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Sleep Apnea Syndromes: HELP
Articles by Charalampos Mermigkis
Based on 35 articles published since 2010
(Why 35 articles?)
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Between 2010 and 2020, Charalampos Mermigkis wrote the following 35 articles about Sleep Apnea Syndromes.
 
+ Citations + Abstracts
Pages: 1 · 2
1 Editorial Insomnia and excessive daytime sleepiness in obstructive sleep apnea: only different clinical phenotypes? 2015

Mermigkis, Charalampos / Bouloukaki, Izolde / Schiza, Sophia E. ·Sleep Disorders Unit, Department of Thoracic Medicine, University General Hospital, Medical School of the University of Crete, Crete, Greece. mermigh@gmail.com. · Sleep Disorders Center, 401 General Army Hospital, Thrakis 61A, Vrilissia, Athens, Greece. mermigh@gmail.com. · Sleep Disorders Center, Henry Dunant Hospital, Athens, Greece. mermigh@gmail.com. · Sleep Disorders Unit, Department of Thoracic Medicine, University General Hospital, Medical School of the University of Crete, Crete, Greece. ·Sleep Breath · Pubmed #25855472.

ABSTRACT: -- No abstract --

2 Editorial Expiratory positive airway pressure (EPAP) nasal device therapy: a welcome addition to obstructive sleep apnea syndrome therapy. 2015

Schiza, Sophia E / Mermigkis, Charalampos / Bouloukaki, Izolde. ·Sleep Disorders Center, Department of Thoracic Medicine, University General Hospital, Medical School of the University of Crete, 711 10, Heraklion, Crete, Greece, schiza@med.uoc.gr. ·Sleep Breath · Pubmed #25847320.

ABSTRACT: -- No abstract --

3 Editorial Leptin and leptin receptor gene polymorphisms and obstructive sleep apnea syndrome: is there an association? 2015

Schiza, Sophia E / Mermigkis, Charalampos / Bouloukaki, Izolde. ·Sleep Disorders Center, Department of Thoracic Medicine, University General Hospital, Medical School of the University of Crete, 71110, Heraklion, Crete, Greece, schiza@med.uoc.gr. ·Sleep Breath · Pubmed #25666382.

ABSTRACT: -- No abstract --

4 Editorial Cost-effectiveness of CPAP treatment related to cardiovascular disease in patients with severe OSAS: the Greek experience. 2015

Mermigkis, Charalampos / Bouloukaki, Izolde / Schiza, Sophia E. ·Sleep Disorders Unit, Department of Thoracic Medicine, University General Hospital, Medical School of the University of Crete, Thrakis 61A, Vrilissia, Athens, Greece, mermigh@gmail.com. ·Sleep Breath · Pubmed #25304123.

ABSTRACT: -- No abstract --

5 Editorial Implications of revised AASM rules on scoring apneic and hypopneic respiratory events in heart failure patients with nocturnal Cheyne-Stokes respiration. 2015

Schiza, Sophia E / Mermigkis, Charalampos / Bouloukaki, Izolde. ·Sleep Disorders Center, Department of Thoracic Medicine, University General Hospital, Medical School of the University of Crete, Heraklion, Crete, 71110, Greece, schiza@med.uoc.gr. ·Sleep Breath · Pubmed #25060193.

ABSTRACT: -- No abstract --

6 Editorial The influence of a clinical classification system on the management of patients with positional dependent obstructive sleep apnoea. 2015

Schiza, Sophia E / Mermigkis, Charalampos / Bouloukaki, Izolde. ·Sleep Disorders Center, Department of Thoracic Medicine, University General Hospital, Medical School of the University of Crete, 71110, Heraklion, Crete, Greece, schiza@med.uoc.gr. ·Sleep Breath · Pubmed #25023523.

ABSTRACT: -- No abstract --

7 Editorial The effect of obstructive sleep apnea syndrome and snoring severity to intima-media thickening of carotid artery. 2015

Schiza, Sophia E / Mermigkis, Charalampos / Bouloukaki, Izolde. ·Sleep Disorders Center, Department of Thoracic Medicine, University General Hospital, Medical School of the University of Crete, 71110, Heraklion Crete, Greece, schiza@med.uoc.gr. ·Sleep Breath · Pubmed #24925821.

