Posted in
Clinical Adult, Literature Updates
Posted:
November 1, 2013
Authors: Querejeta Roca G, Redline S, Punjabi N, Clagget B, Ballantyne CM, Solomon SD, Shah AM.
Published: Am J Respir Crit Care Med. 2013 Oct 24.
In this population-based prospective cohort study, 1,645 adult participants free of coronary artery disease and heart failure participated in the Atherosclerosis Risk in the Communities (ARIC) and the Sleep Heart Health Studies (SHHS). They underwent overnight polysomnography and measurement of high sensitivity Troponin T (hs-TnT) – a marker of sub-myocardial injury; and N terminal pro B-type natriuretic peptide (NT-proBNP) – a marker of ventricular wall stress. After adjusting for confounders, OSA was independently associated with higher levels of hs-TNT and not NT-proBNP levels, indicating subclinical myocardial injury.
http://www-ncbi-nlm-nih-gov/pubmed/24156237
Posted in
Clinical Adult, Literature Updates
Posted:
November 1, 2013
Authors: Steinhorst AP, Gonçalves SC, Oliveira AT, Massierer D, Gus M, Fuchs SC, Moreira LB, Martinez D, Fuchs FD.
Published: Sleep Breath. 2013 Oct 3
In this cross sectional study, 107 hypertensive patients underwent ambulatory blood pressure monitoring and a level III polysomnography to detect 24hr blood pressure and sleep apnea, respectively. Patients with AHI>10 had higher blood pressure variability than those with AHI
http://www-ncbi-nlm-nih-gov/pubmed/24092449
Posted in
Clinical Adult, Literature Updates
Posted:
November 1, 2013
Authors: Ching Y, Fryer CD, Gu Q.
Published: NCHS Data Brief. 2013 Aug;(127):1–8.
In this latest report from the National Health and Nutrition Examination Survey, 2005–2010, prescription sleep aid use amongst a sample of U.S. adults over the age of 20 years was studied. It was found that women(5%) used more sleep aids than men(3.1%); based on ethnicity, Non-Hispanic whites (4.7%) used more sleep aids than non-Hispanic blacks (2.5%) and Mexican-Amrerican (2%) adults. Extremes of sleep duration, less than 5 hours (6%) and more than 9 hours (5.3%) were also associated with increased usage.
http://www-ncbi-nlm-nih-gov/pubmed/24152538
Posted in
Clinical Adult, Literature Updates
Posted:
November 1, 2013
Authors: Baugh R, Burke B, Fink B, Garcia R, Kominsky A, Yaremchuk K.
Contributors: Frances Chung, Stavros Memtsoudis, Mandeep Singh
Published: Laryngoscope. 2013 Nov;123(11):2892–5. doi: 10.1002/lary.24026.
This study evaluated “four hundred fifty-two adult Medicaid obstructive sleep apnea (OSA) patients (404 ambulatory, 48 inpatient) receiving head and neck airway surgeryContrary to guidelines, most OSA patients underwent ambulatory head and neck airway surgery. The observed catastrophic complication rate was zero.
http://www.ncbi.nlm.nih.gov/pubmed/23449781
Posted in
Clinical Adult, Literature Updates
Posted:
November 1, 2013
Authors: Talei B, Cossu AL, Slepian R, Kacker A.
Published: Laryngoscope. 2013 Nov;123(11):2892–5. doi: 10.1002/lary.24026.
Patients undergoing surgery for OSA are considered to be at increased risk of complications. Review of 32 patients failed to show any life-threatening risks or complications.Talei B, Cossu AL, Slepian R, Kacker A.
http://www.ncbi.nlm.nih.gov/pubmed/23504700
Posted in
Clinical Adult, Literature Updates
Posted:
November 1, 2013
Authors: Alonso-Fernández A, de la Peña M, Romero D, Piérola J, Carrera M, Barceló A, Soriano JB, García Suquia A, Fernández-Capitán C, Lorenzo A, García-Río F.
