrillation, which lead to HF with preserved left ventricular ejection fraction. Read More

J Clin Neurophysiol 2021 May 26. Epub 2021 May 26.

Sleep and Disorders Unit, Department of Neurology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey.

Purpose: Apneas are classified in three categories, as obstructive, central, and mixed types. Mixed apneas are calculated together with the obstructive events in diagnosing obstructive sleep apnea syndrome (SAS). The clinical significance of mixed apneas needs to be specified. Read More

Laryngoscope 2021 May 25. Epub 2021 May 25.

Department of Otolaryngology-Head and Neck Surgery, The Hospital for Sick Children, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.

Objectives/hypothesis: Assess the risks and benefits of adenotonsillectomy (AT) for obstructive sleep apnea (OSA) in children with cerebral palsy (CP).

Study Design: Systematic review.

Methods: We conducted a systematic review of Medline, Embase, and Cochrane Central Registry from 1946 to 2021. Read More

Chronobiol Int 2021 May 24:1-9. Epub 2021 May 24.

Department of Sleep Medicine, Mental Illness Research, Clinical, Education Centers of Excellence (MIRECC), VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA.

Obstructive Sleep Apnea (OSA) is a common disorder that is associated with disability, premature mortality and lost quality of life. Excessive daytime sleepiness and depressive symptoms confer a great portion of the disability and lost quality of life associated with the disorder. While showing robust rates of response and symptoms resolutions, current treatments aimed at correcting the respiratory disturbances are not universally successful and a non-negligible proportion of patients who are correctly using available therapies do not experience symptomatic relief, suggesting that mechanisms beyond the respiratory disturbances may be involved in the pathogenesis of symptoms. Read More

Nurs Clin North Am 2021 Jun 10;56(2):203-217. Epub 2021 Mar 10.

School of Nursing, Rutgers, The State University of New Jersey, 65 Bergen Street, Room 1025E, Newark, NJ 07107, USA.

Metabolic syndrome (MetS) refers to the clustering of risk factors for cardiovascular disease and diabetes, including central adiposity, hypertension, dyslipidemia, and hyperglycemia. During the past 20 years, there have been parallel and epidemic increases in MetS and impaired sleep. This article describes evidence on the association between MetS and short sleep duration, circadian misalignment, insomnia, and sleep apnea. Read More

Sleep Breath 2021 May 21. Epub 2021 May 21.

Department of Anesthesiology and Pain Management, Toronto Western Hospital, University Health Network, MCL 2-405, 399 Bathurst St, Toronto, M5T 2S8, ON, Canada.

Purpose: Obstructive sleep apnea (OSA) is prevalent in patients with chronic non-cancer pain. OSA may lead to low sleep quality and an increase in pain sensitivity. Patients reporting greater sleep impairment tend to experience higher pain intensity and vice versa. Read More

Sleep Med Rev 2021 Apr 30;59:101499. Epub 2021 Apr 30.

Department of Medicine, Corporal Michael J. Crescenz VA, Medical Center, Philadelphia, PA, United States; Department of Medicine, University of Pennsylvania, Philadelphia, PA, United States.

Stroke is the leading cause of death and disability globally. Sleep disordered breathing (SDB), a potentially modifiable risk factor of stroke, is highly prevalent in stroke survivors. Evidence supports a causal, bidirectional relationship between SDB and stroke. Read More

Ophthalmic Epidemiol 2021 May 20:1-8. Epub 2021 May 20.

Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung, Taiwan.

: To evaluate the association between obstructive sleep apnea (OSA) and central serous chorioretinopathy (CSCR).: A retrospective, cohort, longitudinal study was conducted using the national health insurance database in Taiwan between 1996 and 2013. Patients diagnosed with OSA were enrolled after exclusion, and a control group with similar age, gender, and major systemic co-morbidities were included in a 1:1 ratio by propensity score matching. Read More

J Clin Neurophysiol 2021 Mar 19. Epub 2021 Mar 19.

Department of Neurology, North Huashan Hospital, Fudan University, Shanghai, China; Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China; and Department of Neurology, The First People's Hospital of Jiashan, Jiaxing, Zhejiang Province, China.

Purpose: We sought to analyze EEG spectral power during slow-wave sleep among patients with arteriosclerotic cerebral small vessel disease (CSVD) compared with community-dwelling individuals. We also sought to determine the relationship between EEG activity and the severity of enlarged perivascular spaces (EPVSs).

Methods: Consecutive subjects with arteriosclerotic CSVD (n = 36) and community-dwelling individuals (n = 26) between 50 and 80 years of age were included. Read More

Physiol Rep 2021 May;9(9):e14837

Department of Nephrology, Shirasagi Hospital, Osaka, Japan.

Background: Clinical significance of objectively measured poor sleep quality (SQ) as a risk for cardiovascular disease (CVD) events is not well known in hemodialysis (HD) patients, independently of sleep-related breathing disorders (SRBDs) and sleep-related metabolic abnormality.

Methods: The present study investigated baseline levels of objective sleep architecture together with obstructive sleep apnea (OSA) and central sleep apnea (CSA) using polysomnography in 88 HD study participants (M/F, 56/32; age 68.4 ± 9. Read More

J Sleep Res 2021 May 14:e13331. Epub 2021 May 14.

Department of Chest Diseases, Ege University Faculty of Medicine, Izmir, Turkey.

Patients with obstructive sleep apnea (OSA) are at increased risk of developing metabolic disease such as diabetes. The effects of positive airway pressure on glycemic control are contradictory. We therefore evaluated the change in glycated hemoglobin (HbA1c) in a large cohort of OSA patients after long-term treatment with positive airway pressure. Read More

J Appl Physiol (1985) 2021 May 13. Epub 2021 May 13.