ABSTRACT: -- No abstract --

8 Editorial The effect of weight loss on obstructive sleep apnea (OSA) severity and position dependence in the bariatric population. 2014

Schiza, Sophia E / Mermigkis, Charalampos / Bouloukaki, Izolde. ·Sleep Disorders Unit, Department of Thoracic Medicine, University General Hospital, Medical School of the University of Crete, 71110, Heraklion, Crete, Greece, schiza@med.uoc.gr. ·Sleep Breath · Pubmed #24638264.

ABSTRACT: -- No abstract --

9 Editorial Obstructive sleep apnea in patients with interstitial lung diseases: past and future. 2013

Mermigkis, Charalampos / Bouloukaki, Izolde / Schiza, Sophia E. ·Sleep Disorders Center, 401 General Army Hospital, Athens, Greece, mermigh@gmail.com. ·Sleep Breath · Pubmed #23579857.

ABSTRACT: -- No abstract --

10 Editorial Epworth sleepiness scale scores and adverse pregnancy outcomes. 2013

Schiza, Sophia E / Bouloukaki, Izolde / Mermigkis, Charalampos. ·Sleep Disorders Unit, Department of Thoracic Medicine, University General Hospital, Medical School of the University of Crete, Heraklion, Crete, Greece, schiza@med.uoc.gr. ·Sleep Breath · Pubmed #23483324.

ABSTRACT: -- No abstract --

11 Editorial Bone mineral density in patients with obstructive sleep apnea syndrome. 2013

Schiza, Sophia E / Bouloukaki, Izolde / Mermigkis, Charalampos. · ·Sleep Breath · Pubmed #22528951.

ABSTRACT: -- No abstract --

12 Review Sleep as a New Target for Improving Outcomes in Idiopathic Pulmonary Fibrosis. 2017

Mermigkis, Charalampos / Bouloukaki, Izolde / Schiza, Sophia E. ·Sleep Disorders Center, Henry Dunant Hospital, Athens; Sleep Disorders Unit, Department of Thoracic Medicine, University General Hospital, Medical School of the University of Crete, Heraklion, Greece. Electronic address: mermigh@gmail.com. · Sleep Disorders Unit, Department of Thoracic Medicine, University General Hospital, Medical School of the University of Crete, Heraklion, Greece. ·Chest · Pubmed #28774636.

ABSTRACT: Idiopathic pulmonary fibrosis (IPF) is the most common type of interstitial pneumonia but remains a disease with a poor outcome. Two drugs, pirfenidone and nintedanib, have shown promising results at stalling disease progression; however, the interplay of sleep disruption or sleep disorders overall and in relation to medication effectiveness remains understudied. In the past, there was limited interest in the role of sleep in patients with IPF. Treating physicians tended to address only the daily disabling symptoms while disregarding the possible significant role of sleep alterations or coexisting sleep disorders. During the past few years, there has been more research related to sleep disturbances in patients with IPF and their possible role in sleep and overall life quality, disease progression, and outcome. In summary, sleep in patients with IPF is significantly impaired, with alterations in sleep architecture, changes in sleep breathing pattern, and decreases in oxygen saturation mainly during vulnerable rapid eye movement sleep. There also is evidence that OSA has an increased prevalence in these patients, playing an important role in the already worse sleep quality related to the disease itself. The focus of this review is not only to present current data related to sleep in patients with IPF but also to point out that therapy for sleep problems and OSA is likely to improve sleep and life quality as well as disease outcome. The main priority remains to increase awareness among treating physicians about early diagnosis of OSA in patients with IPF and to emphasize the need for intense future research, especially on the role of intermittent hypoxia superimposed on chronic hypoxia during sleep in patients with IPF.

