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Sleep Apnea Syndromes: HELP
Articles from Germany
Based on 735 articles published since 2008
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These are the 735 published articles about Sleep Apnea Syndromes that originated from Germany during 2008-2019.
 
+ Citations + Abstracts
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226 Article Reduced upper obstructions in N3 and increased lower obstructions in REM sleep stage detected with manometry. 2018

Wirth, Markus / Schramm, Juliane / Bautz, Maximilian / Hofauer, Benedikt / Edenharter, Günther / Ott, Armin / Heiser, Clemens. ·Department of Otolaryngology, Head and Neck Surgery, Technical University of Munich, Klinikum rechts der Isar, Hals-Nasen-Ohren-Klinik, Ismaninger Straße 22, 81675, Muenchen, Germany. markus.wirth@tum.de. · Department of Otolaryngology, Head and Neck Surgery, Technical University of Munich, Klinikum rechts der Isar, Hals-Nasen-Ohren-Klinik, Ismaninger Straße 22, 81675, Muenchen, Germany. · Department of Anesthesiology, Technical University of Munich, Ismaninger Straße 22, 81675, Muenchen, Germany. · Institute of Medical Statistics and Epidemiology, Technical University of Munich, Ismaninger Straße 22, 81675, Muenchen, Germany. ·Eur Arch Otorhinolaryngol · Pubmed #28975391.

ABSTRACT: In obstructive sleep apnea (OSA), airway obstruction occurs at different anatomic levels. The frequency and location of obstructions play a crucial role in the planning of surgical treatment. The aim of this study was to evaluate the pharyngeal obstruction levels in different sleep stages with manometry in OSA patients. In addition, the manometry results were compared with drug-induced sleep endoscopy (DISE). Forty-one patients with OSA received manometry measurements during one night of sleep. All patients were simultaneously evaluated with polysomnography. The frequency of obstructions in different sleep stages was assessed. Twenty patients were additionally studied with DISE. Obstruction levels detected with manometry were compared with DISE. The frequency of upper and to a lesser extent lower obstructions decreased in sleep stage N3. In rapid eye movement (REM) sleep, lower obstructions increased. The overall proportion of upper and lower obstructions detected with manometry corresponded with DISE in 13 of 20 cases. A significant change in the obstruction levels was detected with manometry in N3 and REM sleep. The reduction of both upper and to a lesser extent lower obstructions in N3 suggests more stable airways in slow-wave sleep. Relevant lower obstructions were not detected in DISE compared to manometry in 5 out of 20 examinations. This could be a potential reason for treatment failure of site-specific surgical OSA treatment when only performing DISE preoperatively. Therefore, manometry could be a useful complementary tool in the preoperative evaluation for OSA.

227 Article Characteristics of sleep-disordered breathing in patients with atrial fibrillation and preserved left ventricular ejection fraction. 2018

Strotmann, Johanna / Fox, Henrik / Bitter, Thomas / Sauzet, Odile / Horstkotte, Dieter / Oldenburg, Olaf. ·Clinic for Cardiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, Georgstraße 11, 32545, Bad Oeynhausen, Germany. · Statistik-Beratung-Centrum (StatBeCe) Zentrum für Statistik, Bielefeld University, Bielefeld, Germany. · Epidemiology and International Public Health, Bielefeld School of Public Health, Bielefeld University, Bielefeld, Germany. · Clinic for Cardiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, Georgstraße 11, 32545, Bad Oeynhausen, Germany. akleemeyer@hdz-nrw.de. ·Clin Res Cardiol · Pubmed #28942524.

ABSTRACT: BACKGROUND: Sleep-disordered breathing (SDB) represents a common and highly relevant co-morbidity in patients with atrial fibrillation (Afib). Obstructive sleep apnea (OSA) has been identified as an independent risk factor for developing Afib and for Afib recurrence after treatment, but the role of central sleep apnea (CSA) is less clear. This study investigated characteristics of SDB in Afib patients with preserved left ventricular ejection fraction (PEF). METHODS AND RESULTS: Consecutive patients (07/2007 to 03/2016) with documented Afib at hospital admission and PEF undergoing 6-channel cardiorespiratory polygraphy (PG) screening were retrospectively analyzed. A total of 211 patients were included (146 men; age 68.7 ± 8.5 years). Only 6.6% of patients had no SDB (apnea-hypopnea index [AHI] < 5/h). When moderate-to-severe SDB (AHI ≥ 15/h) was classified based on the predominant type of apneas and hypopneas, OSA (≥ 80% obstructive events) was found in 15% of patients, CSA (≥ 80% central events) in 10%, and 36% had mixed sleep apnea. For patients with Cheyne-Stokes respiration (CSR; 34%), time spent in CSR increased significantly as total AHI increased (p < 0.001); total CSR duration was 20, 50, and 117 min, respectively, in patients with mild, moderate, and severe SDB. CONCLUSIONS: SDB was highly prevalent in this cohort of patients with Afib and PEF. The proportion of patients with moderate-to-severe OSA, for whom treatment is recommended by current guidelines, was about 15%. With 36% of patients presenting with moderate-to-severe mixed sleep apnea and almost 10% of patients having CSA, treatment guidelines for these types of SDB in the setting of Afib are needed.

228 Article Apnea and heart rate detection from tracheal body sounds for the diagnosis of sleep-related breathing disorders. 2018

Kalkbrenner, Christoph / Eichenlaub, Manuel / Rüdiger, Stefan / Kropf-Sanchen, Cornelia / Rottbauer, Wolfgang / Brucher, Rainer. ·Faculty of Medical Engineering, University of Applied Science Ulm, Albert-Einstein-Allee 55, 89075, Ulm, Germany. kalkbrenner@hs-ulm.de. · Faculty of Medical Engineering, University of Applied Science Ulm, Albert-Einstein-Allee 55, 89075, Ulm, Germany. · Department of Internal Medicine II, University Hospital Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany. ·Med Biol Eng Comput · Pubmed #28849304.

