Pick Topic
Review Topic
List Experts
Examine Expert
Save Expert
  Site Guide ··   
Sleep Apnea Syndromes: HELP
Articles from Yale University
Based on 81 articles published since 2008
||||

These are the 81 published articles about Sleep Apnea Syndromes that originated from Yale University during 2008-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4
1 Editorial Science as observation and experiment: examining the role of sleep apnea and continuous positive airway pressure treatment in cardiovascular outcomes. 2014

Yaggi, H Klar. ·1 Department of Internal Medicine Yale University School of Medicine New Haven, Connecticut and. ·Am J Respir Crit Care Med · Pubmed #24930528.

ABSTRACT: -- No abstract --

2 Review Current Concepts in Orthognathic Surgery. 2018

Naran, Sanjay / Steinbacher, Derek M / Taylor, Jesse A. ·Park Ridge, Ill.; New Haven, Conn.; and Philadelphia, Pa. From Pediatric Plastic and Craniofacial Surgery, Advocate Children's Hospital; the Section of Plastic and Reconstructive Surgery, Yale School of Medicine; the Division of Plastic and Reconstructive Surgery, Children's Hospital of Philadelphia; and the Division of Plastic Surgery, University of Pennsylvania, Perelman School of Medicine. ·Plast Reconstr Surg · Pubmed #29794714.

ABSTRACT: LEARNING OBJECTIVES: After studying this article, the participant should be able to: 1. Identify skeletal differences that are treated with orthognathic surgery; describe the goals of orthognathic surgery; and understand modern virtual surgical planning of orthognathic movement of the mandible, maxilla, and chin. 2. Appreciate the surgical principles of maxilla- versus mandible-first surgery, and orthognathic surgery before orthodontic correction; and understand when an osseous genioplasty may be beneficial, and the potency of this bony movement. 3. Appreciate the utility of fat grafting as an adjunct to orthognathic bony movements, and demonstrate understanding of the utility of orthognathic surgery in the treatment of obstructive sleep apnea. 4. Be aware of associated complications and be able to critically assess outcomes following orthognathic surgery. SUMMARY: This CME article outlines the goals of orthognathic surgery, highlighting advances in the field and current controversies. The principles of the sequencing of osteotomies are discussed and literature is reviewed that may assist in decision-making as to maxilla-first versus mandible-first surgery. The emergence of "surgery first," in which surgery precedes orthodontics, is discussed and important parameters for patient candidacy for such a procedure are provided. The emerging standard of virtual surgical planning is described, and a video is provided that walks the reader through a planning session. Soft-tissue considerations are highlighted, especially in the context of osseous genioplasty and fat grafting to the face. The utility of orthognathic surgery in the treatment of obstructive sleep apnea is discussed. The reader is provided with the most current data on complications following orthognathic surgery and advice on avoiding such pitfalls. Finally, outcome assessment focusing on the most current trend of patient-reported satisfaction and the psychological impact of orthognathic surgery are discussed.

3 Review Sleep-Disordered Breathing in Neuromuscular and Chest Wall Diseases. 2018

Hilbert, Janet. ·Department of Internal Medicine, Section of Pulmonary, Critical Care, and Sleep Medicine, Yale University, Yale University School of Medicine, 300 Cedar Street, PO Box 208057, New Haven, CT 06520-8057, USA. Electronic address: janet.hilbert@yale.edu. ·Clin Chest Med · Pubmed #29779591.

ABSTRACT: Neuromuscular and chest wall diseases include a diverse group of conditions that share common risk factors for sleep-disordered breathing, including respiratory muscle weakness and/or thoracic restriction. Sleep-disordered breathing results from both the effects of normal sleep on ventilation and the additional challenges imposed by the underlying disorders. Patterns of sleep- disordered breathing vary with the specific diagnosis and stage of disease. Sleep hypoventilation precedes diurnal respiratory failure and may be difficult to recognize clinically because symptoms are nonspecific. Polysomnography has a role in both the diagnosis of sleep-disordered breathing and in the titration of effective noninvasive positive-pressure ventilation.