13 Review Idiopathic pulmonary fibrosis and sleep disorders: no longer strangers in the night. 2015

Schiza, Sophia / Mermigkis, Charalampos / Margaritopoulos, George A / Daniil, Zoi / Harari, Sergio / Poletti, Venerino / Renzoni, Elizabetta A / Torre, Olga / Visca, Dina / Bouloukaki, Isolde / Sourvinos, George / Antoniou, Katerina M. ·Dept of Thoracic Medicine, Sleep Disorders Center, Medical School, University of Crete, Heraklion, Greece Both authors contributed equally. · Dept of Thoracic Medicine, Interstitial Lung Disease Unit & Laboratory of Molecular and Cellular Pneumonology, Medical School, University of Crete, Heraklion, Greece Dept of Respiratory Medicine, General Hospital of Kavala, Kavala, Greece. · Respiratory Medicine Dept, University Hospital of Larissa, Larissa, Greece. · U.O. di Pneumologia e Terapia Semi-Intensiva Respiratoria, Servizio di Fisiopatologia Respiratoria ed Emodinamica Polmonare, Ospedale San Giuseppe - MultiMedica, Milan, Italy. · Dept of Diseases of the Thorax/Pulmonology Unit, Ospedale GB Morgagni, Forlì, Italy. · Interstitial Lung Disease Unit, Royal Brompton Hospital, London, UK. · Dept of Thoracic Medicine, Sleep Disorders Center, Medical School, University of Crete, Heraklion, Greece. · Laboratory of Virology, Medical School, University of Crete, Heraklion, Greece. · Dept of Thoracic Medicine, Interstitial Lung Disease Unit & Laboratory of Molecular and Cellular Pneumonology, Medical School, University of Crete, Heraklion, Greece kantoniou@med.uoc.gr. ·Eur Respir Rev · Pubmed #26028644.

ABSTRACT: The prevalence of obstructive sleep apnoea (OSA) is continuously increasing in patients with idiopathic pulmonary fibrosis (IPF) and, for the first time, the recent IPF guidelines recognise OSA as an important associated comorbidity that can affect patient's survival. Thus, it becomes conceivable that clinicians should refer patients with newly diagnosed IPF to sleep centres for the diagnosis and treatment of OSA as well as for addressing issues regarding the reduced compliance of patients with continuous positive airway pressure therapy. The discovery of biomarkers common to both disorders may help early diagnosis, institution of the most appropriate treatment and follow-up of patients. Better understanding of epigenetic changes may provide useful information about pathogenesis and, possibly, development of new drugs for a dismal disease like IPF.

14 Review Obstructive sleep apnea syndrome and cardiovascular disease: The influence of C-reactive protein. 2015

Bouloukaki, Izolde / Mermigkis, Charalampos / Kallergis, Eleftherios M / Moniaki, Violeta / Mauroudi, Eleni / Schiza, Sophia E. ·Izolde Bouloukaki, Charalampos Mermigkis, Eleftherios M Kallergis, Violeta Moniaki, Eleni Mauroudi, Sophia E Schiza, Sleep Disorders Center, Department of Thoracic Medicine, University General Hospital, Medical School of the University of Crete, 71110 Heraklion, Crete, Greece. ·World J Exp Med · Pubmed #25992322.

ABSTRACT: Obstructive sleep apnea syndrome (OSAS) is a common medical condition, associated with atherosclerosis and cardiovascular disease (CVD). The underlying pathophysiologic mechanisms of this association have not been completely understood and may be multifactorial in origin. A number of studies suggest that inflammatory processes have emerged critical in the pathogenesis of CVD in OSAS. A range of circulating inflammatory molecules has been identified and measured, with a view to assess inflammation and predict vascular damage risk, such as plasma cytokines, adhesion molecules, and C-reactive protein (CRP). CRP is a relevant marker worthy of further study, because not only is elevated in patients with OSAS, but also is rapidly becoming a risk factor for cardiac disease. Furthermore, in selected OSAS patients, aggressive treatment of the disorder may lead to retarding or even improvement of CVD progression. However, still there is a debate on the true correlation between CRP and OSAS, as well as the clinical effect of any reduction after OSAS treatment. Further research is required to define those OSAS patients who will have a considerable reduction with treatment, as well as to understand the significance of the interaction between cardiovascular risk factor and CRP reduction in patients with OSAS.

15 Clinical Trial Obstructive sleep apnea should be treated in patients with idiopathic pulmonary fibrosis. 2015

Mermigkis, Charalampos / Bouloukaki, Izolde / Antoniou, Katerina / Papadogiannis, Georgios / Giannarakis, Ioannis / Varouchakis, Georgios / Siafakas, Nikolaos / Schiza, Sophia E. ·Sleep Disorders Unit, Department of Thoracic Medicine, University General Hospital, Medical School of the University of Crete, Heraklion, Greece, mermigh@gmail.com. ·Sleep Breath · Pubmed #25028171.

