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Sleep Apnea Syndromes: HELP
Articles from Grenoble
Based on 173 articles published since 2008
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These are the 173 published articles about Sleep Apnea Syndromes that originated from Grenoble during 2008-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7
1 Guideline [Mandibular advancement device for obstructive sleep apnea treatment in adults. July 2014]. 2016

Bettega, G / Breton, P / Goudot, P / Saint-Pierre, F / Anonymous4070867. ·Service de chirurgie maxillo-faciale et chirurgie plastique, hôpital A.-Michallon, BP 217, 38043 Grenoble cedex 9, France. Electronic address: GBettega@chu-grenoble.fr. · Service de stomatologie, chirurgie maxillofaciale et chirurgie plastique de la face, centre hospitalier Lyon-Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France. · Service de stomatologie et chirurgie maxillo-faciale, hôpital Pitié-Salpêtrière (AP-HP), 47-83, boulevard de l'Hôpital, 75013 Paris, France. · 32, avenue du Pdt Wilson, 75116 Paris, France. ·Rev Mal Respir · Pubmed #27160831.

ABSTRACT: -- No abstract --

2 Guideline [Mandibular advancement device for obstructive sleep apnea treatment in adults. July 2014]. 2015

Bettega, G / Breton, P / Goudot, P / Saint-Pierre, F / Anonymous450818 / Anonymous460818 / Anonymous470818 / Anonymous480818 / Anonymous490818 / Anonymous500818 / Anonymous510818 / Anonymous520818 / Anonymous530818. ·Service de chirurgie maxillo-faciale et chirurgie plastique, hôpital A.-Michallon, BP 217, 38043 Grenoble cedex 9, France. Electronic address: GBettega@chu-grenoble.fr. · Service de stomatologie, chirurgie maxillofaciale et chirurgie plastique de la face, centre hospitalier Lyon-Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France. · Service de stomatologie et chirurgie maxillo-faciale, hôpital Pitié-Salpêtrière (AP-HP), 47-83, boulevard de l'Hôpital, 75013 Paris, France. · 32, avenue du Pdt Wilson, 75116 Paris, France. ·Rev Stomatol Chir Maxillofac Chir Orale · Pubmed #25593082.

ABSTRACT: -- No abstract --

3 Editorial Physical activity: the key to cardiometabolic risk reduction in obstructive sleep apnoea. 2018

Mendelson, Monique / Flore, Patrice. ·Université Grenoble Alpes, Inserm, CHU Grenoble Alpes, HP2, Grenoble, France. ·Eur Respir J · Pubmed #30305333.

ABSTRACT: -- No abstract --

4 Editorial Incorporating polysomnography into obstructive sleep apnoea phenotyping: moving towards personalised medicine for OSA. 2018

Pépin, Jean Louis / Bailly, Sebastien / Tamisier, Renaud. ·Institut National de la Santé et de la Recherche Médicale (INSERM), U 1042, HP2 Laboratory (Hypoxia: Pathophysiology), University of Grenoble-Alpes, Grenoble, France. · Thorax and Vessels Division, Grenoble University Hospital, Grenoble, France. ·Thorax · Pubmed #29477990.

ABSTRACT: -- No abstract --

5 Editorial NERO: a pilot study but important step towards comprehensive management of obesity hypoventilation syndrome. 2018

Borel, Jean-Christian / Borel, Anne Laure / Piper, Amanda J. ·HP2 laboratory (INSERM U1042), Universite Grenoble Alpes, Grenoble, France. · Research and Development Department, AGIRà dom, Non Profit Home Care Provider, Meylan, France. · Diabetologia and Nutrition Department, Grenoble University Hospital, Grenoble, France. · Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia. ·Thorax · Pubmed #29074813.

ABSTRACT: -- No abstract --

6 Editorial Management of hypertension in obstructive sleep apnoea: predicting blood pressure reduction under continuous positive airway pressure. 2017

Tamisier, Renaud / Lévy, Patrick. ·Univ. Grenoble Alpes, Inserm, HP2 Laboratory, Grenoble, France. · Sleep Laboratory, Thorax and Vessels Dept, Grenoble Alpes University Hospital, Grenoble, France. · Univ. Grenoble Alpes, Inserm, HP2 Laboratory, Grenoble, France PLevy@chu-grenoble.fr. ·Eur Respir J · Pubmed #28982770.

