The impact of neck circumference on hypoglossal nerve stimulator therapy outcomes.

Study Objectives: Hypoglossal nerve stimulation (HGNS) therapy has historically had strict eligibility requirements including a body mass index (BMI) < 32 kg/m. However, recent Food and Drug Administration approval expanded indications to a BMI < 40 kg/m. There is a wide variability in body fat distribution.

Obstructive Sleep Apnea Is Associated with Newly Diagnosed Gestational Diabetes Mellitus.

Sleep-disordered breathing (SDB) is associated with increased risk of adverse pregnancy outcomes, including gestational diabetes mellitus (GDM). GDM is a significant cause of maternal and infant morbidities. Assessing these risk factors concurrently may facilitate both the identification of women at GDM risk and the initiation of GDM prevention strategies.

Patients with chronic rhinosinusitis and obstructive sleep apnea have increased paroxysmal limb movement.

Background: Patients with chronic rhinosinusitis (CRS) frequently experience sleep disruption and are at a higher than normal risk for obstructive sleep apnea (OSA). The purpose of this study was to determine how CRS affects polysomnography findings and sleep-related breathing in OSA.

Methods: A cohort study was performed that included 107 adult patients with CRS and comorbid OSA (CRS+OSA group) and 137 patients with OSA and without CRS as the control group.

Actigraphy scoring for sleep outcome measures in chronic obstructive pulmonary disease.

Background: Actigraphy is commonly used to measure sleep outcomes so that sleep can be measured conveniently at home over multiple nights. Actigraphy has been validated in people with sleep disturbances; however, the validity of scoring settings in people with chronic medical illnesses such as chronic obstructive pulmonary disease remains unclear. The purpose of this secondary analysis was to compare actigraphy-customized scoring settings with polysomnography (PSG) for the measurement of sleep outcomes in people with chronic obstructive pulmonary disease who have insomnia.

Habitual sleep and kidney function in chronic kidney disease: the Chronic Renal Insufficiency Cohort study.

Physiological evidence suggests that sleep modulates kidney function. Our objective was to examine the cross-sectional association between kidney function and objectively-estimated habitual sleep duration, quality and timing in a cohort of patients with mild to moderate chronic kidney disease. This study involved two US clinical centers of the Chronic Renal Insufficiency Cohort (CRIC) study, including 432 participants in a CRIC ancillary sleep study.

Risk of obstructive sleep apnea in African American patients with chronic rhinosinusitis.

Background: It is widely known that patients with chronic rhinosinusitis (CRS) commonly experience sleep disruption. Many of these patients have the associated diagnosis of obstructive sleep apnea (OSA). However, little is known about the risk factors for developing OSA in the CRS population.

Efficacy and mechanisms of behavioral therapy components for insomnia coexisting with chronic obstructive pulmonary disease: study protocol for a randomized controlled trial.

Background: Difficulty falling asleep, staying asleep or poor-quality sleep (insomnia) is common in people with chronic obstructive pulmonary disease (COPD). Insomnia is related to greater mortality and morbidity, with four times the risk of mortality for sleep times below 300 min. However, insomnia medications are used with caution in COPD due to their potential adverse effects.

Cognitive behavioral therapy for insomnia comorbid with COPD is feasible with preliminary evidence of positive sleep and fatigue effects.

Background: Many people with COPD report difficulties falling asleep or staying asleep, insufficient sleep duration, or nonrestorative sleep. Cognitive behavioral therapy for insomnia (CBT-I) has proved effective not only in people with primary insomnia but also in people with insomnia comorbid with psychiatric and medical illness (eg, depression, cancer, and chronic pain). However, CBT-I has rarely been tested in those with COPD who have disease-related features that interfere with sleep and may lessen the effectiveness of such therapies.

Prevalence of type 2 diabetes in patients with obstructive sleep apnea in a multi-ethnic sample.