ABSTRACT: STUDY OBJECTIVES: The most recent idiopathic pulmonary fibrosis (IPF) guidelines include obstructive sleep apnea (OSA) among the IPF-associated comorbidities. Furthermore, they recognize the paucity of studies related to continuous positive airway pressure(CPAP) treatment in this patient group and call for intensive research in this field. Our aim was to assess the effect of CPAP treatment on sleep and overall life quality parameters, morbidity, and mortality in IPF patients with OSA. METHODS: Ninety-two treatment-naive, newly diagnosed, consecutive IPF patients underwent overnight-attended polysomnography (PSG). In those patients with an apnea-hypopnea index (AHI) of ≥15, therapy with CPAP was initiated. Patients were divided into poor and good CPAP compliance groups. All subjects completed multiple quality-of-life and sleep instruments before CPAP initiation and at 1 year after the start of CPAP treatment. RESULTS: The good CPAP compliance group (37 patients) showed statistically significant improvement in all quality-of-life and sleep instruments after 1 year's CPAP treatment. The poor CPAP compliance group (18 patients) showed significant changes of smaller strength only in a minority of the used instruments. During the 24-month follow-up period after CPAP initiation, three patients from the CPAP poor compliance group died, whereas all patients from the good CPAP compliance group remained alive. CONCLUSION: Early OSA recognition and treatment is crucial in a fatal disease such as IPF. Effective CPAP treatment in IPF patients with OSA results in a significant improvement in daily living activities and quality of sleep and life. Good CPAP compliance appears to improve mortality.

16 Clinical Trial Translation and validation of Berlin questionnaire in primary health care in Greece. 2013

Bouloukaki, Izolde / Komninos, Ioannis D / Mermigkis, Charalampos / Micheli, Katerina / Komninou, Maria / Moniaki, Violeta / Mauroudi, Eleni / Siafakas, Nikolaos M / Schiza, Sophia E. ·Department of Thoracic Medicine, Sleep Disorders Unit, University of Crete, Heraklion, Crete, Greece. izolthi@gmail.com ·BMC Pulm Med · Pubmed #23347772.

ABSTRACT: BACKGROUND: The aim of our study was to validate a Greek translation of the Berlin Questionnaire (BQ) for obstructive sleep apnoea syndrome (OSAS) and to explore whether this screening questionnaire could be used to help identify primary care patients at greater risk of having OSAS. METHODS: We recruited 189 patients visiting a primary health care setting on the island of Crete, Greece. They all completed the Greek Version of the BQ. Patients were then referred to a Sleep Disorders Unit for evaluation of suspected sleep-disordered breathing. RESULTS: A PSG study was performed in 129 of the 189 subjects (68.3%). BQ identified 74.4% (n = 96) of the patients as high-risk for OSAS and the remaining 25.6% (n = 33) as low-risk. The sensitivity and specificity of BQ for OSAS diagnosis were 76% and 40%, respectively, for an apnoea-hypopnoea index (AHI) ≥5 per hour but <15 per hour, 84% and 61% for an AHI ≥15 per hour but ≤30 per hour, and 79% and 39% for an AHI >30 per hour. CONCLUSIONS: In conclusion, the Greek Version of the BQ is a useful instrument for identifying patients at risk for OSAS in primary health care in Greece. The findings of our study confirm that such screening tools should be used by primary care clinicians for OSAS prediction.

17 Article Cardiovascular Effect and Symptom Profile of Obstructive Sleep Apnea: Does Sex Matter? 2019

Bouloukaki, Izolde / Mermigkis, Charalampos / Markakis, Manolis / Pataka, Athanasia / Alexaki, Ioanna / Ermidou, Christina / Moniaki, Violeta / Mauroudi, Eleni / Michelakis, Stylianos / Schiza, Sophia E. ·Sleep Disorders Center, Department of Respiratory Medicine, Medical School, University of Crete, Heraklion, Greece. ·J Clin Sleep Med · Pubmed #31855159.