ABSTRACT: -- No abstract --

7 Editorial [Obstructive sleep apnea: Time to design new clinical pathways and develop personalized medicine]. 2017

Pépin, Jean-Louis. ·CHU de Grenoble, clinique de physiologie, sommeil et exercice, pôle thorax et vaisseaux, BP 217X, 38043 Grenoble cedex 09, France; Université Grenoble Alpes, laboratoire HP2, Inserm U1042, France. Electronic address: jpepin@chu-grenoble.fr. ·Presse Med · Pubmed #28550932.

ABSTRACT: -- No abstract --

8 Editorial Obstructive sleep apnoea in acute coronary syndrome: the invisible threat? 2017

Arzt, Michael / Hetzenecker, Andrea / Lévy, Patrick. ·Centre of Sleep Medicine, Dept of Internal Medicine II, University Medical Centre Regensburg, Regensburg, Germany Michael.arzt@ukr.de. · Centre for Pneumology, Donaustauf Hospital, Donaustauf, Germany. · Univ. Grenoble Alpes, INSERM, Grenoble Alpes University Hospital, HP2 Laboratory and Sleep Laboratory, Grenoble, France. ·Eur Respir J · Pubmed #28298406.

ABSTRACT: -- No abstract --

9 Editorial Do patients with obstructive sleep apnoea deserve new dedicated antihypertensive strategies? 2017

Tamisier, Renaud / Lévy, Patrick / Pépin, Jean-Louis. ·HP2 Laboratory, Inserm, Univ. Grenoble Alpes, Grenoble, France. · Pôle Thorax et Vaisseaux, Grenoble Alpes University Hospital, Grenoble, France. ·Thorax · Pubmed #28265033.

ABSTRACT: -- No abstract --

10 Editorial Sleep apnoea and pulmonary hypertension in high-altitude dwellers: more than an association? 2017

Scherrer, Urs / Verges, Samuel. ·Dept of Cardiology, University Hospital Bern, Bern, Switzerland. · Dept of Clinical Research, University of Bern, Bern, Switzerland. · Departamento de Biología, Facultad de Ciencias, Universidad de Tarapacá, Arica, Chile. · Laboratoire HP2, Université Grenoble Alpes, Grenoble, France urs.scherrer2@insel.ch. · Unité 1042, Institut National de la Santé et de la Recherche Médicale (INSERM), Grenoble, France. ·Eur Respir J · Pubmed #28153872.

ABSTRACT: -- No abstract --

11 Editorial Focus on prevention and treatment of obstructive sleep disordered breathing in childhood. 2015

Kaditis, Athanasios / Lévy, Patrick. ·Pediatric Pulmonology Unit, First Dept of Paediatrics, University of Athens School of Medicine and Aghia Sophia Children's Hospital, Athens, Greece kaditia@hotmail.com. · HP2 Laboratory, University Grenoble Alpes, Grenoble, France HP2 Laboratory U1042, INSERM, Grenoble, France. ·Eur Respir J · Pubmed #26324693.

ABSTRACT: -- No abstract --

12 Editorial Obstructive sleep apnoea and cardiovascular calcification. 2015

Bäck, Magnus / Stanke-Labesque, Françoise. ·Translational Cardiology, Karolinska Institutet, Stockholm, Sweden Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden. · Université Grenoble Alpes, Grenoble, France INSERM U1042, HP2,Grenoble, France Department of Pharmacology, CHU, Grenoble, France. ·Thorax · Pubmed #26272928.

ABSTRACT: -- No abstract --

13 Editorial New insights in the pathophysiology of chronic intermittent hypoxia-induced NASH: the role of gut-liver axis impairment. 2015

Aron-Wisnewsky, Judith / Pepin, Jean-Louis. ·Institute of Cardiometabolism and Nutrition (ICAN), Assistance Pitié-Salpêtrière Hospital, Paris, France Sorbonne Universités, Université Pierre et Marie Curie-Paris 6, Paris, France INSERM, UMR_S U1166, Paris, France. · Institut national de la santé et de la recherche médicale (INSERM), U 1042, HP2 Laboratory (Hypoxia: Pathophysiology), University of Grenoble-Alpes, Grenoble, France Thorax and Vessels Division, Grenoble University Hospital, Grenoble, France. ·Thorax · Pubmed #26082141.

ABSTRACT: -- No abstract --

14 Editorial Inflammation in sleep debt and sleep disorders. 2015

Kheirandish-Gozal, Leila / Gozal, David / Pépin, Jean-Louis. ·Section of Pediatric Sleep Medicine, Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, Chicago, IL 60637, USA. · INSERM U 1042, HP2 Laboratory, Faculté de Médecine, Université Grenoble Alpes, 38042 Grenoble, France ; CHU and Hôpital A. Michallon, Pôle Thorax et Vaisseaux, 38043 Grenoble, France. ·Mediators Inflamm · Pubmed #25883415.