Study Objectives: Relationship of obstructive sleep apnea (OSA) with insulin resistance and type 2 diabetes in Caucasians has been studied, but this association has not been investigated in Hispanic and African-Americans. The objective of this study is to determine the prevalence of type 2 diabetes in patients evaluated for OSA in a predominantly African American and Hispanic sample. The secondary objective is to evaluate the relationship of REM related OSA and type 2 diabetes.

Continuous positive airway pressure device-based automated detection of obstructive sleep apnea compared to standard laboratory polysomnography.

Purpose: Obstructive sleep apnea (OSA) is a common health problem that affects more than 2-4% of the US population. Polysomnography (PSG) is the gold standard for diagnosing OSA. PSG is, however, expensive, time-consuming, and not always readily accessible.

Liver enzymes and histology in obese patients with obstructive sleep apnea.

Background And Aims: Recent studies have shown an association between obstructive sleep apnea (OSA) and elevated liver enzymes in patients with nonalcoholic fatty liver disease (NAFLD). The aim of the current study was to compare biochemical and histologic findings in patients with NAFLD as a function of OSA status.

Methods: Subjects consisted of 85 patients who had a sleep study followed by a liver biopsy performed at the time of obesity surgery.

Short-term outcome in the first 10 morbidly obese adolescent patients in the FDA-approved trial for laparoscopic adjustable gastric banding.

Background: We received the LAP-BAND Investigational Device Exemption (IDE) from the US Food and Drug Administration in December 2004 to conduct a prospective longitudinal trial examining the safety and efficacy of laparoscopic adjustable gastric banding (LAGB) in morbidly obese adolescents ages 14 to 17 years.

Objectives: To report the short-term results of LAGB in the first 10 adolescents with complete 9 months of follow-up.

Patients And Methods: Baseline characteristics and outcome data were analyzed in 10 patients enrolled between March 2005 and February 2006.

Sleep apnea in an urban public hospital: assessment of severity and treatment adherence.

Objective: To assess obstructive sleep apnea (OSA) severity, continuous positive airway pressure (CPAP) adherence, and factors associated with CPAP adherence among a group of patients with OSA receiving care at a publicly funded county hospital.

Study Design And Setting: A retrospective cohort study in a 464-bed urban public hospital in Cook County, Illinois.

Results: A total of 507 patients were included.

Impact of adherence with positive airway pressure therapy on hypercapnia in obstructive sleep apnea.

Background: Daytime hypercapnia is common in morbidly obese patients with obstructive sleep apnea and is associated with serious complications. Our objective was to quantify the effect of adherence with positive airway pressure on hypercapnia and hypoxia in these patients.

Methods: We performed a retrospective cohort study of 75 patients using a multivariable general linear model analysis to identify variables that predicted changes in PaCO2 and PaO2 after therapy.

The effect of continuous positive airway pressure on glucose control in diabetic patients with severe obstructive sleep apnea.

Obstructive sleep apnea (OSA) is independently associated with glucose intolerance and insulin resistance, and recent studies have shown that continuous positive airway pressure (CPAP) improves insulin sensitivity. The objective of this study was to describe the change in glycosylated hemoglobin (HbA1c) after treatment with CPAP in patients with type 2 diabetes mellitus and OSA. To test this hypothesis, we performed a retrospective analysis of 38 patients seen in the sleep clinic of an urban public teaching hospital.

Type 2 diabetes, glycemic control, and continuous positive airway pressure in obstructive sleep apnea.

Background: Sleep-disordered breathing (SDB) is a prevalent condition associated with significant comorbidities, including hypertension, obesity, cardiovascular disease, and insulin resistance. It has been previously shown that the severity of insulin resistance is related to the severity of SDB.

Methods: Using a 72-hour continuous glucose monitoring system, we studied changes in interstitial glucose levels and measured hemoglobin A1c levels in 25 patients with type 2 diabetes mellitus before and after continuous positive airway pressure (CPAP) treatment for SDB.