ABSTRACT: STUDY OBJECTIVES: To evaluate the influence of sex on obstructive sleep apnea (OSA)-related symptoms and prevalent cardiovascular disease (CVD) in a large clinical population of patients. METHODS: A total of 6,716 patients (mean age 52 years, 24% women) had undergone diagnostic polysomnography and completed the Epworth Sleepiness Scale (ESS), Athens Insomnia Scale, and Beck Depression Inventory. We investigated the predictive value of sex on associated symptoms and prevalent cardiovascular disease, after adjustment for relevant confounding factors including age, obesity, and comorbidities. RESULTS: Most of the patients (90%) had OSA (apnea-hypopnea index [AHI] ≥ 5 events/h), and 66% were obese. Women were older than men and had a higher body mass index; however, men had a thicker neck circumference, a higher waist-to-hip ratio, and increased OSA severity (AHI 36 versus 27 events/h, P < .001). Female sex independently predicted prevalent CVD after adjustment for confounders (odds ratio [95% CI] 1.476 [1.154-1.887], P = .002). Men independently were more likely to report driving problems (3.359 [2.470-4.569], P < .001) and excessive daytime sleepiness (ESS ≥ 16) (1.355 [1.036-1.773], P = .027). Furthermore, female sex was an independent predictive factor for depressive symptoms (2.473 [1.831-3.340], P < .001), frequent awakenings (1.703 [1.323-2.192], P < .001), nocturia (1.727 [1.340-2.226], P < .001) and morning headaches (1.855 [1.488-2.326], P < .001). CONCLUSIONS: Females referred for sleep studies were more likely to exhibit CVD and less likely to complain of typical OSA symptoms than males in this large clinical patient cohort.

18 Article The Association Between Adherence to Positive Airway Pressure Therapy and Long-Term Outcomes in Patients With Obesity Hypoventilation Syndrome: A Prospective Observational Study. 2018

Bouloukaki, Izolde / Mermigkis, Charalampos / Michelakis, Stylianos / Moniaki, Violeta / Mauroudi, Eleni / Tzanakis, Nikolaos / Schiza, Sophia E. ·Sleep Disorders Center, Department of Thoracic Medicine, University of Crete, Heraklion, Greece. ·J Clin Sleep Med · Pubmed #30176976.

ABSTRACT: STUDY OBJECTIVES: To assess the role of different levels of adherence and long-term effects of positive airway pressure (PAP) therapy on gas exchange, sleepiness, quality of life, depressive symptoms, and all-cause mortality in patients with obesity hypoventilation syndrome (OHS). METHODS: A total of 252 patients with newly diagnosed OHS were followed up for a minimum of 2 years after PAP initiation. PAP adherence (h/night) was monitored. Arterial blood gas samples were taken with patients being alert for more than 4 hours after morning awakening. Subjective daytime sleepiness (Epworth Sleepiness Scale [ESS]), quality of life (Short Form 36 [SF-36]) and patient's depressive symptoms (Beck Depression Inventory [BDI]) were assessed before and at the end of the follow-up period, along with all-cause mortality. RESULTS: At the end of the follow-up period (median duration [25th-75th percentile], 30 [24-52] months), PaO CONCLUSIONS: Increased hours of use and long-term therapy with PAP are effective in the treatment of patients with OHS. Clinicians should encourage adherence to PAP therapy in order to provide a significant improvement in clinical status and gas exchange in these patients. COMMENTARY: A commenary on this article appears in this issue on page 1455. CLINICAL TRIAL REGISTRATION: Title: PAP Therapy in Patients With Obesity Hypoventilation Syndrome, Registry: ClinicalTrials.gov, Identifier: NCT03449641, URL: https://clinicaltrials.gov/ct2/show/NCT03449641.

19 Article Complex sleep apnea after full-night and split-night polysomnography: the Greek experience. 2018

Baou, Katerina / Mermigkis, Charalampos / Minaritzoglou, Aliki / Vagiakis, Emmanouil. ·Critical Care and Pulmonary Services, Sleep Disorders Center, University of Athens Medical School, Evangelismos Hospital, Athens, Greece. katebaou@gmail.com. · Sleep Disorders Center, Henry Dunant Hospital, Athens, Greece. · Critical Care and Pulmonary Services, Sleep Disorders Center, University of Athens Medical School, Evangelismos Hospital, Athens, Greece. ·Sleep Breath · Pubmed #29222618.