ABSTRACT: Sleep apnea is one of the most common sleep disorders. Here, patients suffer from multiple breathing pauses longer than 10 s during the night which are referred to as apneas. The standard method for the diagnosis of sleep apnea is the attended cardiorespiratory polysomnography (PSG). However, this method is expensive and the extensive recording equipment can have a significant impact on sleep quality falsifying the results. To overcome these problems, a comfortable and novel system for sleep monitoring based on the recording of tracheal sounds and movement data is developed. For apnea detection, a unique signal processing method utilizing both signals is introduced. Additionally, an algorithm for extracting the heart rate from body sounds is developed. For validation, ten subjects underwent a full-night PSG testing, using the developed sleep monitor in concurrence. Considering polysomnography as gold standard the developed instrumentation reached a sensitivity of 92.8% and a specificity of 99.7% for apnea detection. Heart rate measured with the proposed method was strongly correlated with heart rate derived from conventional ECG (r

229 Article Nocturnal blood pressure fluctuations measured by using pulse transit time in patients with severe obstructive sleep apnea syndrome. 2018

Gehring, Jennifer / Gesche, Heiko / Drewniok, Gesine / Küchler, Gert / Patzak, Andreas. ·SOMNOmedics GmbH, Randersacker, Germany. · Institute of Vegetative Physiology, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany. · Klinik Amsee, Schlaflabor, Waren, Germany. · Institute of Vegetative Physiology, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany. andreas.patzak@charite.de. ·Sleep Breath · Pubmed #28828627.

ABSTRACT: BACKGROUND: Obstructive sleep apnea syndrome (OSAS) is related to arterial hypertension. In the present study, we test the hypothesis that patients with severe OSAS have excessive apnea induced blood pressure (BP). METHODS: We investigated 97 patients with an apnea/hypopnea index (AHI) greater than 30. Systolic BP (SBP) was continuously determined by using the pulse transit time (PTT). Apnea/hypopnea induced nocturnal BP fluctuations (NBPFs) were detected and showed phenomena of continuous increases of the SBP baseline. Such periods of SBP baseline elevations ≥ 10 mmHg were called superposition. Respiratory and cardiac parameters were obtained from the polysomnographic investigation. RESULTS: Eighty-four periods of superposition were detected in 48 patients. They occurred mainly during REM sleep (76%). Apnea duration was increased and the time in respiration was reduced in periods of superposition compared to non-superposition periods. In superposition periods mean oxygen saturation (SpO CONCLUSIONS: The study reveals that patients with severe OSAS can have periods of BP superposition during night with extremely high SBP and very low oxygen saturation, which may add to a high risk for cardiovascular events during the night.

230 Article Outcomes in coronary artery disease patients with sleepy obstructive sleep apnoea on CPAP. 2017

Peker, Yüksel / Thunström, Erik / Glantz, Helena / Wegscheider, Karl / Eulenburg, Christine. ·Dept of Pulmonary Medicine, Faculty of Medicine, Marmara University, Istanbul, Turkey yuksel.peker@marmara.edu.tr. · Dept of Molecular and Clinical Medicine/Cardiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. · Dept of Cardiology, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden. · Dept of Internal Medicine, Skaraborg Hospital, Lidköping, Sweden. · Dept of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. · Medical Statistics and Decision Making, Dept of Epidemiology, University Medical Center Groningen, Groningen, The Netherlands. ·Eur Respir J · Pubmed #29217597.

ABSTRACT: Coronary artery disease (CAD) patients with obstructive sleep apnoea (OSA) have increased risk for major adverse cardiovascular and cerebrovascular events (MACCEs) compared with CAD patients without OSA. We aimed to address if the risk is similar in both groups when OSA patients are treated.This study was a parallel observational arm of the RICCADSA randomised controlled trial, conducted in Sweden between 2005 and 2013. Patients with revascularised CAD and OSA (apnoea-hypopnoea index (AHI) ≥15 events·h

231 Article Phenotyping of Sleep-Disordered Breathing in Patients With Chronic Heart Failure With Reduced Ejection Fraction-the SchlaHF Registry. 2017

Arzt, Michael / Oldenburg, Olaf / Graml, Andrea / Erdmann, Erland / Teschler, Helmut / Wegscheider, Karl / Suling, Anna / Woehrle, Holger / Anonymous1791021. ·Department of Internal Medicine II, University Hospital Regensburg, Germany michael.arzt@klinik.uni-regensburg.de. · Department of Cardiology, Heart and Diabetes Center North Rhine-Westphalia, Bad Oeynhausen, Germany. · ResMed Science Center, Martinsried, Germany. · Clinic III for Internal Medicine, Heart Center University Hospital Cologne, Germany. · Department of Pneumology, Ruhrlandklinik, West German Lung Center, University Hospital Essen University Duisburg-Essen, Duisburg, Germany. · Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. · Sleep and Ventilation Center Blaubeuren, Respiratory Center Ulm, Germany. ·J Am Heart Assoc · Pubmed #29187390.

ABSTRACT: BACKGROUND: Different sleep-disordered breathing (SDB) phenotypes, including coexisting obstructive and central sleep apnea (OSA-CSA), have not yet been characterized in a large sample of patients with heart failure and reduced ejection fraction (HFrEF) receiving guideline-based therapies. Therefore, the aim of the present study was to determine the proportion of OSA, CSA, and OSA-CSA, as well as periodic breathing, in HFrEF patients with SDB. METHODS AND RESULTS: The German SchlaHF registry enrolled patients with HFrEF receiving guideline-based therapies, who underwent portable SDB monitoring. Polysomnography (n=2365) was performed in patients with suspected SDB. Type of SDB (OSA, CSA, or OSA-CSA), the occurrence of periodic breathing (proportion of Cheyne-Stokes respiration ≥20%), and blood gases were determined in 1557 HFrEF patients with confirmed SDB. OSA, OSA-CSA, and CSA were found in 29%, 40%, and 31% of patients, respectively; 41% showed periodic breathing. Characteristics differed significantly among SDB groups and in those with versus without periodic breathing. There was a relationship between greater proportions of CSA and the presence of periodic breathing. Risk factors for having CSA rather than OSA were male sex, older age, presence of atrial fibrillation, lower ejection fraction, and lower awake carbon dioxide pressure (pco CONCLUSIONS: SchlaHF data show that there is wide interindividual variability in the SDB phenotype of HFrEF patients, suggesting that individualized management is appropriate. CLINICAL TRIAL REGISTRATION: URL: https://www.clinicaltrials.gov/. Unique identifier: NCT01500759.