4 Review Patient-centered care in obstructive sleep apnea: A vision for the future. 2018

Hilbert, Janet / Yaggi, Henry K. ·Yale University School of Medicine, Department of Internal Medicine, Section of Pulmonary, Critical Care, and Sleep Medicine, New Haven, CT, USA. Electronic address: janet.hilbert@yale.edu. · Yale University School of Medicine, Department of Internal Medicine, Section of Pulmonary, Critical Care, and Sleep Medicine, New Haven, CT, USA. ·Sleep Med Rev · Pubmed #28633915.

ABSTRACT: Obstructive sleep apnea is a common condition, with multiple potential neurocognitive, cardiovascular, and metabolic consequences. Efficacious treatment is available, but patient engagement is typically required for treatment to be effective. Patients with sleep apnea are phenotypically diverse and have individual needs, preferences, and values that impact treatment decisions. There has been a shift in obstructive sleep apnea management from diagnosis to chronic care management. Making treatment decisions that incorporate an individual patient's values and preferences and are personalized for that patient's biology has the potential to improve patient outcomes. A patient-centered care approach in obstructive sleep apnea is reviewed including 1) determining patient-specific needs to guide treatment decisions, 2) understanding patient values, preferences, and other factors impacting treatment decisions and using shared decision-making, 3) enhancing patient education and support to improve treatment adherence, 4) promoting patient engagement, 5) optimizing care coordination, continuity of care, and access to care, and 6) determining and assessing patient-centered outcomes.

5 Review Prevalence of obstructive sleep apnea in patients with posttraumatic stress disorder and its impact on adherence to continuous positive airway pressure therapy: a meta-analysis. 2017

Zhang, Ye / Weed, Jason G / Ren, Rong / Tang, Xiangdong / Zhang, Wei. ·Mental Health Center, West China Hospital, Sichuan University, Chengdu, China. · Department of Dermatology, Yale University School of Medicine, New Haven, CT, USA. · Sleep Medicine Center, Mental Health Center, Department of Respiratory and Critical Care Medicine, Translational Neuroscience Center, Department of Otolaryngology, West China Hospital, Sichuan University, Chengdu, China. · Mental Health Center, West China Hospital, Sichuan University, Chengdu, China. Electronic address: weizhang27@163.com. ·Sleep Med · Pubmed #28735910.

ABSTRACT: OBJECTIVE: Although some authors have recently investigated the co-occurrence of posttraumatic stress disorder (PTSD) and obstructive sleep apnea (OSA), the topic remains insufficiently studied. The aim of this meta-analysis was to detect the pooled prevalence of OSA in PTSD and its impact on adherence to continuous positive airway pressure (CPAP) therapy. METHODS: We conducted a search for articles published until August 20, 2016, in PubMed, Embase, the Cochrane Library, and PsycINFO. The literature search identified 194 articles, and 12 studies were included in the meta-analysis. RESULTS: The pooled prevalence rates of OSA based on different apnea-hypopnea index (AHI) criteria in PTSD patients was 75.7% (95% confidence interval [CI] = 44.1-92.5%) (AHI ≥5) and 43.6% (95% CI = 20.6-69.7%) (AHI ≥10), respectively. Subgroup analysis showed that there was a significant difference between the prevalence of OSA in veterans with PTSD compared to nonveterans or mixed samples. Patients with PTSD and OSA demonstrated significantly lower adherence to CPAP therapy (regular use: g = -0.658, 95% CI = -0.856 to -0.460; time of average use per night: g = -0.873, 95% CI = -1.550 to -0.196) compared with those with OSA alone. CONCLUSIONS: OSA is commonly seen in patients with PTSD. Given its negative impact on the adherence to CPAP therapy, the possibility of OSA should be monitored carefully in patients with PTSD.

6 Review Phenotypes in obstructive sleep apnea: A definition, examples and evolution of approaches. 2017

Zinchuk, Andrey V / Gentry, Mark J / Concato, John / Yaggi, Henry K. ·Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA. Electronic address: andrey.zinchuk@yale.edu. · Cushing/Whitney Medical Library, Yale University School of Medicine, New Haven, CT, USA. · Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA; Clinical Epidemiology Research Center (CERC), VA Connecticut Healthcare System, West Haven, CT, USA. ·Sleep Med Rev · Pubmed #27815038.

