A strategic approach of the management of sleep-disordered breathing in multiple system atrophy.

Study Objectives: Multiple system atrophy (MSA) is a rare neurodegenerative disorder characterized by autonomic dysfunction associated with a combination of cerebellar, parkinsonian, or pyramidal signs. Sleep-disordered breathing (SDB) such as stridor, obstructive sleep apnea (OSA) and central sleep apnea (CSA) are common in MSA and can impact survival. Several studies have evaluated treatment modalities.

The Role of Patient-Reported Outcomes in Sleep Measurements.

Several questionnaires aka patient-reported outcome measures (PROMs) have been developed for specific use in sleep medicine. Some PROMS are "disease-specific," that is, related to a specific sleep disorder, whereas others are generic. These PROMS constitute a valuable add-on to the conventional history taking.

Diagnosing COVID-19; towards a feasible COVID-19 rule-out protocol.

Introduction: We present the results of the COVID-19 rule-out protocol at Ghent University Hospital, a step-wise testing approach which included repeat NFS SARS-CoV-2 rRT-PCR, respiratory multiplex RT-PCR, low-dose chest CT and bronchoscopy with BAL to confirm or rule-out SARS-CoV-2 infection in patients admitted with symptoms suggestive of COVID-19.

Results: Between 19 March 2020 and 30 April 2020, 455 non-critically ill patients with symptoms suspect for COVID-19 were admitted. The initial NFS for SARS-CoV-2 rRT-PCR yielded 66.

Sex differences in the association between arterial hypertension, blood pressure, and sleep apnea in the general population.

Study Objectives: To assess sex-related differences in the relationship between hypertension (HT), blood pressure (BP), and sleep apnea in the general population.

Methods: We performed home polygraphy in a cohort of 1809 men and women in the general population. Office BP was measured.

Adult-onset congenital central hypoventilation syndrome due to PHOX2B mutation.

Central hypoventilation in adult patients is a rare life-threatening condition characterised by the loss of automatic breathing, more pronounced during sleep. In most cases, it is secondary to a brainstem lesion or to a primary pulmonary, cardiac or neuromuscular disease. More rarely, it can be a manifestation of congenital central hypoventilation syndrome (CCHS).

Sex-specific sleep apnea screening questionnaires: closing the performance gap in women.

Background: The availability of poly(somno)graphy [P(S)G] for sleep apnea (SA) diagnosis is limited, making pre-test case evaluation an important challenge. The Neck, Obesity, Snoring, Age, Sex (NoSAS) and STOP-Bang (SBQ) scores are accepted screening tests, but their sex-specific performance in the general population is unknown.

Objective: To compare the sex-specific diagnostic characteristics of the NoSAS and SBQ scores, and to optimize the performance of these tools for men and women.

Phenotype and Risk Burden of Sleep Apnea: A Population-Based Cohort Study.

Sleep apnea (SA) prevalence had increased. The socioeconomic burden is significant because of healthcare-related costs and adverse outcome, especially in moderate-to-severe SA. However, the population impact is unclear, particularly for mild SA.

Sleep apnea and the impact on cardiovascular risk in patients with Marfan syndrome.

Background: Marfan syndrome (MFS) is an inherited connective tissue disorder characterized by ectopia lentis, aortic root dilation and dissection and specific skeletal features. Obstructive sleep apnea (OSA) in MFS has been described earlier but the prevalence and its relation with the cardiovascular risk is still controversial. This study aimed to further investigate these aspects.

Long-term quality of life outcomes of maxillomandibular advancement osteotomy in patients with obstructive sleep apnoea syndrome.

This study was performed to evaluate the long-term impact of maxillomandibular advancement (MMA) surgery on the apnoea-hypopnoea index (AHI) and quality of life (QoL) in patients with obstructive sleep apnoea syndrome (OSAS). The medical files of 12 OSAS patients who underwent MMA by one surgeon between 1995 and 1999 were reviewed retrospectively. Patients received a clinical assessment, polysomnography, and QoL questionnaires as part of routine care preoperatively (n=12), within 2 years postoperative (n=12), and again in 2016 (n=9).

