Sleep-Disordered Breathing and Stroke
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Abstract:
Sleep-disordered breathing (obstructive and central sleep apnea) is common in persons who have had a cerebrovascular accident (CVA). This article describes both sleep-disordered breathing and CVAs and reviews the related risk factors that link them together. In addition, the article discusses sleep-disordered breathing after CVA. The article concludes by presenting the clinical implications of this topic for nurses.Keywords:
Sleep-Disordered Breathing
Sleep
Central sleep apnea
Stroke
Central sleep apnea
Positive airway pressure
Sleep
Periodic breathing
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Indroduction: Treatment-emergent central sleep apnea(complex sleep apnea) has been observed in approximately 3,5%-20% of patients treated with CPAP for obstructive sleep apnea Aims and objectives: To identify facrors that influence the evolution of treatment-emergent central sleep apnea Patients and methods: 40 patients diagnosed with treatment-emergent central sleep apnea in a general hospital were followed up using data from the CPAP memory cards and repeated clinical examinations.95% were men, with mean age:61±9.7 years, Body Mass Index:29.1±4.2 and polysomnography Apnea Hypopnea Index(AHI):60.9±27.2 Results: 2 to 6 months after the initiatin of treatment with CPAP 45.9% of patients had a residual AHI<5, whereas only 8% had residual AHI>15. There was a further resolution of treatment-emergent central sleep apnea after the initial 6 months of follow-up. Changes in the initial CPAP pressure settings were not found to be related to residual AHI improvement. Conclusions: Improvement in residual AHI of treatment-emergent central sleep apnea patients beyond the initial 6 months warrants further investigation.Changes in the initial CPAP pressure settings are not correlated to improved residual AHI
Central sleep apnea
Apnea–hypopnea index
Sleep
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Central sleep apnea
Cheyne–Stokes respiration
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In this work, a method to analyse the effects of an apnea on the pulse photopletismography signal (PPG) is proposed. Therefore, an apnea detector based on respiratory signals has been developed and a decreases in amplitude of PPG (DAP) detector developed in a previous study was used. The apnea detector was tested using real signals. S and +PV of the detector were 95.3% and 94.4%, respectively. For each of the apneic events, we analyzed the presence of DAP in a window previous to the apnea event and another during/following the apnea. An increase of about 15% in DAP events in the window during/following the apnea with respect to the previous to apnea window is produced. These results shows an association between apneic events and DAP events, which indicates that DAP events provide useful information in sleep research and PPG signals might be useful in the diagnosis of OSAS
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The aim of this study is to investigate the occurrence and mechanism of Cheyne-Stokes breathing pattern in patients with heart failure.Fifty-six patients who performed polusomnography sleep testing at National Center of Cardiovascular Diseases Fuwai Hospital from March to May in 2015. We divided them into chronic heart failure (CHF) group and non-CHF group.The occurrences of sleep apnea in two groups were high. In CHF group (n = 11) , there were 10 patients with apnea hypopnea index (AHI) > 5; and their AHI was 23.93 ±14.63. In non-CHF group (n = 45), there were 33 patients whose AHI > 5; and their AHI was 16.20 ± 18.76. The ratio of center sleep apnea to all gross sleep apnea ratio in CHF group was higher than that in non-CHF group (80.21% ± 30.55% vs 27.16% ± 35.71%, P < 0.01 ).Based upon the new theory of holistic integrative physiology and medicine, we explain the mechanism of circulatory dysfunction induce the oscillation breathing in patients with CHF. The sleep apnea and C-S respiration in CHF should be called circulatory sleep apnea, rather than central sleep apnea.
Central sleep apnea
Cheyne–Stokes respiration
Apnea–hypopnea index
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Central sleep apnea
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Central sleep apnea
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Sleep is imperative for good health and problems related to sleep are common presentations to primary care. Disorders affecting breathing and sleep are varied in their causes and affect multiple body systems. The majority of patients with sleep-disordered breathing remain undiagnosed. This article will consider the pathophysiology of sleep-disordered breathing, how GPs can identify patients with sleep-disordered breathing and how these are managed in primary care.
Sleep-Disordered Breathing
Sleep
Sleep and breathing
Affect
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Central sleep apnea
Periodic breathing
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INTRODUCTION: The Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) is a risk factor for bariatric surgery. There aren´t clear risk factors to identify subpopulations at risk.
OBJECTIVES: Correlate clinical data and OSAHS in candidates for obesity surgery, using home sleep study.
METHODS: 53 sequential candidates for obesity surgery (BMI> 33), without diagnosis of OSAHS. It was recorded: Mallampati score (MS), neck circumference (NC), chin-sternum distance (CSD) and apnea and hypopnea index (AHI - measured by ApneaLink Plus ®). The apnea, as AHI, was classified as: absent ( 30).
RESULTS: 43 women (81%) and 10 males (19%), with medium age of 38 years. Apnea was founded in 31 (58%) patients: mild in 17 (32%), moderate in 8 (19%) and severe in 6 (11%). The greater AHI was 115, and 4 had an AHI > 50. Of the 6 patients with severe apnea, 5 (83.33%) were male. In moderate apnea, 6 (75%) were female and in mild, 16 (94%). In severe apnea, the lowest BMI was 44. At moderate apnea, 80% were classified in grade III (BMI> 40). For MS, of the 44 patients with MS III or IV, 30 (68%) had apnea; , 4 (25%) of 20 patients with MS IV had severe sleep apnea and 6 (30%) had no apnea. For NC, 100% of patients with severe apnea had CC> 40, whereas only 41% of patients with mild apnea had this feature. The CSD had no correlation with AHI. The NC/CSD ratio ≥2.5 identified 77% (17/25) of OSAHS patients and 71% (10/14) of patients with moderate OSAHS.
CONCLUSIONS: Positive correlation with male gender and BMI> 44 was found. NC> 40 and the NC/CSD ratio > 2.5 ratio was associated with moderate or severe OSAHS. The portable monitoring was a reliable tool for this screening.
Hypopnea
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