ABSTRACT: -- No abstract --

15 Editorial Erectile dysfunction and obstructive sleep apnea: from mechanisms to a distinct phenotype and combined therapeutic strategies. 2015

Pépin, Jean-Louis / Tamisier, Renaud / Godin-Ribuot, Diane / Lévy, Patrick A. ·INSERM U 1042, HP2 Laboratory, Université Grenoble-Alpes, Faculté de Médecine, Grenoble F-38042, France; CHU, Hôpital A. Michallon, Pôle Thorax et Vaisseaux, Grenoble F-38043, France. ·Sleep Med Rev · Pubmed #25613436.

ABSTRACT: -- No abstract --

16 Editorial Is CPAP effective in reducing blood pressure in minimally symptomatic obstructive sleep apnoea? 2014

Pépin, Jean-Louis / Timsit, Jean-François / Tamisier, Renaud / Lévy, Patrick. ·INSERM U 1042, Laboratoire HP2 Grenoble, Faculté de Médecine, Université Grenoble Alpes, Grenoble, France Laboratoire EFCR et Sommeil, Pôle Thorax et Vaisseaux, CHU de Grenoble, Grenoble, France. · IAME UMR 1137 INSERM, University Paris Diderot, Paris, France. ·Thorax · Pubmed #25084789.

ABSTRACT: -- No abstract --

17 Editorial Sleep apnoea and cancer: the new challenge. 2014

Lévy, Patrick / Godin-Ribuot, Diane / Pepin, Jean-Louis. ·Univ Grenoble Alpes, HP2 Laboratory, Grenoble, France INSERM, HP2 Laboratory U1042, Grenoble, France University Hospital, CHU Grenoble, Physiology Department, Grenoble, France PLevy@chu-grenoble.fr. · Univ Grenoble Alpes, HP2 Laboratory, Grenoble, France INSERM, HP2 Laboratory U1042, Grenoble, France. · Univ Grenoble Alpes, HP2 Laboratory, Grenoble, France INSERM, HP2 Laboratory U1042, Grenoble, France University Hospital, CHU Grenoble, Physiology Department, Grenoble, France. ·Eur Respir J · Pubmed #24881059.

ABSTRACT: -- No abstract --

18 Review Assessment and interpretation of sleep disordered breathing severity in cardiology: Clinical implications and perspectives. 2018

Linz, Dominik / Baumert, Mathias / Catcheside, Peter / Floras, John / Sanders, Prashanthan / Lévy, Patrick / Cowie, Martin R / Doug McEvoy, R. ·Centre for Heart Rhythm Disorders (CHRD), South Australian Health and Medical Research Institute (SAHMRI), University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia. Electronic address: dominik.linz@adelaide.edu.au. · University of Adelaide, School of Electrical and Electronic Engineering, Adelaide, Australia. · Adelaide Institute for Sleep Health (AISH) and the School of Medicine, College of Medicine & Public Health, Flinders University, and Sleep Health Service, Respiratory and Sleep Services, Southern Adelaide Local Health Network, Adelaide, Australia. · University Health Network and Sinai Health System Division of Cardiology, University of Toronto, Toronto, Ontario, Canada. · Centre for Heart Rhythm Disorders (CHRD), South Australian Health and Medical Research Institute (SAHMRI), University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia. · Univ. Grenoble Alpes, Inserm, CHU Grenoble Alpes, HP2 and Sleep Lab, Grenoble, France. · National Heart and Lung Institute, Imperial College London (Royal Brompton Hospital), London, England, UK. ·Int J Cardiol · Pubmed #30049491.

ABSTRACT: Sleep disordered breathing (SDB) is highly prevalent in patients with atrial fibrillation, heart failure and hypertension and is associated with increased risk of mortality, cardiovascular (CV) events and arrhythmias. Current assessment of the severity of SDB is mainly based on the apnea-hypopnea index (AHI) representing the number of hypopneas and apneas per hour of sleep. However, this event-based parameter alone may not sufficiently reflect the complex pathophysiological mechanisms underlying SDB potentially contributing to CV outcome risk. In this review article, we highlight important limitations and pitfalls of current assessment, quantification and interpretation of SDB-severity in patients with CV disease and will discuss pathophysiological considerations from preclinical and clinical mechanistic studies and possible clinical implications.