ABSTRACT: Obstructive sleep apnea (OSA) is a complex and heterogeneous disorder and the apnea hypopnea index alone can not capture the diverse spectrum of the condition. Enhanced phenotyping can improve prognostication, patient selection for clinical trials, understanding of mechanisms, and personalized treatments. In OSA, multiple condition characteristics have been termed "phenotypes." To help classify patients into relevant prognostic and therapeutic categories, an OSA phenotype can be operationally defined as: "A category of patients with OSA distinguished from others by a single or combination of disease features, in relation to clinically meaningful attributes (symptoms, response to therapy, health outcomes, quality of life)." We review approaches to clinical phenotyping in OSA, citing examples of increasing analytic complexity. Although clinical feature based OSA phenotypes with significant prognostic and treatment implications have been identified (e.g., excessive daytime sleepiness OSA), many current categorizations lack association with meaningful outcomes. Recent work focused on pathophysiologic risk factors for OSA (e.g., arousal threshold, craniofacial morphology, chemoreflex sensitivity) appears to capture heterogeneity in OSA, but requires clinical validation. Lastly, we discuss the use of machine learning as a promising phenotyping strategy that can integrate multiple types of data (genomic, molecular, cellular, clinical) to identify unique, meaningful OSA phenotypes.

7 Review Transoral Robotic Partial Glossectomy and Supraglottoplasty for Obstructive Sleep Apnea. 2016

D'Agostino, Mark A. ·Southern New England Ear, Nose and Throat Group, One Long Wharf Drive Suite 302, New Haven, CT 06511, USA; Section of Otolaryngology, Department of Surgery, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06510, USA; Department of Surgery, Frank H Netter School of Medicine, Quinnipiac University, 370 Bassett Road, North Haven, CT 06473, USA; Department of Surgery, F. Edward Hebert School of Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA; Section of Otolaryngology, Department of Surgery, Middlesex Hospital, 28 Crescent Street, Middletown, CT 06457, USA. Electronic address: madago@comcast.net. ·Otolaryngol Clin North Am · Pubmed #27742107.

ABSTRACT: The standard treatment for patients with obstructive sleep apnea syndrome is positive airway pressure (PAP) therapy. However, when PAP therapy fails, surgery may be an option to alleviate the obstruction. The base of tongue plays an important role in this obstruction, and addressing the tongue base surgically can be a challenge for the head and neck surgeon. Transoral robotic surgery (TORS) using the da Vinci Surgical System provides a safe and effective way to approach and manage the base of tongue and supraglottis. Advantages of TORS include wide-field high-definition 3-D visualization, precise instrumentation, and when compared with open procedures, less operative time, quicker recovery, no external scars, and comparable tissue resection.

8 Review An Introduction to Obstructive Sleep Apnea. 2016

Paskhover, Boris. ·Section of Otolaryngology, Yale School of Medicine, 800 Howard Avenue, Fourth Floor, New Haven, CT 06519, USA. Electronic address: Boris.Paskhover@yale.edu. ·Otolaryngol Clin North Am · Pubmed #27720462.

ABSTRACT: Obstructive sleep apnea (OSA) is a prevalent disease entity that has become commonplace over the past few decades. Its surge in diagnosis can be linked to a better understanding of the process with a concurrent increase in prevalence. The social, economic, and personal impacts are significant; there continues to be a need to improve our treatment modalities for OSA.

9 Review Oral Appliances in Obstructive Sleep Apnea. 2016

Dioguardi, Anthony / Al-Halawani, Moh'd. ·Sleep Apnea and Snoring Dental Therapy of Connecticut, 123 York Street, Suite 2J, New Haven, CT 06511, USA. Electronic address: adioguardi01@gmail.com. · Sleep Medicine Fellowship Program, Section of Pulmonary, Critical Care and Sleep Medicine, Yale University School of Medicine, 20 York Street, New Haven, CT 06510, USA. ·Otolaryngol Clin North Am · Pubmed #27720461.