232 Article Distinct Patterns of Hyperpnea During Cheyne-Stokes Respiration: Implication for Cardiac Function in Patients With Heart Failure. 2017

Perger, Elisa / Inami, Toru / Lyons, Owen D / Alshaer, Hisham / Smith, Stephanie / Floras, John S / Logan, Alexander G / Arzt, Michael / Duran Cantolla, Joaquin / Delgado, Diego / Fitzpatrick, Michael / Fleetham, John / Kasai, Takatoshi / Kimoff, R John / Leung, Richard S T / Lorenzi Filho, Geraldo / Mayer, Pierre / Mielniczuk, Lisa / Morrison, Debra L / Parati, Gianfranco / Parthasarathy, Sairam / Redolfi, Stefania / Ryan, Clodagh M / Series, Frederic / Tomlinson, George A / Woo, Anna / Bradley, T Douglas / Anonymous5290924. ·University Health Network/Mount Sinai Hospital, Toronto, Ontario, Canada. · Centre for Sleep Medicine and Circadian Biology of the University of Toronto, Toronto, Ontario, Canada. · Universitätsklinikum Regensburg, Regensburg, Germany. · Hospital Universitario Txagorritxu, Vitoria, Spain. · Queen's University, Kingston, Ontario, Canada. · Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada. · Juntendo University Hospital, Tokyo, Japan. · McGill University Health Centre, Montreal, Quebec, Canada. · St Michael's Hospital, Toronto, Ontario, Canada. · Instituto do Coração do Hospital das Clínicas da FMUSP, Sao Paulo, Brazil. · Hôpital Hôtel-Dieu du CHUM, Université de Montréal, Montreal, Quebec, Canada. · University of Ottawa Heart Institute, Ottawa, Ontario, Canada. · Capital District Health Authority, Halifax, Nova Scotia, Canada. · Ospedale San Luca, Milan, Italy. · University of Arizona College of Medicine, Tucson, Arizona. · Groupe Hospitalier Pitie-Salpetriere Charles Fox, Paris, France. · Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec City, Quebec, Canada. ·J Clin Sleep Med · Pubmed #29065956.

ABSTRACT: STUDY OBJECTIVES: In heart failure (HF), we observed two patterns of hyperpnea during Cheyne-Stokes respiration with central sleep apnea (CSR-CSA): a positive pattern where end-expiratory lung volume remains at or above functional residual capacity, and a negative pattern where it falls below functional residual capacity. We hypothesized the negative pattern is associated with worse HF. METHODS: Patients with HF underwent polysomnography. During CSR-CSA, hyperpnea, apnea-hyperpnea cycle, and lung to finger circulation times (LFCT) were measured. Plasma N-terminal prohormone of brain natriuretic peptide (NT-proBNP) concentration and left ventricular ejection fraction (LVEF) were assessed. RESULTS: Of 33 patients with CSR-CSA (31 men, mean age 68 years), 9 had a negative hyperpnea pattern. There was no difference in age, body mass index, and apnea-hypopnea index between groups. Patients with a negative pattern had longer hyperpnea time (39.5 ± 6.4 versus 25.8 ± 5.9 seconds, CONCLUSIONS: Patients with HF and a negative CSR-CSA pattern have evidence of worse cardiac function than those with a positive pattern. Greater positive expiratory pressure during hyperpnea is likely generated during the negative pattern and might support stroke volume in patients with worse cardiac function. COMMENTARY: A commentary on this article appears in this issue on page 1227. CLINICAL TRIAL REGISTRATION: The trial is registered with Current Controlled Trials (www.controlled-trials.com; ISRCTN67500535) and Clinical Trials (www.clinicaltrials.gov; NCT01128816).

233 Article Heart rate variability feature selection in the presence of sleep apnea: An expert system for the characterization and detection of the disorder. 2017

Martín-González, Sofía / Navarro-Mesa, Juan L / Juliá-Serdá, Gabriel / Kraemer, Jan F / Wessel, Niels / Ravelo-García, Antonio G. ·Institute for Technological Development and Innovation in Communications, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria 35017, Spain. Electronic address: sofia.martin@ulpgc.es. · Institute for Technological Development and Innovation in Communications, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria 35017, Spain. · Pulmonary Medicine Department, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, 35010, Spain. · Department of Physics, Humboldt-Universität zu Berlin, Berlin 10115, Germany. ·Comput Biol Med · Pubmed #29040884.

ABSTRACT: We introduce a sleep apnea characterization and classification approach based on a Heart Rate Variability (HRV) feature selection process, thus focusing on the characterization of the underlying process from a cardiac rate point of view. Therefore, we introduce linear and nonlinear variables, namely Cepstrum Coefficients (CC), Filterbanks (Fbank) and Detrended Fluctuation Analysis (DFA). Logistic Regression, Linear Discriminant Analysis and Quadratic Discriminant Analysis were used for classification purposes. The experiments were carried out using two databases. We achieved a per-segment accuracy of 84.76% (sensitivity = 81.45%, specificity = 86.82%, AUC = 0.92) in the Apnea-ECG Physionet database, whereas in the HuGCDN2014 database, provided by the Dr. Negrín University Hospital (Las Palmas de Gran Canaria, Spain), the best results were: accuracy = 81.96%, sensitivity = 70.95%, specificity = 85.47%, AUC = 0.87. The former results were comparable or better than those obtained by other methods for the same database in the recent literature. We have concluded that the selected features that best characterize the underlying process are common to both databases. This supports the fact that the conclusions reached are potentially generalizable. The best results were obtained when the three kinds of features were jointly used. Another notable fact is the small number of features needed to describe the phenomenon. Results suggest that the two first Fbanks, the first CC and the first DFA coefficient are the variables that best describe the RR pattern in OSA and, therefore, are especially relevant to extract discriminative information for apnea screening purposes.

234 Article Unobtrusive Nocturnal Heartbeat Monitoring by a Ballistocardiographic Sensor in Patients with Sleep Disordered Breathing. 2017

Zink, Matthias Daniel / Brüser, Christoph / Stüben, Björn-Ole / Napp, Andreas / Stöhr, Robert / Leonhardt, Steffen / Marx, Nikolaus / Mischke, Karl / Schulz, Jörg B / Schiefer, Johannes. ·Department of Cardiology, Pneumology, Angiology and Intensive Care Medicine, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany. mzink@ukaachen.de. · Philips Chair for Medical Information Technology, Helmholtz-Institute, RWTH Aachen, Pauwelsstr. 20, 52074, Aachen, Germany. · Department of Cardiology, Pneumology, Angiology and Intensive Care Medicine, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany. · Department of Neurology, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany. · Jülich Aachen Research Alliance (JARA) - JARA-Institute Molecular Neuroscience and Neuroimaging, FZ Jülich and RWTH University, Aachen, Germany. ·Sci Rep · Pubmed #29030566.