19 Review Sleep biology updates: Hemodynamic and autonomic control in sleep disorders. 2018

Tamisier, Renaud / Weiss, J Woodrow / Pépin, Jean Louis. ·University Grenoble Alpes, HP2, Inserm 1042, Grenoble F-38042, France; Physiology Sleep and Exercise Clinic, Thorax and Vessel division, Grenoble Alpes hospital, Grenoble 38043, France. Electronic address: rtamisier@chu-grenoble.fr. · Pulmonary Physiology Laboratory, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, United States. · University Grenoble Alpes, HP2, Inserm 1042, Grenoble F-38042, France; Physiology Sleep and Exercise Clinic, Thorax and Vessel division, Grenoble Alpes hospital, Grenoble 38043, France. ·Metabolism · Pubmed #29572132.

ABSTRACT: Sleep disorders like obstructive sleep apnea syndrome, periodic limb movements in sleep syndrome, insomnia and narcolepsy-cataplexy are all associated with an increased risk of cardiovascular diseases. These disorders share an impaired autonomic nervous system regulation that leads to increased cardiovascular sympathetic tone. This increased cardiovascular sympathetic tone is, in turn, likely to play a major role in the increased risk of cardiovascular disease. Different stimuli, such as intermittent hypoxia, sleep fragmentation, decrease in sleep duration, increased respiratory effort, and transient hypercapnia may all initiate the pathophysiological cascade leading to sympathetic overactivity and some or all of these are encountered in these different sleep disorders. In this manuscript, we outline the different pathways leading to sympathetic over-activity in different sleep conditions. This augmented sympathetic tone is likely to play an important role in the development of cardiovascular disease in patients with sleep disorders, and it is further hypothesized to that sympathoexcitation contributes to the metabolic dysregulation associated with these sleep disorders.

20 Review Which place of pharmacological approaches beyond continuous positive airway pressure to treat vascular disease related to obstructive sleep apnea? 2018

Gautier-Veyret, Elodie / Pépin, Jean-Louis / Stanke-Labesque, Françoise. ·Univ. Grenoble Alpes, HP2, F-38041 Grenoble, France; INSERM U1042, 38041 Grenoble, France; Centre hospitalier Universitaire Grenoble Alpes, 38043 Grenoble, France. ·Pharmacol Ther · Pubmed #29277633.

ABSTRACT: Obstructive sleep apnea (OSA) is characterized by recurrent episodes of partial or complete upper airway obstruction, occurring during sleep, leading to chronic intermittent hypoxia (IH), which harms the cardiovascular system. OSA is associated with both functional and structural vascular alterations that contribute to an increased prevalence of fatal and non-fatal cardiovascular events. OSA is a heterogeneous disease with respect to the severity of hypoxia, the presence of daytime symptoms, obesity, and cardiovascular comorbidities. Various clusters of OSA phenotypes have been described leading to more highly personalized treatment. The aim of this review is to describe the various therapeutic strategies including continuous positive airway pressure (CPAP), oral appliances, surgery, weight loss, and especially pharmacological interventions that have been evaluated to reduce vascular alterations in both OSA patients and preclinical animal models. Conventional therapies, predominantly CPAP, have a limited impact on vascular alterations in the presence of co-morbidities. A better knowledge of pharmacological therapies targeting IH-induced vascular alterations will facilitate the use of combined therapies and is crucial for designing clinical trials in well-defined OSA phenotypes.

21 Review Anesthesia and sleep apnea. 2018

Tamisier, Renaud / Fabre, Fanny / O'Donoghue, Fergal / Lévy, Patrick / Payen, Jean-François / Pépin, Jean-Louis. ·Laboratoire HP2, Inserm 1042, Universitée Grenoble Alpes, Grenoble F-38042, France; Laboratoire EFCR et Sommeil, Pôle Thorax et Vaisseaux, Grenoble Alpes University Hospital, Grenoble 38043, France. Electronic address: rtamisier@chu-grenoble.fr. · Pôle Anesthésie-réanimation - Hôpital Michallon, Grenoble Alpes University Hospital, Grenoble F-38000, France. · Laboratoire HP2, Inserm 1042, Universitée Grenoble Alpes, Grenoble F-38042, France; Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria 3084, Australia; The University of Melbourne, Parkville, Victoria 3010, Australia. · Laboratoire HP2, Inserm 1042, Universitée Grenoble Alpes, Grenoble F-38042, France; Laboratoire EFCR et Sommeil, Pôle Thorax et Vaisseaux, Grenoble Alpes University Hospital, Grenoble 38043, France. · Pôle Anesthésie-réanimation - Hôpital Michallon, Grenoble Alpes University Hospital, Grenoble F-38000, France; Grenoble Institut des Neurosciences, Univ. Grenoble Alpes, F-38000 Grenoble, France; INSERM, U1216, F-38000 Grenoble, France. ·Sleep Med Rev · Pubmed #29174558.