ABSTRACT: Oral appliance therapy (OAT) has become an increasingly popular nonsurgical option for the treatment of obstructive sleep disorders. Recent research supports its efficacy and high levels of compliance for patients with obstructive sleep disorders. Common side effects of OAT include temporomandibular joint-related symptoms, bite changes, and tooth movement. These side effects can be minimized by the use of exercises. The American Academy of Dental Sleep Medicine and the American Academy of Sleep Medicine have released joint clinical practice guidelines for the treatment of obstructive sleep apnea and snoring with OAT.

10 Review Positive Airway Pressure Therapy for Obstructive Sleep Apnea. 2016

Weiss, Pnina / Kryger, Meir. ·Pediatric Respiratory Medicine and Medical Education, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06520, USA. Electronic address: pnina.weiss@yale.edu. · Pulmonary, Critical Care and Sleep Medicine, Yale School of Medicine, 333 Cedar Street, New Haven, CT 06520, USA. ·Otolaryngol Clin North Am · Pubmed #27720457.

ABSTRACT: Positive airway pressure (PAP) is considered first-line therapy for moderate to severe obstructive sleep apnea and may also be considered for mild obstructive sleep apnea, particularly if it is symptomatic or there are concomitant cardiovascular disorders. Continuous PAP is most commonly used. Other modes, such as bilevel airway pressure, autotitrating positive airway pressure, average volume assured pressure support, and adaptive support ventilation, play important roles in the management of sleep-related breathing disorders. This article outlines the indications, description, and comfort features of each mode. Despite the proven efficacy of PAP in treating obstructive sleep apnea syndrome and its sequelae, adherence to therapy is low. Close follow-up of patients for evaluation of adherence to and effectiveness of treatment is important.

11 Review The emerging role of microRNAs in hypoxia-induced pulmonary hypertension. 2016

Mohsenin, Vahid. ·Section of Pulmonary, Critical Care and Sleep Medicine, Yale University School of Medicine, New Haven, CT, 06510, USA. vahid.mohsenin@yale.edu. ·Sleep Breath · Pubmed #27154628.

ABSTRACT: PURPOSE: The aim of this review is to discuss hypoxia-induced pulmonary hypertension (PH) and the role of microRNAs (miRNAs). BACKGROUND: Acute global hypoxia causes pulmonary vasoconstriction and increased pulmonary arterial blood pressure. Chronic exposure to sustained or intermittent hypoxia as in high altitude residents, chronic obstructive lung disease and sleep-disordered breathing can lead to pulmonary hypertension (PH) and right ventricular dysfunction. The development of PH is a poor prognostic sign in these patients that affects both quality of life and mortality. The mechanism of PH due to hypoxia has not been fully established. However, its pathophenotype is similar to idiopathic pulmonary arterial hypertension in the form of vascular cell proliferation and aberrant vascular remodeling. MicroRNAs (miRNAs) are small non-coding RNA molecules that negatively regulate gene expression, therefore potentially regulating a host of cellular signaling pathways. Several miRNAs have been identified to be involved in hypoxia models of PH in animals, in patients with PH, congestive heart failure and myocardial infarction. RESULTS: MiRNAs have been mechanistically linked to the control of a wide range of cellular responses-hypoxia, TGF-β signaling and inflammatory pathways-known to influence normal developmental physiology as well as regulating pulmonary arterial smooth muscle cell and endothelial cell phenotypes and their influence on pulmonary remodeling in the setting of hypoxia and pulmonary arterial hypertension (PAH). The blood levels of these miRNAs correlate with disease severity and prognosis. CONCLUSIONS: Research on the role of these potential biomarkers will provide insight into the pathogenesis of PH and right heart failure and opportunities in therapeutics.