ABSTRACT: Sleep disordered breathing (SDB) is known for fluctuating heart rates and an increased risk of developing arrhythmias. The current reference for heartbeat analysis is an electrocardiogram (ECG). As an unobtrusive alternative, we tested a sensor foil for mechanical vibrations to perform a ballistocardiography (BCG) and applied a novel algorithm for beat-to-beat cycle length detection. The aim of this study was to assess the correlation between beat-to-beat cycle length detection by the BCG algorithm and simultaneously recorded ECG. In 21 patients suspected for SDB undergoing polysomnography, we compared ECG to simultaneously recorded BCG data analysed by our algorithm. We analysed 362.040 heartbeats during a total of 93 hours of recording. The baseline beat-to-beat cycle length correlation between BCG and ECG was r

235 Article Obstructive sleep apnea and rhonchopathy are associated with downregulation of trefoil factor family peptide 3 (TFF3)-Implications of changes in oral mucus composition. 2017

Siber-Hoogeboom, Regina / Schicht, Martin / Hoogeboom, Sebastian / Paulsen, Friedrich / Traxdorf, Maximilian. ·Department of Anatomy II, Friedrich Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany. · Department of Otorhinolaryngology, Head & Neck Surgery, Friedrich Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany. ·PLoS One · Pubmed #29028798.

ABSTRACT: STUDY OBJECTIVES: Trefoil factor family (TFF) peptides belong to the family of mucin-associated peptides and are expressed in most mucosal surfaces. TFF peptides carry out functions such as proliferation and migration enhancement, anti-apoptosis, and wound healing. Moreover, TFFs are associated with mucins and interact with them as "linker peptides", thereby influencing mucus viscosity. To test the hypothesis that in rhonchopathy and obstructive sleep apnea (OSA) changes occur in the expression of TFF3 and -2 that could contribute to changes in mucus viscosity, leading to an increase in upper airway resistance during breathing. METHODS: RT-PCR, Western-blot, immunohistochemistry and ELISA were performed to detect and quantify TFF3 and -2 in uvula samples. In addition, 99 saliva samples from patients with mild, moderate or severe OSA, as well as samples from rhonchopathy patients and from healthy volunteers, were analyzed by ELISA. RESULTS: TFF3 was detected in all uvula samples. Immunohistochemistry revealed a subjectively decreasing antibody reactivity of the uvula epithelia with increasing disease severity. ELISA demonstrated significantly higher TFF3 saliva protein concentrations in the healthy control group compared to cases with rhonchopathy and OSA. Predisposing factors of OSA such as BMI or age showed no correlation with TFF3. No significant changes were observed with regard to TFF2. CONCLUSIONS: The results suggest the involvement of TFF3 in the pathogenesis of rhonchopathy and OSA and lead to the hypothesis that reduction of TFF3 production by the epithelium and subepithelial mucous glands of the uvula contribute to an increase in breathing resistance due to a change in mucus organization.

236 Article On the difference of cardiorespiratory synchronisation and coordination. 2017

Krause, Harald / Kraemer, Jan F / Penzel, Thomas / Kurths, Jürgen / Wessel, Niels. ·AG NLD - Cardiovascular Physics, Humboldt-Universität zu Berlin, Berlin, Germany. ·Chaos · Pubmed #28964129.

ABSTRACT: Cardiorespiratory phase synchronisation (CRS) is a type of cardiorespiratory coupling that manifests through a prediliction for heart beats to occur at specific points relative to the phase of the respiratory cycle. It has been under investigation for nearly 20 years, and while it seems to be mostly occurring in relaxed states such as deep sleep and anesthesia, no clear clinical implications have been established. Cardiorespiratory coordination (CRC) is a recent development in this field where the relationship between the respiratory onset and heart beat is analysed in the time domain and the possible relationship of each heart beat is considered for both the previous and the next respiratory onset. This ostensibly closely related effect must not only show relevant information content but also do so independent of CRS in order to be relevant for future studies. In this paper, we investigate CRC and its relation to CRS mainly using graphical and statistical methods on two exemplary datasets: measurements from a pregnant woman participating in a preeclampsia study and those from a man suffering from sleep apnea. We show fundamental differences between the results of both approaches and are able to show a formerly unknown dependency between the heart activity and respiratory rate, potentially indicating heartbeat-initiated inspiration. Despite their differences, methods developed for the quantification of CRS can be adapted to CRC. Completing the comparison is an investigation into the relationship between CRC and respiratory sinus arrhythmia. Similar to previous results for CRS, the two effects are found to be orthogonal, meaning that they can be observed independently or in conjunction.

237 Article Surgical anatomy of the hypoglossal nerve: A new classification system for selective upper airway stimulation. 2017

Heiser, Clemens / Knopf, Andreas / Hofauer, Benedikt. ·Department of Otorhinolaryngology, Head and Neck Surgery, Technische Universität München, Munich, Germany. ·Head Neck · Pubmed #28960569.

ABSTRACT: BACKGROUND: Selective upper airway stimulation (UAS) has shown effectiveness in treating patients with obstructive sleep apnea (OSA). The terminating branches of the hypoglossal nerve show a wide complexity, requiring careful discernment of a functional breakpoint between branches for inclusion and exclusion from the stimulation cuff electrode. The purpose of this study was to describe and categorize the topographic phenotypes of these branches. METHODS: Thirty patients who received an implant with selective UAS from July 2015 to June 2016 were included. All implantations were recorded using a microscope and resultant tongue motions were captured perioperatively for comparison. RESULTS: Eight different variations of the branches were encountered and described, both in a tabular numeric fashion and in pictorial schema. CONCLUSION: The examinations showed the complex phenotypic surgical anatomy of the hypoglossal nerve. A schematic classification system has been developed to help surgeons identify the optimal location for cuff placement in UAS.

238 Article REM Sleep Imposes a Vascular Load in COPD Patients Independent of Sleep Apnea. 2017

Grote, Ludger / Sommermeyer, Dirk / Ficker, Joachim / Randerath, Winfried / Penzel, Thomas / Fietze, Ingo / Sanner, Bernd / Hedner, Jan / Schneider, Hartmut. ·a Center for Sleep and Wakefulness Disorders , Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden. · b Department of Respiratory and Critical Care Medicine , Johns Hopkins University , Baltimore , USA. · c ochschule Mannheim - University of Applied Sciences , Department of Information Technology , Mannheim , Germany. · d Department of Respiratory Medicine, Allergology and Sleep Medicine , Klinikum Nuremberg/ Paracelsus Medical University , Nuremberg , Germany. · e Department of Pulmonary Medicine, Bethanien Hospital , Solingen , Germany. · f Department of Cardiology , University Hospital Charité , Berlin , Germany. · g Department of Pulmonary Medicine , Bethesda Hospital , Wuppertal , Germany. ·COPD · Pubmed #28949781.