ABSTRACT: Due to its low rate of diagnosis, in the general population over half of those experiencing obstructive sleep apnea (OSA) are unaware that they have the condition. However, any acute medical event may exacerbate OSA and could have serious health consequences. In this context the management of the perioperative period, from anesthesia through the surgery itself and into the postoperative period, is more problematic for patients with sleep disordered breathing than for others. There is prolific literature in this area although large randomized trials are few due to the high sample size needed and possible ethical difficulties of withholding OSA treatment in the perioperative period. In 2014 the American Society of Anesthesiologists published an updated set of recommendations to guide OSA management during the perioperative period. In this present review we provide an overview of the different issues that practitioners face with regard to OSA, from the initial consultation with the anesthesiologist to the extended post-operative period. There is considerable evidence that OSA patients are at high risk of perioperative complications, though the inherent risks from OSA per se and its comorbidities remain difficult to discern. Nevertheless, appropriate screening and management allow clinicians to minimize OSA associated risk.

22 Review Diseases of the retina and the optic nerve associated with obstructive sleep apnea. 2018

Mentek, Marielle / Aptel, Florent / Godin-Ribuot, Diane / Tamisier, Renaud / Pepin, Jean-Louis / Chiquet, Christophe. ·Grenoble Alpes University, HP2 Laboratory, INSERM U1042, Grenoble, France. · Grenoble Alpes University, HP2 Laboratory, INSERM U1042, Grenoble, France; Department of Ophthalmology, University Hospital of Grenoble, Grenoble, France. · Grenoble Alpes University, HP2 Laboratory, INSERM U1042, Grenoble, France; Pôle Thorax et Vaisseaux, University Hospital of Grenoble, Grenoble, France. · Grenoble Alpes University, HP2 Laboratory, INSERM U1042, Grenoble, France; Department of Ophthalmology, University Hospital of Grenoble, Grenoble, France. Electronic address: christophe.chiquet@inserm.fr. ·Sleep Med Rev · Pubmed #29107469.

ABSTRACT: Many associations between ocular disorders and obstructive sleep apnea (OSA) have been studied, such as nonarteritic anterior ischemic optic neuropathy, glaucoma, papilledema, retinal vein occlusion, eyelid hyperlaxity, lower-eyelid ectropion and recurrent corneal erosions. The objective of this review is to synthetize the possible vascular disorders of the retina and the optic nerve associated with sleep apnea patients and to discuss the underlying pathophysiological hypotheses. Main mechanisms involved in the ocular complications of OSA are related to intermittent hypoxia, sympathetic system activation, oxidant stress, and deleterious effects of endothelin 1. The main evidence-based medicine data suggest that OSA should be screened in patients with ischemic optic neuropathy and diabetic retinopathy. The effect of OSA treatment and emerging therapies are discussed.

23 Review Does remote monitoring change OSA management and CPAP adherence? 2017

Pépin, Jean L / Tamisier, Renaud / Hwang, Dennis / Mereddy, Suresh / Parthasarathy, Sairam. ·Laboratory for Hypoxia and Pathophysiology, University of Grenoble Alpes, Grenoble, France. · Inserm U1042 and Pole Thorax and Vaisseaux, Grenoble Alps University Hospital, Grenoble, France. · Sleep Medicine, Southern California Permanente Medical Group, Kaiser Permanente Fontana Sleep Disorders Center, Fontana, California, USA. · Department of Medicine, University of Arizona, Tucson, Arizona, USA. · University of Arizona Health Sciences, Center for Sleep and Circadian Sciences, University of Arizona, Tucson, Arizona, USA. ·Respirology · Pubmed #29024308.