12 Review Reducing cardiovascular risk through treatment of obstructive sleep apnea: 2 methodological approaches. 2016

Yaggi, Henry Klar / Mittleman, Murray A / Bravata, Dawn M / Concato, John / Ware, James / Stoney, Catherine M / Redline, Susan. ·Department of Medicine, Yale School of Medicine, New Haven, CT; VA Clinical Epidemiology Research Center, VA Connecticut HCS, West Haven, CT. Electronic address: henry.yaggi@yale.edu. · Department of Medicine, Beth Israel Deaconess, Harvard Medical School, Boston, MA; Department of Epidemiology, Harvard School of Public Health, Boston, MA. · VA Center of Excellence on Implementing Evidence-Based Practice, Richard L. Roudebush VA Medical Center, Indianapolis, IN; Department of Medicine, Indiana School of Medicine, Indianapolis, IN; Department of Neurology, Indiana University School of Medicine, Indianapolis, IN. · Department of Medicine, Yale School of Medicine, New Haven, CT; VA Clinical Epidemiology Research Center, VA Connecticut HCS, West Haven, CT. · Department of Biostatistics, Harvard School of Public Health, Boston, MA. · National Heart, Lung, and Blood Institute, NIH, Bethesda, MD. · Department of Medicine, Harvard Medical School, Boston, MA; Division of Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA. ·Am Heart J · Pubmed #26856225.

ABSTRACT: Obstructive sleep apnea (OSA) significantly impacts cardiovascular health, demonstrated by observational investigations showing an independently increased risk of ischemic heart disease, diabetes, hypertension, congestive heart failure, acute coronary syndrome, stroke, cardiovascular mortality, and all-cause mortality. Positive airway pressure (PAP), a medical therapy for sleep apnea, reverses airway obstruction and may help reduce cardiovascular risk. Prior to planning large phase III randomized controlled trials to test the impact of PAP on cardiovascular outcomes, several gaps in knowledge need to be addressed. This article describes 2 independent studies that worked collaboratively to fill these gaps. The populations, design features, and relative benefits/challenges of the 2 studies (SleepTight and BestAIR) are described. Both studies were encouraged to have multidisciplinary teams with expertise in behavioral interventions to improve PAP compliance. Both studies provide key information that will be useful to the research community in future large-scale, event-driven, randomized trials to evaluate the efficacy and/or effectiveness of strategies to identify and treat significant OSA for decreasing risk of major adverse cardiovascular events in high-risk patients.

13 Review Excessive Daytime Sleepiness in Stroke Survivors: An Integrative Review. 2016

Ding, Qinglan / Whittemore, Robin / Redeker, Nancy. ·School of Nursing, Yale University, West Haven, CT, USA qinglan.ding@yale.edu. · School of Nursing, Yale University, West Haven, CT, USA. ·Biol Res Nurs · Pubmed #26792913.

ABSTRACT: Excessive daytime sleepiness (EDS) is a prevalent symptom among stroke survivors. This symptom is an independent risk factor for stroke and may reduce stroke survivors' quality of life, cognitive functioning, and daytime functional performance. The lack of a universally accepted definition of EDS makes it difficult to measure EDS and synthesize research. The purpose of this integrative review is to describe poststroke EDS, ascertain conceptual and operational definitions of EDS, identify factors that contribute to EDS in stroke survivors, and explore outcomes associated with EDS in stroke survivors. We searched the following databases: PubMed and MEDLINE (OvidSP 1946-April; Week 2, 2015), Embase (OvidSP 1974-March; Week 1, 2015), and PsycINFO (OvidSP 1967-April; Week 2, 2015). Our search yielded 340 articles, 27 of which met inclusion criteria. The literature reveals EDS to be a multidimensional construct that is operationalized with both subjective and objective measures. Choosing measures that can quantify both the objective and subjective components is useful for gaining a comprehensive understanding of EDS. The antecedents of EDS are stroke, sleep-disordered breathing, reversed Robin Hood syndrome, and depression. The outcomes associated with EDS in stroke patients are serious and negative. Via synthesis of this research, we propose a possible framework for poststroke EDS, which may be of use in clinical practice and in research to identify valid quantifying methods for EDS as well as to prevent harmful outcomes in stroke survivors.

14 Review The use of positive airway pressure therapy for treatment of resistant hypertension. 2016

Won, Christine / Guilleminault, Christian. ·a Department of Psychiatry, School of Medicine , Yale University, Section of Pulmonary, Critical Care, and Sleep Medicine , New Haven , USA. · b Department of Psychiatry, School of Medicine , Stanford University , Redwood City , CA , USA. ·Expert Rev Cardiovasc Ther · Pubmed #26671301.