ABSTRACT: Arterial stiffness, a marker for cardiovascular risk, is increased in patients with Chronic Obstructive Pulmonary Disease (COPD) and Obstructive Sleep Apnea (OSA). The specific influence of both on arterial stiffness during sleep is unknown. Nocturnal arterial stiffness (Pulse Propagation Time (PPT) of the finger pulse wave) was calculated in 142 individuals evaluated for sleep apnea: 27 COPD patients (64.7 ± 11y, 31.2 ± 8 kg/m

239 Article Characterization of the CPAP-treated patient population in Catalonia. 2017

Turino, Cecilia / Bertran, Sandra / Gavaldá, Ricard / Teixidó, Ivan / Woehrle, Holger / Rué, Montserrat / Solsona, Francesc / Escarrabill, Joan / Colls, Cristina / García-Altés, Anna / de Batlle, Jordi / Sánchez de-la-Torre, Manuel / Barbé, Ferran. ·Group of Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain. · Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain. · Department of Computer Science, UPC-BarcelonaTech, Barcelona, Spain. · Department of Computer Science & INSPIRES, University of Lleida, Lleida, Spain. · Sleep and Ventilation Center Blaubeuren, Respiratory Center Ulm, Ulm, Germany. · Unit of Bioestatistics and Epidemiology, IRBLleida, Lleida, Spain. · Chronic Care Program (Hospital Clínic) & Master Plan for Respiratory Diseases (Ministry of Health, Catalonia) & REDISSEC, Barcelona, Spain. · Public Health Department, Government of Catalonia, Barcelona, Spain. ·PLoS One · Pubmed #28934303.

ABSTRACT: There are different phenotypes of obstructive sleep apnoea (OSA), many of which have not been characterised. Identification of these different phenotypes is important in defining prognosis and guiding the therapeutic strategy. The aim of this study was to characterise the entire population of continuous positive airway pressure (CPAP)-treated patients in Catalonia and identify specific patient profiles using cluster analysis. A total of 72,217 CPAP-treated patients who contacted the Catalan Health System (CatSalut) during the years 2012 and 2013 were included. Six clusters were identified, classified as "Neoplastic patients" (Cluster 1, 10.4%), "Metabolic syndrome patients" (Cluster 2, 27.7%), "Asthmatic patients" (Cluster 3, 5.8%), "Musculoskeletal and joint disorder patients" (Cluster 4, 10.3%), "Patients with few comorbidities" (Cluster 5, 35.6%) and "Oldest and cardiac disease patients" (Cluster 6, 10.2%). Healthcare facility use and mortality were highest in patients from Cluster 1 and 6. Conversely, patients in Clusters 2 and 4 had low morbidity, mortality and healthcare resource use. Our findings highlight the heterogeneity of CPAP-treated patients, and suggest that OSA is associated with a different prognosis in the clusters identified. These results suggest the need for a comprehensive and individualised approach to CPAP treatment of OSA.

240 Article The Erlangen Questionnaire: a new 5-item screening tool for obstructive sleep apnea in a sleep clinic population - A prospective, double blinded study. 2017

Traxdorf, M / Tziridis, K / Scherl, C / Iro, H / Haferkamp, J. ·Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany. maximilian.traxdorf@uk-erlangen.de. ·Eur Rev Med Pharmacol Sci · Pubmed #28925472.

ABSTRACT: OBJECTIVE: The aim of this study was to develop and validate a simplified screening tool for identifying obstructive sleep apnea (OSA) in a sleep clinic population. PATIENTS AND METHODS: A total of 160 patients from a sleep clinic population was enrolled in the prospective, double-blinded study. OSA was defined by using diagnostic criteria of the ICSD-3 after overnight polysomnography (n=96) or polygraphy (n=64). The first 60 patients filled out a multi-item questionnaire and formed the development group. Subsequently, the five most predictive factors were selected to create the Erlangen Questionnaire (EQ). For validation of the EQ, the next 100 patients formed the validation group. RESULTS: The following factors were incorporated into the 5-item EQ: (1) ESS > 10, (2) age > 60, (3) gasping and (4) cardiovascular risk factors, (5) witnessed apneas. The EQ had sensitivities of 94.3%, 92.7% and 92.3%, specificities of 50.0%, 33.3% and 22.9%, positive predictive values of 81.5%, 62.9% and 29.6%, and negative predictive values of 78.9%, 78.9% and 89.5% with respect to mild, moderate and severe OSA. CONCLUSIONS: EQ is a compact 5-item-based, concise and easy-to-use screening tool to identify both male and female patients with OSA in a sleep clinic-population and exhibits all essential factors of internal and external validity. The results of the EQ are comparable to the best-validated and most commonly used STOP-Bang questionnaire regarding sensitivity and specificity in a sleep clinic population.

241 Article Predominant obstructive or central sleep apnea in patients with atrial fibrillation: influence of characterizing apneas versus apneas and hypopneas. 2017

Strotmann, Johanna / Fox, Henrik / Bitter, Thomas / Schindhelm, Florian / Gutleben, Klaus-Jürgen / Horstkotte, Dieter / Oldenburg, Olaf. ·Herz- und Diabeteszentrum NRW, Department of Cardiology, University Hospital, Ruhr- University Bochum, Georgstraße 11, 32545, Bad Oeynhausen, Germany. Electronic address: johanna.strotmann@rub.de. · Herz- und Diabeteszentrum NRW, Department of Cardiology, University Hospital, Ruhr- University Bochum, Georgstraße 11, 32545, Bad Oeynhausen, Germany. Electronic address: hfox@hdz-nrw.de. · Herz- und Diabeteszentrum NRW, Department of Cardiology, University Hospital, Ruhr- University Bochum, Georgstraße 11, 32545, Bad Oeynhausen, Germany. Electronic address: tbitter@hdz-nrw.de. · Herz- und Diabeteszentrum NRW, Department of Cardiology, University Hospital, Ruhr- University Bochum, Georgstraße 11, 32545, Bad Oeynhausen, Germany. Electronic address: florian.schindhelm@rub.de. · Herz- und Diabeteszentrum NRW, Department of Cardiology, University Hospital, Ruhr- University Bochum, Georgstraße 11, 32545, Bad Oeynhausen, Germany. Electronic address: kjgutleben@hdz-nrw.de. · Herz- und Diabeteszentrum NRW, Department of Cardiology, University Hospital, Ruhr- University Bochum, Georgstraße 11, 32545, Bad Oeynhausen, Germany. Electronic address: dhorstkotte@hdz-nrw.de. · Herz- und Diabeteszentrum NRW, Department of Cardiology, University Hospital, Ruhr- University Bochum, Georgstraße 11, 32545, Bad Oeynhausen, Germany. Electronic address: akleemeyer@hdz-nrw.de. ·Sleep Med · Pubmed #28899542.