ABSTRACT: PURPOSE: Treatment-emergent central sleep apnea (TE-CSA) is defined as the emergence or persistence of central respiratory events during the initiation of positive airway pressure (PAP) without a back-up rate in obstructive sleep apnea (OSA) patients and after significant resolution of obstructive events. Previous studies have estimated a prevalence from 0.56 to 20.3%. The aim of this study was to establish the prevalence of TE-CSA in a Greek adult population. METHODS: One thousand fifty nine patients with newly diagnosed OSA, who were referred to the Sleep Disorders Center of Evangelismos Hospital of Athens over an 18-month period, were included in this study. A split-night polysomnography (PSG), or two formal overnight PSGs (diagnostic and continuous PAP (CPAP) titration study), were performed. RESULTS: Patients with OSA were divided in two groups; the first group included 277 patients, who underwent two separate studies (diagnostic and CPAP titration study), and the second group 782 patients, who underwent split-night studies. The prevalence of TE-CSA in the first group was 2.53% (7 patients), and in the second group was 5.63% (44 patients). CONCLUSIONS: The prevalence of TE-CSA in Greece was lower compared to most previous reported studies. The significant variation in the prevalence of TE-CSA between different centers throughout the world is mainly associated with the used diagnostic criteria as well as methodological and technical aspects.

20 Article Evaluation of Inflammatory Markers in a Large Sample of Obstructive Sleep Apnea Patients without Comorbidities. 2017

Bouloukaki, Izolde / Mermigkis, Charalampos / Tzanakis, Nikolaos / Kallergis, Eleftherios / Moniaki, Violeta / Mauroudi, Eleni / Schiza, Sophia E. ·Sleep Disorders Center, Department of Thoracic Medicine, University of Crete, Heraklion, Greece. ·Mediators Inflamm · Pubmed #28831208.

ABSTRACT: Systemic inflammation is important in obstructive sleep apnea (OSA) pathophysiology and its comorbidity. We aimed to assess the levels of inflammatory biomarkers in a large sample of OSA patients and to investigate any correlation between these biomarkers with clinical and polysomnographic (PSG) parameters. This was a cross-sectional study in which 2983 patients who had undergone a polysomnography for OSA diagnosis were recruited. Patients with known comorbidities were excluded. Included patients (

21 Article Intensive versus standard follow-up to improve continuous positive airway pressure compliance. 2014

Bouloukaki, Izolde / Giannadaki, Katerina / Mermigkis, Charalampos / Tzanakis, Nikolaos / Mauroudi, Eleni / Moniaki, Violeta / Michelakis, Stylianos / Siafakas, Nikolaos M / Schiza, Sophia E. ·Sleep Disorders Center, Dept of Thoracic Medicine, University of Crete, Heraklion, Crete, Greece izolthi@gmail.com. · Sleep Disorders Center, Dept of Thoracic Medicine, University of Crete, Heraklion, Crete, Greece. ·Eur Respir J · Pubmed #24993911.

ABSTRACT: We aimed to compare the effect of intensive versus standard interventions on continuous positive airway pressure (CPAP) adherence 2 years after CPAP initiation, as well as on sleepiness, quality of life, depression, hospitalisation and death rate due to cardiovascular disease (CVD). 3100 patients with newly diagnosed sleep apnoea were randomised into the standard group, with usual follow-up care, or the intensive group, with additional visits, telephone calls and education. Subjective daytime sleepiness (Epworth Sleepiness Scale; ESS), quality of life (36-item Short Form Health Survey; SF-36) and the patient's level of depression (Beck Depression Inventory; BDI) were recorded before and 2 years after CPAP initiation, together with CVD hospitalisations and death rate. 2 years after CPAP initiation, the intensive group used CPAP significantly more than the standard group (6.9 versus 5.2 h per night; p<0.001). ESS, SF-36 and BDI scores were also significantly better in the intensive group. Furthermore, the standard group had significantly more deaths and hospitalisations due to CVD. CPAP usage can be improved by both intensive and standard patient support. However, the patients who received intensive CPAP support had significantly better ESS, BDI and SF-36 scores, and lower cardiovascular morbidity and mortality, suggesting that an intensive programme could be worthwhile.