ABSTRACT: It is well accepted that obstructive sleep apnea (OSA) is a risk factor for hypertension. In the subgroup of patients with resistant hypertension (rHTN), OSA appears to be particularly rampant; suggesting sleep disordered breathing may contribute to pathological mechanisms that make blood pressure difficult to control. This article explores potential mechanisms by which sleep apnea contributes to rHTN, and examines the impact of treating OSA with positive airway pressure therapy on blood pressure control. In recent years, there has been a surge of interest in randomized controlled trials of positive airway pressure therapy in patients with OSA and rHTN, because patients with rHTN respond poorly to medications. As a result, identifying novel targets for blood pressure control in this high-risk population has become paramount.

15 Review Obstructive sleep apnea: a new preventive and therapeutic target for stroke: a new kid on the block. 2015

Mohsenin, Vahid. ·Section of Pulmonary, Critical Care and Sleep Medicine, Yale University School of Medicine, New Haven, Conn. Electronic address: vahid.mohsenin@yale.edu. ·Am J Med · Pubmed #25731137.

ABSTRACT: Stroke is the second leading cause of death worldwide and a major cause of mental and physical impairment. Numerous studies have identified risk factors for stroke, including hypertension, atrial fibrillation, diabetes, and smoking. However, even after considering these well-recognized risk factors, there is substantial variation in stroke rates and stroke-related outcomes. There is emerging evidence that obstructive sleep apnea increases the risk of stroke independently of traditional risk factors. Obstructive sleep apnea is present in the majority of patients with stroke and contributes to persistent neurologic impairment. Early recognition and treatment of obstructive sleep apnea during the post-stroke period lead to better neurologic outcome. Healthcare providers should be aware of the strong association of obstructive sleep apnea as a risk factor for stroke and its effect on neurologic recovery. The presence of hypertension and diabetes-the 2 most common comorbid conditions in obstructive sleep apnea-should prompt diagnostic workup for and treatment of obstructive sleep apnea as a way of primary and secondary prevention of stroke.

16 Review Sleep and sleep disordered breathing in hospitalized patients. 2014

Knauert, Melissa P / Malik, Vipin / Kamdar, Biren B. ·Section of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut. · Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, National Jewish Health, University of Colorado, Denver, Colorado. · Division of Pulmonary and Critical Care Medicine, David Geffen School of Medicine at University of California, Los Angeles, California. ·Semin Respir Crit Care Med · Pubmed #25353103.

ABSTRACT: Sleep is a fundamental physiological process necessary for recovery from acute illness. Unfortunately for hospitalized patients, sleep is often short, fragmented, and poor in quality, and may be associated with adverse outcomes including inpatient delirium. Many factors contribute to poor sleep in the hospital setting, including preexisting sleep deprivation, sleep disordered breathing, environmental noise and light, patient care activities, and medications. Sleep disordered breathing increases the risk of potentially life-threatening cardiovascular, respiratory, and metabolic consequences, and therefore should be diagnosed and treated in hospitalized patients. Mitigating the sequelae associated with poor sleep quality and sleep disordered breathing requires early identification of modifiable factors impacting a patient's sleep, including engagement of a multidisciplinary team. In this article, we review the current knowledge of sleep in hospitalized patients with a detailed focus on patients with sleep disordered breathing.

17 Review Sleep in patients with restrictive lung disease. 2014

Won, Christine H J / Kryger, Meir. ·Section of Pulmonary, Critical Care and Sleep Medicine, Yale University School of Medicine, PO BOX 208057, 333 Cedar Street, New Haven, CT 06520-8057, USA. Electronic address: christine.won@yale.edu. · Section of Pulmonary, Critical Care and Sleep Medicine, Yale University School of Medicine, PO BOX 208057, 333 Cedar Street, New Haven, CT 06520-8057, USA. ·Clin Chest Med · Pubmed #25156766.

ABSTRACT: Restrictive lung disease leads to ventilatory defects and diffusion impairments. These changes may contribute to abnormal nocturnal pathophysiology, including sleep architecture disruption and impaired ventilation and oxygenation. Patients with restrictive lung disease may suffer significant daytime fatigue and dysfunction. Hypercarbia and hypoxemia during sleep may impact progression of lung disease and related symptoms. Little is known about the impact of treatment of sleep disruption on sleep quality and overall prognosis in restrictive lung disease. This review discusses the pathophysiology of sleep and comorbid sleep disorders in restrictive lung diseases including interstitial lung disease, neuromuscular disease, and obesity hypoventilation syndrome.