ABSTRACT: OBJECTIVE/BACKGROUND: Sleep-disordered breathing (SDB) is common in patients with atrial fibrillation (Afib). Although a high proportion of respiratory events are hypopneas, previous studies have only used apneas to differentiate obstructive (OSA) from central (CSA) sleep apnea. This study investigated the impact of using apneas and hypopneas versus apneas only to define the predominant type of SDB in Afib patients with preserved ejection fraction. PATIENTS/METHODS: This retrospective analysis was based on high-quality cardiorespiratory polygraphy (PG) recordings (07/2007-03/2016) that were re-analyzed using 2012 American Academy of Sleep Medicine criteria, with differentiation of apneas and hypopneas as obstructive or central. Classification of predominant (>50% of events) OSA and CSA was defined based on apneas only (OSA RESULTS: A total of 211 patients were included (146 male, age 68.7 ± 8.5 y). Hypopneas accounted for >50% of all respiratory events. Based on apneas only, 46% of patients had predominant OSA and 44% had predominant CSA. Based on apneas and hypopneas, the proportion of patients with OSA was higher (56%) and that with CSA was lower (36%). In the subgroup of patients with moderate to severe SDB (AHI ≥ 15/h), the proportion with predominant CSA was 55.2% based on apneas only versus 42.1% with apneas and hypopneas. CONCLUSIONS: In hospitalized patients with Afib and SDB, use of apneas and hypopneas versus apneas alone had an important influence on the proportion of patients classified as having predominant OSA or CSA.

242 Article Severity of individual obstruction events increases with age in patients with obstructive sleep apnea. 2017

Leppänen, Timo / Töyräs, Juha / Mervaala, Esa / Penzel, Thomas / Kulkas, Antti. ·Department of Clinical Neurophysiology, Seinäjoki Central Hospital, Seinäjoki, Finland; Department of Applied Physics, University of Eastern Finland, Kuopio, Finland. Electronic address: leppanen_timo@outlook.com. · Department of Applied Physics, University of Eastern Finland, Kuopio, Finland; Department of Clinical Neurophysiology, Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland. · Department of Clinical Neurophysiology, Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland; Department of Clinical Neurophysiology, Institute of Clinical Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland. · Interdisciplinary Sleep Center, Department of Cardiology, Charité - Universitätsmedizin Berlin, Berlin, Germany; International Clinical Research Center, St Anne's University Hospital Brno, Brno, Czech Republic. · Department of Clinical Neurophysiology, Seinäjoki Central Hospital, Seinäjoki, Finland; Department of Applied Physics, University of Eastern Finland, Kuopio, Finland. ·Sleep Med · Pubmed #28899537.

ABSTRACT: BACKGROUND: Age is a risk factor of obstructive sleep apnea (OSA). It has been shown that OSA progresses over time, although conflicting results have been reported. However, the effect of age on the severity of OSA and individual obstruction events has not been investigated within different OSA severity categories by taking the most prominent confounding factors (i.e., body mass index, gender, smoking, daytime sleepiness, snoring, hypertension, heart failure, and proportion of supine sleep) into account. METHODS: Polygraphic data of 1090 patients with apnea-hypopnea index (AHI) ≥5 were retrospectively reanalyzed. The effect of age on the severity of OSA and obstruction events was investigated in general, within different OSA severity categories, and in different age groups (age <40, 40≤ age <50, 50≤ age <60, and age ≥60 years). RESULTS: In the whole population, AHI and durations of apneas, hypopneas, and desaturations increased with increasing age (B ≥ 0.108, p ≤ 0.010). In more detailed analysis, AHI increased with age only in the moderate OSA category (B = 0.075, p = 0.022), although durations of apneas increased in mild and severe OSA categories (B ≥ 0.076, p ≤ 0.038). Furthermore, durations of hypopneas increased with age in mild and moderate OSA categories (B ≥ 0.105, p ≤ 0.038), and durations of desaturations (B ≥ 0.120, p ≤ 0.013) in all OSA severity categories. AHI was not statistically significantly different between the age groups, although durations of obstruction events tended to increase towards older age groups. CONCLUSION: As obstruction event severity was more strongly dependent on the age than it was dependent on AHI, considering the severity of obstruction events could be beneficial while estimating the long-term effects of the treatments and prognosticating the disease progression.

243 Article Validation of the screening tool ApneaLink 2017

Stehling, Florian / Keull, Judith / Olivier, Margarete / Große-Onnebrink, Jörg / Mellies, Uwe / Stuck, Boris A. ·Pediatric Pulmonology and Sleep Medicine, Children's Hospital, University of Duisburg-Essen, Essen, Germany. Electronic address: florian.stehling@uk-essen.de. · Pediatric Pulmonology and Sleep Medicine, Children's Hospital, University of Duisburg-Essen, Essen, Germany. · Department of General Pediatrics, Pediatric Respiratory Medicine Unit, University Children's Hospital Muenster, Muenster, Germany. · Department of Otorhinolaryngology, Head and Neck Surgery, Essen University Hospital, University Duisburg-Essen, Essen, Germany; Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Marburg, Philipps Universität Marburg, Germany. ·Sleep Med · Pubmed #28899523.

ABSTRACT: OBJECTIVE: While out-of-center testing was introduced as an alternative for the diagnosis of obstructive sleep apnea in adults, polysomnography (PSG) is still considered mandatory in the diagnosis of sleep-disordered breathing (SDB) in children. The purpose of this study was to validate the outpatient screening device ApneaLink METHODS: Sixty consecutive children and adolescents (10.4 ± 6.2, 0-22 years) with suspected SDB admitted to the sleep laboratory underwent simultaneous recording with full PSG and the screening device ApneaLink RESULTS: The mean apnea-hypopnea index (AHI) was 11.8 ± 19.7 in PSG and 10.3 ± 12.0 in ApneaLink CONCLUSION: These results show that the outpatient screening device ApneaLink

244 Article Sleep-Disordered Breathing in Acute Ischemic Stroke: A Mechanistic Link to Peripheral Endothelial Dysfunction. 2017