Published: Mayo Clin Proc. 2013 Jun;88(6):579–87.
The objective of this study was “to compare the prevalence of obstructive sleep apnea (OSA) in patients with pulmonary embolism (PE) with a sex-, age-, and body mass index (BMI)-matched, population-based control group and to assess the association between OSA and PE.” The authors found that “a higher prevalence of OSA was detected in patients diagnosed as having acute PE than controls” and thus “this study identified a significant and independent association between OSA and PE.
http://www.ncbi.nlm.nih.gov/pubmed/23578813
Posted in
Clinical Adult, Literature Updates
Posted:
November 1, 2013
Authors: Tanaka Y, Hino M, Mizuno K, Gemma A.
Published: Clin Respir J. 2013 Aug 1. doi: 10.1111/crj.12051.
Some complications of obstructive sleep-disordered breathing (OSDB), such as heart failure including right ventricular (RV) overload, are more serious than an increase of the apnea-hypopnea index (AHI) or respiratory disturbance index (RDI).”The authors of this observational study found that “RV function gradually deteriorated from the early stages of obstructive sleep apnea syndrome, even though there was no apparent increase in pulmonary artery pressure.
http://www.ncbi.nlm.nih.gov/pubmed/23902520
Posted in
Clinical Adult, Literature Updates
Posted:
November 1, 2013
Authors: Svider PF, Pashkova AA, Folbe AJ, Eloy JD, Setzen M, Baredes S, Eloy JA.
Published: Otolaryngol Head Neck Surg. 2013 Sep 11.
Jury verdict and settlement reports were examined for outcome, awards, patient demographic factors, defendant specialty, and alleged causes of malpractice by analysis of Westlaw legal database. Out of 54 identified cases, Otolaryngologists and anesthesiologists were the most frequently named defendants. Forty-seven cases (87.1%) stemmed from OSA patients who underwent procedures with resultant perioperative adverse events. Common alleged factors included death (48.1%), permanent deficits (42.6%), intraoperative complications (35.2%), requiring additional surgery (25.9%), anoxic brain injury (24.1%), inadequate informed consent (24.1%), inappropriate medication administration (22.2%), and inadequate monitoring (20.4%).
http://www.ncbi.nlm.nih.gov/pubmed/24025916
Posted in
Clinical Adult, Literature Updates
Posted:
November 1, 2013
Authors: Myers KA, Mrkobrada M, Simel DL.
Published: JAMA. 2013 Aug 21;310(7):731–41.
The most useful observation for identifying patients with obstructive sleep apnea was nocturnal choking or gasping (summary likelihood ratio [LR], 3.3; 95% CI, 2.1–4.6) when the diagnosis was established by AHI ≥10/h). Snoring is common in sleep apnea patients but is not useful for establishing the diagnosis (summary LR, 1.1; 95% CI, 1.0–1.1). Patients with mild snoring and body mass index lower than 26 are unlikely to have moderate or severe obstructive sleep apnea (LR, 0.07; 95% CI, 0.03–0.19 at threshold of AHI ≥15/h).
http://www.ncbi.nlm.nih.gov/pubmed/23989984
Posted in
Clinical Adult, Literature Updates
Posted:
November 1, 2013
Authors: Orlov D, Ankichetty S, Chung F, Brull R.
Published: J Clin Anesth. 2013 Aug 27. pii: S0952-8180(13)00220–1.
The review tries to determine the rate of cardiorespiratory complications following neuraxial opioid administration in the setting of obstructive sleep apnea (OSA). Five studies, including a total of 121 patients, were selected for study. Six major cardiorespiratory complications were reported among 5 (4.1%) patients and included three deaths, one cardiorespiratory arrest, and two episodes of severe respiratory depression. Five of these complications occurred during continuous fentanyl-containing epidural infusions and without concurrent positive airway pressure treatment.
ttp://www.ncbi.nlm.nih.gov/pubmed/23994284