18 Review Sleep in asthma. 2014

Khan, Wajahat H / Mohsenin, Vahid / D'Ambrosio, Carolyn M. ·Department of Sleep Medicine, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA. · Department of Pulmonary and Critical Care Medicine, Yale Center for Sleep Disorders, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06520, USA. · Department of Pulmonary, Critical Care and Sleep Medicine, The Center for Sleep Medicine, Tufts Medical Center, Tufts University School of Medicine, 800 Washington Street, Boston, MA 02111, USA. Electronic address: cdambrosio@tuftsmedicalcenter.org. ·Clin Chest Med · Pubmed #25156764.

ABSTRACT: Many patients with asthma experience worsening of symptoms at night. Understanding the mechanism of nocturnal asthma and the factors that exacerbate asthma during sleep would lead to better management of the condition.

19 Review Obstructive sleep apnea and hypertension: a critical review. 2014

Mohsenin, Vahid. ·Section of Pulmonary, Critical Care and Sleep Medicine, Yale University, P.O. Box 208057, LLCI 106, 15 York Street, New Haven, CT, 06510, USA, Vahid.mohsenin@yale.edu. ·Curr Hypertens Rep · Pubmed #25139780.

ABSTRACT: Obstructive sleep apnea (OSA) is a prevalent sleep disorder which is characterized by recurrent upper closure with oxygen desaturation and sleep disruption. OSA increases the risk of vascular disorders in the form of stroke, myocardial infarction, congestive heart failure, and hypertension. The mechanisms underlying the vascular disorders are several and include intermittent hypoxia with release of cytokines, angiogenic inhibitors, free radicals, and adhesion molecules. During apneas, arterial blood pressure gradually rises and surges abruptly after the termination of apnea. Two thirds of patients with OSA will ultimately have diurnal hypertension. This review discusses the literature supporting the significant role of OSA in hypertension and the effect of OSA treatment on blood pressure.

20 Review Clinical consequences of altered chemoreflex control. 2013

Plataki, Maria / Sands, Scott A / Malhotra, Atul. ·Department of Internal Medicine, Bridgeport Hospital, Yale New Haven Health, Bridgeport, CT, USA. ·Respir Physiol Neurobiol · Pubmed #23681082.

ABSTRACT: Control of ventilation dictates various breathing patterns. The respiratory control system consists of a central pattern generator and several feedback mechanisms that act to maintain ventilation at optimal levels. The concept of loop gain has been employed to describe its stability and variability. Synthesizing all interactions under a general model that could account for every behavior has been challenging. Recent insight into the importance of these feedback systems may unveil therapeutic strategies for common ventilatory disturbances. In this review we will address the major mechanisms that have been proposed as mediators of some of the breathing patterns in health and disease that have raised controversies and discussion on ventilatory control over the years.

21 Review Restless legs syndrome: impact on sleep-related breathing disorders. 2013

Roux, Francoise J. ·Section of Pulmonary and Critical Care Medicine and Yale Center of Sleep Medicine, Yale University School of Medicine, New Haven, Connecticut 06520-8057, USA. francoise.roux@yale.edu ·Respirology · Pubmed #22882720.