The Link Between Obstructive Sleep Apnea and Cardiovascular Disease.

Obstructive sleep apnea (OSA) is common in the general population and highly prevalent in patients with cardiovascular disease. In this paper, we review (1) the pathophysiological mechanisms of OSA that may causally contribute to cardiovascular disease; (2) current evidence regarding the association between OSA and hypertension, stroke, ischemic heart disease, heart failure, atrial fibrillation, and cardiovascular mortality; and (3) the impact of continuous positive airway pressure (CPAP) treatment on cardiovascular risk factors and outcomes. We emphasize the importance of obesity as a comorbidity of OSA and a confounder in the association between OSA and cardiovascular disease.

Feasibility of following up gamma-hydroxybutyric acid concentrations in sodium oxybate (Xyrem®)-treated narcoleptic patients using dried blood spot sampling at home: an exploratory study.

Background: Gamma-hydroxybutyric acid (GHB), well known as a party drug, especially in Europe, is also legally used (sodium oxybate, Xyrem(®)) to treat a rare sleep disorder, narcolepsy with cataplexy. This exploratory study was set up to measure GHB concentrations in dried blood spots (DBS) collected by narcoleptic patients treated with sodium oxybate. Intra- and inter-individual variation in clinical effects following sodium oxybate administration has been reported.

The value of auto-adjustable CPAP devices in pressure titration and treatment of patients with obstructive sleep apnea syndrome.

In moderate to severe obstructive sleep apnea syndrome (OSAS), the use of Continuous Positive Airway Pressure (CPAP) is the gold standard therapy. In the last decade, new technologies such as auto-adjustable CPAP (APAP) have been promoted as having an added advantage over CPAP, because of their ability to adapt the pressure level to the patient's need at all times. This could logically result in the deliverance of lower pressures, which was hypothesized to improve patient acceptance and compliance for therapy.

Titration procedures for nasal CPAP: automatic CPAP or prediction formula?

Background: The best method for titration of continuous positive airway pressure (CPAP) therapy in obstructive sleep apnea (OSA) syndrome has not yet been established. The 90th or 95th percentiles of the pressure titrated over time by automatic CPAP (A-CPAP) have been recommended as reference for prescribing therapeutic fixed CPAP (F-CPAP). We compared A-CPAP to F-CPAP, which was determined by a common prediction formula.

Titration efficacy of two auto-adjustable continuous positive airway pressure devices using different flow limitation-based algorithms.

Background: Auto-adjustable continuous positive airway pressure devices are widely used in titration procedures to determine therapeutic pressure levels in obstructive sleep apnea patients. However, differences in operational characteristics may influence the effect on the apnea-hypopnea index (AHI).

Objectives: We compared the titration performance of two devices based on detection of inspiratory flow limitation, i.

Efficacy of flow- vs impedance-guided autoadjustable continuous positive airway pressure: a randomized cross-over trial.

Study Objectives: Autoadjustable continuous positive airway pressure (CPAP) devices are increasingly used in the treatment of obstructive sleep apnea (OSA). Since different measurements of upper airway obstruction are applied, it is uncertain whether these devices are equally effective in controlling sleep-disordered breathing. Hypothesizing that differences in therapeutic efficacy were to come out, we compared the performance of the AutoSet device (ResMed; Sydney, Australia), which features autoadjustable positive airway pressure (APAP) guided by detection of flow limitation (APAPfl), with the SOMNOsmart device (Weinmann; Hamburg, Germany), which features APAP guided by the forced oscillation technique (APAPfot).

Comfort and pressure profiles of two auto-adjustable positive airway pressure devices: a technical report.

Study Objectives: The purpose of this study was to compare comfort parameters and pressure profiles of the AutoSet (Resmed) and the SOMNOsmart (Weinmann), two auto-adjustable positive airway pressure (APAP) devices.

Setting: The sleep disorders center of a university hospital.

Design: A single-blind randomized trial protocol was applied.