Department of Psychiatry, grid.214572.7University of Iowa, Iowa City, IA, United States.

Background: Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) are both independently associated with increased cardiovascular disease (CVD) risk and impaired cognitive function. It is unknown if individuals with both COPD and OSA (i.e. Read More

Can Respir J 2021 22;2021:6657724. Epub 2021 Apr 22.

Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing 100034, China.

This study aimed to investigate the effects of continuous positive airway pressure (CPAP) on the electroencephalographic (EEG) characteristics of patients with primary central sleep apnea syndrome (CSAS). Nine patients with primary CSAS were enrolled in this study. The raw sleep EEG data were analyzed based on two main factors: fractal dimension (FD) and zero-crossing rate of detrended FD. Read More

BMJ Open 2021 05 10;11(5):e044499. Epub 2021 May 10.

Department of Respiratory Diseases, Univ Montpellier, CHU Montpellier, Montpellier, France.

Introduction: To date, continuous positive airway pressure (CPAP) remains the cornerstone of obstructive sleep apnoea treatment. CPAP data describing residual sleep-disordered breathing events (ie, the CPAP-measured apnoea-hypopnoea indices (AHI-CPAP)) is difficult to interpret because it is an entirely different metric than the polysomnography (PSG) measured AHI gold standard (AHI-PSG). Moreover, manufacturer definitions for apnoea and hypopnoea are not only different from those recommended for PSG scoring, but also different between manufacturers. Read More

Respir Physiol Neurobiol 2021 May 7;291:103680. Epub 2021 May 7.

Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan 430060, China. Electronic address:

Objective: Exploring whether the genioglossus discharge in chronic intermittent hypoxia(CIH) - pretreated rats could be enhanced by intermittent electrical stimulation combined with acute intermittent hypoxia(AIH).

Methods: Rats were pretreated with CIH for 4 weeks and then were randomly divided into 6 groups: time control, intermittent electric stimulation, AIH, intermittent electric stimulation + AIH, continuous electric stimulation and continuous hypoxia exposure. The genioglossus discharges were recorded and compared before and after stimulation. Read More

NeuroRehabilitation 2021 Apr 30. Epub 2021 Apr 30.

Seattle Children's Hospital and Division of Pulmonary and Sleep Medicine, University of Washington, Seattle, WA, USA.

Background: Patients with cerebral palsy and other static encephalopathies (CP) are known to be at increased risk of sleep-related breathing disorders (SRBD). Few studies have reviewed whether intrathecal baclofen (ITB) can contribute to SRBD.

Objective: To assess the prevalence of SRBD in patients with CP receiving ITB by using nocturnal polysomnography (NPSG). Read More

J Craniomaxillofac Surg 2021 Apr 28. Epub 2021 Apr 28.

Craniofacial Center, Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA, 98105, USA. Electronic address:

The aim of the study was to determine if the additional surgical complexity of Lefort II distraction with zygomatic repositioning (LF2ZR) results in increased complications compared to Lefort III distraction (LF3). A retrospective review was performed of all LF3 and LF2ZR advancements performed by the senior author over 15 years. Demographic, operative, postoperative, and cephalometric data were collected from initial procedure through greater than 1 year postoperatively. Read More

Sleep Breath 2021 May 7. Epub 2021 May 7.

Sleep Disorders Center, Division of Pulmonary and Critical Care, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.

Purpose: Central sleep apnea (CSA) syndrome commonly occurs with other medical conditions such as congestive heart failure, opiate use, and brainstem disorders. Various treatment modalities have been used with varied effectiveness in an attempt to improve ventilation and reduce the apnea-hypopnea index (AHI) in patients with CSA. This study evaluated whether or not a bilevel positive airway pressure mode of noninvasive ventilation, average volume-assured pressure support (AVAPS) is effective in treating CSA. Read More

Am J Med Genet A 2021 May 7. Epub 2021 May 7.

Department of Pediatric Pulmonology, School of Medicine, Hacettepe University, Ihsan Dogramaci Children's Hospital, Ankara, Turkey.

The aims of the study were to evaluate the prevalence of sleep-disordered breathing (SDB) by using polysomnography (PSG) in children with MPS IVA and MPS VI who underwent enzyme replacement therapy (ERT) and to analyze the effect on SDB of having upper airway surgery, pulmonary functions, and exercise capacity. A retrospective cross-sectional study was conducted on patients with MPS IVA (n:17) and MPS VI (n:11) aged under 19 years who underwent polysomnography. Descriptive and nonparametric analyses were performed for demographic, PSG, pulmonary function and exercise capacity variables. Read More

Retina 2021 Apr 23. Epub 2021 Apr 23.

Centre for Sight group of hospitals, Delhi,India Centre for Sight group of hospitals, Delhi , India.

Retina 2021 Apr 23. Epub 2021 Apr 23.

Department of Ophthalmology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University, New York, New York, USA Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan Department of Respiratory Care, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan Sleep Disorders Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.

Oxid Med Cell Longev 2021 17;2021:5577634. Epub 2021 Apr 17.

Department of Pediatrics, Peking University First Hospital, Beijing 100034, China.

Hypoxic pulmonary vascular remodelling (PVR) is the major pathological basis of aging-related chronic obstructive pulmonary disease and obstructive sleep apnea syndrome. The pulmonary artery endothelial cell (PAEC) inflammation, and pulmonary artery smooth muscle cell (PASMC) proliferation, hypertrophy and collagen remodelling are the important pathophysiological components of PVR. Endogenous sulfur dioxide (SO) was found to be a novel gasotransmitter in the cardiovascular system with its unique biological properties. Read More