ABSTRACT: Restless legs syndrome (RLS) is a common chronic sensory-motor neurological disorder that remains a clinical diagnosis. Most RLS patients present with sleep complaints in the form of initiation and/or maintenance insomnia as RLS has a circadian rhythmicity. An increased number of periodic leg movements during sleep (PLMS) is a supportive criterion in the diagnosis of RLS. Abnormalities in the central dopaminergic and iron systems are involved in the physiopathology of RLS. There is a higher prevalence of RLS and PLMS in sleep-disordered breathing patients, particularly those with obstructive sleep apnoea (OSA), the most common sleep disorder in western societies. The complex mechanisms underlying the association between OSA, RLS and PLMS remain unclear. Untreated OSA can lead to adverse cardiovascular consequences due to cardio-metabolic dysfunction. It remains controversial whether RLS could further adversely impact the cardiovascular consequences of OSA. The PLMS do not have an additive effect on the hypersomnia experienced by some sleep-disordered breathing patients. Continuous positive airway pressure (CPAP) therapy is the most effective therapy for OSA. The presence of PLMS during CPAP treatment could be a marker of an incomplete resolution of sleep-disordered breathing in the form of increased upper airway resistance syndrome, despite treatment. Dopaminergic agonists are the preferred agent for the treatment of RLS, and are indicated when RLS symptoms are frequent and affect quality of life. PLMS and RLS do not seem to contribute to the residual hypersomnia that can be observed in some sleep-disordered breathing patients despite adequate compliance and effective CPAP therapy.

22 Review Implications of OSA on Work and Work Disability Including Drivers. 2012

Teng, Ann Y / Won, Christine. ·Occupational Environmental Medicine, Yale School of Medicine, 135 College Street, 3rd Floor, New Haven, CT 06515, USA. ann.teng@yale.edu ·Clin Chest Med · Pubmed #23153612.

ABSTRACT: This article illustrates the impact of obstructive sleep apnea (OSA) on the work force and emphasizes that there are public health risks and significant societal financial losses in untreated OSA. Specifics of OSA impact on individuals are discussed with regard to veterans, first responders, farmers, and pilots, specially focusing on commercial vehicle drivers. The pathophysiology of OSA and the consequence of impairment and disability due to OSA on work capacity are introduced. Federal guidelines for occupational-specific recommendations are presented. The health care provider's role in identifying and incorporating effective screening and treatment strategies for workers with sleep apnea is emphasized.

23 Review Sleep-disordered breathing in pregnancy. 2011

Bourjeily, Ghada / Ankner, Gina / Mohsenin, Vahid. ·Pulmonary and Critical Care Medicine, Department of Medicine, Women and Infants Hospital of Rhode Island, The Warren Alpert Medical School of Brown University, 100 Dudley Street, Suite 1100, Providence, RI 02905, USA. Electronic address: GBourjeily@wihri.org. · Department of Medicine, Women and Infants Hospital of Rhode Island, 100 Dudley Street, Suite 1100, Providence, RI 02905, USA. · Yale Center for Sleep Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06520, USA. ·Clin Chest Med · Pubmed #21277458.

ABSTRACT: Symptoms of sleep-disordered breathing are more common in pregnant women compared with nonpregnant women. It is likely that physiology of pregnancy predisposes to the development or worsening of sleep-disordered breathing, but some physiologic changes may also be protective against the development of this disease. Clinical presentation may be less predictive of sleep disordered breathing in pregnancy than in the non-pregnant population; nonetheless, snoring is associated with adverse pregnancy outcomes. Treatment strategies are similar to the nonpregnant population, however, pregnancy-specific scenarios may arise and these subtleties are addressed in this review.

24 Review Tonsillectomy and adenoidectomy and myringotomy with tube insertion. 2010

Baum, Eric D. ·Department of Surgery-Otolaryngology, Yale University School of Medicine, New Haven, CT, USA. ·Pediatr Rev · Pubmed #20889736.

ABSTRACT: -- No abstract --

25 Review Polysomnography. 2010

Jafari, Behrouz / Mohsenin, Vahid. ·Section of Pulmonary, Critical Care and Sleep Medicine, Yale Center for Sleep Medicine, Yale University School of Medicine, New Haven, CT, USA. ·Clin Chest Med · Pubmed #20488287.

ABSTRACT: Polysomnography (PSG) is an essential tool for diagnosis of a variety of sleep disorders. The results of PSG should be interpreted in the context of a patient's history and medications and observation in the sleep laboratory. As new technologies evolve, it is expected that the field will evolve. Further work is needed to determine if computerized scoring, with or without human revision, may reliably replace visual scoring in normal and abnormal sleep. Improved techniques to measure and quantify sleep itself will allow for more meaningful assessment of sleep disruption that can lead to the recognition of new disorders and better predictions of the outcomes of these disorders.

Next