ABSTRACT: It is increasingly recognized that the high prevalence of obstructive sleep apnoea (OSA), and its associated cardio-metabolic morbidities make OSA a burden for society. Continuous positive airway pressure (CPAP), the gold standard treatment, needs to be used for more than 4 h/night to be effective, but suffers from relatively poor adherence. Furthermore, CPAP is likely to be more effective if combined with lifestyle changes. Thus, the remote telemonitoring (TM) of OSA patients in terms of CPAP use, signalling of device problems, following disease progression, detection of acute events and monitoring of daily physical activity is an attractive option. In the present review, we aim to summarize the recent scientific data on remote TM of OSA patients, and whether it meets expectations. We also look at how patient education and follow-up via telemedicine is used to improve adherence and we discuss the influence of the profile of the healthcare provider. Then, we consider how TM might be extended to encompass the patient's cardio-metabolic health in general. Lastly, we explore how TM and the deluge of data it potentially generates could be combined with electronic health records in providing personalized care and multi-disease management to OSA patients.

24 Review Impact of obstructive sleep apnoea and intermittent hypoxia on cardiovascular and cerebrovascular regulation. 2017

Beaudin, Andrew E / Waltz, Xavier / Hanly, Patrick J / Poulin, Marc J. ·Department of Physiology and Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. · Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. · Laboratoire HP2, U1042, INSERM, Université Grenoble Alpes, Grenoble, France. · Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. · Sleep Centre, Foothills Medical Centre, Calgary, AB, Canada. · Libin Cardiovascular Institute of Alberta, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. · Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. · Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada. ·Exp Physiol · Pubmed #28439921.

ABSTRACT: NEW FINDINGS: What is the topic of this review? This review examines the notion that obstructive sleep apnoea (OSA) and intermittent hypoxia (IH) have hormetic effects on vascular health. What advances does it highlight? Clinical (OSA patient) and experimental animal and human models report that IH is detrimental to vascular regulation. However, mild IH and, by extension, mild OSA also have physiological and clinical benefits. This review highlights clinical and experimental animal and human data linking OSA and IH to vascular disease and discusses how hormetic effects of OSA and IH relate to OSA severity, IH intensity and duration, and patient/subject age. Obstructive sleep apnoea (OSA) is associated with increased risk of cardiovascular and cerebrovascular disease, a consequence attributed in part to chronic intermittent hypoxia (IH) resulting from repetitive apnoeas during sleep. Although findings from experimental animal, and human, models have shown that IH is detrimental to vascular regulation, the severity of IH used in many of these animal studies [e.g. inspired fraction of oxygen (FI,O2) = 2-3%; oxygen desaturation index = 120 events h

25 Review Efficacy of the New Generation of Devices for Positional Therapy for Patients With Positional Obstructive Sleep Apnea: A Systematic Review of the Literature and Meta-Analysis. 2017

Ravesloot, Madeline J L / White, David / Heinzer, Raphael / Oksenberg, Arie / Pépin, Jean-Louis. ·Department of Otorhinolaryngology, OLVG West, Amsterdam, The Netherlands. · Department of Sleep Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts. · Center for Investigation and Research in Sleep (CIRS), University Hospital of Lausanne, Switzerland. · Sleep Disorders Unit, Loewenstein Hospital -Rehabilitation Center, Raanana, Israel. · Department of Physiology and Sleep, Albert Michallon Hospital, Grenoble, France. ·J Clin Sleep Med · Pubmed #28212691.

ABSTRACT: STUDY OBJECTIVES: In approximately 56% to 75% of patients with obstructive sleep apnea (OSA), the frequency and duration of apneas are influenced by body position. This is referred to as position-dependent OSA or POSA. Patients with POSA can be treated with a small device attached to either the neck or chest. These devices-a new generation of devices for positional therapy (PT)-provide a subtle vibrating stimulus that prevents patients adopting the supine position. The objectives of this study were to determine whether PT is effective in improving sleep study variables and sleepiness, and to assess compliance. METHODS: A systematic review and meta-analysis. RESULTS: Three prospective cohort studies and four randomized controlled trials were included in this review. Combined data for studies reporting on the effect of PT show that there was a mean difference of 11.3 events/h (54% reduction) in apnea-hypopnea index and 33.6% (84% reduction) in percentage total sleeping time in the supine position. The standardized mean difference for both parameters demonstrated a large magnitude of effect (> 0.8 in both cases). CONCLUSIONS: There is strong evidence that the new generation of devices for PT are effective in reducing the apnea-hypopnea index during short-term follow-up. These devices are simple-to-use for patients and clinicians and are reversible. Under study conditions with short-term follow-up, compliance is high; however, long-term compliance cannot be assessed because of lack of reliable data. Additional long-term, high-quality studies are needed to confirm the role of PT as a single or as a combination treatment modality for OSA patients and to assess long-term compliance.

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