Scherbakov, Nadja / Sandek, Anja / Ebner, Nicole / Valentova, Miroslava / Nave, Alexander Heinrich / Jankowska, Ewa A / Schefold, Jörg C / von Haehling, Stephan / Anker, Stefan D / Fietze, Ingo / Fiebach, Jochen B / Haeusler, Karl Georg / Doehner, Wolfram. ·Center for Stroke Research Berlin (CSB), Charité-Universitätsmedizin Berlin, Berlin, Germany nadja.scherbakov@charite.de. · Innovative Clinical Trials, Department of Cardiology and Pneumology, University Medicine Goettingen (UMG), Goettingen, Germany. · Center for Stroke Research Berlin (CSB), Charité-Universitätsmedizin Berlin, Berlin, Germany. · Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland. · Cardiology Department, Military Hospital, Wroclaw, Poland. · Department of Intensive Care Medicine, Inselspital, University Hospital of Bern, Switzerland. · Interdisciplinary Center of Sleep Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany. · Department of Neurology, Charité-Universitätsmedizin Berlin, Berlin, Germany. · Department of Cardiology, Charité-Universitätsmedizin Berlin, Berlin, Germany. ·J Am Heart Assoc · Pubmed #28893762.

ABSTRACT: BACKGROUND: Sleep-disordered breathing (SDB) after acute ischemic stroke is frequent and may be linked to stroke-induced autonomic imbalance. In the present study, the interaction between SDB and peripheral endothelial dysfunction (ED) was investigated in patients with acute ischemic stroke and at 1-year follow-up. METHODS AND RESULTS: SDB was assessed by transthoracic impedance records in 101 patients with acute ischemic stroke (mean age, 69 years; 61% men; median National Institutes of Health Stroke Scale, 4) while being on the stroke unit. SDB was defined by apnea-hypopnea index ≥5 episodes per hour. Peripheral endothelial function was assessed using peripheral arterial tonometry (EndoPAT-2000). ED was defined by reactive hyperemia index ≤1.8. Forty-one stroke patients underwent 1-year follow-up (390±24 days) after stroke. SDB was observed in 57% patients with acute ischemic stroke. Compared with patients without SDB, ED was more prevalent in patients with SDB (32% versus 64%; CONCLUSIONS: SDB was present in more than half of all patients with acute ischemic stroke and was independently associated with peripheral ED. Normalized ED in patients with normalized breathing pattern 1 year after stroke suggests a mechanistic link between SDB and ED. CLINICAL TRIAL REGISTRATION: URL: https://drks-neu.uniklinik-freiburg.de. Unique identifier: DRKS00000514.

245 Article Adaptive servo ventilation for central sleep apnoea in heart failure: SERVE-HF on-treatment analysis. 2017

Woehrle, Holger / Cowie, Martin R / Eulenburg, Christine / Suling, Anna / Angermann, Christiane / d'Ortho, Marie-Pia / Erdmann, Erland / Levy, Patrick / Simonds, Anita K / Somers, Virend K / Zannad, Faiez / Teschler, Helmut / Wegscheider, Karl. ·ResMed Science Center, ResMed Germany Inc., Martinsried, Germany hwoehrle@lungenzentrum-ulm.de. · Sleep and Ventilation Center Blaubeuren, Respiratory Center Ulm, Ulm, Germany. · Imperial College London, London, UK. · Department of Epidemiology, University Medical Center Groningen, Groningen, the Netherlands. · Department of Medical Biometry and Epidemiology, University Medical Center Eppendorf, Hamburg, Germany. · Department of Medicine I and Comprehensive Heart Failure Center, University Hospital and University of Würzburg, Würzburg, Germany. · University Paris Diderot, Sorbonne Paris Cité, Hôpital Bichat, Explorations Fonctionnelles, DHU FIRE, AP-HP, Paris, France. · Heart Center, University of Cologne, Cologne, Germany. · CHU de Grenoble, Grenoble, France. · Royal Brompton Hospital, London, UK. · Mayo Clinic and Mayo Foundation, Rochester, MN, USA. · INSERM, Université de Lorraine, CHU Nancy, France. · Department of Pneumology, Ruhrlandklinik, West German Lung Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany. ·Eur Respir J · Pubmed #28860264.

ABSTRACT: This on-treatment analysis was conducted to facilitate understanding of mechanisms underlying the increased risk of all-cause and cardiovascular mortality in heart failure patients with reduced ejection fraction and predominant central sleep apnoea randomised to adaptive servo ventilation

246 Article Validation of a New System Using Tracheal Body Sound and Movement Data for Automated Apnea-Hypopnea Index Estimation. 2017

Kalkbrenner, Christoph / Eichenlaub, Manuel / Rüdiger, Stefan / Kropf-Sanchen, Cornelia / Brucher, Rainer / Rottbauer, Wolfgang. ·Faculty of Medical Engineering, University of Applied Science Ulm, Ulm, Germany. · School of Engineering, University of Warwick, Coventry, United Kingdom. · Department of Internal Medicine II, University Hospital Ulm, Ulm, Germany. ·J Clin Sleep Med · Pubmed #28859722.

ABSTRACT: STUDY OBJECTIVES: The current gold standard for assessment of obstructive sleep apnea is the in-laboratory polysomnography. This approach has high costs and inconveniences the patient, whereas alternative ambulatory systems are limited by reduced diagnostic abilities (type 4 monitors, 1 or 2 channels) or extensive setup (type 3 monitors, at least 4 channels). The current study therefore aims to validate a simplified automated type 4 monitoring system using tracheal body sound and movement data. METHODS: Data from 60 subjects were recorded at the University Hospital Ulm. All subjects have been regular patients referred to the sleep center with suspicion of sleep-related breathing disorders. Four recordings were excluded because of faulty data. The study was of prospective design. Subjects underwent a full-night screening using diagnostic in-laboratory polysomnography and the new monitoring system concurrently. The apnea-hypopnea index (AHI) was scored blindly by a medical technician using in-laboratory polysomnography (AHI RESULTS: AHI CONCLUSIONS: The proposed sleep monitor accurately estimates AHI and diagnoses sleep apnea and its severity. This minimalistic approach may address the need for a simple yet reliable diagnosis of sleep apnea in an ambulatory setting. CLINICAL TRIAL REGISTRATION: Trial name: Validation of a new method for ambulant diagnosis of sleep related breathing disorders using body sound; URL: https://drks-neu.uniklinik-freiburg.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00011195; Identifier: DRKS00011195.