22 Article Abnormal cytokine profile in patients with obstructive sleep apnea-hypopnea syndrome and erectile dysfunction. 2014

Bouloukaki, Izolde / Papadimitriou, Vaios / Sofras, Frank / Mermigkis, Charalampos / Moniaki, Violeta / Siafakas, Nikolaos M / Schiza, Sophia E. ·Sleep Disorders Center, Department of Thoracic Medicine, University of Crete, 711 10 Heraklion, Crete, Greece. · Department of Urology, University of Crete, 711 10 Heraklion, Crete, Greece. ·Mediators Inflamm · Pubmed #24966468.

ABSTRACT: Patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) show a high prevalence of erectile dysfunction (ED). Although the underlying pathogenesis is still unknown, endothelial dysfunction, induced by inflammatory cytokines, chemokines, and adhesion molecules, has been proposed as a possible mechanism. The aim of this study was to assess whether OSAHS is associated with activation of the inflammatory cytokine system in patients with ED compared to the matched OSAHS patients with normal sexual function. Thirty-one patients with severe OSAHS and ED were included. Fifteen patients with severe OSAHS and without ED served as controls. Serum concentrations of high-sensitivity C-reactive protein (hsCRP), tumor necrosis factor-α (TNF-a), interleukin-6 (IL-6), interleukin-8 (IL-8), and adiponectin were measured after the diagnostic polysomnography. We found that hsCRP levels were significantly elevated in OSAHS patients with ED compared to controls. Similarly, TNF-a levels, IL-6, and IL-8 were elevated in OSAHS patients with ED compared to controls. Serum adiponectin levels were lower in OSAHS-ED patients, but the difference did not reach statistical significance. The presence of ED in patients with severe OSAHS is associated with elevated levels of inflammatory markers, underlining a possible involvement of endothelial dysfunction in the pathogenesis of ED.

23 Article Hooking of the soft palate and a large cervical osteophyte: two troubles in the same airway. 2013

Mermigkis, Charalampos / Mermigkis, Demetrios / Bouloukaki, Izolde / Alogdianakis, Vagelis / Schiza, Sophia E. ·Sleep Disorders Unit (CM, IB, SES), Department of Thoracic Medicine, University General Hospital, Medical School of the University of Crete, Crete, Greece · and Sleep Disorders Unit (CM, DM, VA), Army General Hospital of Athens, Athens, Greece. ·Am J Med Sci · Pubmed #24263081.

ABSTRACT: We report a case of severe obstructive sleep apnea in a 72-year-old, thin male caused by upper airway obstruction due to an enlarged cervical osteophyte at the C2-C3 level in association with a hooking of the soft palate. This is the first reported case with magnetic resonance imaging recognizing 2 simultaneously existing unusual obstructive causes: the oropharynx (hooking palate) and the hypopharynx (large cervical osteophyte).

24 Article Medical treatment with thiamine, coenzyme Q, vitamins E and C, and carnitine improved obstructive sleep apnea in an adult case of Leigh disease. 2013

Mermigkis, Charalampos / Bouloukaki, Izolde / Mastorodemos, Vasileios / Plaitakis, Andreas / Alogdianakis, Vangelis / Siafakas, Nikolaos / Schiza, Sophia. ·Sleep Disorders Unit, Department of Thoracic Medicine, University General Hospital, Medical School of the University of Crete, Heraklion, Crete, Greece. ·Sleep Breath · Pubmed #23389837.

ABSTRACT: PURPOSE: The multi-organ involvement of mitochondrial diseases means that patients are likely to be more vulnerable to sleep disturbances. We aimed to assess if early recognition and treatment of obstructive sleep apnea (OSA) in patients with Leigh disease may influence primary disease outcome. METHODS: We describe a case of adult-onset Leigh disease presenting as severe brainstem encephalopathy of subacute onset. Based on the clinical symptoms that developed after the appearance of the neurological disease, an attended overnight polysomnography examination was performed. RESULTS: A marked clinical recovery was seen after administration of high doses of thiamine, coenzyme Q, L-carnitine, and vitamins C and E, combined with effective treatment with continuous positive airway pressure for the underlying severe obstructive sleep apnea (OSA). The latter condition was diagnosed on the basis of suggestive symptoms that appeared a few weeks before the establishment of the neurological disease. The improvement in the neurological disease (based on clinical and brain MRI features) with the appropriate medical treatment also resulted in a significant improvement in the OSA. CONCLUSIONS: Early recognition and treatment of sleep apnea may not only improve sleep and overall quality of life but also ameliorate the deleterious effects of nocturnal desaturations on the neurological features. This may be crucial for disease outcome when added to the generally advised pharmacological therapy.

25 Article CPAP therapy in patients with idiopathic pulmonary fibrosis and obstructive sleep apnea: does it offer a better quality of life and sleep? 2013

Mermigkis, Charalampos / Bouloukaki, Izolde / Antoniou, Katerina M / Mermigkis, Demetrios / Psathakis, Kostas / Giannarakis, Ioannis / Varouchakis, Georgios / Siafakas, Nikolaos / Schiza, Sophia E. ·Sleep Disorders Unit, Department of Thoracic Medicine, University General Hospital, Medical School of the University of Crete, Heraklion, Greece, mermigh@gmail.com. ·Sleep Breath · Pubmed #23386371.

ABSTRACT: BACKGROUND: The recent literature shows an increased incidence of obstructive sleep apnea (OSA) in patients with idiopathic pulmonary fibrosis (IPF). On the other hand, there are no published studies related to continuous positive airway pressure (CPAP) treatment in this patient group. Our aim was to assess the effect of CPAP on sleep and overall life quality parameters in IPF patients with OSA and to recognize and overcome possible difficulties in CPAP initiation and acceptance by these patients. METHODS: Twelve patients (ten males and two females, age 67.1 ± 7.2 years) with newly diagnosed IPF and moderate to severe OSA, confirmed by overnight attended polysomnography, were included. Therapy with CPAP was initiated after a formal in-lab CPAP titration study. The patients completed the Epworth Sleepiness Scale (ESS), the Pittsburgh Sleep Quality Index (PSQI), the Functional Outcomes in Sleep Questionnaire (FOSQ), the Fatigue Severity Scale (FSS), the SF-36 quality of life questionnaire, and the Beck Depression Inventory (BDI) at CPAP initiation and after 1, 3, and 6 months of effective CPAP therapy. RESULTS: A statistically significant improvement was observed in the FOSQ at 1, 3, and 6 months after CPAP initiation (baseline 12.9 ± 2.9 vs. 14.7 ± 2.6 vs. 15.8 ± 2.1 vs. 16.9 ± 1.9, respectively, p = 0.02). Improvement, although not statistically significant, was noted in ESS score (9.2 ± 5.6 vs. 7.6 ± 4.9 vs. 7.5 ± 5.3 vs. 7.7 ± 5.2, p = 0.84), PSQI (10.7 ± 4.4 vs. 10.1 ± 4.3 vs. 9.4 ± 4.7 vs. 8.6 ± 5.2, p = 0.66), FSS (39.5 ± 10.2 vs. 34.8 ± 8.5 vs. 33.6 ± 10.7 vs. 33.4 ± 10.9, p = 0.44), SF-36 (63.2 ± 13.9 vs. 68.9 ± 13.5 vs. 72.1 ± 12.9 vs. 74.4 ± 11.3, p = 0.27), and BDI (12.9 ± 5.5 vs. 10.7 ± 4.3 vs. 9.4 ± 4.8 vs. 9.6 ± 4.5, p = 0.40). Two patients had difficulty complying with CPAP for a variety of reasons (nocturnal cough, claustrophobia, insomnia) and stopped CPAP use after the first month, despite intense follow-up by the CPAP clinic staff. Heated humidification was added for all patients in order to improve the common complaint of disabling nocturnal cough. CONCLUSION: Effective CPAP treatment in IPF patients with OSA results in a significant improvement in daily living activities based on the FOSQ, namely an OSA-specific follow-up instrument. Improvement was also noted in other questionnaires assessing quality of life, though not to a statistically significant degree, probably because of the multifactorial influences of IPF on physical and mental health. The probability of poor CPAP compliance was high and could only be eliminated with intense follow-up by the CPAP clinic staff.

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