247 Article Omega-3 Index and Obstructive Sleep Apnea: A Cross-Sectional Study. 2017

Tittus, Janine / Huber, Marie Theres / Storck, Klaus / Köhler, Anton / Köhler, Jan M / von Arnim, Thomas / von Schacky, Clemens. ·Preventive Cardiology, University of Munich, Munich, Germany. · Lungenärzte am Rotkreuzplatz Munich, Munich, Germany. · Rotkreuzklinikum, Munich, Germany. · Omegametrix, Martinsried, Germany. ·J Clin Sleep Med · Pubmed #28859717.

ABSTRACT: STUDY OBJECTIVES: Erythrocyte levels of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) (Omega-3 Index) were previously found to be associated with obstructive sleep apnea (OSA) at very low levels (< 5.0%) in only one epidemiologic study. OSA has comorbidities, such as arterial hypertension, heart failure, or major depression, also associated with a low Omega-3 Index. These comorbidities can be improved by increasing intake of EPA and DHA, and thus the Omega-3 Index, preferably to its target range of 8% to 11%. Symptoms of OSA might improve by increasing the Omega-3 Index, but more research is needed. METHODS: In our sleep laboratory, 357 participants with OSA were recruited, and data from 315 participants were evaluated. Three categories of OSA (none/ mild, moderate, severe) were defined based on apnea-hypopnea index. Anthropometrics and lifestyle characteristics (smoking, alcohol, fish intake, omega-3 supplementation) were recorded. Erythrocyte fatty acid compositions were assessed with the HS-Omega-3 Index methodology. RESULTS: The mean Omega-3 Index in all 3 categories of OSA was 5.7%, and no association with OSA was found. There were more male participants with severe OSA (79.7%, CONCLUSIONS: In contrast to our hypothesis, an Omega-3 Index of 5.7% was not associated with OSA severity. Previously, an Omega-3 Index < 5.0% was associated. Although our results suggest aiming for an Omega-3 Index > 5.7% in an intervention trial with EPA and DHA in OSA, comorbidities of OSA suggest a target range of 8% to 11%.

248 Article Performance of an automated algorithm to process artefacts for quantitative EEG analysis during a simultaneous driving simulator performance task. 2017

Szentkirályi, András / Wong, Keith K H / Grunstein, Ronald R / D'Rozario, Angela L / Kim, Jong Won. ·CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, The University of Sydney, PO Box M77, Missenden Road, 2050, NSW, Australia; Institute of Epidemiology and Social Medicine, Westfälische Wilhelms-University of Münster, Domagkstraße 3, D-48149 Münster, Germany; Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, PO Box M30, Sydney Local Health District, Missenden Road, Sydney 2050, NSW, Australia. Electronic address: szentkir@uni-muenster.de. · CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, The University of Sydney, PO Box M77, Missenden Road, 2050, NSW, Australia; School of Psychology, Brain and Mind Centre and Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia. Electronic address: keith.wong@sydney.edu.au. · CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, The University of Sydney, PO Box M77, Missenden Road, 2050, NSW, Australia; School of Psychology, Brain and Mind Centre and Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia. Electronic address: ron.grunstein@sydney.edu.au. · CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, The University of Sydney, PO Box M77, Missenden Road, 2050, NSW, Australia; Institute of Epidemiology and Social Medicine, Westfälische Wilhelms-University of Münster, Domagkstraße 3, D-48149 Münster, Germany; Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, PO Box M30, Sydney Local Health District, Missenden Road, Sydney 2050, NSW, Australia; School of Psychology, Brain and Mind Centre and Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia. Electronic address: angela.drozario@sydney.edu.au. · CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, The University of Sydney, PO Box M77, Missenden Road, 2050, NSW, Australia; Department of Healthcare IT, Inje University, Inje-ro 197, Kimhae, Kyunsangnam-do 50834, Republic of Korea. Electronic address: jongwonkim@inje.ac.kr. ·Int J Psychophysiol · Pubmed #28821403.

ABSTRACT: -- No abstract --

249 Article [Apnea Detection by Means of Respiratory Sound Recordings and Polysomnography - A Comparative Study]. 2017

von Heydebrand, M / Hildebrandt, O / Cassel, W / Schäfer, A / Kesper, K / Weissflog, A / Taher, N / Sohrabi, K / Gross, V / Koehler, U. ·Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität, Marburg. · Thora Tech GmbH, Gießen. · Fachbereich Gesundheit, Technische Hochschule Mittelhessen, Gießen. ·Pneumologie · Pubmed #28759934.

ABSTRACT:

250 Article Sleep apnoea is common in severe peripheral arterial disease. 2017

Schahab, Nadjib / Sudan, Sarah / Schaefer, Christian / Tiyerili, Vedat / Steinmetz, Martin / Nickenig, Georg / Skowasch, Dirk / Pizarro, Carmen. ·University Hospital Bonn, Department of Internal Medicine II, Cardiology, Pneumology and Angiology, Bonn, Germany. ·PLoS One · Pubmed #28759652.

ABSTRACT: BACKGROUND: Atherosclerotic conditions have been demonstrated to be associated with sleep- disordered breathing (SDB). Peripheral arterial disease (PAD) represents severe atherosclerosis with a high mortality. In early stages of PAD a substantial prevalence of sleep apnoea has already been shown. Here, we sought to determine the frequency of undiagnosed sleep apnoea in a homogeneous group of advanced PAD patients undergoing percutaneous revascularization. METHODS: 59 consecutive patients (mean age: 71.1 ± 9.8 years, 67.8% males) with PAD in Fontaine stages IIb-IV that underwent percutaneous transluminal angioplasty at our department were enrolled for pre-procedural polygraphy. RESULTS: Patients appertained to Fontaine clinical stage IIb, III and IV in 54.2%, 23.8% and 22.% of cases, respectively, and were principally intervened for femoropopliteal occlusive disease (71.2% of total study population). Polygraphy revealed sleep apnoea in 48 out of 59 patients (81.4%), of whom 60.4% offered a primarily obstructive-driven genesis. Among those patients with polygraphically confirmed sleep apnoea, mean apnoea hypopnoea index (AHI) and mean oxygen desaturation index (ODI) averaged 28.2 ± 19.5/h and 26.7 ± 18.8/h, respectively. 18 patients even offered an AHI ≥30/h that is indicative of severe sleep apnoea. For obstructive-driven apnoeic events, AHI correlated significantly with PAD severity stages (p = 0.042). CONCLUSIONS: In our PAD collective, sleep apnoea was frequent and obstructive sleep apnoea´s severity correlated with PAD severity stages. Long-term results regarding the vasoprotective impact of CPAP treatment on PAD course remains to be determined.

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